INTRODUCTION: Antibodies against the S protein are used to investigate post-vaccine and post-infection immunity. In this study, it was aimed to determine the antibody levels and the efficacy of the vaccine after the CoronaVac vaccine in healthcare workers.
METHODS: Data from 96 healthcare workers who had the CoronaVac vaccine were analyzed. From the first dose, monthly antibody measurements were made over a 5-months period with an interval of 28 days between two vaccine doses. Total antibodies (IgM and IgG) against SARS-CoV-2 were detected by the Electrochemiluminescence method using the Elecsys® Anti-SARS-CoV-2 S kit, which contains recombinant protein representing the receptor-binding site of the S1 antigen.
RESULTS: 51% (n=49) of the volunteers aged 22-69 (39.75±11.19) were female. The mean antibody concentration was 8.93 U/mL one month after the first vaccine dose, 171.30 IU/ mL one month after the second vaccine dose, 125.90 IU/mL two months after the second dose, 98.57 IU three months later, and 89.85 IU/mL after four months. Increase in antibody levels in the first and second months; The decreases in antibody levels in the in the following months were statistically significant. The proportion of subjects with antibody positivity
≥0.8 IU/mL and developing neutralizing antibodies (≥15 IU/mL) was 68.75% and 5.21% after the first dose of vaccination. The rate of individuals developing neutralizing antibodies were 100%, 93.8%, 91.7%, and 89.6% with regard to the months after the second dose of vaccination.
One person had SARS-CoV-2 D3L-containing variant (UK variant) PCR positivity 9
weeks after the second vaccine dose.
DISCUSSION AND CONCLUSION: In the long-term follow-up, the neutralizing antibody level was found to be significantly higher even at the end of the 5th month, indicating that the vaccine is protective. The decrease in post-vaccination antibody concentrations and the emergence of new SARSCOV-2 variants suggest that a booster dose may be beneficial.

INTRODUCTION: This study aims to measure and compare the CURB-65 score and the predictive performance of physician’s gestalt in predicting mortality for COVID-19 patients admitted to the emergency department (ED) and intended for hospitalization.
METHODS: This study was designed as prospective-observational. All COVID-19 patients admitted to the ED between May 1 and June 1, 2021, were included in the study. Based on these results, the gestalt percentages and CURB-65 scores of the hospitalized patients were calculated, and the in-hospital mortality predictive power was analyzed.
RESULTS: This study was performed with 101 patients after utilising the inclusion-exclusion criteria. The mean age of the patients was 75.9±9.31 years and 55 (54.5%) were male. The most suitable cut-off value for CURB-65 was found to be ≥2.50, and the most suitable cutoff value for Gestalt was found to be ≥35%. Area under the curve (AUC) value, sensitivity and specificity of CURB-65, was calculated as 0.668, 0.500 and 0.841, respectively. For Gestalt, these values were found as 0.630, 0.789 and 0.444, respectively.
DISCUSSION AND CONCLUSION: In this study, it was revealed that the predictive powers of the CURB-65 score and physician’s gestalt were successful in predicting in hospital mortality for COVID-19 patients, but they were not superior to each other. According to the results of our study, we suggest the use of gestalt for physicians working in limited-resource or crowded EDs.

INTRODUCTION: The Covid-19 pandemic has caused delays in elective medical and surgical procedures in accordance with the measures and precautions to be taken. Alternative, low transmission risk procedures had to be adopted. Urgent and emergent interventional bronchoscopic procedures (IBP) were continued to be performed in life-threatening conditions. We aimed to evaluate the IBP performed during the ongoing pandemic in terms of patient selection, diagnoses, emergency/urgency, type of procedure used, success, and complications.
METHODS: Patients who underwent IBP in the first wave of pandemic between March 11, 2020, when the first patient was diagnosed with Covid-19, and June 1, 2020, in Turkey.
RESULTS: Twenty-one patients with a mean age of 54.7±17 years underwent 23 emergent/urgent IBP. Nine patients had malignant and 9 had benign airway obstruction. The remaining 3 patients were diagnosed with hemoptysis and pulmonary alveolar proteinosis.The success rate of IBP treatment was 100%, the acute complication rate was 4.7%, the chronic complication rate was 4.7%, the procedural mortality was 0.0% and the 30-days early mortality rate was 9%. All procedures were performed in interventional pulmonology (IP) unit with negative room pressure with as few auxiliary staff as possible. None of our team members developed signs and symptoms of coronavirus disease with the contribution of the constantly updated literature to our increasing clinical experience and measures taken.
DISCUSSION AND CONCLUSION: IBP can be performed with high success and low complication rates, even under pandemic conditions, especially in emergent/urgent life threatening situations such as central airway obstructions, massive hemoptysis, and other diseases, in the absence of other surgical and invasive procedures. They have a life-saving, survival-prolonging and time-saving role up to primary therapy, provided that all necessary precautions are taken.

