Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 49
Filter
1.
J Plast Reconstr Aesthet Surg ; 95: 161-169, 2024 Jun 04.
Article in English | MEDLINE | ID: mdl-38924894

ABSTRACT

Similar to other developing countries, the elderly population has increased in Türkiye in the last 30 years. Due to this increase, there has been a rise in the number of elderly patients suffering from maxillofacial injuries. This retrospective study aimed to evaluate the data of patients with geriatric facial trauma treated in our trauma center between 2010 and 2022 and the leading types of injuries, their causes, accompanying findings, and preferred treatment methods according to sex and age. In the study, the demographic characteristics, including age, sex, comorbidities, causes and sites of injury, treatment options, accompanying injuries, and facial injury severity scores of 292 patients were analyzed. Among more than 4000 patients undergoing treatment for maxillofacial injuries screened from January 2010 to August 2022, 292 (166 males, 56%; age range, 65-98 years) fulfilled the eligibility criteria for the study, of whom 60 had a surgical operation. Falls were the most typical cause of injury (70.20%), followed by motor vehicle accidents (18.15%) and assaults (7.87%). Zygomaticomaxillary complex fractures were the most frequently encountered fracture type (n=126, 29.92%), followed by nose fractures (n=122), orbital fractures (n=85), and mandible fractures (n=72). It was observed that the fractures were managed by surgical intervention or conservative measures and that conservative treatment was mostly preferred at an increasing rate with advancing age. As the elderly population increases, so does the incidence of geriatric facial trauma. Due to increased age, deterioration of health, and increase in the number of comorbidities, surgical interventions are less preferred.

2.
Eplasty ; 22: e60, 2022.
Article in English | MEDLINE | ID: mdl-36545643

ABSTRACT

Background: Complex wounds are associated with a challenging healing process, prolonged hospitalization, increased treatment cost, and workforce loss. In this case series, negative pressure wound therapy (NPWT) with and without instillation and dwell time (NPWTi-d), closed incision negative pressure therapy (ciNPT), and open abdomen negative pressure therapy (OA-NPT) use in the management of complex wounds were examined. Methods: Fifty-nine patients (mean age, 55.0 ± 14.8 years) across secondary and tertiary care centers in Turkey were treated. Patients were examined, and a NPWT system was selected based on wound care needs. Dressing changes occurred every 2 to 7 days, depending on therapy type. Wound closure occurred through surgical closure or secondary intention. Results: Patient wound types consisted of acute wounds (n = 10), chronic wounds (n = 34), postoperative wound dehiscence (n = 9), and tumor resection/flap necrosis (n = 6). Thirty-six patients (61.0%) received NPWT, 16 (27.1%) received NPWTi-d, 5 (8.5%) received ciNPT, and 2 (3.4%) received OA-NPT. Average treatment duration was 19.7 ± 13.7 days. Surgical closure occurred in 45 patients, and secondary closure was observed in 13 patients; the remaining patient showed wound improvement. Wound healing complications were observed in 2 patients (scar formation and partial flap necrosis). Conclusions: Our findings indicate an association of negative pressure therapy with favorable wound healing outcome in complex wounds. Negative pressure therapy seems to be a useful treatment option to bridge wound care between initial debridement and final reconstruction.

3.
Injury ; 52(10): 2803-2812, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34391576

ABSTRACT

INTRODUCTION: Lamotrigine, an anticonvulsant drug with inhibition properties of multi-ion channels, has been shown to be able to attenuates secondary neuronal damage by influencing different pathways. The aim of this study was to look into whether lamotrigine treatment could protect the spinal cord from experimental spinal cord ischemia-reperfusion injury. MATERIALS AND METHODS: Thirty-two rats, eight rats per group, were randomly assigned to the sham group in which only laparotomy was performed, and to the ischemia, methylprednisolone and lamotrigine groups, where the infrarenal aorta was clamped for thirty minutes to induce spinal cord ischemia-reperfusion injury. Tissue samples belonging to spinal cords were harvested from sacrificed animals twenty-four hours after reperfusion. Tumor necrosis factor-alpha levels, interleukin-1 beta levels, nitric oxide levels, superoxide dismutase activity, catalase activity, glutathione peroxidase activity, malondialdehyde levels and caspase-3 activity were studied. Light and electron microscopic evaluations were also performed to reveal the pathological alterations. Basso, Beattie, and Bresnahan locomotor scale and the inclined-plane test was used to evaluate neurofunctional status at the beginning of the study and just before the animals were sacrificed. RESULTS: Lamotrigine treatment provided significant improvement in the neurofunctional status by preventing the increase in cytokine expression, increased lipid peroxidation and oxidative stress, depletion of antioxidant enzymes activity and increased apoptosis, all of which contributing to spinal cord damage through different paths after ischemia reperfusion injury. Furthermore, lamotrigine treatment has shown improved results concerning the histopathological and ultrastructural scores and the functional tests. CONCLUSION: These results proposed that lamotrigine may be a useful therapeutic agent to prevent the neuronal damage developing after spinal cord ischemia-reperfusion injury.


