Efficacy of concentrated growth factor versus collagen membrane in reconstructive surgical therapy of peri-implantitis: 3-year results of a randomized clinical trial.

OBJECTIVES To compare the 3-year clinical and radiographic outcomes of two different reconstructive surgical management of peri-implantitis using a bone substitute in combination with either concentrated growth factor (CGF) or collagen membrane (CM). MATERIAL AND METHODS Fifty-one patients who had at least one implant presenting peri-implantitis with an intrabony defect were filled with a xenogenic bone grafting material and covered either CGF or CM. Clinical and radiographic assessments were carried out at baseline and postoperative years 1 and 3. Three different composite outcomes were defined to evaluate treatment success at a 3-year follow-up. The effects of possible prognostic indicators on treatment success were identified by using multilevel regression analysis. RESULTS The changes in probing depth (PD) and radiographic vertical defect depth (VDD) between baseline and year 1 and baseline and year 3 presented significantly greater decreases for the CM group in comparison with the CGF group (p < 0.05). No significant differences between the two treatment modalities were demonstrated regarding treatment success outcomes. History of periodontitis, VDD at baseline, and the number of intrabony defect walls revealed significant impacts on treatment success (p = 0.033; OR = 3.50, p = 0.039; OR = 0.975, and p = 0.024; OR = 7.0 and p = 0.019;OR = 6.0, respectively). CONCLUSIONS CM in combination with a bone substitute seems to have slightly better outcomes compared to the CGF membranes in reconstructive surgical therapy of peri-implantitis. The history of periodontitis, baseline VDD, and peri-implant bone defect configuration could be possible predictors influencing treatment success. TRIAL REGISTRATION ClinicalTrials.gov NCT04769609. CLINICAL RELEVANCE For the reconstruction of peri-implant bone defects, using a bone substitute in combination with a collagen membrane may show more favorable outcomes

Machine learning model to identify prognostic factors in glioblastoma: a SEER-based analysis

Purpose: Analyzing and interpreting large amounts of complex health care data are becoming more insufficient by traditional statistical approaches. However, analyzing Big Data (BD) by machine learning (ML) supports the storage, classification of patient information. Therefore, improves disease identification, treatment evaluation, surgical planning, and outcome prediction. The current study aims to create a competing risk model to identify prognostic factors in glioblastoma (GB). Materials and methods: The study included 31663 patients diagnosed with GB between 2007 and 2018. The data in the study were taken from the Surveillance, Epidemiology, and End Results (SEER) database. Overall survivals (OS), age, race, gender, primary site, laterality, surgery and tumor size at the time of diagnosis, vital status, and follow-up time (months) were selected for the analyzes. Results: The median OS of the patients was found to be 9.00±0.09 months. In addition, all variables in the table were statistically significant risk factors for survival except gender. Therefore, surgery, age, laterality, primary site, tumor size, race, gender variables were used as independent risk factors, and vital status was used as a dependent variable for ML analysis. Looking at the ML results, hybrid model gave the best results according to Accuracy, F-measure, and MCC performance criteria. According to hybrid model, which has the best performance, the diagnosis of alive/dead in 84 and 74 out of 100 patients can be interpreted as correct for 1- and 2-year, respectively. Conclusions: The model created by ML was 84.9% and 74.1% successful in predicting 1- and 2-year survival in GB patients, respectively. Recognition of the fundamental ideas will allow neurosurgeons to understand BD and help evaluate the extraordinary amount of data within the associated healthcare field

Fetal nuchal translucency: is there an association with birthweight and neonatal wellbeing?

Objective:To evaluate the relationship between nuchal translucency (NT) values with birthweight and the wellbeing of the newborn.Materials and Methods:This retrospective cohort study that included 508 patients made use of data on healthy full-term, singleton, live birth newborns in a university hospital between 2016 and 2018. The relationship between the NT multiple of the median (MoM) value and maternal body mass index, birthweight, sex, need for neonatal intensive care unit (NICU), and APGAR scores was evaluated. Similarly, the relationship between birthweight and NT MoM, and biochemical data in the first trimester was also evaluated.Results:There was a positive correlation between NT and birthweight (p<0.001). The need for NICU admission increased (p=0.001), and APGAR 1st minute scores decreased (p=0.001) with increasing NT, and APGAR 5th minute scores remained unchanged (p=0.057).Conclusion:The present study identified a positive correlation between first trimester NT and birthweight, and a negative correlation with the wellbeing of the neonate

