Search

Neglected bilateral posterior shoulder dislocation is a rare injury caused primarily by an epileptic seizure. The injury is usually associated with a reverse Hill-Sachs lesion in the anteromedial aspect of the humeral head. The modified McLaughlin technique may avoid instability and osteoarthritis when 20 to 40% of the articular surface is affected by reverse Hill-Sachs. In this article, we present the clinical results of a case overlooked in the literature for the longest time, i.e., for 15 months. A 46-year-old male patient was receiving treatment for epilepsy for five years. There was no fall or trauma in the four seizures he had during this time. The last seizure was 15 months ago. When the patient presented to our clinic, both shoulders were symmetrically deformed, the anterior shoulder contour disappeared (empty socket sign), and there was a loss of upper contour. The computed tomography (CT) scan revealed a posteriorly locked dislocation with a reverse Hill-Sachs lesion in 32% of the left shoulder and 36% of the right shoulder. We applied the modified McLaughlin procedure to the dominant right shoulder and, two months later, we used it to the left shoulder (with a graft taken from the anterior superior iliac spine). At one-year of follow-up, both shoulders were moderately functional: forward elevation left 70° and right 50°, abduction left 40° and right 60°, and internal rotation: the back of the hand could touch the fifth lumbar vertebra. Meanwhile, the patient did not suffer from recurrent dislocation. The pre- and postoperative Constant-Murley Scores for the right and left shoulder were 30/52 and 11/48, respectively. Although the operational outcomes using the modified McLaughlin technique were not ideal, with no recurrence, the patient seemed to be satisfied with this outcome. In conclusion, in neglected locked shoulder fracture-dislocations, the modified McLaughlin technique is a method that can respond to the pathophysiology by eliminating reverse Hill-Sachs lesion.

Chronic cases of peroneal subluxation typically call for surgical treatment; however, research on current surgical procedures suggests nonuniformity. The purpose of this study is to remind surgeons of the efficacy of an older surgical method by using the case of a selected patient. In this study, the Ellis Jones procedure was performed on a patient who had been suffering from a chronic peroneal subluxation for 22 years, since, in this particular case, other approaches were deemed likely to be unsuccessful. The patient had hypertrophied, frayed, and swollen tendons, which were unsuitable to be rerouted, whereas the superior peroneal retinaculum was diminished and deepening procedures would not be able to establish sufficient volume for retaining the hypertrophied tendons. After the debridement and repair of the peroneal tendons, ¼ of the lateral Achilles tendon was split, passed through a hole in the fibula, and sutured onto itself, and the subluxation path of the peroneal tendons was closed with an effective tendon barrier. The patient returned to work after 8 weeks of the surgery and was followed up for 4 years postoperatively. On selected patients, the Ellis Jones surgical method might therefore still be applied. Levels of Evidence: Level V.

Gold (Au) and silver (Ag) nanostructures have widespread utilization from biomedicine to materials science. Therefore, their synthesis with control of their morphology and surface chemistry have been among the hot topics over the last decades. Here, we introduce a new approach relying on sugar derivatives that work as reducing, stabilizing, and capping agents in the synthesis of Au and Ag nanostructures. These sugar derivatives are utilized alone and as mixture, resulting in spherical, spheroid, trigonal, polygonic, and star-like morphologies. The synthesis approach was further tested in the presence of acetate and dimethylamine as size- and shape-directing agents. With the use of transmission electron microscopy (TEM), selected area electron diffraction (SAED), x-ray diffraction (XRD), scanning electron microscopy (SEM), and ultraviolet-visible (UV-vis) absorption spectroscopy techniques, the particle size, shape, assembly, aggregation, and film formation characteristics were evaluated. NPs' attributes were shown to be tunable by manipulating the sugar ligand selection and sugar ligand/metal-ion ratio. For instance, with an imine side group and changing the sugar moiety from cellobiose to lactose, the morphology of the Ag nanoparticles (NPs) transformed from well dispersed cubic to rough and aggregated. The introduction of acetate and dimethylamine further extended the growth pattern and morphological properties of these NPs. As examples, L5 AS, G5AS, and S5AS ligands formed spherical or sheet-like structures when used alone, which upon the use of these additives transformed into larger multicore and rough NPs, revealing their significant effect on the NP morphology. Selected samples were tested for their stability against protein corona formation and ionic strength, where a high chemical stability and resistance to protein coating were observed. The findings show a promising, benign approach for the synthesis of shape- and size-directed Au and Ag nanostructures, along with a selection of the chemistry of carbohydrate-derivatives that can open new windows for their applications.

Introduction: Many orthopaedic procedures require drilling of bone, especially fracture repair cases. Bone drilling results in heat generation due to the friction between the bone and the drill bit. A high-level of heat generation kills bone cells. Bone cell death results in resorption of bone around bone screws. Methods: We searched in the literature for data on parameters that influence drilling bone and could lead to thermal necrosis. The points of view of many orthopaedists and neurosurgeons based upon on previous practices and clinical experience are presented. Results: Several potential complications that lead to thermal necrosis are discussed and highlighted. Discussion: Even in the face of growing evidence as to the negative effects of heat induction during drilling, simple and effective methods for monitoring and cooling in real-time are not in widespread usage today. For that purpose, we propose some suggestions for the future of bone drilling, taking note of recent advances in autonomous robotics, intelligent systems and computer simulation techniques. Conclusions: These advances in prevention of thermal necrosis during bone drilling surgery are expected to reduce the risk of patient injury and costs for the health service.

