Determination of risk factors for instability in pediatric distal radius fractures

Aim: Distal radius fractures (DRF) are one of the most common injuries in childhood. DRF most commonly occurs as a result of low-energy falls onto an outstretched hand, resulting in axial loading of the metaphysodiaphyseal junction of skeletally immature long bones. One of the most common complications after the closed reduction and casting of displaced DRF is fracture relocation or loss of reduction. The aim of our study is to investigate the characteristics of these fractures by retrospectively scanning the patients who require surgical intervention in patients with distal radius fractures. Methods: Between January 2018 and January 2021, patients aged 1-16 years with a diagnosis of distal radius fracture who were treated in our hospital were included in this study. The preoperative X-rays of the patients were evaluated and the fractures were classified according to their displacement ratio. The reduction quality was rated according to the study of Alemdaroglu criteria. The distance of the fracture line to the joint line, the presence of ipsilateral ulna fracture, the angle of the fracture, and whether it was fragmented were determined. Patients with and without surgery were compared. Results: 206 patients who met the inclusion criteria were included in the study. A significant difference was found between the non-operated and operated groups in terms of age by Student's t-test (p=0.032). The distance from the fracture line of the surgical group to the joint line was measured to be 43.8 mm on average. A significant difference was found between the non-operated and operated groups in terms of the joint line distance of the fracture line by Student's t-test (p=0.010).  There was a significant difference between the groups according to the Alemdaroğlu criteria and Mania criteria (p=0.001). Conclusions: Our results show that complete displacement of distal radius fracture and non-anatomical reduction are important risk factors for re-displacement and therefore emerge as surgical indications in pediatric patients. Our study also emphasizes that surgical treatment may be required in older pediatric patients when the ulna fracture coexistence and the joint distance of the fracture line increases

Balloon asisted tracking technique in complex transradial access: A single center experience

Aim: The transradial technique (TRA) has become widely accepted for coronary catheterization. While TRA offers numerous benefits, certain anatomical challenges can lead to access failure. Balloon-assisted tracking (BAT) has emerged as a valuable technique to overcome these challenges and improve success rates. This study aims to evaluate the feasibility and efficacy of BAT during coronary interventions using TRA. Methods: A retrospective analysis was conducted on patients who underwent diagnostic or percutaneous coronary intervention (PCI) procedures between September 2020 and May 2023. Patient demographics, clinical data, and procedural information were collected for cases where BAT was employed to overcome radial or brachial arterial complexity. Results: A total of 23 patients encountered anatomical difficulties necessitating BAT during the procedure, both elective and acute coronary syndrome (ACS). Radial artery spasm was the most common indication for BAT, with a high proportion of female patients. Successful completion of coronary intervention using BAT, without the need for femoral artery crossover, was achieved in all cases except one. Also, the complexity of anatomy (such as tortuosity, arterial loop, or small artery crossing) was another reason for BAT use. The mean procedural time was 47.9 minutes, and no complications related to the access site were observed. Conclusions: The findings demonstrate that BAT is a safe and effective technique for overcoming complex radial artery anatomical challenges and radial spasm during TRA. The study supports the adoption of BAT in TRA procedures and highlights its potential benefits in both elective and ACS cases

A preliminary study of the anti-proliferative effect of Aronia Melanocarpa extract on human colon cancer cells and its relation with human TERT protein

Aim: Aronia melanocarpa is a fruit exhibiting antioxidant, anti-inflammatory, antidiabetic, hypolipidemic, and anticarcinogenic properties. Telomerase is a critical factor in the development of colon cancer, and it is being looked at as a target for cancer treatments. In the present study, we aimed to examine the potential effect of Aronia melanocarpa extract on cell viability and protein concentration of the human telomerase reverse transcriptase (hTERT) in the human colon cancer cell line (HT-29) and the non-tumorigenic human umbilical vein endothelial cell line (HUVEC). Methods: Cell lines were treated with different concentrations of Aronia extract (50-750 μg/ml) for 48 h. The cytotoxic activity of Aronia extract was determined using the MTT assay. hTERT protein concentration (pg/ml) was measured using a sandwich ELISA. Results: The MTT assay test showed that Aronia extract induces 50% cell death (IC50) at a concentration of 186 μg/mL at 48 h post-treatment in the HT-29 cell line. Cytotoxicity results showed a dose-dependent decrease in cell viability in the HT-29 cell line. However, increasing Aronia extract concentrations showed no similar effect on the HUVEC cell line. The hTERT protein concentration in HT-29 cells was 1.9-fold higher than that of HUVEC cells. Increasing concentrations of Aronia extract was linked with a significant decrease in hTERT protein level in HT-29 cells, whereas the hTERT protein concentration in HUVEC cells did not change significantly. Conclusions: Our results suggest that A. melanocarpa may be a potential therapeutic agent for anticarcinogenic activity. Also, the anti-proliferative effects of Aronia extract may be attributed, at least partly, to the decreased hTERT protein level of HT-29 cells.&nbsp