An Optimal Uterine Closure Technique for Better Scar Healing and Avoiding Isthmocele in Cesarean Section: A Randomized Controlled Study

WOS: 000470582700001PubMed: 31070072Objective: The aim of this study is to compare the effects of two different uterine closure techniques, used during cesarean section (CS) operations on isthmocele formation. Material and Methods: This prospective, randomized, controlled study was performed on 138 patients in a university hospital between the dates December 2016 and August 2017. Uterine closures were performed using the double-layer, far-far-near-near (FFNN) unlocked technique, in the study group (n = 70) and using a single-layer continuous locked (SLL) technique in the control group (n = 68). The presence of isthmocele, residual myometrial thickness (RMT), postmenstrual spotting, dysmenorrhea, chronic pelvic pain and uterus position were evaluated in postoperative sixth month. Results: Isthmocele formation was less frequent and RMT was greater in the study group when compared to the control group (p < 0.001 and p < 0.001, respectively). Duration of operation, amount of blood loss and additional hemostatic suture requirement were not significantly different between the two groups (p = 0.221, p = 0.520 and p = 0.930, respectively). Postmenstrual spotting was less common in FFNN group, while the rates of chronic pelvic pain and dysmenorrhea were not significantly different between the groups (p = 0.002, p = 0.205 and p = 0.490, respectively). Conclusion: The findings of the present study demonstrate that uterine closure using the FFNN technique is beneficial in terms of providing protection from isthmocele formation and ensuring sufficient RMT. This method has the potential to become the optimal uterine closure technique, but the findings of the present study should be supported by large-scale studies in the future

Evalution Of the Patiens Oral Health Related Quality of Life After Harvesting Free Gingival Graft

Objectives: Oral Health Related Quality of Life is the individual's perception of how oral health affects the quality of life and general health. Periodontal plastic surgery procedures have been reported to negatively affect the quality of life of patients after the operations. The aim of this study was to evaluate the effects of different treatment procedures applied for wound healing of the donor palate site after free gingival graft (FGG) operations on the quality of life.Materials and Methods: After FGG harvesting, 60 patients’ palatal donor sites were randomly assigned one of the six groups, giving 10 participants per group. Palatal wounds were treated with platelet-rich fibrin (PRF), essix retainer, ozone therapy, low-level laser therapy (LLLT) or collagen fleece. As a control group, palatal donor sites were left to secondary healing without any of the treatment procedures. After the postoperative procedures, The Oral Health Impact Profile (OHIP-14) questions were asked to patients to evaluate their quality of life, whereas parameters in relation to postoperative morbidity were analyzed by using Visual Analogue Scale (VAS).Results: Regarding to the questions belonging Turkish version of OHIP-14 (OHIP-14 TR), there were statistically significant relationships between the group categorical variables and the categorical results of question 7 and 10 (p=0.002 and p=0.015). For these questions, the lowest scores were mostly given in the LLLT group. No statistically significant difference was observed between the study groups and total OHIP scores (TOHIP) and the means of 7 subscales of OHIP-14 (p&gt;0.05). Significant differences were found between PRF-ozone groups on the 5th day (p=0.011) for mean VAS scores exhibiting postoperative pain.Conclusions: It has been observed that applying LLLT procedures to the donor wound area following FGG operations may have positive effects on the quality of life and PRF treatments may be more effective in terms of patient comfort after operation

Experience of Fully Awake Craniotomy for Supratentorial Lesions: A Single Institution Study

AIM: To report and to discuss our experience of awake craniotomy for the treatment of supratentorial lesions. MATERIAL and METHODS: We included patients who underwent awake craniotomy for supratentorial tumors between 2007 and 2018. A bipolar stimulation probe was used for patients with eloquent area lesions. The demographic features, presenting symptoms, comorbidities, localization, histopathology, pre- and postoperative Karnofsky performance status, mean operation length, mean length of hospital stay, and intraoperative and postoperative complications were recorded. RESULTS: We included 250 patients (age, 53.5 ± 15.3 years; range, 15–90 years; 105 females and 145 males) mostly with metastasis (46%). The tumor resection rate was 90 ± 3.6%. Of 30 patients (12%) who experienced an increase in weakness, 26 experienced improvements within three days, and the remainder had permanent symptoms. Intraoperative and postoperative seizures occurred in three (1.2%) and seven (2.8%) patients, respectively, which were controlled by antiepileptic drugs. Dysphasia occurred intraoperatively in seven patients (2.8%) but improved in a month. The mean follow-up duration was 31.8 ± 11.9 months (range, 7–70 months). No mortality was seen during hospitalization. CONCLUSION: Awake procedures are a good option in supratentorial lesions to avoid the complications of general anesthesia for patients in poor medical condition. To obtain maximal tumor resection and to maintain better quality of life, neurosurgeons should opt for awake craniotomy when necessary. © 202

