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BACKGROUND AND OBJECTIVES: Changes in ocular perfusion play an important role in the pathogenesis of ischemic optic neuropathy. Ocular perfusion pressure is equal to mean arterial pressure minus intraocular pressure. The aim of this study was to evaluate the changes in the intraocular pressure and the retinal nerve fiber layer thickness in patients undergoing spinal surgery in the prone position. METHODS: This prospective study included 30 patients undergoing spinal surgery. Retinal nerve fiber layer thickness were measured one day before and after the surgery by using optical coherence tomography. Intraocular pressure was measured by tonopen six times at different position and time-duration: supine position (baseline); 10 min after intubation (Supine 1); 10 (Prone 1), 60 (Prone 2), 120 (Prone 3) min after prone position; and just after postoperative supine position (Supine 2). RESULTS: Our study involved 10 male and 20 female patients with the median age of 57 years. When postoperative retinal nerve fiber layer thickness measurements were compared with preoperative values, a statistically significant thinning was observed in inferior and nasal quadrants (p = 0.009 and p = 0.003, respectively). We observed a statistically significant intraocular pressure decrease in Supine 1 and an increase in both Prone 2 and Prone 3 when compared to the baseline. Mean arterial pressure and ocular perfusion pressure were found to be significantly lower in Prone 1, Prone 2 and Prone 3, when compared with the baseline. CONCLUSIONS: Our study has shown increase in intraocular pressure during spinal surgery in prone position. A statistically significant retinal nerve fiber layer thickness thinning was seen in inferior and nasal quadrants one day after the spinal surgery.

Configuraciones domésticas cambiantes tras la Cumbre de Helsinki de 1999 y la creciente influencia de los EEUU en Irak tras el 2002, crearon unas circunstancias políticas distintas en las cuales los militares en Turquía tuvieron que ceder su protagonismo en el proceso de toma de decisión en política exterior. El proceso de armonización con la UE privó a los militares de sus instrumentos burocráticos más influyentes para ejercer influencia sobre la formulación de las decisiones concernientes la política exterior, y eliminó así uno de los principales obstáculos que impedían a los gobiernos ejercer su plena autoridad en tal ámbito. Además, la invasión de Irak causó una reacción en cadena que acabó limitando la posición tan influyente del ejército en los asuntos exteriores de Turquía. Este artículo intenta esclarecer el impacto combinado de las reformas de la UE y la invasión de Irak que logró reducir la influencia del ejército en el proceso de toma de decisiones en Turquía.

Abstract Background and objectives To investigate the differences in the number of squamous epithelial cells carried to the spinal canal by three different types of spinal needle tip of the same size. Methods Patients were allocated into three groups (Group I, Group II, Group III). Spinal anesthesia was administered to Group I (n = 50) using a 25G Quincke needle, to Group II (n = 50) using a 25G pencil point spinal needle, and to Group III (n = 50) using a non-cutting atraumatic needle with special bending. The first and third drops of cerebral spinal fluid (CSF) samples were taken from each patient and each drop was placed on a slide for cytological examination. Nucleated and non-nucleated squamous epithelial cells on the smear preparations were counted. Results There was statistically significant difference between the groups in respect to the number of squamous epithelial cells in the first drop (p < 0.05). Group III had lower number of squamous epithelial cells in the first drop compared to that of Group I and Group II. Mean while Group I had higher number of squamous epithelial cells in the third drop compared to the other groups. The number of squamous epithelial cells in the first and third drops was statistically similar in each group respectively (p > 0.05 for each group). Conclusions In this study of different needle tips, it was seen that with atraumatic needle with special bending a significantly smaller number of cells were transported when compared to the Quincke tip needles, and with pencil point needles.