A common cause of death in children and young adults, is important for injury management. Neuroinflammation is responsible for both primary and secondary brain injury, and C-reactive protein-albumin ratio (CAR) has allowed use of biomarkers such as procalcitonin (PCT) in predicting mortality. Here, we compared the performance of CAR and PCT in predicting ICU mortality in TBI.Methods: Adults with TBI were enrolled in our study. The medical records of 82 isolated TBI patients were reviewed retrospectively.Results: The mean patient age was 49.0 ± 22.69 years; 59 of all patients (72%) were discharged, and 23 (28%) died. There was a statistically significant difference between PCT and CAR values according to mortality (P<0.05). The area under the curve (AUC) was 0.646 with 0.071 standard error for PCT and 0.642 with 0.066 standard error for CAR. The PCT showed a similar AUC of the receiver operating characteristic to CAR.Conclusions: This study shows that CAR and PCT are usable biomarkers to predict ICU mortality in TBI. When the determined cut-off values are used to predict the course of the disease, the CAR and PCT biomarkers will provide more effective information for treatment planning and for preparation of the family for the treatment process and to manage their outcome expectations.

Background and Objectives: This study aimed to discuss positional changes in the sternocleidomastoid (SCM) muscle and vagus nerve with head position, their effect on the surgical path, positional variations, the selection of an appropriate position for surgery, their effects on the surgical procedure, and complications by using peroperative ultrasonography. Materials and Methods: Vagal nerve stimulation surgery patients over the age of 18 years were included. Peroperative ultrasonography images were scanned, and changes in head position and anatomical and positional variations in the SCM muscle and vagus nerve at the surgical incision level were examined. Results: SCM localization was most frequently observed in the lateral aspect of the carotid sheath (n:16) in neutral position, while it was mostly observed in the medial aspect of the carotid sheath (n:16) at a 15 degree rotation. The vagus nerve was mostly observed between the jugular vein and carotid artery in neutral position (n:21), and it was observed at the same position at a 15 degree rotation (n:17). The positional change of the SCM muscle with head position was found to be statistically significant (p < 0.001), while the positional change of the vagus nerve was not (p:0.198). Conclusions: The SCM muscle closes the surgical path with head rotation by either deviating over the carotid sheath or increasing its deviation. In addition to its anatomical variations, the vagus nerve shows different positional changes with head rotation. Deciding on the head position in vagal nerve stimulation surgery, using peroperative ultrasonography rather than a routine position, may be effective in reducing surgical time and possible complications.

Introduction: Glioblastoma multiforme (GBM) is an aggressive central nervous system tumor that results in poor overall survival due to its rapid and aggressive course. Prognostic indicators are important in treatment strategies. This study aimed to investigate the effectiveness of inflammatory markers C-reactive protein (CRP)/albumin ratio, and white blood cell (WBC) count, as well as the pathological indicator Ki-67, for survival prediction and prognosis and their superiority.Material and methods: The demographic data of the patients, Glasgow Coma Scale (GCS), WBC, CRP, albumin, CRP/albumin values, Ki-67 values ​​at pathological diagnosis, and overall survival were examined in this study. Adults over the age of 18 who underwent gross total surgery in a single center and whose pathological diagnosis was glioblastoma multiforme, who received radiotherapy and chemotherapy after surgery, were included. Patients with chronic and comorbid diseases were excluded because of their potential to affect the parameters to be examined.Results: Among the 133 GBM cases, between 23 and 72 years of age were included, and 72.9% (n: 97) had a survival less than one year survival. Ki-67, WBC, CRP, albumin, and the CRP/albumin ratios were found to be statistically significant for 1-year overall survival (p values ​​in order: <0.001, <0.001, <0.001, 0.013, <0.001). The receiver operating characteristic (ROC) curve analysis revealed significant cutoff value at 22.5 for Ki-67, 0.70 for CRP/albumin ratio, and 7.42 for the WBC count for 1-year survival.Conclusion: The WBC count, CRP/albumin ratio, and Ki-67 parameters can be used to predict 1-year overall survival in patients with glioblastoma multiforme. These findings emphasize the need for more prognostic scoring models and evaluations of the role of inflammation in GBM prognosis.

