Establishment of a core outcome set for burn care research: development and international consensus

Objective: To develop a core outcome set for international burn research.Design: Development and international consensus, from April 2017 to November 2019.Methods: Candidate outcomes were identified from systematic reviews and stakeholder interviews. Through a Delphi survey, international clinicians, researchers, and UK patients prioritised outcomes. Anonymised feedback aimed to achieve consensus. Pre-defined criteria for retaining outcomes were agreed. A consensus meeting with voting was held to finalise the core outcome set.Results: Data source examination identified 1021 unique outcomes grouped into 88 candidate outcomes. Stakeholders in round 1 of the survey, included 668 health professionals from 77 countries (18% from low or low middle income countries) and 126 UK patients or carers. After round 1, one outcome was discarded, and 13 new outcomes added. After round 2, 69 items were discarded, leaving 31 outcomes for the consensus meeting. Outcome merging and voting, in two rounds, with prespecified thresholds agreed seven core outcomes: death, specified complications, ability to do daily tasks, wound healing, neuropathic pain and itch, psychological wellbeing, and return to school or work.Conclusions: This core outcome set caters for global burn research, and future trials are recommended to include measures of these outcomes

Majör yanıklı hastalarda erken dönem fizyoterapinin biyokimyasal parametreler üzerine etkisi: Bir yanık merkezi deneyimi | [The effects of early physiotherapy on biochemical parameters in major burn patients: A burn center's experience]

BACKGROUND: This study sets out to investigate the effects of early physiotherapy on biochemical parameters in major burn patients. METHODS: Ten women (50%) and 10 men (50%) aged 21-47 years old were included in this study. Participants were divided into two groups: the first group was the treatment group and the second group was the control group. In the treatment group, patients were admitted to the physiotherapy programme from the first day they have been hospitalised, in addition to their routine treatment (e.g. medical, surgery), for four days per week. The physiotherapy programme consisted of parameters, such as early mobilisation and ambulatory training, chest physiotherapy, and both active and passive normal joint movement exercises. The days of treatment were determined as of Tuesday, Wednesday, Thursday and Friday. Patients could not be treated on a Monday because that was surgery day. The control group consisted of patients who could not receive physiotherapy due to various reasons. All patients included in this study were evaluated weekly for six weeks after admission to the hospital. Parameters, such as demographic information, characteristics of burn injury, C-reactive protein, fibronectin, transferrin and prealbumin, were evaluated. RESULTS: When the results obtained in this study were considered, there was a significant difference in favour of the treatment group for all biochemical parameters (p<0.05). From the second week, a significant increase was observed in prealbumin values in the treatment group (p<0.05). A significant increase was observed in fibronectin after the fourth week (p<0.05). CONCLUSION: We believe that early physiotherapy should be included in the treatment in major burns. Early physiotherapy may reduce the effects of hypermetabolic response after major burns. There is a need for multi-centered and broader studies

Restoration of pull-out strength of the failed pedicle screw: biomechanical comparison of calcium sulfate vs polymethylmethacrylate augmentation

Objective: The aim of the present study was to compare calcium sulfate (CAS) and polymethylinethaaylate (PMMA) bone cements used for the augmentation of a failed pedicle screw with biomechanical pull-out strength (POS) testing. Methods: Thirty lumbar vertebrae were harvested from 6 calves and bone mineral densities (BMD) were measured. Primary polyaxial pedicle screws were randomly inserted and pulled out and the POSs of the specimen were recorded. For revision, specimens were randomly assigned to the CAS-augmented pedide screws group (Group 1) or PMMA-augmented pedicle screw group (Group 2). Pull-out tests were repeated to compare both groups. Results: Mean BMD of the specimens was 1.006 +/- 0.116 g/cm(2). There were no statistically significant differences between BMD results of the two groups (p=0.116). For Group 1, mean POS of primary screws was 2,441.3 +/- 936.4 N and was 2,499.5 +/- 1,425.1 N after CAS augmentation, demonstrating no statistically significant difference (p=0.865). In Group 2, mean POS of the primary screws was 2,876.6 +/- 926.6 N and significantly increased to 3,745.5 +/- 1,299.2 N after PMMA augmentation (p=0.047). There was also a significant difference in mean POS between the CAS and PMMA groups (p=0.026). Conclusion: Although CAS augmentation facilitates a revision screw POS as strong as that of primary screws, it is not as strong as PMMA augmentation

The effect of systemic isotretinoin on male fertility

Background/objective: Acne vulgaris is one of the most common diseases of the youth. Systemic isotretinoin is the only drug which acts on all of the etiopathogenic mechanisms of acne. Isotretinoin has some well-known side effects. Besides these, there is a suspicion whether it causes infertility or not. In this study, we aimed to evaluate the effects of systemic isotretinoin on male fertility.Methods: Eighty one male patients, who were older than 18 years of age, and had severe or refractory acne vulgaris were included in the study. They were given a total dose of 120 mg/kg of systemic isotretinoin over a period of six months. Before and after the study, the spermiogram parameters of the patients were evaluated to show any possible effect on male fertility. The patients' total testosterone, follicle stimulating hormone and luteinizing hormone levels were also evaluated.Results: All of the spermiogram parameters changed positively (p<0.05). There was no significant change in the hormone levels.Conclusion: Systemic isotretinoin has a positive effect on male fertility. Since the hormone levels did not change significantly, this positive effect of isotretinoin is not via the hypothalamic-pituitary-gonadal axis but can be due to its regenerative and proliferative effects on the testes

Aortic arch branches are occluded: Which artery nourishes the brain ?

Takayasu arteritis is an inflammatory vascular disease that primarily affects the aorta and its major branches. In this report, we present a 47-year-old woman whose aortic arch branches were totally occluded and the cerebral circulation is dependent on a dilated right vertebral artery

Maize seeds forecasting with hybrid directional and bi-directional long short-term memory models

The purity of the seeds is one of the important factors that increase the yield. For this reason, the classification of maize cultivars constitutes a significant problem. Within the scope of this study, six different classification models were designed to solve this problem. A special dataset was created to be used in the models designed for the study. The dataset contains a total of 14,469 images in four classes. Images belong to four different maize types, BT6470, CALIPOS, ES_ARMANDI, and HIVA, taken from the BIOTEK company. AlexNet and ResNet50 architectures, with the transfer learning method, were used in the models created for the image classification. In order to improve the classification success, LSTM (Directional Long Short-Term Memory) and BiLSTM (Bi-directional Long Short-Term Memory) algorithms and AlexNet and ResNet50 architectures were hybridized. As a result of the classifications, the highest classification success was obtained from the ResNet50+BiLSTM model with 98.10%