Effects of supplementing a direct-fed microbial containing Enterococcus faecium 669 on performance, health, and metabolic responses of preweaning Holstein dairy calves.

This study aimed to evaluate the effects of Enterococcus faecium 669 supplementation on performance, health, parasitological, microbiological, and hematological responses of preweaning dairy calves. Forty-two newborn Holstein female calves (initial body weight [BW] 44 ± 4.5 kg) were used in the present study. At birth, calves were ranked by initial BW and assigned to 1 of 2 treatment groups: (1) whole milk (CON; n = 21) and (2) whole milk with the addition of direct-fed microbial Ent. faecium 669 (DFM; n = 21). During the entire experimental period (63 d), DFM was daily-fed at a rate of 2.5 × 109 cfu/head. All calves were offered a mixture of a starter feed and wheat straw for ad libitum consumption. Supplement intake was evaluated daily, whereas calves were weighed on a weekly basis from d 0 to weaning (d 63). Diarrhea was assessed once a day, and fecal and blood samples were collected for microbiological, parasitological, and hematological responses. All data were analyzed with SAS using calf as the experimental unit. A treatment × week interaction was observed for BW, as DFM-supplemented calves were heavier than CON cohorts on d 56 (+ 4.7 kg) and at weaning on d 63 (+ 4.8 kg). A similar interaction was observed for average daily gain (ADG) and dry matter intake (DMI), with greater ADG for DFM-supplemented calves from d 35 to 42, greater ADG and DMI from d 49 to 56, and greater DMI from d 56 to weaning. Moreover, diarrhea occurrence tended to be lower, whereas rectal temperature was 0.2°C lower for DFM-supplemented calves. Treatment × day interactions were observed for the occurrence and counts of Eimeria spp., as DFM-supplemented calves tended to have a reduced number of positive observations on d 42 of the study versus CON, and a significant reduction in positive animals from d 21 to 42 was observed in the DFM group but not in CON calves. For Cryptosporidium spp., no treatment effects were observed on overall occurrence (%), but DFM-supplemented calves had a greater count of oocyst per gram versus CON. No treatment × day interaction or main treatment effects were observed for any of the blood variables analyzed herein, exception being monocytes concentration. In summary, preweaning Ent. faecium 669 supplementation improved performance, diarrhea occurrence, and reduced the number of calves positively-detected for Eimeria spp.

Occupational Risks of Podologists: A Combined Assessment of VOCs, Vibration, Noise Levels and Health Complaints.

Podologists are exposed to many occupational hazards, including volatile organic compounds (VOCs) from insole manufacturing and noise/vibration during nail or tissue grinding. In this study, VOCs, noise, and vibration were measured in five podiatry clinics and three offices. Questionnaires were administered to 23 podologists and 19 office workers to inquire about their pain, ocular, skin and respiratory complaints. The results showed that the podologists' exposure to the total VOC concentrations was approximately twice as high as that of the office workers. The podologists' complaints regarding pain were found to be correlated with ambient noise and hand-arm vibration levels. Ocular, skin, and respiratory complaints were also found to be correlated with total VOC concentrations. These results suggest that VOCs, noise and vibration in the working environment may impair podologists' health and that they have an intensifying effect on each other, increasing the severity of health issues.

Subcutaneous fat index: a reliable tool for lumbar spine studies.

