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Purpose: The present study evaluates the effects of the application of Self-Care Deficit Nursing Theory (SCDNT) on the self-care knowledge and skills in adolescents with Cystic Fibrosis., Design and Methods: This randomized controlled study included 30 adolescents who were equally divided into the intervention and control groups. The data were collected by using the Sociodemographic Data Form and the Self-Care Knowledge and Skills Evaluation Forms for Adolescents with Cystic Fibrosis. A total of seven home visits were conducted with the adolescents in the intervention group, during which individualized care plans were applied based on the Self-Care Deficit Nursing Theory. The self-care needs of the adolescents in the control group were identified based on data collected during two home visits conducted at the onset of the study and after 4.5 months., Results: As a result of the application of nursing interventions based on the SCDNT, a statistically significant increase was noted in the self-care knowledge and skills of the adolescents in the intervention group (p < 0.05). Additionally, after the interventions based on SCDNT, the need of adolescents for nursing interventions decreased significantly over time in all adolescents in the intervention group (p < 0.05)., Conclusions: The application of nursing interventions based on the SCDNT was effective in enhancing the self-care knowledge and skills of adolescents with Cystic Fibrosis., Practice Implications: Nurses can benefit from Orem's Self-Care Deficit Nursing Theory in the design and application of the individualized care of adolescents with Cystic Fibrosis to improve their self-care practices., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: This study aimed to compare the effectiveness of 2% chlorhexidine gluconate in 70% alcohol with that of 10% povidone-iodine, for dressing changes in pediatric hematology-oncology patients with port catheters, in preventing catheter-related bloodstream infection (CRBSI)., Methods: In this prospective, multicenter, observational, and cross-sectional study, 45 patients (25 patients for chlorhexidine, 20 patients for povidone-iodine) with port catheters were evaluated from January 2018 to May 2019. The sociodemographic, clinical, and port catheter-related variables were evaluated. The mean age of the patients was 6.28 ± 4.58 years, and 60% of patients were female., Results: Among the patients whose dressings were changed using 2% chlorhexidine gluconate in 70% alcohol, the mean number of dressing changes was 39.52 ± 29.7 and the rates of exit-site infection and CRBSI were 20% (2.37/1000 catheter-days) and 16% (1.90/1000 catheter-days), respectively. Among the patients whose dressings were changed using 10% povidone-iodine, the mean number of dressing changes was 48.0 ± 31.48 and the rates of exit-site infection and CRBSI were 15% (1.59/1000 catheter-days) and 10% (1.06/1000 catheter-days), respectively. None of the patients developed pocket infections. The rates of CRBSI and exit-site infections were not different between the 2 antiseptic solutions., Conclusion: This study found no differences between the effectiveness of 2% chlorhexidine in 70% alcohol and that of 10% povidone-iodine solution in preventing CRBSI. Therefore, both solutions can be used in dressing changes.

Background: It is important to develop self-management behaviours in adolescents to prevent chronic kidney disease progression., Objectives: This study evaluates the effect of a self-management program that was developed based on individual and family self-management theory to aid adolescents with chronic kidney disease in the acquisition of competencies in the management of their disease., Design: This is a randomized controlled study., Participants: The study was conducted with 20 intervention and 20 control patients, who were treated at two hospitals in Ankara between December 2018 and May 2019., Measurements: Self-Management Assessment Form, Paediatric Quality of Life Inventory-Adolescent Form and clinical parameters. A training program, specific to chronic kidney disease, was administered over three sessions in a group training setting when the patients came to the clinic for follow-up. After the training program was completed, the patients were monitored for three months through home visits once every two weeks, totalling six visits., Results: Following the application of self-management training, a statistically significant difference was found self-management knowledge and behaviours, quality of life and anxiety mean scores of intervention and control group (p <.05), a significant decrease in only blood urea nitrogen among the clinical parameters when compared to the control group., Conclusions: In this study, a self-management training program was developed based on Individual and Family Self-Management Theory, aiming to have a positive effect on the self-management behaviours of adolescents in the cognitive and psychosocial domains., (© 2020 European Dialysis and Transplant Nurses Association/European Renal Care Association.)

