Search

Abstract Study design Retrospective case series. Objectives We aimed to describe with a novel surgical approach for the removal of posterior thoracolumbar implant in patients with symptomatic failure of the implant and present our preliminary results with this method. Methods This retrospective, single-center study was performed in the neurosurgery department of a university hospital. Data were gathered from the medical files of 314 patients (243 women, 77.39%; 71 men, 22.61%) with symptomatic thoracolumbar implant failure that underwent implant removal operation using our novel technique between 2010 and 2020. Symptoms, radiological findings, intraoperative findings as well as clinical outcomes were evaluated. Results In our series, the average age was 46.5 years (range: 21–84) with a mean follow-up duration of 7 years (range: 3 months to 10 years). Preoperatively, the most common symptoms were leg pain and numbness of the lower extremity. Postoperatively, no major complications were noted. Clinical progression of symptoms was avoided by surgery in all patients, while we came across removal difficulties due to screw–screwdriver mismatch in 15 of 314 surgeries (4.78%). Our novel approach allowed successful screw removal including these challenging cases. Conclusions We suggest that our novel approach is a practical and effective for the removal of posterior thoracolumbar implant in cases with symptomatic failure attributed to screw–screwdriver mismatch. Further trials are warranted to assess the efficacy of this technique to overcome surgical problems associated with screw removal.

Amaç: Bu çalışmanın temel amacı motorlu kuryelerde çalışma koşullarının iş tatmini ve işten ayrılma niyeti üzerindeki etkisini tespit etmektir. Yöntem: Araştırma amacına ulaşmak için toplam 266 katılımcıdan veri toplanmıştır. Çalışmada farklı değişkenler arasındaki ilişkileri araştırmak için korelasyon ve regresyon analizi tekniklerinden yararlanılmıştır. Bulgular: Toplanan verilerin analizi önemli bilgiler ortaya çıkarmıştır. Özellikle, sonuçlar çalışma koşulları ile iş tatmini arasında anlamlı ve pozitif yönlü bir ilişki olduğunu göstermektedir. Ayrıca bu araştırma, çalışma koşulları ile işten ayrılma niyeti arasında negatif ve istatistiksel olarak anlamlı bir ilişki olduğunu ortaya çıkarmıştır. Sonuç: Araştırma bulgularına göre çalışma koşullarının iyileştirilmesi motorlu kuryelerin iş tatminlerinin yükseltmekte, işten ayrılma niyetlerini azaltmaktadır. Bu sonuç örgüt yöneticilerinin çalışma koşullarına dikkat etmesi gerektiğini göstermektedir.

In this study, the effect of exports on capital structure decisions was investigated at the firm level. Annual data of 208 companies exporting in Turkey for the period 2005-2019 were used. Leverage was used as the dependent variable, and export intensity was used as the primary independent variable. In addition, asset structure, cash flow, firm size variables were added as control variables in the study. The current ratio, real effective exchange rate, and real gross domestic product variables are added to test the estimation results of the model. Panel data regression analysis was applied. According to the analysis results, a positive relationship was found between export intensity and leverage, but this relationship is statistically insignificant. A positive and statistically significant association was found between asset structure and firm size and leverage. A negative relationship was found between cash flow and leverage. There is a negative relationship between the current ratio and the leverage and there is a negative relationship between the real effective exchange rate and leverage. Additionally, gross domestic product negatively affects the leverage, but this relationship is statistically insignificant.

Objective:The relevance of Tp-e, QT dispersion and the ratios between these two as predictive variables of ventricular arrhythmias, particularly ventricular prematurity depolarization and sudden cardiac death, were assessed in this study of patients who were identified with small heart syndrome.Method:The study included 94 female patients, as 47 small-heart and 47 normal-heart patients, by calculating their cardiothoracic ratios. We measured QTmax, QTmin, QRS, JT and Tp-e intervals, Tp-e/QTmax, Tp-e/QTcmax, Tp-e/JT and Tp-e/JTc rates and estimated QTcmax, QTcmin, cQTd and JTc intervals.Results:cQTd, Tp-e, Tp-e/QTcmax, and Tp-e/JTc values were significantly higher in the small heart patient group. QTcmin and QTcmin values were significantly lower.Conclusion:Tp-e and QT dispersion values are important markers in patients with small heart syndrome in terms of predicting ventricular repolarization and a possible ventricular arrhythmia.