OBJECTIVES: Obesity has been proposed as a risk factor for low back pain (LBP), and the body mass index (BMI) has been used for obesity; however, a more reliable tool is required to assess obesity-related health issues. A recent study depicted the subcutaneous fat tissue thickness (SFTT) at the L1-L2 level as superior to BMI in predicting LBP and spine degeneration. However, the study failed to answer the following questions: (1) What was the cutoff value for the SFTT to predict LBP and spine degeneration? (2) Could this new index be adjusted according to gender? (3) Could this new index predict fatty infiltration in the paraspinal muscles, severe intervertebral disk degeneration (IVDD), and Modic changes in the lumbar spine? Therefore, the current study aimed to answer these questions by developing and validating a new anthropometric index-the subcutaneous fat index (SFI). METHODS: This study retrospectively reviewed the magnetic resonance imaging database of patients with LBP and compared them with asymptomatic volunteers. RESULTS: Appropriate cutoff values for females and males were 8.45 mm and 9.4 mm, respectively. Females and males with the SFI of > 8.45 mm and > 9.4 mm, respectively, had significantly higher rates of spine degeneration. CONCLUSION: The SFI reliably distinguished patients with LBP from the asymptomatic subjects and could reliably distinguish patients with severe IVDD/Modic changes at the lower lumbar levels and those with moderate-to-severe fat-infiltrated paraspinal muscles at all lumbar levels with reliable cutoff values for males and females. KEY POINTS: • The subcutaneous fat tissue thickness at L1-L2 level (subcutaneous fat index [SFI]) was superior to BMI in predicting LBP and spine degeneration. However, a reliable cutoff value has not been previously defined. • The subcutaneous fat index had reliable cutoff values of 8.45 mm and 9.4 mm for females and males, respectively. • Females with an SFI of > 8.45 mm and males with > 9.4 mm had significantly higher rates of severe IVDD, Modic changes, and fatty infiltration in their paraspinal muscles.

The residue levels of spinosad and abamectin in eggs and tissues of laying hens following spray application.

Spinosad (SPN) and abamectin (ABM) are used in poultry premises to control external parasites including red mites (Dermanyssus gallinae). This study aimed to determine levels of SPN (spinosyn A + spinosyn D) and ABM residues in egg and edible tissues of laying hens following spray application. A total of 36 laying hens were divided into four groups of nine birds each, and they were kept in individual cages. Two different concentrations of SPN (2 and 4 g/l) and ABM (0.025 and 0.033 g/l) were applied in stocked and empty cages, respectively. Eggs were collected individually for 30 days. All hens were sacrificed at day 30 post-treatment, and tissue samples (liver, breast muscle, fat and skin) were collected. The residue levels in eggs and tissues were determined by high pressure liquid chromatography. ABM residues were not detectable in egg samples. SPN residues in eggs and residues of both ABM and SPN in liver, muscle and fat were under the maximum residue limits (MRLs) following low and high concentration applications. However, although the MRLs have not been established for SPN and ABM in skin tissue of chicken, residues in the skin detected at the low and high concentrations were greater than the MRLs for other edible tissues (except fat tissue) indicating that a withdrawal period would be necessary for the skin tissue after ABM and SPN use in laying hens.

Tick species (Acari: Ixodida) in Antalya City, Turkey: species diversity and seasonal activity.

Ticks (Acari: Ixodida) are an important group of ectoparasites of vertebrates. Most species are known vectors of diseases including Lyme disease, Q fever, and Crimean-Congo hemorrhagic fever. A 3-year research was conducted in Antalya, Turkey, to determine tick species composition, seasonal abundance, and spatial distribution. The study was carried out in five districts (Aksu, Dosemealti, Kepez, Konyaalti, and Muratpasa) of Antalya Metropolitan Municipality area in Turkey, between May 2010 and May 2013, where 1393 tick specimens were collected from domestic and wild animals (cattle, goats, sheep, hedgehogs, tortoises, dogs, cats, chickens) and from the environment. The collected ticks were preserved in 70 % alcohol and then were identified. Five genus and eight hard and soft tick species were identified, including Argas persicus, Rhipicephalus annulatus, R. sanguineus, R. turanicus, Hyalomma aegyptium, H. marginatum, Haemaphysalis parva, and Dermacentor niveus. Rhipicephalus sanguineus, R. turanicus, and H. aegyptium were the most common tick species in Antalya city. Rhipicephalus turanicus and R. sanguineus were the most abundant tick species infesting dogs in the city. The hosts of H. aegyptium are primarily tortoises in Antalya. The results of this research will contribute to establishing appropriate measures to control tick infestations on animals and humans and their environment in the city of Antalya.

