1
|
Ogden M, Karagedik MI, Ozdemir A, Bulut IU, Erdogan AM, Bakar B. Investigation of the Efficacy of Bilateral Osteoligamentous Decompression via Hemilaminectomy in Cervical Spondylotic Myelopathy: A Clinical Study. World Neurosurg 2023; 180:e560-e578. [PMID: 37778625 DOI: 10.1016/j.wneu.2023.09.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Cervical stability may deteriorate and kyphotic spinal deformities may develop in cervical spondylotic myelopathy (CSM) after laminectomy or laminoplasty. This study aimed to investigate the therapeutic efficacy of the "bilateral osteoligamentous decompression via unilateral hemilaminectomy approach (UHBOLD)" technique in CSM patients. METHODS The study included 34 adult patients who underwent UHBOLD surgery for CSM between 2016 and 2022. A record was made for all patients of age, gender, number of operated levels, preoperative and postoperative long-term follow-up VAS scores, Nurick grade values and mJOA scores, kyphosis angles measured on X-ray, and spinal canal areas measured on T2-weighted MR axial images. RESULTS Preoperative VAS scores of the patients were 6 (4-9), Nurick grade values were 3 (2-5), mJOA scores were 10.50 ± 3.42, kyphosis angles were -13.34 ± 13.69° and spinal canal areas were 87.11 ± 28.30 mm2. In postoperative long-term follow-up of these patients, VAS scores were 2 (1-5), Nurick grade values were 1 (0-5), mJOA scores were 13.94 ± 3.09, kyphosis angles were -15.07 ± 12.78° and spinal canal areas were 149.65 ± 42.57 mm2. A statistically significant difference was determined between the preoperative and the postoperative long-term follow-up VAS scores, Nurick grade values, mJOA scores, and spinal canal areas (P < 0.001). Kyphosis angles were not different (P = 0.198), and no instability was observed in any patient in long-term follow-up. CONCLUSIONS The UHBOLD technique performed in multilevel CSM patients did not cause any change in cervical lordosis angle in long-term follow-up, did not cause cervical kyphotic deformity or cervical instability, and significantly improved Nurick grade values, and VAS and mJOA scores.
Collapse
Affiliation(s)
- Mustafa Ogden
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey.
| | | | - Alemiddin Ozdemir
- Department of Neurosurgery, Iskenderun State Hospital, Hatay, Turkey
| | - Ibrahim Umud Bulut
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Ahmet Melih Erdogan
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Bulent Bakar
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| |
Collapse
|
2
|
Ogden M, Erdogan AM, Karagedik MI, Baser S, Bulut IU, Sevimoglu O, Yuksel U, Bakar B. Analysis of radiological measurement parameters that can predict the type of treatment to be applied in odontoid fractures: Clinical research. J Craniovertebr Junction Spine 2023; 14:245-252. [PMID: 37860024 PMCID: PMC10583795 DOI: 10.4103/jcvjs.jcvjs_20_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/12/2023] [Indexed: 10/21/2023] Open
Abstract
Introduction Although various conservative and surgical treatment methods have been proposed, treatment options for patients with odontoid fractures remain controversial. This study was conducted to determine some demographic and radiological measurement parameters that can predict treatment options in patients with odontoid fractures. Materials and Methods The patients were separated into the surgery (-) group (n = 9) and the surgery (+) group (n = 10). Patient data were recorded of age, gender, type of odontoid fracture, morphological measurement results obtained from computed tomography images, treatment regimens, duration of stay in the hospital, and mortality rate. In the operating room, a halo-vest corset or Philadelphia-type cervical collar was applied to the surgery (-) patients after the reduction of the fracture under fluoroscopy. Anterior odontoid lag screw fixation was performed on surgery (+) patients. Results The amount of displacement of the fractured odontoid, the distance between the C1 vertebra and the odontoid process, the angle between the posterior wall of the odontoid process and the posterior wall of the clivus, the slip angle, and the anterior to posterior width of the spinal canal were not different between the groups. No difference was determined between the groups in respect of the amount of lateral displacement of the odontoid process in the spinal canal in the axial plane and the angle of the fractured odontoid process with the C2 vertebral body. Conclusion This preliminary study showed that the demographic data and radiological measurement parameters analyzed in the present study could not be used as predictive markers either in decision-making for treatment modality or mortality risk.
Collapse
Affiliation(s)
- Mustafa Ogden
- Department of Neurosurgery, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Ahmet Melih Erdogan
- Department of Neurosurgery, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | | | - Selcuk Baser
- Department of Radiology, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Ibrahim Umud Bulut
- Department of Neurosurgery, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Ozge Sevimoglu
- Department of Neurosurgery, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Ulas Yuksel
- Department of Neurosurgery, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Bulent Bakar
- Department of Neurosurgery, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| |
Collapse
|
3
|
Karagedik MI, Yuksel U, Kartal B, Ceylan AF, Ogden M, Bakar B. Evaluation of the effectiveness of oxytocin and enalapril in the prevention of epidural fibrosis developed after laminectomy in rats. Injury 2023:110793. [PMID: 37211471 DOI: 10.1016/j.injury.2023.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/21/2023] [Accepted: 05/05/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Except for methylprednisolone, there is no current low-cost and low-side-effect drug/barrier method to prevent epidural fibrosis after spine surgery. However, the use of methylprednisolone has led to substantial controversy because of its serious side effects on wound healing. This study aimed to evaluate the effects of enalapril and oxytocin on preventing the development of epidural fibrosis in a rat laminectomy model. MATERIALS Under sedation anesthesia, T9, T10, and T11 laminectomy was performed on 24 Wistar Albino male rats. The animals were then separated into four groups; Sham group (only laminectomy was performed; n = 6), MP group (laminectomy was performed and 10 mg/kg/day methylprednisolone was administered intraperitoneally (ip) for 14 days; n = 6), ELP group (laminectomy was performed and 0.75 mg/kg/day enalapril was administered ip for 14 days; n = 6), OXT group (laminectomy was performed and 160 µg/kg/day oxytocin was administered ip for 14 days; n = 6). Four weeks after the laminectomy, all the rats were euthanised, and the spines were removed for histopathological, immunohistochemical, and biochemical examinations. RESULTS Histopathological examinations revealed that the degree of epidural fibrosis (X2=14.316, p = 0.003), collagen density (X2=16.050, p = 0.001), and fibroblast density (X2=17.500, p = 0.001) was higher in the Sham group and lower in the MP, ELP, and OXT groups. Immunohistochemical examinations showed that collagen type 1 immunoreactivity was higher in the Sham group and lower in the MP, ELP, and OXT groups (F = 54.950, p < 0.001). The highest level of α-smooth muscle actin immunoreactivity was seen in the Sham and OXT groups, and the lowest was in the MP and ELP groups (F = 33.357, p < 0.001). Biochemical analysis revealed that tissue levels of TNF-α, TGF-β, IL-6, CTGF, caspase-3, p-AMPK, pmTOR, and mTOR/pmTOR were higher in the Sham group and lower in MP, ELP, and OXT groups (p < 0.05). The GSH/GSSG levels were lower in the Sham group and higher in the other three groups (X2=21.600, p < 0.001). CONCLUSION The study results showed that enalapril and oxytocin, which are known to have anti-inflammatory, antioxidant, anti-apoptotic, and autophagy-related regenerative properties, could reduce the development of epidural fibrosis after laminectomy in rats.
