Neutrophil-Lymphocyte Ratio Connected to Treatment Options and Inflammation Markers of Ankylosing Spondylitis

BACKGROUND

In recent years, white blood cells (WBCs) and their subtypes have been studied in relation to inflammation. The aim of our study was to assess the relationship between neutrophil-lymphocyte ratio (NLR) and ankylosing spondylitis (AS).

MATERIALS AND METHODS

We enrolled a total of 177 patients, 96 AS and 81 healthy controls. Complete blood count, WBC, neutrophil and lymphocyte levels were measured, and the NLR was calculated. In the assessment of AS, we used the erythrocyte sedimentation rate, C-reactive protein (CRP), the Bath Ankylosing Spondylitis Disease Activity Index, and the Bath Ankylosing Spondylitis Functional Index.

RESULTS

In the present study, 96 AS and 81 healthy individuals were enrolled. The mean age was 43.8 ± 12.9 and 46.5 ± 11.2 years, respectively. Mean disease duration of AS patients was 6.9 ± 5.6 years (median = 5, min-max = 1-25). The patients with AS had a higher NLR than the control individuals (mean NLR, 2.24 ± 1.23 and 1.73 ± 0.70, respectively, P < 0.001). A statistically significant positive correlation was observed between NLR and CRP (r = 0.322, P = 0.01). The patients receiving antitumor necrosis factor α therapy had a lower NLR than the patients receiving nonsteroidal anti-inflammatory drug therapy (mean NLR, 1.71 ± 0.62 and 2.41 ± 1.33, respectively, P = 0.02).

CONCLUSION

NLR may be seen as a useful marker for demonstrating inflammation together with acute phase reactants such as CRP and in evaluating the effectiveness of anti-TNF-α therapy.

P-wave and QT dispersion in spinal cord injury

OBJECTIVE

Spinal cord injury (SCI) can lead to significant cardiac arrhythmia. However, P-wave, QT dispersion, and risk factors in these patients have not been widely investigated. In this study, we assessed whether there is a relationship between electrocardiogram (ECG) parameters and risk factors in SCI patients.

METHODS

The study population consisted of 85 SCI patients and 38 control subjects. P-wave durations were measured using 12 leads of the surface ECG. P-wave dispersion was defined as the difference between the P-wave maximum and P-wave minimum duration. QT dispersion was defined as the difference between the largest and smallest QT interval for any of the 12 leads (QTmax-QT-min). QT intervals were also corrected (QTc) in accordance with the heart rate using Bazett's formula (QT Interval/√[RR interval]). We also evaluated the independent risk factors for P-wave dispersion and QT dispersion in SCI patients.

RESULTS

The P-wave minimum, P-wave maximum, QT minimum, and dispersion were significantly different between the control and SCI groups. There was no significant difference in P-wave dispersion, QT maximum, or QTc. Multivariate regression analysis showed that disease duration, glucose and high-density lipoprotein cholesterol (HDL-C) levels, and systolic tension were independent risk factors for P-wave dispersion.

CONCLUSION

Our results demonstrate that QT dispersion is related to SCI and that P-wave dispersion was linked to the duration of SCI, HDL-C and glucose levels, and arterial tension in SCI patients.

A case of posterior mediastinal ganglioneuroma: the importance of preoperative multiplanar radiological imaging

Ganglioneuromas are mostly seen in adolescents and young adults and they are neurogenic tumors originating from sympathetic ganglions with a benign histology. Although ganglioneuromas are benign, the treatment is surgical as they can cause pain or compression symptoms, can be locally aggressive and can lead to cord compression. We present a young adult female with a ganglioneuroma of the right posterior mediastinum who presented with lower back pain, together with the clinical features, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) findings, differential diagnosis tips and their contribution to surgical planning.

[Kyphoplasty method for the treatment of traumatic osteoporotic vertebral compression fractures: case report]

The aim of the kyphoplasty method for the treatment of traumatic osteoporotic vertebral compression fractures in geriatric patients is to improve the patient's quality of life. In this report we present two elderly patients who were suffering of traumatic osteoporotic vertebral compression fractures and underwent successful kyphoplasties. Percutaneous kyphoplasty method for the surgical treatment of these fractures decreases the hospitalization, morbidity and mortality in these patients.

A new visual field test in empty sella syndrome: rarebit perimetry

PURPOSE

Several visual field defects can be seen in empty sella syndrome (ESS). In this study, the authors aimed to evaluate the visual field defects in patients with ESS by rarebit perimetry and to compare the results with Humphrey perimetry.

METHODS

Left eyes of 13 patients with ESS and left eyes of 15 age-matched normal subjects were included in the study. Visual field testing was performed by Humphrey Visual Field Analyzer II (Fastpack 30-2 strategy) and rarebit perimetry (regular test). Statistical analysis was performed by independent-samples t-test, Mann-Whitney U test, receiver operating characteristic (ROC) curves, and Pearson correlation test.

