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BACKGROUND: Symptomatic degenerative meniscus tears are common in middle and old age. Arthroscopic partial meniscectomy (APM), physical therapy (PT) and hyaluronic acid injection (HAI) are the most commonly used treatment options. OBJECTIVES: The aim of our study is to compare the effectiveness of APM and PT in degenerative meniscus tears and to investigate the effect of HAI with a prospective, randomized, single-blind study. METHODS: The study included 192 patients with symptomatic degenerative meniscus tears. The patients were randomly divided into the four groups. The first group consisted of patients who underwent APM, the second group received HAI with APM, the third group received PT, and the fourth group received HAI with PT. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS) scores, and range of motion (ROM) values were used for evaluation. RESULTS: There was no difference between four groups according to age, gender, BMI, affected side, grade of osteoarthritis. In the 4 groups, WOMAC and VAS results at the 2nd and 6th months were better than pre-treatment. There was no difference between the groups in terms of WOMAC and VAS. In terms of ROM, the results were found better in PT group (Group 3, Group 4) at the 2nd and 6th months. However, the results were found worse in APM group (Group 1, Group 2). In addition, it was found that HAI applied with APM and PT had no effect on VAS, WOMAC, and ROM. It was determined that the increase of knee osteoarthritis negatively affected both the results of APM treatment and PT. VAS, WOMAC, and ROM results were found worse in patients with stage 3 osteoarthritis than grade 1 and 2, but there was no difference between grade 1 and 2. CONCLUSIONS: APM and PT give good results in terms of pain and functional results. However, ROM limitation develops after APM. Conversely, there is an increase in ROM after PT. Administration of HAI with these treatments has no effect on the results. PT is an easily applicable noninvasive method. Adding HAI to the treatment has no effect on the results and increases the cost.

PURPOSE: This study aimed to evaluate the incidence of femoral neck shortening (FNS) after the treatment of displaced and non-displaced femoral neck fractures with closed or open reduction internal fixation, and determine the independent factors associated with this condition. METHOD: The study included 81 patients who underwent internal fixation by closed or open reduction with multiple screws between 2013 and 2018 due to femoral neck fracture (FNF) and were followed up for at least 1 year. Patients were divided into two groups as with and without FNS. The patient, fracture, and surgical parameters compared between the two groups, and the factors affecting development of FNS were investigated. RESULTS: Internal fixation was applied by closed reduction in 56 patients (69.1%) and open in 25 (30.9%). FNS was detected in 41 patients (50.6%), with the mean shortening 6.3 ± 6.4 mm. Fracture union achieved in 72 patients (89%). The mean time to fracture union was 4.3 ± 2.3 months. No statistically significant relationship found between FNS and the parameters of gender, age, smoking, reduction type, number, type and orientation of screws, Singh index, and Garden fix index (p > 0.05). However, there was significant difference between two groups regarding energy of the fracture, fragmentation, coronal angulation, Garden type, and fixation with medial buttress plate (p

Objective: To investigate the factors affecting the recurrence of anterior shoulder dislocation, identify the patient group with the highest recurrence rate for shoulder dislocation, and determine the patient population to be recommended surgical treatment after primary dislocation. Material and Methods: Patients diagnosed with primary shoulder dislocation and treated in our hospital between January 2005 and January 2017 were retrospectively screened. Of the 1395 patients identified, 1253 were reached by phone to obtain follow-up information. Patients whose follow-up information was not available, those with posterior dislocations, multidirectional instabilities, general joint hypermobility, traumatic nerve injury or shoulder fracture-dislocations (including greater tuberosity and glenoid fractures), and those that had undergone surgical treatment after primary dislocation were excluded from the study. The general joint laxity of the patients was evaluated using the Beighton scale. Patients with traumatic primary anterior shoulder dislocation and at least two years of follow-up data were included in the study and divided into three age groups as under 20, 20 to 40, over 40. Results: After applying the exclusion and inclusion criteria, 1,004 patients were included in the study. Recurrence was detected in 408 of these patients (40.6%). The highest recurrence rate was in the under 20 years old group at 52% (88/170). The recurrence rate was determined as 43% (283/659) for the 20-40 years group and 21% (37/175) for the over 40 group. It was determined that except for age, gender and presence of bone defects (Hill-Sachs lesion), the remaining parameters, namely immobilization time, injury mechanism, presence and type of sports activity, dominant-side dislocation, and smoking had no significant effect on the risk of recurrence after primary dislocation. Conclusion: In conclusion, the surgical treatment option should be presented to young male patients with bone defects after primary dislocation and they should be informed about the possible problems due to recurrent instability.

This study aimed to investigate the risk factors for dislocation in patients diagnosed with developmental dysplasia of the hip (DDH) who underwent total hip arthroplasty.We retrospectively reviewed 40 patients who developed dislocation and compared them with 400 patients in the control group without hip instability. Patients-, surgery-, and implant-related factors were investigated. Risk factors were evaluated using multivariate logistic regression.The mean follow-up period was 32.3 months. The mean time to dislocation was 4.4 months. There were 7 men (17.5%) and 33 women (82.5%) in the dislocation group and 83 men (20.7%) and 317 women (79.3%) in the control group (P = .627). Diabetes mellitus (DM; P = .032) and history of previous hip surgery for DDH were associated with dislocation (P.001). The subtrochanteric shortening osteotomy (P = .001), acetabular inclination (P = .037), acetabular anteversion (P.001), femoral head size (P.001), and postoperative infection (P = .003) were associated with dislocation. Major predictors of hip dislocation after total hip arthroplasty in patients with DDH were previous hip surgery (odds ratio [OR], 6.76; 95% confidence interval [CI], 1.86-24.6; P = .004), high hip center (OR, 2.90; 95% CI, 1.31-6.38; P = .008), DM (OR, 2.68; 95% CI, 1.06-6.80; P = .037), and acetabular inclination (OR, 2.62; 95% CI, 1.09-6.26; P = .03).Patients with DM and previous hip surgery should be informed about increased dislocation rates. Using a larger head diameter and restoration of the true hip rotation center are essential to prevent hip dislocation in these patients. Furthermore, accurate positioning of the acetabular inclination and anteversion are also important.

Objectives:We aimed to evaluate the relevancy of QuantiFERON-TB Gold (QFT) test which was required for the specific aims from the various clinics of Cerrahpaşa Medical Faculty by determining the using frequency and results of the QFT test in this retrospective study.Materials and Methods:The in vitro studies of QFT test were performed from the whole blood samples according to the manufacturer’s recommendations between January 2018 and December 2019. The numbers and results of QFT test were retrospectively determined according to the required clinics and were taken into consideration.Results:The test positivity was detected in 151 (12.5%) from the whole blood samples of 1,207 patients from various clinics. It was determined that the test request was made most frequently from the neurology clinic with 297 (24.6%) cases, followed by the rheumatology and infectious diseases clinics with 235 (19.5%) and 142 (11.8%), respectively. It was also determined that the most common positivity detection rate among the clinics requesting the test was from the ophthalmology clinic.Conclusion:It is noteworthy that the frequency of the test request was expected to be higher in the chest diseases and infectious diseases clinics, but unexpectantly, test request frequency was rather higher in the neurology and rheumatology clinics, whereas the high positivity in the test request was observed in the ophthalmology clinic. When the QFT test was examined on the number of test requests in the clinics and the relation between positive results, it was determined that there was a discrepancy between the number of purposeful requests and the positive result obtained. Considering the effectiveness of both the cost of the commercial kit and the positive results obtained in guiding clinicians, we believe that it would be beneficial to review the test requests at the national algorithms level by clinics.