Subject(s)
Neuroprotective Agents , Reperfusion Injury , Spinal Cord Ischemia , Animals , Rats , Anticonvulsants/therapeutic use , Disease Models, Animal , Lamotrigine/therapeutic use , Neuroprotective Agents/pharmacology , Reperfusion Injury/drug therapy , Reperfusion Injury/prevention & control , Spinal Cord , Spinal Cord Ischemia/drug therapy
4.
World Neurosurg ; 150: e287-e297, 2021 06.
Article in English | MEDLINE | ID: mdl-33689849

ABSTRACT

OBJECTIVE: Inflammation and oxidative stress are 2 important factors in the emergence of paraplegia associated with spinal cord ischemia-reperfusion injury (SCIRI) after thoracoabdominal aortic surgery. Here it is aimed to investigate the effects of Ganoderma lucidum polysaccharide (GLPS) on SCIRI. METHODS: Rats were randomly selected into 4 groups of 8 animals each: sham, ischemia, methylprednisolone, and GLPS. To research the impacts of various pathways that are efficacious in formation of SCIRI, tumor necrosis factor α, interleukin 1ß, nitric oxide, superoxide dismutase levels, and catalase, glutathione peroxidase activities, malondialdehyde levels, and caspase-3 activity were measured in tissues taken from the spinal cord of rats in all groups killed 24 hours after ischemia reperfusion injury. The Basso, Beattie, and Bresnahan locomotor scale and inclined plane test were used for neurologic assessment before and after SCIRI. In addition, histologic and ultrastructural analyses of tissue samples in all groups were performed. RESULTS: SCIRI also caused marked increase in tissue tumor necrosis factor α, interleukin 1ß, nitric oxide, malondialdehyde levels, and caspase-3 activity, because of inflammation, increased free radical generation, lipid peroxidation, and apoptosis, respectively. On the other hand, SCIRI caused significant reduction in tissue superoxide dismutase, glutathione peroxidase, and catalase activities. Pretreatment with GLPS likewise diminished the level of the spinal cord edema, inflammation, and tissue injury shown by pathologic and ultrastructural examination. Pretreatment with GLPS reversed all these biochemical changes and improved the altered neurologic status. CONCLUSIONS: These outcomes propose that pretreatment with GLPS prevents progression of SCIRI by alleviating inflammation, oxidation, and apoptosis.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Polysaccharides/therapeutic use , Reishi/chemistry , Reperfusion Injury/drug therapy , Reperfusion Injury/pathology , Spinal Cord Injuries/drug therapy , Spinal Cord Injuries/pathology , Animals , Anti-Inflammatory Agents/therapeutic use , Antioxidants/metabolism , Apoptosis/drug effects , Disease Progression , Inflammation Mediators/metabolism , Locomotion , Male , Methylprednisolone/therapeutic use , Molecular Weight , Oxidative Stress/drug effects , Polysaccharides/chemistry , Rats , Rats, Sprague-Dawley , Spinal Cord/pathology , Spinal Cord/ultrastructure , Treatment Outcome
5.
Bosn J Basic Med Sci ; 21(2): 174-178, 2021 Apr 01.
Article in English | MEDLINE | ID: mdl-33091330