Collapse
Affiliation(s)
| | - Ulas Yuksel
- Kirikkale University, Faculty of Medicine, Department of Neurosurgery, Kirikkale, Turkey
| | - Bahar Kartal
- Ankara Yıldırım Beyazıt University, Faculty of Medicine, Department of Histology and Embriology, Ankara, Turkey
| | - Asli Fahriye Ceylan
- Ankara Yıldırım Beyazıt University, Faculty of Medicine, Department of Medical Pharmacology, Ankara, Turkey
| | - Mustafa Ogden
- Kirikkale University, Faculty of Medicine, Department of Neurosurgery, Kirikkale, Turkey
| | - Bulent Bakar
- Kirikkale University, Faculty of Medicine, Department of Neurosurgery, Kirikkale, Turkey.
| |
Collapse
|
4
|
Ozdemir A, Ogden M, Kartal B, Ceylan AF, Yuksel U, Bakar B. Investigation of therapeutic effects of calcium dobesilate in cerebral hypoxia/ reperfusion injury in rats. Neurol Res 2022; 45:472-487. [PMID: 36548871 DOI: 10.1080/01616412.2022.2159109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Cerebral stroke is a serious clinical condition in which oxidative stress, inflammation, necrosis, apoptosis, and autophagy play important roles in its pathogenesis. This study investigated the neuroprotective and healing effects of calcium dobesilate (CD) on cerebral hypoxia/reperfusion injury in rats. METHODS Forty Wistar albino male rats, each weighing 300-350 g, were separated into the Control group (no surgery and no pharmacological agent was administered); Sham-A group (only surgery was performed); DBL-A group (surgery was performed and CD 100 mg/kg/day was administered intraperitoneally for 3 days); Sham-C group (only surgery was performed); and DBL-C group (surgery was performed and 100 mg/kg/day CD was administered intraperitoneally for 10 days). Under sedation anesthesia, the bilateral common carotid arteries of all rats except the Control group were clipped for 30 min. After 4 h, the CD was given to the relevant groups, and then, all subjects were euthanized at scheduled times. The brain of each animal was removed for histopathological (hematoxylin and eosin staining), immunohistochemical (beclin-1, anti-MHC class II and anti-CD-68 staining), and biochemical (TNF, IL-1β, IL-6, caspase-3, GSH/GSSG, malondialdehyde, protein carbonyl, LC3II/LC3I, and beclin-1 levels) evaluations. RESULTS It was observed that CD could reduce necrosis and mitigate polarization of microglia to the M1 phenotype, autophagy, free oxygen radicals, protein carbonylation, lipid peroxidation, IL-1β, IL6, TNF, caspase-3, beclin-1, and LC3II/LC3I levels in acute and chronic periods of hypoxia/reperfusion injury. CONCLUSION From these results, it was observed that CD treatment could reduce neuronal necrosis and create anti-inflammatory, anti-edema, anti-oxidant, anti-apoptotic, and anti-autophagic effects in hypoxia/reperfusion injury in rats.
Collapse
Affiliation(s)
- Alemiddin Ozdemir
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| | - Mustafa Ogden
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| | - Bahar Kartal
- Faculty of Medicine, Department of Histology and Embriology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Asli Fahriye Ceylan
- Faculty of Medicine, Department of Medical Pharmacology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Ulas Yuksel
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| | - Bulent Bakar
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| |
Collapse
|
5
|
Akkaya S, Ogden M, Kartal B, Say B, Ceylan AF, Aydemir Akkaya M, Bakar B. Evaluation of the therapeutic effects of calcium dobesilate in sciatic nerve crush injury in rats. Injury 2022; 53:3624-3635. [PMID: 36070970 DOI: 10.1016/j.injury.2022.08.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/26/2022] [Accepted: 08/26/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Proinflammatory cytokines released from nerve endings and surrounding injured tissue after nerve damage can prolong the inflammation process, delay nerve healing or result in poor quality nerve healing. In this case, due to the loss of function in the muscles innervated by the damaged nerve, the patient may have neurological and functional difficulties which may reduce the patient's quality of life and create an economic burden. Although the attempts of many pharmacological agents to heal crush injury of peripheral nerves have been recorded in literature, a drug that can provide adequate recovery of the crushed nerve and can be applied in daily life has not been defined as yet. This study aimed to assess the effects of calcium dobesilate on sciatic nerve crush injury in a rat model. METHODS A total of 26 male Wistar albino rats were separated into four groups as follows: CONTROL group (healthy subjects, n=6); SHAM group (crush injury was created, n=6); MP group (after created crush injury, methylprednisolone was administered, n=7); and CAD group (after created crush injury, calcium dobesilate was administered, n=7). A crush injury was created, then the electrophysiological findings and sciatic nerve functional index (SFI) were recorded before euthanasia. After the euthanasia of all the rats, samples of the crushed nerve and gastrocnemius muscle were evaluated histopathologically, immunohistochemically, and biochemically. RESULTS Both pharmacological agents were histopathologically effective in axon regeneration and repair. Calcium dobesilate did not preserve total muscle mass but was seen to prevent atrophy microscopically. Immunohistochemistry and biochemistry results showed that calcium dobesilate and methylprednisolone had anti-inflammatory, anti-oxidant, anti-apoptotic, and anti-autophagic activity in the crushed sciatic nerve. Neither calcium dobesilate nor methylprednisolone improved the nerve conductance level. SFI values obtained on day 30 from the CAD group were numerically closer to the values of the healthy animals but not at a statistically significant level. CONCLUSION The study results demonstrated that calcium dobesilate could suppress inflammatory processes and provide histopathological and functional improvements in the injured nerve in rats. Therefore, further clinical studies are recommended to investigate in detail the therapeutic effects of calcium dobesilate on peripheral nerve crush injury.
Collapse
Affiliation(s)
- Suleyman Akkaya
- Department of Neurosurgery, Van Education and Research Hospital, Van, Turkey
| | - Mustafa Ogden
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kırıkkale, Turkey
| | - Bahar Kartal
- Faculty of Medicine, Department of Histology and Embryology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Bahar Say
- Faculty of Medicine, Department of Neurology, Kirikkale University, Kırıkkale, Turkey
| | - Aslı Fahriye Ceylan
- Faculty of Medicine, Department of Medical Pharmacology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | | | - Bulent Bakar
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kırıkkale, Turkey.
| |
Collapse
|
6
|
Yuksel U, Burulday V, Akkaya S, Baser S, Ogden M, Alhan A, Bakar B. Possible predictive clinical and radiological markers in decision making for surgical intervention in patients with Chiari Malformation type 1. Neurol Res 2022; 44:975-988. [PMID: 35758154 DOI: 10.1080/01616412.2022.2089402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The first aim of this study was to compare the clinical data and posterior fossa morphometry obtained during the admission to the hospital between control group individuals (who had not Chiari Malformation (CM) type 1) and CM type 1 patients treated surgically or not. The second aim was to create a valid and reliable scale that can predict the decision-making for surgical intervention simply and easily in these patients. MATERIALS Medical data and radiological images of 70 CM type 1 patients during their admission to the hospital were compared with the data of 69 control group individuals. RESULTS Conservative treatment and/or follow-up was applied to 58 (82.9%) patients, and 12 (17.1%) patients underwent surgery. ROC analysis showed that the presence of myelopathy, tonsillar herniation >8 mm, Chamberlain line >84 mm, McRae line >44.50 mm, and odontoid process-McRae line angle <10.50 degrees could be used as predictive markers in decision-making for surgical intervention (p < 0.05). Logistic Regression analysis revealed that symptoms severity, and McRae line value would be the 'best parameters' in decision-making for surgical intervention (p < 0.05). A scale named the CHIASURG scale developed using this study's parameters showed that the parameters of 'depth of tonsillar herniation', 'Chamberlain line', and 'McRae line' could predict the surgical intervention risk. CONCLUSION It was found that symptoms severity and McRae line value could be used as predictive markers in decision-making for surgical intervention. Additionally, it was concluded that a new scale called CHIASURG could predict surgical intervention risk validly and reliably.