A Method for Diabetic Wound Specific Insole Design, Manufacturing and Biomechanical Validation for Better Recovery.

Muscle disorders may cause a change in plantar pressures by the misalignment on the foot during gait phases. Therefore, corns or calluses develop at the plantar regions, and diabetic foot ulcers follow for severe cases although it can be prevented and even treated by podiatric approaches with patient specific therapeutic insole and footwear. Although the importance of a threshold value of 200 kPa in peek plantar pressure reduction has been highlighted as a gold standard to prevent re-ulceration in diabetic foot, it may not be possible to ensure this pressure reduction for each patient. In this study, 3 types of ethylene-vinyl acetate have been utilized to optimize the off-loading performance for pre-determined early-stage diabetic foot ulcer scenarios by means of baropodometric plantar pressure analyses and finite element method for each gait phase. The total cost of the manufacturing for this study was reduced down to $10.26 and was performed in 24.6 minutes. In addition, the offloaded pressure was increased by 2.3 times while the volume of the off-loading geometry was increased 8.12 times based on the utilized foam polymer. Consequently, improved off-loading was obtained and a standard was proposed for the first time to calculate the off-loading performance before manufacturing of the therapeutic insole model to ensure a better recovery period.

Distribution of Scabies Infestations in Stray Dogs in Bursa Province.

Objective: Scabies infestation is a major parasitic disease affecting both human and animal health worldwide. This study aimed to determine the distribution of scabies infestation in stray dogs in Bursa province. Methods: The study material was obtained from stray dogs suspected of mange kept in a municipal shelter in Bursa between June 2020 and February 2022. Samples from stray dogs were examined in a laboratory, and dogs with scabies were determined. Results: During the study, samples were collected from 205 (115 males, 90 females) scabies-suspected stray dogs, 58 (28.29%) of which had scabies. Demodex spp. were detected in 35 of the positive dogs (60.34%) (D. canis, D. injae), 19 (32.76%) Sarcoptes scabiei canis, 2 (3.44%) mixed infestation (Sarcoptes and Demodex), and 2 (3.44%) Otodectes cynotis agents. It was determined that 32 (55.17%) of 58 scabies-positive dogs were male and 26 (44.83%) were female. The association of infestations with age, season, and sex has not been found to be statistically meaningful. Conclusion: This study identified scabies agents and their prevalence rate in stray dogs of Bursa province, Türkiye.

Entomopathogenic fungi with biological control potential against poultry red mite (Dermanyssus gallinae, Arachnida: Dermanyssidae).

The poultry red mite, Dermanyssus gallinae (Arachnida: Dermanyssidae) is a pest that causes significant economic loss in laying hens for which control methods are limited. In this study, the effects of 20 indigenous fungal strains on poultry red mites in chicken farms were investigated. All experiments were conducted under laboratory condition at 28 ± 1 °C and 80 ± 5% humidity. A screening test showed that Metharizium flavoviride strain As-2 and Beauveria bassiana strain Pa4 had the greatest measured effect on D. gallinae at 1 × 107 conidia/ml 7 days after application. In a subsequent does-response experiment, these strains also caused 92.7% mortality at 1 × 109 conidia/ml within the same period. The LC50 of these strains was 5.5 × 104 (95% CI: 0.8-37.5) conidia/ml for As-2 and 3.2 × 104 (95% CI: 0.4-26.0) conidia/ml for Pa4, and their LT50 were 1.94 and 1.57 days, respectively. The commercial Metarhizium anisopliae bioinsecticide Bio-Storm 1.15% WP, used as a comparator, had LC50 and LT50 1 × 105 (95% CI: 0.1-7.9) conidia/ml and 3.03 (95% CI: 2.4-3.8) days, respectively. It is suggested that mycoacaricides could be developed using the best two fungal strains found in this study (As-2 and Pa4), providing potential for biological control of poultry red mites.