Purpose. We aimed to evaluate the demographic and clinical features of patients with cervical spinal injuries secondary to shallow-water diving and share our therapeutic outcomes. Methods. A retrospective study was carried out using data extracted from the medical files of 39 patients (3 females and 36 males) who were treated surgically (n = 29) or conservatively (n = 10). Demographics, clinical features, operative data, American Spine Injury Association (ASIA) impairment scales, and Karnofsky Performance Status (KPS) results were noted. Results. The average age of our series (n = 39) was 31.59 ± 14.80 (range, 14 to 92) years. The vast majority of patients (n = 34, 87.2%) presented with isolated cervical trauma. At initial admission, neurological deficits were diagnosed in 22 (56.4%) patients. A single-level cervical involvement was noted in 18 (46.2%) patients, while 21 cases (53.8%) displayed injury involving multiple levels. The levels of cervical injury were C5 (n = 16, 41%), C6 (n = 11, 28.2%), C7 (n = 6, 15.4%), C1 (n = 5, 12.8%), and C4 (n = 1, 2.6%). A total of 22 patients had neurological deficits at admission. Surgery was performed using anterior (n = 21, 72.4%), posterior (n = 7, 24.1%), and combined anterior and posterior (n = 1, 3.4%) routes. Nine patients (23.1%) exhibited improvement in their neurological deficits. There were significant improvements in both the ASIA impairment scale and KPS results after treatment. Conclusion. Our data indicated that dive- or fall-related cervical spinal injuries are associated with profound morbidity. Reinforcement of primary prevention, identification of target population, and increased awareness on this topic are the key steps to minimize the frequency and severity of complications and to optimize therapeutic outcomes.

Amaç: Bu araştırmanın amacı, firmaların stratejik seçimlerinin belirlenerek, bu seçime etki eden içsel ve dışsal faktörlerin neler olduğunun ortaya çıkarılmasıdır.Yöntem: Araştırma, Türkiye’ de faaliyet gösteren tuğla ve kiremit sektörü üzerinde gerçekleştirilmiştir. Araştırma farklı ölçek, üretim sistemi ve ürünlere sahip olan toplam 14 firmanın sahip, ortak ve üst düzey yöneticileri ile yapılan mülakatlar ve ikincil veriler toplanarak gerçekleştirilmiştir. Araştırmanın analizinde nitel yöntemler kullanılmıştır. Öncelikle katılımcı firmalar, takip ettikleri Miles ve Snow Tipolojisi ekseninde rekabet stratejilerine göre sınıflandırılmıştır. Daha sonra firmaların strateji seçimlerine etki eden faktörler ortaya çıkartılmıştır. Bulgular: Araştırma neticesinde katılımcı firmalar arasında Miles ve Snow tipolojisine göre yapılan sınıflandırmada tepkici, analizci ve savunmacı olmak üzere üç farklı strateji tipi ortaya çıkmıştır. Atılgan stratejiyi takip eden firma olmadığı görülmüştür. İşletmelerin seçimlerine etki eden temel faktörler ise; hammadde, üretim sistemi, işletmenin sahip olduğu kaynaklar, ilişkili sektörler, coğrafik konum, rekabet ortamı, ikame ürünler olarak belirlenmiştir. Sonuç: Araştırmaya katılan firmaların stratejik yönelimlerinin çoğunlukla tepkici olduğu belirlenmiştir. Sektörde ön plana çıkan firmaların ise analizci ve savunmacı stratejiyi takip ettiği tespit edilmiştir. İşletmelerin stratejik kararlarının altında yatan nedenlerin dışsal faktörlerden daha ziyade içsel faktörler olduğu tespit edilmiştir. Analizci ve savunmacı firmaların tepkici firmalara nazaran daha üstün kaynaklara sahip oldukları belirlenmiştir. Çalışmanın sonunda ise gerek uygulamaya gerek araştırmacılara yönelik öneriler geliştirilmiştir.