Collapse
Affiliation(s)
- Ulaş Yuksel
- Kirikkale University Faculty of Medicine, Department of Neurosurgery, Kirikkale, Turkey
| | - Veysel Burulday
- Inonu University Faculty of Medicine, Department of Radiology, Kirikkale, Turkey
| | - Suleyman Akkaya
- Kirikkale University Faculty of Medicine, Department of Neurosurgery, Kirikkale, Turkey
| | - Selcuk Baser
- Kirikkale University Faculty of Medicine, Department of Radiology, Kirikkale, Turkey
| | - Mustafa Ogden
- Kirikkale University Faculty of Medicine, Department of Neurosurgery, Kirikkale, Turkey
| | - Aslihan Alhan
- Ufuk University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
| | - Bulent Bakar
- Kirikkale University Faculty of Medicine, Department of Neurosurgery, Kirikkale, Turkey
| |
Collapse
|
7
|
Francis SA, Elyan J, Ogden M, Franklin BD, Mattick KL, Kajamaa A, Yardley S. Prescribing and medication use for symptom control in palliative care: stakeholder engagement within an activity theory study. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac019.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
People with palliative care needs often use prescription medication to achieve symptom control. Prescribing and medication use are complex, multi-step processes influenced by prescribers, patients, carers, and contexts. They are shaped by historically established divisions of labour and normative rules. However, in the care of palliative patients, approximately 20% of NHS serious incident reports involve prescription medications with causes and contributing factors poorly understood (1). Understanding the mismatches between what is intended to happen and what is experienced in practice is key to improving safety and confidence in palliative care.
Phase one of this study focuses on how the processes of prescribing and medication use are intended to happen, and comprises stakeholder engagement (presented here) and a scoping review.
Aim
To develop a model of intended processes of prescribing and medication use for symptom control in palliative care across the contexts of home, hospital, and hospice.
Methods
Stakeholder engagement was undertaken with a purposive sample of participants who had an interest in, or direct experience of, palliative medications. Invitations to participate were sent to professional networks and a patient and public involvement group. Informal conversations with a topic guide including known steps in the processes of prescribing and medication use were held either via video-call (recorded with permission) or by email. Conversations were examined for content relating to steps in the processes, and for themes that ran across multiple steps. An iterative cycle of listening, identifying steps, theme attribution and development of an intended processes model was undertaken with each recording.
Results
Twenty video and one email conversations were conducted with 7 family carers, 4 pharmacists/pharmacy researchers, 4 specialist palliative care professionals, 3 non-clinical researchers and 3 general practitioners.
Different steps in the intended processes of prescribing and medication use at home and in hospital were identified. Themes of decision-making, prescribing, monitoring/supply, use/administration, and stopping/disposal were all represented. Further themes of deprescribing, anticipatory medicines, and contexts of practice - including out-of-hours care - were all raised. The processes model that resulted was not linear and incorporated complex feedback loops that facilitated ‘tinkering’, safe-to-fail experiments, and negotiations balancing ‘gut feeling’ with protocols and patients’ wishes.
Conclusion
Engaging with carer and professional stakeholders as a preliminary step in our study provided opportunity for clarification of key concepts, exploration of the nature and diversity of experiences, and identification of knowledge gaps. Whilst our engagement work may have been limited with the inclusion of only one nursing representative and little discussion of the hospice context, these aspects together with the content and themes identified will inform the design of our scoping review using the Joanna Briggs Institute framework. Data from the stakeholder engagement and the scoping review will be combined to finalise a model of intended processes in prescribing and medication use in symptom control in palliative care.
Phase two of this study is a focussed ethnography to develop an experienced processes model. Synthesising the intended (phase one) and experienced (phase two) processes models using activity theory (2) will lead to when, how, and why processes in prescribing and medication use are misaligned and to ways in which systems can be improved to support patients and their families.
References
(1) Yardley I, Yardley S, Williams H, Carson-Stevens A, Donaldson LJ. Patient safety in palliative care: A mixed-methods study of reports to a national database of serious incidents. Palliat Med. 2018;32(8):1353–62.
(2) Engeström Y, Davydov V, Toulmin S, Lektorsky V, Tolman C, Cole M, et al. Theoretical Issues. In: Engeström Y, Miettinen R, Punämaki R-L, editors. Perspectives on Activity Theory. Cambridge: Cambridge University Press; 1999. p. 1–146.
Collapse
Affiliation(s)
- S A Francis
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - J Elyan
- Barking Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - M Ogden
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | | | - K L Mattick
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - A Kajamaa
- Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
| | - S Yardley
- Marie Curie Palliative Care Research Department, University College London, London, UK
- Palliative Care, Central & North West London NHS Foundation Trust, London, UK
| |
Collapse
|
8
|
Ogden M, Yuksel U, Karagedik MI, Bulut IU, Bakar B. Predictive Markers In Decision-Making For Screwing The Fractured Thoracolumbar Vertebra In The Short-Segment Instrumentation. Spine Surg Relat Res 2022; 6:503-511. [DOI: 10.22603/ssrr.2021-0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/21/2021] [Indexed: 11/05/2022] Open
Affiliation(s)
- Mustafa Ogden
- Department of Neurosurgery, Kirikkale University Faculty of Medicine
| | - Ulas Yuksel
- Department of Neurosurgery, Kirikkale University Faculty of Medicine
| | | | | | - Bulent Bakar
- Department of Neurosurgery, Kirikkale University Faculty of Medicine
| |
Collapse
|
9
|
Bakar B, Yuksel U, Ozdemir A, Bulut IU, Ogden M. Clinical and Laboratory Markers in Determination of Treatment Modalities and Short-Term Prognosis in Patients with Traumatic Acute Subdural Hematoma: Original Study. Indian Journal of Neurotrauma 2021. [DOI: 10.1055/s-0041-1739475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Objective In patients with traumatic acute subdural hematoma (ASH), it has not been yet fully elucidated which patients can benefit from surgery or from clinical follow-up. This study was constructed to predict treatment modality and short-term prognosis in patients with ASH using their clinical, radiological, and biochemical laboratory findings during admission to hospital.
Methods Findings of patients with ASH determined on their CT scan between 2015 and 2018 were evaluated. Patients were grouped in terms of ASH-FOL (patients followed-up without surgery, n = 13), ASH-OP (patients treated surgically, n = 10), and ASH-INOP (patients considered as inoperable, n = 5) groups. They also were divided into “survived (n = 14)” and “nonsurvived (n = 14)” groups.
Results ASH developed as a result of fall from a height in 15 patients and traffic accidents in 13 patients. In deciding for surgery, it was determined that Glasgow coma scale (GCS) scores < 8, midline shift (MLS) level > 5 mm, MLS-hematoma thickness ratio > 0.22, leukocyte count > 12730 uL, and presence of anisocoria could be used as predictive markers. It was determined that GCS scores < 8, hematoma thickness value > 8 mm, and the presence of anisocoria could be considered as biomarkers in prediction of mortality likelihood.
Conclusion It could be suggested that GCS scores, MLS level, MLS-hematoma thickness ratio, presence of anisocoria, and leukocyte count value could help in determination of the treatment modality in patients with ASH. Additionally, GCS scores, hematoma thickness value, and presence of anisocoria could each be used as a marker in the prediction of early-stage prognosis and mortality likelihood of these patients.
Collapse
Affiliation(s)
- Bulent Bakar
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Ulas Yuksel
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Alemiddin Ozdemir
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Ibrahim Umud Bulut
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Mustafa Ogden
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| |
Collapse
|
10
|
Yüksel U, Ogden M, Karagedik MI, Kultur T, Bakar B. Possible predictive markers in surgical decision making in patients with degenerative or isthmic lumbar spondylolisthesis. roneuro 2021. [DOI: 10.33962/roneuro-2021-049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Although age, comorbidity, duration and severity of symptoms, slippage degree, and flexion-extension slipping stability during X-ray imaging are effective in making a surgical decision in patients with spondylolisthesis, these factors are rarely based on definitive evidence. The aim of this study was to determine the efficacy of clinical, radiological and biochemical findings in surgical decision making in these patients.