Localization of Maxillary Artery for Cerebral Revascularization: L-Shaped Perpendicular Two-Step Drilling Technique Stretching from the Foramen Ovale to Rotundum.

BACKGROUND: The use of the maxillary artery (MA) as a donor has increasingly become an alternative method for cerebral revascularization. Localization difficulties emerge due to rich infratemporal anatomical variations and the complicated relationships of the MA with neuromuscular structures. We propose an alternative localization method via the interforaminal route along the middle fossa floor. METHODS: Five silicone-injected adult cadaver heads (10 sides) were dissected. Safe and effective localization of the MA was evaluated. RESULTS: The MA displayed anatomical variations in relation to the lateral pterygoid muscle (LPM) and the mandibular nerve branches. The proposed L-shaped perpendicular 2-step drilling technique revealed a long MA segment that allowed generous rotation to the intracranial area for an end-to-end anastomosis. The first step of drilling involved medial-to-lateral expansion of foramen ovale up to the lateral border of the superior head of the LPM. The second step of drilling extended at an angle approximately 90° to the initial path and reached anteriorly to the foramen rotundum. The MA was localized by gently retracting the upper head of the LPM medially in a posterior-to-anterior direction. CONCLUSIONS: Considering all anatomical variations, the L-shaped perpendicular 2-step drilling technique through the interforaminal space is an attainable method to release an adequate length of MA. The advantages of this technique include the early identification of precise landmarks for the areas to be drilled, preserving all mandibular nerve branches, the deep temporal arteries, and maintaining the continuity of the LPM.

Management of Persistent Syringomyelia in Patients Operated for Chiari Malformation Type 1.

BACKGROUND: The treatment of persistent syringomyelia associated with Chiari malformation type 1 (CM1) is unclear. This study aims to evaluate the clinical and radiologic outcomes of syringo-subarachnoid shunt (SSS) as a treatment for persistent syringomyelia following posterior fossa decompression (PFD) for CM1. METHODS: Forty-nine cases treated for CM1 associated syringomyelia at a single center were analyzed, 17 of them undergoing reoperation due to persistent syrinx formation. The patients' demographic data, neurologic presentations, and radiologic results were analyzed, including cerebellar herniation, posterior fossa volume, the level at which the syrinx started and finished, the size and diameter of the syrinx. RESULTS: Seventeen patients underwent SSS placement, with 1 minor surgical complication (a cerebrospinal fluid leak) occurring and requiring revision. No morbidity or mortality was observed. Among these 17 reoperated patients, partial or complete resorption of the syrinx was observed in all cases. The results suggest that if the syrinx diameter is >10 mm at its thickest point, extends for more than 10 vertebrae, and starts from the upper cervical region and extends to the upper thoracic region, the syrinx may not regress after the first surgery and potentially predicting the need for a second operation before PFD. CONCLUSIONS: SSS placement for persistent syrinx following PFD for CM1 is a safe and effective surgical treatment method. These criteria may also help predict the need for a second surgery and the overall disease outcome for both the surgeon and patient.

Tick survey and detection of Crimean-Congo hemorrhagic fever virus in tick species from a non-endemic area, South Marmara region, Turkey.

Crimean-Congo hemorrhagic fever (CCHF) is an increasing health concern in Turkey since 2002. There were also some recent human cases from the South Marmara region of Turkey; thus, a tick survey was performed, and possible vector tick species for the CCHF virus were determined in the region. A total of 740 adult ticks were collected from infested livestock from five locations: Çanakkale-Biga, Bursa-Orhaneli, Bursa-Keles, Balikesir and Bilecik. Total of 11 tick species from the genera Hyalomma, Rhipicephalus, Dermacentor, Ixodes and Haemaphysalis were identified. Rhipicephalus ticks were dominant in the region; the most frequently observed tick species was R. turanicus, (53.1 %), and only 15.4 % of the identified ticks were H. marginatum. The occurrence of H. rufipes infestation in the region fort he first time. A total of 73 pools of adult ticks were tested with both an antigen-detecting ELISA and RT real-time PCR (RT rt PCR). The presence of the CCHF virus was demonstrated in 9 (12.3 %) of the tested tick pools. Although seven of the tick pools were positive for the CCHF virus with both of the methods, one pool was positive only with RT rt PCR and the other pool was only positive with the ELISA. Positive results were obtained from ticks collected from cattle, sheep and goats from two locations, Bursa-Orhaneli and Bilecik. The CCHF virus was detected in R. turanicus (n = 3), R. bursa (n = 2), H. marginatum (n = 2) and D. marginatus (n = 2) ticks. The results of this study confirm the presence of the CCHF virus and present preliminary data on the vector tick species in the southern Marmara region of Turkey.

