Comparison of entropy and bispectral index values during propofol induction

To identify the entropy levels that would correspond to bispectral index [BIS] levels in general anesthesia [GA] induction in patients who will undergo elective lumbar disc surgery [LDS]. Thirty cases who underwent LDS under GA were included in our study after obtaining patient consent and approval of the Ethics Committee of Afyon Kocatepe University Medical School, Afyonkarahisar, Turkey, between January 01, 2004 to December 31, 2005. Bispectral index and entropy electrodes were applied at the same time to 30 cases in the study group. In order to assess the level of sedation during anesthesia and recovery, 'Observers Assessment of Alertness/Sedation' [OAA/S] scale was used. Bispectral index, state-entropy [SE], response-entropy [RE], and OAA/S values were recorded simultaneously. Induction OAA/S scores were in correlation with BIS and entropy values [RE-SE] in 30 cases. A significant difference was found between BIS and entropy induction values [p=0.0398]. Induction mean arterial pressure and heart rate values at 30, 60, 90, and 120 seconds were lower than the values of the control, which was statistically significant [p=0.0412]. During the induction of GA, we found entropy values to be more sensitive and they demonstrated a more rapid increase than BIS. Therefore, it would be safer to monitor entropy while using agents of induction that might cause severe hypotension. Induction agents that might cause severe hypotension could be more safely administered under entropy monitoring

Which is more effective in reducing secondary brain damage resulting from cyclooxygenase expression following traumatic brain injury: calcium channel blockers or cox inhibitors?

To evaluate localizations of cyclooxygenase [COX]-1 and COX-2 following traumatic brain injury [TBI] and the effects of 2 therapeutic agents on COX inhibition. Forty rabbits were used in this study for developing a TBI model and divided into 4 groups [n=10] at Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey in June 2004. Differential cellular COX-1 and COX-2 protein expression profiles were analyzed following TBI, and the effects of 2 therapeutic agents, indomethacin and nimodipine, on COX inhibition were evaluated immunohistochemically. This study revealed that COX-1 and COX-2 protein expression were significantly increased in vascular endothelial, smooth muscle cells, and CD68+ microglia/macrophages following TBI. Indomethacin inhibited the COX expression in glial cells more than nimodipine, however, both did not affect endothelial COX-1 and COX-2 expression. The restricted accumulation of COX-1 at the perilesional area points to an acute inflammatory response and the role of COX-1 in TBI. This study revealed that COX-1 expression should be a pharmacological target following TBI, and COX-2 should also be evaluated in this aspect, and indomethacin is more effective than nimodipine for blocking COX-1

Comparison of unilateral posterior lumbar interbody fusion and bilateral posterior interbody fusion with simple discectomy at degenerative disc herniations

To evaluate the early results of unilateral posterior lumbar interbody fusion technique in lumbar discectomy cases compared with simple discectomy and bilateral posterior interbody fusion cases using visual analog scale [VAS] and Oswestry outcomes instruments and radiological and physical examinations. The control group had 40 patients who underwent simple discectomy. In group one, 8 patients had recurrent disc herniations and facet joint hypertrophy, 21 patients had degenerative disc disease and facet joint hypertrophy. In this group polyetheretherketone [PEEK] cage was used for protecting the disc height and recurrence. In group 2, 15 patients had degenerative lumbar disc herniations and bilateral facet joint hypertrophy. All patients were operated upon between October 2002 between February 2004 at the Neurosurgery Department of Kocatepe University Medical School, and were followed by the help of radiological exams, VAS and Oswestry scores, and clinical exams. The groups were compared to each other statistically. In the control group [n=40] there were recurrences and disc height loss. In group one [n=29] there were no recurrences and the height lost was limited. In group 2, [n=15] there was no recurrence, however, the lost disc height was more than group one. If the patient has degenerative disc disease, the use of unilateral posterior PEEK cage and interbody grafting is a safer mode of treatment after discectomy

age a prognostic factor of postoperative outcome of lumbar disc herniation operations?

To evaluate the influence of the patients age on preoperative symptoms and outcome. The general data, symptoms, signs, and neurological examination findings were recorded from 511 patients between 2000 and 2006 at Vakif Gureba Hospital and Afyon Kocatepe University Neurosurgery Departments, Afyonkarahisar, Turkey. The mean follow-up of the patients was 44.7 months. All patients younger than 64 were defined as younger patients [n=449]. The others were defined as elderly patients [n=62]. The measuring method of the outcome was visual analogue rating scale [VAS]. Preoperative and postoperative VAS values were found similar in both the younger and older group. Only preoperative differences were found in the older group, due to systemic disease. The outcome was not statistically different in both groups, indicating that age is not a valuable prognostic factor for lumbar discectomy