Veli Citisli

Choroidal thickness and retinal vascular caliber correlations with internal carotid artery Doppler variables.

Decreased retinal arteriolar caliber and increased retinal venular caliber have been associated with increased cardiovascular mortality. This study aimed to evaluate correlations of choroidal thickness and retinal vascular caliber measurements with internal carotid artery (ICA) Doppler ultrasound variables.

Spontaneous Remission of a Big Subligamentous Extruded Disc Herniation: Case Report and Review of the Literature

Spontaneous Regression of a Big Subligamentous Extruded Disc Herniation: Case Report And Review of The Literature The most efficient method for the treatment of lumbar disc herniation is still controversial. The most important aspect is the application of the suitable conservative or surgical treatment to the right patient at the right time. In lumbar disc herniation patients, one must not precipitate except for cases that require surgical indications as in cauda equina syndrome, evolutive motor deficit and persistence of pain in spite of the narcotics. However, the spontaneous regression mechanism has not been completely determined yet. The proposed hypotheses are; dehydration, retraction of the disc to the hernia in the annulus fibrosis, enzymatic catabolism and phagocytosis. In this study, the case of a patient with huge lumbar disc hernia regressing by itself has been presented and the potential mechanisms of disc regression have been discussed.

Evaluation of simple blood counts as inflammation markers for brain tumor patients

AIMS Hemogram parameters in routine blood panels have been proposed as inflammation markers. These parameters, especially the red cell distribution width (RDW) and mean platelet volume (MPV), were evaluated as surrogate inflammatory markers in brain tumor patients. We aimed to observe RDW and MPV values of tumor patients and compare to those in healthy population. METHODS We recorded white blood cell count, neutrophil count, lymphocyte count, hemoglobin, hematocrit, RDW, platelet count, and MPV of the study group at the time of diagnosis and compared to those of the control subjects. RESULTS The RDW was significantly elevated in study group compared to that of the control subjects (p=0.001). The MPV was significantly lower in study group than that of the control group (p=0.01). CONCLUSION Decreased MPV and increased RDW were both associated with brain tumor. However, prospective studies with larger sample sizes are needed to support the results and expose MPV and RDW variations between metastatic and primary brain tumors.

Stem Cell Therapy for Amyotrophic Lateral Sclerosis:Yesterday, Today and Tomorrow

Stem Cell Therapy for Amyotrophic Lateral Sclerosis:Yesterday, Today and Tomorrow Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease, which have no any effective treatment method. There are various pathophysiological processes underlying the disease such as oxidative stress, glutamate toxicity, inflammation and loss of the glial neurotrophic support. There is no cure yet for ALS but there are many clinical trials that focused different therapeutic targets. One of the most popular treatment methods is cell transplantation. The cellbased therapies are promising for ALS patients with many evidences including beneficial effects in protection neurons and replacement of degenerated neurons.

The Effects of Physical Therapy and Rehabilitation On Pain, Disability, Depressive Symptoms and Sleep Quality of Subjects With Chronic Back Pain