Materials and Methods: Patients’ data including age, gender, degree and type (i.e. degenerative or isthmic) of the spondylolisthesis, urinary incontinence, neurogenic claudication were recorded. Radiological imaging studies (lumbar dynamic X-ray, computed tomography, magnetic resonance imaging), serum glucose, C-reactive protein and erythrocyte sedimentation rate values of the patients obtained during hospital admissions were evaluated.
Results: Forty patients were followed conservatively and 12 patients were treated surgically. Degenerative spondylolisthesis was seen in 22 patients. Nine patients had neurogenic urinary incontinence and 19 patients had neurogenic claudication. When the patients were divided into two groups with and without surgical treatment, the presence of the pars defect, slipping distance in a neutral position and slipping distance in flexion position was significantly different between groups. A positive correlation was found between pars defect and surgical treatment. Likelihood ratio test results revealed that the presence of pars defect, neurogenic claudication and neurogenic urinary incontinence could be the best parameters in decision making the surgical treatment.
Conclusion: The presence of pars defect, neurogenic claudication and urinary incontinence could be the best parameters that may help the surgeon to make the surgical treatment decision.
Collapse
|
11
|
Kamasak K, Basarslan K, Dagli AT, Ogden M, Alabalik U, Ekinci A, Ceviz A. Effects of Nimodipine and Nigella sativa on Oxidative Stress and Apoptosis in Serum and Brain Tissue of Rats with Experimental Head Trauma. Turk Neurosurg 2021; 31:8-17. [PMID: 31124573 DOI: 10.5137/1019-5149.jtn.25523-19.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM To investigate whether Nimodipine (N) and Nigella sativa (NS) oil have protective, antioxidant effects in brain injury caused by experimental head trauma. MATERIAL AND METHODS Fifty albino Wistar rats were randomly divided into 5 groups that underwent experimental head trauma. Oxidative parameters were compared in the serum and brain tissue of the different groups. In addition, apoptosis and caspase-3 immunoreactivity were evaluated by histopathological examination. RESULTS Serum total antioxidant status (TAS) levels were significantly increased in N and N+NS groups when compared with controls (p=0.001, p < 0.01). Tissue TAS levels were significantly higher in the NS and N+NS groups compared to controls (p=0.001, p < 0.01). Total oxidant status levels in the brain tissue were significantly higher in the NS group than in the control group (p=0.021). CONCLUSION N and NS were shown to significantly reduce the occurrence of oxidative stress in secondary brain injury due to head trauma. We also found that apoptosis levels decreased in response to N, NS and N+NS treatments after head trauma.
Collapse
Affiliation(s)
- Kagan Kamasak
- Hitit University, School of Medicine, Department of Neurosurgery, Corum, Turkey
| | | | | | | | | | | | | |
Collapse
|
12
|
Bakar B, Akkaya S, Say B, Yuksel U, Alhan A, Turğut E, Ogden M, Ergun U. In spontaneous intracerebral hematoma patients, prediction of the hematoma expansion risk and mortality risk using radiological and clinical markers and a newly developed scale. Neurol Res 2021; 43:482-495. [PMID: 33402048 DOI: 10.1080/01616412.2020.1870338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: In patients with spontaneous intracerebral hematoma (ICH), early-stage hematoma expansion has been associated with poor prognosis in literature. This study aimed to develop predictive parameter(s) as well as a new scale to define hematoma expansion and short-term prognosis in patients with ICH.Methods: In 46 patients with ICH, Glasgow Coma Scale (GCS) scores, non-contrast CT (NCCT) markers (hematoma volume on admission and follow-up, hypodensity, intraventricular hemorrhage, blend and island sign, BAT score), and modified Rankin Scale scores were evaluated for predicting the hematoma expansion risk and mortality risk. Furthermore, a newly developed scale called the 'HEMRICH scale' was constituted using the GCS score, hematoma volumes, and some NCCT markers.Results: Roc-Curve and Logistic Regression test results revealed that GCS score, initial hematoma volume value, hypodensity, intraventricular haemorrhage, BAT score, and HEMRICH scale score could be the best markers in predicting hematoma expansion risk whereas GCS score, intraventricular haemorrhage, BAT score, hematoma expansion, and HEMRICH scale score could be the best markers in predicting mortality risk (p = 0.01). Moreover, Factor analysis and Reliability test results showed that HEMRICH scale score could predict both hematoma expansion and mortality risks validly (Kaiser-Meyer-Olkin test value = 0.729) and reliably (Cronbach's alpha = 0.564).Conclusion: It was concluded that the GCS score, intraventricular haemorrhage, and BAT score could predict both hematoma expansion risk and mortality risk in the early stage in patients with ICH. Furthermore, it was suggested that the newly produced HEMRICH scale could be a valid and reliable scale for predicting both hematoma expansion and mortality risk.
Collapse
Affiliation(s)
- Bulent Bakar
- Department of Neurosurgery, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Suleyman Akkaya
- Department of Neurosurgery, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Bahar Say
- Department of Neurology, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Ulas Yuksel
- Department of Neurosurgery, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Aslihan Alhan
- Department of Biostatistics, Ufuk University Faculty of Medicine, Ankara, Turkey
| | - Esra Turğut
- Department of Neurology, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Mustafa Ogden
- Department of Neurosurgery, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Ufuk Ergun
- Department of Neurology, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| |
Collapse
|
13
|
Yuksel U, Ogden M, Ozdemir A, Kisa U, Bakar B. Predictive diagnostic and/or prognostic biomarkers obtained from routine blood biochemistry in patients with solitary intracranial tumor. J Med Biochem 2021; 40:67-73. [PMID: 33584142 PMCID: PMC7857846 DOI: 10.5937/jomb0-24722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/15/2020] [Indexed: 11/02/2022] Open
Abstract
Background Radiological and/or laboratory tests may be sometimes inadequate distinguishing glioblastoma from metastatic brain tumors. The aim of this study was to find possible predictive biomarkers produced from routine blood biochemistry analysis results evaluated preoperatively in each patient with solitary brain tumor in distinguishing glioblastoma from metastatic brain tumors as well as revealing short-term prognosis. Methods Patients admitted to neurosurgery clinic between January 2015 and September 2018 were included in this study and they were divided into GLIOMA (n=12) and METASTASIS (n=17) groups. Patients' data consisted of age, gender, Glasgow Coma Scale scores, duration of stay in hospital, Glasgow Outcome Scale (GOS) scores and histopathological examination reports, hemoglobin level, leukocyte, neutrophil, lymphocyte, monocyte, eosinophil, basophil and platelet count results, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio values, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were evaluated preoperatively. Results The CRP levels of METASTASIS group (143.10 mg/L) were higher than those of GLIOMA group (23.90 mg/L); and it was 82% sensitive and 75% specific in distinguishing metastatic brain tumor from glioblastoma if CRP value was >55.00 mg/L. A positive correlation was determined between GOS score and hemoglobin level and between ESR and CRP values. However, GOS scores were negatively correlated with the ESR level and duration of stay in hospital. Conclusions Study results demonstrated that CRP values could be predictive biomarker in distinguishing metastatic brain tumor from glioblastoma. In addition, ESR, CRP, hemoglobin levels and duration of stay in hospital could be prognostic biomarkers in predicting short-term prognosis of patients with solitary brain tumor.
Collapse
Affiliation(s)
- Ulas Yuksel
- Kirikkale University, Faculty of Medicine, Department of Neurosurgery, Yahsihan, Kirikkale, Turkey
| | - Mustafa Ogden
- Kirikkale University, Faculty of Medicine, Department of Neurosurgery, Yahsihan, Kirikkale, Turkey
| | - Alemiddin Ozdemir
- Kirikkale University, Faculty of Medicine, Department of Neurosurgery, Yahsihan, Kirikkale, Turkey
| | - Ucler Kisa
- Kirikkale University, Faculty of Medicine, Department of Biochemistry, Kirikkale, Turkey
| | - Bulent Bakar
- Kirikkale University, Faculty of Medicine, Department of Neurosurgery, Yahsihan, Kirikkale, Turkey
| |
Collapse
|
14
|
Yüksel U, Ogden M, Bulut IU, Bakar B, Kisa U. Can routine biochemical tests be a short-term prognostic biomarker in patients operated for chronic subdural hematoma? roneuro 2020. [DOI: 10.33962/roneuro-2020-061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives: The effect of routine blood biochemistry parameters on the short-term prognosis of patients with chronic subdural hematoma (CSDH) has not been evaluated in literature before. In this study, it was aimed to establish markers for determination of short-term prognosis using data of patients who were operated for CSDH.
