Intracavitary amphotericin B in the treatment of intracranial aspergillosis.

Intracranial aspergillosis is a rare infectious disease of the central nervous system with high mortality rates. Our aim is to present 3 cases of intracranial aspergillosis who were surgically treated with intracavitary amphotericin B administration. First case was a 21-year-old male patient. Allogeneic stem cell transplantation treatment was performed because of aplastic anemia and vocal cord paralysis developed 10 days after treatment. Multiple aspergillosis abscesses were observed in the cranial magnetic resonance imaging (MRI). Cerebral lesions were excised and 0.3 cc of amphotericin B was applied locally. Second case was a 18-year-old male patient treated for acute lymphocytic leukemia. MRI was performed on the development of consciousness change during treatment and right frontal abscess was detected. The abscess was excised and amphotericin B was applied locally. Third case was a 45-year-old woman with mastectomy. She had chemotherapy after surgery and had blood stem cell transplantation because of pancytopenia. Two months after treatments, MRI was performed on the development of ataxia and a cerebellar abscess was detected. The abscess was surgically excised and local amphotericin B was applied. The first case deceased 2 weeks after surgery and the second case died 2.5 years later due to multi-organ failure. The third case is stil alive and neurologically stable after 14 years of surgical treatment. In intracranial aspergillosis, intracavitary amphotericin B therapy may be used as an adjunct after the surgical excision of abscess. This procedure may contributes to the regression of abscess or prevention of the recurrence. But comparative clinical studies are needed for more accurate conclusions.

Comparison of Sleep Quality and Sleepiness in Patients Operated for Pituitary Adenoma and in Healthy Individuals.

AIM: To investigate whether sleep quality and sleepiness of patients who undergo surgery for pituitary adenomas differ from healthy individuals. MATERIAL AND METHODS: Forty-four patients who were operated for pituitary adenomas and 44 healthy individuals, 88 subjects in total, were evaluated by a questionnaire. All questionnaires and scales were applied by the same researcher without the name of the participant in order to maintain consistency. Statistical analyses were conducted with the SPSS for Windows 23.00 package program. RESULTS: Of the 88 participants, 44 (50%) were patients who were operated for pituitary adenomas, while 44 (50%) were control subjects. 38 (43.2%) of the participants were male, 50 (56.8%) were female. The average age of the participants was 37 ± 12.24 years. The best sleep quality was found in 41-50 years group (7 patients). In the control group, 23 patients (52.3%) had a sleep quality index above 5 and 21 patients (47.7%) had a value below 5. In the control group, 8 patients (21.2%) between 21-30 years were found to have poor sleep quality by age. CONCLUSION: Sleepiness and sleep quality have physiological, social and psychological effects on individuals. There is no statistically significant difference in sleep quality and sleepiness scales between patients operated for pituitary adenomas and healthy individuals. However, it is recommended that polysomnography should be used to examine these patients in more detail.