Our aim was to compare the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) over supplementary motor area with that of sham stimulation in restless legs syndrome (RLS). In this prospective study, patients were randomly assigned to either real stimulation group (11 patients), or sham stimulation group (8 patients) in a double-blinded fashion. Five patients, who were initially in the sham stimulation group, received real stimulation 1 month after the sham stimulation. One session of intervention was performed once every 3 days and total of ten sessions were done in each group. The International RLS-Rating Scale (IRLS-RS) was assessed at baseline and after 5th and 10th sessions in both groups and also in five patients in whom both sham and real stimulation were performed. A statistically significant difference was seen in the IRLS scores between real (n = 11) and sham stimulation (n = 8) after 5th and 10th sessions. The real stimulation significantly improved the IRLS-RS scores although they were unaffected by the sham stimulation. In five patients, in whom both sham and real stimulation were performed, a statistically significant improvement was seen in the IRLS-RS scores with the real stimulation and a statistically significant difference was seen in the IRLS scores between real and sham stimulation after 10th session. In conclusion, this method is safe and non-invasive, and the results of this pilot study may support that rTMS has the potential to be used in the treatment of RLS, which should be verified in larger series.
Our findings indicate that open drainage leads to better results compared to those of Eloesser flap in patients with chronic tuberculous empyema. Patients who underwent pneumonectomy were expected to have higher complication rates and the procedure must therefore be avoided when possible.
Central venous catheters are frequently used for different causes, like fluid infusions, haemodialysis, and measurement of central venous pressure. Complications that occur at the time or after the placement of these catheters can give harm to the patient or can cause need for a new attempt. Complications, like malfunction of the catheter, arterial puncture, haemothorax, or pneumothorax, can be seen in 5%-26% of the patients, and early detection is very important. We want to present a venous perforation and lung injury case according to the catheter based upon the literature.
ÖZET
GİrİŞAnestezi ve cerrahideki gelişmelere rağmen, pnömo-nektomi ameliyatına bağlı komplikasyon oranları % 50'e kadar yükselebilmektedir. Bu komplikasyonlar kardiyak herniasyon, hemoraji, pnömotoraks, şilo-toraks, atelektazi, mediastinal kayma, bronkoplevral fistül, ampiyem, postoperatif pnömoni, postpnömo-nektomi sendromu, pulmoner ödem, aritmi, pulmoner emboli, miyokard infarktüsü gibi çok çeşitli olabilir [1] . Pnömonektomi sonrası mortalite oranları ise % 5-13 arasında değişmekte olup; sağ pnömonektomi sonrasında daha fazladır. Mortalitenin en sık nedeni postoperatif aritmi ve akut akciğer hasarıdır [1][2][3] .Pnömonektomilerden sonrası ender olarak mediastenin aşırı kayması ile ana bronş aorta, pulmoner arter veya vertebra arasında sıkışabilmektedir. Bu ender bir postpnömonektomi komplikasyonu olup; genellikle geç dönemde gelişir. Sağ pnömonektomi sonrasında, mediastenin aşırı kayması ve trakea ile pulmoner damarların saat yönünün tersine dönmesi, sol ana bronşun anteriorda pulmoner arter, posteriorda desendan aorta arasında sıkışmasına neden olmaktadır. Sol pnömonektomi sonrası da gelişebilen bu klinik tabloda sağ ana bronş ve pulmoner damarlar, saat yönünde dönerek, anteriorda yine pulmoner arter, posteriorda ise vertebra arasında sıkışmaktadırlar [4,5] .Sol pnömonektomi sonrası erken dönemde mediasAlındığı tarih:
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