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Aim: We aimed to investigate the correlation between the temporal changes of computed tomography severity score (CT-SS) ​​and mean renal parenchymal attenuation (MRPA) values in consecutive chest computed topographies (CT). Material and Method: This retrospective, single-center study included 65 (≥18 years) COVID-19 patients with positive RT-PCR tests. A radiologist calculated three consecutive chest CT-SSs and measured the MPRAs on CTs from the upper half of each kidney included in the cross-section. Paired samples test and Wilcoxon signed-rank test were used to evaluate the temporal changes of mean renal parenchymal attenuation (RPA) and median CT-SS values, in three consecutive CTs. Spearman's test was used to evaluate the correlation of each RPA and CT-SS value on three consecutive CTs. Results: The study population included 65 patients with a mean age of 61.49±13.91 years. A total of 36/65 (55.4%) were male. We found a significant increase between the first and second CT-SS (p

The presence of mediastinal lymph node enlargement (MLNE) in computed tomography (CT) of Coronavirus disease 2019 (COVID-19) patients can be associated with disease severity.To investigate the relationship between MLNE with intensive care unit admission (ICU), mortality rates, and CT findings, especially in early-stage COVID-19 patients.This single-center retrospective case-control study, included aged ≥18 years, 250 COVID-19 patients with positive RT-PCR tests. We included two patient groups, 125/250 with and without MLNE. Demographic information of the patients, laboratory findings, length of stay in hospital or ICU, mortality rates, initial CT imaging findings and CT severity scores (CT-SS) were recorded and their relationship with MLNE was investigated.Patients with MLNE were older (69.61 ± 11.16; p 0.001) and had a higher CT-SS (14.67 ± 7.55; p 0.001). There was a significant difference between the presence of MLNE with mortality (58/77, 75.3%; p 0.001) and ICU admission (49/61, 80.3%; p 0.001). Also, a statistical association was found between MLNE with ICU admission (p = 0.001) and (p 0.001) mortality rates in patients with CORADS≤2 CT findings. In multivariate logistic regression analysis, MLNE was 8.8-fold (95% CI: 1.62-47.86, p = 0.01) more correlated with linear opacity and 0.25-fold with bronchial wall thickening (95% CI: 0.07-0.92, p = 0.04).Mediastinal lymph node enlargement is an important CT finding that can predict the severe prognosis of COVID-19 patients. Even in patients without lung involvement on initial CT, the presence of MLNE should be carefully examined as it is associated with disease severity.

We aimed to determine the incidences of neuroimaging findings (NIF) and investigate the relationship between the course of pneumonia severity and neuroimaging findings.Our study was a retrospective analysis of 272 (18 years) COVID-19 patients who were admitted between "March 11, 2021, and September 26, 2022". All patients underwent both chest CT and neuroimaging. The patient's chest CTs were evaluated for pneumonia severity using a severity score system (CT-SS). The incidence of NIF was calculated. NIF were categorized into two groups; neuroimaging positive (NIP) and neuroimaging negative (NIN). Consecutive CT-SS changes in positive and negative NIF patients were analyzed.The median age of total patients was 71; IQR, 57-80. Of all patients, 56/272 (20.6%) were NIP. There was no significant relationship between NIP and mortality (p = 0.815) and ICU admission (p = 0.187). The incidences of NIF in our patients were as follows: Acute-subacute ischemic stroke: 47/272 (17.3%); Acute spontaneous intracranial hemorrhage: 13/272 (4.8%); Cerebral microhemorrhages: 10/272 (3.7%) and Cerebral venous sinus thrombosis: 3/25 (10.7%). Temporal change of CT-SSs, there was a statistically significant increase in the second and third CT-SSs compared to the first CT-SS in both patients with NIP and NIN.Our results showed that since neurological damage can be seen in the late period and neurological damage may develop regardless of pneumonia severity.

