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Lucia K, Setzer M, Jussen D, Prinz V, Kilinc F, Seifert V, Czabanka M. Comparison of head positioning using the Mayfield skull clamp versus padded headrest in anterior cervical discectomy and fusion surgery. J Spine Surg 2024; 10:80-88. [PMID: 38567005 PMCID: PMC10982923 DOI: 10.21037/jss-23-117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/10/2023] [Indexed: 04/04/2024]
Abstract
Background Anterior cervical discectomy and fusion (ACDF) is a commonly implemented surgical intervention for a variety of pathologies affecting the cervical spine. The current literature and daily practice reveal variations on patient head positioning for this procedure with both rigid fixations in the Mayfield skull clamp as well as use of a padded headrest being used. In this study, we therefore examine whether patients undergoing surgery using head positioning in the Mayfield skull clamp versus a padded headrest differ in regard to adverse events, surgical parameters and clinical outcome. Methods A single-center, retrospective analysis of 121 patients treated with ACDF for degenerative disease, traumatic cervical spine injury and infectious disease between November 2019 and March 2023 was performed. Clinical and imaging data for 59 patients positioned in the Mayfield skull clamp and 62 patients positioned in a padded headrest were evaluated using electronic medical records. In addition to demographic data, surgical indications, procedures performed were analyzed for both groups. Level of training (chief, attending and resident), length of surgery and intraoperative radiation exposure (measured by dose area product and total radiation time) were also examined. Finally, modified Rankin Scale (mRS) preoperatively and at last follow-up as well as adverse events were compared between groups. Results We found no statistically significant differences between the Mayfield and headrest groups regarding surgical indications (P=0.583), procedures performed (P=0.069), level of training of the surgeon (P=0.218), length of surgery (P=0.752), adverse events (P=0.619) or neurological impairment (P=0.080) following surgical intervention. There was a significant difference regarding dose area product between both groups with patients positioned in the Mayfield skull clamp showing lower mean levels of radiation than those in the headrest group (99 versus 131 cGy/cm2; P=0.003). Conclusions Patient positioning using the Mayfield skull clamp may reduce required radiation exposure during ACDF procedures versus use of a padded headrest.
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Affiliation(s)
- Kristin Lucia
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Matthias Setzer
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Daniel Jussen
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Vincent Prinz
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Fatma Kilinc
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Volker Seifert
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Marcus Czabanka
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
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Kilinc F, Gessler F, Kessel J, Dubinski D, Won SY, Tanneberger A, Ghanaati S, Prinz V, Czabanka M, Setzer M, Freiman T, Behmanesh B. From the Oral Cavity to the Spine: Prevalence of Oral Cavity Infections in Patients with Pyogenic Spinal Infection. J Clin Med 2024; 13:1040. [PMID: 38398352 PMCID: PMC10889745 DOI: 10.3390/jcm13041040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
Background incidence of pyogenic spinal infections has increased in recent years. In addition to treating the spinal infection, optimal care also includes identifying the source of the pyogenic spinal infection and the presence of other infections. The aim of this study is to elucidate the prevalence of oral cavity infection (OCI) within this patient cohort. Methods As part of a prospective study conducted from 2016 to 2021, the number of patients with dental infections was investigated by means of an orthopantomogram (OPG) and subsequent dental examination. Results The presence of an oral infection was investigated in 55 (47%) of 118 patients by an OPG, 29 (53%) of whom had a corresponding abnormality of the oral cavity. In addition to the spinal infection, patients with an oral cavity infection revealed an increased incidence of endocarditis, sepsis and brain abscess. A spinal epidural abscess, a multilevel affection of the infection, and an elevated CRP value were also found in patients with a co-existing oral cavity infection. Back pain assessed at admission and 3 months after surgery was also more pronounced in patients with an oral cavity infection. Neurological deficits were often present in patients with spinal and oral cavity infection. Conclusions The presence of an oral cavity infection has proven to be one of the important factors in the detection of the source of the pyogenic spinal infection. In addition, a pronounced spinal affection and frequent co-infections were seen in patients with an oral cavity infection.
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Affiliation(s)
- Fatma Kilinc
- Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt, Germany; (F.K.); (V.P.); (M.C.); (M.S.)
| | - Florian Gessler
- Department of Neurosurgery, University Medicine of Rostock, 18057 Rostock, Germany; (F.G.); (D.D.); (S.-Y.W.); (T.F.)
| | - Johanna Kessel
- Department of Medicine, Infectious Diseases Unit, Goethe University Hospital, 60596 Frankfurt, Germany;
| | - Daniel Dubinski
- Department of Neurosurgery, University Medicine of Rostock, 18057 Rostock, Germany; (F.G.); (D.D.); (S.-Y.W.); (T.F.)
| | - Sae-Yeon Won
- Department of Neurosurgery, University Medicine of Rostock, 18057 Rostock, Germany; (F.G.); (D.D.); (S.-Y.W.); (T.F.)
| | - Anna Tanneberger
- Department of Maxillofacial Surgery, Goethe University Hospital, 60596 Frankfurt, Germany; (A.T.); (S.G.)