We present a case of polyarticular synovitis following alendronate treatment for osteoporosis. The patient had no evidence of rheumatoid arthritis, pyrophosphate arthropathy, or seronegative/seropositive arthritis. Our main aim in this study is to highlight the potential adverse effects of alendronate and to warn orthopedic surgeons about the possibility of such a side effect that might lead orthopedic surgeons to administer wrong and unnecessary treatments like arthrocentesis. The withdrawal of alendronate is found to be the treatment of choice. Alendronate should be considered as a possible cause of synovitis or polyarthritis in patients treated with this agent in the absence of any other pathology. An association between alendronate and synovitis has rarely been described in the literature. We present a patient who developed polyarticular synovitis after treatment with alendronate and responded to its withdrawal. [ABSTRACT FROM AUTHOR]

Background: Associated joint disorders with popliteal cysts were stated approximately between the ranges of 41-83 % in all reported cases. Combined treatment strategies that eliminate intra-articular pathologies and cyst- associated valve mechanisms are thought to be a good option in treatment of the disease. In this study, our main objective is to present clinical results of our combined treatment results, which includes posterior cyst excision with supine arthroscopic intervention, targeting intra-articular pathologies on recalcitrant cases. Methods: One hundred three knees of 100 patients treated with posterior open cystectomy with valve and repair of posterior capsule, in addition to arthroscopic treatment of intra-articular lesions, were included in the study. Preoperative magnetic resonance imaging (MRI) studies were performed in order to evaluate location of Baker cysts behind the knee. Rauschning-Lindgren and Lysholm Knee Scoring Scales were used to assess pre/post-operative knee functions. Mann-Whitney U test was used to evaluate the differences between genders in comparison of Lysholm and Lindgren scores. Mean age within gender groups was compared using independent samples t-test. Wilcoxon test was used to compare the change in Lysholm and Lindgren scores. A p-value of less than 0.05 was considered to show a statistically significant result. Over the 1-year follow-up period, US and MR imaging was performed only with symptomatic patients. Results: Cyst recurrence was seen only in 2 (1.94 %) patients. Post-operative Lysholm Knee and Lindgren knee scores demonstrated improvement in knee function and general comfort level of the patients. Conclusions: Our midterm follow-up (Mean: 39 Months) results showed that open cyst excision with valve and capsule repair with knee arthroscopy that targets associated intra-articular pathologies reduced the pain and improved the knee function in those patients. Level of evidence: IV (Retrospective clinical study without comparison group). [ABSTRACT FROM AUTHOR]

Trevor's disease, also known as dysplasia epiphysealis hemimelica, is a rare nonhereditary skeletal development disorder that affects epiphyses. This type of dysplastic lesion was first reported by Mouchet and Berlot in 1926 under the name 'tarsomegaly'. The main aim of this study is to raise awareness of Trevor's disease among orthopedic surgeons and underline some important aspects of treatment by a detailed presentation of four different possible manifestations of the disease. Four different treatment methods were used on four different patients (three localized in hindfoot ankle region and one classic Trevor's disease case). Treatment methods, localization of the sides involved, different characteristics of entire lower extremity, asymetry, distal femoral lateral epiphysis involvement, and hip involvement were analyzed thoroughly and the results were compared with those found in the most recent literature. Of our four patients, three were localized (hind foot ankle) cases and one was a classic dysplasia epiphysealis hemimelica with hemimelic distribution of the entire lower extremity. We used arthroscopic resection, observation, excision, and temporary hemiepiphysiodesis treatment methods in each of our cases. Clinical follow-up results were reported to be between good and excellent. In sum, our opinion is that the treatment for this condition should be customized according to lesion localization and lesion size. Majority of cases with ankle involvement show good prognosis following excision. Observation is also an alternative in patients who refuse surgery. If an intra-articular lesion is present, the surgeon should perform an arthroscopy for assessment of lesion surface. If the lesion is adapted to the joint curvature, it should be left alone and hemiepiphysiodesis should be considered for correction. The most risky involvements that are related to deformities and limb-length discrepancies are the hip and the knee. This is usually the result of corrective osteotomy targeted at the supracondylar femoral area in immature skeletons. Hemiepiphysiodesis might be a more feasible option in those cases as it provides the surgeon with the choice to remove the staples when necessary.

The coracoid base is a very rare location for tumors. It is difficult to diagnose and approach, but easy to dismiss. In this case, the tumor (eosinophilic granuloma of the scapula) was located at the base of the coracoid, and the posterior cortex was eroded by the tumor. Accessing this lesion through the deltopectoral approach with coracoid osteotomy without penetrating the supposed tumor extending posterior soft tissue will be discussed. This approach gives a wider and safer access to the surgeon than the posterior approach. This report presents a customized solution with the deltopectoral approach, and the chevron-type osteotomy to access the coracoid base and tension band wiring to fix the osteotomy side.

Background . The aim of the study was to evaluate whether or not there was any incompatibility between four-strand hamstring tendons taken from the same knee and the dimensions of the ACL and PCL. Methods . 15 fresh frozen cadaver hamstrings were prepared as four-strand grafts and measurements made of the ACL and PCL circumferences in the midsection were made in the narrowest part of the midsection. The cross-section areas and diameters were calculated with geometric calculations used to measure the cross-sectional area of cylinders. Accepting that the geometric insertions were elliptical, the length, width, and area were calculated for entry areas. Results . A significant relationship at 96.2% was determined between the ACL mid and the hamstring diameter. A significant relationship at 96.7% was determined between the ACL and the hamstring mid area. A significant relationship at 96.4% was determined between the PCL mid and the hamstring diameter. A significant relationship at 95.7% was determined between the PCL and the hamstring mid area. Conclusion . For the reconstruction of ACL and PCL, it was determined that there is less incompatibility between the four-strand hamstring tendons taken from the same knee and the dimensions of the midsection PCL compared to the ACL dimensions., Competing Interests: The authors declare that they have no competing interests.

We would like to highlight unusual sequelae of healed distal third diaphyseal tibia fracture that was treated conservatively 36 years ago, in which we incidentally detected peripheral CT angiography. The anterior tibial artery was enveloped three-quarterly by the healing callus of the bone (distal tibia).