INTRODUCTION: The admission rates to intensive care units and mortalities in geriatric patients are higher than the rest of the population with COVID-19 infection. Although the efficacy of hydroxychloroquine sulfate has been recognized, especially when started early during infection, its effectiveness at these early time points in geriatric patients has not been investigated. In this study, our primary aim was to investigate the effects of early treatment of hydroxychloroquine sulfate on COVID-19 positive geriatric patients, according to their clinical symptoms, situation before the intensive care, and patient survival.

METHODS: A total of 147 geriatric patients diagnosed with COVID-19 in the intensive care unit were divided into three groups: Patients who were admitted to the intensive care unit from the emergency department but did not receive treatment (Group 1); from the service for whose a 5-day treatment was initiated but not completed (Group 2); and those who completed 5-days of drug therapy (Group 3).
RESULTS: Although demographic data were similar between the three groups, the age parameters were significantly differed between them. Furthermore, there was no difference between the groups regarding mortality rate, discharge time, or extubation. The time to mortality and the duration of mechanical ventilation were found to be significantly shorter in Group 1 (p=0.001).
DISCUSSION AND CONCLUSION: No significant effect was observed on patient survival and outcome due to early administration of hydroxychloroquine sulfate.According to our main findings, this study cannot recommend pre-admission hydroxychloroquine treatment for critically ill geriatric patients with COVID-19.

INTRODUCTION: Healthcare workers (HCWs) are at higher risk of COVID-19 infection. As in many countries, priority has been given to the vaccination of healthcare in Turkey. Our aim in the present study is to examine healthcare workers who contracted COVID-19 infection after receiving the first dose of the CoronaVac vaccine in our hospital.
METHODS: In this retrospective observational study, the first dose of the CoronaVac vaccine was administered to healthcare workers in our hospital on January 14, 2021. All healthcare workers of both sexes, who were confirmed to have COVID-19 infection by RT-PCR test in the one month post-vaccination period, were included in the study. The patients’ demographics and general clinical data were analysed using the hospital’s electronic patient record management system (EPRMS).
RESULTS: There are 4,195 healthcare workers in our hospital. Of these, 3,259 (77.68%) received the first dose of the CoronaVac vaccine. Of all healthcare workers diagnosed with COVID-19 infection, 17 (56.7%) were female and 13 (43.3%) were male, with an average of 38.96±11.23 years. Two patients were admitted to the pandemic service. None of the patients were admitted to the intensive care unit or died.
DISCUSSION AND CONCLUSION: Undetected cases of COVID-19, especially among healthcare workers, can be dangerous for patients and other healthcare workers. Therefore, vaccination of all healthcare workers should be the primary goal. It should always be kept in mind that even if vaccinated, it is possible to become infected with COVID-19, and thus, personal protective measures should always be maintained in the fight against the disease. The occurrence of COVID-19 cases after the first dose of the.