ABSTRACT

Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue sarcoma that originates from the dermis or subcutaneous tissue in the skin. While its prognosis is generally favorable, disease recurrence is relatively frequent. Because morbidity after repeated surgery may be significant, an optimized prediction of recurrence-free survival (RFS) has the potential to improve current management strategies. The purpose of this study was to investigate the prognostic value of the Ki-67 proliferation index with respect to RFS in patients with DFSP. We retrospectively analyzed data from 45 patients with DFSP. We calculated the Ki-67 proliferation index as the percentage of immunostained nuclei among the total number of tumor cell nuclei regardless of the intensity of immunostaining. We constructed univariate and multivariate Cox proportional hazards regression models to identify predictors of RFS. Among the 45 patients included in the study, 8 developed local recurrences and 2 had lung metastases (median follow-up: 95.0 months; range: 5.2-412.4 months). The RFS rates at 60, 120, and 240 months of follow-up were 83.8%, 76.2%, and 65.3%, respectively. The median Ki-67 proliferation index was 14%. Notably, we identified the Ki-67 proliferation index as the only independent predictor for RFS in multivariate Cox proportional hazards regression analysis (hazard ratio = 1.106, 95% confidence interval = 1.019-1.200, p = 0.016). In summary, our results highlight the potential usefulness of the Ki-67 proliferation index for facilitating the identification of patients with DFSP at higher risk of developing disease recurrences.


Subject(s)
Dermatofibrosarcoma/metabolism , Dermatofibrosarcoma/pathology , Ki-67 Antigen/metabolism , Neoplasm Recurrence, Local/epidemiology , Skin Neoplasms/metabolism , Skin Neoplasms/pathology , Adult , Aged , Cell Proliferation , Dermatofibrosarcoma/mortality , Disease-Free Survival , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Proportional Hazards Models , Retrospective Studies , Skin Neoplasms/mortality , Young Adult
6.
Turk Neurosurg ; 29(2): 279-284, 2019.
Article in English | MEDLINE | ID: mdl-30649822

ABSTRACT

AIM: To compare the outcomes of fluoroscopically guided transforaminal epidural steroid injections between L4-L5 paramedian disc herniation and L5-S1 paramedian disc herniation for the treatment of radicular pain. MATERIAL AND METHODS: A total of 593 patients treated by transforaminal epidural steroid injections for the treatment of L4-5 paramedian disc herniation and 504 patients treated by transforaminal epidural steroid injections for the treatment of L5-S1 paramedian disc herniation were included in the study. All the patients were regularly followed up for 12 weeks. Preprocedural Visual Analogue Scale (VAS) scores, 12-week post-procedural VAS scores and complications were recorded. RESULTS: The mean preprocedural and postprocedural VAS scores for L4-5 paramedian disc herniation were 63.09 ± 5.37 and 15.81 ± 3.58, respectively, and the mean preprocedural and postprocedural VAS scores for L5-S1paramedian disc herniation were 61.15 ± 5.45 and 27.06 ± 3.62, respectively, for radicular pain. There was a statistically significant difference between preprocedural and postprocedural VAS scores for L4-5 and L5-S1 paramedian disc herniation (p < 0.05). Transforaminal epidural steroid injections for L4-5 paramedian disc herniation were more effective than transforaminal epidural steroid injections for L5-S1 paramedian disc herniation. CONCLUSION: This study showed that transforaminal epidural steroid injections for L4-5 paramedian disc herniation were more effective than transforaminal epidural steroid injections for L5-S1 paramedian disc herniation in the 12-week follow-up period.


Subject(s)
Adrenal Cortex Hormones/administration & dosage , Intervertebral Disc Displacement/drug therapy , Adult , Female , Humans , Injections, Epidural , Lumbar Vertebrae , Male , Middle Aged , Treatment Outcome
7.
Turk Neurosurg ; 27(6): 952-961, 2017.
Article in English | MEDLINE | ID: mdl-27476927