The relationship between the levels of anti-Mullerian hormone, vaspin, visfatin, and the patterns of nutrition and menstruation in non-polycystic ovary syndrome and non-obese young women

WOS: 000474747400016Purpose of Investigation: The aim of this study was to investigate the relationship between the levels of anti-Mullerian hormone (AMH), vaspin, visfatin, and the patterns of nutrition and menstruation in healthy non-polycystic ovary syndrome (PCOS) and non-obese young women. Materials and Methods: A total of 77 medical faculty students aged between 18 and 28 years were included in the study. Blood levels of AMH, vaspin, and visfatin of individuals were examined by the enzyme-linked immunosorbent assay (ELISA) method. Results: There was no statistically significant relationship between the AMH vaspin, and visfatin (p = 0.712), a statistically significant positive correlation was found between the vaspin and visfatin (p <0,001), There was no relationship of AMH, vaspin, and visfatin with age, body mass index (BNI), and anthropometric body measurements. The levels of vaspin and visfatin increased (P < 0.001 and p < 0.001, respectively), as the nutritional quality decreased, in the group with regular exercise. The AMH levels were lower in the smokers and also in the group with irregular menstrual cycle (p = 0.048 and p = 0.001, respectively). Conclusion: Based on the present study results, the authors conclude that there is an interactive relation among the reproductive system, adipose tissue, and daily life habits of young individuals

Is it possible to predict the side of hepatic metastases according to the primary location of colorectal cancer?

Purpose: The aim of this study was to investigate the impact of the primary location of colorectal adenocarcinoma on the lobar distribution of its hepatic metastases based on the streamline hypothesis. Material and methods: The hospital database was utilised to identify the colorectal cancer patients. Eighty-six patients diagnosed with colorectal adenocarcinoma, who had hepatic metastases on the initial diagnostic stage or on the follow-up investigations, were enrolled the study. Computed tomography (CT) images of the study population were reviewed for the primary location of the colorectal tumour, and the side and number of hepatic metastases. Results: A total of 481 metastases were counted on CT from 22 right-sided and 64 left-sided colon tumours. The ratio of right-to-left hemiliver involvement was 1.97 : 1 for whole study population. The right-to-left ratio was calculated as 1.55 : 1 for right colon tumours and 2.17 : 1 for left colon tumours (p = 0.106). In the subgroup analysis with unilobar metastatic patients, again there was no significant difference in terms of the colorectal tumours’ primary location (p = 0.325). Conclusions: The lobar distribution of hepatic metastases from colorectal adenocarcinoma may not be associated with the primary tumour localisatio

Applications of enhanced recovery after surgery protocols for unruptured anterior circulation aneurysms in tertiary-level healthcare institutions: a national study

OBJECTIVE Enhanced recovery after surgery (ERAS) protocols are standardized perioperative care that reduce patients' stress response during hospitalization and improve hospitalization time, complication rates, costs, and read-mission rates. This study aimed to investigate the application rate of protocols for elective craniotomy in the surgery of unruptured anterior circulation aneurysms (AnCAs) at tertiary-level healthcare (TLH) institutions in Turkiye and its effect on the outcomes of the patients.METHODS An electronic survey was sent to all Turkish TLH institutions (n = 127) between May and June 2023. The number of institutions participating in the survey was 38 (30%). The institutions were subdivided according to three main factors: institution type (university hospital [UH] vs training and research hospital [TRH]), annual case volume (low [= 20 aneurysms] vs high [> 20 aneurysms]), and institution accreditation status (accredited vs nonaccredited).RESULTS Overall, 55.3% (n = 21) of the institutions participating in the study were UHs. The rates of those that were accredited and had a high case volume were 55.3% (n = 21) and 31.6% (n = 12), respectively. It was determined that the accredited clinics applied preoperative protocols at a higher rate (p = 0.050), and the length of stay in the postoperative period was shorter in the clinics that used the intraoperative protocols (p = 0.014).CONCLUSIONS The length of stay in the postoperative period is lower in TLH institutions in Turkiye that highly imple-ment intraoperative protocols. Furthermore, this is the first study in the literature evaluating protocols for elective crani- otomy in unruptured AnCAs