INTRODUCTION: Patients with coronavirus 2019 (COVID-19), the disease caused by infection with severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), frequently have comorbidities and this is thought to be a risk factor for poorer outcomes. The aim of this study was to determine the prevalence and effect of comorbidities on the severity and prognosis of patients hospitalized with a diagnosis of COVID-19.
METHODS: This was a retrospective, single-center, epidemiological study. Patients with a confirmed SARS-CoV-2 infection of the upper respiratory tract based on a reverse transcription-polymerase chain reaction test using throat and nasal swab samples and/or clinically diagnosed according to lung imaging features compatible with coronavirus pneumonia hospitalized between March 15 and June 15, 2020 were included in the study. The relationship between the severity and prognosis of COVID-19 and comorbidities was analyzed.
RESULTS: A total of 258 patients diagnosed with COVID-19 were included in the study; 140 (54.3%) patients had at least 1 comorbidity and 118 (45.7%) patients were categorized as patients without a comorbidity. In the group, 134 (51.9%) patients were male and 124 (48.1%) were female, with a mean age of 54.2±16.6 years (range: 18–92 years). The most common comorbidities were hypertension (32.9%) and diabetes mellitus (22.1%). The rate of development of severe pneumonia was significantly higher in the presence of hypertension (47.0% vs. 34.1%), heart failure (66.6% vs. 36.2%), and immunosuppression (69.2% vs. 37.0%) (p<0.05). Intensive care unit (ICU) admission was necessary for 12.1% of the patients with a comorbidity and 6.8% of the patients without a comorbidity (p=0.147). While the mortality rate was 4.2% in patients without a comorbidity, mortality was observed in 8.6% of the patients with comorbidities (p=0.162). The mortality rate was 11.7% vs. 4.0% (p=0.019) for hypertension, 23% vs 5.7% (p=0.046) for immunosuppression, 22.2% vs. 5.4% (p=0.022) for heart failure, 14.0% vs. 4.4% for diabetes mellitus (p=0.029), and 33.3% vs. 5.6% for chronic kidney disease (p=0.016).
DISCUSSION AND CONCLUSION: The findings indicated that the course of COVID-19 was more severe in patients with comorbidities, and negative effects, such as ICU admission and death, were more common. It is important to determine comorbid diseases when taking the medical history of COVID-19 patients in order to identify patients likely to have a more dangerous clinical course and to adjust the treatment plan accordingly.

INTRODUCTION: The aim of this study was to evaluate the effectiveness of vacuum-assisted closure (VAC) therapy in thoracic surgery patients who developed chronic infections or large tissue defects for different reasons.
METHODS: A total of 10 patients who underwent VAC therapy in our clinic between February 2017 and December 2020 were included in the study. Age, gender, length of hospital stay, primary pathology etiology, duration of VAC stay, number of sponge changes, microbiologicalculture results from the wound site, recurrence, presence of comorbidity, morbidity, and mortality data of the patients were analyzed.
RESULTS: Of the 10 patients, 7 were male and 3 were female. The mean age was 47 (23–71). The average length of hospital stay was 61.3 days (13–141 days) and the mean VAC stay was 43.2 days (12–102 days). VAC changes were made at 3–4-day intervals and it was determined that changes were made every 3.6 days on average. Two patients were treated for gunshot wounds, one for sternal dehiscence (SD) after coronary bypass surgery, one for traumatic tissue defect due to fall from height, one for bronchopleural fistula (BPF) and empyema after cyst hydatid surgery, and three for chronic infection after chest wall malignant mass (two primary, one metastasis) resection and two for BPF after pulmonary resection (primary lung cancer). The most commonly isolated microorganism in wound cultures was the pseudomonas subspecies. Two patients were re-treated after the completion of VAC treatment. No mortality was observed in the patients during hospitalization or after discharge.
DISCUSSION AND CONCLUSION: VAC application is a system that works on the basis of controlled negative
pressure used to support and accelerate wound healing in wounds or infections where there
is no normal healing. VAC is a useful and safe method for the management of thoracic infections
and the reduction of dead space.

INTRODUCTION: Neutrophil-to-lymphocyte Ratio (NLR) is an easily measurable parameter with prognostic value for various types of cancer. The role of NLR in terms of prognosis in small cell lung cancer (SCLC) is controversial. The aim of this study was to investigate the relationship between NLR, platelet-to-lymphocyte ratio (PLR), other potential factors and prognosis in patients with SCLC.
METHODS: A retrospective cohort study enrolled 396 patients diagnosed with SCLC between January 1, 2008, and December 31, 2012 in the department of chest diseases of a tertiary hospital. Patients were grouped according to their NLR levels at the time of diagnosis; low-NLR (<4) (Group 1) and high-NLR (≥4) (Group 2). These groups were compared with the recorded data and predictors of mortality and the results were analyzed.
RESULTS: Patients with low-NLR (<4) (Group 1) had worse performance status, extensive stage, and lower response rate compared to patients with high-NLR (≥4) (Group 2). Median overall survival (OS) was worse in the high-NLR group than in the low-NLR group (Group 1). In contrast, elevated PLR was not associated with OS. Multivariate analysis showed that elevated NLR and lactate dehydrogenase, stage, smoking history, presence of malign pleural effusion were independent prognostic factors for OS.
DISCUSSION AND CONCLUSION: Elevated NLR is easily measurable can be used as a prognostic marker that reflects poor prognosis, while PLR is not associated with survival for patients with SCLC.

Objective: The cases operated using the microscopic anterior interhemispheric transcallosal approach due to third ventricular colloid cyst during 2015–2020 in our clinic were discussed in the light of the literature.