From 1992 to 1997 a series of 12 multiply operated (averaging 2.5 previous operations) patients with recurrent peridural fibrosis and postlaminectomy kyphosis underwent surgery at our clinic. The surgery was designed to restore the physiological lordosis and relax tethered cord and epidural veins by transpedicular decancellation osteotomy at a vertebra other than the vertebra with peridural fibrosis. This paper presents the long-term functional outcome of these 12 patients. Clinical assessments were conducted pre-operatively and at 3-month intervals postoperatively and included X-ray assessment and evaluation of the patients’ functional status by Oswestry Disability Index (ODI) and of pain by visual analogue scale (pain VAS). All symptoms and the pain due to peridural fibrosis disappeared in the early postoperative period. Patients had lower disability and pain scores at their early and long-term follow-ups (follow-up period 24–74 months, mean 36.3 months). For patients with failed medical therapy for peridural fibrosis accompanied by lumbar kyphosis or hypolordosis, transpedicular decancellation osteotomy should be the surgical treatment of choice. [ABSTRACT FROM AUTHOR]

The painful os peroneum syndrome is widely recognized. It is often the result of trauma. However degenerative changes between the os peroneum and the articular facet is much rarer and we could only find two other case reports in the literature. This report concerns a middle aged woman with chronic plantar-lateral foot pain and a limp secondary to degenerative changes between the os peroneum and its articular facet with cuboid. The aim of this study is to remind to orthopaedic surgeons about painful os peroneum syndrome and to highlight the rarity of our case. In our case the mid term result of the excision of the os peroneum with painful articulation appear good, providing symptomatic pain relief with little alteration in the function of the foot., (Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.)

Inferior shoulder dislocation also referred to as luxatio erecta is an unusual and rare type of shoulder dislocation. Its incidence is about 0.5% among all shoulder dislocations. After an exhaustive search of all the available literature we were unable to find a swimming accident case that did not have other associated injuries and an uneventful reduction. The mechanism of the injury was mostly related to direct axial loading and indirect hyperabduction lever arm. We would like to emphasize the importance of this being a swimming accident, a type of accident that requires awareness of the possibility of dangerous asphyxia injuries caused by panic in the water (swimming pool, river, lake, sea, etc.). We described the nature of the injury and review the literature concerning the mechanism of the injury and associated neurovascular impairment at admission time. We also presented a supplemental video to contribute to the education of young residents and orthopedic surgeons.

Herein, we report clinical, radiological, and follow-up results of seven cases of extraordinary located osteochondromas and highlight the importance of rare and unusual properties of unusual locations of osteochondromas. Seven patients with extraordinary located osteochondromas were treated in our institution (Antalya Memorial Hospital) between the period of February 2009 and March 2014 were reported. The patients were classified according to the localization, symptomatology, and the presence of neurovascular involvement or organ compression. The results were discussed with the existing literature data. Five of our patients had unusual symptomatology. Surgical excision was performed on six of seven patients. One patient was followed with scheduled outpatient visits alone. Our clinical follow-up results were good to excellent. In our case series, one patient with clavicular involvement had impaired shoulder mechanic which resulted in painful shoulder, while another with pubic ramus involvement had obstructive urination symptoms and dysuria. One patient with scapular involvement had snapping scapula symptoms, while two patients with fibular head involvement had peroneal nerve compression and tibial nerve compression symptoms in each. One patient with ischial ramus involvement had sciatica, whereas another with first rib involvement had radiological evidences for subclavian artery compression due to osteochondroma without any symptom. Based our experience, the flat bones which are usually ossified by intramembranous type of ossification during the fetal period (including the scapula, ilium, pubic ramus, ischium ramus, ribs and clavicle) are much less commonly affected and often have unusual symptoms. The osteochondromas originating from the fibular head may seem innocent to an orthopedic surgeon. However, an orthopedic surgeon should be alert to tibiofibular synostosis and nerve compression in this patient population.

Objectives: The metal contamination levels in soil, water, and fish samples from the Sundarbans in Bangladesh were thoroughly examined. Key pollutants were identified using Principal Component Analysis (PCA), and pollution and health risks were evaluated using indices like TRI, Igeo, and Pearson correlation coefficients. Metal concentrations (Mn, Cu, Zn, Pb, Cd, Cr, As, Ni, Hg) were analyzed in various regions of the Sundarbans. In addition, the study extensively evaluated pollution severity and toxicity using indices like PLI, MPI, and TRI to assess the health risks associated with consuming fish. Methods: The study utilized different techniques to evaluate metal pollution in the Sundarbans. Fifteen locations were sampled for soil, water, and fish and then analyzed for metal concentrations using AAS. To evaluate the health risks related to fish consumption, the study measured the Estimated Daily Intake (EDI) and examined bioconcentration patterns in various fish species. Risk assessments utilized indices like Pollution Load Index (PLI), Metal Pollution Index (MPI), Toxicity Risk Index (TRI), Enrichment Factor (EF), Geoaccumulation Index (Igeo), and Contamination Factor (CF). Statistical methods such as Pearson correlation coefficients and PCA were used to assess the connection between metal concentrations and pollution risks. Specific contamination levels were emphasized using contamination factors and modified contamination factors. Results: Significant levels of metal contamination were uncovered in the Sundarbans during the study. Pb, Cd, Mn, Ni, Hg, and Cr were detected at high concentrations in soil, water, and fish samples from fifteen sites. Soil showed moderate pollution (Igeo: 1–2) for Mn, Pb (highest 1.7783), and Zn (lowest-1.2153). Water had Pb with the highest Igeo of 1.9951. Fish showed the highest Igeo values for Pb at 1.9259 and Cd at 1.9510. The Gangetic mystus had a high EDI of Zinc (Zn) at 2.3 µg/kg body weight per day, posing health risks if consumed. The concentration of mercury in Goby fish was 0.45 mg/kg, whereas Pama croaker had only 0.12 mg/kg of zinc. High Total Target Cancer Risk values of (1.7 × 103), PLI 3.2–5.6, MPI 2.7–4.8, and TRI 4.1–6.3 underscored severe pollution. The EF values ranged from 4.5 to 7.2, and Pb (3.2) and Cd (2.8) showed significant geoaccumulation as per the Igeo. The CF indicated significant contamination, ranging from 2.5 to 6.1. The results of Pearson correlation coefficients and PCA confirm that pollution risks have a significant impact on both aquatic life and human health. Conclusion: The study uncovered severe metal contamination in soil, water, and fish samples from the Sundarbans. High TRI values indicated substantial toxicity risks, threatening ecosystems, human health, and water quality. Principal Component Analysis identified critical pollutants, revealing that Pb, Cd, Mn, Ni, Hg, and Cr levels were dangerously high. Immediate action is needed to mitigate these risks, especially for children consuming contaminated fish, highlighting urgent health and environmental concerns. [ABSTRACT FROM AUTHOR]