Objectives: All-arthroscopic surgery and mini-open surgery for repairing rotator cuff tears are widely used and clinically developed. The purpose of our study is to compare the functional results, isokinetic shoulder muscle strength and shoulder position sense of patients who have undergone all-arthroscopic and mini-open surgery to repair their rotator cuff tears. Material and Methods: The results from 28 patients (20 females and 8 males) with isolated rotator cuff tears were evaluated. Twelve had have all-arthroscopic surgery (ASR) (mean age 54.3 yrs) and 16 had have mini-open surgery (MOP) (mean age 51.5 yrs). Clinical and functional results were compared using the American Shoulder and Elbow Surgeons (ASES), and Disabilities of the Arm, Shoulder and Hand (DASH) indices. Shoulder Muscle Strength and shoulder joint position sense were measured with an isokinetic dynamometer (CSMI Humac Norm, USA). Results: Mean age of the patients was 52.8 yrs (min-max: 40-67). Mean post-operative ASES and DASH scores of ASR-operated patients were 78 and 18.8, respectively. MOP- implemented patients had mean ASES and DASH scores of 86 and 13.6, respectively. As for functional results, there was no statistically significant difference (p>0.05). For patients who went through either surgery, there were no statistically significant different result in terms of isokinetic shoulder muscle strength (internal rotation, external rotation, adduction, abduction) and joint position sense results (p>0.05). Conclusion: There were no significant differences between two methods in means of functional outcomes, joint strength and position sense. But, these two methods should be investigated by more comprehensive studies.

In clinical practice, soft tissue interposition may occur during femoral graft fixation. Soft tissue interposition between the lateral femoral cortex and the cortical button may affect graft tension and related longitudinal graft motion in the tunnel. We aimed to investigate the effect of soft tissue interposition on button migration and clinical outcomes in anatomical single-bundle anterior cruciate ligament reconstruction.Eighty-four patients aged 18-40 years, who underwent anatomical single-bundle anterior cruciate ligament reconstruction with quadruple hamstring autograft were included. Patients were divided into two groups as Group 1 (n = 32) with soft tissue interposition between the cortical button and cortex, and Group 2 (n = 52) without soft tissue interposition. At the one-year follow-up visit, the anteroposterior knee stability of the patients was evaluated using the Lachman test and KT-2000 arthrometer, and rotational stability was assessed with the pivot shift test. The Lysholm knee score was used to evaluate the functional outcome of the patients. Relationship between tissue interposition and clinical outcome, and button migration was examined.Button migration was observed in 12 patients in Group 1 (37.5%) and two patients (3.84%) in Group 2 (p 0.001). However, no significant difference was observed between patients with and without tissue interposition or those with and without button migration regarding knee stability parameters and clinical outcome (p 0.05).Postoperative tissue interposition is found to be associated with cortical button migration during the follow-up. However, it does not affect the clinical outcome.

To investigate the effect of preoperative coronal tibiofemoral subluxation (CTFS) on functional outcome, prosthesis type, insert thickness and revision rates in patients who underwent total knee arthroplasty (TKA).A total of 224 knees of 186 patients were included. Patients were divided into two groups as either with (Group 1, 114 knees of 86 patients) or without (Group 2, 124 knees of 100 patients) coronal lateral tibiofemoral subluxation. The mean follow-up period was 71.3 ± 7.3 (range 60-84) months in group 1 and 69.4 ± 6.6 (range 61-79) months in group 2 (n.s.). Coronal tibiofemoral subluxation degree was measured in degrees on standing anteroposterior knee radiographs. Group 1 was divided into three subgroups according to amount of subluxation ( 5 mm, 6-10 mm and 10 mm). Functional outcome was evaluated using the Western Ontario and McMaster Osteoarthritis Index (WOMAC) score and Knee Injury and Osteoarthritis Outcome Score (KOOS) preoperatively and at the last follow-up visit. Prosthesis type, insert thickness and revision rates were compared between the two groups.There were no significant differences between the two groups regarding patient demographics, prosthesis type, and revision rates (n.s.). The insert thickness was found significantly higher in group 1 (p 0.001). The preoperative and postoperative WOMAC and KOOS scores were found no significantly different between the two groups (n.s.). Among subluxation (+) subgroups, there was no significant difference in functional outcome scores and revision rates (n.s.). However, prosthesis type and insert thickness were significantly associated with the amount of subluxation (p = 0.009 and p = 0.001, respectively). There was no significant correlation between the degree of lower extremity deformity and coronal tibiofemoral amount of subluxation (n.s.).Preoperative CTFS does not adversely affect the WOMAC score, KOOS and revision rates after TKA. In the clinical practice, surgeons should be aware of the need for a posterior cruciate stabilizing prosthesis and a thicker insert in the presence of CTFS, especially with subluxation greater than 10 mm and to consider a spared bony resection on the tibia in patients suffering from CTFS.IV.

Background and Objectives Healthcare workers (HCWs) were among the first groups to be vaccinated in Turkey. The data to be obtained by the vaccination of HCWs would guide wide spread vaccination programs. Materials and Methods The study included 330 HCWs working at Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty Hospital and vaccinated with inactive CoronaVac (Sinovac Life Sciences, China) SARS-CoV-2 vaccine in two doses (28 days apart). Anti-Spike /RBD IgG levels were measured 14 days after the first dose and 28 days after the second dose. Chemiluminescent microparticle immunoassay (CMIA) (ARCHITECT IgG II Quant test, Abbott, USA), which is 100% compatible with plaque reduction neutralization test (PRNT), was used. Results Of the participants, 211 (63.9%) were female, 119 (36.1%) were male, and mean age was 39.6 ± 7.7 years. In those without prior COVID-19 history; (n = 255) antibody positivity was detected as 48.2% (95% CI: 42.1–54.3) 14 days after the first dose of vaccine, and 99.2% (95% CI: 98.1–100) at day 28 after the second dose. Antibody titers were significantly lower in patients with hypertension (p = 0.011). In those with prior history of COVID-19 (n = 75); both the antibody positivity rates after the first vaccine (48.2% vs 100%, p = 0.000) and the anti-spike/RBD antibody levels after the second vaccine (with a ≥ 1050 AU/mL titer equivalent to PRNT 1/80 dilution) was significant than infection-naive group (25.9% vs. 54.7%, p = 0.000). Antibody positivity after two doses of vaccination for all study group was 99.4% (95% CI: 98.6–100). Conclusions Two doses CoronaVac produce effective humoral immunity in HCWs. Antibody response is significantly higher in those with prior history of COVID-19 than infection-naive group. Given no significant benefit of the second dose, a single shot of vaccination may be sufficient for those with prior history of COVID-19. Monitoring humoral and cellular immune responses, considering new variants, is required to validate this approach.

Background The increase in the pigmentation of skin grafts during the healing process is a cosmetic problem. There are a variety of medical and surgical treatment options for skin graft darkening. Aims The aim of this study was to investigate the effects of topical hydroquinone, tretinoin, and betamethasone application on hyperpigmentation of skin grafts. Methods A skin defect was created on the backs of 17 Long-Evans rats, and a 2 × 2 cm split-thickness skin graft was sutured. After 15 days, eight rats in the treatment group were treated with application of hydroquinone, tretinoin, and betamethasone cream, while nine rats in the control group were not treated. Visual evaluation was performed on days 45 and 75 using the Melasma Severity Scale (MSS), and histological evaluation was performed on day 75 using S100 and Masson Fontana (MF) staining. The Mann-Whitney U test was used for statistical analysis. Results Mean MSS values of the treatment group on days 45 were significantly lower compared to the control group (P = .036). On day 75, the mean MSS score of the treatment group was also lower; however, the difference was not statistically significant (P = .302). Histological evaluation of S100 and MF staining scores of the treatment group showed fewer melanocytes and fewer pigments in epidermis (P = .009 and P = .002, respectively). Conclusions This study showed that topical application of hydroquinone, tretinoin, and betamethasone reduced the hyperpigmentation, number of melanocytes, and melanin pigment intensity that developed on the rat skin graft models. Clinical studies are needed to assess whether a similar effect could be observed with human skin grafts.