Previous studies reported axillary lymphadenopathy (LAP) as a side effect of the anti-COVID-19 vaccine. However, the effects of nonsteroidal anti-inflammatory drug (NSAID)s on mRNA COVID-19 vaccine-related LAP have not been investigated.We aimed to investigate the effects of NSAIDs on temporal changes in sonographic findings of COVID-19 vaccine-associated LAP.Our single-center retrospective cohort study was conducted between October 2021 and April 2022. We included patients (aged ≥ 18 years) who applied with complaints of swelling in the ipsilateral axillary region after the COVID-19 vaccine and had axillary region ultrasound (US) scans in electronic medical records within 30 days pre-vaccination. The serial US was performed on the third, 10th, and 30th days post-vaccination.Our study included 38 patients with a median age of 36 (IQR, 32-43) years. In 18 (47.4%) patients used NSAIDs in the early post-vaccination period. Measurements of LAPs on ultrasound scans increased at day 3 post-vaccination compared with pre-vaccination both in NSAID users and non-users. On the 10th day, a statistically insignificant decrease in LAP diameters and cortical thickness was observed in NSAID users compared to non-users. On the post-vaccination 30th day, axillary LAPs regressed similarly in both groups.In our study, post-vaccine NSAID use had no statistically significant effect on the course of axillary LAPs.

Objective: The aim of this retrospective study was to identify the amount of TBL and HBL and analyse the risk factors using multivariate linear regression analysis during single-level OTLIF surgery. Methods: In this study 62 patients (32 male, 30 female, mean age 49.22 ± 13.26) who underwent single-level interbody fusion proce dures by a single surgeon between 2015 and 2021 were included. Retrospectively, relevant statistics regarding body mass index (BMI), American Society of Anesthesiologist Score (ASA), preoperative mean arterial pressure (MAP), and age were gathered. Preoperative MR images were used to assess and measure radiological parameters such as skin-disc distance (SDA), canal area (CA), paravertebral muscle area (PVMA),lumbosacral maximum subcutaneous fat thickness (LSMSF), operation level subcutaneous fat thickness (OPSF) and spi nous process length (SPL).Total blood loss (TBL) was calculated according to Nadler's formula. Hidden blood loss (HBL) was measured by deducting the measured (visible) blood loss from TBL. TBL, HBL and their relationship with preoperative parameters were assessed. Results: HBL was determined to be significantly higher in older patients (P = 0.012). MAP was seen to have a statistically significant cor relation with operating time (P = 0.002), operative bleeding (P = 0.002), TBL (P = 0.006), and HBL (P = 0.001), and an inverse correlation with postoperative drainage (P = 0.007). The ASA scores were observed to be statistically significantly correlated with TBL (P = 0.001), and HBL (P = 0.001). LSMSF showed a significant correlation with TBL (P = 0.005) and HBL (P = 0.002). OPSF was determined to be correlated with TBL (P = 0.011), HBL (P = 0.009) and length of stay in hospital (P =0.034). SDD was correlated with TBL (P =0.043), and SPL with HBL (P = 0.013). It was shown that age (P =0.012), MAP (P =0.001), ASA (P =0.001), LSMFS (P = 0.002), OPSF (P = 0.009), SPL (P = 0.013) were risk factors for HBL. According to multivariate logistic regression analysis; two anatomical factors LSMSF and SPL were independent risk factors for HBL (P < 0.05). Conclusion: This results of this study have revealed that most patient-related parameters have a significant effect on HBL and TBL.The study has also demonstrated that LSMSF and SPL are independent risk factors for HBL. Level of evidence: Level IV, Therapeutic Study. WOS:000860761700006 35943076 Q4

Type 4 supracondylar fractures are challenging to treat. Closed reduction may become impossible due to brachialis muscle penetration and devastating results like a neurovascular injury that may occur during recurrent manipulations. We here report an intra-focal percutaneous reduction technique for maintaining closed reduction. An extensively posterior displaced type 4 supracondylar fracture with a dimple at the antecubital fossa and an extensive ecchymosis is presented. During surgery, we could not obtain closed reduction with the milking maneuver. We inserted an intrafocal K-Wire from the posterior side into the fracture site. With the levering of the wire, the dimple disappeared, after which we maintained the anatomical reduction and fixed the fracture with two lateral K-wires. Neither complication nor residual deformity was observed during postoperative follow-up. To show the exact long-term effects and the safety of this procedure, we need more fractures with brachialis penetration operated on by the described technique