ABSTRACT

AIM: To evaluate the effect of pregabalin pre-treatment on spinal cord ischemia-reperfusion (I/R) injury and compare with methylprednisolone (MP). MATERIAL AND METHODS: Thirty-two rats were randomly divided into four groups as follow: Group 1 (sham)(n=8), group 2 (ischemia only)(n=8), group 3 (30 mg/kg pregabalin)(n=8), and group 4 (30 mg/kg methylprednisolone)(n=8). Laparotomy was performed without aortic clamp in the sham group. All animals were sacrificed 24 hours after surgery. The spinal cord tissue samples were harvested and caspase-3 activity, tumor necrosis factor-alpha (TNF-α) and Interleukin-1 Beta (IL-1ß) levels, catalase (CAT) activity, glutathione peroxidase (GPx) activity, superoxide dismutase (SOD) levels malondialdehyde (MDA) levels and nitric oxide (NO) levels were analyzed to investigate the effects of different excitatory and inflammatory pathways in mechanism of I/R injury. Ultrastructural and histopathological examinations were carried out. Neurological recovery was measured by Basso, Beattie, Bresnahan (BBB) test and Inclined Plane Test. RESULTS: Decresead caspase-3 activity and decreased inflammatory markers like TNF-α, IL-1ß, and decresaed excitotatory pathways like CAT, GPx, MDA, NO and SOD were observed in both pregabalin pre-treatment and MP treatment groups. Pregabalin pre-treatment produced better ultrastructural results compared to MP treatment, as with histopathological examination. Pregabalin group showed better recovery compared to MP treament group according to BBB scoring system. CONCLUSION: Pregabalin pre-treatmet and MP treatment both has neuroprotective effect on I/R injury by decreasing caspase dependant apoptosis, and inflammatory and oxidative stress markers. In addition, pregabalin pre-treatment had better clinical effects compared to MP treatment.


Subject(s)
Neuroprotective Agents/pharmacology , Oxidative Stress/drug effects , Pregabalin/pharmacology , Reperfusion Injury/pathology , Spinal Cord Ischemia/pathology , Animals , Apoptosis/drug effects , Male , Methylprednisolone/pharmacology , Rats
8.
J Med Food ; 19(6): 601-6, 2016 Jun.
Article in English | MEDLINE | ID: mdl-27183321

ABSTRACT

Garlic has been used as a food as well as a component of traditional medicine. Aged garlic extract (AGE) is claimed to promote human health through antioxidant/anti-inflammatory activities with neuroprotective effects. We evaluated the possible beneficial effect of AGE neurologically, pathologically, ultrastructurally, and biochemically in a spinal cord ischemia-reperfusion (I/R) model of rats. Twenty-four Sprague-Dawley rats were divided into three groups: sham (no I/R), I/R, and AGE (I/R+AGE); each group consisted of eight animals. Animals were evaluated neurologically with the Basso, Beattie, and Bresnahan (BBB) scoring system. The spinal cord tissue samples were harvested for pathological and ultrastructural examinations. Oxidative products (Malondialdehyde, nitric oxide), antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase), inflammatory cytokines (tissue tumor necrosis factor alpha, interleukin-1), and caspase-3 activity were analyzed. The AGE group had significantly higher BBB scores than the I/R group. Pathologically, AGE group revealed reduced degree of ischemia and spinal cord edema. Ultrastructural results also showed preservation of tissue structure in the AGE group. Oxidative product levels of the I/R group were significantly higher than both the other groups, and antioxidant enzyme levels of AGE group were significantly higher than the I/R group. There was also significant difference between the sham and AGE groups in terms of total antioxidant enzyme levels. Furthermore, AGE treatment significantly reduced the inflammatory cytokines and caspase-3 activity than the I/R group. This study demonstrates the considerable neuroprotective effect of AGE on the neurological, pathological, ultrastructural, and biochemical status of rats with I/R-induced spinal cord injury.


Subject(s)
Garlic/chemistry , Neurons/drug effects , Neuroprotective Agents/administration & dosage , Plant Extracts/administration & dosage , Reperfusion Injury/drug therapy , Animals , Caspase 3/metabolism , Disease Models, Animal , Glutathione Peroxidase/metabolism , Humans , Male , Malondialdehyde/metabolism , Neurons/metabolism , Nitric Oxide/metabolism , Rats , Rats, Sprague-Dawley , Spinal Cord/drug effects , Spinal Cord/metabolism , Spinal Cord Ischemia/therapy , Superoxide Dismutase/metabolism , Tumor Necrosis Factor-alpha/metabolism
9.
J Stroke Cerebrovasc Dis ; 25(5): 1196-1207, 2016 May.
Article in English | MEDLINE | ID: mdl-26935117