Our patient was a 76-year-old female who has been operated on 2 times in 8 years for pelvic chondrosarcoma. The patient came to our clinic with a large mass in left iliac region which extended into the paravertebral area. Physical examination and preoperative imagining studies revealed a mass at the left iliac area that infiltrated sciatic notch and extended from posterior iliac region towards the anterior side of iliac bone through the sciatic notch and an incisional hernia including descending colon. The mass was also penetrating the abdominal cavity through the hernia. Surgical intervention was planned. Since the tumor infiltrated the sciatic nerve, hemipelvectomy was indicated. Patient refused hemipelvectomy. Therefore, palliative debulking surgery was considered. We treated the case with marginal excision and abdominal wall reconstruction employing prolene and vicryl suture materials in order to prevent a postoperative visceral herniation and local invasion. At the latest follow-up appointment in 2 years, the patient still had no signs of tumor recurrence. This case showed us that an incisional hernia can serve as a pathway for the recurrence invasion of the chondrosarcoma.

An introduction to the journal is presented in which the guest editors discusses the epiphyseal growth disorder of the skeleton which known as Trevor's disease or dysplasia epiphysealis hemimelica that dealt with by a resection.

We present a 25-year-old male case of osteochondroma originating from ischial ramus which causes sciatica. The pelvic involvement is rare. Iliac crest of the pelvis is often involved. Ischial ramus involvement is extremely rare. In this article, we presented a rare case of ischial ramus involvement that misleading the physician to L4-L5-S1 radiculopathy.

This report concerns an unusual cause of anterior ankle impingement. The case of a young male with Trevor's disease mimicking an anterior spur of the ankle that resulted in anterior impingement and treated with ankle arthroscopy is presented. The aim of this study is to explain the different diagnostic properties of Trevor's disease from a classic anterior spur. Level of evidence IV.

The concentrations of cadmium, cobalt, chromium, copper, iron, manganese, nickel, lead and zinc were determined by ICP-AES in muscles and livers of 12 fish species sampled from the Marmara, Aegean and Mediterranean seas of Turkey. Iron showed the highest levels in examined tissues of all fish species. Following Fe, Zn generally showed the second highest levels. Metal concentrations in edible parts of fish species were 0.02-0.37mgkg(-1) for cadmium, 0.04-0.41mgkg(-1) for cobalt, 0.04-1.75mgkg(-1) for chromium, 0.32-6.48 mgkg(-1) for copper, 7.46-40.1mgkg(-1) for iron, 0.10-0.99 mgkg(-1) for manganese, 0.02-3.97mgkg(-1) for nickel, 0.33-0.86mgkg(-1) for lead, 4.49-11.2mgkg(-1) for zinc, respectively. All metal concentrations in livers were higher than those in muscles. In some stations, cadmium and chromium concentrations in both muscles and livers, and lead levels in livers of the examined species were higher than permissible safety levels for human uses., (Copyright © 2007 Elsevier Ltd. All rights reserved.)

Due to the increasing harmful effects of metal(loid)s over time, it has become important in environmental studies carried out to increase environmental awareness. It is important to investigate the cumulative presence of metal(loid)s in nature, their interactions with each other and risks posed by fish consumption for human health. Total concentrations of As, Cd, Cu, Fe, Mn, Ni, Pb, and Zn were determined in muscle and gill tissues of horse mackerel (Trachurus trachurus) and sardine (Sardina pilchardus). Metal analyses were carried out using Inductively Coupled Plasma-Mass Spectroscopic (ICP-MS) methods. In both tissues, Fe and Zn concentrations were the highest and Cd, Cu and Pb concentrations were the lowest. The target hazard coefficient, estimated daily intake, target cancer risk, total target hazard coefficient, and hazard indices were calculated to assess the risks to an individual's health from consuming fish. Hazard index and total target hazard coefficient values calculated for each fish exceeded 1 but were very close to 1. Target cancer risk values of As and Ni were found to be 10–6 and 10–4 for Pb. These limit values indicate the need for regular monitoring of the region. In addition, the interactions between the metal(loid)s accumulated in the tissues were analyzed and a high correlation was found between As-Ni, which poses a risk to public health. [ABSTRACT FROM AUTHOR]

The present work tried to evaluate whether arbuscular mycorrhizal fungi (AMF) affected physiological aspects of saffron corms by triggering flowering and dormancy together with improving growth parameter. Endomycorrhizal fungi inoculum was inoculated into potted saffron corms (Crocus sativus L.) exposed to stress conditions (water and salinity) and followed for two growing seasons. Results highlighted a variation among saffron responses to endomycorrhizal fungi inoculum under water and salinity stress. The mycorrhizal corms showed a regular flowering period that occurred earlier than that of non-inoculated with AMF. The superior values of morphological traits, such as leaf and root length, leaves number and daughter corm number were between 3 and 12 cm, 11 to 25 cm; 13.4–4.5; 7 and 3 at respective concentrations of 1 g/l and 5 g/l of NaCl. Similarly, in AMF inoculated saffron, no statistical difference was observed in the dry weight average of aerial part in plants facing water level 60% (0.38 g) and 40% (0.27 g) compared respectively to 0.36 g and 0.22 g in control plants. The fresh weight of aerial saffron parts were 2 g (1 g/L), 0.6 g/L and 0.33 g at 5 g/L of NaCl compared to 1.6 g, 0.4 g and 0.2 g in control plants. At water level of 60% and 40%, this weight decreased from 1.46 g to 0.85 g. Almost equal values of dry weight of root parts were noted at 3 g/L (0.33 g) and 5 g/L of NaCl (0.22 g) in saffron plants from bulbs grown in soil incorporated with AMF inoculum compared to 0.25 g (3 g/L) and 0.18 g at 5 g/L of NaCl in control plants. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Posterior shoulder dislocation is an uncommon injury, accounting for less than 5% of all glenohumeral dislocations. Bilateral locked posterior shoulder fracture-dislocation is an extremely rare entity with an incidence of 0.6 cases/100 000 people/year. A few reports have been published in the literature, predominantly associated with epileptic seizures. Case Report: We present a rare case of a 55-year-old male patient with a history of epileptic seizures, who presented with bilateral, locked, posterior fracture-dislocation of the shoulder following an epileptic seizure. The patient was diagnosed with a cavernous hemangioma, which caused his epileptic episode. He was treated operatively, with a modified McLaughlin procedure performed on both sides, at 1 stage, by 2 surgical teams. The cavernous hemangioma was also resected 2 months later. After a follow-up period of 18 months, no recurrent episodes of instability or dislocation were identified. Full range of motion was present on both sides, with good clinical and radiological outcomes. We also conducted a literature review to elucidate the causes of this rare incidence, along with diagnostic workup and treatment options. We were able to identify 36 cases, involving 72 shoulders of bilateral posterior fracture-dislocations in 30 case reports and 2 case series. Conclusions: Bilateral posterior fracture-dislocation of the shoulder is uncommon. Treatment strategy depends on the chro- nicity, involvement of the humeral head, and the patient's age and functional level. The target is to restore shoulder anatomy and maintain a functional range of motion. [ABSTRACT FROM AUTHOR]