| | - Shahram Ghanaati
- Department of Maxillofacial Surgery, Goethe University Hospital, 60596 Frankfurt, Germany; (A.T.); (S.G.)
| | - Vincent Prinz
- Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt, Germany; (F.K.); (V.P.); (M.C.); (M.S.)
| | - Marcus Czabanka
- Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt, Germany; (F.K.); (V.P.); (M.C.); (M.S.)
| | - Matthias Setzer
- Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt, Germany; (F.K.); (V.P.); (M.C.); (M.S.)
| | - Thomas Freiman
- Department of Neurosurgery, University Medicine of Rostock, 18057 Rostock, Germany; (F.G.); (D.D.); (S.-Y.W.); (T.F.)
| | - Bedjan Behmanesh
- Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt, Germany; (F.K.); (V.P.); (M.C.); (M.S.)
- Department of Neurosurgery, University Medicine of Rostock, 18057 Rostock, Germany; (F.G.); (D.D.); (S.-Y.W.); (T.F.)
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Kilinc F, Setzer M, Behmanesh B, Jussen D, Gessler F, Bayerl S, Kempf VAJ, Kessel J, Czabanka M, Prinz V. Effectiveness of outpatient parenteral antimicrobial therapy (OPAT) for patients with cranial infection. Front Med (Lausanne) 2023; 10:1202969. [PMID: 37942421 PMCID: PMC10628042 DOI: 10.3389/fmed.2023.1202969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
Objective Outpatient parenteral antimicrobial therapy (OPAT) is a well-established and cost-effective method for improving the efficient use of healthcare resources. However, only a few centres in Germany perform it. Here we analysed OPAT for the treatment of patients with cranial infections in our neurosurgical department. Methods This retrospective study analysed patients with cranial infections and the need for intravenous (i.v.) antimicrobial treatment between 2018 and 2021.All diagnosed intracranial infections were defined into two infection categories such as long-term antimicrobial treatment and short-term antimicrobial treatment. All included patients were discharged with a peripherally inserted central catheter (PICC) line. Prior to discharge, all patients received training in the safe administration of their medications via the PICC line. The duration of OPAT and the rate of readmission after OPAT were analysed. Results We identified a total of 45 patients treated with OPAT for cranial infections. Intradural involvement was present in 40 cases (88.9%). The average length of hospital stay for this cohort after surgical treatment was 45 ± 15 days. 5 patients were treated for soft tissue/skin infection. Surgery was not required in this cohort. The mean hospital stay for this cohort was 8 ± 6 days. Gram-positive organisms were isolated in most cases (53.3%). The most common pathogens were Staphylococcus aureus followed by other Staphylococcus species. For all included patients, OPAT was performed after discharge for an average of 43.1 ± 14 days. There were five cases of readmission due to treatment failure. No serious adverse events or complications of OPAT were observed. Conclusion OPAT enables better patient-centred healthcare close to home. The length of hospital stay can be reduced and adverse events due to prolonged hospitalisation can be avoided.
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Affiliation(s)
- Fatma Kilinc
- Department of Neurosurgery, Goethe University Hospital, Frankfurt am Main, Germany
| | - Matthias Setzer
- Department of Neurosurgery, Goethe University Hospital, Frankfurt am Main, Germany
| | - Bedjan Behmanesh
- Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany
| | - Daniel Jussen
- Department of Neurosurgery, Goethe University Hospital, Frankfurt am Main, Germany
| | - Florian Gessler
- Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany
| | - Simon Bayerl
- Department of Neurosurgery, Charité-Universitätsmedizin, Berlin, Germany
| | - Volkhard A. J. Kempf
- Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Frankfurt am Main, Germany
- University Center of Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
- University Center of Competence for Infection Control of the State of Hesse, Frankfurt am Main, Germany
| | - Johanna Kessel
- University Center of Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
- Department of Medicine, Infectious Diseases Unit, Goethe University Hospital, Frankfurt am Main, Germany
| | - Marcus Czabanka
- Department of Neurosurgery, Goethe University Hospital, Frankfurt am Main, Germany
| | - Vincent Prinz
- Department of Neurosurgery, Goethe University Hospital, Frankfurt am Main, Germany
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Kilinc F, Setzer M, Behmanesh B, Jussen D, Geßler F, Prinz V, Czabanka M. Surgical management and clinical outcome of cervical, thoracic and thoracolumbar spinal tuberculosis in a middle-European adult population. Sci Rep 2023; 13:7000. [PMID: 37117321 PMCID: PMC10147912 DOI: 10.1038/s41598-023-34178-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 04/25/2023] [Indexed: 04/30/2023] Open
Abstract
Spinal tuberculosis is due to globalization no longer a disease limited to developing nations. It remains in Germany a rarity and still a difficult diagnosis. Here we analyzed patients with spinal tuberculosis treated at our neurosurgical department. According to the infected anatomic segment, patients were assigned in one of three groups. Surgery was performed when neurological deficit due to mechanical compression, deformity, instability, severe pain, necrotic bone or failure to respond to anti-tuberculous treatment were observed. We identified 34 patients with spinal tuberculosis who underwent surgical treatment. In the cervical spinal tuberculosis group, there were 15 cases (46.9%) In most cases treatment consisted of spinal instrumentation. In the thoracic group, 10 cases (29.4%) were observed. The treatment was performed by dorsolateral spinal instrumentation. For the thoracolumbar group, 9 cases (26.4%) were observed. In most cases dorsolateral spinal instrumentation was performed. One patient in the first group and one patient in the third group relapsed after operation. A second surgery was necessary. Patients with chronic back pain, immigration background and/or neurological deficit spinal TB should be considered as a differential diagnosis. Combined surgical intervention and medical treatment is associated with a favorable outcome.