Purpose: To evaluate the effects of information-motivation-behavioral skills model interventions given by nurses during home visits on the knowledge levels, personal and social motivation levels, behavioral skills, and HbA1C levels of adolescents with poor glycemic control., Design and Methods: The present study was designed as randomized controlled trial. 50 adolescents with type 1 diabetes were equally divided into study and control groups. Socio-Demographic Form, Diabetes Information Evaluation Form, The Child Attitude Toward Illness Scale, The Multidimensional Scale of Perceived Social Support, and Diabetes Management Self-Efficacy Scale were utilized in data collection. The scales were administered at the beginning of the study and six months later. HbA1c levels of adolescents were evaluated in the third and sixth months. Multiple home visits and phone calls were made to each participant in the intervention group. Interventions to improve the information-motivation-behavioral skills model-based knowledge, personal and social motivation, and behavioral skills were applied during the home visits., Results: As a result of information-motivation-behavioral skills model-based interventions, knowledge levels (p<0.001), personal motivation levels (p = 0.001), social motivation levels (p = 0.004), and behavioral skills (p<0.001) of the study group improved. Additionally, HbA1c levels decreased significantly in the third (p<0.001) and sixth months (p<0.001)., Conclusion: Information-Motivation-Behavioral Skills Model-based intervention effectively improved glycemic control among adolescents with type 1 diabetes., Practice Implications: Nurses should develop strategies to increase personal motivation, social motivation, and behavioral skills to training programs planned for adolescents with type 1 diabetes., Competing Interests: Declaration of Competing Interest There are no conflicts of interest to declare., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Purpose: The aim of this study is to examine the effects of self-efficacy, social support and quality of life on readiness for transition to adult care in adolescents with cystic fibrosis., Design and Methods: A descriptive and cross-sectional study design was used. Data were collected from 50 adolescent between 14 and 17 years old with cystic fibrosis, by using The Transition Readiness Assessment Questionnaire, Social Support Appraisals Scale for Children, Self-Efficacy Questionnaire for Children and health-related quality-of-life instrument, the KIDSCREEN-10., Results: A positive correlation was found between the readiness levels of adolescents for transition to adult care and self-efficacy levels. In path analysis, self-efficacy was found to have a significant effect on the level of readiness for transition to adult care. There was not statistically significant relationship between the level of readiness for transition to adult care and health-related quality of life and perceived social support. Path analysis revealed that health-related quality of life and perceived social support had significant effects on the self-efficacy levels of adolescents., Conclusions: Self-efficacy were associated with readiness for the transition to adult care. Although perceived social support and quality of life were not related with transition readiness these variables had significant effects on perceived self-efficacy, which was determined as a factor affecting the readiness for the transition to adult care., Practice Implications: In adolescents with cystic fibrosis, self-efficacy, social support and quality of life levels should be taken into account when planning preparation programs for transition to adult care., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background:  Far-lateral lumbar disk herniation (FLDH) is defined as a disk herniation located laterally to the medial wall of the pedicle. The aim of our study is to describe the extraforaminal microdiskectomy by midline incision for FLDH, which does not include laminotomy-partial facetectomy, and to evaluate mid-term surgical outcomes., Methods:  107 patients who underwent surgery for FLDH by midline incision for the first time between 2012 and 2017 were included in our study. The assessment of neurological status of the patients was done by physical examination, preoperative Oswestry Disability Index (ODI), Visual Analog Scala (VAS) scores, and magnetic resonance images. They were then followed-up postoperatively and at 12 months with VAS and ODI tests., Result:  58 (54.2%) patients were male and 49 (45.8%) were female. The mean age at the time of surgery was 55.0 ± 8.6 years. The mean ODI scale score was 32.4 ± 6.2 preoperatively, 11.4 ± 2.1 early postoperatively, and 9.7 ± 2.2 in late postoperative follow-up (statistically significant, p  = 0.001). The average VAS was 7.51 ± 1.1 preoperatively, 2.74 ± 0.7 early postoperatively, and 0.68 ± 0.08 in late postoperative follow-up (statistically significant, p  = 0.001). The average operative time was 41 ± 7 (37 to 58) minutes., Conclusions:  The extraforaminal microdiskectomy without laminotomy by midline incision is a minimally invasive approach for FLDH. Our technique allows a sufficient and safe decompression of the neural structures, and thus results in a significant reduction of the symptoms and disability., Competing Interests: The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper., (Thieme. All rights reserved.)