Introduction: The optimal arthroscopic management for popliteal cyst decompression remains uncertain, with ongoing debate between preserving the cyst wall or completely removing it. The purpose of this study is to compare the outcomes and complications of arthroscopic popliteal cyst decompression with cyst wall preservation and cyst wall resection., Methods: A systematic review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines was conducted. It encompassed studies that focused on arthroscopic popliteal cyst decompression, considering both cyst wall preservation and cyst wall resection. The quality assessment of the included studies was carried out using the Methodology Index for Non-Randomized Research criteria. Following this, meta-analyses were conducted, employing odds ratios (ORs) for dichotomous outcomes and calculating mean differences (MDs) for continuous outcomes., Results: Four articles included a collective of 214 knees. Each of these studies presented level 3 evidence. The comparison between the cyst wall preservation group and the cyst wall resection group revealed similar clinical outcomes based on the Rauschning and Lindgren grade (grade 0 [OR = 0.66, 95% CI: 0.37-1.19, p = 0.17]; grade I [OR = 1.33, 95% CI: 0.66-2.67, p = 0.43]; grade II [OR = 1.39, 95% CI: 0.46-4.14, p = 0.56]; grade III [OR = 3.46, 95% CI: 0.13-89.95, p = 0.46]) and Lysholm score (MD = 0.83, 95% CI: -0.65-2.32, p = 0.27). However, MRI results indicated a significant improvement in the cyst wall resection group (cyst disappearance [OR = 0.50, 95% CI: 0.28-0.90, p = 0.02]; cyst shrinkage or decrease in size [OR = 1.41, 95% CI: 0.78-2.55, p = 0.26]; cyst persistence or recurrence [OR = 7.63, 95% CI: 1.29-45.08, p = 0.02]). Nevertheless, the operative time for cyst resection was significantly longer compared to cyst preservation (MD = -14.90, 95% CI: -21.96 - -7.84, p < 0.0001), and the cyst wall resection group experienced significantly higher complications than the cyst wall preservation group (OR = 0.24, 95% CI: 0.06 to 1.02, p = 0.05)., Conclusion: During arthroscopic popliteal cyst decompression, cyst wall resection led to longer operative times and higher complication rates but lower recurrence rates and better MRI outcomes. The functional outcomes after surgery were found to be similar., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The recognized antibacterial properties of silver nanoparticles (AgNPs) characterize them as attractive nanomaterials for developing new bioactive materials less prone to the development of antibiotic resistance. In this work, we developed new composites based on self-assembling Fmoc-Phe3 peptide hydrogels impregnated with in situ prepared AgNPs. Different methodologies, from traditional to innovative and eco-sustainable, were compared. The obtained composites were characterized from a hydrodynamic, structural, and morphological point of view, using different techniques such as DLS, SEM, and rheological measurements to evaluate how the choice of the reducing agent determines the characteristics of AgNPs and how their presence within the hydrogel affects their structure and properties. Moreover, the antibacterial properties of these composites were tested against S. aureus, a major human pathogen responsible for a wide range of clinical infections. Results demonstrated that the hydrogel composites containing AgNPs (hgel@AgNPs) could represent promising biomaterials for treating S. aureus-related infections. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the effect of two portal posterior ankle arthroscopy (PAA) procedures using American Orthopaedic Foot and Ankle Society (AOFAS) and Visual Analog Scale (VAS) scores for the treatment of patients with ankle pain associated with Os trigonum (OT) and Flexor hallusis longus (FHL) tenosynovitis. The effect of PAA treatment on the degree and localization of effusion around the FHL tendon was also investigated. Methods: Between March 2016 and August 2021, 41 patients who underwent PAA with the diagnosis of OT and stenosing FHL tenosynovitis, whose arthroscopy video records could be reviewed retrospectively, and who had at least 1 year of follow-up results were included in the study. Patients in the pediatric age group, diabetes patients, patients with inflammatory disease, and those with subtalar and tibiotalar osteoarthritis were excluded from the study. Preoperative and postoperative physical examinations, lateral radiography of the pressing foot, MRI, and the VAS and AOFAS scores were evaluated. In the statistical analysis, data were statistically analyzed using SPSS 19.0 (SPSS, Chicago, Illinois, USA). p < 0.05 was accepted as statistically significant. Results: The mean age was 35.6 years (range: 19-55), among which the mean age of the women was 36.2 years (range: 24-48), and the mean age of the men was 35.2 years (range: 19-55). The mean follow-up was 34 months (range: 14-62). The AOFAS value increased from 38.61 ± 7.176 preoperatively to 89.83 ± 6.34 at the postoperative follow-up, and the difference was statistically significant (p < 0.001). Five patients fully regained their normal function (AOFAS score = 100 points). The VAS value increased from 90 ± 5.916 preoperatively to 18.682 ± 7.688 at the last postoperative follow-up, and the difference was statistically significant (p < 0.001). Pre-PAA FHL tenosynovitis was seen only in zone 1 in 26 patients, zones 1 and 2 in 14 patients, and in zones 1, 2, and 3 in two patients. There was no significant decrease in effusion in the magnetic resonance imaging (MRI) at 1 month after the PAA (p = 0.117). A significant decrease in effusion was observed in the MRI taken at the last control (p < 0.001). Conclusions: In the treatment of patients with ankle pain associated with OT and FHL tenosynovitis, the twoportal PAA treatment was observed to be an effective method that resulted in significant improvement in the AOFAS and VAS scores. [ABSTRACT FROM AUTHOR]