Methods: Seven patients (four females, three males) operated for colloid cyst of the third ventricle were examined retrospectively in terms of their presentation complaints, neurological examinations, size of the colloid cysts detected, presence/absence of accompanying hydrocephalus, surgery performed, callosal incision diameter used in the surgery, post-operative neurological conditions, complications, epilepsy, and development of disconnection and neurocognitive disorders.

Results: No neurological deficits were observed in the post-operative examinations of any patients. It was observed that the colloid cysts of six patients were completely removed. None of the patients required shunts during their follow-up, and epileptic seizure, disconnection syndrome, and neurocognitive disorders were not observed.

Conclusion: The anterior interhemispheric transcallosal approach is a safe way to treat colloid cysts of the third ventricle for a good total resection, with a short operative time. This is associated with minimal morbidity.

INTRODUCTION: The literature points to the role of neuroinflammation in the aetiology of vasospasm, which is the leading cause of mortality and morbidity after aneurysmal subarachnoid haemorrhage. Neuroinflammation has been found to contribute to early and delayed brain injury, both of which are associated with poor clinical outcomes. Resolvin D1 is hypothesised to have a protective effect on neurons against apoptosis and has anti-inflammatory and pro-resolving effects on the neuroinflammation and vasospasm after aneurysmal subarachnoid haemorrhage. In this study, we aimed to investigate the serum resolvin D1 levels and its possible relationship with vasospasm and inflammatory markers, such as C-reactive protein, neutrophil and albumin in patients with aneurysmal subarachnoid haemorrhage.
METHODS: Fifteen patients with spontaneous aneurysmal subarachnoid haemorrhage between June 2017 and May 2018 presenting at our institution were included in the study. Their data were compared with those of 17 healthy volunteers. Patients with aneurysmal subarachnoid haemorrhage were divided into two groups: the subarachnoid haemorrhage with vasospasm group (8 patients), which included patients with subarachnoid haemorrhage and angiographic vasospasm, and subarachnoid haemorrhage without vasospasm group (7 patients), which included patients with subarachnoid haemorrhage without angiographic vasospasm. Serial serum resolvin D1 measurements were taken on days 1, 4, 9 and 14 after subarachnoid haemorrhage.
RESULTS: Resolvin D1 levels were statistically significantly higher on day 1 after subarachnoid haemorrhage in patients with angiographic vasospasm (p=0.021). Additionally, in the group with angiographic vasospasm, all the measured resolvin D1 values were also higher compared to other groups. The measurements of serum C-reactive protein and neutrophil levels were found to be statistically significantly higher on day 1 after subarachnoid haemorrhage in both groups compared to the control group.
DISCUSSION AND CONCLUSION: Resolvin D1 levels tend to increase secondary to inflammation because of its neuroprotective and anti-inflammatory properties. Thus, high resolvin D1levels in the subarachnoid haemorrhage + vasospasm group indicated that inflammatory processes play a role in the aetiopathogenesis of angiographic vasospasm after aneurysmal subarachnoid haemorrhage. Consequently, resolvin D1 might be an important biomarker in the prediction of the angiographic vasospasm after aneurysmal subarachnoid haemorrhage.

INTRODUCTION: The aim of this study was to investigate the value of T1-weighted (T1W)/FLAIR (fluid attenuation inversion recovery) imaging in routine brain magnetic resonance (MR) evaluation by comparing the T1W spin-echo (SE) sequence with the T1W rapid FLAIR sequence in terms of identifiability of anatomical structures and image quality.
METHODS: T1W SE and T1W rapid FLAIR sequences were qualitatively and quantitatively analysed with regard to the identification of anatomical structures, general image quality and presence of artefacts in 30 healthy cases. Signal-to-noise ratio (SNR) and contrast-to-noiseratio (CNR) values were determined using the signal intensity values of two sequences from equivalent localisations, including the grey substance, white substance and cerebrospinal fluid at the level of the posterior fossa and thalamus.
RESULTS: SNR values were significantly higher in T1W SE than in T1W FLAIR sequences at the level of the thalamus and posterior fossa (p<0.001). Measurements at the thalamic level revealed that CNR values of T1W FLAIR for cerebrospinal fluid-grey substance and grey white substance were significantly higher when compared to T1W SE (p=0.0001). The measurements at the posterior fossa level demonstrated that CNR values of T1W FLAIR for grey-white substance were significantly higher when compared to T1W SE (p=0.006).
DISCUSSION AND CONCLUSION: In this study, we found that in T1W imaging of the brain, T1W FLAIR sequence was superior to T1W SE in qualitative and quantitative evaluations in terms of CNR values. Nevertheless, SNR values were found to be higher in T1W SE imaging.