Methods: During admission to hospital, data of patients including age, sex, antiaggregan and/or anticoagulant drugs usage, comorbidity, Glasgow Coma Scale (GCS) and Glasgow Outcome Scale scores were evaluated. Location and thickness of CSDH were recorded using brain CT or MR images. Blood leukocyte, neutrophil, lymphocyte, eosinophil, basophil, platelet count results, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio results, activated prothrombin time and INR values, serum glucose, aspartate aminotransferase, alanine aminotransferase, C-reactive protein, sodium, potassium, blood urea nitrogen and creatinine level values were also recorded. Patients were divided into two groups according to CSDH located “unilaterally (n=19)” and “bilaterally (n=12)”. In addition, patients with unilateral CSDH were divided into two groups as CSDH located at the "right hemisphere (n=6)” and "left hemisphere (n=13)".
Results: It was concluded that short-term prognosis of patients with unilateral or bilateral CSDH was similar. Correlation analysis showed no correlation between short-term prognosis and demographic, clinical and laboratory findings. However, Likelihood Ratio test revealed that GCS score could be a biomarker in order to predict short-term prognosis of these patients, albeit weak (X2=6.138, p=0.046).
Conclusion: It was thought that GCS scores could be effective in predicting short-term prognosis in patients with CSDH but routine biochemistry laboratory parameters could not predict short-term prognosis of these patients.
Collapse
|
15
|
Yuksel U, Bakar B, Ozdemir A, Zengin M, Comert S, Ogden M. Using of the synthetic dural graft as described in bogota bag technique to decrease the adhesions in decompressive craniectomy. Turk Neurosurg 2020; 31:838-844. [PMID: 33759157 DOI: 10.5137/1019-5149.jtn.31128-20.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM The aim of this study was to create an alternative synthetic dural graft using a parenteral solution bag made of polyvinyl chloride/polypropylene (PVC/PP). MATERIAL AND METHODS Twenty-two albino rats were divided into the Sham, DC and BAG groups. Except for the Sham group animals, the right parietal bone of the rats was totally drilled in a diameter of 1.0 x 0.5 mm. Then, the PVC/PP BAG was layered over the craniectomized bone of the BAG group animals. Thirty days later, all animals were sacrificed, and inflammatory processes consisting of polymorphonuclear cell infiltration, inflammation, edema, hyperemia, lymphocytosis, histiocytosis, vascular proliferation, and fibrosis were graded at the craniectomy site. RESULTS The grade values of inflammation, edema, histiocytosis, and fibrosis were found different among the groups (p 0.017). It was observed that placing a synthetic graft to the surgical site undergoing craniectomy could prevent fibrotic adhesions that might occur between the brain tissue and scalp in the chronic period. Furthermore, it was considered that this synthetic material did not increase inflammatory processes secondary to surgery at the surgical site and did not produce a foreign body reaction, toxicity, or infection. CONCLUSION As a result of this study, it was argued that the synthetic material used in this study could be compatible with dermal and neural tissues and reduce adhesions at the craniectomy field. Therefore, it was considered that this material could be used as an alternative synthetic dural graft in decompressive craniectomy in human subjects after detailed toxicity studies.
Collapse
|
16
|
Jones DJ, Baldwin C, Lal S, Stanmore E, Farrer K, Connolly E, Weekes CE, Anderson L, Murphy J, Gillespie L, Welsh N, Ogden M, McDevitt M, Day R, Lynne S, Paulden P, Gronlund T, Burden ST. Priority setting for adult malnutrition and nutritional screening in healthcare: a James Lind Alliance. J Hum Nutr Diet 2019; 33:274-283. [DOI: 10.1111/jhn.12722] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- D. J. Jones
- Faculty of Biology, Medicine and Health University of Manchester Manchester UK
| | - C. Baldwin
- Department of Nutritional Sciences Kings College London London UK
| | - S. Lal
- Salford Royal Foundation Trust Salford UK
| | - E. Stanmore
- Faculty of Biology, Medicine and Health University of Manchester Manchester UK
| | - K. Farrer
- NHS Salford CCG St James House Salford UK
| | | | - C. E. Weekes
- Guy's & St Thomas' NHS Foundation Trust London UK
| | - L. Anderson
- Buckinghamshire Healthcare NHS Trust Stoke Mandeville Hospital Aylesbury Bucks UK
| | - J. Murphy
- Bournemouth University Bournemouth UK
| | | | - N. Welsh
- Manchester University NHS Foundation Trust Manchester UK
| | - M. Ogden
- Patient and Carer Involvement/Representatives Manchester UK
| | - M. McDevitt
- Patient and Carer Involvement/Representatives Manchester UK
| | - R. Day
- Patient and Carer Involvement/Representatives Manchester UK
| | - S. Lynne
- Patient and Carer Involvement/Representatives Manchester UK
| | - P. Paulden
- Patient and Carer Involvement/Representatives Manchester UK
| | | | - S. T. Burden
- Faculty of Biology, Medicine and Health University of Manchester Manchester UK
| |
Collapse
|
17
|
Ogden M, Karaca SB, Aydin G, Yuksel U, Dagli AT, Akkaya S, Bakar B. The Healing Effects of Thymoquinone and Dexpanthenol in Sciatic Nerve Compression Injury in Rats. J INVEST SURG 2019; 34:504-512. [PMID: 31462122 DOI: 10.1080/08941939.2019.1658831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Functional healing of peripheral nerve injuries is still difficult. In this study, potential healing effects of thymoquinone and dexpanthenol in sciatic nerve compression injury (SCI) were investigated. Method: Twenty-four male Wistar albino rats which were applied compression injury to their sciatic nerves were randomly separated into four groups as following: "control" group contained six rats administered no pharmacological agent; "TMK" group consisted of six rats administered 10 mg/kg intraperitoneal thymoquinone once a day for one week; "DXP" group contained six rats administered 50 mg/kg intraperitoneal dexpanthenol once a day for one week; and "TMK-DXP" group consisted of six rats administered separately 10 mg/kg intraperitoneal thymoquinone and 50 mg/kg intraperitoneal dexpenthanol once a day for one week. Four weeks later from SCI, sciatic nerve function index (SFI) was applied before sacrifice of all rats, and then their crushed sciatic nerves were histopathologically examined, in terms of "Schwann cell count", "axon and myelin degeneration", "axon shape/size differences", "fibrosis", and "neovascularisation". Results: "Schwann cell count" (p = 0.011), "axon and myelin degeneration" (p = 0.001), "axon shape/size differences" (p = 0.011), and "fibrosis and neovascularisation" (p = 0.026) scores were different between the control and TMK-DXP groups. SFI scores were different between the control and TMK groups (p = 0.002), between the control and TMK-DXP groups (p < 0.001), and between the DXP and TMK-DXP groups (p = 0.029). Conclusions: This study results revealed that these pharmacological agents used alone had no histopathological healing effect in rats with SCI, but thymoquinone could improve walking function. However, thymoquinone and dexpanthenol used together had a significant histopathological and functional healing effect.
