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Copyright of Journal of Polytechnic is the property of Journal of Polytechnic and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aims to investigate the effectiveness of the exchange rate channel as a monetary transmission mechanism in Yemen, using technique of the Vector Autoregression (VAR) model and its help tools, such as impulse reaction function analysis and variance decomposition analysis in 1991–2018. The results of the study were compatible with theoretical expectations for the exchange rate (EXR) impact on the net exports (NX), the real economic growth (RGDP), and the inflation rate (CPI). Consequently, the exchange rate channel plays an important role in transferring the impact of monetary policy decisions to RGDP and the CPI in Yemeni economy. Our study has shown the effectiveness of the exchange rate channel in influencing both RGDP and CPI, due to the large role that the exchange rate plays in influencing economic activity in Yemen since the Yemeni economy is highly open to other economies. [ABSTRACT FROM AUTHOR]

The dissolution of the Eastern Bloc at the end of the Cold War compelled most of the centrally-planned economies to adjust their economic order to become free market economies. During the transition process, most of those countries experienced severe external debt overhang problems, due to excessive budget deficits and rapid liberalization of foreign trade and capital account regimes. In addition, most of those countries were facing political unrest due to internal and external conflicts by the end of the Cold War, with rampant weapons proliferation and the arms race. By employing the fixed effect panel threshold regression approach, we unveil the non-linear relationship between military spending and external indebtedness, which has not been examined for the selected twelve transition economies over the period from 1997 to 2016. Our findings reveal the presence of double threshold effects that are embedded in military expenditure, and the debt-accelerating effect of military spending emerges after the first regime. In the early stages, countries tend to finance military expenditure with the help of domestic savings, whereas the requirement for external borrowing emerges later as domestic savings become inadequate. We have also produced some crucial policy recommendations to reflect our findings. [ABSTRACT FROM AUTHOR]

We investigate the problem of partitioning the vertices of a directed acyclic graph into a given number of parts. The objective function is to minimize the number or the total weight of the edges having end points in different parts, which is also known as the edge cut. The standard load balancing constraint of having an equitable partition of the vertices among the parts should be met. Furthermore, the partition is required to be acyclic; i.e., the interpart edges between the vertices from different parts should preserve an acyclic dependency structure among the parts. In this work, we adopt the multilevel approach with coarsening, initial partitioning, and refinement phases for acyclic partitioning of directed acyclic graphs. We focus on two-way partitioning (sometimes called bisection), as this scheme can be used in a recursive way for multiway partitioning. To ensure the acyclicity of the partition at all times, we propose novel and efficient coarsening and refinement heuristics. The quality of the computed acyclic partitions is assessed by computing the edge cut. We also propose effective ways to use the standard undirected graph partitioning methods in our multilevel scheme. We perform a large set of experiments on a dataset consisting of (i) graphs coming from an application and (ii) some others corresponding to matrices from a public collection. We report significant improvements compared to the current state of the art. [ABSTRACT FROM AUTHOR]

Exercise-induced hypoalgesia (EIH) typically reported during and/or following exercise, but less is known the mechanisms responsible for EIH. Previous reports suggest that melatonin plays a role in pain modulation. In this study, we investigated the role of melatonin on pain threshold at rest, and following exercise in both sedentary and exercise trained rats under light-induced functional pinealectomy. Male wistar rats were assigned to one of four groups: sedentary control (C), sedentary pinealectomized (Px), exercise trained (T), and trained under pinealectomy (T-Px) groups. Exercise trained groups were subjected to eight?weeks of motor-driven treadmill exercise. C and T groups exposed to normal light/dark cycle (12:12-h light/dark cycle) and Px and T-Px rats exposed to continuous light for eight?weeks. Hot-plate test was repeated before and after melatonin injection and paw withdrawal latencies were recorded as pain threshold. Acute exercise resulted increased pain threshold in all groups. Animals in T group had significantly highest pain thresholds compared with other groups, and pinealectomy resulted decreased pain threshold in trained animals both at rest, and following exercise. Pain threshold in T-Px group was found to be increased after melatonin administration. Our findings support the hypothesis that melatonin plays a role on hypoalgesic response in exercise-trained rats. [ABSTRACT FROM AUTHOR]

Background. Idiopathic hypoparathyroidism is a rarely seen disease which progresses with the hypocalcaemia, hyperphosphatemia and low level of parathyroid hormones. The main symptoms such as leg cramps and generalized muscle weakness result from neuromuscular irritability due to hypocalcaemia, and skeletal abnormalities as well as ectopic calcifications are among the well known features. Case Report. A 32 year-old male patient was referred to our clinic with four years of progressive inflammatory low back and hip pain, prolonged morning stiffness. Upon physical examination limited movements and posture resembling that seen in patients with ankylosing spondylitis (AS) were observed. In laboratory investigation revealed hypocalcaemia (4.6 mg/dL), hyperphosphatemia (7.0 mg/dL) and hypoparathyroidism (7.2 pg/mL). Serum C reactive protein and erythrocyte sedimentation rate were normal. The direct graphic and sacroiliac magnetic resonance image were identified sacroiliitis. A rise in bone density in dual-energy x-ray absorptiometry was recorded. According to the Modified New York criteria, AS includes the whole diagnostic criterias completely. Conclusion. Idiopathic hypoparathyroidism, when undiagnosed for a long period, may result in extreme calcification of soft and bony tissues. The vertebral calcification may be so intense that it may result in an AS like clinical picture. Therefore, idiopathic hypoparathyroidism should also be considered in the differential diagnosis of AS. [ABSTRACT FROM AUTHOR]

Copyright of Abant İzzet Baysal Üniversitesi Journal of Social Sciences / Sosyal Bilimler Enstitüsü Dergisi is the property of Journal of Abant Social Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Bartter's Syndrome is a renal tubular defect characterized with low or normal blood pressure, hypokalemic metabolic alkalosis and hyperreninemic hyperaldosteronism due to renal sodium loss. Herein we reported a case who presented with growth retardation, growth hormone deficiency previously treated with growth hormone for a period of 6 months in mind and with hypopituitarism similar findings such as primary amenorrhea, fatigue, weakness and just diagnosed as Bartter's syndrome. Case report. A 18 year-old female patient was referred to our hospital for amenorrhea, growth retardation and fatigue. Her history revealed that she was diagnosed with growth hormone deficiency two years ago and given growth hormone treatment for 6 months. Physical examination showed growth retardation. Laboratory tests revealed that serum potassium was 2,3 mmol/L. Further investigations demonstrated metabolic alkalosis, increased urinary potassium excretion and hyperreninemic hyperaldosteronism. The patient was considered as Bartter syndrome and spironolactone, indomethacin and potassium chloride were initiated. While she had growth retardation and primary amenorrhea, we searched basal hormone levels and performed stimulation tests for evaluating pituitary reserve. Insulin tolerance test showed that serum growth hormone and cortisol levels were 10 mcg/dL and 19 mcg/dL respectively during hypoglycemic period. It demonstrated that both of the axes were intact. Luteinizing hormone releasing hormone test showed that hypothalamo pituitary gonadal axis was also intact. Conclusions. Bartter syndrome can lead to growth retardation that mimicking hypopituitarism in case of delay in diagnosis. [ABSTRACT FROM AUTHOR]