A difficult diagnosis of anaplasmosis with pneumonia: A case report.

Anaplasmosis (Human Granulocytic Anaplasmosis, HGA), is a disease caused by Anaplasma phagocytophilum but also formerly known as Ehrlichia phagocytophilum and Ehrlichia equi. We present a 57-year-old male diagnosed with systemic HGA and lung involvement, who had lived in Benin. A possible tick bite had been reported in his history. There was a dramatic response to treatment.

Brain Abscess: A Comparison of Surgical Outcomes between Conventional Burr Hole Aspiration and Endoscope-Assisted Evacuation.

BACKGROUND: Brain abscesses are a major health problem with significant morbidity and mortality rates. The objective of this study was to compare the surgical efficacy of endoscope-assisted evacuation of a brain abscess with that of single burr hole aspiration in a tertiary health care center. METHODS: This single-center nonrandomized clinical study was conducted during the period from July 2020 to December 2021. Male and female patients younger than 30 years who presented with brain abscess were enrolled in this study. They were divided into two groups and treated with two different techniques: conventional burr hole aspiration group and endoscope-assisted evacuation group. RESULTS: Thirty patients were enrolled in this study. The mean age was 13.0 ± 6.3 years in the burr hole group and 13.1 ± 6.4 years in the endoscope-assisted group. There was ≥75.0% evacuation of brain abscess on postoperative day 1 in 13 (92.9%) patients in the endoscope-assisted group and in 5 (33.3%) patients in the burr hole group. The mortality rate was 6.7% in both groups. The mean residual volume on postoperative day 30 was 0.75 mL in the endoscope-assisted group and 1.75 mL in the burr hole aspiration group. No patients treated with endoscope-assisted evacuation required a repeat surgery, whereas five patients (33.3%) treated with the conventional burr hole method required a repeat surgery. CONCLUSIONS: This study showed that the endoscope-assisted procedure has a better rate of abscess evacuation, lower residual risk, and less chance of repeat surgeries than the conventional burr hole procedure.

Acaricidal activity of the essential oils from three Lamiaceae plant species on Rhipicephalus turanicus Pom. (Acari: Ixodidae).

Acaricidal effects of three Labiatae essential oils extracted from ariel parts of Thymus sipyleus Boiss. subsp. sipyleus, Mentha longifolia L., and Dorystoechas hastata Boiss. & Heldr. ex Bentham on 10-day-old Rhipicephalus turanicus Pom. (Acari: Ixodidae) larvae were evaluated by using the larval packet test bioassay. Serial dilutions of the three essential oils were tested from a starting concentration of 1-0.1% (1.0, 0.5, 0.25, and 0.1% w/v). Results showed that all essential oils had very similar activity, producing complete mortality (100%) in all tested concentrations on 10-day-old R. turanicus tick larvae.

Distribution and seasonal activity of tick species on cattle in the West Aegean region of Turkey.