To evaluate the effects of COVID-19 infection on the ocular vascular structure including choroidal thickness and retrobulbar blood flow values in comparison with healthy subjects.Ninety eyes of 90 patients were included in this study. Participants were divided into Group 1 (n = 30) with mild COVID-19 infection, Group 2 (n = 31) with moderate disease, and Group 3 with age- and sex-matched healthy subjects (n = 29). Choroidal thickness was measured at the subfoveal area and at 500-µm intervals nasal and temporal to the fovea up to a distance of 1500 µm, using the enhanced depth imaging (EDI) technique of spectral coherence tomography (SD-OCT). The peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI), and pulsatility index (PI) values of the central retinal artery (CRA) and ophthalmic artery (OA) were evaluated with color Doppler ultrasonography (CDU).The choroidal thickness was significantly thinner in Group 1 and Group 2 than in Group 3 at all measurement points (p0.001). This difference was not present between Group 1 and Group 2 who had COVID-19 disease of different severity (p0.05).Among the retrobulbar blood flow parameters, OA PSV value was significantly lower in Group 1 and Group 2 compared to Group 3 (p = 0.025, p = 0.016, respectively). However, the CRA PSV and EDV and OA EDV values, and the CRA and OA PI and RI values were not statistically different between the groups (p0.05).COVID-19 infection may predispose patients to ocular vascular pathologies by affecting both choroidal and retrobulbar blood flow.

The aim of this single-center study is to assess the outcomes in patients with acute ischemic stroke underwent endovascular mechanical thrombectomy. The data and outcome of patients who were admitted due to acute ischemic stroke caused by a large vessel occlusion in the anterior or posterior circulation and treated with endovascular stent retriever mechanical thrombectomy between 2014 and 2018 were retrospectively evaluated. Recanalization success was assessed based on Thrombolysis in Cerebral Infarction (TICI) scores, and the TICI grades 2b and 3 were considered as successful. Functional outcomes of the patients were assessed by modified Rankin Scale (mRS) at the 3rd month follow up and a score of ≤2 points was considered as good clinical outcome. Successful recanalization was achieved in 34 patients (69%). At the 3rd month follow-up, 23 patients (46,9%) had mRS scores of ≤2 points. The overall mortality rate at the 90th day was %30 (n=15). After endovascular thrombectomy, symptomatic intracranial hemorrhage was seen in 9 patients, groin hematoma due to vascular access in 5 patients, which did not require additional treatment, and pseudoaneurysm in 3 patients. Stent retriever mechanical thrombectomy is an effective and safe procedure in patients admitted due to acute ischemic stroke caused by large vessel occlusion. [Med-Science 2020; 9(3.000): 700-3]

Introduction: COVID-19 disease may pose a considerable health threat to healthy individuals and individuals with comorbidity. The SARS-CoV-2 virus affects the respiratory tract and may cause damage to the pancreas by binding to the ACE-2 receptor in the pancreas. In our study, we investigated the effects of hyperlipasemia on morbidity and mortality in patients diagnosed with COVID-19. Material and Method: In this study, 2350 patients diagnosed with COVID-19 between November 2020 and December 2020 were retrospectively reviewed. Other possible causes of hyperlipasemia were excluded. Hyperlipasemia secondary to COVID-19 was detected in 338 patients. These patients were divided into two groups based on their lipase elevation rates. Results: Hyperlipasemia was detected in 14.4% of the patients diagnosed with COVID-19, and severe hyperlipasemia (>3x) was detected in 2.3%. The mean age of the patients was 64±13.8 (18-92), of which 59.5% (201) were male. In our study, 24 patients (1%) were diagnosed with acute pancreatitis. When compared according to lipase level, a significant difference was found between the groups regarding the history of HT, CCI score, development of ARF at follow-up, development of ARDS, need for ICU hospitalization, need for intubation, length of stay in ICU, and death rates. A weak correlation was found in the correlation analysis between hyperlipasemia and ARDS development and mortality. Conclusion: Elevated lipase levels were associated with poor prognosis and mortality in patients with COVID-19 infection.