In this case, we present a case of atraumatic lateral compartment syndrome of the thigh in a patient undergoing anticoagulant treatment. The patient received high-dose low molecular weight heparin (LMWH) treatment due to the diagnosis of an ischemic cerebrovascular event and developed lateral compartment syndrome of the thigh after the LMWH injection into the thigh; therefore, an emergency fasciotomy was performed. After negative-pressure dressing and monitoring, the wound was closed on the sixth day and the patient was discharged. No complication occurred during the one-month follow-up. Compartment syndrome of the thigh is a rare, but potentially devastating. The purpose of the current report was to highlight this rare, but serious, complication of a routine treatment procedure.

Background To compare the efficacy, functional outcome, and complication frequency of splinting and external fixation in the initial treatment of ankle fracture-dislocations. Method Ankles with poor soft tissue conditions who underwent temporary stabilization due to using a splint or external fixator due to an ankle fracture-dislocation between 2012 and 2019 were retrospectively evaluated. Ankles were divided into two groups as the splint (n = 69) and external fixator (n = 48). The time between the injury to definitive surgery, reduction loss, operation time, functional outcome, pain, and soft-tissue complication frequency before and after definitive surgery were compared. Results The frequency of reduction loss (25% vs. 4%, p = 0.019) and skin necrosis (22% vs. 6%, p = 0.028) were significantly higher in the splint group. Posterior malleolar fracture fragment ratio was calculated by dividing the fracture fragment axial length by the total axial length of the articular surface on computed tomography. Posterior malleolar fracture fragment ratio was found to be significantly higher in ankles with reduction loss in both the splint (25% vs 75%, p = 0.032) and fixator groups (4% vs 96%, p = 0.021). The mean time period between injury and definitive surgery was significantly shorter in the external fixator group (11 ± 5 vs 7 ± 4 days, p = 0.033). Before definitive treatment, pin tract infection was observed in two ankles in the fixator group. Conclusion Splint immobilization of ankle fracture-dislocations may predispose to reduction loss, soft tissue complications, and a longer time period between injury and definitive fixation. The risk of these potential complications can be reduced with the use of an external fixator.

Objective: Helicobacter pylori is an important pathogen that causes the development of important gastroduodenal pathologies such as acute and chronic gastritis, ulcer and gastric cancer. This pathogen is estimated to infect about half of the world’s population. In this study, it was aimed to evaluate the five-year data retrospectively by investigating the presence of H. pylori antigen in stool samples taken from patients who applied to Istanbul University-Cerrahpaşa Medical Faculty Medical Microbiology Department Serology/ELISA laboratory with gastroduodenal complaints between January 2015 and December 2019. Method: Stool specimens of 4696 patients admitted to the hospital with gastroduodenal complaints between January 2015 and December 2019 were analyzed using an immunochromotographic H. pylori stool antigen test containing monoclonal antibodies. Results: Among 4696 patients who were examined retrospectively in a five-year period, 1176 (25%) had positive, and 3520 (75%) of them negative H. pylori test results. H. pylori-positivity was found in 210 (21.30%) of 986 children and 966 (26.04%) of 3710 adults. H. pylori detection rate in children was found to be significantly lower than adults (p: 0.002). H. pylori positivity was found higher in the 30-39 age range compared to other age groups. Conclusion: Although current study results showed a lower prevalence compared to recent studies, it has been concluded that H. pylori is an important pathogen in all age groups with gastroduodenal complaints and should be monitored in the community.

PubMed: 33882652 2-s2.0-85104693874 Following the emergence of severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) and using only PCR for diagnosis, antibody tests have been rapidly developed by various commercial companies. There are differences between the sensitivity and specificity of these tests due to the usage of different viral target proteins and antibody subclasses. In order to evaluate the diagnostic use of these tests, we aimed to examine the diagnostic performance, especially sensitivity and specificity, of SARS-CoV-2 IgM, IgA and IgG tests of various companies (Abbott, Roche, Euroimmun, Dia.Pro, Anshlabs, Vircell, UnScience and RedCell), which have different principles (ECLIA/CLIA, EIA, LFA). Current (n= 180) and past (n= 180) COVID-19 patients with clinical and molecular diagnosis of COVID-19 admitted to Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine Hospital, Pandemic Polyclinic with suspected COVID-19 infection, were included in our study. The patients admitted within the first 3 weeks after the onset of symptoms were included in the current patient group, and those admitted at the third and after the third week were included in the past patient group. Serum samples (n= 180) obtained from Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Blood Center between April and June 2018 before the COVID-19 pandemic were included in the study as a control group. All the tests included in our study were studied with the recommendations of the manufacturer companies. Between the IgG detection tests with different principles in patients with past COVID-19, the sensitivity and specificity values of the most effective tests were; 86.7%/99.4% (Abbott), 86.1%/98.9% (Dia.Pro), 91.3%/95% (RedCell). Between the IgM detection tests with different principles in current COVID-19 patients, the sensitivity and specificity values were; 67.8%/99.4% (Abbott), 68.9%/98.6% (Vircell), 50%/97.5% (RedCell). Abbott IgM with a kappa coefficient of 0.67 and Vircell IgM + IgA test with a kappa coefficient of 0.65 showed the best fit in patients with current COVID-19 infection. In patients with past COVID-19, Abbott IgG with 0.86 kappa coefficient and Dia.Pro IgG test with 0.85 kappa coefficient showed the best match. Due to the low sensitivity of IgM detection antibody tests, they should not be preferred instead of real-time reverse transcriptase polymerase chain reaction in routine diagnosis. IgG detection tests may be preferred to detect the antibody response and the titers in people who have had COVID-19 for population seroprevalence and especially therapeutic immune plasma production. However, it is thought that the combined use of both ECLIA/CLIA-based and EIA/ELISA-based tests together may be more effective in routine use for SARS-CoV-2 IgG tests. © 2021 Ankara Microbiology Society. All rights reserved.

Subjective tinnitus is the most common and manifest auditory symptom of an existing pathology in the auditory system. Although the effect of obesity on tinnitus is still uncertain, it is known that increased fat tissue increases the severity and symptoms of tinnitus. In this study, it was aimed to evaluate the effect of weight loss through diet and physical activity on tinnitus.Forty-six obese subjects diagnosed with tinnitus were randomized into the diet + physical activity (PA) (n = 13), diet (n = 16) and the control groups (n = 17). The anthropometric measurements, tinnitus severity scores, tinnitus handicap inventory (THI) scores and short form quality of life (SF-36) scores of the individuals were recorded and compared at the beginning and at the end of the study.In the diet + PA and diet groups; body weight (diet + PA:-6.5 ± 2.6; diet: -4.1 ± 1) tinnitus severity (diet + PA:-11.0 ± 7.0; diet: -9.0 ± 8.7) and THI scores (diet + FA:-15.0 ± 9.5; diet: -14.0 ± 10.0) significantly decreased compared to the control group (p 0.01). This decline was more in those with weight loss of ≥5.0% than those with5.0%. SF-36 score was significantly increased in the diet + PA and diet groups (respectively 10.0 ± 5.5 and 6.0 ± 2.7) compared to the control group (p 0.05).Diet and physical activity intervention ameliorated the tinnitus severity and quality of life in obese patients with tinnitus. However to generalize this findings further studies are needed. REGISTERED UNDER CLINICALTRIALS.NCT00123456.