Introduction High-grade primary brain tumors cause serious morbidity and mortality. This study aimed to investigate the role of transforming growth factor beta (TGF-β) and suppressor of mothers against decapentaplegic (Smad) receptors in high-grade primary brain tumors. Material and Method Thirteen patients with a pathological diagnosis of glioblastoma multiforme were included in the study. Pathological preparations of each patient were analyzed retrospectively in histochemistry and immunohistochemistry laboratories. Transforming growth factor beta 1, TGF-β2, TGF-β3, Smad 1/2/3, Smad 6, and Smad 7 stainings were evaluated, and the immunoreactivity densities were examined. Result We found out an increase in the expression of TGF-β1 and TGF-β3 protein. Regarding the inhibitin receptors, Smad 6 showed much more expression than Smad 7. Thus, we found that Smad 6 has a protective effect and role in the tissue. Immunhistochemically, TGF-β family stains, which are activated by types I-and -II receptors, and the stainless staining of the Smad family might also be showing that the TGF-β family is taking action with a secondary pathway other than the Smad family. Conclusion In addition to Smad family receptors, Shc-GBR2, SARA, and Ras-Erk1/2 receptors should be investigated in future research. After that, the prognosis, diagnosis, and patient-based chemotherapy strategies for the treatment of glioblastoma multiforme may take a more prominent role.

Primer omurilik tümörleri tüm merkezi sinir sistem tümörlerinin %2-4’üdür. İntramedüller tümörler tüm spinal tümörlerin en nadir görüleni olup tüm tümörlerin %20-30’unu oluşturmaktadır. İntramedüller tümörler arasında en sık astrositomlar ve epandimomlar görülmektedir. Tanıda en sık manyetik rezonans görüntüleme, kemik tutulum açısından bilgisayarlı tomografi kullanılmaktadır. Preoperatif nörolojik muayene, tümör lokalizasyonu ve derecesi postoperatif komplikasyonları belirleyen başlıca faktördür. Preoperatif motor defisit varlığında prognoz daha kötüdür. Torakal seviyedeki tümörlerin cerrahisinde komplikasyon oranı artmaktadır. Başlıca komplikasyonlar postoperatif nörolojik defisit, beyin omurilik sıvı kaçağı, enfeksiyon, operasyon bölgesinde epidural kanama, mesane ve bağırsak disfonksiyonu, sistemik komplikasyonlarda pulmoner emboli, derin ven trombozu sayılabilir. Komplikasyonların en aza indirilmesinde uygun hasta seçimi ile doğru ve güvenli cerrahi ön hazırlık yanında intraoperatif görüntülemelerin kullanılması, operasyon sonrası rehabilitasyon önemlidir. Bu bölümde spinal intramedüller tümör cerrahisi sonrası gelişebilecek komplikasyonlar, risk faktörleri ve önleme stratejileri derlenmiştir.

Sağlık bilimleri, moleküler düzeydeki mekanizmaların anlaşılmasından klinik kararlara uzanan karmaşık bir bilgi zincirini kapsamaktadır. Bu sürecin etkin, güvenilir ve yenilikçi bir şekilde işlemesi, temel bilimlerle klinik bilimler arasındaki yapıcı iş birliğine bağlıdır. Sağlık Bilimlerinde Bütüncül Perspektifler ve Klinik Süreçler başlıklı bu eser, sağlık alanındaki bilgi üretimini disiplinler arası bir bağlamda ele alarak, özellikle temel bilimsel verilerin klinik uygulamalara entegrasyonuna odaklanmaktadır. Bu kitap temel bilim alanlarından elde edilen bulguların, tanı, tedavi ve izlem süreçlerindeki yansımalarını değerlendirmektedir. Klinik pratikteki sorunların, laboratuvar temelli yaklaşımlarla nasıl daha iyi anlaşılabileceğini ve çözümlenebileceğini tartışmak, bu çalışmanın temel hedeflerinden biridir. Hedef kitlemiz; lisansüstü öğrenciler, araştırmacılar ve temel bilim veya klinik alanda çalışan sağlık profesyonelleridir. Okuyucuların, disiplinler arası bilgi akışını daha iyi kavramaları ve bu bilgi birikimini klinik kararlara entegre edebilmeleri amaçlanmaktadır. Kitap aynı zamanda, translasyonel araştırmaların önemine ve laboratuvar bulgularının hasta yatak başına uzanan yolculuğuna dikkat çekmektedir. Bu kitap, temel bilimsel bilginin yalnızca akademik birikimle sınırlı kalmayıp, klinik pratiğe yön verdiği bir sağlık sistemi tasavvuruna katkı sunmayı hedeflemektedir. Bu yaklaşımın, daha bütüncül, daha etkili ve daha bilim temelli sağlık hizmetlerinin inşasında önemli bir rol oynayacağına inanıyoruz.