Total diz artroplastisi sonrası gelişen peroneal sinir palsi klinik sonuçları önemli derecede olumsuz etklileyen ve nadir görülen bir sorundur. Bu çalışmamızda 62 yaşında sağ dizde ileri derecede gonartroz nedeniyle total diz artroplastisi uyguladığımız hastada ameliyat sonrası 15. günde gelişen peroneal palsinin klinik ve elektrofizyolojik takip sonuçlarını sunuyoruz. Elektromyografik değerlendirmede peroneal sinir motor dalının fibula başı seviyesinde ağır derecede parsiyel aksonal hasarı izlendi. Medikal tedavi ile takibi sonrası 6. Haftadan itibaren klinik iyileşme bulguları başlayan hastada, peroneal sinir eksplorasyon ve nöroliz gerekliliği olmadan, 6. ayda total klinik ve elektrofizyolojik iyileşme sağlandı. Dejeneratif disk hastalığına bağlı klinik bulgu vermeyen kök basısı olan hastalarda uygulanan total diz artroplastisinde peroneal palsi yatkınlığında artış olabileceği akılda tutulmalıdır. Peroneal nerve palsy that develops after total knee arthroplasty is a rare problem that negatively affects the clinical results. In this study, we present the clinical and electrophysiological follow-up results of peroneal palsy that developed on the 15th postoperative day in a 62-year-old patient who underwent total knee arthroplasty due to severe gonarthrosis in the right knee. Electromyographic evaluation showed severe partial axonal damage at the level of the fibular head of the peroneal nerve motor branch. With the medical treatment, clinical signs of improvement started after the 6th week, without the need for peroneal nerve exploration and neurolysis, total clinical and electrophysiological recovery was achieved in the 6th month. It should be kept in mind that peroneal palsy susceptibility may be increased in total knee arthroplasty performed in patients with lomber nerve root compression without clinical symptoms due to degenerative lomber disc disease.

PurposeTo evaluate the effects of obesity on ocular blood flow including choroidal thickness and retrobulbar blood flow values in comparison with healthy subjectsMethodsThe 102 eyes of 102 female patients were included in this prospective study.Color Doppler ultrasonography (CDU) was used to evaluate the retrobulber vessels.Choroidal thickness was measured by using the optical coherence tomography (OCT). ResultsThere was a significant difference in IOP values within the groups with the highest values in group 3 and the lowest in group 1.There was also a positive correlation between BMI and IOP. The CT was found to be statistically significantly lower in group 2 and group 3 than in the control group at all measurement points. The choroidal thickness was also statistically significantly lower in group 3 than in group 2 at the subfoveal, nasal 500 µm, and the temporal 500 and 1000 µm measurement points.The mean CRA PSV and EDV values were lower in group 2 and group 3 than in group 1, while group 3 had the lowest mean CRA PSV value among the groups. When compared to group 1, the OA EDV value was lower only in group 3 while the OA PSV value was statistically significantly lower in group 3 than in both group 2 and group 1. There was no significant difference between the groups in terms of RI and PI.ConclusionsObesity can create a predisposition to ocular pathologies both by increasing the IOP and decreasing the retrobulbar and choroidal blood flow.

AIM To estimate the rupture risk of anterior communicating artery (AComA) and AComA-related aneurysms according to their localization, angiographic architecture, and morphological features. MATERIAL AND METHODS In this study, 124 patients with AComA and AComA-related anterior system aneurysms were retrospectively evaluated. The aneurysms were classified according to their morphological appearance and angiographic architecture. The size, size ratio, angiographic architecture, and aneurysmal dome orientation of ruptured and non-ruptured aneurysms were compared using digital subtraction angiography (DSA) 3D images. RESULTS There was a significant relationship between rupture risk and the size ratio (p=0.043), morphological properties of the aneurysm (p < 0.001), aneurysm dome orientation (OR 1.29, 95% CI 1.32-6.818), and aneurysm type according to the angiographical architecture (p < 0.005). CONCLUSION In determining the rupture risk of AComA and AComA-related aneurysms, size alone is not a sufficient parameter with aneurysm morphology proving to be more efficacious. Grouping of aneurysms according to angioarchitecture, and its significant correlation with aneurysm rupture, may help to understand the underlying mechanisms in the formation and rupture of aneurysms. From this, more specific treatment protocols can be created, helping to improve the clinical evaluation of AComA aneurysms.