Metal nanoparticles are increasingly gaining interest in the field of heterogeneous catalysis. Here, we present a novel strategy for synthesizing sugar-coated platinum nanostructures (SC-Pt-NS) from the carbohydrates sucrose and D(-)-fructose. In the synthesis from a mixture of H2PtCl6·6H2O, the carbohydrate in an ionic liquid (IL) yielded primary particles of a homogeneous average size of ~10 nm, which were aggregated to hierarchical Pt nanostructures of ~40–65 nm and surrounded or supported by the carbohydrate. These sugar-coated platinum nanostructures present a facile way to support and heterogenize nanoparticles, avoid leaching and enable easier separation and handling. The catalytic activity of the SC-Pt-NS was shown in the hydrosilylation test reaction of phenylacetylene with triethylsilane, where very high turnover frequency (TOF) values of up to 87,200 h−1 could be achieved, while the platinum metal leaching into the product was very low. [ABSTRACT FROM AUTHOR]

Background: While most cases of sciatica result from degenerative conditions of the low back, some cases result from conditions of the hip and pelvic region. Sciatica developing in relation to pregnancy or labor also presents unique considerations. Case presentation: A 37-year-old African American woman with a history of hypertension and polycystic ovary syndrome presented to a chiropractor at a hospital-based outpatient clinic with a seven-week history of low back pain with radiation into the right lower extremity which began during labor. The chiropractor performed a brief trial of care, yet when the patient's symptoms worsened, ordered lumbar spine radiographs, followed by lumbar magnetic resonance imaging (MRI), which were both normal. The chiropractor then ordered hip radiographs, which were suggestive of ischial osteochondroma, and referred the patient to an orthopedic oncologist. MRI findings were compatible with an osteochondroma with associated adventitial bursitis and mass effect on the sciatic nerve. The patient initially chose conservative management with bursa aspiration and therapeutic injection. Despite initial relief, there was eventual return of symptoms. The patient elected to undergo surgical removal, with a positive outcome. Conclusion: The key distinguishing features that led to a diagnosis of osteochondroma in this case included attention to the patient-reported symptoms and history, worsening of symptoms despite conservative care, and lack of explanatory findings on lumbar imaging. This case highlights the benefit of evaluating the hip and pelvis when the clinical features of sciatica cannot be ascribed to a lumbar etiology. This case also illustrates the role of a chiropractor working in an integrative health system to facilitate timely imaging and referrals to resolve a challenging diagnosis. [ABSTRACT FROM AUTHOR]

Plant science is a major research topic addressing some of the most important global challenges we face today, including energy and food security. Plant science has a role in the production of staple foods and materials, as well as roles in genetics research, environmental management, and the synthesis of high-value compounds such as pharmaceuticals or raw materials for energy production. Nanosensors—selective transducers with a characteristic dimension that is nanometre in scale—have emerged as important tools for monitoring biological processes such as plant signalling pathways and metabolism in ways that are non-destructive, minimally invasive, and capable of real-time analysis. A variety of nanosensors have been used to study different biological processes; for example, optical nanosensors based on Förster resonance energy transfer (FRET) have been used to study protein interactions, cell contents, and biophysical parameters, and electrochemical nanosensors have been used to detect redox reactions in plants. Nanosensor applications in plants include nutrient determination, disease assessment, and the detection of proteins, hormones, and other biological substances. The combination of nanosensor technology and plant sciences has the potential to be a powerful alliance and could support the successful delivery of the 2030 Sustainable Development Goals. However, a lack of knowledge regarding the health effects of nanomaterials and the high costs of some of the raw materials required has lessened their commercial impact. [ABSTRACT FROM AUTHOR]

Copyright of Namık Kemal Tıp Dergisi is the property of Galenos Yayinevi Tic. LTD. STI 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 was conducted to determine the health status of three water bodies (Badagry Creek, Ologe Lagoon and River Owo) exposed to varying degrees of sand mining activities and industrial pollution. Water, sediment and fish samples were collected monthly from the three water bodies between April 2019 and March 2020. Standard methods were used for the analysis of physico-chemical parameters, fish diversity indices, length-weight relationship, condition factor, sediment pollution indices, ecotoxicology of heavy metals in sediment, potential ecological risks and health risk assessment of heavy metals. Positive matrix factorization (PMF) was used to identify and quantify metal source. Shannon's diversity index (H′) and condition factor varied between 2.03–2.37 and 0.84–4.86 respectively. Enrichment factor had a range of 4.05×10−4–8.65×10−1, while geoaccumulation index varied from −12.14 to −0.38. The mean quotients using the probable effect level (m-PEL-Q) are 3.91×10−4, 4.77×10−4 and 7.87×10−4 for Ologe Lagoon, Badagry Creek and River Owo respectively. The trend was the same with mean quotients using effect range-median (m-ERM-Q). The estimated dietary intake ranged from 0.00 mg/kg/day in Pb from River Owo to 1.15 × 10−3 mg/kg/day in Fe still from River Owo. The range of values of the target hazard quotient of the metals in Badagry Creek, River Owo and Ologe Lagoon are 1.23×10−4–1.65×10−2, 0.00–1.64×10−2 and 5.76×10−5–1.65×10−2 respectively. PMF identified three sources of metal into the aquatic ecosystems: agricultural, industrial and geological inputs. The study showed that the three aquatic ecosystems are healthy but require regular monitoring to promptly detect sudden changes in their health status. [ABSTRACT FROM AUTHOR]