The aim of the present study was to determine the identity, seasonal activity and distribution of tick species of cattle in the West Aegean region of Turkey between June 2006 and May 2008. Nine villages within three provinces, viz. Manisa, Izmir and Aydin, were included in the study and a total of 75 animal barns were visited monthly for a period of 24 months and 443 cattle were examined for the presence of ticks. It was determined that 23% of cattle were infested with ticks. A total of 19,679 adult ticks were collected. The most abundant tick species was Hyalomma marginatum (33.5%) and H. excavatum (16.9%) in the study area. Seasonal appearance of the adult ticks varied among species. Adult ticks of the Hyalomma genus were present throughout the year, although in smaller numbers during the winter. Species of Rhipicephalus were detected in all seasons except autumn. Rhipicephalus (Boophilus) annulatus was identified in July and August, Haemaphysalis parva was detected during the autumn. Ixodes ricinus and Dermacentor marginatus were identified during spring, autumn and winter. The study demonstrated the presence of I. ricinus, D. marginatus, Hyalomma rufipes and Hae. parva for the first time in the West Aegean region of Turkey.

Evaluation of the efficacy of cow colostrum in the treatment and its effect on serum proteomes in calves with cryptosporidiosis.

This study aimed to investigate the effect of using high-quality colostrum in addition to paromomycin on the treatment outcomes and serum proteomes of calves naturally affected by cryptosporidiosis. Thirty Holstein calves infected with only Cryptosporidium spp. were divided into three equal groups. Calves in the PC group received paromomycin orally at a dose of 100 mg/kg once daily for 5 days. Calves in PCOL and PBCOL groups received 250 ml colostrum 3 h after feeding twice a day for 3 days. The PBCOL group was also given 6 g of sodium bicarbonate 15 min before colostrum administration. While the fecal scores of all calves were evaluated daily for 10 days from the initiation of the treatment, fecal oocyst counts were determined on the 0, 1, 2, 3, 5, 7, and 10th days. Brix%, total protein (TP), immunoglobulin G (IgG), gamma-glutamyltransferase (GGT) levels, and proteomic analyses were performed on the 0 and 3rd days' sera. Considering pretreatment values, fecal scores (8th, 2nd, and 2nd day), and fecal oocyst counts (10th, 3rd, and 2nd day) improved in a significantly (p < 0.05) shorter time in the colostrum groups than in the control group. By serum proteomic analysis, 99, 93, and 83 proteomes were detected in PC, PCOL, and PBCOL groups, respectively. Although the significant changes in any protein in Group PC were absent, significant changes were observed in Alpha-1B-glycoprotein (A1BG), Zinc transporterZIP11 (S39AB), Cathelicidin-1 (CTHL1), Actin_ cytoplasmic-1 (ACTB), and Apolipoprotein A-IV (APOA4) proteins in Group PCOL and Alpha-1-antiproteinase (A1AT), Serum amyloid A protein (SAA), Actin-cytoplasmic-2 (ACTG), Protein HP-20 homolog (HP20) proteins in Group PBCOL with colostral treatment, which indicated that the use of colostrum had an effect on calf serum proteomes. The more pronounced healing and shorter clinical improvement time in the colostrum groups especially colostrum with sodium bicarbonate revealed that these proteomes have positive effects in the treatment with their systemic and local effects in the intestines.

Experimentation of Essential Oils and Entomopathogenic Fungi Against Wax Moth Larvae in Laboratory Conditions

Objective: Larvae of wax moths cause great harm to honeybee hives and especially stored honeycombs. In the battle for wax moth in storage rooms; biological methods of struggle that does not harm the bee, product and the environment have become important. This study was conducted to determine the effect of essential oils of cloves, thyme and bay plants at 5% and commercial preparation derived from the entomopathogenic fungus Metarhizium anisopliae under laboratory conditions against wax moth larvae. Methods: Content analyses of essential oils have determined components by doing them with the gas chromatography/mass spectrometry device. Previously collected and cultured lesser wax moth (Achroia grisella) larvae are divided into three groups, small/medium/large, based on their period. For each group of fifteen larvae, three volatile oils, one fungal experiment were performed, and two control groups were formed. The trials were conducted in glass jars and the larvae were retained in an incubator with a temperature of 25 °C/75% relative humidity conditions. Each jar was checked daily for nine weeks with dead/live larvae recorded and dead ones taken from the jar. Results: At the end of the study, moth emerging rates were determined for each group of dead larvae and remainders. Based on their percentage average; while no difference was seen between the essential oil groups and the control group, the fungal groups were observed to be effective relative to the control groups. Conclusion: According to the data, it was determined that M. anisopliae fungus preparation could be used as an alternative control methods against wax moth larvae in storage conditions.

