Comparison of COVID-19 patients who underwent thrombectomy with those in the pre-pandemic period in terms of etiology and prognosis.

OBJECTIVE: We aimed at determining the effectiveness of mechanical thrombectomy (MT) in patients with major vessel occlusion and infected with COVID-19, evaluating its clinical outcome and comparing it with non-COVID patients. PATIENTS AND METHODS: During the pandemic, 729 patients who underwent MT in stroke centers due to Acute Ischemic Stroke (AIS) with large vessel occlusion were evaluated. This study included 40 patients with a confirmed COVID-19 diagnosis by a positive PCR test between March 11, 2020, and December 31, 2020. These patients were compared to 409 patients who underwent MT due to major vessel occlusion between March 11, 2019, and December 31, 2019. RESULTS: Of the patients with AIS who are infected with COVID-19, 62.5% were males, and all patients have a median age of 63.5 ± 14.4 years. The median NIHSS score of the COVID-19 group was significantly higher than that of the non-COVID-19 groups. Dissection was significantly more in the COVID-19 group. The mortality rates at 3 months were higher in the COVID-19 groups compared to non-COVID-19 groups. CONCLUSIONS: This study revealed an increased frequency of dissection in patients with COVID-19. COVID-19-related ischemic strokes are associated with worse functional outcomes and higher mortality rates than non-COVID-19 ischemic strokes.

Risk factors for postoperative nausea and vomiting in pediatric patients undergoing ambulatory dental treatment.

AIM: This study aimed to determine the risk factors for postoperative nausea and vomiting (PONV) in children receiving dental treatment under general anesthesia and to identify the subcategories leading to risk formation. MATERIALS AND METHODS: The study comprised of 100 American Society of Anesthesiologists I patients aged 2-7 years who were administered dental treatment under general anesthesia. Patients were evaluated with regard to PONV risk. Eight different independent risk factors were identified as follows: age, gender, weight, duration of anesthesia, duration of recovery, postoperative pain, rescue analgesia, and type of dental treatment. Classification and regression trees method was used to choose the best predictor for PONV. RESULTS: The incidence of PONV was 25%. No significant difference was found between those with PONV and those without PONV with regard to gender, weight, duration of anesthesia, duration of recovery, or the type of dental treatment (P > 0.05). However, postoperative pain level and use of rescue analgesia with tenoxicam were both predictors of PONV (P < 0.05). For the postoperative pain (≤1.5) subgroup, age proved to be the best predictive variable. CONCLUSION: The risk limit for PONV was determined to be ≥5.5 years for children who underwent dental procedures under general anesthesia. Postoperative pain and rescue analgesia constituted risks for PONV.

An unusual cause of generalised seizure following cardiac surgery: with bolus cefazolin administration.

Although some of the aetiological factors of seizure, such as cerebral microemboli, cerebral oedema, hypoperfusion, cerebral hypoxia and metabolic encephalopathy cannot be completely controlled during cardiac surgery, cautious management of all steps in the procedure may prevent the administrative causes of seizure. Cefazolin, which is known to be a proconvulsant agent, may be a suspected agent of seizure complications in patients with renal insufficiency. Surprisingly, intravenous bolus administration of cefazolin may also trigger seizure in patients with normal renal function. In this case report, a complication of generalised seizure after cardiac surgery with intravenous bolus administration of cefazolin is described, along with a brief review of the literature.

Evaluation of preoperative and postoperative S-100B levels in children with chronic adenotonsillar hypertrophy: preliminary results.

OBJECTIVES: Upper air obstruction leads hypoxia, it is also known that S-100B levels increase by glial activations indicate cerebral hypoxic injury. This study aimed to evaluate the preoperative and postoperative S-100B levels in children with chronic adenotonsillar hypertrophy. PATIENTS AND METHODS: The study comprised 40 patients with indications for tonsillectomy and/or adenoidectomy following a diagnosis of chronic adenotonsillar hypertrophy and 40 age-gender matched control patients. Blood samples were taken from the patients preoperatively and at four weeks postoperatively. Preoperative and postoperative serum S-100B levels were analyzed. RESULTS: The serum S-100B levels in the preoperative period were found to be significantly higher compared to those of the control group (p < 0.05). The S-100B levels were significantly decreased in the postoperative period (p < 0.05). CONCLUSIONS: The development of chronic adenotonsillar hypertrophy would play a role in increased S-100B levels. This indicates that neuronal damage would exists in patients with chronic adenotonsillar hypertrophy.