The relationship between glycaemic control and coronary artery disease (CAD) in type 2 diabetes mellitus (T2DM) is controversial. In the current cross-sectional study, we addressed the relationship between Hemoglobin A1c (HbA1c) values and the need for revascularization among diabetic patients undergoing coronary angiography. A total of 301 consecutive patients with known T2DM (age 61.8±10.1 years, 46.2 % women) requiring coronary angiography due to CAD symptoms were included. T2DM patients were categorized into two groups based on their HbA1c values: 93 (30.9%) diabetics with good glycaemic control (HbA1c≤7 %), and 208 (69.1%) diabetics with poor glycaemic control(HbA1c>7 %). A total of 123 patients (40.9%) required revascularization. The revascularization rate was 28.0% among T2DM patients with good glycaemic control and 46.6% among T2DM patients with poor glycaemic control, respectively (p=0.002). In a logistic regression analysis, the need for revascularization was predicted by poor glycaemic control (Odds Ratio [OR] 2.26, 95% Confidence Interval [CI] 1.32-3.82; p=0.003) adjusted for age, gender, Body-Mass-Index and diabetes duration. Moreover, there was a linear relationship between HbA1c values and number of affected coronary arteries (r= 0.169; p=0.003). Our data suggest that there is a close association between poorglycaemic control and increased revascularization rate in T2DM, which should be considered in primary and secondary prevention models.

In the molecular structure of the title hydrazide derivative, C27H24ClN3OS, the acetohydrazide group is approximately planar, with a maximum deviation of 0.017 (3) Å. The dihedral angle between the naphthylene system and the phenyl ring is 78.91 (18)°. The crystal structure is stabilized by one weak intermolecular C—H...O hydrogen bond and two aliphatic C—H...π hydrogen-bonding associations.

The molecular conformation of the title compound, C25H27ClN4OS, is stabilized by an intramolecular benzylidine C—H...Nthiazole hydrogen bond. The thiazole ring makes dihedral angles of 12.0 (3) and 20.4 (2)°, respectively, with the phenyl and benzene rings, while the phenyl and benzene rings make a dihedral angle of 22.6 (2)°. The crystal packing involves weak intermolecular thiazole C—H...Ocarbonyl and methyl C—H...π hydrogen-bonding associations.

Creating decent work is among the priority issues for sustainable employment and development. This study aimed to determine the effect levels of the International Labour Organization (ILO) decent work criteria by augmenting nine indicators in the ILO manual to 12 criteria through a comprehensive literature review. Fuzzy DEMATEL, a multi-criteria decision-making method, has been preferred in this context. According to the analysis results of the study, the most heavily ranked criteria are 'healthy workplace environment', 'decent working hours' and 'safe working conditions' respectively, which contribute to the decent work concept. Further, 'balance between work-family-personal life' has been found the most affected criterion, while 'education and training system' has been the most affecting. Based on the findings, remedial and developing strategies are suggested on issues such as corporate culture, working hours regulation, safe working environment, subordinate-superior relations, social activities and regulations that take family life into account.

Background: Ischemia-reperfusion injury (IRI) is a phenomenon that affects transplant survival. The aim of our study was to examine the effects of IRI in isogenic and allogeneic muscle and skin transplantation models exposed to prolonged warm ischemia., Methods: Forty-eight Lewis rats and 16 Brown-Norway rats were used to create four groups: Isogenic Inguinal Flap Transplantation (IST), Isogenic Gastrocnemius Muscle Flap Transplantation (IMT), Allogeneic Inguinal Flap Transplantation (AST), and Allogeneic Gastrocnemius Muscle Flap Transplantation (AMT). Malonyldialdehyde (MDA) and superoxide dismutase (SOD) levels were measured on postoperative days 1, 7, 21, 35, 63, 100, and 120 in all groups. Donor-specific chimerism (DSC) in peripheral blood was evaluated in the allogeneic groups on postoperative days 7, 21, 35, 63, 100, and 120. The microRNA-21 and microRNA-205 levels were evaluated on postoperative days 1, 7, and 120 in all groups. At the end of the study, a histopathological examination was performed., Results: A statistically significant difference was found between the groups in terms of MDA and SOD levels. DSC was detected in the AMT group. A significant increase in microRNA-205 was observed, especially in the AMT group. There was no significant difference in the number of functional muscle units between the muscle transplantation groups., Conclusion: The presence of DSC in the AMT group and the lack of a significant difference in the number of functional muscle units in the IMT and AMT groups are noteworthy findings.