ABSTRACT

OBJECTIVES: Curcumin is a molecule found in turmeric root that possesses anti-inflammatory and antioxidant properties and has been widely used to treat neurodegenerative diseases. We investigated whether curcumin stimulates the neurorepair process and improves locomotor function in a rat model of spinal cord ischemia-reperfusion injury. METHODS: Thirty-two Wistar albino rats (190-220 g) were randomly allocated into 4 groups of 8 rats each: 1 sham-operated group and 3 ischemia-reperfusion injury groups that received intraperitoneal injections of saline vehicle, methylprednisolone (MP, 30 mg/kg following induction of ischemia-reperfusion [IR] injury), or curcumin (200 mg/kg for 7 days before induction of IR injury). Spinal cord IR injury was induced by occlusion of the abdominal aorta for 30 minutes. After 24 hours of reperfusion, locomotor function was assessed using the Basso, Beattie, and Bresnahan scale. All animals were sacrificed. Spinal cord tissues were harvested to evaluate histopathological and ultrastructural alterations and to analyze levels of malondialdehyde, tumor necrosis factor-alpha, interleukin-1 beta, nitric oxide, and caspase-3, as well as enzyme activities of superoxide dismutase and glutathione peroxidase. RESULTS: Intraperitoneal administration of curcumin significantly reduced inflammatory cytokine expression, attenuated oxidative stress and lipid peroxidation, prevented apoptosis, and increased antioxidant defense mechanism activity in comparison to treatment with MP or saline. Histopathological and ultrastructural abnormalities were significantly reduced in curcumin-treated rats compared to the MP- and saline-treated groups. Furthermore, curcumin significantly improved locomotor function. CONCLUSIONS: Curcumin treatment preserves neuronal viability against inflammation, oxidative stress, and apoptosis associated with ischemia-reperfusion injury.


Subject(s)
Anti-Inflammatory Agents/pharmacology , Antioxidants/pharmacology , Curcumin/pharmacology , Inflammation Mediators/metabolism , Neuroprotective Agents/pharmacology , Oxidative Stress/drug effects , Reperfusion Injury/prevention & control , Spinal Cord Ischemia/drug therapy , Spinal Cord/drug effects , Animals , Apoptosis/drug effects , Biomarkers/metabolism , Cytoprotection , Disease Models, Animal , Lipid Peroxidation/drug effects , Locomotion/drug effects , Male , Motor Activity/drug effects , Rats, Wistar , Reperfusion Injury/metabolism , Reperfusion Injury/pathology , Reperfusion Injury/physiopathology , Spinal Cord/metabolism , Spinal Cord/physiopathology , Spinal Cord/ultrastructure , Spinal Cord Ischemia/metabolism , Spinal Cord Ischemia/pathology , Spinal Cord Ischemia/physiopathology , Time Factors
10.
J Neurosurg Spine ; 24(6): 949-59, 2016 Jun.
Article in English | MEDLINE | ID: mdl-26871652

ABSTRACT

OBJECTIVE Ischemia-reperfusion (I/R) injury of the spinal cord following thoracoabdominal aortic surgery remains the most devastating complication, with a life-changing impact on the patient. Thymoquinone (TQ), the main constituent of the volatile oil from Nigella sativa seeds, is reported to possess strong antioxidant, antiinflammatory, and antiapoptotic properties. This study investigated the effects of TQ administration following I/R injury to the spinal cord. METHODS Thirty-two rats were randomly allocated into 4 groups. Group 1 underwent only laparotomy. For Group 2, aortic clip occlusion was introduced to produce I/R injury. Group 3 was given 30 mg/kg of methylprednisolone intraperitoneally immediately after the I/R injury. Group 4 was given 10 mg/kg of TQ intraperitoneally for 7 days before induction of spinal cord I/R injury, and administration was continued until the animal was euthanized. Locomotor function (Basso, Beattie, and Bresnahan scale and inclined plane test) was assessed at 24 hours postischemia. Spinal cord tissue samples were harvested to analyze tissue concentrations of malondialdehyde, nitric oxide, tumor necrosis factor-α, interleukin-1, superoxide dismutase, glutathione-peroxidase, catalase, and caspase-3. In addition, histological and ultrastructural evaluations were performed. RESULTS Thymoquinone treatment improved neurological outcome, which was supported by decreased levels of oxidative products (malondialdehyde and nitric oxide) and proinflammatory cytokines (tumor necrosis factor-α and interleukin-1), increased activities of antioxidant enzymes (superoxide dismutase, glutathione-peroxidase, and catalase), as well as reduction of motor neuron apoptosis. Light microscopy and electron microscopy results also showed preservation of tissue structure in the treatment group. CONCLUSIONS As shown by functional, biochemical, histological, and ultrastructural analysis, TQ exhibits an important protective effect against I/R injury of the spinal cord.