Background Articular chondroprogenitors are a promising contender for cartilage repair due to their inherent nature which stands primed for chondrogenesis and minimal hypertrophic preponderance. Platelet rich plasma (PRP) has been extensively used for treating cartilage defects and osteoarthritis (OA), due to its chondro-inductive properties and abundant pool of growth factors. The aim of this study was to assess the efficacy of chondroprogenitors injected with PRP versus PRP alone in the healing of experimentally created early OA and osteochondral defects (OCD) in a rabbit model. Methods Adult New Zealand White male rabbits were used for cell and PRP isolation. Chondroprogenitors were isolated by fibronectin adhesion assay, labelled with iron oxide, characterized for surface markers, differential potential and expanded. PRP was isolated by double spin centrifugation using a TriCell kit. Study groups included (a) Monosodium iodoacetate induced early OA and (b) critical OCD. Following intervention (test arm: PRP+ chondroprogenitors and control arm: PRP), assessment was performed at 6- and 12-weeks which included histopathological examination and scoring (OARSI and Modified Wakitani score), immunohistochemistry analysis (Collagen type II and X) and synovial fluid S100A12 levels. Results and conclusion Comparable, evident healing was noticed in both test and control arms when the OA group samples were assessed at both time points. In the OCD group, PRP alone exhibited significantly better results than the test arm, although repair was notable in both interventions. Further evaluation of chondroprogenitors is required to assess their role as a standalone therapy and in combination with PRP to further cartilage regeneration.

Objectives This study aims to investigate the effects of deltopectoral and anterolateral acromial approaches commonly used in open reduction-internal fixation of proximal humeral fractures on the clinical outcomes, and axillary nerve damage through electrophysiological assessment. Patients and methods Forty-eight patients (22 males, 26 females; mean age 47.9±13.2 years; range, 22 to 73 years) diagnosed with Arbeitsgemeinschaft fur Osteosynthesefragen (AO)/Orthopaedic Trauma Association (OTA) type 11 proximal humeral fractures who underwent osteosynthesis with anatomical locking plates in our hospital between January 2015 and June 2016 were prospectively examined. The patients were divided into two groups according to either the deltopectoral or anterolateral deltoid-split surgical approach used. Clinical outcomes were evaluated using the Disabilities of the Arm, Shoulder, and Hand (DASH) scores and Constant-Murley scores (CMS) obtained at three- and 12-month follow-up visits. Needle electromyography (EMG) was performed for the electrophysiological assessment of the deltoid muscle. Results There were no significant differences between the groups in terms of demographic data, follow-up times, and complications. DASH scores and CMS obtained postoperatively at three months (p=0.327 and p=0.531, respectively) and 12 months (p=0.324 and p=0.648, respectively) revealed no significant differences. In addition, the two groups did not significantly differ with respect to the presence of EMG abnormalities (p=0.792). Avascular necrosis of the humeral head was detected in only two patients from the deltopectoral group. Conclusion Deltopectoral and anterolateral approaches do not differ regarding the presence of postoperative EMG abnormalities and functional outcomes. Surgeons can thus adopt either approach. However, dissection without damaging the soft tissue should be performed in both approaches.

To evaluate the effects of untreated stable ramp lesions on clinical and functional outcomes, return to sports rates, and complications of patients who underwent anterior cruciate ligament reconstruction. A total of 879 patients with anterior cruciate ligament rupture were evaluated. Of these, 66 patients [33 patients with anterior cruciate ligament rupture and stable medial meniscal ramp lesion (ramp + group) and 33 patients with isolated anterior cruciate ligament rupture (ramp − group)] with a minimum 3-year of follow-up were included. Stable ramp lesions were not repaired in the ramp + group. Preoperative and postoperative Lachman and pivot-shift grades, Lysholm knee scores, International Knee Documentation Committee score and 12-Item Short Form Health Survey score were compared between groups. The return to sports rates, level of return to sports, time to return to sports and complications were compared. The mean patient age was 27.8 ± 7.2 years. The mean follow-up period was 47.3 ± 9.4 months. There were no significant differences between groups regarding preoperative and postoperative Lachman and pivot-shift grades, 12-Item Short Form Health Survey mental and physical component summary scores, Lysholm and International Knee Documentation Committee scores, and complication rates (n.s.). Although the return to sports rates (84.8% vs 90.1%) and the level of the return to sports (return to preinjury level: 75% vs 78%) were similar between groups (n.s.), the time to return to sports was significantly longer for patients with ramp lesions (11.1 ± 4.0 vs. 8.7 ± 2.5 months, p = 0.007). Leaving the stable ramp lesion unrepaired does not negatively affect clinical and functional outcomes as well as return to sports rates after ACL reconstruction. However, the time to return to sports is prolonged in patients with ramp lesions In clinical practice, surgeons should be aware that repairing stable ramp lesions is not an absolute necessity and will not affect return to sport rates. Level III.

Pazopanib is a potent multi-targeted kinase inhibitor approved for the treatment of advanced renal cell carcinoma and soft tissue sarcoma. The pharmacokinetics of pazopanib is characterized by a significant inter- and intra-patient variability and a target through plasma concentration of 20.5 mg·L−1. However, routine monitoring of trough plasma concentrations at fixed hours is difficult in daily practice. Herein, we aimed to characterize the pharmacokinetic (PK) profile of pazopanib and to identify a target area under the curve (AUC) more easily extrapolated from blood samples obtained at various timings after drug intake. A population pharmacokinetic (popPK) model was constructed to analyze pazopanib PK and to estimate the pazopanib clearance of a patient regardless of the time of sampling. Data from the therapeutic drug monitoring (TDM) of patients with cancer at Institute Gustave Roussy and a clinical study (phase I/II) that evaluates the tolerance to pazopanib were used. From the individual clearance, it is then possible to obtain the patient’s AUC. A target AUC for maximum efficacy and minimum side effects of 750 mg·h·L−1 was determined. The comparison of the estimated AUC with the target AUC would enable us to determine whether plasma exposure is adequate or whether it would be necessary to propose therapeutic adjustments.

Though the number is on the increase throughout the world each day, an estimated 100 million females worldwide so far are known to have been subjected to genital mutilation. Female genital mutilation (FGM), which is also known as female circumcision (FC), is a life threatening practice that results in many long-lasting health complications in both women and children's lives, especially in underdeveloped regions where its practice is carried out under unhygienic conditions by people who lack medical knowledge even without using any anesthesia and equipment. Furthermore, this non-medical practice brings about a number of both immediate and later complications. In addition to causing sexually dysfunctional, the other immediate effects following the circumcision can be bleeding, infections. psychological shock, and not being able to pass urine. Other complications include repetitive infections of urinary tract, urinary genital tract fistula, pelvic pain, sexually dysfunctional, complications during delivery such as bleeding because of tears and cuts, and maternal and fatal morbidity in case of prolonged stages of labour, thus leading to an increase in mortalities. Despite the opposition of World Health Organization (WHO), UNICEF and the efforts of many Civil Works Organisations, along with the legislations of the Governments for its eradication, circumcision is still continuing to be practised in Africa. In this article the authors aimed to present a case of a ten-year-old child who has a two-year history of type 3 circumcision and discuss the complications of female circumcision performed at early ages.