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Affiliation(s)
- Fatma Kilinc
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany.
| | - Matthias Setzer
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany
| | - Bedjan Behmanesh
- Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany
| | - Daniel Jussen
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany
| | - Florian Geßler
- Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany
| | - Vincent Prinz
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany
| | - Marcus Czabanka
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany
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Kilinc F, Setzer M, Behmanesh B, Jussen D, Gessler F, Keil F, Kempf VAJ, Kessel J, Czabanka M, Prinz V. Safety and feasibility of outpatient parenteral antimicrobial therapy for patients with spinal infection. Sci Rep 2023; 13:6863. [PMID: 37100824 PMCID: PMC10133347 DOI: 10.1038/s41598-023-33502-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 04/13/2023] [Indexed: 04/28/2023] Open
Abstract
Outpatient parenteral antimicrobial therapy (OPAT) is a cost-effective method of administering intravenous antimicrobial therapy. Although OPAT is well established in the UK and US healthcare systems, few centres in Europe perform it. Here we analysed OPAT for the treatment of patients with spinal infections at our institution. In this retrospective study, patients with spinal infection who required intravenous (i.v.) antimicrobial treatment between 2018 and 2021 were analysed. The duration of short-term antimicrobial treatment for skin and soft tissue infections and complex infections requiring long-term antimicrobial treatment, such as spinal bone or joint infections, were analysed. All patients were discharged with a peripherally inserted central catheter (PICC) line. Prior to discharge, all patients received training in the safe administration of their medications via the PICC line. The duration of OPAT and the rate of readmission after OPAT were analysed. For this study a total of 52 patients who were treated via OPAT due to spinal infections were analyzed. In 35 cases (69.2%) complex spinal infection was reason for i.v. antimicrobial therapy. Surgery was required in 23 of these 35 patients (65.7%). The average hospital stay for these patients was 12 ± 6 days. The remaining 17 patients were treated for an infection of the soft tissue or the skin and hospital stay for these patients was on average 8 ± 4 days. Gram-positive organisms were isolated in 64.4%. Staphylococcus aureus followed by other Staphylococcus species, was the most common detected organism. After discharging i.v. antimicrobial treatment was given for an average of 20 ± 14 days. The duration of antimicrobial treatment for soft tissue was 10.8 ± 8 days, and for complex infections 25.1 ± 18 days. The mean follow-up was 21 ± 14 months. There was one case of readmission due to treatment failure. There were no difficulties encountered in implementing OPAT. OPAT is a feasible and effective option for delivering intravenous antimicrobial therapy to patients with spinal infections who can be managed without hospitalisation. OPAT offers patient-centred treatment at home while avoiding the risks associated with hospitalisation, with high levels of patient satisfaction.
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Affiliation(s)
- Fatma Kilinc
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt Am Main, Germany.
| | - Matthias Setzer
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt Am Main, Germany
| | - Bedjan Behmanesh
- Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany
| | - Daniel Jussen
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt Am Main, Germany
| | - Florian Gessler
- Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany
| | - Fee Keil
- Department of Diagnostic and Interventional Radiology, Goethe University Hospital Frankfurt, Frankfurt Am Main, Germany
| | - Volkhard A J Kempf
- Department of Medical Microbiology, Goethe University Hospital, Frankfurt Am Main, Germany
| | - Johanna Kessel
- Department of Medicine, Infectious Diseases Unit, Goethe University Hospital, Frankfurt Am Main, Germany
| | - Marcus Czabanka
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt Am Main, Germany
| | - Vincent Prinz
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt Am Main, Germany
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Kilinc F, Setzer M, Prinz V, Jussen D, Marquardt G, Gessler F, Czabanka M, Freiman T, Dubinski D, Won SY, Haberland M, Behmanesh B. The Beneficial Effect of Preoperative Exercise on Postoperative Clinical Outcome, Quality of Life and Return to Work after Microsurgical Resection of Spinal Meningiomas. J Clin Med 2023; 12:jcm12082804. [PMID: 37109141 PMCID: PMC10146916 DOI: 10.3390/jcm12082804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE While outcomes of surgical treatment for spinal meningiomas are well-described within the literature, factors affecting early return to work as well as long-term health related quality of life remain unclear. METHODS In this retrospective study, patients with spinal meningioma and surgical treatment from two university-level neurosurgical institutions between 2008 and 2021 were analyzed. Time to return to work, physical activities and long-term health related quality of life (assessed by telephone interviews using the EQ-5D-5L health status measure and visual analogue scale (EQ VAS) were analyzed. RESULTS We identified a total of 196 patients who underwent microsurgical resection of spinal meningioma between January 2008 and December 2021. Of those, 130 patients of working age were included and analyzed. The median follow-up time was 96 months. All included patients returned to work. The median time of return to work was 45 days for the whole cohort. Patients who preoperatively performed physical activity returned to work significantly earlier compared to patients who did not (p < 0.001). Furthermore, younger age (p = 0.033) and absence of obesity (p = 0.023) correlated significantly with earlier return to work. Significant differences were also observed in all 5 EQ-5D-5L dimensions between patients with and without preoperative physical activity. CONCLUSIONS Despite the benign nature of spinal meningioma preoperative physical activity and physiological body weight are associated with favorable postoperative outcome, higher quality of life and early return to work.