Subject(s)
Apoptosis/drug effects , Benzoquinones/pharmacology , Neuroprotective Agents/pharmacology , Oxidative Stress/drug effects , Reperfusion Injury/drug therapy , Spinal Cord Ischemia/drug therapy , Animals , Antioxidants/metabolism , Apoptosis/physiology , Caspase 3/metabolism , Disease Models, Animal , Interleukin-1/metabolism , Male , Malondialdehyde/metabolism , Motor Neurons/drug effects , Motor Neurons/pathology , Motor Neurons/physiology , Neuroimmunomodulation/drug effects , Neuroimmunomodulation/physiology , Nitric Oxide/metabolism , Oxidative Stress/physiology , Random Allocation , Rats, Wistar , Reperfusion Injury/pathology , Reperfusion Injury/physiopathology , Spinal Cord/drug effects , Spinal Cord/pathology , Spinal Cord/physiopathology , Spinal Cord Ischemia/pathology , Spinal Cord Ischemia/physiopathology , Tumor Necrosis Factor-alpha/metabolism
11.
Injury ; 46(11): 2146-55, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26298021

ABSTRACT

INTRODUCTION: Ganoderma lucidum (G. lucidum) is a mushroom belonging to the polyporaceae family of Basidiomycota and has widely been used as a traditional medicine for thousands of years. G. lucidum has never been studied in traumatic spinal cord injury. The aim of this study is to investigate whether G. lucidum polysaccharides (GLPS) can protect the spinal cord after experimental spinal cord injury. MATERIALS AND METHODS: Rats were randomized into five groups of eight animals each: control, sham, trauma, GLPS, and methylprednisolone. In the control group, no surgical intervention was performed. In the sham group, only a laminectomy was performed. In all the other groups, the spinal cord trauma model was created by the occlusion of the spinal cord with an aneurysm clip. In the spinal cord tissue, caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, nitric oxide levels, and superoxide dismutase levels were analysed. Histopathological and ultrastructural evaluations were also performed. Neurological evaluation was performed using the Basso, Beattie, and Bresnahan locomotor scale and the inclined-plane test. RESULTS: After traumatic spinal cord injury, increases in caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels were detected. After the administration of GLPS, decreases were observed in tissue caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels. Furthermore, GLPS treatment showed improved results in histopathological scores, ultrastructural scores, and functional tests. CONCLUSIONS: Biochemical, histopathological, and ultrastructural analyses and functional tests reveal that GLPS exhibits meaningful neuroprotective effects against spinal cord injury.


Subject(s)
Neuroprotective Agents/pharmacology , Polysaccharides/pharmacology , Reishi/chemistry , Spinal Cord Injuries/pathology , Spinal Cord/pathology , Animals , Disease Models, Animal , Male , Rats , Rats, Wistar , Spinal Cord/drug effects , Spinal Cord Injuries/drug therapy
12.
Plast Surg (Oakv) ; 23(1): 9-14, 2015.
Article in English | MEDLINE | ID: mdl-25821766