In present study, “Saurani” Turkish olive monocultivar extra virgin olive oil (EVOO) was extracted by using Mobile Olive Oil Processing Unit (MOOPU)” (TEM Oliomio 500-2GV, Italy). Free fatty acid content, peroxide value, moisture content and UV absorbance value, minor and major components and quality characteristics changes were surveyed during a year storage. “Saurani” olive oil samples weren’t categorized as EVOO according to the trade standards of International Olive Council (IOC) based on peroxide value, UV absorbance values after five and two months of storing, respectively. Free fatty acid content of VOO samples increased during 12 months’ storage, but it was under the IOC limitation for extra virgin olive oil (

The effects of storage time on the stability and quality of cold press extra virgin olive oils (EVOO) extracted from cv. Tavşan Yüreği locally grown in Antalya Region of Anatolia was investigated. The Mobile Olive Oil Processing Unit (TEM Oliomio 500-2GV, Italy) was designed and used for the monocultivar olive oil production. Changes on the free fatty acid, peroxide value, UV absorption values, total phenol content, phenolic and tocopherol profiles, and sensory properties of EVOO samples were determined for 12 months. Results showed that fresh “Tavşan Yüreği” EVOO was classified as EVOO declared by the International Olive Council (IOC) standards-based in terms of chemical and sensory properties. It had a sensory profile with an equilibrated taste of intense fruitiness and medium bitterness and pungency at the end of one year. Although positive attributes (fruitiness, bitterness, and pungency) slightly decreased, color values of EVOO changed from green to yellow. Although total phenols content of EVOO samples were 385.27 ± 0.908 ppm at the beginning of storage, it decreased to 327.58 ± 0.212 ppm after a year storing. Luteolin was the most abundant phenolic compound and its content decreased by 14% at the end of storage, while tyrosol content of EVOO increased from 12 to 36.17 ppm. After twelve months, α-tocopherol contents decreased 22.38%. Using Mobile Olive Oil Processing Unit increased oxidative stability and quality of extracted EVOO.

In this study, effects of filtration and storage time on the chemical composition and sensory profile of the virgin olive oil extracted from a local olive cultivar known as Saurani grown in Hatay province of Turkey were determined. Before storing both filtered (F) and unfiltered (UF) samples were categorized as virgin olive oil (VOO) according to the International Olive Council (IOC) standards. The main characteristics of Saurani olive oils were: a mid-oleic acid (69.3%), low linoleic acid (7.7%) and high linolenic (0.85%) acid contents with high total phenolic content (522.34 ppm as gallic acid). Monitoring of stored samples for 24 months revealed significant differences between F and UF olive oils in terms of free acidity and peroxide values, and filtered oils appeared to be better protected against hydrolysis and oxidative deterioration. Free fatty acidity of F and UF olive oil samples which were initially 0.4% and reached to 0.9% after 23 and 11 months’ storage respectively. Peroxide values of the F and UF olive oil samples were exceeded the limit of IOC standard (20 mEq oxygen/kg oil) after ten and three months, respectively. Total phenol contents were higher in UF samples and their contents decreased with storing. Luteolin was the most abundant phenolic compound and tyrosol contents of both F and UF samples reached maximum values in the ninth month of storage. It seemed filtration had no detectable effect on tocopherols contents and about 50% of α-tocopherol destroyed after 24 months’ storage.

Background: Left ventricular hypertrophy (LVH) is very frequent in haemodialysis patients. Only few investigations have reported its regression, and only by the use of antihypertensive drugs. Because volume load is at least as important as pressure load, we investigated whether persistent strict volume control by ultrafiltration alone may be effective in improving LVH. [ABSTRACT FROM PUBLISHER]

Introduction: The purpose of the study is to compare the effects of genistein, estradiol, estradiol/progesterone combination on the bone mineral density and biomechanical properties of ovariectomized rats’ bone. Methods: 50 female adult Sprague-Dawley rats were divided into five groups. Bilaterally ovaeriectomy were performed in all groups except the sham-operated group. Groups were a sham-operated group and a control group (water was given), estradiol treated group (17-β estradiol 0.015 mg/kg per day), genistein treated group (genistein 10 mg/kg per day), and an estradiol/progesterone combination group (17-β estradiol 0.015 mg/kg plus drosperinone 0.028 mg/kg per day). The water or hormones were implemented in relevant groups for eight weeks by orogasthric catheter. The bone mineral density and biomechanical properties of the femur were analyzed. Results: Genistein, estradiol, and estradiol/progesterone groups increased bone mineral density significantly compared to the control group. In diaphysis and metaphysis bending test, all groups had higher peak load values than the control group. There were statistically significant differences between the estrogen/progesterone group and control group in diaphysis bending with regard to peak load. There were statistically significant differences between the estradiol and control groups in metaphysis bending with regard to peak load. In axial rotation test, all groups had higher peak torque values than the control groups. Conclusions: Genistein, estradiol and estrogen/progesterone combination improved the biomechanical properties of the ovariectomized rat bone. Genistein which has less side effects may be considered as an alternative in the treatment of postmenopausal osteoporosis.

We investigated effects of multivitamin and mineral supplementation on lipid peroxidation, reduced glutathione, glutathione peroxidase, vitamin A, vitamin C and vitamin E values in serum and follicular fluid of 56 women undergoing IVF and 13 age matched control. We concluded that multivitamin and mineral supplementation in serum and follicular fluid of women undergoing IVF may strengthen the antioxidant defense system by decreasing oxidative stress. [ABSTRACT FROM AUTHOR]

A 52-year old women was diagnosed with acromegaly 5 years ago, and transseptal transsphenoidal pituitary microsurgery has been performed. Later the patient did not come to controls and the complaints prior to operation growth of the hands and feet, headache, sweating and resistant hypertension have continued. She was referred to our clinic with the same complaints. Physical examination showed typical acromegalic features without typical Cushingoid features. Magnetic resonance imaging of the brain revealed the presence of a pituitary macroadenoma. Basal plasma levels of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels were high. GH suppression was not observed in 75 gr oral glucose suppression test. Due to refractory hypertension and central obesity hypothalamo-pituitary-adrenal (HPA) axis was evaluated. HPA showed a lack of circadian rhythm of adrenocorticotropic hormone (ACTH) and cortisol, non-suppressibility to 1 mg overnight and classical 2 day low-dose dexamethasone, but suppressibility to high-dose (8 mg) dexamethasone. The tumour resected by transsphenodial surgery was histopathologically consistent with the diagnosis of adenoma. Immunostaining showed GH and ACTH producing cells. After surgery plasma GH and IGF-1 levels decreased to normal along with normalization of HPA axis. Hypertension disappeared without medical treatment after removal of the pituitary tumour. This is a very rare case of GH-producing pituitary adenoma causing typical acromegaly with concomitant production of ACTH causing subclinical Cushing's disease. [ABSTRACT FROM AUTHOR]