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Affiliation(s)
- Fatma Kilinc
- Department of Neurosurgery, University Hospital Frankfurt, Schleusenweg 2-16, 60528 Frankfurt am Main, Germany
- Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt am Main, Germany
| | - Matthias Setzer
- Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt am Main, Germany
| | - Vincent Prinz
- Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt am Main, Germany
| | - Daniel Jussen
- Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt am Main, Germany
| | - Gerhard Marquardt
- Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt am Main, Germany
| | - Florian Gessler
- Department of Neurosurgery, University Medicine Rostock, 18057 Rostock, Germany
| | - Marcus Czabanka
- Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt am Main, Germany
| | - Thomas Freiman
- Department of Neurosurgery, University Medicine Rostock, 18057 Rostock, Germany
| | - Daniel Dubinski
- Department of Neurosurgery, University Medicine Rostock, 18057 Rostock, Germany
| | - Sae-Yeon Won
- Department of Neurosurgery, University Medicine Rostock, 18057 Rostock, Germany
| | - Moritz Haberland
- Department of Neurosurgery, University Medicine Rostock, 18057 Rostock, Germany
| | - Bedjan Behmanesh
- Department of Neurosurgery, University Medicine Rostock, 18057 Rostock, Germany
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Won SY, Walter J, Hernandez-Duran S, Alhalabi OT, Behmanesh B, Bernstock JD, Czabanka M, Dinc N, Dubinski D, Flüh C, Freiman TM, Grosch AS, Herrmann E, Kang YS, Konczalla J, Kramer A, Lehmann F, Lemcke J, Melkonian R, Mielke D, Müller L, Ringel F, Rohde V, Schneider M, Senft C, Schuss P, Turgut MÖ, Synowitz M, Ullmann JM, Vatter H, Zweckberger K, Kilinc F, Gessler F. Reappraisal of Intracerebral Hemorrhages and Intracerebral Hemorrhage Grading Scale Score in Surgically and Medically Managed Cerebellar Intracerebral Hemorrhage. Neurosurgery 2022; 92:1021-1028. [PMID: 36700686 DOI: 10.1227/neu.0000000000002318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/21/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND As compared with supratentorial intracerebral hemorrhages (ICH), bleeds that occur within the cerebellum require special consideration given the nature of the posterior fossa. OBJECTIVE To validate ICH and ICH grading scale (ICH-GS) scores in patients with cerebellar hemorrhage and examine the outcomes of patients managed surgically as compared with those who underwent conservative treatment. METHODS This observational multicenter study included 475 patients with cerebellar hemorrhage from 9 different neurosurgical departments in Germany between 2005 and 2021. The prognostic accuracy of ICH and ICH-GS scores were calculated by the area under the curve of the receiver operating characteristic curves. Analyzed outcomes were the in-hospital mortality, mortality at 6 months, in-hospital outcome, and outcome at 6 months. RESULTS Of 403 patients, 252 patients (62.5%) underwent surgical treatment and 151 patients (37.5%) conservative treatment. Both ICH and ICH-GS scores demonstrated good prognostic accuracy regarding both overall mortality and functional outcomes. In those patients presenting with severe cerebellar hemorrhages, ie, ICH score >3 and ICH-GS score >11, overall mortality was significantly lower in surgically treated patients. Mortality was significantly higher in those patients managed surgically who presented with ICH scores ≤3; in such patients, improved outcomes were noted when the hematoma was treated conservatively. CONCLUSION ICH and ICH scores are useful tools for prediction of survival and outcome in patients with cerebellar ICH. Surgical management may be beneficial for those who present with severe cerebellar ICH as reflected by ICH scores >3, while conservative management seems reasonable in patients with lower ICH scores.