INTRODUCTION: Moderate and vigorous physical activity (PA) has been associated with better cardiometabolic risk factors in adolescents, regardless of the quantity of sedentary time. The aim of this study was to determine the level PA engagement and perception of sufficient PA among students of a faculty of medicine and to investigate a correlation with personality traits.
METHODS: A questionnaire was used to collect data about the level of PA and factors that might influence participation. A 10-item personality inventory and the short form of the International Physical Activity Questionnaire (IPAQ) were also administered in student interviews.
RESULTS: According to the IPAQ scores, 38.7% of the students had a low level of activity or were inactive (LPA), 47.8% had a moderate level of participation (MPA), and 13.4% ranked as highly active (HPA). The results indicated that 10.9% of the students who reported regular PA were classified as LPA, 50.9% were graded as MPA, and 38.2% had an HPA score. Of the students who reported a perception of sufficient PA, 17.5% were scored as LPA. Students who participated in cycling, running, dancing, and team sports had a significantly higher IPAQ measurement (p<0.05). Personality scores, body mass index, some types of PA (walking and swimming), and gender were not correlated with PA level.
DISCUSSION AND CONCLUSION: The findings indicated that 17.5% of the students who thought that they engaged in sufficient PA actually had an LPA score. The IPAQ results revealed that only 13.4% of the students actually had a sufficient level of PA, as defined by the World Health Organization guidelines. The level of PA participation was not affected by personality traits.

INTRODUCTION: Adequate training and protective measures are some of the effective ways to preventi latex allergy. This study aimed to assess the level of knowledge about latex allergy, behavioral patterns and the incidence of latex allergy.
METHODS: Four hundred ten healthcare workers (HCWs) were invited to participate in a survey and answer a questionnaire on the level of knowledge and protective methods of latex allergy. A second supplemental questionnaire was applied to 53 HCWs who were diagnosed with latex allergy or had symptoms of latex exposure.
RESULTS: The study population consisted of 410 HCWs; 240 (61.9%) were female and had a median working duration of 5 (IQR: 0.13–38) years. 74 (18%) HCWs described symptoms after latex exposure with a median working time of 34.5 (IQR: 21–50) years. Despite the symptoms, skin test was not performed 41 (78.8%) of 74 patients. When the knowledge levels of protection methods from the latex allergen were compared, research assistants and nurses were found to be more than the technicians (p=0.047, p=0.016, respectively). When the anxiety level was compared between occupational groups, it was significantly higher in nurses and technicians compared to research assistants (p=0.012, p=0.001, respectively).
DISCUSSION AND CONCLUSION: The data indicated that HCWs are not adequately informed about latex allergy, and comparing the occupational groups, this fact was more remarkable among technicians. Continuing education of HCWs regarding latex allergy, appropriate diagnostic tests in the presence of symptoms, and taking effective protective measures are essential steps in the fight against latex allergy.

INTRODUCTION: To compare refractive results after cataract surgery using AL-Scan and IOL-Master500 optical biometers for intraocular lens power calculation.
METHODS: 78 eyes of 78 consecutive patients undergoing cataract surgery and implanted with the same intraocular lens (Eyecryl Plus HSAS600) were included in the study. In Group 1, preoperative biometry was performed with AL-Scan, and in Group 2, with IOL Master 500. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and mean absolute refractive error (MARE) at preoperative and 6-month follow-up visits were recorded.
RESULTS: The postoperative mean MARE was -0.28±0.30 Diopter (D) and –0.32±1.13 D in Groups 1 and 2, respectively (p=0.38). At the 6th month visit, 92% of eyes in Group 1 were within 0.50 D of target refraction in Group 1 and, 93% of eyes in Group 2 were within 0.50 D (p=0.99). Uncorrected and corrected distance visual acuity improved significantly in both groups (p<0.001). The mean postoperative UDVA were 0.72±0.12 and 0.66±0.16 in Groups 1 and 2, respectively (p=0.20). No sight-threatening complication occurred during or after the operation in either group.
DISCUSSION AND CONCLUSION: These findings show the AL – Scan provides comparable postoperative results with the IOL Master after implantation of the same intraocular lenses.