Abstract: The basicities and nucleophilicities along with prototautomerism of biologically active oxazolidin-4-one and its thio and azo analogs were investigated by semi-empirical methods. The oxo and thion protonation were found to be easier than that of azo protonation for 4-oxo and 4-thion derivatives whereas amino protonation was found to be easier than imino and azo protonation in 4-imino derivative. The preferred tautomeric form for 4-oxo and 4-thion derivatives were found to be the keto and thion forms, respectively, whereas the amino form was found to be preferred in 4-imino derivatives. An acceptable correlation between gas phase proton affinities and aqueous phase acidity constants as well as the correlation between nucleophilicity and acidity constants was observed. [Copyright &y& Elsevier]

Aims. In August 2015, FDA published a black box declaring that DPP-4 inhibitors may cause severe joint pains. The impact on autoimmunity marker positivity of these drugs has not been comprehensively evaluated. We compared the incidence of arthritis/arthralgia in patients with T2DM who were using DPP-4 inhibitors and patients who were not using. Methods. A number of 93 DPP-4 inhibitor users and 107 non-users were included into the study. Arthritis/arthralgia were found in 41 of 93 (44.1%) DPP-4 inhibitor users and in 19 of 107 (17.8%) non-users (p<0.05). Results. No inflammatory rheumatological condition was identified in 27 of 41 (65.9%) patients in DPP-4 inhibitor user group as well as in 13 of 19 (68.4%) patients in non-user group (p>0.05). After adjusting for gender the incidence for arthritis/arthralgia was significantly increased in the DPP-4 inhibitor user group (p value for any DPP-inhibitor <0.05). There was 3.77 times increased risk for arthritis/arthralgia in the DPP-4 inhibitor using group (p value= 0.001) and this risk increases 2.43 times for each year of DPP-4 inhibitor usage. Conclusions. Arthritis/arthralgia were more common among T2DM patients who were using DPP-4 inhibitors compared to non-users, but the seropositivity did not differ between DPP-4 inhibitor users and non-users. [ABSTRACT FROM AUTHOR]

Background: Nutrigenetics explores how genetic variations influence an individual's responses to nutrients, enabling personalized nutrition. As dietary supplements gain popularity, understanding genetic factors in their metabolism and effectiveness is crucial for optimal health outcomes. This study examines the role of genetic differences in the metabolism and effects of nutraceuticals, underscoring the significance of personalized nutrition within precision health. It aims to reveal how individual genetic profiles influence responses to dietary supplements, highlighting the value of nutrigenetics in optimizing health interventions. The study explores how genetic variations affect the absorption and effects of nutraceuticals, focusing on personalized supplement choices based on nutrigenetics., Methods: Sixteen patients from an Epigenetic Coaching clinic who were using supplements such as quercetin, curcumin, green tea, and sulforaphane and reporting side effects were studied. Their clinical outcomes were analyzed in relation to their supplement choices and genetic backgrounds. The study involved five women and 11 men, including eight with autism and others with conditions like Hashimoto's thyroiditis (HT) disease and joint pain., Results: In the study, it was observed that removing sulforaphane and sulfur-rich supplements from the diet of five patients reduced agitation. Removing sulforaphane and sulfur-rich supplements from the diet of four patients reduced clinical symptoms. Green tea caused discomfort in two patients. Responses to quercetin showed clinical differences in two patients. Anxiety and hyperactivity increased in three patients who took curcumin. Conclusion This study highlights the importance of considering individual genetic profiles when recommending dietary supplements. The findings suggest that personalized nutrition, guided by nutrigenetic insights, can enhance the efficacy and safety of nutraceutical interventions. Tailoring supplement choices based on genetic information can lead to better health outcomes and reduced adverse effects, emphasizing the need for integrating genetic testing into nutritional planning and healthcare practices., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Biruni University Ethics Committee issued approval 2023/78-03. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Meral et al.)

Introduction: In literature, there have been many studies conducted to research the alternatives of standard interlocking intramedullary nailing. The expandable wedge locked nail fixation, which is thought as a new alternative to the standard interlocking nailing, has been presented in previous numerical studies. The antegrade usage of the wedge locked nail fixation has provided promising results. From this point, the aim of the study is to evaluate mechanical behavior of its retrograde usage on femur models. Additionally, another aim of the study is to investigate the effect of fracture level on mechanical properties of the fixation., Materials and Methods: The mechanical behaviors of the wedge locked nail and standard interlocking nail fixations were compared by finite element methods. Sawbones femurs having osteotomies at five different levels to simulate different fractures were fixed with wedge locked nail or interlocking nail by using retrograde approach. With respect to the fracture level, two different nail lengths were used. Axial compression load was applied to fixations. The mechanical behaviors of the fixations were evaluated with respect to stiffness of the fixations and stresses occurred on both implants and bones., Results: Any of the wedge locked nail fixation did not slip at canal. The stress and stiffness results were mostly close with each other for both nail types. The maximum stresses at locking elements or bones contacting these elements increased with decreased distance between the fracture and relevant locking elements., Discussion: The wedge locked nail fixation showed comparable results to the standard interlocking nail fixation with respect to the stiffness and stress. Under axial loading, wedge locked nail provided a secured fixation without any slippage and preserved its position inside the medullary canal. It may be thought as a safe alternative to the standard interlocking nail fixation for retrograde usage. Additionally, according to stress results, it is advised to the surgeons to avoid a close locking to the fracture line., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To determine the effect of psychological resilience levels of nurses on perceived stress levels in this study., Methods: The research was carried out with 153 nurses. Socio-demographic Questionnaire, The Brief Resilience Scale, and Perceived Stress Scale were used as data collection tools., Results: The nurses' total Brief Resilience Scale score average was 17.72 ± 4.48, and the total Perceived Stress Scale score average was 31.74 ± 7.18. There was a negative and moderately significant relationship between the resilience and stress level of the nurses. During the pandemic process, the level of stress that nurses perceive increases as their psychological resilience decreases., Conclusion: Psychological resilience and coping with stress are traits that can be improved. It is important to establish strategies to increase the resilience of nurses and improve their ability to cope effectively with stress.