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Affiliation(s)
- Sae-Yeon Won
- Department of Neurosurgery, University Medicine Rostock, Rostock, Germany
| | - Johannes Walter
- Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | | | - Obada T Alhalabi
- Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | - Bedjan Behmanesh
- Department of Neurosurgery, University Medicine Rostock, Rostock, Germany
| | - Joshua D Bernstock
- Department of Neurosurgery, Brigham and Women`s Hospital, Harvard Medical School, Boston, USA
| | - Marcus Czabanka
- Department of Neurosurgery, University Hospital, Goethe-University, Frankfurt, Germany
| | - Nazife Dinc
- Department of Neurosurgery, Jena University Hospital, Jena, Germany
| | - Daniel Dubinski
- Department of Neurosurgery, University Medicine Rostock, Rostock, Germany
| | - Charlotte Flüh
- Department of Neurosurgery, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Thomas M Freiman
- Department of Neurosurgery, University Medicine Rostock, Rostock, Germany
| | - Anne S Grosch
- Department of Neurosurgery, BG Klinikum Unfallkrankenhaus Berlin, Berlin, Germany
| | - Eva Herrmann
- Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University, Frankfurt am Main, Germany
| | - Young Sill Kang
- Department of Neurosurgery, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Juergen Konczalla
- Department of Neurosurgery, University Hospital, Goethe-University, Frankfurt, Germany
| | - Andreas Kramer
- Department of Neurosurgery, Göttingen University Hospital, Göttingen, Germany
| | - Felix Lehmann
- Department of Anesthesiology and Intensive Care, University Hospital Bonn, Bonn, Germany
| | - Johannes Lemcke
- Department of Neurosurgery, BG Klinikum Unfallkrankenhaus Berlin, Berlin, Germany
| | | | - Dorothee Mielke
- Department of Neurosurgery, Göttingen University Hospital, Göttingen, Germany
| | - Lukas Müller
- Department of Neurosurgery, University Medicine Rostock, Rostock, Germany
| | - Florian Ringel
- Department of Neurosurgery, University Hospital Mainz, Germany
| | - Veit Rohde
- Department of Neurosurgery, Göttingen University Hospital, Göttingen, Germany
| | | | - Christian Senft
- Department of Neurosurgery, Jena University Hospital, Jena, Germany
| | - Patrick Schuss
- Department of Neurosurgery, BG Klinikum Unfallkrankenhaus Berlin, Berlin, Germany.,Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | | | - Michael Synowitz
- Department of Neurosurgery, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Joana M Ullmann
- Department of Neurosurgery, University Medicine Rostock, Rostock, Germany
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Klaus Zweckberger
- Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | - Fatma Kilinc
- Department of Neurosurgery, University Hospital, Goethe-University, Frankfurt, Germany
| | - Florian Gessler
- Department of Neurosurgery, University Medicine Rostock, Rostock, Germany
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Tuncer Kara K, Kizil M, Çakmak E, Yildirim TT, Kilinc F, Kuloğlu T, Gözel N. Comparison of plasma and salivary meteorin-like protein levels in patients with newly diagnosed Type-2 diabetes and treated with metformin. Eur Rev Med Pharmacol Sci 2022; 26:7145-7150. [PMID: 36263562 DOI: 10.26355/eurrev_202210_29900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The present study compares the plasma and salivary Metrnl levels of patients newly diagnosed with type-2 diabetes who were treated with metformin for three months with those of a healthy volunteer group and immunohistochemically analyzes Metrnl in salivary glands. PATIENTS AND METHODS 30 healthy volunteers and 30 newly diagnosed type-2 diabetes patients were included in the study. The newly diagnosed diabetes patients were treated with metformin for three months, and the plasma and salivary metformin levels of both groups were measured at baseline and after the three months of metformin treatment in the patient group. Plasma HbA1c, low-density lipoprotein (LDL-C) and Triglyceride (TG) values of all groups were also measured at baseline following three months of metformin treatment. Biopsies were taken from the parotid and submandibular glands and immunohistochemical staining was performed to show Metrnl immunoreactivity. RESULTS Plasma Metrnl, HbA1c, LDL-C and TG levels were higher in the newly diagnosed diabetes group than in the other group, and salivary Metrnl levels were higher than in the control group after three months of metrformin treatment. An examination of the immunohistochemical staining of salivary gland biopsies under light microscope revealed Metrnl immunoreactivity in the intralobular and interlobular ducts of the parotid gland, while Metrnl immunoreactivity was observed in the acinar cells in the intralobular striated duct and interlobular ducts in the submandibular gland. CONCLUSIONS Plasma Metrnl, HbA1c, LDL-C and TG levels were higher in the newly diagnosed diabetes group than in the other group. Metrnl immunoreactivity was detected in the parotid and submandibular glands. The relationship between Metrnl and DM should be investigated in larger groups.
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Affiliation(s)
- K Tuncer Kara
- Department of Public Health, Faculty of Medicine, Department of Physiology, Faculty of Veterinary, Department of Internal Medicine, Faculty of Medicine, Firat University, Elazig, Turkey.