Serum acidic mammalian kinase as a new laboratory test to define subclinical inflammation in Familial Mediterranean fever: Serum CHIA levels of Familial Mediterranean fever patients

Aim: To investigate the relationship between acidic mammalian chitinase (CHIA) level and autoinflammatory diseases, especially in Familial Mediterranean fever. Methods: We first analyzed CHIA expression, methylation in various autoinflammatory diseases, including, SLE (Systemic Lupus Erythematosus), RA (Rheumatoid Arthritis), SJS (Stevens-Johnson syndrome), SSc (Systemic Sclerosis) and T1D (Type 1 diabetes) patients, case-control and correlation between the MEFV and CHIA genes by using bioinformatics tools. We then measured serum CHIA level in ninety individuals; thirty FMF attacks, thirty FMF remissions and thirty healthy control groups. Statistical analysis was used to evaluate the interaction between clinical parameters and serum CHIA level. The potential of serum CHIA level was tested using AUC and ROC analysis. Results: According to our ADEx analysis, we observed high CHIA expression in SLE, RA and T1D patients than in the control group. Moreover, we detected that the methylation level decreased in each disease, especially in the cg17143643 and cg7497781 probes. We also observed a correlation between MEFV and CHIA in these autoinflammatory diseases. According to our ELISA results, we also showed an increased CHIA level in FMF attack and remission as compared to the control group in serum (p <0.001, p =0.007; resp). We further observed a relationship between CHIA level and patients with amyloidosis, attack per month, and neutrophil and WBC levels.  Conclusion: Our primary data suggest that CHIA is related to FMF pathogenesis and can be followed in the subclinical period of the disease

Why the first pregnancy results with ectopic location? A retrospective analysis to identify the potential risk factors

Aim: To identify potential risk factors associated with ectopic pregnancy (EP) in healthy primigravid women. Methods: This retrospective study was conducted at a tertiary research hospital, involving primigravid patients diagnosed with EP between 2016 and 2023. The control group comprised primigravid women with healthy term birth (HB). Demographic parameters, including age, body mass index (BMI), fertility status, menstrual pattern, systemic disease presence, surgical history, previous pelvic infection were documented and compared between two groups. Correlation and regression analyses were performed to determine significant factors linked to EP. Results: A total of fifty primigravid women had EP, while the control group included fifty with HB. Women with EP had a significantly higher mean age compared to those with HB (26.5 ±5.2 vs. 21.5 ±2.3, p<0.01). The mean BMI was lower in women with EP compared to those with HB (23.8 ±4.1 vs. 25.9 ±2.5, p<0.01). Irregular menstrual patterns were more prevalent in the EP group than the HB group (28% vs. 12%, p=0.04). The EP group had a higher rate of previous abdominal surgery (8% vs. 2%, p=0.04). The regression analysis indicated that older age and lower BMI were significant risk factors associated with the presence of ectopic pregnancy. Conclusions: EP poses a distressing situation for couples, and predicting the risk of such pregnancies remains challenging. This study highlights that higher age and lower BMI are primary risk factors for ectopic pregnancy in primigravid women

The relationship between the personality traits with COVID-19 in intensive care professionals: A cross-sectional study

Aim: To investigate the relationship between personality traits and COVID-19 in intensive care professionals. In addition, demographic, occupational, institutional data, symptoms and characteristics related to COVID-19 are evaluated. Methods: We conducted a multicenter, cross-sectional study with 218 intensive care professionals who had and did not have COVID-19 infection from June 2020 to September 2020. The study population consisted of physicians, nurses, and allied health personnel working in intensive care units in Turkey. The data were collected through an online questionnaire including demographics, occupations and institutions, Personality Belief Questionnaire (PBQ) scores, symptoms, and characteristics related to COVID-19 disease. Results: This study showed that intensive care professionals who were younger, single, and had asthma experienced a much higher risk of COVID-19 compared to those who did not have COVID-19. Intensive care professionals who were physicians experienced a much higher risk of infection than nurses. Among these intensive care professionals having COVID-19 disease, the personality traits questionnaire showed that COVID-19 positivity resulted in dependent, antisocial, and borderline personalities. Among the intensive care professionals with COVID-19 disease, the nurses had a significantly higher risk of fever and chest pain. Conclusions: The present study reveals a higher prevalence of dependent, antisocial, and borderline personality traits among intensive care professionals who tested positive for COVID-19. Regarding personnel, better exploration of these factors could contribute to more effectively adapting to and combating the challenges of future public health crises

Comparison of cases with and without carpal tunnel release in volar plate fixation of AO type 23-B and 23-C fractures