Introduction: Intramedullary nailing has been used as a standard in the treatment of the long bone fractures with its clinical and mechanical advantages. However, using distal locking screws has been associated with longer operative times, higher radiation exposure rates, and complications like breakages of distal screw or nail at the screw hole level. Therefore, attempts to eliminate distal locking screws has been always present for intramedullary nail fixation. With a similar purpose, the present study has been carried out to compare mechanical behaviors of intramedullary nail fixations with different distal locking elements., Materials and Methods: In this study, mechanical behaviors of standard interlocking and clawed nail fixations were compared experimentally in the first part. Six fourth generation Sawbones femurs, which have a simulated subtrochanteric fracture, were divided equally and were fixed with standard interlocking and clawed nails. During axial compression tests, experimental strain measurements were taken from all fixations. After validation of numerical models with using experimental strains and stiffnesses, mechanical behaviors of standard interlocking, clawed, and wedge locked nail fixations were compared numerically under axial compression loads. In numerical comparison, the stress-strain distributions were evaluated., Results: Experimental results showed that although that there was no significant difference in stiffnesses, standard nail fixation bore two times higher loads than clawed nail fixations. Under loading, decrease in the distance between fracture surfaces was approximately seven times higher in the clawed nail fixation when compared to standard nail fixations. Numerical results showed that wedge locked nail fixation provided equivalent mechanical behavior to standard interlocking nail., Discussion: In experiments of clawed nail fixation, the high decrease in the distance between fracture surfaces was evidence of the slippage of nail in the medullary canal. For a safe fixation, claws should be deployed when they are completely in contact with the cortical bone, they should be stuck into the bone in a fair amount, and the deployment in the distal third of the femur should be avoided. According to experimentally validated numerical analyses, wedge locked nail fixation may be an alternative for standard interlocking nail fixation if experimental studies support the present results., Competing Interests: Declaration of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The superiority of synbiotics in terms of their biological effects depends primarily on a suitable combination of both components, pro-biotic and pre-biotic. The present study was conducted to compare the efficacy of mono- and multistrain synbiotics on overall performance, caecal fermentation, intestinal health, meat and bone quality along with some blood biochemical indices in broilers. A total of 231, 1-day-old male Ross 308, broiler chicks were randomly assigned to three experimental groups using 11 replicates each and seven chicks/replicate. The dietary treatments included control group with no synbiotic supplementation, monostrain (Maflor) and multistrain (Maflor plus) synbiotic groups with 1 g/kg of added synbiotics each. Synbiotics feeding significantly improved animal performance with a clear impact on meat quality in terms of low-fat, optimum ultimate pH24, higher water holding capacity, and lower drip and cooking losses. Of the two synbiotics, multistrain seemed to have responded better in modifying small intestinal epithelia and fermentation metabolites, although both synbiotics were comparable in reducing the pathogen load. Load-bearing capacity of both leg bones (femur and tibia) was also enhanced with synbiotics supplementation, which was also reflected in their mineral profile. The blood serum biochemical analysis showed a reduction in circulating cholesterol and triglycerides levels and an increment in IgA and IgG concentrations. In conclusion, the remarkable efficacy of tested synbiotics in providing higher growth, better meat quality in tandem with the optimum gut environment, lower pathogen load, healthy epithelia, immunomodulation, hypocholesterolemic, and hypotriglyceridemic effects affirms their great potential to be used as feed additives in broiler diets. Contrary to our expectations, the effectiveness of a mono-strain in comparison to multistrain synbiotic in improving almost all the features investigated was also notable. Further evaluation under challenging conditions should be explicitly conducted to achieve more comprehensive results., (© 2022 Wiley-VCH GmbH.)

Aim: This study aimed to investigate the effectiveness of an absorbable polyglycolic acid patch (PGA) in the early prevention of alveolar air leaks after pulmonary decortication operations., Methods: Between January 2016 and December 2019, files of 185 patients with pleural effusion, empyema, or hemothorax were examined retrospectively. Thirty-five patients who underwent decortication surgery were included in the study. Two-way posteroanterior (PA) chest x-ray, computed tomography (CT), pulmonary function tests (PFT), arterial blood gas, hemogram, and biochemical tests were performed for all patients before the operation. The patients were divided into two groups. Group 1 was composed of 16 patients (45.7%) with standard decortication, and Group 2 was formed with 19 patients (54.3%) with standard decortication + PGA patch., Results: The median age was 55 years (minimum = 25, maximum = 75) and the vast majority (82.9%; n = 29) of patients were males. There was no significant difference between groups in age, aetiology, or sex. The most common etiological cause in both Group 1 and Group 2 was nonspecific infection (56.3% and 73.7%, respectively). When Group 2 and Group 1 were compared regarding median times (day) of air leak cessation (Group 2 = 4; Group 1 = 8.5), chest drain removal (Group 2 = 5; Group 1 = 10), and hospital discharge times (Group 2 = 8; Group 1 = 13),the durations were statistically significantly shorter in Group 2 than in Group 1 (P < 0.001)., Conclusion: Use of the PGA patch in pulmonary decortication operations significantly reduced the duration of air leaks, drain removal, and discharge time from the hospital in the postoperative period., (© 2022 Royal Australasian College of Surgeons.)

Objective: The objective of the study is to evaluate the clinical findings and treatment results of COVID-19 in pediatric cancer patients., Study Design: The study was designed as a single-center retrospective observational study. Pediatric cancer patients with COVID-19 admitted to the University of Health Sciences Adana City Training and Research Hospital pediatric COVID wards from October 2020 to October 2021 were included. Clinical data and demographic characteristics were retrieved from patient files., Results: A total of 45 pediatric cancer patients diagnosed with COVID-19 were included in the study. The mean age of the patients was 8.68 ± 5.16 years (range 1.5-17.5), 62.2% were men, 37.8% were Turkish citizens, and 62.2% were Syrian refugees. A total of 41 patients (91.1%) had leukemia/lymphoma, while 4 (8.9%) had solid tumors. The most common symptoms were fever (66.7%), respiratory (35.6%), and gastrointestinal symptoms (17.8%). Disease severity was evaluated as mild in 46.7%, moderate in 44.4%, and severe in 8.9% of patients. Patients presented with lymphopenia (88.9%), thrombocytopenia (73.3%), anemia (71.1%), and neutropenia (62.2%). Mean hospital length of stay was 15.18 ± 10.34 (range 6-62) days overall and 9.5 ± 2.39 (range 2 to 28) days in the PICU. Intensive care unit admission rate was 8.9%, and mortality rate was 4.4%. Median viral shedding period was 21 days (range 7-52)., Conclusions: Our study reveals that the mortality rate, length of hospital stay, and the need for intensive care of pediatric cancer patients with COVID-19 are higher than those of healthy children. Prospective studies with larger sample sizes are needed to further evaluate the clinical findings and treatment results of COVID-19 in pediatric cancer patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Tolunay, Çelik, Arslan, Tutun and Özkaya.)

Aim: To determine the psychological resilience and perceived stress levels of healthcare workers in COVID-19 intensive care units., Methods: The study was conducted with 418 physicians and nurses in Turkey between July and August 2020. The data were collected with an online survey consisting of a personal information form, the Brief Resilience Scale, and the Perceived Stress Scale., Results: The study sample comprised 32.5% physicians and 67.5% nurses. Fear of transmission of COVID-19 from the patients in their care was stated by 92.6% of the physicians and 95.7% of the nurses. Almost all of the participants (99.3%) were afraid of transmitting COVID-19 to their families. The psychological resilience level of the physicians (18.42 ± 2.25) participating in the study was higher than that of the nurses (17.88 ± 2.00), and the perceived stress level was lower. It was determined that most physicians and nurses strengthened their team/work friendship bonds during the pandemic, but the motivation to work decreased., Conclusion: The study results suggest that frontline intensive care workers should be closely monitored as a high-risk group for psychological problems. The provision of better personal protective equipment, together with on-going monitoring and provision of psychological support, and strong family support will increase the resilience of frontline healthcare workers., (© 2021 Japan Academy of Nursing Science.)