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Gundeslioglu OO, Alabaz D, Kose S, Cay U, Tapac N, Kilinc F, Kaymaz ST, Dogan C, Sahin G, Horoz OO, Yi;ldizdas RD, Unal I, Kibar F. Evaluation of pediatric patients with COVID-19 in a Turkish university hospital. Niger J Clin Pract 2022; 25:1889-1895. [DOI: 10.4103/njcp.njcp_331_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Kilinc F, Setzer M, Marquardt G, Keil F, Dubinski D, Bruder M, Seifert V, Behmanesh B. Functional outcome and morbidity after microsurgical resection of spinal meningiomas. Neurosurg Focus 2021; 50:E20. [PMID: 33932928 DOI: 10.3171/2021.2.focus201116] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/17/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate functional outcome, surgical morbidity, and factors that affect outcomes of surgically treated patients. METHODS The authors retrospectively analyzed patients who underwent microsurgical resection for spinal meningiomas between 2009 and 2020. Patient data and potential variables were collected and evaluated consecutively. Functional outcomes were evaluated using univariate and multivariate analyses. RESULTS A total of 119 patients underwent microsurgical resection of spinal meningioma within the study period. After a mean follow-up of 25.4 ± 37.1 months, the rates of overall complication, tumor recurrence, and poor functional outcome were 9.2%, 7.6%, and 5%, respectively. Age, sex, revision surgery, and tumor recurrence were identified as independent predictors of poor functional outcome. Obesity and surgeon's experience had an impact on the complication rate, whereas extent of resection and tumor calcification affected the rate of tumor recurrence. CONCLUSIONS Microsurgical resection of spinal meningiomas remains safe. Nevertheless, some aspects, such as obesity and experience of the surgeons that result in a higher complication rate and ultimately affect clinical outcome, should be considered when performing surgery.
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Affiliation(s)
| | | | | | - Fee Keil
- 2Neuroradiology, Goethe-University, Frankfurt am Main, Germany
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11
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Hadjiathanasiou A, Kilinc F, Behmanesh B, Bernstock J, Güresir E, Heimann M, Konczalla J, Scharnböck E, Schneider M, Weinhold L, Seifert V, Vatter H, Gessler F, Schuss P. Impact of Comorbidities and Frailty on Early Shunt Failure in Geriatric Patients With Normal Pressure Hydrocephalus. Front Med (Lausanne) 2020; 7:596270. [PMID: 33330560 PMCID: PMC7734184 DOI: 10.3389/fmed.2020.596270] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022] Open
Abstract
Background/Aim: Older patients are considered to bear a higher perioperative risk. Since idiopathic normal pressure hydrocephalus (NPH) predominantly concerns older patients, identifying risk factors for early shunt failure for preoperative risk/benefit assessment is indispensable for indication and/or consultation of patients for ventriculoperitoneal shunting (VPS). Methods: We performed a retrospective study design, including data acquired from two university hospital neurosurgical institutions between 2012 and 2019. Overall, 211 consecutive patients with clinical/radiological signs for NPH who additionally showed alleviation of symptoms after lumbar cerebrospinal fluid (CSF) drainage, received VPS and were included for further analysis. Frailty was measured using the Clinical Frailty Scale (CFS). Main outcome was early shunt failure or post-operative complications within 30 days after initial VPS surgery. Results: The overall complication rate was 14%. Patient-related complications were observed in 13 patients (6%) and procedure-related complications in 16 patients (8%). Early post-operative complications resulted in a significantly prolonged length of hospital stay 6.9 ± 6.8 vs. 10.8 ± 11.8 days (p = 0.03). Diabetes mellitus with end-organ damage (OR 35.4, 95% CI 6.6 – 189.4, p < 0.0001) as well as preexisting Parkinson's disease were associated with early patient-related post-surgical complications after VPS for NPH. Conclusions: Patients comorbidities but not frailty were associated with early post-operative patient-related complications in patients suffering NPH. While frailty may deter patients from other (neurosurgical) procedures, VPS surgery might contribute to treating NPH in these patients at a tolerable risk.
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Affiliation(s)
| | - Fatma Kilinc
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Bedjan Behmanesh
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Joshua Bernstock
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States
| | - Erdem Güresir
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Muriel Heimann
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Jürgen Konczalla
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Elisa Scharnböck
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | | | - Leonie Weinhold
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Bonn, Germany
| | - Volker Seifert
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Florian Gessler
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Patrick Schuss
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
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12
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Kilinc F, Demircan F, Gozel N, Onalan E, Karatas A, Pekkolay Z, Özdemir FA. ASSESSMENT OF SERUM ALARIN LEVELS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS. Acta Endocrinol (Buchar) 2020; 16:165-169. [PMID: 33029232 DOI: 10.4183/aeb.2020.165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE We aimed to investigate the potential relationship between plasma alarin levels and type 2 diabetes mellitus (T2DM). PATIENTS AND METHOD We included 154 participants, divided into four groups in a cross-sectional study design. The first group includes patients with T2DM without complications (n=30), the second group patients with T2DM with microvascular complications (T2DM-noC n=32), the third group patients with T2DM with macrovascular complications, T2DM-MV (n=32) and the last group is the healthy control group (n=60). RESULTS In our study 94 patients were diabetic; 47 females and 47 males. The control group consists of 60 people, 30 women and 30 men. It was found that these had a significant (p>0.05) variation in serum alarin levels among the T2DM (T2DM-noC=3.1±0.7 ng/mL T2DM-mV=2.8±0.4 ng/mL, T2DM-MV= 3.6±0.4 ng/mL) versus control group (15.6±2.6).We failed to find a significant variation of serum alarin levels (p>0.05) between T2DM subgroups. Serum alarin levels were significantly higher among control patients (p<0.05). There was no difference between diabetic sub-groups. CONCLUSION We concluded that serum alarin levels in patients with T2DM are lower than in normal people. Further studies are needed to investigate the possible prognostic value of alarin in clinical practice in T2DM.