ABSTRACT

BACKGROUND: Peripheral nerves can be injured by congenital, mechanical, thermal or chemical causes. Peripheral nerve injuries are increasing in frequency, particularly in countries that are becoming more industrialized. Nerve and extremity injuries result in work loss and high treatment costs, and can lead to separation of patients from their social environment. Failure of nerve repair causes muscle functional losses, sensory losses and painful neuropathies. OBJECTIVES: To compare the effects of condensed polytetrafluoroethylene (cPTFE) and cPTFE-extractum cepae-heparin-allantoin (cPTFE-EHA) gel compound on nerve and functional recovery, and the prevention of adhesion and scar tissue formation after total peripheral nerve injury repaired by primary suture in a rat model. RESULTS: cPTFE alone and cPTFE-EHA gel was found to provide better functional recovery and nerve regeneration compared with primary repair only. In the macroscopic evaluation, the cPTFE-EHA gel was found to have no negative effect on wound healing and, despite increasing extra-neural scar tissue and adhesions, it had no negative effect on nerve function; in addition, it facilitated functional recovery. CONCLUSIONS: Compared with the cPTFE application alone, the application of perineural cPTFE-EHA gel during peripheral nerve surgery appeared to provide better functional recovery without causing any significant changes in epineural and extraneural scar tissue formation.


HISTORIQUE: Les nerfs périphériques peuvent être soumis à des lésions congénitales, mécaniques, thermiques ou chimiques. Les lésions des nerfs périphériques sont de plus en plus fréquentes, surtout dans les pays qui s'industrialisent. Les lésions des nerfs et des membres s'associent à des pertes d'emploi et à des coûts de traitement élevés. Elles peuvent également écarter les patients de leur environnement social. L'échec de la réparation nerveuse cause une perte fonctionnelle des muscles, des pertes sensorielles et des neuropathies douloureuses. OBJECTIFS: Comparer les effets du polytétrafluoréthylène condensé (PTFEc) et d'un composé de PTFEc et de gel contenant de l'extrait d'oignon, de l'héparine et de l'allantoïne (PTFEc-EHA) sur le rétablissement nerveux et fonctionnel et sur la prévention de la formation d'adhérences et de tissus cicatriciels après une lésion totale des nerfs périphériques réparée par une suture primaire chez un modèle de rat. RÉSULTATS: Il a été établi que le PTFEc seul et le PTFEc-EHA assurait un meilleur rétablissement fonctionnel et une meilleure régénération nerveuse que la réparation primaire seule. Lors de l'évaluation macroscopique, le PTFEc-EHA n'avait pas d'effet négatif sur la cicatrisation de la plaie et, malgré la formation d'adhérences et de tissus cicatriciels extraneuraux, il ne nuisait pas à la fonction nerveuse. Par ailleurs, il facilitait le rétablissement fonctionnel. CONCLUSIONS: Par rapport à la seule application de PTFEc, l'application de PTFEc-EHA périneurale pendant une chirurgie des nerfs périphériques semblait assurer un meilleur rétablissement fonctionnel sans vraiment aggraver la formation de tissus cicatriciels extraneuraux.

13.
Spine J ; 15(3): 522-9, 2015 Mar 01.
Article in English | MEDLINE | ID: mdl-25452015

ABSTRACT

BACKGROUND CONTEXT: Epidural fibrosis is a major challenge in spine surgery, with some patients having recurrent symptoms secondary to excessive formation of scar tissue resulting in neurologic compression. One of the most important factors initiating the epidural fibrosis is assumed to be the transforming growth factor-1ß (TGF-1ß). Rosuvastatin (ROS) has shown to demonstrate preventive effects over fibrosis via inhibiting the TGF-1ß. PURPOSE: We hypothesized that ROS might have preventive effects over epidural fibrosis through the inhibition of TGF-1ß pathways. STUDY DESIGN: Experimental animal study. METHODS: Forty-eight adult male Wistar Albino rats were equally and randomly divided into four groups (laminectomy, spongostan, topical ROS, and systemic ROS). Laminectomy was performed at the L3 level in all rats. Four weeks later, the extent of epidural fibrosis was assessed both macroscopically and histopathologically. RESULTS: Our data revealed that topical application and systemic administration of ROS both were effective in reducing epidural fibrosis formation. Furthermore, the systemic administration of ROS yielded better results than topical application. CONCLUSIONS: Both topical application and systemic administration of ROS show meaningful preventive effects over epidural fibrosis through multiple mechanisms. The results of our study provide the first experimental evidence of the preventive effects of ROS over epidural fibrosis.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Cicatrix/prevention & control , Epidural Space/pathology , Fluorobenzenes/administration & dosage , Laminectomy/adverse effects , Pyrimidines/administration & dosage , Sulfonamides/administration & dosage , Transforming Growth Factor beta1/antagonists & inhibitors , Administration, Topical , Animals , Cicatrix/etiology , Disease Models, Animal , Epidural Space/drug effects , Fibrosis , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Intubation, Gastrointestinal , Male , Rats , Rats, Wistar , Rosuvastatin Calcium
14.
Aging Male ; 18(2): 97-9, 2015 Jun.
Article in English | MEDLINE | ID: mdl-24844632