Intracranial lipomas: clinical and imaging findings.

PURPOSE: Intracranial lipomas are rare congenital malformations. The most common location of intracranial lipoma is the midline cerebral structures. The most frequently seen symptoms are headaches, seizures, psychomotor retardation and cranial nerve deficits. This study aimed to evaluate the clinical and radiological findings of 14 patients with intracranial lipoma. MATERIALS AND METHODS: The study comprised 14 patients diagnosed with intracranial lipoma from computed tomography and magnetic resonance imaging taken after presentation at our hospital with headaches or seizures between January 2008 and April 2012. The cranial CT and MR images were evaluated by two experienced specialist radiologists. The lipoma localisation, size, morphology, any concomitant anomalies and findings of compression were recorded. RESULTS: The study comprised 14 patients diagnosed with intracranial lipoma. The lipoma was observed to be located pericallosal, adjacent to the mamillary body and the optic chiasm, interhemispheric, in the quadrigeminal cistern and sylvian fissure. 3 patients had a history of seizures. The others had headaches. CONCLUSIONS: If there are no concomitant central nervous system (CNS) anomalies, there are no significant clinical or neurological findings apart from headaches.

Heparin treatment for allergic conjunctivitis in the experimental BALB/c model.

PURPOSE: To compare the inhibitory effects of dexamethasone and heparin on the infiltration of mast cells in the conjunctiva by using a mouse allergic conjunctivitis model. METHODS: 24 Balb/c mice were divided into four groups: allergy group (positive control), dexamethasone group, heparin group, and negative control group, as groups 1, 2, 3, and 4, respectively. Each group comprised 6 mice, and experimental allergic conjunctivitis was developed in groups 1, 2, and 3. The mice in group 2 were treated with topical 0.1% dexamethasone eye ointment, and the mice in group 3 were treated topically with 5,000 IU/ml standard heparin. Both dexamethasone and heparin were instilled once a day for 4 days. Hanks' balanced salt solution was dropped into both eyes of the mice in group 4 instead of dexamethasone or heparin. Eyeballs and eyelids were removed from the mice in all groups while one eye of each animal was used for histopathological, the other for molecular biological examination. RESULTS: Mast cells, infiltrating the subconjunctival tissue, were significantly lower in group 2 (p < 0.0001), group 3 (p < 0.0001) and group 4 (p < 0.0001) when compared to group 1. CONCLUSIONS: Topical heparin could be a viable option in treating IgE-induced allergic eye disease since it is found to be as effective as topical dexamethasone in experimental acute allergic eye disease.

Trial of a new pain assessment tool in patients with low education: the full cup test.

AIMS AND SCOPE: Pain is subjective and pain assessment depends on the patient's self-report. The measurement of pain needs simple tools, especially in patients with low education. There are limited reports about pain assessment in this type of patient. The aims of the present study were to develop a pain scale that is easy for patients with low education to understand and to evaluate its usefulness in these patients. METHODS: A total of 128 adult non-demented patients presenting with headaches or rheumatologic pain were included in this study. The first phase of the study involved 114 patients and aimed to estimate the usefulness of the full cup test (FCT) compared with the visual analogue scale (VAS). The second phase of the study involved 23 patients with headaches selected randomly from the 114 patients and assessed the usefulness of the FCT for detecting changes in pain levels. The third phase of the study involved 14 patients with low education suffering from headaches and examined the usefulness of the FCT in these patients. RESULTS: The mean VAS and FCT scores were statistically correlated and reliable and did not differ significantly. Patients with low education understood the FCT more easily than the VAS. CONCLUSION: We concluded that the FCT is useful for both assessing and differentiating changes in pain, and is suitable for assessing pain in patients with low education.