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Affiliation(s)
- F Kilinc
- Firat University, School of Medicine, Dept. of Endocrinology, Turkey
| | - F Demircan
- Private Etik Life Medical Center Dept. of Internal Diseases, Istanbul, Turkey
| | - N Gozel
- Dept. of Internal Medicine, Turkey
| | - E Onalan
- Dept. of Medical Biology, Turkey
| | - A Karatas
- Dept. of Rheumatology, Elazig, Turkey
| | - Z Pekkolay
- Dicle University, School of Medicine, Dept. of Endocrinology, Diyarbakir, Turkey
| | - F A Özdemir
- Bingol University, School of Sciences, Dept. of Molecular Biology and Genetics, Bingol, Turkey
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13
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Kilinc F, Gessler F, Dubinski D, Won SY, Quick-Weller J, Seifert V, Behmanesh B. Academic output of German neurosurgical residents in 35 academic neurosurgery residency programs. Acta Neurochir (Wien) 2019; 161:1969-1974. [PMID: 31321540 DOI: 10.1007/s00701-019-04011-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/09/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND The scientific activity of neurosurgeons and neurosurgery residents as measured by bibliometric parameters is of increased interest. While data about academic output for neurosurgeons in the USA, the UK, and Canada have been published, no similar results for German neurosurgical residents exist. Within this study, we aim to evaluate the academic output of German neurosurgery residents in 35 academic residency programs. METHODS Data for each resident were collected from the departmental websites, Pubmed, and Scopus. Further analyses evaluated the relationship between publication productivity, sex, and academic degree (Dr. med.). RESULTS Data from 424 neurosurgery residents were analyzed. A total of 1222 publications were considered. A total of 355 (29%) of the 1222 publications were first-author publications. The average number of publications per resident was 2.9; the average h-index and m-quotient was 1.1 and 0.4, respectively. There was a statistically significant difference in academic output and h-index among neurosurgical residents with a doctoral degree compared with residents without such degree (5.3 vs. 1.3, p < 0.0001 and 2.0 vs. 0.5, p < 0.0001). CONCLUSION This is the very first study evaluating the academic output of neurosurgical residents in academic neurosurgical departments in Germany.
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14
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Simsek FS, Balci TA, Dönder Y, Ugur K, Kilinc F, Cetinkaya Z, Ustundag B, Ozercan IH, Elmali F. The importance in diagnosing patients with conflicting observational data for post surgery radioiodinated ablation of thyroid remnants. Hell J Nucl Med 2019; 22:58-63. [PMID: 30843011 DOI: 10.1967/s002449910960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 02/08/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE There is a special group of patients, according to 2015 American Thyroid Association guidelines. This group is defined as "the patients with conflicting observational data for post-surgery radioiodine ablation (COD for PSRIA)". For this special group of patients RIA is applied after a thorough reassessment of histopathological, clinical and biochemical features, including thyroglobulin (Tg). However, there is no consensus on what is the suitable cut-off value for the radioiodine ablation (RIA) decision or for therapy prediction. Moreover, is also unclear which Tg parameters should be used for these purposes. If we can determine useful and practical cut-off values for excellent response (ER) and non-structural incomplete response (non-SIR) response categories, this will facilitate our therapy response prediction before RIA and may allow us to categorize the group of "COD for PSRIA" based on a higher risk of recurrence/relapse or disease specific mortality rates according to serum thyroglobulin (Tg). This categorization may also enable us to plan the follow-up frequency of patients more scientifically. Consequently, it may provide the more efficient use of medical facility and healthcare system resources. SUBJECTS AND METHODS Two hundred forty-nine patients (out of 577 examined) with "COD for PSRIA" were included in this study. Firstly, patients with indeterminate, biochemical incomplete and structural incomplete responses were considered as the non-ER group and compared to the ER group. Secondly, patients with excellent, indeterminate, and biochemically incomplete responses were considered as the non-SIR group and compared to the SIR group. The data were evaluated by MedCalc Statistical Software version 18.9. RESULTS The cut-off value for ER patients was calculated as ≤6.57ng/mL. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 67.9%, 75.4%, 55.6% and 83.8%, respectively. The cut-off value for non-SIR patients was calculated as ≤12.7ng/mL. Sensitivity, specificity, PPV and NPV were 78.5%, 91.7%, 35.5% and 98.6%, respectively. CONCLUSION If a patient has ≤6.57ng/mL pre-ablative Tg, follow-up intervals of patients with "COD for PSRIA" may be extended due to lower recurrence/relapse rates. However, if a patient has >12.7ng/mL pre-ablative Tg, these patients should be followed-up more frequently in order to determine SIR earlier. This approach may enable more efficient use of medical facility and healthcare system resources and a more scientific planning of their follow-up treatment. This approach seems to have the potential to contribute significantly to cost-effectiveness.
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Affiliation(s)
- F S Simsek
- Firat University, Faculty of Medicine, Nuclear Medicine Department, Turkey.