The incidence of celiac disease has been increasing in recent years. Celiac disease is an autoimmune enteropathy that emerges mostly in the childhood period. This disorder is a chronic condition of the small intestine due to gluten intake in individuals with genetic predisposition. In the treatment of celiac disease, gluten-free diet therapy is applied. However, the adaptation process to the diet may create difficulties for patients. Compliance with diet is much more difficult among patients with celiac disease in childhood and adolescence than in adult patients. Children and adolescents face distinct difficulties in their homes, at school, and in their social lives. Besides following dietary treatment, children and adolescents living with celiac disease need peer support to manage their daily routines. In this article, we aimed to discuss the problems experienced by children and adolescents living with celiac disease and nursing approaches to these problems.

Objective: To examine the effects of a home follow-up program in Turkey on care problems, anxiety, and depression levels of mothers after the birth of a premature baby., Methods: A semi-experimental study with a pretest-posttest control group design. Eighty premature newborns and their mothers were included in the study. Nursing care was given to mothers and babies in the study group through a total of four home visits on weeks 1, 2, 3, and days 40-42 in Kırıkkale, Turkey guided by the Nursing Diagnosis System and Nursing Interventions Classification (NIC) system of the North American Nursing Diagnosis Association (NANDA). Data were collected from a sociodemographics form, home care needs evaluation form, Edinburgh Postpartum Depression Scale, and State Anxiety Inventory., Results: There were no significant differences between groups for nursing diagnoses at baseline, while the study group resulted in significantly fewer problems on days 40-42, compared to the control group. Mothers had a comparatively lower depression and state anxiety risk in the study group compared to the control group., Conclusions: Providing home-based nursing care for preterm mothers and babies during the first 40-42 days has the potential to decrease postnatal care problems, including maternal depression and state anxiety levels., (© 2019 Wiley Periodicals, Inc.)

Objectives: In this study, we aimed to share the surgical approaches and clinical experiences of cranio-orbital tumors, which are surgically difficult anatomies., Methods: A total of 22 orbital tumors with extraorbital-transcranial pathology between January 2004 and December 2017 were retrospectively reviewed. Information was obtained from hospital, operation and outpatient records for this study. Preoperative demographic data, ophthalmologic examination findings, clinical and radiological findings were recorded. All patients had cranial magnetic resonance and cranial computerised tomography examinations at this time. The location of the tumor, its size and its relation to neighboring structures were recorded in the light of these examinations., Results: The lateral approach was performed in 12 cases. The lateral approach was performed with frontotemporal craniotomy. Because of the lateral inferior location of the tumor in three of 12 cases, zygoma osteotomy was added to classical osteotomy. In 10 cases, the anterior approach was applied and the frontal craniotomy was found sufficient in seven cases. In three cases subfrontal craniotomy was added to classical craniotomy., Conclusion: The findings obtained in this study suggest that high resection rates can be achieved with appropriate surgical intervention in orbital tumors requiring a transcranial surgical approach. The most important factor in surgical planning is the location of the tumor. The size of the tumor and the expectation of the percentage of surgical removal are the other important factors. In our series, it has reached high excision ratio in most cases with low complication rate, good visual field and eye movements results., Competing Interests: Conflict of interest: None declared., (Copyright: © 2019 by The Medical Bulletin of Sisli Etfal Hospital.)