COVID-19, Anxiety, and Hopelessness: Quality of Life Among Healthcare Workers in Turkey.

The aim of the study is to investigate the effects of intense anxiety and hopelessness experienced by healthcare workers during the pandemic on their quality of life. This cross-sectional, online questionnaire-based study was conducted between August 31, 2020 and October 31, 2020, with 729 healthcare workers in Turkey. The study showed that hopelessness, the weekly working time, fatigue, and the workload of healthcare workers negatively affected their quality of life, those who found the pandemic measures inadequate had a lower quality of life and higher hopelessness levels, and those who needed knowledge on various issues to improve their skills had lower quality of life and higher levels of anxiety and hopelessness. Increasing the measures to make healthcare workers feel competent and ready during the COVID-19 pandemic and meet their information needs to improve their skills will reduce their anxiety and hopelessness and improve their quality of life. Identifying the factors affecting anxiety, hopelessness, and quality of life will help achieve sustainable success in the delivery of health services and promote employee health and safety.

Analysis and Differences of the Neurosurgical Complications During COVID-19 Pandemic.

Objectives: The objective of the study was to analyze the complications of neurosurgical operations during the COVID-19 pandemic by comparing them with the complications observed in the pre-pandemic period. Methods: Two groups were formed: (1) Patients who were operated in the 5-month period of the pandemic (March-July 2020) and (2) those who were operated the same operations in the same period 1 year before (March-July 2019). Demographics, characteristics, medical follow-up data, complications, and outcome compared between the groups. Results: Similar demographics were observed between the groups. The number of all neurosurgical cases and neurotrauma cases decreased by 79% and 68% in pandemic period, respectively. The rate of emergency surgeries was significantly higher in pandemic group (p<0.001). The operation time was significantly longer in pandemic group (p=0.014). Total complication rate was significantly higher in pandemic group (p=0.002). Specifically, the rate of pulmonary complications was significantly higher during pandemic period (p<0.001). The infection rate (p<0.001), antibiotic use (p<0.001), and intensive care unit stay (p=0.023) were significantly higher in pandemic group. Conclusion: During pandemic period complication rates increased and a higher risk than expected was encountered. Treatment should be performed by taking the precautions and informing the patients about additional risks.

Lumbar Intradiscal Ozone Chemonucleolysis Applied Together with the Epidural Steroid Treatment.

OBJECTIVES: Intradiscal ozone treatment is a minimally-invasive method that can be applied to patients who have low back pain and do not respond to conservative treatment. This retrospectively designed study aimed to evaluate its clinical efficacy, adverse effects, or complication rates. METHODS: Patients with lumbar degenerative disc disease (LDDD) who underwent intradiscal O2-O3 treatment between January 2016 and April 2018 were included in the study. Pain and disability levels were assessed at pre-injection, 1-month and 1-year post-injection periods using visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively. RESULTS: A total of 520 patients (270 males and 250 females) with the mean age of 38.9±5.7 years included in the study. First-month and 1st-year post-injection VAS and ODI scores were significantly lower than pre-injection scores (p<0.001). Remarkable VAS score reduction (more than 50%) was found in 60.2% of patients at 1st month and in 52.9% of patients at the 1st year. No important side effects recorded. CONCLUSION: Intradiscal ozone therapy applied together with the epidural steroid treatment, one of the percutaneous application techniques for the treatment of low back pain related to LDDD, has successful outcomes, clinical efficacy, and low rate of side effects, and thus, is one of the methods that should be considered before surgery when appropriate patients.