Infection and septic complications in burn patients can be monitored by procalcitonin (PCT) and neopterin plasma values. The aim of the study was to investigate serum neopterin and PCT levels with WBC (white blood cell) and CRP (C-reactive protein) levels in patient group (PG) and healthy control group (HCG) and to investigate the relationship of these markers with burn wound infections (BWI). As the PG, 23 patients between 0-12 ages and up to 30% Total Body Surface Area (TBSA) burned and 15 HCG were included. PCT, neopterin, WBC, and CRP results on the first, the seventh, the fourteenth and the 21st day have been compared. During the follow-up period, 11 patients with BWI and 12 patients without BWI were classified as infected and non-infected patients, respectively. PCT and neopterin levels were detected higher in patients with BWI but no significant difference were present. Also, PCT and neopterin levels within the first 24 hours following the burn were detected higher in PG than HCG. CRP and WBC levels were detected high due to burn trauma. PCT and neopterin levels were increased in patients with BWI. PCT levels were increased during the pre-infectious period, while neopterin levels increased during the post-infectious period.

Obesity which developes due to multifactorial reasons, was associated recently with human Adenovirus-36 (Ad-36). The aim of this study was to investigate the prevalence of Ad-36 antibodies in obese adults and also to investigate the DNA of Ad-36 in their adipose tissue. In this cross-sectional and case-control based study, 49 obese adults, with BMI ≥ 30 kg/m(2), and 49 non-obese adults, with BMI ≤ 25 kg/m(2), applied for esthetic purposes and were included in this study as patient and control groups, respectively. Adipose tissue samples, obtained by the lipoaspiration method, were studied by single-step PCR and nested-PCR methods. Simultaneously, the presence of Ad-36 antibodies and serum leptin and adiponectin levels were assessed by serum neutralization assay (SNA) and ELISA, respectively. Serum samples which didn't cause a cytopathic effect at ≥ 1:8 were accepted as positive. Ad-36 antibody was detected in 6 (12.2%) of 49 patients by SNA and was statistically significant (p < 0.05). Ad-36 DNA was not detected in any of the adipose tissue samples of the patient or control groups. Mean BMI and leptin levels were higher in the Ad-36-positive group, while adiponectin levels were found to be lower in the Ad-36-positive group. Although no statistically significant difference was found in cholesterol and triglyceride levels between the two groups (p > 0.05), lower mean serum cholesterol and triglyceride levels were found in the Ad-36-positive patients. In conclusion, we couldn't detect Ad-36 DNA in adipose tissue; however, we detected significantly higher Ad-36 antibody levels in the obese group compared to the non-obese group, according to the both univariant and multivariant analyses, suggesting that Ad-36 may play a role in obesity. There is a need for new and extended serial, particularly cohort and human-based, studies in order to have a clear understanding of the Ad-36-obesity relationship., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Although the free-nipple breast-reduction technique is essentially an amputation, achieving aesthetic results still is important. The authors present their technique for free nipple-areola complex (NAC) transfer over the superomedial or superior pedicle full-thickness flaps in patients for whom a free-nipple technique is inevitable due to certain risk factors., Methods: The study included 25 patients who underwent surgery with the aforementioned method for addressing severe gigantomastia. The patients had a mean age of 43 years (range 34-59 years) and a mean body mass index (BMI) of 35.8 kg/m(2) (range 28-42 kg/m(2)). During the operation, the NAC was elevated as a full-thickness skin graft, then transposed to the superior or superomedial pedicles, which had been planned previously. The subsequent stages of the operation thus became a Wise-pattern breast reduction., Results: The mean resection per breast was 1,815 g (range 1,620-2,410 g). Breast projection, shape, and areolar pigmentation were assessed during the follow-up visit. One patient experienced a partial loss of the NAC graft, which healed secondarily, and three patients experienced a patchy hypopigmentation of the NAC. Breast projection and conical structure were observed to be preserved during the follow-up period., Conclusions: The modified free-nipple technique aimed to convert the reduction procedure to a technique similar to pedicle methods, yielding successful results during the early phases. The full-thickness flap constructed in this way provides more fullness and a maximum contribution to projection in patients who will inevitably undergo breast reduction with the free-nipple method., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Rhinoplasty is one of the most challenging procedures to master in plastic surgery. A successful outcome almost always requires a detailed preoperative analysis. However, intraoperative assessment should not be underestimated as well. To give a rough idea about the changing positions of the basic landmarks of the nose, we would like to demonstrate the "3-point suture determination" test. With this simple method, surgeons might estimate the instant effects of certain maneuvers during surgery.

Hydatid cyst is a zoonotic infection caused by Echinococcus granulosus. Majorly affected body regions are the liver and the lungs. However, rare localizations of the neck region, mastoids, parotid glands, orbita, and the mandible have been reported in literature. In this case, we report a large hydatid cyst of the maxillozygomatic region presenting as a slowly growing mass.