Objectives: The most common peripheral neuropathy is carpal tunnel syndrome. The present study aims to describe our minimally invasive open surgical approach for carpal tunnel syndrome and evaluate surgical outcomes., Methods: We included 217 patients who were operated in our clinic for carpal tunnel syndrome by minimally invasive open surgical approach. Visual Analogue Scale and Functional Outcome Scale scores were obtained preoperative, postoperative at one month and three months to determine surgical outcomes., Results: The mean age of the patients was 55.4±12.8 years (32 to 69), 175 (80.6%) were women and 42 (19.4%) were men. The assessment of carpal tunnel syndrome's etiology showed that 189 (%87.1%) of the cases were idiopathic, 19 (8.8%) had hypothyroidism, 5 (2.3%) had rheumatoid arthritis and 4 (1.8%) were due to pregnancy. The average improvement of VAS between preoperatively and late postoperatively was 5.41±1.05. The average improvement FOS was 17.44±3.06. They were statistically significant., Conclusion: The minimally invasive open surgical approach for carpal tunnel syndrome (an average of 1 cm skin incision) is performed with local anesthesia and successful surgical outcomes are achieved., Competing Interests: Conflict of interest: The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this study., (Copyright: © 2019 by The Medical Bulletin of Sisli Etfal Hospital.)

Sufficient energy and essential nutrients are vital for normal growth and development in childhood. Ideally, nutrition should be provided orally. However, if the gastrointestinal system is functional, enteral tube feeding can be used when nutritional requirements cannot be provided orally, thus providing nutritional benefits and enabling positive disease management in pediatric patients. Postoperative care in children allows monitoring of the position and functionality of the tube; performing nutrition intolerance, growth, hydration, and nutritional assessments; and performing metabolic and complication follow-ups. Tube feeding in pediatric patients is beneficial and has positive effects in controlling and managing diseases and providing appropriate nutrition in children. However, in postoperative patients, it is important to prevent potential complications, which can be classified into 5 groups: mechanical, gastrointestinal, metabolic, infectious, and pulmonary complications. Important points for managing complications include having enteral nutrition practices based on evidence-based guidelines, sharing outcomes with nurses working in clinical settings, creating enteral feeding guides in clinical settings, providing patients/patients' family with training in line with these guides, and maintaining follow-ups at home. This literature review discusses complications and practices regarding the management of complications after percutaneous endoscopic gastrostomy.

Aim: This descriptive and comparative research was conducted to determine the level of psychological resilience of adolescents diagnosed with leukemia., Method: The sample research group comprised of eighty adolescents in the 15-18 age group who have leukemia in pediatric hematology outpatient clinics. The sample comparison group comprised of eighty healthy adolescents in the 15-18 age group who were students from years 9, 10, 11, and 12 th in a high school. Data was collected using a socio-demographic questionnaire and the California Healthy Kids Survey Resilience and Youth Development Module High School Questionnaire form. The Mann-Whitney U Test, Kruskal Wallis variance analysis, homogeneity test (Levene), and Ki kare Test were used to evaluate the data., Results: It was seen that there were no significant differences between the psychological resilience of adolescents with leukemia and healthy adolescents (p>0.05) Females were observed to have higher levels of psychological resilience than males in the research group. A lower level of psychological resilience was identified in adolescents from the research group who did not receive psychological support during the illness compared with those who received psychological support (p<0.05). The sub-factor point average of caring relationships and high expectations at school were higher in the research group, whereas the sub-factor point average of goals and aspirations were higher in the healthy adolescents (p<0.05)., Conclusion: As a result, it was suggested that preventive mental health services should be planned and implemented to develop resilience levels and protective relationships provided by the school, friends, family and society should be supported., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (Copyright © 2019 Florence Nightingale Journal of Nursing.)