Objective The incidence of varicocele is approximately 15% in adolecent men. Early treatment with varicocele is aimed to resolve testicular hypotrophy and ensure catch-up growth. The aim of this study was to evaluate ipsilateral catch-up growth rates relative to contralateral testicular growth in adolescents with varicocele undergoing microsurgical subinguinal varicocelectomy. Material and methods Fifty adolescents with unilateral grade 2-3 varicoceles were included in the study. All patients underwent microsurgical subinguinal left varicocelectomies performed by the same experienced surgeon. All patients were evaluated clinically and using orchidometric measurements to define the grade of varicocele and testicular volume at presentation and follow-up. The number of internal and external spermatic veins, testicular arteries and lymphatic vessels preserved during the subinguinal microsurgical varicocelectomy were recorded. The mean follow-up period was 26 months (range 6-48 months). Results At presentation, mean patient age was 12.9±2.1 years. Mean testicular preoperative volumes were 7.1±4.3 mL for the right and 5.4±3.4 mL for the left testis. There were significant differences between mean volumes of the right and left testis (p=0.002). At the final postoperative follow-up visit, mean testicular volumes were 10.8±5.1 mL (range 3-25) for the right and 9.9±4.3 mL (range 2-20) for the left, and the difference between the right and left testicular volumes was insignificant (p=0.47). In our series, catch-up growth was observed in 70% (35/50) of our patients. Conclusion Adolescent varicocelectomy is associated with a higher percentage of patients showing testicular catch-up growth. In our study, similarly to the available literature the catch-up growth rate was found as 70% and observed to have positive effects of adolescent varicocelectomy on testicular growth.

H. pylori infection is a global public health problem associated with some gastrointestinal diseases in children, especially in developing countries, since prevalence of H. pylori is low in the developed world. Both noninvasive (stool antigen test, urea breath test, and blood test) and invasive (histology, rapid urease test, and microbiological culture) tests have been utilized to detect H. pylori infection. However, a single test is not reliable enough and does not provide accurate enough data to determine H. pylori infection among children. Risk factors of H. pylori infection in children were related to ethnicities, household properties, geographic location, living conditions, water sources, type of housing, presence/absence of sewage systems, and garbage collection within the living environment. These risk factors were usually associated with the socioeconomic status of the family. This review article aims to determine the gaps in the knowledge of the epidemiology, risk factors, and diagnostic tests of H. pylori infection among children. How to cite this article Ozbey G, Hanafiah A. Epidemiology, Diagnosis, and Risk Factors of Helicobacter pylori Infection in Children. Euroasian J Hepato-Gastroenterol 2017;7(1):34-39.

Purpose: This study investigated the short-term effects of KT on back pain (BP) in patients with Lenke Type 1 adolescent idiopathic scoliosis (AIS). Methods: We chosen Lenke Type 1 scoliosis who have had only back pain (the localization of the pain: the only in the apical convex edge). Forty patients suffering from BP with Lenke Type 1 AIS were randomly separated into two groups, Group 1 (20 patients) and Group 2 (20 patients). Group 1 was given KT with tension and home exercises and Group 2 was given KT without tension and home exercises. KT and home exercises was applied to the thoracic area of the patients in both groups for four weeks. Pain intensity was measured using a visual analog scale (VAS) and SRS-22 (subtotal SRS-20) before and after treatment. Results: Mean age of both groups was 16.1 years. Mean Cobb angle of the thoracic scoliosis was 31.8° (range: 17°–44°) in Group 1 and 32.8° (range: 19°–43°) in Group 2 before the treatment. The decrease in VAS score of Group 1 after taping was higher than that of Group 2. The difference between the pre- and post-treatment VAS scores of both groups was statistically significant (p

Colonization of the human gastric mucosa by H. pylori may cause peptic and duodenal ulcers (DUs), gastric lymphomas, and gastric cancers. The cagL gene is a component of cag T4SS and is involved in cagA translocation into host. An association between the risk of gastric cancer and the type of HLA class II (DR and/or DQ) was suggested in different populations. The aim of this study was to investigate, the clinical association of the cagL gene with host HLA alleles in H. pylori strains that were isolated from patients with gastric cancer, DU, and non-ulcer dyspepsia (NUD) and to determine the HLA allele that confers susceptibility or resistance for the risk of gastric cancer and DU development in Turkish patients. A total of 94 patients (44 gastric cancer and 50 DU patients; 58 male, 36 female; mean age, 49.6 years), and 86 individuals (50 NUD patients and 36 persons with normal gastrointestinal system [NGIS]; 30 male, 56 female; mean age, 47.3 years) were included as the patient and the control groups, respectively. CagA and cagL were determined by PCR method. DNA from peripheral blood samples was obtained by EZ-DNA extraction kit. For HLA SSO typing, LIFECODES SSO Typing kits (HLA-A, HLA-B HLA-C, HLA-DRB1 and HLA-DQA1/B1 kits) were used. The CagL/CagA positivity distribution in the groups were as follows: 42 (95.4%) gastric cancer, 46 (92%) DU and, 34 (68%) NUD and no NGIS cases. The HLA-DQA1*01 (OR: 3.82) allele was significantly different, suggesting that these individuals with H. pylori strains harbouring the CagL/CagA positivity are susceptible to the risk of gastric cancer and DU, and the HLA-DQA1*05 (OR, 0.318) allele was suggested as a protective allele for the risk of gastric cancer and DU using univariate analyses. HLA-DQA1*01 (OR, 2.21), HLA-DQB1*06 (OR, 2.67), sex (male, OR, 2.27), and CagL/CagA/(

Varicocele, which is one of the causes of infertility in men, can be defined as the expansion of spermatic cord veins. The presence of apelin and apelin receptor (APJ) in many tissues and the effects of apelin have been reported in several studies. There is no study showing apelin and APJ protein expressions in normal and varicocele-induced testicular tissues. In this study, we aimed to demonstrate varicocele-induced changes in apelin and APJ expressions in testicular tissue by immunohistochemical and western blotting techniques. In our study, Wistar male rats were randomly divided into three groups as control, varicocele, and sham. While the control group rats were not subjected to any treatment, the unilateral varicocele model was created under anesthesia in the varicocele group. In the sham group, the left abdominal region was opened and closed to exclude the effect of the surgical procedure. At the 13th postoperative week, the left testes were obtained under anesthesia in all groups, and the immunohistochemistry and Western blotting techniques were used to detect apelin and APJ expressions. In our study; apelin and APJ were significantly expressed in control group's testicular tissue; apelin in testicular tissues of varicocele groups increased compared to the control group, whereas APJ expression decreased. In conclusion, the presence of apelin/APJ system in normal testis and the increased expression of apelin in varicocele-induced testicular tissue suggested that apelin may have a role in the varicocele etiopathogenesis.

Purpose: To evaluate the short-term clinical and radiological outcomes with degenerative changes in patients over 40 years old following isolated vertical medial meniscal tear repair. Methods: Between 2007 and 2015, 438 patients underwent arthroscopic meniscal repair. Thirty-three patients aged over 40 years with isolated vertical medial meniscal repair (23 males and 10 females, mean age 46.1 ± 7.0; range 40–67) were included in the study. Preoperative and postoperative physical examination findings, Lysholm knee score, the International Knee Documentation Committee score, magnetic resonance imaging findings, and Kellgren–Lawrence osteoarthritis stage were evaluated. Results: The mean follow-up period was 31.1 months ± 20.1 (range 12–100 months). There was statistically significant improvement in functional scores ( p < 0.05) and physical examination findings. In 22 patients (66.7%), improvement in the clinical and radiological results was detected ( p < 0.05). However, no correlation was found between clinical and radiological outcomes. There was also no significant change in osteoarthritis stages at the last follow-up visit. No significant difference was found between smokers and nonsmokers regarding clinical outcomes. Conclusion: Successful clinical and radiological outcomes can be obtained following isolated vertical medial meniscal tear repair in patients older than 40 years. Age is not the sole criterion for the success of meniscal repair; rather, the functional capacity of the patient, the location of the tear, the grade of knee joint arthritis, and the quality of the meniscal tissue should be taken into consideration.