INTRODUCTION: The aim of the study was to assess the results of 577 nm subthreshold yellow micropulse laser treatment (SYMLT) in patients with chronic central serous chorioretinopathy (CSC) with a five-year follow-up. We also evaluated the effect of baseline characteristics on relapse and the SYMLT treatment responses.
METHODS: A total of 81 eyes of 72 patients with chronic CSC were followed for at least 5 years. Patients were treated with 577-nm SMYLT in multiple sessions at a 5% duty cycle. Best-corrected visual acuity (BCVA), central macular thickness (CMT), central macular volume (CMV), total macular volume (TMV) and subfoveal choroidal thickness (SFCT) were measured by spectral-domain optical coherence tomography (SD-OCT). Other basic SDOCT parameters were recorded.
RESULTS: The mean BCVA improved from 0.46±0.25 Log MAR to 0.11±0.22 Log MAR and the mean CMT decreased from 404.60±72.46 μm to 243.50±24.97 μm at last visit (p<0.001). At the last visit, 70 eyes (86.4%) had complete subretinal fluid (SRF) resorption with SYMLT sessions, and 11 eyes (13.6%) had residual SRF. While recurrence was not observed in sixty-eight (83.9%) patients within five years, it was observed in 13 (16.1%). In multivariate analyses, there was a statistically significant correlation between recurrence and SFCT≥ 416.00 μm (p<0.001) and baseline SFCT≥ 474.00 μm and baseline BCVA were significantly correlated with non-response to SYMLT (p=0.025 and p=0.040, respectively).
DISCUSSION AND CONCLUSION: SYMLT has been found to be a safe and effective in long-term follow-up. Clinical characteristics and some SD-OCT parameters might be predictors of treatment response to SYMLT and its recurrence.

INTRODUCTION: In the present study, it was aimed to retrospectively evaluate the intraoperative and postoperative outcomes of all laparoscopic hysterectomy procedures carried out at the obstetrics and gynecology department between January 2018 and September 2020.
METHODS: The files and operation case notes of 445 patients who underwent total laparoscopic hysterectomy for benign indications between January 2018 and September 2020 were retrieved from the hospital information management system and their intraoperative and postoperative outcomes were analysed.
RESULTS: The mean age of 445 patients included in the present study was 51.2±8.5 and parity 2.98±1.85, and the most common indication for hysterectomy was myoma uteri. The mean operation time was determined as 100.7±36.7 min. The overall major complication rate was 3.2% and the rate of conversion to laparotomy was found to be 1.5%.
DISCUSSION AND CONCLUSION: In patients who are not suitable for vaginal hysterectomy, total laparoscopic hysterectomy may be a reasonable option in terms of increasing the patient comfort, lower complication rates, and increasing the the experience of the surgical team.

INTRODUCTION: We investigated the effects of ultrasound-guided erector spinae plane block in elective thoracic surgery cases.
METHODS: 40 ASA I-II-III patients, aged between 18–70 years who underwent elective thoracic surgery were included. We seperated Erector Spinae Plane Block (ESPB) and control groups, each containing 20 patients. The demographic features, Body Mass Index (BMI), comorbidities, the type and duration of surgery, pethidine requirement within the first hour, time of first analgesic requirement, the total analgesic amount within 24 hours were recorded.
RESULTS: The first analgesic requirement time was 5.90±2.61 hours in the ESPB group and 1,80±0,95 hours in the control group. The mean paracetamol requirement was 2.00±0.56 g, dexketoprofen requirement was 15.00±28.56 mg, and tramadol requirement was 30.00±47.01 mg in the ESPB group in the postoperative 24 hours. In the control group, the mean paracetamol requirement was 2.90±0.31 g, dexketoprofen requirement was 22.50±30.24 mg, tramadol requirement was 80.00±76.78 mg. The mean static VAS in the ESPB group was 3.01±0.76, the mean in the control group was 4.03±0.51, the mean dynamic VAS in the ESPB group was 3.65±0.76, and the average in the control group was 4.70±0.54. Static VAS values were lower in the ESPB group at all follow-ups. In the ESPB group, the dynamic VAS values were also lower at all follow-ups.
DISCUSSION AND CONCLUSION: ESPB was found to improve postoperative analgesia and reduce the need for analgesia in thoracic surgery.

Pneumomediastinum and pneumorrhachis may occur secondary to various pathologies, though it is usually a traumatic injury. The coexistence of these pathologies is rare. This report is a description of the spontaneous development of pneumomediastinum and pneumorrhachis in an 18 year-old male patient and a brief discussion of the relevant literature.