Collapse
Affiliation(s)
- Mustafa Ogden
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| | - Sahika Burcu Karaca
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Kirikkale University, Kirikkale, Turkey
| | - Gulcin Aydin
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Kirikkale University, Kirikkale, Turkey
| | - Ulas Yuksel
- Department of Neurosurgery, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Ankara, Turkey
| | - Ahmet Turan Dagli
- Faculty of Medicine, Department of Neurosurgery, Hitit University, Çorum, Turkey
| | - Suleyman Akkaya
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| | - Bulent Bakar
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| |
Collapse
|
18
|
Yüksel U, Akkurt İ, Ogden M, Bakar B, Keskil S. BILATERAL SUBDURAL HEMATOMA AFTER VENTRICULOPERITONEAL SHUNT SURGERY. Journal of Emergency Medicine Case Reports 2019. [DOI: 10.33706/jemcr.550572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
19
|
Ogden M, Yuksel U, Akkurt I, Bakar B. Performing the screw fixation from C3 to odontoid process in a patient with Klippel-Feil syndrome and type II odontoid fracture. J Craniovertebr Junction Spine 2019; 9:277-279. [PMID: 30783354 PMCID: PMC6364369 DOI: 10.4103/jcvjs.jcvjs_54_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 56-year-old female patient was admitted with a history of pain during neck movements after cervical injury. Computerized tomography scan revealed type II odontoid fracture and fusion anomaly between C2 and C3 vertebrae. At surgery, the anteroinferior part of C2 vertebra corpus could not be reached; therefore, transodontoid screw was advanced from C3 vertebra toward odontoid process. At follow-up examination, the complaints of the patient had recovered, and fracture line was completely fused. Advancing screw from C3 to odontoid process via anterior cervical approach could be thought an alternative treatment option in the patient with short neck caused from vertebra fusion anomaly and/or obesity.
Collapse
Affiliation(s)
- Mustafa Ogden
- Department of Neurosurgery, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - Ulas Yuksel
- Department of Neurosurgery, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - Ibrahim Akkurt
- Department of Neurosurgery, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - Bulent Bakar
- Department of Neurosurgery, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| |
Collapse
|
20
|
Ogden M, Yuksel U, Bakar B, Akkaya S, Kamasak K, Dagli AT. The Effects of Microdecompression on Patients with Lumbar Degenerative Spinal Stenosis with or without Degenerative Spondylolisthesis. Turk Neurosurg 2019; 29:205-212. [PMID: 30649783 DOI: 10.5137/1019-5149.jtn.22988-18.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIM To investigate the mid-term efficacy of bilateral decompression with a unilateral approach (BDUA) on symptoms and quality of life of in patients with lumbar spinal stenosis (LSS), with low grade (with percentage slip < 25%) degenerative spondylolisthesis or without spondylolisthesis. MATERIAL AND METHODS The study included patients who underwent BDUA due to one or two-level LSS related to degenerative spondylosis and/ or degenerative spondylolisthesis. Pre- and postoperative data of the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), and walking distance were compared. RESULTS Evaluation was made up of a total of 53 patients, comprising 32 males and 21 females with a mean age of 60.6 ± 9.0 years. Compared with the preoperative data, VAS, ODI and walking distance improved significantly in all patients at the 3-year follow-up examination. Furthermore, a significant improvement was determined in the clinical parameters of patients with degenerative spondylolisthesis, with no worsening of slip and no requirement for instrumentation. Moreover, when patients were separated into two groups according to age, as elderly ( > 60 years) and adult ( < 60 years), similar improvements were seen in both groups. CONCLUSION BDUA could be quite effective in reducing pain, improving quality of life and walking distance with no worsening of the grade or degree of slipping.
Collapse
Affiliation(s)
- Mustafa Ogden
- Kirikkale University, Faculty of Medicine, Department of Neurosurgery, Kirikkale, Turkey
| | | | | | | | | | | |
Collapse
|
21
|
Ogden M, Bakar B, Karagedik MI, Bulut IU, Cetin C, Aydin G, Kisa U, Ozveren MF. Analysis of biochemical laboratory values to determine etiology and prognosis in patients with subarachnoid hemorrhage: a clinical study. Neurol Res 2018; 41:156-167. [PMID: 30417744 DOI: 10.1080/01616412.2018.1545414] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aim of this study was to establish prognostic and predictive markers in patients with subarachnoid hemorrhage (SAH) using simple laboratory methods. METHODS A retrospective examination was made of patients with SAH diagnosed secondary to isolated head trauma, isolated anterior communicating artery aneurysm rupture, and angiography-negative SAH. Age, gender, Glasgow Coma Scale (GCS) scores, and Fisher's grade scores, Glasgow Outcome Scale (GOS) scores, leukocyte count, neutrophil count, lymphocyte count, platelet count, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio results (PLR) were evaluated. RESULTS NLR and PLR values, which were similar in patients with spontaneous SAH, were significantly high in patients with traumatic SAH. NLR and PLR values could be 80% sensitive and 75% specific for distinguishing traumatic SAH from spontaneous SAH. Eosinophil count was lower in patients with angiography-negative SAH and patients with aneurysmal SAH than in patients with traumatic SAH. Initially measured GCS score, Fisher's grade score, eosinophil, neutrophil and lymphocyte counts could be prognostic in all patients with SAH. Moreover, it was concluded that the initially measured number of eosinophils might be directly related to patient prognosis. The eosinophil count was generally found to be high in traumatic SAH patients and it was observed that this parameter could be predictive for these patients. Lymphocyte count and NLR values could be prognostic markers in patients with angiography-negative SAH. CONCLUSION NLR, PLR and eosinophil count values could be predictive for etiological factors (traumatic SAH or spontaneous SAH) of patients who were admitted unconscious to the emergency room with SAH detected on radiological imaging.
Collapse
Affiliation(s)
- Mustafa Ogden
- a Faculty of Medicine, Department of Neurosurgery , Kirikkale University , Kirikkale , Turkey
| | - Bulent Bakar
- a Faculty of Medicine, Department of Neurosurgery , Kirikkale University , Kirikkale , Turkey
| | - Mustafa Ilker Karagedik
- a Faculty of Medicine, Department of Neurosurgery , Kirikkale University , Kirikkale , Turkey
| | - Ibrahim Umud Bulut
- a Faculty of Medicine, Department of Neurosurgery , Kirikkale University , Kirikkale , Turkey
| | - Cansel Cetin
- a Faculty of Medicine, Department of Neurosurgery , Kirikkale University , Kirikkale , Turkey
| | - Gulcin Aydin
- b Faculty of Medicine, Department of Anaesthesiology and Reanimation , Kirikkale University , Kirikkale , Turkey
| | - Ucler Kisa
- c Faculty of Medicine, Department of Biochemistry , Kirikkale University , Kirikkale , Turkey
| | - Mehmet Faik Ozveren
- a Faculty of Medicine, Department of Neurosurgery , Kirikkale University , Kirikkale , Turkey
| |
Collapse
|
22
|
Ogden M, Akgul MH, Yuksel U, Bakar B, Kamasak K, Özveren MF. An Evaluation of the Quality of Sleep Before and After Surgical Treatment of Patients with Cervical Disc Herniation. J Korean Neurosurg Soc 2018; 61:600-607. [PMID: 30196657 PMCID: PMC6129744 DOI: 10.3340/jkns.2017.0248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/15/2017] [Indexed: 11/27/2022] Open
Abstract
Objective It has been reported in recent studies that 50-80% of patients with cervical disc hernia have concomitant sleep disorders. The aim of this study was to evaluate the quality of sleep before and after surgical treatment in patients with cervical disc hernia and to assess the effects on treatment.
Methods The study included 32 patients performed discectomy and fusion with an intervertebral cage through the right anterior cervical approach. Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were applied to all patients preoperatively and at one month postoperatively.
Results The postoperative PSQI total points and all the PSQI subscale points, the ODI and VAS scores were significantly reduced compared to the preoperative values. A positive correlation was determined between the preoperative ODI points and the PSQI total points and sleep duration, sleep latency and daytime functional loss subscale points. A positive correlation was also found between preoperative ODI points and VAS points. A positive correlation was determined between the preoperative VAS points and and the PSQI total points and sleep duration, and sleep latency subscale points. A negative correlation was determined between the postoperative ODI and the daytime functional loss subscale points.