This research aimed to explore the variability in the distribution of muscle, perivisceral, and retroperitoneal fat in Diplodus sargus during the pre-spawning period (the period of maximum accumulation of fat reserves) and its possible relationship with the abnormally tough specimen syndrome (ATS) affecting this species. Since pollutants accumulate in adipose tissue, trace metal load in the fattest specimens were also analyzed. Muscle fat content and abdominal fat were highly correlated, and larger individuals had more abundant abdominal fat. However, given its great variability (26% of the specimens had no abdominal fat at all), abdominal fat is likely a transitional fat to be quickly transferred to other tissues. The liver appeared to have a minor role as a fat deposit in D. sargus since HSI varied relatively little. None of the fishes without lipidic reserves were ATS individuals; by contrast, the only ATS individual found, a 28 cm male, showed a muscle fat content above the observed average and one of the highest amounts of perivisceral and retroperitoneal fat. Therefore, we conclude that flesh hardness is not directly related to the low lipid reserves. However, this ATS individual showed a very high liver copper concentration, suggesting a potential link between fat content, copper concentration, and ATS syndrome that should be explored in the future. [ABSTRACT FROM AUTHOR]

This study provides information on the potential human health risk of Hg, Cd, Pb and As exposure from consumption of two fish species (Umbrina cirrosa and Sciaena umbra) in the general population and in high-level fish consumers. The concentrations did not show significant differences between the two species, and no fish length element level–body-length relationship was observed, except for Hg. The average metal(loid) levels, irrespective of species, varied in the following ranges: Hg = 0.18–0.19, Cd = 0.07–0.10, Pb = 0.10–0.12, As = 0.59–0.69 μg g−1 w.w. The concentrations remained below the maximum permissible limits (MPLs) for human consumption, except for Cd. The estimated intakes of Hg, Cd and Pb in both consumption scenarios were lower than the respective PTWI/PTMIs, as well as those of inorganic As, which were even lower than the BMDL01. The non-carcinogenic risk (THQ) did not reveal any concerns, except for Hg. The lifetime health cancer risk (ILCR) suggested hazard exclusively from Cd, although for high-level fish consumers, even the ILCR of inorganic As was, in some cases, above the acceptable range. Continuous monitoring of metal(loid) levels in these fish is strongly recommended because the results demonstrate the occurrence of potential health risks, especially in high-level fish consumers, due to the presence of Hg and Cd. [ABSTRACT FROM AUTHOR]

The fatty acid composition of top-selling fish oil dietary supplements in the markets was compared with the content stated on product label, and their oxidative qualities and heavy metal contents were evaluated in this study. While all the capsule groups (C) confirmed the label information, it was observed that one-third of the syrup groups (S) had less than the specified content. Capsule groups generally had richer EPA and DHA contents than syrup groups in the samples examined. The peroxide values (PV) of all fish oil capsules and syrups were found in the range of 1.97–2.89 mEq/kg and 2.22–18.30 mEq/kg, respectively. As for free fatty acids (FFA) values, the C4, S6, S9, and S10 groups were above the 3% oleic acid limit recommended for high-quality oils. However, thiobarbituric acid reactive substances (TBARs) values were found below 1 mg MA/kg in all groups. All fish oil supplements were within the limits specified in terms of As (0.50–4.19 µg/g), Cd (0.14 µg/g detected for one group, C5), Cu (not detected), Fe (0.32–15.7 µg/g), and Hg (≤ 0.1 µg/g). On the other hand, two fish oil supplements from the capsule group (0.17 for C6 and 1.01 µg/g for C8) and one group from the syrup group (0.29 µg/g for S10) exceeded the recommended limit in terms of Pb (0.1 mg/kg). As a result of the research, it can be concluded that the chemical quality of fish oils in syrup form needs to be improved and their reliability in terms of fatty acid content should be increased. Considering the heavy metals, it seems significant to follow up the fish oil products more strictly. [ABSTRACT FROM AUTHOR]

Rationale: Osteochondroma is one of the most common primary benign bone tumors. In most cases, this disease is asymptomatic. However, it may become symptomatic owing to nerve and vascular compression when it affects the knee joint. Isolated tibial nerve palsy caused by proximal fibular osteochondroma is rare., Patients Concerns: A 60-year-old male, was treated for degenerative arthritis of the right knee, referred to the right great toe flexion limitation that occurred 3 weeks prior., Diagnoses: Magnetic resonance imaging revealed compression of the tibial nerve and surrounding muscles due to an osseous lesion in the fibular head. A nerve conduction test confirmed tibial neuropathy in the right lower leg., Interventions: Exploratory surgery was performed to decompress the tibial nerve and remove the bony lesion histopathologically diagnosed as an osteochondroma., Outcomes: Fifty-five months postoperatively, toe flexion recovered to normal. No recurrence of osteochondroma was observed., Lessons: As in our case, if a bony lesion is diagnosed on radiographs with neurological symptoms, early decompression surgery is necessary. Moreover, since it can be misdiagnosed as a simple bony spur, magnetic resonance imaging and tissue biopsy are also indicated., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Due to the development of the metallurgical and energy industries and the operation of incinerators, more and more environmental pollution is occurring. Toxic elements accumulate in the biosphere and affect the state of the population of the regions of large-scale production or the disposal of industrial waste. The main goal of this study was to compare the toxic elements hair composition in people from different regions of the world. The concentrations of toxic and potentially toxic elements (Al, As, Be, Cd, Hg, Pb, Sn) in 198 people, first-year students of People's Friendship University of Russia, who arrived from different regions of the world, were measured with inductively coupled plasma mass spectrometry. Students were divided into 6 groups: from South and East Asia, from Latin America, from Arab countries, Central Asia and Afghanistan, from South and Central Africa, from Iran and Azerbaijan, and from Russia, Ukraine, and Moldova. Medians of the concentrations of elements in the hair in the general group were 5.8 μg/g for Al, 30 ng/g for As, 0.6 ng/g for Be, 9.0 ng/g for Cd, 0.11 μg/g for Hg, 0.24 μg/g for Pb, and 0.11 μg/g for Sn. All these values fall within the normal range. Students from Russia, Moldova, and Ukraine showed a significantly higher Sn content (0.28 μg/g) in their hair than subjects from other regions except for Latin America, p<0,05. Except for As, cases of exceeding their recommended concentrations in the hair were identified. However, the proportion of subjects with deviations in each group was not high — not more than 7%. In all regions, a positive correlation was found between Cd, Pb, and Sn, p<0.05, r>0.5 for all. Cases of exceeding the maximum permissible concentrations of various toxic elements in the hair were detected in people from all regions of the Earth included in the study. And although the overall picture of the content of toxic elements in the hair of students from all regions in our study does not look critical, the results of previous studies, as well as information about the total deterioration of the environmental situation throughout the Earth, necessitate further large-scale environmental studies. [ABSTRACT FROM AUTHOR]

