Alaettin Yurt

Background and Objectives: Ischemia-modified albumin (IMA) has previously been identified as a biomarker for early ischemia, rapidly formed by acidosis and free radical modification of the N-terminus of human serum albumin. This study aimed to compare albumin and IMA levels in blood and cerebrospinal fluid (CSF) from 30 patients with spontaneous subarachnoid hemorrhage (SAH) and 15 patients with normal pressure hydrocephalus (NPH) at a single center between 2021 and 2022. Materials and methods: This prospective study included 30 patients diagnosed with subarachnoid hemorrhage (SAH), confirmed radiologically, who were admitted to the Health Sciences University İzmir Bozyaka Training and Research Hospital and constituted the study group. The control group consisted of 15 patients diagnosed with normal pressure hydrocephalus (NPH) without a history or radiological evidence of subarachnoid hemorrhage or any other intracranial hemorrhagic pathology. In the control group, no pathological findings suggestive of hemorrhage or inflammation were detected in serum or cerebrospinal fluid (CSF) analyses. Blood and CSF samples were collected simultaneously from all participants, and albumin and ischemia-modified albumin (IMA) levels were measured. Serum and CSF albumin and IMA levels were compared between the study and control groups. Results: Of the 30 patients included in the study, 19 (63.3%) were male and 11 (36.7%) were female. The albumin level was lower in the patient group compared to the NPH group (3.8 g/dL [1.8–4.7] vs. 4.3 g/dL [3.2–5.0], respectively, p = 0.008). The serum IMA level was higher in the patient group compared to the NPH group (0.36 ABSU [0.30–0.65] vs. 0.25 ABSU [0.05–0.32], respectively, p = 0.010). The serum IMA level was higher in the vasospasm group compared to the group without vasospasm. Conclusions: In patients with SAH, a condition associated with high morbidity and mortality, modified albumin levels were found to be significantly higher in both CSF and blood compared to the NPH group. IMA may be a potential biomarker associated with SAH and vasospasm; however, further large-scale studies with multivariable analysis and external validation are required to confirm its diagnostic and prognostic utility.

Background and Objectives: Osteoporotic vertebral compression fractures (OVCFs) are a common cause of morbidity in the elderly, often resulting in pain, reduced mobility, and diminished quality of life. Treatment options include conservative management, vertebroplasty (VP), and kyphoplasty (KP). This study aimed to compare the clinical outcomes and complication rates of patients treated with kyphoplasty/vertebroplasty versus conservative methods and identify risk factors associated with the development of new fractures. Materials and Methods: This retrospective cohort study included patients diagnosed with OVCFs who were treated either surgically (KP/VP) or conservatively between January 2020 and January 2025. Inclusion criteria encompassed vertebral height loss on CT, STIR hyperintensity on MRI, and a T-score below −2.5. Patients were followed for at least one year. Clinical evaluations included pain scores (VAS), functional status (ODI), and quality of life assessments. Complications and new fracture rates were recorded. Logistic regression analysis was performed to identify risk factors influencing fracture recurrence. Results: A total of 132 patients were analyzed: 65 in the KP/VP group and 67 in the conservative treatment group. The KP/VP group achieved better postoperative pain results (3.2 ± 1.0 vs. 4.0 ± 1.2) with a significant difference of −0.8 (95% CI: −1.2 to −0.4, p = 0.032) and better mobility results (ODI: 4.5 ± 0.8 vs. 3.9 ± 0.9) with a significant difference of 0.6 (95% CI: 0.3–0.9, p = 0.047) and improved quality of life scores (6.7 ± 1.1 vs. 5.9 ± 1.3) with a significant difference of 0.8 (95% CI: 0.4–1.2, p = 0.041). The incidence of new fractures was similar between groups (15.4% vs. 17.9%, p = 0.678). Overall complication rates were 7.7% in the KP/VP group versus 11.9% in the conservative group (p = 0.435). The results from logistic regression analysis showed that age (adjusted OR: 2.48, 95% CI: 1.20–5.13), low bone mineral density (adjusted OR: 0.31, 95% CI: 0.15–0.63), and cement leakage (adjusted OR: 3.10, 95% CI: 1.21–7.99) were identified as risk factors for new fractures. The study found that outdoor activity (adjusted OR: 0.38, 95% CI: 0.20–0.73) and anti-osteoporosis treatment (adjusted OR: 0.17, 95% CI: 0.04–0.79) acted as protective factors against new fractures. The KP/VP group required half the time to recover from their injuries because they used their braces for 3.0 ± 0.5 months instead of 6.0 ± 1.0 months (p < 0.001). Conclusions: Kyphoplasty and vertebroplasty were more effective than conservative treatment in improving pain, mobility, and quality of life in patients with OVCFs. Although the incidence of new fractures did not differ significantly between groups, surgical treatment demonstrated lower complication rates and significantly faster recovery, as evidenced by reduced brace use duration. These findings support the use of KP/VP as a viable option for managing OVCFs in appropriately selected patients.

Primary bone lymphoma is a rare entity, accounting for approximately 3-7% of malignant bone tumors, 5% of extra-nodal lymphomas and <1% of all non-Hodgkin lymphomas. Primary spine localized lymphoma is 1.7% of all primary bone lymphomas. A 73 year-old female presented with a two month history of severe backache. T1W and T2W MRI showed a hypointense soft tissue component extending from the left posterior elements to Th7 corpus. The patient underwent Th6-7-8 total laminectomy. Th7-8 extradural mass was totally resected. Excisional biopsy was performed through Th7 left pedicle and vertebroplasty was applied. Significant reduction in pain was seen postoperatively. The patient was diagnosed with diffuse large B cell lymphoma. R-CHOP chemotherapy and local radiotherapy were applied. Any other lesions were not detected after the examinations following 6 months period and it was accepted as primary bone lymphoma.