Conclusion The results of the study showed that in patients with cervical disc hernia, sleep quality and daytime functionality were negatively affected by severity of pain that limited daily activities. Bringing the pain under control with surgical treatment was observed to increase sleep quality. It can be concluded that when planning treatment for these patients, it should be taken into consideration that there could be a sleep disorder in addition to the complaints and symptoms such as pain, hypoestesia and loss of strength.
Collapse
Affiliation(s)
- Mustafa Ogden
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | | | - Ulas Yuksel
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Bulent Bakar
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Kagan Kamasak
- Department of Neurosurgery, Hitit University, Faculty of Medicine, Çorum, Turkey
| | - Mehmet Faik Özveren
- Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| |
Collapse
|
23
|
Nursoy E, Ogden M, Bakar B, Dincel GÇ, Kisa U, Ozveren MF. Research on the Effects of Levetiracetam in Spinal Cord Injury Model in Rats: An Experimental Study. J INVEST SURG 2018; 33:252-262. [PMID: 30204031 DOI: 10.1080/08941939.2018.1490828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: Despite advances in spinal biomechanic research, surgical techniques, and rehabilitation processes, no significant improvement has been identified in the treatment of spinal cord injury (SCI) and neurological recovery. Aim of the Study: This study was designed to investigate the potential therapeutic effects of methylprednisolone and levetiracetam on SCI. Materials and Methods: In this study, 42 male Wistar Albino rats, each weighing 300-350 g, were separated into three main groups: control group, acute and subacute stage groups. With the exception of the control group, a T7-8 dorsal laminectomy was performed on the spinal column of the rats. A temporary vascular aneurysm clip was then applied to the spinal cord for 1 min to create SCI and methylprednisolone or levetiracetam was administered intraperitoneally to all except the control and SHAM control groups. The damaged spinal cord was removed for histopathological and biochemical examinations. Results: Both pharmacological agents were determined to have improved the histopathological architecture in damaged neural tissues during the acute period of SCI, but could not sustain this activity in the subacute period. Neither pharmacological agent affected the biochemical data in the acute nor subacute stages. Conclusions: Both pharmacological agents showed histopathological healing effects in injured tissues during the acute phase of SCI in this rat model but these effects could not be sustained in the subacute period. No effect on biochemical data was seen in either the acute or subacute period. There is a need for further advanced studies to determine the effects of levetiracetam on the healing processes in SCI.
Collapse
Affiliation(s)
- Egemen Nursoy
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| | - Mustafa Ogden
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| | - Bulent Bakar
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| | - Gungor Çagdaş Dincel
- Eskil Vocational High School, Laboratory and Veterinary Science, Aksaray University, Aksaray, Turkey
| | - Uçler Kisa
- Faculty of Medicine, Department of Biochemistry, Kirikkale University, Kirikkale, Turkey
| | - Mehmet Faik Ozveren
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| |
Collapse
|
24
|
Akkurt I, Cetin C, Erdogan AM, Dincel GC, Ceylan AF, Kisa U, Oppong J, Akkurt A, Ogden M, Bakar B. Cerebral ischaemia/reperfusion injury could be managed by using tramadol. Neurol Res 2018; 40:774-784. [DOI: 10.1080/01616412.2018.1477556] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Ibrahim Akkurt
- Department of Neurosurgery, Yozgat City Hospital, Yozgat, Turkey
| | - Cansel Cetin
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| | | | - Gungor Cagdas Dincel
- Eskil Vocational High Scholl, Laboratory and Veterinary Science, Aksaray University, Aksaray, Turkey
| | - Aslı Fahriye Ceylan
- Faculty of Medicine, Department of Pharmacology, Kirikkale University, Kirikkale, Turkey
| | - Ucler Kisa
- Faculty of Medicine, Department of Biochemistry, Kirikkale University, Kirikkale, Turkey
| | - Jonathan Oppong
- Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - Adem Akkurt
- Department of Neurology, Samsun Medicana Hospital, Samsun, Turkey
| | - Mustafa Ogden
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| | - Bulent Bakar
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Kirikkale, Turkey
| |
Collapse
|
25
|
Yuksel U, Bakar B, Dincel GC, Budak Yildiran FA, Ogden M, Kisa U. The Investigation of the Cox-2 Selective Inhibitor Parecoxib Effects in Spinal Cord Injury in Rat. J INVEST SURG 2018; 32:402-413. [PMID: 29355394 DOI: 10.1080/08941939.2017.1423423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Aim: Today, spinal cord injury (SCI) can be rehabilitated but cannot be treated adequately. This experimental study was conducted to investigate possible beneficial effects of methylprednisolone and parecoxib in treatment of SCI. Materials and methods: Forty-eight male Wistar albino rats were assigned into CONTROL, acute (MP-A, PX-A, and PXMP-A), and subacute (MP-S, PX-S, and PXMP-S) stage groups. Then, to induce SCI, a temporary aneurysm clip was applied to the spinal cord following T7-8 laminectomy, except in the CONTROL group. Four hours later parecoxib, methylprednisolone, or their combination was administered to rats intraperitoneally except CONTROL, SHAM-A, and SHAM-S groups. Rats in the acute stage group were sacrificed 72 h later, and whereas rats in the subacute stage were sacrificed 7 days later for histopathological and biochemical investigation and for gene-expression analyses. Results: Parecoxib and methylprednisolone and their combination could not improve histopathological grades in any stage. They also could not decrease malondialdehyde or caspase-3, myeloperoxidase levels in any stage. Parecoxib and methylprednisolone could decrease the TNF-α gene expression in subacute stage. Methylprednisolone could increase TGF-1β gene-expression level in acute stage. Conclusion: Neither of the experimental drugs, either alone or in combination, did not show any beneficial effects in SCI model in rats.
Collapse
Affiliation(s)
- Ulas Yuksel
- a Department of Neurosurgery, Sanliurfa Training and Research Hospital , Sanliurfa , Turkey
| | - Bulent Bakar
- b Department of Neurosurgery, Faculty of Medicine, Kirikkale University , Kirikkale , Turkey
| | - Gungor Cagdas Dincel
- c Laboratory and Veterinary Science, Eskil Vocational High School, Aksaray University , Aksaray , Turkey
| | | | - Mustafa Ogden
- b Department of Neurosurgery, Faculty of Medicine, Kirikkale University , Kirikkale , Turkey
| | - Ucler Kisa
- e Department of Biochemistry, Faculty of Medicine, Kirikkale University , Kirikkale , Turkey
| |
Collapse
|
26
|
Akkurt I, Bakar B, Dincel GC, Yıldıran FAB, Ogden M, Nursoy E, Sari E. Effectiveness of the Biophysical Barriers to the Peridural Fibrosis in Rat Laminectomy Model. J INVEST SURG 2018; 32:361-368. [PMID: 29345503 DOI: 10.1080/08941939.2017.1423422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Purpose: Peridural fibrosis which could occur after the spinal surgery could adhere neural tissue closely and may cause to neural entrapment symptoms and require surgical reintervention. Aim of the study: Present study was designed to reduce occurrence of peridural fibrosis in rat laminectomy model by using biophysical barriers called hyaluronic acid (HAS) dural barrier, activated polyethylene glycol and polyethylene imine (PEG) dural barrier, and platelet-rich plasma (PRP). Materials and methods: In this study, 2 of 26 male Wistar albino rats (325-350 g body weight), which were not included into study groups were sacrificed by removing their total blood and their blood was used for preparation of PRP, and remaining rats were randomly delivered into four groups called SHAM, HAS, PEG, and PRP groups. Then L3-4-5 laminectomy was performed to all animals and experimental agents were administered to the selected groups mentioned above. Spinal colons of all animals were removed gross total after 6-week period and investigated histopathologically. Additionally, real-time-polymerase chain reaction was used to obtain collagen type I and type III, transforming growth factor-1β, and tumor necrosis factor-α gene expressions. Results: All results demonstrated that polyethylene glycol and polyethylene imine dural barrier and PRP could decrease peridural fibrosis formation efficiently in rat. Conclusion: Present study results suggested that to reduce or block formation of peridural fibrosis, either polyethylene glycol and polyethylene imine dural barrier or PRP could be used effectively in human subjects after they will be closely investigated in future studies.