In this study, element levels (Cr, Mn, Fe, Co, Ni, Cu, Zn, Al, V, As, Ba, Sr, K, Pb) in the liver, gill, muscle, and stomach tissues of Ocean Sunfish (Mola mola) caught from Mersin Bay in 2018 were determined, and the first report on the elemental composition of M. mola from the Mediterranean sea presented. Spectrophotometric methods were used in the determination of tissue element levels. Metal analysis of the tissues was performed on the ICP-MS device. The reference material IAEA- 436 was used to follow the quality of the analytical process. Metal accumulation in M. mola tissues was determined as K> Fe> Zn>Sr> Cu> As> Al> V>Mn> Ni> Ba> Cr>Pb> Co. A statistical difference was found between tissues in terms of metal levels. It was determined that Fe and Cu were higher in the liver, Mn, Zn, Sr in gill, Al, Pb, Cr in muscle tissue. There were no statistical differences between the levels of As, V, and Ba detected in gill and muscle tissues. The K levels were similar in all tissues except the liver. [ABSTRACT FROM AUTHOR]

Background: The principal aim of this study was to investigate the presence of factors affecting Baker's cyst volume in young and middle-aged populations.Methods: Open cyst excision with valve and capsule repair, as well as knee arthroscopy, were used to treat eighty-five patients. The cases were categorized in terms of age, effusion, chondral lesion degree, meniscal tear degree, and Lindgren scores. An ultrasonography (USG) device was used to calculate the cyst volume. The IBM-SPSS 22 program was used for statistical analysis and to assess the relationships between variables using Spearman's correlation tests.Results: The degree of chondral lesion was moderately and positively correlated with cyst volume in the total population (correlation coefficient: 0.469; p < 0.05). The degree of the chondral lesion was moderately and positively correlated with the degree of effusion (correlation coefficient: 0.492; p < 0.005). The cyst volume was weakly and positively correlated with the degree of effusion (correlation coefficient: 0.20; the correlation was at the limits of statistical significance p = 0.07 < 0.08).Conclusions: This study revealed that an increase in chondral lesion severity increases the amount of effusion and cyst volume. [ABSTRACT FROM AUTHOR]

The present study aims to determine the proximate, fatty acid and amino acid profiling of consumed fresh narrow-barred Spanish mackerel (Scomberomorus commerson). Landed fish were freshly sampled (total length 33.7-48.7 cm and weight 617-1260 g) from the Yumurtalık Bay (north-eastern Mediterranean Sea) in Turkey during January, February and March. The protein values were highest in January (22.89%) while the and lowest in February (21.38%) and March (21.73%). Lipid and ash values were not significantly differencing among sampling time. The fatty acid data revealed that the saturated fatty acid values were found higher than the polyunsaturated and monounsaturated fatty acid values. In general, the fillets were abundant in palmitic acid (C16:0), stearic acid (C18:0), oleic acid (18:1n-9) and docosapentaenoic acid (C22:6n-3; DHA) values, regardless of the sampled months. DHA value was recorded as 315.08 mg 100g-1 in January, while it increased to 327.55 mg 100g-1 in the March samples. A total of 16 amino acids were determined from the fresh fillets. Compared with the other essential amino acids, the concentration of lysine and leucine were found to be higher in the fillet. At the same time, the lower rates of tryptophan were detected in examined samples for all months. Consequently, this study shows that the narrowbarred Spanish mackerel as a finfish (commercially valuable) from the north-eastern Mediterranean Sea has precious nutritional values that of the protein, fatty acids and amino acids during the sampling period. This fish can be recommended in terms of detected essential fatty acid and amino acid profile that completely nutritious for the human as well as other organisms' dietary requirements. [ABSTRACT FROM AUTHOR]

Heavy metals are continuously released into the oceans from both natural and anthropogenic sources. They are serious threats to both ecosystem and human health because of their toxicity, persistence, bioaccumulation, and biomagnification. We present metal concentrations in the economically important bluefish from Iskenderun Bay, providing valuable information on Northeastern Mediterranean aquatic ecosystem health, as well as the human health risk. The concentrations of manganese, iron, copper, zinc, selenium, cadmium, lead, and mercury were determined in the gill, liver, and muscle tissues of bluefish (Pomatomus saltatrix) caught in Iskenderun Bay (Turkey) during four seasons. Samples were analysed via inductively coupled plasma mass spectrometer. Fe and Zn were detected in the highest concentrations during all four seasons. The ranges of Fe concentrations were 61.15–108.76, 229.78–377.02, and 6.35–8.63 and those of Zn were 25.21–44.25, 42.25–76.08, and 6.27–13.59 in the gills, livers, and muscles, respectively. In contrast, Hg and Cd were not found in the bluefish tissues in any season with the exception of Cd in the gills during the spring (0.757 mg/kg, above the legal limit of 0.5 mg/kg). On a seasonal basis, no meaningful accumulation trend was observed for the muscles or gills, while the highest concentrations of Mn, Fe, Cu, Zn, and Se in the liver were found in the spring. Liver tissues possessed higher metal concentrations than gill and muscle tissues. Estimated daily and weekly intakes of the metals due to human consumption of the bluefish were considerably lower than the provisional tolerable intake. In this study, there was an inflow of metals into Iskenderun Bay; however, no significant metal accumulation was found in bluefish tissues at a rate that would harm human health. [ABSTRACT FROM AUTHOR]