Introduction: There has been a great effort in preventing the disadvantages of distal locking in intramedullary nailing to date. From this scope, a novel expandable nail fixation eliminating distal locking screws has been designed. The primary aim of this numerical parametric study is to investigate mechanical behavior of expandable nail fixation on the fractured femur model under different contact parameters which are effective in maintaining the nail position and to specify the appropriate values of these contact parameters for a safe fixation. The second aim is to compare mechanical behavior of the expandable nail fixation with the standard interlocking nail fixation., Materials and Methods: The expandable nail has three wedges which are responsible for distal fixation by compressing the medullary canal in the radial direction. 4th generation Sawbones femur model was used as bone model. A transverse osteotomy with 20 mm gap was created to simulate a subtrochanteric fracture. The fixations have been examined under axial compression with 1200 N and torsion with 7 Nm. In the parametric study, the tightening torque and static friction coefficient in wedge-canal contact were selected as contact parameters. The outputs were stiffnesses of the fixations, equivalent von-Mises stress distribution on the models, and load sharing between the canal and distal locking elements., Results: The results of the parametric study showed that the model with the tightening torque of 3 Nm and friction coefficient of 0.7 was the safest. The load borne by wedges is generally prone to increase with increased tightening torque and friction coefficient. The both fixations showed close stiffness and stress values., Conclusion: The tightening torque of the wedge locking mechanism is directly effective in maintaining the nail position constant in canal, and the safety of the fixation is better ensured with increased tightening torque but stress states on bone must be carefully evaluated. The expandable nail provided comparable results to standard interlocking nails with respect to the fixation stiffness, stress, and contact forces. The expandable nailing may be evaluated as an alternative in the fractures of long bones in the case that the numerical results are supported by future experimental studies., Competing Interests: Declarations of Competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021. Published by Elsevier Ltd.)

Introduction Renal colic is often confused with low back pain (LBP) and other pathologies. Computed tomography (CT) is frequently used to reach a definitive diagnosis, but its use increases the exposure to radiation. Researchers have tried to predict urinary stones in patients presenting with flank pain. Several scoring systems have been introduced; however, none of them provide a prediction based on the physical examination of the patient upon initial presentation to the outpatient clinic. In this study, we aimed to investigate whether we can predict the presence of stone with visual analogue scale (VAS) questionnaire during the first admission. Materials and methods Patients with complaints of flank pain were started to be followed for three months in our urology clinic. After the definitive diagnosis was made the patients were classified into two groups: renal colic group (group 1; n=36) and the LBP group (group 2; n=30). Results In logistic regression analysis, the possibility of renal colic increased 5.4 times more per one-unit increase in the VAS score. In receiver operating characteristic (ROC) analyses, when the VAS was 4.5, the diagnosis of renal colic could be made with 88% sensitivity and 71% specificity. Conclusion If the VAS score is ≤ 4 in patients that have flank pain without limitation of movement, it is more likely to manage these patients with a simple medical treatment plan. In these patients, unnecessary ultrasonography (US) scans be reduced by 86.3% and unnecessary CT scans by 88.8%. A VAS score of ≥5 should warn the clinician about the necessity of routine urinary stone examinations., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Caniklioğlu et al.)

Photobiomodulation therapy (PBMT) is a method currently used in the treatment of hard and soft tissue injuries due to its accelerating and enhancing effects on healing. In this study, we aimed to evaluate the possible additional benefits of applying PBMT with nonsurgical periodontal treatment in type 2 diabetes mellitus (DM) patients with chronic periodontitis (CP). Twenty-two type 2 DM patients with CP were enrolled in this clinical split-mouth study. Probing pocket depth (PPD), gingival index (GI), plaque index (PI), and clinical attachment level (CAL) were measured by intracaliber clinician (H.G.) at baseline and at 1 m, 3 m, and 6 m after treatment. Gingival crevicular fluid (GCF) samples were collected at baseline and at 1 week and 1 m, 3 m, and 6 m after treatment. According to split-mouth design, one randomly selected quadrant was treated with PBMT + nonsurgical periodontal treatment (NSPT) and the other quadrant was treated only non-surgical periodontal treatment. PBMT was applied the test quadrant on NSPT day and first, third, and seventh day after treatment at an energy density of 7.64 J/cm 2 . Repeated measures analysis of variance test was used for the intragroup comparison and a "paired t test" in the intergroup comparison of the clinical and laboratory findings. Comparing the test and control quadrant after treatment, the test quadrant showed significant decrease in PPD at 1 month, 3 months, and 6 months; in GI at 3 months and 6 months; in CAL at month 6; in GCF at 1 week, 1 month, 3 months, and 6 months; and in IL-1β data at 3 months in comparison to the control quadrant. In contrast, there was no statistically significant difference in PI data at all times. Within the limitation of this study, adjunct use of PBMT on NSPT in patient with DM may positively affect the clinical and biochemical parameters.

Purpose: Traumatic pulmonary pseudocysts (TPP) are rarely talked about, developing in less than 3% of patients with pulmonary parenchymal injuries. Resolution usually occurs within a few weeks to a few months., Methods: A retrospective study was undertaken in 30 cases treated in Antalya Training and Research Hospital, Turkey, from January 2014 to December 2017., Results: The 30 patients with TPP were 28 males (93.3%) and 2 females (6.7%) aged 14-64 years (mean age 31.9 years). Most of them are located in the right lower lobe (50%). The mean size of TPP was 2.07 cm. The overall resolution time for TPP was found to range from 8 to 124 days with a mean of 45.1 ± 32.9 days., Conclusions: Computed tomography (CT) is a more beneficial than chest radiograph for early diagnosis. Physicians should control follow-up chest radiograph or CT scans until the pseudocyst resolves. Conservative treatment is acceptable in most cases, but intervention may be necessary if complications show up., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Indian Association of Cardiovascular-Thoracic Surgeons 2018.)