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15
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Kilinc F, Noack A, Lortz I, Seifert V, Behrens M, Forster M. P01.164 Cognitive and neuropsychological outcome after awake surgery for left frontal and left temporal tumor resection. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- F Kilinc
- Goethe University, Frankfurt, Germany
| | - A Noack
- Goethe University, Frankfurt, Germany
| | - I Lortz
- Goethe University, Frankfurt, Germany
| | - V Seifert
- Goethe University, Frankfurt, Germany
| | - M Behrens
- Goethe University, Frankfurt, Germany
| | - M Forster
- Goethe University, Frankfurt, Germany
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16
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Kilinc F, Sener S, Akbaş A, Metin A, Kirbaş S, Neselioglu S, Erel O. Oxidative stress parameters in localized scleroderma patients. Arch Dermatol Res 2016; 308:625-629. [DOI: 10.1007/s00403-016-1682-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 07/01/2016] [Accepted: 08/30/2016] [Indexed: 11/28/2022]
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17
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Goren MR, Kilinc F, Kayaselcuk F, Ozer C, Oguzulgen I, Hasirci E. Effects of experimental left varicocele repair on hypoxia-inducible factor-1α and vascular endothelial growth factor expressions and angiogenesis in rat testis. Andrologia 2016; 49. [DOI: 10.1111/and.12614] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2016] [Indexed: 01/13/2023] Open
Affiliation(s)
- M. R. Goren
- Department of Urology; Baskent University Adana Medical and Research Center; Adana Turkey
| | - F. Kilinc
- Department of Urology; Baskent University Adana Medical and Research Center; Adana Turkey
| | - F. Kayaselcuk
- Department of Pathology; Baskent University Adana Medical and Research Center; Adana Turkey
| | - C. Ozer
- Department of Urology; Baskent University Adana Medical and Research Center; Adana Turkey
| | - I. Oguzulgen
- Department of Urology; Baskent University School of Medicine; Ankara Turkey
| | - E. Hasirci
- Department of Urology; Baskent University School of Medicine; Ankara Turkey
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18
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Akoglu G, Emre S, Metin A, Akbas A, Yorulmaz A, Isikoglu S, Sener S, Kilinc F. Evaluation of total oxidant and antioxidant status in localized and generalized vitiligo. Clin Exp Dermatol 2013; 38:701-6. [PMID: 23601201 DOI: 10.1111/ced.12054] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Vitiligo is an acquired depigmentation disorder, and oxidative stress is suggested to have a major role in its aetiopathogenesis. AIM To assess whether oxidative stress has a greater role in generalized than in localized vitiligo. METHODS We assessed 31 patients with active vitiligo (17 localized, 14 generalized) and 38 healthy controls. Serum total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) were determined. RESULTS Patients with vitiligo had significantly lower TAS and higher TOS and OSI values than controls. Both localized and generalized vitiligo were associated with lower TAS and higher TOS and OSI values, compared with controls, and all three did not differ with vitiligo type. CONCLUSIONS A systemic oxidative stress exists in patients with vitiligo. These results indicate that the global antioxidant capacity of patients might have been exhausted through a defence mechanism against oxidative processes. The imbalance in TOS/TAS status may have an important role in the aetiopathogenesis of vitiligo, regardless of the clinical variant of the disease.
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Affiliation(s)
- G Akoglu
- Dermatology Clinic, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
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Abstract
OBJECTIVE The aim of this study was to evaluate the effect of long-term sitting on serum prostate-specific antigen (PSA) levels. METHOD The serum PSA levels of 50 bus drivers under the age of 45 (mean 37.7) years who worked at least 8 h a day for more than 3 weeks were compared with those of 50 healthy surgeons in similar age groups (mean 37.7 years) who spent most of their working time standing. RESULTS There was no statistically significant difference between the mean PSA level of the study group (1.211 +/- 0.96 ng/ml) and that of the control group (1.214 +/- 0.74 ng/ml; p > 0.05). The PSA levels returned to normal after a 5-day resting period in cases who had higher values than the anticipated 2.5 ng/ml for this age group at the initial determination. CONCLUSIONS These results suggest that there is no relationship between long-term sitting and serum PSA levels. A second PSA determination after a 5-day resting period may be helpful in cases with higher than normal initial values.
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Affiliation(s)
- E Gumus
- 2nd Urology Clinic, Sisli Etfal Teaching Hospital, Istanbul, Turkey
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20
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Abstract
To evaluate our diagnosis and treatment policy of penile fractures, we reviewed 13 cases treated between August 1992 and August 1995. In ten patients early surgical correction, in one patient an elective surgical intervention was carried out. Two patients with minimal haematoma were suggested to undergo conservative treatment, but only one of them came to the control examination and he complained of fixed induration, pain and mild deviation in erection. In the group of early surgical repair there was no complication. In a patient who had had a delayed procedure small induration and minimal deviation were found. In the light of these findings we think that in penile fractures early surgical repair produces the best results.
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Affiliation(s)
- L Saporta
- 2nd Department of Urology, Sisli Eftal Teaching Hospital, Istanbul, Turkey
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