We aimed to describe the presentation of long-term complications of female genital mutilation/cutting and the surgical management of clitoral keloids secondary to female genital mutilation/cutting. Twenty-seven women who underwent surgery because of clitoral keloid between May 2014 and September 2015 in Sudan Nyala Turkish Hospital were evaluated in this retrospective descriptive case series study. The prevalence of type 1, type 2, and type 3 female genital mutilation/cutting were 3.7%, 22.2%, and 74.1%, respectively (type 1: 1/27, type 2: 6/27, and type 3: 20/27). All patients had long-term health problems (dysuria, chronic pelvic pain, vaginal discharge, and chronic pruritus) and sexual dysfunction. Keloids were removed by surgical excision. There were no postoperative complications in any patient. Although clitoral keloid lesions can be seen after any type of female genital mutilation/cutting, they usually develop after type 3 female genital mutilation/cutting. Most of these keloids were noticed after menarche. Keloids can be removed by surgical excision and this procedure can alleviate some long-term morbidities of female genital mutilation/cutting.

INTRODUCTION: Visfatin is a novel adipokine originally described to be produced predominantly by visceral fat tissue. The aim of the study was aimed to investigate visfatin level in non-diabetic obese patients with or without MetS and prediabetes. METHODS: The cross-sectional study enrolled 169 subjects. Anthropometric measures and metabolic parameters were obtained. Exclusion criteria were pregnancy, smoking, any of the chronic disease. Blood sample was collected overnight fasting and centrifuged, and stored at refrigerator at -70º degree until to be assayed. Visfatin was assayed with ELISA method. RESULTS: The study enrolled 169 subjects aged 36.9 ± 8.5 years (control group = 52 and obese group: 117; and Male: 28 and Female: 141). Among obese subjects, the frequency of MetS, and PreDM was respectively 35.1% (n = 41) and 70.1% (n = 82). Mean concentration of serum visfatin among subjects with obesity was significantly higher those with normal weight subjects (10.39 ± 2.30 versus 6.9 ± 2.2 ng/mL; p < 0.001). The subjects with IR+ (10.58 ± 2.48 ng/mL ) had significantly higher visfatin concentration than those with IR- (10.58 ± 2.48 ng/mL and 8.47 ± 2.65 ng/mL) (p < 0.001, respectively). Visfatin positively correlated with BMI (r = +0.627 and p < 0.001), WHR (r = +0.203 and p = 0.023), HOMA-IR (r = +0.329 and p < 0.001), and hs-CRP (r = +0.421 and p < 0.001). Mean concentration of serum visfatin was not significantly different between groups of MetS and PreDM. DISCUSSION AND CONCLUSION: Visfatin was associated with body mass index and insulin resistance, but not with metabolic syndrome and impaired glucose metabolism.

Evolution of intima media thickness and breast arterial calcifications as cardiovascular risk factor, effect of pregnancy and breast feeding Objective: The aim of retrospective study was to evaluate intima media thickness (IMT) of common carotid artery and breast arterial calcifications (BAC) as indicator of cardiovascular risk factors. We also aimed to evaluate contribution of pregnancy count and total time spent on breast feeding to BAC and IMT. Material and Method: This study included 40 patients with BCI and 40 patients without BCI, referred to Taksim Research and Education Hospital Radiology Clinic. All individuals cardiovascular risk factors were noted and common carotid artery IMT was measured with color doppler imaging. Number of pregnancies and time spent on breast feeding were also noted. Results: There was statistically significant relation between age and IMT, BCI both. Patients with increased IMT had higher cardiovascular risk factors compared to normal cases (1.82 against 1.33). There was not different cardiovascular risk factor value between BAC positive and negative patients (Same as 1.675). We could not find any effect of number of pregnancies and time spent on breast feeding to IMT and BAC. Conclusion: IMK was a better indicator of cardiovascular disease compared to BAC. We could not find any any effect of number of pregnancies and time spent on breast feeding to IMT and BAC.

Aim: To investigate the incidence of concomitant osteochondral lesions of the talus (OLT) and their effect on clinical outcome in anterolateral impingement syndrome (ALIS).Materials and Methods: Patients who underwent ankle arthroscopy due to ALIS of the ankle between 2012 and 2018 were retrospectively screened. The patients were divided into two groups according to the presence of OLT. Preoperatively hindfoot alignment (HA) was measured on long axial view radiographs. All measurements were performed by the experienced musculoskeletal radiologist. The association between osteochondral lesions of the talus and hindfoot alignment disorder was statistically assessed. The patients before and after surgery were evaluated with American Orthopedic Foot and Ankle Society (AOFAS) Hindfoot score for clinical performance.Results: OLT accompanied impingement syndrome in 38 (34.8%) of 109 patients examined. The preoperative and postoperative AOFAS Pain and AOFAS Function results were found no significantly different between the two groups according to the presence of OLT (n.s.). However, AOFAS Alignment results of OLT (-) Group were significantly higher than OLT (+) Group. Mean Hindfoot Angle (HA) was −3.7 ± 12.8 (varus) and 4.6 ± 11.2 (valgus) in feet with and without OLT, respectively (Table 1). In this study, there was a significant association between positive OLT and clinical varus hindfoot (p .001)Conclusion: In the current study the hindfoot alignment showed association with the location of OLT in Anterolateral Impingement Syndrome. However, it was also determined that the presence of chondral damage had no negative effect on the treatment of anterolateral impingement syndrome. It should be kept in mind that this syndrome can be accompanied by osteochondral lesions of the talus at a significant rate.

Aim: To investigate the relationship between adhesive capsulitis and serum vitamin D levels. Materials and Methods: Patients who were diagnosed with primary adhesive capsulitis between 2015 and 2019 and had regular follow-up data were retrospectively evaluated. Age, gender, body mass index, affected side, disease duration, serum 25-OH vitamin D levels, range of shoulder motion, the Visual Analog Scale (VAS) score, the Constant-Murley score, and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire score were evaluated. Patients with a diagnosis of diabetes, history of rheumatic diseases, presence of cervical pathologies, history of fracture and/or shoulder surgery, history of infection, and full-thickness rotator cuff tear were excluded from the study. The serum 25 (OH) D levels below 20 ng/ml were accepted as deficiency. The patients were divided into two groups according to the serum vitamin D level (Group 1 if 20 ng/mL and Group 2 if ≥20 ng/mL). The VAS score, functional scores, range of motion (flexion, abduction, external and internal rotation) of the patients in the two groups were compared.Results: Of the 74 patients included in the study, 59 (79.2%) were female and 15 (20.3%) were male, with a mean age of 50.6 ± 9.74 years. The mean duration of pain was 8.21 ± 2.3 months. The serum vitamin D level was below 20 ng/ml in 43 patients (58.1%) who were then allocated to Group 1, and Group 2 comprised 31 patients. The mean VAS score was 7.8 for Group 1 and 5.2 for Group 2. The mean Constant-Murley and DASH scores were 54.4 ± 15.9 and 21.6 ± 9.78, respectively in Group 1 and 52.04 ± 12.2 and 24.3 ± 6.4, respectively in Group 2. No significant difference was observed between the groups according to the range of joint motion, Constant scores, or DASH scores. Conclusion: Vitamin D deficiency may be associated with shoulder pain in patients with adhesive capsulitis. However, the serum vitamin D level had no effect on the functional results. Conclusion: In the present study, serum CRP, TNF-α and H.pylori IgA levels were significantly higher than normal pregnant women.

