Dobrava Hantavirus Infection Complicated by Panhypopituitarism, Istanbul, Turkey, 2010

We identified Dobrava-Belgrade virus infection in Turkey (from a strain related to hantavirus strains from nearby countries) in a patient who had severe symptoms leading to panhypopituitarism, but no known risk for hantavirus. Our findings emphasize the need for increased awareness of hantaviruses in the region and assessment of symptomatic persons without known risk factors for infection

Evaluation of Midterm Clinical Results of All inside Suture Technique in Meniscus Repair

Aim: The aim of this study was to evaluate the functional outcomes of arthroscopic all-inside meniscal repair at an average 5-year follow-up. Methods: Thirty-two patients (29 males 3 females; 19 right knees, 13 left knees), who underwent arthroscopic all-inside meniscal repair, were included in the study. Clinical examination and magnetic resonance imaging were the main diagnostic tools. The mean age of the patients was 28 years (23-41 years). ACL reconstruction was performed in the same session in 12 patients with meniscal injury associated with ACL tear. Preoperative and postoperative functional knee scores of the patients were assessed by modified Marshall functional knee scores in their last follow-up. Results: The mean follow-up period was 58 months (range 49- 81). Marshall knee scores in the last follow-up were found to be excellent in 23 patients, good - in 8 patients, and moderate in 1 patient. ACL reconstruction was performed in the same session in 12 patients with meniscal injury associated with ACL tear. A statistically significant functional improvement was detected in patients with meniscal repair after 5 years. Conclusion: This study showed that all-inside meniscal repair technique is an easy and reliable method for the treatment of meniscus tears. (The Medical Bulletin of Haseki 2015; 53:47-51

Diz çevresi deformiteleri tedavisinde Taylor spatial frame’in etkinliği

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Objective: The aim of this study was to determine whether the Taylor spatial frame (TSF) can precisely correct deformities around the knee and whether application of TSF is easy and safe for treatment of the deformities around the knee. Methods: This study included 50 retrospectively reviewed limbs of 37 patients (mean age: 23 years, range: 10 to 58 years) with deformity around the knee joint treated using the TSF. Thirty-three limbs had tibial and 17 femoral deformities. Preoperative standard anteroposterior, lateral radiographs and standing orthoroentgenographic measurements were taken for each patient. Mechanical axis deviation- (MAD), leg-length discrepancy (LLD) and lateral femoral distal angle (LDFA) and medial proximal tibial angle (MPTA) were measured from standing orthoroentgenographics. All measurements were repeated after external fixator removal. Results: The frame was applied for an average of 20.3 (range: 4 to 36) weeks. Mean follow-up time following removal of external fixator was 32 (range: 15 to 54) months. An effective and accurate correction was achieved in all cases. Solid bone consolidation was obtained in all but two cases which underwent bone grafting. Conclusion: Taylor spatial frame appears to be a safe and effective method for the gradual correction of the complex translational and rotational deformities around the knee.Amaç: Bu çalışmanın amacı Taylor spatial frame (TSF) ile diz çevresi deformitelerinin tamamen düzeltilip düzeltilemeyeceğini ve diz çevresi deformitelerinde TSF uygulamasının kolay ve güvenli bir tedavi şekli olup olmadığını belirlemekti. Çalışma planı: Diz eklemi çevresinde deformitesi olan ve TSF ile tedavi edilen 37 hastanın (ortalama yaş: 23, dağılım: 10-58) 50 alt ekstremitesi geriye dönük olarak değerlendirildi. Bu ekstremitelerin 33 tanesinde tibial, 17’sinde femoral deformiteler mevcuttu. Tüm hastalara operasyon öncesi standart ön-arka, lateral grafiler çekildi ve ayakta çekilen boy grafilerinde ölçümleri yapıldı. Ayakta çekilen boy grafilerinde mekanik aks sapması, bacak boyu eşitsizliği, lateral femoral distal açı (LFDA) ve medial proksimal tibial açı (MPTA) ölçümleri yapıldı. Tüm ölçümler eksternal fiksatör çıkarıldıktan sonra tekrarlandı. Bulgular: TSF ile geçirilen ortalama süre 20.3 (dağılım: 4-36) hafta idi. Eksternal fiksatörün çıkarılmasından sonraki ortalama takip süresi 32 (dağılım: 15-54) ay olarak bulundu. Tüm deformiteler TSF ile tam olarak tedavi edildi iki vaka dışındaki tüm olgularda konsolidasyon sağlandı; bu 2 olguda kemik greftine ihtiyaç duyuldu. Çıkarımlar: Sonuç olarak, diz çevresindeki translasyon ve rotasyon ile komplike olmuş büyük deformitelerde TSF’nin güvenli ve etkin bir tedavi yöntemi olduğunu düşünmekteyi

Comparison of the effects of various anticancer agents on intestinal anastomosis after intraperitoneal administration

WOS: 000081910200010PubMed: 10483749In this study, the effects of intraperitoneal 5-fluorouracil (5-FU), cisplatinum (Cis), adriamycin (Adr), and methotrexate (MTX) administration on rat intestinal anastomosis were compared. Cis and MTX led to significant weight loss in the first 5 days compared with the control group. Within 14 days all rats except the MTX group nearly reached their preoperative weight. No remarkable weight loss or systemic toxicity was observed among the 5-FU and Adr groups. The anastomosis bursting pressure (ABP) at 1 week was significantly lower than that of the control group (P < 0.01 and P < 0.005, respectively). On day 14 the anastomosis bursting pressure in the Cis group was similar to that of the control group but was significantly lower in the MTX group (P < 0.002). Histopathologically, MTX avoided the development of a mucosal layer at the anastomosis site and led to ulcer formation in some of the rats, The ABPs at 7 and 14 days were similar to those in the control group. Neither of the agents had any significant mechanical or histopathologic adverse effects on anastomosis, According to the results of our study, MTX impaired the healing of the anastomosis, and we thus conclude that the intraperitoneal administration of this agent is not safe. On the other hand, Cis showed a detrimental effect on the anastomosis, particularly in the early phase, but this effect disappeared in the late phase. Cis thus should not be administered in the early postoperative phase. As a result, 5-FU and Adr were found to be the safest agents as they did not delay wound healing and did not reduce the anastomotic strength