Objectives: Over the past decade, minimal invasive surgery for correction of pectus carinatum has gained worldwide acceptance. This study reviews our clinical experience with minimally invasive repair of pectus carinatum (MIRPC) since 2008., Methods: Between 2008 and 2018, 101 patients (77 male, 24 female) underwent correction of pectus carinatum with the MIRPC technique. The mean age of the patients was 14.7 ± 4.8 (3-38) years. Over an 8 years' experience we slightly modified the original Abramson technique. All patients presented with cosmetic complaints and all had a flexible chest wall on "compression test". Early follow-up was on postoperative day 15 and 30., Results: The mean operative time was 42.1 ± 16.9 min. The mean hospital stay was 4.2 ± 0.9 days. Postoperative complications included pneumothorax (n = 2, 1.9%), wound infection (n = 2, 1.9%), skin perforation (n = 2, 1.9%), intolerable pain (n = 1, 0.9%), skin hyperpigmentation (n = 1, 0.9%), and overcorrection (n = 1, 0.9%). Initial postoperative results were excellent in all patients. The bars were removed at a median of 24.8 ± 4.5 months in 44 of 101 patients. 43 of 44 (97.7%) patients whose bar were removed reported excellent results., Conclusions: MIRPC is a feasible procedure with low morbidity and excellent cosmetic results in the treatment of pectus carinatum deformities in selected patients.

Supracondylar humerus fractures are common fractures around the elbow. Open fractures, comminuted metaphyseal fractures and also fractures with bone loss may need to be treated with external fixators. The aim of this study is to compare two different external fixators, tubular external fixators and polymethyl methacrylate with K wires external fixators, with regard to stiffness and stability for metaphyseal-diaphyseal osteotomies of distal humerus close to the joint. Six matched pairs (24 specimens) of second-generation sawbone humerus were prepared in a standard fashion to create a metaphyseal fracture, 5 cm proximal to the distal joint line of humerus and were randomly divided into two groups of 12 specimens each. Each sawbone humerus was osteotomized transversely at the mid-olecranon fossa with a 2-mm oscillating saw to simulate a Gartland type III fracture. The osteotomy was then reduced and stabilized using two different external fixation methods: carbon tubular external fixator with Schanz screws and methyl methacrylate with multiple K wires. Three-point bending and torsion tests were performed on the specimens. Bending and torsional stiffness of specimens were obtained for the fixation methods. According to the results of the study, the methyl methacrylate group has provided higher stiffness than classical tubular fixator with Schanz screws in three-point bending test (7.79 ± 2.33 N/mm vs 3.78 ± 1.18 N/mm, p = 0.006). The methyl methacrylate group also showed better stiffness in torsion test (0.12 ± 0.042 N m/° vs 0.067 ± 0.013 N m/°, p = 0.02). We determined for the first time in literature that external fixation with methyl methacrylate was significantly superior to the classical tubular external fixator with Schanz screws with regard to stiffness and stability under three-point bending and torsional loads. Moreover, methyl methacrylate is inexpensive and easily applied.

Introduction: The minimally invasive pectus carinatum surgery described by Abramson has been performed in many centers. We modified the "sub-muscular tunnel creation" part of the original Abramson technique., Aim: To compare the operative time between the original Abramson technique and a lightly modified approach., Material and Methods: A retrospective review of 84 patients who underwent minimally invasive repair of pectus carinatum deformity between July 2008 and November 2017 was performed. We applied two different techniques, the original Abramson technique and the modified technique. Sixty-eight patients - 49 (72%) males and 19 (28%) females - underwent minimally invasive repair of a pectus carinatum deformity as described by Abramson (Abramson group). Sixteen patients - 13 (81%) males and 3 (19%) females - were operated on by our modified Abramson technique at our institution (Modified group)., Results: Eighty-four patients were included in this study: 68 patients from the Abramson group and 16 patients from the Modified group. There was no significant difference between the groups with respect to preoperative demographic features, including median age and sex. Median operative time was significantly shorter in the Modified group than the Abramson group (43 min, range: 32-54 min) in the Modified group vs. 30 min (range: 20-35 min) in the Abramson group (p < 0.001)., Conclusions: This article describes a modification of a surgical technique that is safely and easily used in minimally invasive correction of pectus carinatum deformities, with minimal complications, high satisfaction rates and shorter operative time.

Transforaminal lumbar interbody fusion was an alternative to posterior lumbar interbody fusion for decompression surgeries. This study investigates the biomechanical responses of the unilateral and bilateral pedicle screw fixations with/without transforaminal lumbar interbody fusion cages under axial compression, flexion, and torsional loads. Ovine vertebrae were used in this study. Cadavers, randomly divided into five, were intact control group, bilateral pedicle screw fixation group, bilateral pedicle screw fixation group with transforaminal lumbar interbody fusion cage, unilateral pedicle screw fixation group, and unilateral pedicle screw fixation group with transforaminal lumbar interbody fusion cage. Axial compression, flexion, and torsion tests were performed on specimens. All study groups provided higher stiffness and yield load values than control group under axial compression. Addition of transforaminal lumbar interbody fusion cage to bilateral fixation increased the stiffness under axial compression. Moreover, additional use of transforaminal lumbar interbody fusion in unilateral fixation increased the yield load values under axial compression. Control group was the stiffest in flexion test. Placing a transforaminal lumbar interbody fusion cage to both unilateral and bilateral fixations did not significantly change the stiffness values. Additional transforaminal lumbar interbody fusion cage increased the yield moment of the bilateral fixation. In torsion test, control group had the highest stiffness and yield torque. The facet joints are the most important parts of the vertebrae on the stability. When comparing the bilateral and unilateral fixations with transforaminal lumbar interbody fusion addition, the more facet preserving approach has significantly higher stability under axial compression, flexion, and torsion. Unilateral fixation with transforaminal lumbar interbody fusion cage can be said biomechanically stable and advantageous fixation system because of the advantage on the less facet and soft tissue resection compared to bilateral fixation with transforaminal lumbar interbody fusion.

Transdiscal screw fixation is generally performed in the treatment of high-grade L5-S1 spondylolisthesis. The main thought of the study is that the biomechanical performances of the transdiscal pedicle screw fixation can be identical to standard posterior pedicle screw fixations with or without transforaminal lumbar interbody fusion cage insertion. Lumbosacral portions and pelvises of 45 healthy lambs' vertebrae were dissected. Animal cadavers were randomly and equally divided into three groups for instrumentation. Three fixation systems, L5-S1 posterior pedicle screw fixation, L5-S1 posterior pedicle screw fixation with transforaminal lumbar interbody fusion cage insertion, and L5-S1 transdiscal pedicle screw fixation, were generated. Axial compression, flexion, and torsion tests were conducted on test samples of each system. In axial compression, L5-S1 transdiscal fixation was less stiff than L5-S1 posterior pedicle screw fixation with transforaminal lumbar interbody fusion cage insertion. There were no significant differences between groups in flexion. Furthermore, L5-S1 posterior fixation was stiffest under torsional loads. When axial compression and flexion loads are taken into consideration, transdiscal fixation can be alternatively used instead of posterior pedicle screw fixation in the treatment of L5-S1 spondylolisthesis because it satisfies enough stability. However, in torsion, posterior fixation is shown as a better option due to its higher stiffness.