The reoperation for recurrent lumbar disc herniation (LDH) causes difficulties and low surgical outcome. The operation technique which was preferred in the first surgery has gained importance in reoperation for recurrent-LDH. The aim of our study is to evaluate the efficacy of lumbar microdiscectomy technique with preserving of ligamentum flavum (LF) for recurrent lumbar disc surgery. 149 patients were evaluated in two groups in our study, who were treated for single level recurrent-LDH in our clinic. The first group contains 86 patients who were treated by lumbar microdiscectomy without preserving LF during first surgery in other clinics, the second group contains 63 patients who were treated by lumbar microdiscectomy with preserving of LF during first surgery in our clinic. We investigated age, weight, gender, recurrence-time, level-side of recurrent-LDH, the surgical outcomes and hemorrhage, complications, operation-time. The mean-age was 45,9 ± 12,9, 44,1 ± 11,6 years and mean-weight was 73,4 ± 14,4, 77,3 ± 14,2 kg in two groups. 29 patients were treated for L3-4, 63 patients for L4-5, 57 patients were treated for L5-S1 recurrent LDH. The preoperative and follow-up back-leg pain Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) scores decreased significantly in all patients (p < 0,05). The average operation-time was 70,9 ± 5,2 and 42,3 ± 4,6 min and the average surgical hemorrhage was 91,1 ± 11,3 and 50,3 ± 7,4 ml in 1. group and 2. group respectively. Preserving of LF in first surgery is gaining importance for recurrent lumbar disc surgery with protected anatomical structures. Our technique decreases complication, operation time, surgical hemorrhage and provides good surgical outcomes in recurrent lumbar disc surgery., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: To evaluate long-term outcome and reoperation rate for microsurgical bilateral decompression via unilateral approach of lumbar spinal stenosis, a common degenerative spinal disease of the lumbar spine., Methods: In this observational prospective study, 918 patients were treated for single-level or multilevel lumbar spinal stenosis by bilateral decompression via unilateral approach between January 2002 and January 2016. Of 918 patients, 180 underwent microdiscectomy with decompression. Follow-up consisted of radiologic investigations, Oswestry Disability Index questionnaire, and 36-Item Short-Form Health Survey at 6 and 12 months postoperatively., Results: There were 492 female patients (53.6%) and 426 male patients (46.4%) with a mean age of 63.83 ± 10.16 years (range, 43-79 years). Symptom duration was 4-49 months. Average follow-up time was 98 months (range, 25-168 months), and reoperation rate was 2.5%. Oswestry Disability Index scores decreased significantly (from 30.65 ± 7.82 to 11.32 ± 2.50 at 6 months and 11.30 ± 2.49 at 12 months), and 36-Item Short-Form Health Survey parameter scores demonstrated a significant improvement in the early and late follow-up results., Conclusions: Bilateral decompression via unilateral approach for lumbar spinal stenosis allowed a sufficient and safe decompression of the neural structures, resulting in a highly significant reduction of symptoms and disability, acceptable reoperation rate, and improved health-related quality of life., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Thoracic disc herniation (TDH) surgery carries risks of neurological worsening due to thoracic cord retraction injury. Multiple approaches have been developed aiming for resecting the disc herniations of the thoracic segment. We have conducted a prospective observational study to evaluate the mid-term outcome of thoracic microdiscectomy with bilateral decompression via a unilateral approach (BDUA). Patients were checked pre-operative, post-operative, and late follow-up by Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), and radiological images. Twenty-three patients were treated for TDH by microdiscectomy with BDUA between January 2010 and January 2015. Nine patients were female, fourteen were male, and all of those mean age was 51,2 ± 8,3 (range 29-64 years). The mean follow-up time was 22,04 ± 8,59 months (range 13-58 m). The ODI and VAS scores decreased significantly in both postoperative and late follow-up evaluations. Microdiscectomy with BDUA for thoracic disc herniations allowed sufficient and safe decompression of the neural structures and resulted in a significant reduction of symptoms and disability., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: There are a limited number of studies examining the effects of products used in stoma care. This study compares the effects of 3 different methods of care on the peristomal skin integrity of children with percutaneous endoscopic gastrostomy (PEG) tubes., Methods: In this randomized controlled study, 60 children were allocated to the 3 study groups (group 1: hydrogel, group 2: soap and water, group 3: saline solution). Dressings were changed daily for all groups during the first week, then weekly for group 1 and daily for groups 2 and 3. The evaluations were performed using a PEG Region Peristomal Skin Integrity Observation Form and devices measuring stoma region pH, moisture, and temperature. One evaluation was performed in a hospital and 4 during home visits in the first month after PEG insertion., Main Results: Moisture levels in the stoma region were normal in the saline solution group, high in the hydrogel group, and low in the soap and water group (P < .05). Complications potentially affecting peristomal skin integrity in the stoma region (erythema, drainage, hemorrhage, hypergranulation tissue) were observed most frequently in the soap and water group (5%-45%) and least frequently in the hydrogel group (15%-25%). However, there was no statistically significant difference among the groups with respect to these complications (P > .05)., Conclusions: Because the dressing requires 6 times fewer changes per month, and wound site infection in the stoma site is minimized, the use of glycerin hydrogel should be considered for inclusion in pediatric stoma care procedures.