A nationwide survey on the impact of COVID-19 pandemic on minimal invasive surgery in urology practice

Objective: The beta-coronavirus (COVID-19) pandemic has changed the clinical approach of 93% of urologists worldwide, and this situation has affected the use of laparoscopic and robot-assisted laparoscopic methods, which are known as minimally invasive surgery (MIS). This study aimed to determine the effects of the COVID-19 pandemic on MIS in urology practice at national level. Design, setting and participants: A total of 234 urologists in Turkey participated in an online survey between August 22 and September 23, 2020. Outcome measurements and statistical analysis: Descriptive statistical analyses were conducted to determine the participants’ demographic characteristics and responses to multiple-choice questions. Results: While 54% of urologists stated that they were concerned about the possibility that the patients planned to undergo MIS were carrying COVID-19 or false-negative for the virus, 51% considered that open surgery was safer than MIS in this regard. The pandemic led to a difference in the preferences of 40% of the urologists in relation to open or MIS methods, and during the pandemic, 39% of the urologists always directed their patients to open surgery. It was determined that during the pandemic, there was a statistical decrease in the intensity and weekly application of MIS methods among all surgical procedures compared to the pre-pandemic (P <.001 and P <.001, respectively). MIS was preferred for oncological operations by 97.3% of the urologists during the pandemic, with the most performed operation being radical nephrectomy (90.7%). Among oncological operations, radical prostatectomy was most frequently postponed. To prevent virus transmission during MIS, 44% of the urologists reported that they always used an additional evacuation system and 52% took additional precautions. There were a total of 27 healthcare workers who took part in MIS and tested positive for COVID-19 after the operation. Conclusions: Although the number of operations has decreased during the ongoing pandemic, MIS is a method that can be preferred due to its limited contamination and mortality in urology practice provided that safety measures are taken and guideline recommendations are followed

Bosworth and modified Phemister techniques revisited. A comparison of intraarticular vs extraarticular fixation methods in the treatment of acute Rockwood type III acromioclavicular dislocations

Objective: The aim of this study was to compare the long-term clinical and radiological results of Acromioclavicular (AC) fixation with K-wires (the modified Phemister procedure) and Coracoclavicular (CC) fixation with the Bosworth screw in the surgical treatment of Type 3 AC joint dislocations. Methods: Thirty-two patients with complete set of medical records and who received surgical treatment between September 2005 and January 2009 due to acute Rockwood Type 3 AC joint dislocation and properly attended their follow-ups were retrospectively evaluated. Sixteen patients (13 males, 3 females; mean age: 38, range: 24–52 years) were treated with CC fixation with Bosworth screw (Group 1), and the other 16 (12 males, 4 females; mean age: 53.3, range: 38–64 years) with AC fixation using K-wires (Group 2). Results: The mean follow-up time was 96 months for Group 1 and 93 months for Group 2 patients (p > 0.05). The mean Constant–Murley score at the final follow-up was 84.7 in Group 1 and 87.3 in Group 2 (p = 0.069). Radiological evaluation of the patients revealed AC arthrosis in 2 and 3 patients in Group 1 and 2, respectively. In Group 2, one patient had a recurrent dislocation, three patients had AC arthrosis and two patients had ossification in the CC ligament (Fig. 2).There was no superficial or deep wound infection in Group 1, while two patients from Group 2 had a superficial wound infection. Conclusions: Our results suggest that both techniques are reliable and provide adequate reduction and similar outcomes in terms of functionality and pain levels, following the reduction of Type 3 AC joint dislocations. With lower rates of wound site infection in the early and AC arthrosis in the late postoperative period, CC fixation method with the Bosworth screw may be a better surgical option than AC fixation method with K-wires. Level of Evidence: Level III, Therapeutic study. Keywords: Acromioclavicular separation, Type 3 separation, Bosworth screw, Phemister procedur

The effects of indoor and outdoor sports participation and seasonal changes on vitamin D levels in athletes

Objective: Nowadays, people tend to spend more time in the closed areas and benefit less from sunlight. In this study, we examined the results of vitamin D measurements of athletes from different disciplines in different months and aimed to determine if the synthesis of vitamin D decreases or not according to exercise environment and month. Methods: The study was conducted in participants aged 5–52 years. A total of 555 elite-level sportsmen who were admitted to our Sports Medicine Clinic in the study participated in this study. Indoor and outdoor environmental and seasonal effects on the measurements in different months were statistically evaluated. Independent-samples test and definitive statistics were used for statistical analyses and a p-value less than 0.05 has been considered significant. Results: The study group consisted of 229 male and 326 female athletes. The serum 25-hydroxyvitamin D concentration was observed; 120 (21.6%) athletes have severe serum vitamin D deficiency (<11–20 ng/mL). Vitamin D levels were not significantly different from outdoor athletes (393; 70.8%). Winter measurements of vitamin D levels were significantly lower than those measured in autumn (p = 0.000). Conclusion: Increasing vitamin D levels are very important especially in participating athletes and additional supplements are recommended whenever necessary. Gender and indoor/outdoor sports participation showed no statistically significant outcomes on vitamin D levels. However, winter season had a negative effect on vitamin D levels. Therefore, adequate precautions should be taken to increase vitamin D, especially during winter, to maintain the best performance of the athletes