Özet GİRİŞ ve AMAÇ: Kişinin fiziksel fonksiyonunu, sosyal yaşamını, yaşam kalitesini olumsuz yönde etkileyen ve uyku düzenine kadar birçok aktivitesini etkileyen kronik bel ağrısında (KBA) fizik tedavi ve rehabilitasyon (FTR) sıklıkla tercih edilen nonfamakolojik bir tedavi seçeneğidir. Bu çalışma KBA olan olgularda fizik tedavi ve rehabilitasyon programının ağrı, özürlülük, depresif bulgular ve uyku kalitesi üzerine etkilerini incelemek amacıyla yapıldı YÖNTEM ve GEREÇLER: Bu çalışmaya Denizli ilindeki özel bir tıp merkezine en az altı aydır bel ağrısı şikâyeti nedeniyle başvuran ve FTR programına yönlendirilen 35 (K: 20, E: 15) olgu dahil edildi. Olgular haftada 5 gün toplam 15 seans FTR programına alındı. Olguların demografik verileri kaydedildi. Tedavi öncesi ve sonrasında olguların ağrı şiddeti Görsel Analog Skalası (GAS), özürlülük düzeyi Oswestry Disabilite İndeksi (ODİ) ve depresif bulgular Beck Depresyon Ölçeği (BDÖ) ile değerlendirildi. Uyku kalitesinin değerlendirilmesinde ise Pitsburg Uyku Kalitesi indeksi (PUKİ) kullanıldı. BULGULAR: Olguların yaş ortalaması 47,83± 14,35 (min: 27max: 65) yıldır. Olguların tedavi öncesi ve sonrası GAS, BDI, OÖİ ve global PUKİ skorları karşılaştırıldığında istatistiksel olarak anlamlı farklılık bulundu (p<0,05). Olguların tedavi sonrasında ağrı şiddeti, depresif bulguları ve özürlülük düzeyi anlamlı şekilde azaldı, minimal düzeyde bozukluk olan uyku kalitesinde ise anlamlı bir artış olduğu görüldü TARTIŞMA ve SONUÇ: Kronik bel ağrılı olgularda yüzeyel ve derin sıcaklık uygulamaları, fizik tedavi modaliteleri ve egzersiz eğitimini içeren FTR programlarının ağrıyı azaltıp bunun sonucunda da fonksiyonelliği arttırması nedeniyle etkili bir tedavi seçeneği olduğunu, ayrıca depresif bulgular ve uyku kalitesinde olumlu etkileri olabileceğini düşünüyoruz. Abstract INTRODUCTION: Chronic back pain (CBP) affects physical functions, social life, and quality of life negatively and causes to abnormal behaviors, even sleep disorders as a result of pain. The physical therapy and rehabilitation (PTR) intervention is one of the common nonpharmacological choices in treatment of CBP. The aim of this study was to analyze the effects of PTR on pain, disability, depressive symptoms and sleep quality in subjects with CBP. METHODS: Thirty-five subjects (F: 20,M: 15) with CBP for at least six months who applied to a private medical center in Denizli and were referred for PTR were included in this study. The subjects received 15 séance PTR for 5 days a week. The demographic data of subjects were recorded. The pain level was measured by Visual Analog Scale (VAS), the disability level was measured by Oswestry Disability Index (ODI) and the depressive symptoms were assessed by Beck Depression Scale (BDS). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. RESULTS: The average age of subjects was 47,83± 14,35 (min: 27max: 65) years. When the results of VAS, ODI, BDS and PSQI were compared, a significant difference was found (p<0,05). The pain and disability levels, and the depressive symptoms of subjects significantly decreased and an increase in minimally deteriorated sleep quality was observed after PTR. DISCUSSION AND CONCLUSION: We think that PTR, including superficial/deep thermal therapy, physical modalities and exercise, is an effective choice of treatment which increase functionality and also can have positive effects on depressive symptoms and sleep quality

Reply: Choroidal thickness shows diurnal variation.

We have read with interest the letter by Aksoy et al commenting on our recent paper, in which we investigated the correlation between the internal carotid artery Doppler variables and choroidal thickness (CT). We appreciate their comments and thank the authors for their interest in our study. As they pointed out, there are many systemic and ocular factors that may affect CT. We tried to eliminate several confounding factors in order to provide more reliable outcomes in our study. Sildenafil citrate ingestion affects CT, and many other systemic medications may affect CT. Therefore, we excluded all the participants who were on systemic medications, including sildenafil. CT shows significant diurnal variations. We performed all CT measurements between 1 and 3 PM. We do agree with the authors’ suggestion that attention should be paid to diurnal variations and systemic medications when conducting a research related to CT.

Spontaneous recovery of post-traumatic cerebrospinal fluid rhinorrhea following meningitis: A case report

The aim of the present report was to present the patient with an anterior cranial base fracture who developed post-traumatic cerebrospinal fluid rhinorrhea, which recovered after onset of meningitis complication. A 26-year-old male patient who had a traffic accident one week ago was sent to our clinic because of his rhinorrhea persisting for 4 days. On cranial computed tomography, fracture of the left frontal skull base and sinus walls, a fracture line on temporal bone, parenchymal bleeding in the vicinity of the frontal sinus, subarachnoidal bleeding and left temporal extradural hematoma were detected. Then he underwent sinus wall repair and extradural hematoma was drained through bifrontal craniotomy. However, rhinorrhea persisted which resulted a deterioration in consciousness and he entered into a deep somnolent state. When his symptoms of meningitis became apparent, rhinorrhea of the patient disappeared. The patient transferred in intensive care unit and re-connected to a lumbar drainage system. On cerebral magnetic resonance imaging, regression of contrast-enhanced lesions localized in the left anterotemporal and frontal and in the regions lateral to the right trigon and medial to the right thalamus and in the right posteroparietal regions was observed. Despite repair of the anterior cranial fracture and lumbar drainage, rhinorrhea may persist. Herein, development of meningitis caused disappearing of rhinorrhea symptoms without any need for surgical intervention.

Unusual presentation of multiple nerve entrapment: a case report.

Cubital tunnel syndrome is the most common form of ulnar nerve entrapment and the second most common entrapment neuropathy of the upper extremity after carpal tunnel syndrome. However, bilateral compressive ulnar neuropathy is a rare condition. Electro diagnostic studies are a valid and reliable means of confirming the diagnosis.