Obscure gastrointestinal (GI) bleeding is identified as persistent or repeated bleeding from the gastrointestinal tract which could not be defined by conventional gastrointestinal endoscopy and radiological examinations. These GI bleedings are assessed through invasive diagnostic and treatment methods including enteroscopy, angiography and endoscopy. In addition, video capsule endoscopy (VCE) is a non-invasive method used to determine the location of the bleeding, however, this does not provide any treatment. Despite of these successful but invasive methods, an effective non-invasive treatment is desperately needed. Herein, we prepare non-invasive theranostic capsules to cure obscure GI bleeding. An effective theranostic capsule containing endothelin as the targeting agent, thrombin-fibrinogen or fibrin as the treating agent, and fluorescein dye as the diagnostic tool is suggested. These theranostic capsules can be administered orally in a simple and non-invasive manner without a risk of complication. By using these novel capsules, one can diagnose obscure GI bleeding with having a possibility of curing., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Unlabelled: Family-centered care (FCC) is a healthcare delivery model in which planning care for a child incorporates the entire family. The purpose of this study was to describe and compare how healthcare providers from three countries with varied cultural and healthcare systems perceive the concept FCC by measuring attitudes, and to psychometrically identify a measure that would reflect "family-centeredness.", Design and Methods: The Working with Families questionnaire, translated when appropriate, was used to capture participants' perceptions of caring for hospitalized children and their parents from pediatric healthcare providers in the United States, Australia and Turkey (n=476)., Results: The results indicated significantly more positive attitudes reported for working with children than parents for all countries and individual score differences across countries: the U.S. and Turkey child scores were significantly higher than Australia, whereas the U.S. and Australia parent scores were both significantly higher than Turkey., Conclusions: Perceptions of working with families were different for nurses from the three countries that call for a clearer understanding about perceptions in relation to delivery systems. Further analyses revealed FCS scores to be significantly different between nurses and physicians and significantly correlated with age, number of children and education., Practice Implications: The results of this study add to our understanding of influences on practice from different countries and healthcare systems. The FCS score may be useful to determine baseline beliefs and ascertain effectiveness of interventions designed to improve FCC implementation., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose: The purpose was to determine the perceived social support and psychological symptoms of adolescents with leukemia., Design and Methods: The sample consisted of 70 adolescents with leukemia. The Brief Symptom Inventory (BSI), Multidimensional Perceived Social Support Scale (MPSSS), and a demographical data form were used for data collection., Results: Scores of the Global Severity Index, Positive Symptom Distress Index (PSDI), and Positive Symptom Total (PST) of the BSI were higher than those of the healthy adolescents with the same age in other studies. There was a negative relationship between the MPSSS and negative self-image, depression, anxiety, PSDI, and PST of the BSI., Practice Implications: It would likely be beneficial to increase adolescents' perceived social support in order to decrease psychological symptoms., (© 2014, Wiley Periodicals, Inc.)