Rigid and semi-rigid fixations are investigated several times in order to compare their biomechanical stability. Interbody fusion techniques are also preferable for maintaining the sagittal balance by protecting the disk height. In this study, the biomechanical comparison of semi-rigid and rigid fixations with posterior lumbar interbody fusion or transforaminal lumbar interbody fusion procedures is conducted under trauma. There were four different test groups to analyze the effect of acute load on treated ovine vertebrae. First and second groups were fixed with polyetheretherketone rods and transforaminal lumbar interbody fusion and posterior lumbar interbody fusion cages, respectively. Third and fourth groups were fixed with titanium rods and posterior lumbar interbody fusion and transforaminal lumbar interbody fusion cages, respectively. The drop tests were conducted with 7 kg weight. There were six samples in each group so the drop test repeated 24 times in total. The test samples were photographed and X-rayed (laterally and anteroposteriorly) before and after drop test. Two fractures were observed on group 1. Conversely, there were no fractures observed for group 2. There were no anterior element fractures for both groups 1 and 2. However, one fracture seen on group 3 was anterior element fracture, whereas the other three were posterior element fractures. All three fractures were anterior element fractures for group 4. Treated vertebrae with polyetheretherketone rods and posterior lumbar interbody fusion cages showed the best durability to the drop tests among the groups. Semi-rigid fixation gave better results than rigid fixation according to failed segments. Posterior lumbar interbody fusion cages seem to be better option for semi-rigid fixation, however mentioned surgical disadvantages must be considered.

Interferon-alpha (IFN-α) is an effective drug used for the treatment of chronic hepatitis C. So far its numerous side effects have been reported in the literature. It may be difficult to always put IFN-induced thyroid diseases into a single classic thyroid disease table. There are numerous atypical thyroid diseases due to IFN usage for hepatitis C virus. Herein, we present a case with a rare clinical table such as thyrotoxicosis observed following IFN-α therapy in a patient with euthyroid nodular thyroid without autoimmune thyroiditis findings and the use of therapeutic apheresis method for the treatment of disease., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Purpose: The purpose of this study was to investigate the mechanical strength of both monoplanar and biplanar medial opening-wedge high tibial osteotomy (MOWHTO) procedures and assess the risk of lateral cortex disruption for both techniques., Methods: Twelve synthetic tibia models with cortical shells were used as test models. Saw cuts for monoplanar MOWHTO and biplanar MOWHTO were generated on the test models in equal numbers (n = 6 for both groups). Wedge opening load and wedge gap distance were evaluated via compressive tests., Results: The mean gap distance just before the lateral cortex fracture in the monoplanar group was 14.7 ± 2.9 mm, which was significantly narrower than that in the biplanar group of 19.1 ± 2.0 mm (p = 0.015). The mean load just before the occurrence of lateral cortex fracture of 32.4 ± 3.2 N in the monoplanar osteotomy group was significantly lower than that in the biplanar osteotomy group of 111.8 ± 9.3 N (p = 0.009)., Conclusion: Performing a MOWHTO via the biplanar rather than the monoplanar technique allows larger-sized wedges to be opened with less risk of lateral cortical fracture. Thus, larger gaps can be opened and higher angle corrections can be achieved using the biplanar osteotomy procedure. From a clinical viewpoint, the biplanar osteotomy technique reduced the risk of lateral cortical hinge fracture during MOWHTO.

Background: The correlation of S100A8/S100A9 with various inflammatory conditions, including autoimmune diseases have been reported. There is no study investigating the levels of S100A8/S100A9 in autoimmune thyroid diseases (AITD)., Aims: We aimed to evaluate the level of serum S100A8/S100A9 in AITD., Study Design: Case control study., Methods: Fifty patients with AITD (25 Hashimoto's thyroiditis (HT) and 25 Graves' disease (GD)) were included in the study. Twenty seven healthy subjects participated as a control group. Blood samples were obtained in the 3 months after the initiation of medical treatment. Serum levels of total antioxidant status (TAS), total oxidative status (TOS), total free sulfhydryl (SH), lipid hydroperoxide (LOOH) and S100A8/S100A9 were analyzed., Results: The patients with AITD had significantly higher S100A8/S100A9, OSI, LOOH and TOS levels than the healthy control group. There was no significant difference between GD and HT patients in terms of S100A8/S100A9, TOS and OSI levels. S100A8/S100A9 level was positively correlated with LOOH, TOS and OSI levels but negatively correlated with -SH level in the patients with AITD., Conclusion: Serum S100A8/S100A9 levels were increased in patients with AITD and positively correlated with LOOH, TOS and OSI whereas negatively correlated with SH., Competing Interests: No conflict of interest was declared by the authors.

Differentiated thyroid carcinoma (DTC) has good prognosis but 5% of the patients already have distant metastasis at the diagnosis. Tumour cells can lose their iodine uptake ability and enter a state of dedifferentiation. Treatment for differentiated thyroid carcinoma that is not suitable for the local surgery and unresponsive to radioactive iodine uptake is not always easy for physicians. We present a case of a 64-year-old man who had total thyroidectomy surgery and central lymph node dissection with diagnosis of multinodular goitre disease. Histopathological evaluation was papillary thyroid cancer with tall cell variant. Treatment using 150 mCi radioiodine was administered to the patient three times but could not effect a cure. We performed Ga-68 labelled DOTATE (synthetic somatostatin analogue peptide). This provided a good outcome. As evident from our case, Lu-177 radionuclide labelled synthetic somatostatin analogue peptides have therapeutic effect on radioiodine refractory DTC, as an alternative treatment modality., (2016 BMJ Publishing Group Ltd.)

Background: Compression fractures at adjacent mobile segments have been reported as adjacent segment disease under trauma in several studies. In this study, the occurrence of fractures at the adjacent segment was evaluated experimentally under trauma., Methods: Static testing of different fixation systems was performed to show their biomechanical performances. The ovine vertebrae fixed with rigid, dynamic, and semirigid systems were used as test samples. The stiffness values of the systems were obtained by testing the vertebrectomy models under compression bending, lateral bending, and torsion tests. In addition, their effects on the adjacent segments were experimentally evaluated within a drop mechanism. A free-fall drop mechanism was designed and manufactured. Next, 3.5-kg, 5-kg, and 7-kg weights were released from 1 m above the test samples to generate compression fractures. The occurrence of compression fractures was observed with the use of radiograph of test samples, which were obtained before and after the drop test., Results: Dynamic and semirigid systems have advantages compared with rigid systems as the result of their lower stiffness values. Radiographs showed that epiphysis fractures occurred at fixed and adjacent mobile segments, which were fixed with semirigid fixation. In addition, dynamic fixation well preserved the fixed and adjacent mobile segments under trauma., Conclusions: The dynamic system with a polyetheretherketone rod can better preserve both adjacent and fixed segments. However, because of the cantilever beam effect, the semirigid system exhibits a great disadvantage., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Using the unilateral pedicle screw fixation was thought to decrease the stiffness of the fixed segments. Various prospective, randomized studies were performed to determine whether unilateral pedicle screw fixation provides the necessities of bilateral fixation in one- or two-segment lumbar spinal fusion. In this study, four different unilateral pedicle screw fixation systems were evaluated to determine which one best approximated an intact spine with respect to biomechanics and kinematics. The four groups included an intact group, a unilateral facetectomy group with no fixation, a unilateral semi-rigid pedicle screw fixation group with a poly-ether-ether-ketone rod, and a unilateral dynamic pedicle screw fixation group. The bone mineral densities of all specimens were measured and specimens were matched with groups randomly. Flexion, lateral bending, and axial rotation tests were performed to compare the groups. For the flexion, lateral bending, and axial rotation tests, the best biomechanical outcomes were in the control group. The unilateral facetectomy group had the poorest performance and was not stable enough, compared with the control group. The dynamic and semi-rigid groups showed performance closer to that of the control group. The biomechanical responses of these two groups were also in good agreement, showing no significant statistical differences. Based on these test results, it is concluded that the unilateral dynamic and semi-rigid pedicle screw fixations can be used to provide stability to the vertebrae., (© IMechE 2015.)