ABSTRACT

BACKGROUND: The elderly population is more likely to be affected by accidents, such as burns, compared to younger populations because of their diminished host defense. There is limited data about the outcomes of elderly burn patients requiring hospitalization. METHODS: In this retrospective study, we assessed the epidemiology and outcomes of burn injuries in elderly patients (>60 years old) admitted to a burn unit of a tertiary medical center based on patient characteristics, type and extent of burns, treatment, hospital stay and mortality rates. RESULTS: Forty-eight elderly burn patients among 870 burn patients during the study period were evaluated. Fire was the most common cause of burns (77.1%). Most of the burns involved more than 20% of total body surface area. Twenty-six (54.2%) patients died during hospitalization. Although burn surface area slightly and non-significantly increased in patients over 75 years, there was a significantly increased mortality rate in these patients. Multivariate linear regression analysis revealed burn area and age as independent associates of mortality. CONCLUSION: Our data show a high mortality rate in elderly burn patients. Extensive burns and increased age seem to increase the mortality risk.


Subject(s)
Burns/epidemiology , Hospital Mortality , Hospitalization/statistics & numerical data , Aged , Aged, 80 and over , Burn Units/statistics & numerical data , Female , Humans , Length of Stay , Male , Middle Aged , Prognosis , Retrospective Studies , Survival Rate
15.
Eur J Pharmacol ; 741: 45-54, 2014 Oct 15.
Article in English | MEDLINE | ID: mdl-25084223

ABSTRACT

Rosuvastatin, which is a potent statin, has never been studied in traumatic spinal cord injury. The aim of this study was to investigate whether rosuvastatin treatment could protect the spinal cord after experimental spinal cord injury. Rats were randomized into the following five groups of eight animals each: control, sham, trauma, rosuvastatin, and methylprednisolone. In the control group, no surgical intervention was performed. In the sham group, only laminectomy was performed. In all the other groups, the spinal cord trauma model was created by the occlusion of the spinal cord with an aneurysm clip. In the spinal cord tissue, caspase-3 activity, tumor necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, nitric oxide levels, and superoxide dismutase levels were analyzed. Histopathological and ultrastructural evaluations were also performed. Neurological evaluation was performed using the Basso, Beattie, and Bresnahan locomotor scale and the inclined-plane test.After traumatic spinal cord injury, increases in caspase-3 activity, tumor necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels were detected. In contrast, the superoxide dismutase levels were decreased. After the administration of rosuvastatin, decreases were observed in the tissue caspase-3 activity, tumor necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels. In contrast, tissue superoxide dismutase levels were increased. Furthermore, rosuvastatin treatment showed improved results concerning the histopathological scores, the ultrastructural score and the functional tests. Biochemical, histopathological, ultrastructural analysis and functional tests revealed that rosuvastatin exhibits meaningful neuroprotective effects against spinal cord injury.


Subject(s)
Fluorobenzenes/therapeutic use , Neuroprotective Agents/therapeutic use , Pyrimidines/therapeutic use , Spinal Cord Injuries/pathology , Spinal Cord Injuries/prevention & control , Sulfonamides/therapeutic use , Animals , Male , Rats , Rats, Wistar , Rosuvastatin Calcium , Thoracic Vertebrae , Treatment Outcome
16.
Injury ; 2014 Mar 31.
Article in English | MEDLINE | ID: mdl-24742980

ABSTRACT

This article has been withdrawn at the request of the editor since, in breach of ethical guidelines and journal policies, the manuscript was submitted without the full knowledge and consent of all authors listed. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

18.
J Neurosci Rural Pract ; 4(3): 361-2, 2013 Jul.
Article in English | MEDLINE | ID: mdl-24250189
SELECTION OF CITATIONS
SEARCH DETAIL
...