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    Effectiveness of the Thermal Genicular Nerve Radiofrequency Ablation Therapy Under Fluoroscopy in Patients with Non-operative Advanced Stage Knee Osteoarthritis: 1-Year Follow-Up Results
    (Springer Heidelberg, 2022) Kaya, Oguz; Senel, Ahmet; Batur, Omer Cihan; Gonder, Nevzat; Ergen, Emre; Peker, Baris
    Background In this study, our aim was to present the 1-year results of the effect of thermal genicular nerve radiofrequency ablation (GNRFA) therapy on pain and functional outcomes in patients with advanced knee osteoarthritis. Materials and Methods After retrospectively examining the hospital records, 49 knees of 35 patients who had undergone thermal RFA of the superior medial, superior lateral, and inferior medial branches of the genicular nerve under fluoroscopic guidance between July 2019 and December 2020 were included in the study. The visual analog scale (VAS) scores of the patients were recorded before RFA, on the day of RFA, and at the first, sixth, and 12th months postoperatively, as well as their Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores before RFA and at the 12th month postoperatively. Complications developed after the procedure and during the follow-up period were screened. Results Twenty-five of the patients were females and 10 males, with a mean age of 77.3 +/- 7.9 years (range 61-92 years). The mean VAS score was 8.4 +/- 0.9 before RFA, and as 1.7 +/- 1.0 right after the procedure, 2.4 +/- 1.7 at the first month, 3.4 +/- 1.8 at the sixth month, and 4.4 +/- 1.9 at the 12th month (p < 0.01). In terms of the WOMAC score, the average value was 69.7 +/- 6.4 before the treatment and 36.1 +/- 11.8 at the final follow-up at the 12th month (p < 0.01). No complications were observed in any patient during the treatment or the follow-up period. Conclusion Non-surgical thermal GNRFA therapy of knee osteoarthritis provides significant outcomes in terms of pain and functionality, with no significant systemic or local side effects. Therefore, the technique can be considered as an alternative to other methods when treating advanced osteoarthritis.
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    Epilepsy in the emergency department: Who needs hospitalization?
    (2020) Unsal, Aysen; Senel, Ahmet
    Aim: Epilepsy is one of the most common serious chronic neurological diseases, imposing a huge economic burden on the individual and the society. Hospital services have been shown to be the highest direct-cost source for epilepsy patients. Therefore, in our study, we planned to discern the indications of hospitalization and the factors affecting the decision to hospitalize.Material and Methods: Patients admitted to our adult emergency department with epileptic seizures were included in the study between February 2017 and September 2018. A total of 111 patients were recorded in terms of demographic data, preferred transportation method when arriving at the emergency department, anti-epileptic drugs they used, seizure triggers, pre-hospital treatments, duration of seizures, and indication, and duration of hospitalization. Results: The rate of status epilepticus was lower in patients receiving a single antiepileptic drug compared to patients receiving two antiepileptic drugs and those using three or more antiepileptic drugs. The duration of the hospital stay was longer in patients receiving three or more antiepileptic drugs. Single antiepileptic drug users had a lower rate of hospitalization and a lower rate of intensive care unit admission and pre-hospital ambulance medication. Conclusion: The most significant variable affecting the study’s results was the number of antiepileptic drugs used by the patients. Patients receiving polytherapy should be considered as a special group, and the effects of this situation on both the individual and the health care system should be examined in more detail.