Objective: The prevalence of stone diseases is high in Turkey. Thanks to the technological improvements and to the increase in the number of qualified and experienced specialists in the last thirty years, there has been an increase in the application of minimally invasive methods in the stone disease surgery. This study, with a sample survey of Western Black Sea region, aims at revealing the changes and improvements in the treatment of stone diseases in different centers in Anatolia within the last ten years., Material and Methods: Six centers in 4 of the provinces of the Western Black Sea Region were selected and the patients' files were retrospectively analyzed. The treatment methods that were recommended for and/or applied to the patients diagnosed with urinary stone diseases were recorded by years. The urinary stone diseases were divided into three separate groups; kidney, ureters and bladder. Treatment options were recorded into categories as open surgery, percutaneous nephrolithotripsy, retrograde intrarenal surgery, semirigid ureterorenoscopy, flexible ureterorenoscopy, and ESWL., Results: A total of 26044 patients with stone diseases have been treated in the above-mentioned centers for the last 10 years. The distributions of the stone diseases in relation to their localization were as follows: - kidney stones: 9040 (34.7%), ureter stones: 15264 (58.6%), and bladder stones: 1740 (6.7%). As for the distribution of the treatment in relation to the treatment methods, it was seen that open surgery for 1032 (4%) patients, endoscopic surgery for 15038 (58%) patients, and ESWL for 9974 (38%) patients had been applied. While URS and PCNL are currently the commonly used treatment methods in the Western Black Sea Region, RIRS has begun to be used in a limited number of patients for the last 3 years., Conclusion: Though being a little late, the advances in endrourology offer practical applications in the Western Black Sea region as well. Although this study suggests implications for the evaluating of the periphery outcomes of the improvements in stone disease treatments, for the planning of training schemes, and for equipment planning, further research based on more data from more centers is needed to have a nation-wide perspective.

This study was conducted with the goal of evaluating the challenge of diabetes in elderly individuals and affecting factors. This descriptive study was conducted with 88 diabetic patients 65 years of age or older who were admitted to the endocrinology and metabolism disorders outpatient clinic data of the study collected by using a questionnaire prepared by the researchers and the Elderly Diabetes Burden Scale. Total score of the scale varies between 19 and 92 points. While a higher score indicates a higher burden a lower score indicates a lower burden, data were analyzed by using Student t test, 1-way analysis of variance, Mann-Whitney U test, and Kruskal-Wallis test. Subscale and total mean scores of patients were as follows: 9.4 ± 3.2 for symptom burden; 12.4 ± 3.4 for social burden; 11.4 ± 3.3 for burden by dietary restrictions; 11.9 ± 3.7 for burden of worry about diabetes; 4.3 ± 1.3 for burden from treatment dissatisfaction; 9.4 ± 4.6 for burden by oral antidiabetic drugs or insulin; and 58.5 ± 9.6 for total diabetes burden score. Diabetes burden was found to be higher for patients who were at an advanced age, single, female, had a lower income, receiving oral antidiabetic or insulin treatment, and had diabetes duration of 6 to 11 years, a concomitant chronic condition or a diabetic person among first-degree relatives and who did not come for regular follow-up visits, had no assistance for their care, and who stated a poor quality of life and treatment compliance. Elderly diabetic patients were found to have a high total Elderly Diabetes Burden Scale score, and the highest scores were observed for the subscales of burden by dietary restrictions, social burden, and burden of worry about diabetes. Thus, it could be recommended to perform appropriate nursing interventions in order to assess and reduce diabetes challenge during planning of necessary treatment and care in elderly diabetic patients.

Objective: The aim of this study was to evaluate paraoxonase-1 (PON1) activities and oxidative stress status, and the changes in their levels after total thyroidectomy in patients with papillary thyroid cancer (PTC)., Materials and Methods: Twenty-five patients with PTC and 27 healthy controls were enrolled in the study. Blood samples were obtained from the PTC patients before and 3 months after the operation. Preoperative and postoperative serum samples from PTC patients and healthy controls were analyzed for paraoxonase (PON), arylesterase (ARE) activities, and lipid hydroperoxide (LOOH) and -SH (total free sulfhydryl) levels., Results: The preoperative PON, ARE and -SH levels of the patients with PTC were significantly lower compared to those of the control group (p = 0.033, p < 0.001, p = 0.002, respectively), while LOOH levels were significantly higher (p < 0.001). The levels of PON and ARE decreased significantly in patients with PTC after the operation (p = 0.038, p = 0.023, respectively), while LOOH and -SH levels remained unchanged (p = 0.117, p = 0.487, respectively). PON and ARE levels showed a positive correlation with -SH (r = 0.211, p = 0.065; r = 0.471, p < 0.001, respectively) and a negative correlation with LOOH (r = - 0.391, p < 0.001, r = - 0.486, p < 0.001, respectively)., Conclusion: Serum PON1 activity is decreased in patients with PTC, and serum PON1 is positively correlated with -SH, a well-known antioxidant, and negatively correlated with LOOH, an oxidant. PON1 activity is significantly decreased after total thyroidectomy.

Introduction. Polyaxial screws had been only tested according to the ASTM standards (when they were perpendicularly positioned to the rod). In this study, effects of the pedicle screws angled fixation to the rod on the mechanical properties of fixation were investigated. Materials and Method. 30 vertically fixed screws and 30 screws fixed with angle were used in the study. Screws were used in three different diameters which were 6.5 mm, 7.0 mm, and 7.5 mm, in equal numbers. Axial pull-out and flexion moment tests were performed. Test results compared with each other using appropriate statistical methods. Results. In pull-out test, vertically fixed screws, in 6.5 mm and 7.0 mm diameter, had significantly higher maximum load values than angled fixed screws with the same diameters (P < 0.01). Additionally, vertically fixed screws, in all diameters, had significantly greater stiffness according to corresponding size fixed with angle (P < 0.005). Conclusion. Fixing the pedicle screw to the rod with angle significantly decreased the pull-out stiffness in all diameters. Similarly, pedicle screw instrumentation fixed with angle decreased the minimum sagittal angle between the rod and the screw in all diameters for flexion moment test but the differences were not significant.