Unfortunately, the co-author name was published as ‘‘A. Hamit Misir’’ instead of ‘‘Abdulhamit Misir’’ in the original publication. The correct version of author name is updated here.

Purpose:To evaluate the acetabular cup and graft survival in patients who underwent total hip arthroplasty (THA) with the diagnosis of dysplastic hip osteoarthritis and received a femoral head autograft due to acetabular coverage deficiency.Methods:Between January 2005 and December 2016, 83 hip prostheses of 80 patients who underwent THA using femoral head autografts and were followed up for at least 2 years were retrospectively evaluated. Seventy-four hips of the remaining 71 patients (57 female (80%)) were included. Mean patient age at surgery was 51 ± 16 (range 18–76) years. The mean follow-up duration was 76 ± 25 (range 25–161) months. Acetabular inclination and graft thickness, contact length, percentage of coverage, and graft resorption were examined on postoperative and final follow-up radiographs. The presence of a radiolucent area around the acetabular and femoral components indicating loosening was also evaluated.Results:The mean postoperative acetabular component inclination was 44 ± 5.1° (range 30–48°) with mean graft coverage of 34 ± 4.8% (range 24–46%). In all patients, autograft union with the pelvis was seen and the lateral overflow was remodeled. Fifteen patients (20%) underwent revision surgery due to aseptic acetabular component loosening in four, nontraumatic recurrent dislocations in eight, periprosthetic infection in one, acetabular component protrusion in one, and traumatic hip dislocation in one.Conclusion:In patients with osteoarthritis secondary to developmental hip dysplasia, the use of femoral head autografts to eliminate acetabular coverage deficiency during THA achieves acceptable midterm postoperative radiological outcomes. Increased acetabular bone stock may be beneficial in possible future revision surgeries.

Pelvic organ prolapse is a common problem in female population, and it may cause minor urological problems such as recurrent urinary system infection and voiding difficulty, as well as serious clinical problems such as advanced bilateral hydronephrosis and acute renal failure. Bilateral hydroureteronephrosis and acute renal failure secondary to pelvic organ prolapse are rarely seen. In our paper, we present the case of a 69 year old woman that developed bilateral hydroureteronephrosis, anuria and acute renal failure secondary to pelvic organ prolapse with a review of the literature.

Ectopic pregnancy, defined as the placement of an embryonic sac somewhere other than the uterine wall, is the most common life-threatening emergency seen during early pregnancy. Interstitial ectopic pregnancy is defined as the placement of an ectopic pregnancy to the uterine part of the fallopian tubes and makes up about 2-4% of all ectopic pregnancies. Compared to other tubal pregnancies, they rupture later during pregnancy and gross hemorrhage is seen as a result of this rupture. Maternal mortality risk is 2 to 5 times more in interstitial ruptured pregnancy in comparison with other tubal pregnancies. Early diagnosis and treatment of interstitial ectopic pregnancy is therefore very crucial, as they carry a very high risk of morbidity associated with the rupture. In this case report, we present a case presenting with severe abdominal pain and amenorrhea for 3 months to our clinic. After examination, the patient was diagnosed with a cornual ectopic pregnancy which was late for a case like this. We would like to discuss this case with a literature review on this subject

The objectives of the present study were to determine Helicobacter pylori via culture, polymerase chain reaction and histopathological diagnosis in 101 children ranging in age from 4 to 18 years, to identify the association among restriction fragment length polymorphism types and clinical disease and to investigate the relationships among different isolates of H. pylori in different age groups. We observed a high prevalence of H. pylori infections in children between the ages of 13 and 18 (75.8%), while children aged 4 to 6 years had the lowest prevalence of infection (40%). H. pylori was detected in 30.7% (31 of 101), 66.3% (67 of 101) and 63.2% (60 of 95) of children as determined by culture methods, PCR and histological examination, respectively. H. pylori isolates with RFLP types I and III were the most common among children with antral nodularity, whereas RFLP types II and IV were the least detected types. Interestingly, all isolates from peptic ulcer patients were type III. Although our results show a high prevalence of H. pylori infections in the pediatric population in eastern Turkey, no association was identified between H. pylori infection with antral nodularity and recurring abdominal pain. In addition, we found low genetic variation among H. pylori isolates from children and no association between RFLP types and antral nodularity (p > 0.05). Additionally, we found that H. pylori isolates with specific RFLP types were predominant in different age groups.

Background The cardiovascular system is a primary target of stress and stress is the most important etiologic factor in cardiovascular diseases. Stressors increase expressions of atrial natriuretic peptide (ANP) and apelin in cardiac tissue. Aim The aim of the present study was to investigate whether stress-induced apelin has an effect on the expression of ANP in the right atrium of rat heart. Methods The rats were divided into the control, stress and F13A + stress groups. In the stress and F13A + stress groups, the rats were subjected to water immersion and restraint stress (WIRS) for 6 h. In the F13A + stress group, apelin receptor antagonist F13A, was injected intravenously immediately before application of WIRS. The plasma samples were obtained for the measurement of corticosterone and atrial natriuretic peptide. The atrial samples were used for immunohistochemistry and western blot analysis. Results F13A administration prevented the rise of plasma corticosterone and ANP levels induced by WIRS. While WIRS application increased the expressions of apelin, HIF-1α and ANP in atrial tissue, while F13A prevented the stress-induced increase in the expression of HIF-1α and ANP. Conclusion Stress-induced apelin induces ANP expression in atrial tissue and may play a role in cardiovascular homeostasis by increasing ANP expression under WIRS conditions.

WOS: 000419489200014 PubMed ID: 28634705 Objective Data regarding pregnancies in relation to pituitary tumors are limited. The effects of pregnancy on pituitary adenomas and the effects of adenoma itself (hormonal activity, mass effects and pituitary insufficiency) and/or treatment on the ongoing gestation and developing fetus were evaluated. Methods The study was a retrospective study. A questionnaire involving questions regarding medical history before index gestation, history of related pregnancy, result of index gestation and postpartum follow-up of the patients was filled by the investigator in one of the eight Referral Endocrinology Centers from Turkey. Results One hundred and thirteen (83 prolactinoma, 21 acromegaly, 8 NFPA and 1 plurihormonal pituitary adenoma) pregnancies of 87 (60 prolactinoma, 19 acromegaly, 7 NFPA and 1 plurihormonal pituitary adenoma) patients were reviewed. The clinically important pregnancy-related tumor growth of pituitary adenomas was found to be low in previously treated adenomas. Prolactinomas were more likely to increase in size during pregnancy especially if effective prior treatment was lacking. The risk of hypopituitarism is also minimal due to pituitary adenomas during pregnancy. The results of pregnancies did not differ in patients who were on medical treatment or not for prolactinomas and acromegaly during gestation. Neural tube defect and microcephaly associated with maternal cabergoline use; Down syndrome and corpus callosum agenesis associated with maternal bromocriptine use; unilateral congenital cataract, craniosynostosis and microcephaly associated with maternal acromegaly were detected for the first time. Conclusion Medical treatment can be safely done stopped in patients with prolactinoma and acromegaly when pregnancy is confirmed and reinstituted when necessary. Prospective studies may help to determine the effects of medical treatment during gestation on the mother and fetus.

