Carpal Tunnel Syndrome Surgery Anti-Adhesion Gel Is Effective?

PURPOSE OF THE STUDY The purpose of the current study is to assess the efficacy of anti-adhesion gel on the symptom severity and functional outcomes after mini incision open surgery for carpal tunnel syndrom (CTS). MATERIAL AND METHODS A total of 200 CTS patients (154 women, 46 men) were included in this study. Group I (n = 100; 78 women, 22 men) did not receive local administration of anti-adhesion gel, while anti-adhesion gel consisting of hyaluronic acid-carboxymethylcellulose (Seprafilm®, SanofiBiosurgery, Bridgewater, NJ, USA) was locally applied to patients in Group II (n = 100; 76 women, 24 men). All patients recruited in this study had received conservative treatment comprised of non-steroidal antiinflammatory drugs, steroid injection, replacement of vitamin B and stabilization with splints. Cases that did not benefit from these therapeutic options during one year were assigned as candidates for surgical treatment. RESULTS There was no significant difference between two groups in terms of mean age, gender distribution, preoperative and postoperative Boston questionnaire (BQ) scores, difference of BQ scores after the operation, and the presence of the disease on the left or right side. According to postoperative 1. Year results, there was no significant difference between two groups. CONCLUSIONS Results of the current study demonstrated that use of anti-adhesion gel during mini incision open surgery for CTS did not bring about significant advantages in terms of functional or symptomatic outcomes. Further, controlled trials on larger series are warranted to understand the beneficial effects of anti-adhesive materials during the surgical treatment of CTS. Key words: anti-adhesion gel, Boston questionnaire, carpal tunnel syndrome.

The risk factors for mortality in elderly patients with hip fractures: postoperative one-year results.

INTRODUCTION: Hip fractures in the elderly are associated with significant mortality. This study aimed to investigate the risk factors for mortality in elderly patients with hip fractures during a one-year period. METHODS: This was a prospective study which included consecutive isolated nonpathologic hip fractures in 74 (52 female, 22 male) patients in a level-1 trauma centre. These patients were 65 years or older and were ambulatory before the fracture. The patients were treated with hemiarthroplasty. The factors investigated were age, gender, nutritional status determined by blood albumin and total lymphocyte count, haemoglobin levels on the day of admission, mobilisation time after surgery, length of hospital stay, comorbidities, American Society of Anaesthesiologists (ASA) rating of operative risk, and the time period between injury and surgery. The patients were followed up for one year after surgery, or until death. RESULTS: In total, 15 patients died during the one-year period. Patient survival was 94.6 percent at 3 months, 81.1 percent at 6 months and 79.7 percent at 12 months. There were two in-hospital deaths. The factors significantly associated with mortality were patients with more than two comorbidities, an ASA score of III-IV, a blood albumin level of less than 3.5 g/dl and a total lymphocyte count of less than 1500 cells/ml on admission. However, after the multivariate analysis, an ASA score of III-IV, low total lymphocyte count, female gender and low haemoglobin levels on admission remained the independent and significant risk factors associated with a one-year mortality. CONCLUSION: This study confirms that a high ASA score, female gender, a lower lymphocyte count and low haemoglobin levels on admission are significant factors in assessing the one-year mortality in elderly patients with hip fractures. Predicting these risk factors improves the case management.

Evaluation and comparison of the antimicrobial efficacy of teicoplanin- and clindamycin-coated titanium implants: an experimental study.

We studied the effects of coating titanium implants with teicoplanin and clindamycin in 30 New Zealand White rabbits which were randomly assigned to three groups. The intramedullary canal of the left tibia of each rabbit was inoculated with 500 colony forming units of Staphylococcus aureus. Teicoplanin-coated implants were implanted into rabbits in group 1, clindamycin-coated implants into rabbits in group 2, and uncoated implants into those in group 3. All the rabbits were killed one week later. The implants were removed and cultured together with pieces of tibial bone and wound swabs. The rate of colonisation of the organisms in the three groups was compared. Organisms were cultured from no rabbits in group 1, one in group 2 but from all in group 3. There was no significant difference between groups 1 and 2 (p = 1.000). There were significant differences between groups 1 and 3 and groups 2 and 3 (p < 0.001). Significant protection against bacterial colonisation and infection was found with teicoplanin- and clindamycin-coated implants in this experimental model.

[Surgery of cardiac hydatid cysts. Experience of 39 years]. / Chirurgie des kystes hydatiques cardiaques. Trente-neuf ans d'expérience.

In some countries, Hydatidosis is a common public health problem but cardiac hydatid cysts are rarely observed. The evaluations of operative results and follow up of cardiac hydatid cases. Twenty-five consecutive unselected patients suffering from cardiac hydatidosis and operated on between 1967 and 2006 in Siyami Ersek Cardiothoracic and Vascular Surgery Center were retrospectively analyzed. In 10 of these patients the hydatid cyst was intracardiac, while in 13 patients cysts were extracavitary but located into the pericardium. In 2 patients the hydatid cyst was both intra and extracavitary. Mean age of the patients was 31+/-9.2. The female/male ratio was 17/8. The 12 patients with intracavitary and 2 patients wit extracavitary hydatid cysts were operated on with the aid of extracorporeal circulation. One patient died postoperatively. In one patient recurrence of the hydatidosis was observed. The majority of cases in previous publications were located in the left side of the heart. In our series, most were located in the right heart. In such cases clamping the pulmonary artery is mandatory to prevent pulmonary migration. Careful resection is important for prevention of recurrence.

Echinococcal cyst of the interventricular septum with right ventricular protrusion.

Although echinococcosis (echinococcal hydatidosis) is common in sheep-raising countries such as Turkey, cardiac involvement is rare; the presence of a hydatid cyst in the interventricular septum is rarer still. We report a case of hydatid cyst of the interventricular septum that was first revealed by 2-dimensional echocardiography and then confirmed by right ventricular angiography. The cyst was removed surgically under cardiopulmonary bypass. Within the context of the medical literature concerning this rare lesion, we discuss this case and 10 other cases of cardiac hydatidosis, previously unreported in the world literature, that we have treated from January 1967 through January 1987.