Aim: To compare the functional results and the frequency of carpal tunnel syndrome between patients who underwent Open reduction internal fixation(ORIF)+carpal tunnel release(CTR) and those who underwent isolated open reduction internal fixation in AO 23 B and C type fractures. Methods: Patients with AO Type 23-B1, 23-B2, 23-B3, 23-C1, 23-C2, and 23-C3 fractures who underwent ORIF were included in the study. The patients who underwent ORIF were divided into two groups: those who underwent CTR and those who did not. The patients’ VAS scores and Patient-Rated Wrist Evaluation (PRWE) scores were evaluated on postoperative day 1,  month one,  month three,  month six, and month twelve. Results: Eighty-two patients were included in the study. ORIF+CTR was performed in 46 patients, and isolated ORIF was performed in 36 patients. CTS symptoms were observed in 6 patients in the group that only underwent ORIF at postoperative three months. At the 6-month control EMG, CTS was detected in 5 out of 6 patients where only ORIF was performed. Conclusion: Concomitant CTR during ORIF in AO type 23B and 23C fractures is an effective surgical treatment procedure in preventing the development of CTS. &nbsp

It isn't over ‘till it’s over: A continuing concern of the SARS-CoV-2 variants, and miRNAs targeting the S protein as a probable absolute cure

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak which still continues to affect the general population, has mutated day by day and new variants have emerged. More than 40 variants, usually caused by mutations in the spike (S) protein, have been recorded. Observation of S protein mutations in the development of t herapeutic agents will increase success rates. As we identify the three-dimensional (3D) conformation of viruses, it is more and more possible to work on models for understanding molecular interactions. Development of agents for arrays and 3D sequencing of proteins paves the way for potential therapeutic studies against variants. MicroRNAs (miRNAs) seemingly act as a potentially important group of biomolecules in combating uncontrolled cytokine release. Besides antiviral response, miRNAs promise to be  powerful therapeutic agents against infections. Studies have shown that miRNAs are able to inhibit the genome directly by miRNA-based treatments as they are sprecific to the SARS-CoV-2 genome. In order to expose this potential, in silico studies before continuing with lab studies are helpful. In our bioinformatics analysis, we proposed to compare the S protein similarities of Delta and Omicron, two of the most common variants, and to detect miRNAs targeting the S protein. The S proteins and coding sequences were compared between the two variants, and differences were determined. Within our analysis, 105 and 109 miRNAs for the Delta and Omicron variants, respectively, were detected. We believe that our study will be a potential guide for deciding on the miRNAs that may most likely have an effect on the management of the infection caused by both variants

Comparison of alpha/beta T cell depletion with posttransplant cyclophosphamide in haploidentical transplantation

Aim: To compare alpha/beta T-cell depletion with posttransplant Cyclophosphamide (PTCy) in haploidentical allogeneic transplantation in adult hematological patients, this is the first study. Method: In our study, we reported 36 haploidentical allogeneic stem cell transplants which were performed in our clinic. Results: Twenty-six of these haploidentical transplants received standard treatment and transplanted either with PTCy (n=21, 81%) or with alpha/beta T-cell depletion (n=5, 19%). Less CD34+ stem cells were administered in the T-cell depletion group. When the two groups were compared in terms of survival, no difference was found in relapse-free and overall survival in each group. Acute GVHD cases developed in the PTCy group mostly developed after CMV infection, whereas acute GVHD did not develop in the T-cell depletion group. In the PTCy group, 8 cases developed graft failure and relapse; 4 cases developed graft failure or relapse in the T-cell depletion group, and 2 of them developed graft failure or relapse following EBV infection and 1 of them following CMV infection. Conclusion: We have a small number of patients in the T cell depletion group. Due to our long follow-up period, we believe that our patients with T cell depletion can be compared with those who underwent PTCy, and similar survival results can be achieved in adult patients having hematologic malignancies

Histopathological effects on kidney of diclofenac potassium and diazepam used in an experimental epilepsy model

Aim: To investigate the effects of diazepam, which has anticonvulsant and anxiolytic effects, and diclofenac potassium, which has anti-inflammatory, analgesic and antipyretic effects, on rat kidney tissue, used in an experimental epilepsy model. Methods: 32 Wistar albino rats (2-4 months old, 200-250 gr) were used in the study. The rats were grouped in four as 8 rats in each group: Epilepsy, Epilepsy + Diazepam, Epilepsy + Diclofenac potassium, Epilepsy + Diazepam + Diclofenac potassium. Epileptic seizure model was created with penicillin (500.000 IU) injected intracortically under urethane anesthesia. 30 minutes later, diazepam (0.1 mg/kg) and diclofenac potassium (10 mg/kg) were administered intraperitoneally. At the end of the study, rat kidneys were removed and evaluated histopathologically in terms of inflammation, glomerular shrinkage, tubular dilatation, tubular epithelial thinning, desquame epithelium, brush epithelial loss, vacuolization, hemorrhage and congestion. Results: No difference was found between diazepam and diclofenac potassium in terms of vacuolization, glomerular shrinkage, tubular dilatation and hemorrhage. Inflammation, congestion and tubular epithelial thinning rate were found to be lower inEpilepsy + Diclofenac potassium and Epilepsy + Diazepam + Diclofenac potassium group when compared with Epilepsy + Diazepam group. While brush epithelial loss and desquame epithelial rate was found to be lowest in the epilepsy group, these parameters were not found to show a significant difference between drug groups. Conclusion: It was concluded that combined use of diazepam and diclofenac potassium in their effects on kidney are more useful than their single use