PubMed ID: 28079463 Background: The pharmacokinetics and the pharmacodynamics of antidepressants show large inter-individual variations which result in unpredictable clinical responses. Aim: The aim of the study was to examine the effect of ABCB1 polymorphisms and the serum concentrations on the efficacy and tolerability of venlafaxine in patients with major depressive disorder (MDD). Methods: Fifty-two outpatients who met the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria for MDD were recruited for the study. The severity of depression was assessed using the 17-item Hamilton Rating Scale for Depression scale (HDRS17) and tolerability was assessed based on a query regarding side-effects for 6 weeks. The ABCB1 C3435T/A and G2677T/A polymorphisms were genotyped by PCR/RFLP and steady-state serum venlafaxine concentrations were measured by high-performance liquid chromatography. Results: Patients with the TT genotype for the C3435T and the TT/TA genotype for the G2677T/A polymorphism showed significantly higher frequencies in venlafaxine-induced akathisia. This relationship was not observed for efficacy. As regards serum venlafaxine concentrations, patient groups showed no significant differences in efficacy and tolerability. Conclusion: The results suggest that individuals with the TT-TT/TA genotypes for the C3435T-G2677T/A polymorphisms of ABCB1 may be pre-disposed to a risk of akathisia. This study was supported by grants from the Scientific Research Projects of Gaziosmanpasa University (Project No: 2007/36), Turkey. Publisher's Version

Aim: Total hip arthroplasty in patients with developmental dysplasia of the hip is challenging due to accompanying acetabular and femoral deformities, soft-tissue contractures and shortening of the affected limb. In addition, changed anatomy after pelvic and/or femoral osteotomies can also make the total hip arthroplasty procedure challenging. This study aimed to evaluate the effect of previous hip surgery on clinical and radiological outcomes after total hip arthroplasty in previously operated patients due to developmental dysplasia of the hip. Material and Methods: A total of 55 developmental dysplasia of the hip patients, twenty-five patients (29 hips) with a previous hip surgery (Group 1) and 30 patients (31 hips) without previous hip surgery (Group 2) were included. The primary outcome measures were major complication and revision rates. The secondary outcome measure was the Harris Hip Score.Results: Major complications were found significantly higher in group I (p = 0.009). However, no significant difference was observed between groups regarding revision rates (p = 0.514). No significant difference was observed between groups in the preoperative and the last follow-up Harris Hip scores.Conclusion: Although similar revision rates, patients with a previous hip surgery due to developmental dysplasia of the hip who underwent total hip arthroplasty are more prone to major complications than patients without previous hip surgery patients. Level of Evidence IV. Case-Control Study.

Recent studies have shown that adult human articular cartilage contains stem-like cells within the native structure. In this study, we aimed to determine the localization of putative stem cell markers such as CD90, STRO-1, OCT-3/4, CD105 and CD166 in adult human articular cartilage tissue sections and demonstrate the expression of these markers within the expanded surface zone colony-forming (CF) cells and evaluate their differentiation potential. Biopsy samples were either fixed immediately for immunohistochemical analyses or processed for in vitro cell culture. Immunohistochemical and flow cytometry analyses were performed by using CD90, STRO-1, OCT-3/4, CD105 and CD166 antibodies. Isolated colony-forming (CF) cells were further stimulated, by using the appropriate growth factors in their pellet culture, to obtain cartilage, bone and adipose lineages. We observed that the expression of the stem cell markers were in various zones of the human adult cartilage. Flow cytometry results showed that in CF cells the expression of CD90 and CD166 was high, while OCT-3/4 was low. We also determined that CF cells could be stimulated towards cartilage, bone and adipose lineages. The results of this research support the idea that the resident stem-like cells in adult human articular cartilage express these putative stem cell markers, but further experimental investigations are needed to determine the precise localization of these cells.

Apelin has been identified as an endogenous ligand of the orphan G-protein-coupled apelin receptor (APJR). These receptors are widely expressed in the central nervous system and periphery and play a role in the regulation of fluid and glucose homeostasis, feeding behavior, vessel formation, cell proliferation and immunity. We aimed to investigate whether water immersion and restraint stress have effects on apelin and APJR expression and apoptosis in heart tissue of male Wistar rats. The cardiac tissues were obtained from control, water immersion and restraint stress (WIRS) and apelin antagonist (F13A)+WIRS groups of rats and embedded in paraffin wax. Immunohistochemical staining methods were used to localize apelin, APJR and TUNEL immunopositive cells. H-SCORE was used for semi-quantitative determinations. Apelin protein levels were determined by Western blot in the cardiac tissues and plasma corticosteroid levels were measured by enzyme immunoassay (EIA). Apelin immunolocalization was found especially in endothelial cells and mast cells and faintly in cardiomyocytes, APJR immunostaining was shown in endothelial cells and cardiomyocytes, and TUNEL reaction was observed in endothelial cells and in some fibroblasts. Apelin expression was significantly increased in the WIRS and F13A+WIRS groups compared to the control group. The APJR reaction was similar in all groups. The number of TUNEL-positive cells was significantly higher in the F13A+WIRS group than that of the control group. Our study showed that WIRS for 6h increased plasma corticosterone levels and cardiac apelin expression in rats. The increased levels of apelin inhibited stress-induced apoptosis in heart. These results may be important for the therapeutic approach to a variety of stress-related heart disease.

Although modern contraceptive options are becoming more widely available, even in the developing world, women still use traditional contraceptive methods. Other reports of the use of non-medical devices for contraception and abortion are available. With this report, we discuss a patient seeking treatment for the removal of a traditional contraceptive intrauterine device.

Background: Resveratrol (RVT), one of the most commonly employed dietary polyphenol, is used in traditional Japanese and Chinese medicine for treatment of cardiovascular diseases. Recently, we have shown that RVT has a potent relaxant effect on rat corpus cavernosum via endothelium-dependent and -independent mechanisms. Objective: The present study addressed the question whether different types of potassium channels are involved in the endothelium-dependent and -independent mechanism of corpus cavernosum relaxation induced by RVT. Materials and Methods: Strips of corpus cavernosum from rats were mounted in an organ-bath system for isometric tension studies. Results: RVT (1-100 μmol/L) produced concentration-dependent relaxation responses in rat corpus cavernosum pre-contracted by phenylephrine. The non-selective potassium channels blocker tetraethylammonium chloride (TEA, 10 mmol/L), ATP-sensitive potassium (K ATP ) channels blocker glibenclamide (10 μmol/L), and inward rectifier potassium (Kir) channels inhibitor barium chloride (BaCl 2 , 30 μmol/L) caused a significant inhibition on the relaxation response to RVT, whereas voltage-dependent potassium channels inhibitor 4-aminopyridine (4-AP, 1 mmol/L), and large conductance calcium-activated potassium (BK Ca ) channels inhibitor iberiotoxin (IbTX, 0.1 μmol/L) did not significantly alter relaxant responses of corpus cavernosum strips to RVT. In addition, relaxant responses to RVT did not significantly inhibited by the combination of selective inhibitors of small and intermediate conductance BK Ca channels (0.1 μmol/L charybdotoxin and 1 μmol/L apamin, respectively). Conclusion: These results demonstrated that endothelial small and intermediate conductance BK Ca channels are not thought to be an important role in RVT-induced endothelium-dependent relaxation of corpus cavernosum. The endothelium-independent corpus cavernosum relaxation induced by RVT is seems to largely depend on Kir channels and K ATP channels in corporal tissue.