Factors Affecting Resorption Following Cranioplasty with an Autologous Bone Graft.

AIM: To evaluate the relationship between the surgical techniques, the waiting time for surgery, postoperative distance between the graft-bone margin and the percentage of bone resorption, we analyzed patients who underwent cranioplasty. Cranioplasty is a necessary surgery to preserve brain tissue and provide an appropriate microenvironment. MATERIAL AND METHODS: In this study, patients who underwent autologous bone grafting after decompressive craniectomy by the Neurosurgery Clinic of University of Health Sciences Ankara Training and Research Hospital between 2018 and 2021 were examined. RESULTS: Thirty-nine patients who underwent autologous cranioplasty following decompressive craniectomy were included in the study. The average expected time for cranioplasty surgery following decompressive craniectomy was 16.97±13.478 weeks (min:2 max:62 weeks). The expected time between decompressive craniectomy and cranioplasty surgeries and resorption rates were compared. The resorption rate was above 30% in 7 of 10 patients with 24 weeks or more between craniectomy and cranioplasty, and less than 30% in 17 of 25 patients in surgeries less than 24 weeks (p=0.04). Following cranioplasty surgery, the distance between the graft-bone margin and the resorption rates were also compared. In this analysis, statistically significant differences were detected between the distance between the graft-bone border and the resorption rates. Resorption rates increased in 15 of 19 patients with a postcranioplasty distance of 1 mm or more (p < 0.00001). CONCLUSION: Early cranioplasty surgery is important in order to reduce complications that may occur after craniectomy. In addition, it is important to keep the defect area small in size during craniectomy surgery and to keep the cutting edge thinner when the bone graft is taken, in order to reduce the development of bone graft resorption.

Depression and hopelessness in pre-clinical medical students.

BACKGROUND: Mental distress seriously affects the quality of life of medical students. Medical students face mental health problems such as depression, anxiety and hopelessness. The pre-clinical years include substantial changes in a student's life, such as moving cities and losing friends, which can complicate an already stressful life, leading to depression and hopelessness. This study aims to determine the levels of depression and hopelessness, and the habits that can affect these levels, among pre-clinical medical students. METHODS: A descriptive cross-sectional study was conducted using anonymous questionnaires composed of the Beck Depression Scale (BDS), the Beck Hopelessness Scale (BHS), and questions about sociodemographic and perceived reasons for happiness or unhappiness. We invited pre-clinical medical students to join the study. Particularly during the pre-clinical years, medical students face the adverse effects of changing cities, social circles co-workers RESULTS: A total of 1015 (70.5%) students participated in the study. The prevalence of depression among pre-clinical students was found to be 27.7 per cent and mild levels of hopelessness were found in 54.4 per cent. A meaningful positive correlation was found between the BDS scores and BHS scores of medical students (r = 0.535; p < 0.0001). The BDS scores of students who were ex-smokers, daily consumers of fizzy beverages and energy drinks, and students with chronic diseases were significantly higher (p < 0.05). The BHS scores of the students who were ex-smokers and daily consumers of fizzy drinks, as well as intersex students, had significantly higher scores than the other groups (p < 0.05). DISCUSSION: A healthy social life and effective psychological counselling services are very much needed for mental well-being among medical students in their pre-clinical year.