Purpose: The aim of the study was to determine the effect of Orem's self-care model on the self-care of adolescents with asthma., Design and Methods: In this experimental design, adolescents with asthma (N = 80) received home visits and individualized care based on theory-guided nursing diagnoses. Patients in the experimental group were visited in their homes eight times, and those in the control group were visited two times., Results: The five self-care skills of medicine usage, peak expiratory flow meter usage, applying an asthma action plan, keeping a daily follow-up schedule, and protecting against triggering factors differed significantly between the first and last visits in the experimental group, whereas the self-care skills of adolescents in the control group did not change., Practice Implications: Applying Orem's self-care model increased the self-care skills of adolescents with asthma., (© 2013, Wiley Periodicals, Inc.)

Object: The aim of this study was to evaluate the results and effectiveness of bilateral decompression via a unilateral approach in the treatment of lumbar degenerative spondylolisthesis (DS)., Methods: Operations were performed in 84 selected patients (mean age 62.1 ± 10 years) with lumbar DS between the years 2001 and 2008. The selection criteria included lower back pain with or without sciatica, neurogenic claudication that had not improved after at least 6 months of conservative treatment, and a radiological diagnosis of Grade I DS and lumbar stenosis. Decompression was performed at 3 levels in 15.5%, 2 levels in 54.8%, and 1 level in 29.7% of the patients with 1 level of spondylolisthesis. All patients were followed up for at least 24 months. For clinical evaluations, a visual analog scale, Oswestry Disability Index (ODI), and Neurogenic Claudication Outcome Score (NCOS) were used. Spinal canal size and (neutral and dynamic) slip percentages were measured both pre- and postoperatively., Results: Neutral and dynamic slip percentages did not significantly change after surgery (p = 0.67 and p = 0.63, respectively). Spinal canal size increased from 50.6 ± 5.9 to 102.8 ± 9.5 mm(2) (p < 0.001). The ODI decreased significantly in both the early and late follow-up evaluations, and good or excellent results were obtained in 64 cases (80%). The NCOS demonstrated significant improvement in the late follow-up results (p < 0.001). One patient (1.2%) required secondary fusion during the follow-up period., Conclusions: Postoperative clinical improvement and radiological findings clearly demonstrated that the unilateral approach for treating 1-level and multilevel lumbar spinal stenosis with DS is a safe, effective, and minimally invasive method in terms of reducing the need for stabilization.

Objective: To analyze functioning and nonfunctioning pituitary adenomas (PAs)>3 cm, with special emphasis on preoperative and postoperative visual functions., Methods: The cases consisted of 49 women and 54 men with mean age of 43.2 years (range 19-66 years). All cases had a macroadenoma >3 cm in diameter. The transsphenoidal approach was performed in 117 procedures, and the transcranial approach was performed in 8 procedures. Radical tumor excision was achieved in 50 of 103 patients. Postoperative evaluation was done in 88 patients. Preoperative and postoperative visual acuity, visual field, and ocular fundi and their relationship with the pattern and duration of the symptoms and the size of the tumor were evaluated., Results: Normalization of visual acuity was obtained in 71.5% of patients, improvement occurred in 13.6%, symptoms persisted in 13.6%, and symptoms worsened in 1%. Postoperative improvement of visual field defects (VFDs) was observed in 74.1% of patients, and visual impairment score improved postoperatively in 92% of patients. Patients operated on <6 months before the onset of vision loss had better and more sustained visual improvement. One patient died, and 15.5% of patients experienced surgery-related complications., Conclusions: This study shows that patients with severe visual impairment may have remarkable improvement if surgical decompression is done early. The transsphenoidal approach should be performed to correct the patient's visual impairment and to relieve the pressure on the optic apparatus caused by macroadenoma of any size., (Copyright © 2011 Elsevier Inc. All rights reserved.)