RESULTS

Humphrey perimetry mean deviation was -3.67 dB in control group and -6.06 dB in patients with ESS (p=0.12). Mean hit rate calculated by rarebit test was 91.8% in control group and 75.9% in cases with ESS (p=0.005). Area under ROC curve was 0.756 for Humphrey visual field test and 0.827 for rarebit hit rate (p=0.59). There was a significant correlation between rarebit hit rate and Humphrey visual field test mean deviation (r=0.755, p<0.001).

CONCLUSIONS

Rarebit perimetry correlates significantly with Humphrey perimeter in detecting visual field defects related with ESS and has a higher sensitivity and specificity.

Vertebral body pneumatocyst in the cervical spine and review of the literature

A pneumatocyst in the cervical spine is extremely rare and to our knowledge only a few reports have been published in the English literature. Although the etiology and natural course of vertebral body pneumatocyst is unclear, nitrogen gas accumulation is claimed. A 65-year-old-man was admitted to the emergency department with neck pain and numbness and incapacity in his both hands and fingers. The radiological images revealed a vertebral located pneumatocyst in the C4 cervical vertebra. In this report, we present a case of cervical pneumatocyst located in the C4 vertebral body. The clinical and radiological features and natural course of the pneumatocyst were evaluated.

Dog bite causing ischemia and neurological deficit at the upper extremity: a case report

We present a case with median and radial nerve injuries together with brachial artery occlusion after a dog bite that is seen rarely in the literature. A 26 year-old man was admitted to our emergency department with a complaint of dog bite and weakness of fingers at the left upper extremity. There were bite impressions at the left arm. The physical examination of the patient revealed no brachial and radial artery pulse. The neurological examination revealed radial and median nerve deficits. The patient underwent a thromboembolectomy operation following laboratory and radiological evaluations. The nerve injuries were evaluated as partial and medical treatment was administered.

Rapid resolution of acute subdural hematoma and effects on the size of existent subdural hygroma: a case report

The diagnosis and management of acute subdural hematoma is important in neurosurgery practice. Rapid spontaneous resolution of acute subdural hematoma within a few hours is seen rarely on the CT scan. We present a case that enlarged the existent subdural hygroma showing rapid resolution of acute subdural hematoma with resolution in 9 hours after the trauma. Additionally, the follow-up CT scans in the 1st month showed the decrease of enlargement of subdural hygroma. The resolution of acute subdural hematoma and effect of acute subdural hematoma on subdural hygroma must be considered during management. The relation of acute subdural hematoma and subdural hygroma is important for the resolution and management of acute subdural hematoma.

Idiopathic recurrent transverse myelitis with syringomyelia: a case report

Idiopathic transverse myelitis is a monophasic demyelinating disease of the central nervous system (CNS) and its recurrence is a rare entity. Existence of syringomyelia in the spinal cord in inflammatory CNS disease is not usually encountered. This case study describes a 45-year-old man who was admitted with features of a cervical demyelinating disease. The history of the patient indicated that this could be a recurring attack. Cervical MRI and laboratory examination of the patient showed evidence of recurrent transverse myelitis. The patient was managed with medical therapy. The follow-up cervical MRI of the patient 2 years later indicated syringomyelia in the cervical cord.

Apoptosis and cerebral ischemic reperfusion injury developed after haemorrhagic shock: experimental study

BACKGROUND

Apoptosis is a process of programmed cell death that plays a role in some normal and pathological conditions. In this study, we investigated the apoptosis during cerebral ischemic reperfusion injury in response to haemorrhagic shock in a rat model.

METHODS

Thirty-six adult Sprague-Dawley rats were divided into six groups: control, haemorrhagic shock (HS), ischemic reperfusion (IR), 1st hour IR, 3rd hour IR, 6th hour IR and 24th hour IR. Rats were sacrificed by taking blood from intracardiac area after finishing the experiment. The tissues were fixed using neutral buffered 10% formaldehyde solution for histopathological examination. Tissues were stained immunohistochemically with APO 2.7 and positive expression apoptotic cells were counted using a Clemex Vision Lite 3.5 vision analysis system.

RESULTS

There were 2-3 apoptotic cells in the control group (group 1) and this number increased to 8-11 in the haemorrhagic shock group (group 2) (p<0.05). Secondary or more serious injury occurs during ischemic reperfusion injury. The number of apoptotic cells increased to 11-14 at the 1st hour (group 3) and it was significant as compared to group 2 (p<0.05). The number of apoptotic cells significantly increased to 15-17 by the 3rd hour (group 4) as compared to group 3 (p<0.05). While there was no additional increase by the end of the 6th hour (group 5) as compared to group 4, the number of apoptotic cells significantly increased to 18-24 by the end of 24th hour (group 6) as compared to group 5 (p<0.05).

CONCLUSION

The majority of injuries to the brain following haemorrhagic shock occur during ischemic reperfusion. We observed that apoptosis increases step by step on the 1st, 3rd and 24th hours after ischemic reperfusion injury.