Collapse
Affiliation(s)
- Ibrahim Akkurt
- a Yozgat City Hospital , Department of Neurosurgery , Yozgat , Turkey
| | - Bulent Bakar
- b Department of Neurosurgery, Faculty of Medicine , Kirikkale University , Kirikkale , Turkey
| | - Gungor Cagdas Dincel
- c Laboratory and Veterinary Science, Eskil Vocational High School , Aksaray University , Aksaray , Turkey
| | | | - Mustafa Ogden
- b Department of Neurosurgery, Faculty of Medicine , Kirikkale University , Kirikkale , Turkey
| | - Egemen Nursoy
- b Department of Neurosurgery, Faculty of Medicine , Kirikkale University , Kirikkale , Turkey
| | - Elif Sari
- e Department of Plastic and Reconstructive Surgery , Faculty of Medicine, Kirikkale University , Kirikkale , Turkey
| |
Collapse
|
27
|
Ogden M, Özveren MF. Air in the Subdural Space at the Clivus. Pediatr Neurosurg 2018; 53:69-70. [PMID: 28926835 DOI: 10.1159/000480022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 07/28/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Mustafa Ogden
- Department of Neurosurgery, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | | |
Collapse
|
28
|
Ogden M, Ozveren MF, Kayacı S. Petrobasilar, petroclival or petrosphenoidal canal of the abducens nerve. Acta Neurochir (Wien) 2017; 159:2145-2146. [PMID: 28942544 DOI: 10.1007/s00701-017-3324-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/04/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Mustafa Ogden
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Yahsihan, 71450, Kirikkale, Turkey.
| | - Mehmet Faik Ozveren
- Faculty of Medicine, Department of Neurosurgery, Kirikkale University, Yahsihan, 71450, Kirikkale, Turkey
| | - Selim Kayacı
- Faculty of Medicine, Department of Neurosurgery, Erzincan University, Erzincan, Turkey
| |
Collapse
|
29
|
Menku A, Ogden M, Saraymen R. The protective effects of propofol and citicoline combination in experimental head injury in rats. Turk Neurosurg 2010; 20:57-62. [PMID: 20066623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM Lipid peroxidation (LP) is an important factor in tissue damage following head injury. Reactive oxygen radicals which damage cellular components play an important role in ischemic or hypoxic tissue. They initiate the lipid peroxidation process after head trauma. However, antioxidant agents may protect brain tissue against oxidative damage MATERIAL AND METHODS 39 male Swiss Albino rats (200-250 g) were used in this experimental study. These animals were divided into 3 groups: 1) control group, 2) propofol group (100 mg/kg) and, 3) citicoline (250 mg/kg) and propofol (100 mg/kg) combination group. Oxidant effect in brain tissue content was assessed by measuring the Malonyldialdehyde (MDA), Superoxide Dismutase (SOD) and Gluthatione Peroxidase (GPx) activities. RESULTS There was no statistically meaningful difference among the groups regarding GPx levels. MDA levels were significantly lower in the citicoline and combination group than those of the control group. As for the levels of SOD, there was an increase both in the propofol and combination groups. CONCLUSION Atherapeutic benefit of the propofol and citicolin combination in head trauma has not been previously demonstrated. We examined the possible potential protective effect of propofol and citicolin against oxidative damage in experimental head trauma in the present study.
Collapse
Affiliation(s)
- Ahmet Menku
- Erciyes University, Faculty of Medicine, Department of Neurosurgery, Kayseri, Turkey.
| | | | | |
Collapse
|
30
|
Laha SK, Taylor R, Collin SA, Ogden M, Thomas AN. ICS Free Paper Presentation (Clinical Practice) Winner. J Intensive Care Soc 2007. [DOI: 10.1177/175114370700800121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | | | | | - AN Thomas
- Department of Statistics Hope Hospital, Salford, Manchester
| |
Collapse
|
31
|
Absalom AR, Lee M, Menon DK, Sharar SR, De Smet T, Halliday J, Ogden M, Corlett P, Honey GD, Fletcher PC. Predictive performance of the Domino, Hijazi, and Clements models during low-dose target-controlled ketamine infusions in healthy volunteers. Br J Anaesth 2007; 98:615-23. [PMID: 17389691 PMCID: PMC3838936 DOI: 10.1093/bja/aem063] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Healthy volunteers received low-dose target-controlled infusions (TCI) of ketamine controlled by the Domino model while cognitive function tests and functional neuroimaging were performed. The aim of the current study was to assess the predictive performance of the Domino model during these studies, and compare it with that of three other ketamine models. METHODS Fifty-eight volunteers received ketamine administered by a TCI device on one or more occasions at target concentrations of either 50, 100, or 200 ng ml-1. At each target concentration, two or three venous blood samples were withdrawn during infusion, with a further sample after the infusion ended. Ketamine assays were performed by gas chromatography. The plasma concentration time courses predicted by the Hijazi, Clements 125, and Clements 250 models were calculated retrospectively, and the predictive performance of each of the models was assessed using Varvel methodology. RESULTS For the Domino model, bias, inaccuracy, wobble, and divergence were - 2.7%, 33.9%, 24.2%, and 0.1463% h-1, respectively. There was a systematic increase in performance error over time. The Clements 250 model performed best by all criteria, whereas the Hijazi model performed least well by all criteria except for bias. CONCLUSIONS Performance of the Domino model during control of low-dose ketamine infusions was sub-optimal. The Clements 250 model may be a better model for controlling low-dose TCI ketamine administration.
Collapse
Affiliation(s)
- A R Absalom
- University Division of Anaesthesia, Addenbrooke's Hospital, and University of Cambridge School of Clinical Medicine, CB2 2QQ, UK.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Ogden M. Change comes to Texas workers' comp environment. Healthtexas 1991; 47:16. [PMID: 10120899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- M Ogden
- Texas Hospital Insurance Network
| |
Collapse
|
33
|
Abstract
Three groups of housewives adhering to strict inclusion criteria were compared along several variables. The groups were patients with non-alcoholic liver disease (N = 19), alcoholic liver disease (N = 15) and alcoholics attending a community treatment centre (N = 13). The study confirms the differences between alcoholics who develop liver disease from those who do not. There was a strong relationship between dissatisfaction with the role of housewife and severity of alcoholism.
Collapse
Affiliation(s)
- B Farid
- New Cross Hospital, Wolverhampton, U.K
| | | | | | | | | |
Collapse
|
34
|
|
35
|
|
36
|
Abstract
Although the safety of splenic preservation has been demonstrated in a small number of cases, the follow-up in these cases has been too short to determine whether the patients are adequately protected from sepsis. The purpose of this study was to test the ability of the spleen to clear pneumococcal organisms after repairing lacerations with a surface hemostatic agent. Three groups of 20 New Zealand white rabbits were studied. Group I animals received sham operations, group II animals were given total splenectomies, and group III animals had splenic lacerations repaired with Collastat (American Medical Products Corp., Freehold, New Jersey), a local hemostatic agent. Three months later, when challenged with intracardiac Streptococcus pneumoni type III, the animals without spleens failed to clear pneumococcal organisms. This spleen-intact and spleen-repaired animals, however, both cleared pneumococcal organisms in a normal fashion.
Collapse
|
37
|
Ogden M, Spector MI, Hill CA. Suicides and homicides among Indians. Public Health Rep (1896) 1970; 85:75-80. [PMID: 4983432 PMCID: PMC2031630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|