Concomitantly intra-articular fracture of proximal condylar second and third proximal phalanges: A rare case report

AbstractIntroductionA rare case of proximal phalange fractures has been presented in this study.Presentation of caseA 29-year-old male patient from Turkey was admitted to the orthopedics and traumatology clinic with a complaint of left hand pain, which had persisted for 10days. He described a rotational trauma that had occurred right after hitting his hand on the wheel of a car as a result of an in-car traffic accident 10days ago. Radiological work-ups were requested. In the anteroposterior (AP) graph of the case in which the fracture line could not be observed in the oblique graph, unicondylar fractures in the proximal section of the second and third proximal phalanges have been observed. Surgical treatment was not planned because 10days had passed since the trauma. In the control graphs taken after 3 weeks, healing at the fracture site was observed, and he was referred to physiotherapy after the removal of the splint. A good result was observed after physiotherapy.DiscussionBecause of the extension of tendons is important over the bone, the goal of the treatment is not only to heal the fracture, but also to preserve the sliding mechanism of these tendons. Regarding to lack of soft tissue trauma, favored joint movements after the healing of the fracture can be achieved more easily with conservative treatment; however, the fracture must be closely followed up.ConclusionCondylar fractures of proximal phalanges those nondisplaced can be conservatively treated with closed methods

A rare and serious syndrome that requires attention in emergency service: traumatic asphyxia

Traumatic asphyxia is a rare syndrome caused by blunt thoracoabdominal trauma and characterized by cyanosis, edema, and subconjunctival and petechial hemorrhage on the face, neck, upper extremities, and the upper parts of the thorax. Traumatic asphyxia is usually diagnosed by history and inspection; however, the patient should be monitored more closely due to probable complications of thoracoabdominal injuries. Treatment is conservative, but the prognosis depends on the severity of the associated injuries. Herein we present a traumatic asphyxia due to an elevator accident in a 32-year-old male patient and discuss the diagnosis, treatment, and prognosis by reviewing the relevant literature

Aortic distensibility and coronary artery bypass graft patency

<p>Abstract</p> <p>Background</p> <p>Aortic distensibility is an elasticity index of the aorta, and reflects aortic stiffness. Coronary artery disease has been found to be substantially associated with increased aortic stiffness. In this study we aimed to retrospectively analyze the association of angiographically determined aortic distensibility with the patency rates of coronary bypass grafts</p> <p>Methods</p> <p>The study was conducted in the Cardiology department of the Applied Research Centre for Health of Uludağ University. The coronary angiograms of 53 consecutive coronary bypass patients were analysed retrospectively. Aortic distensibility was calculated using the formula: 2 × (change in aortic diameter)/(diastolic aortic diameter) × (change in aortic pressure). The number of stenosed and patent bypass grafts and the patient characteristics like age, risk factors were noted.</p> <p>Results</p> <p>There were 44 male (83%) and 9 female (17%) cases. Eighteen cases had only one saphenous vein grafting. The number of cases with two, three and four saphenous grafting were 18, 11 and 1; respectively. In the control angiograms the number of cases with one, two, three and four saphenous vein graft obstruction were 15 (31.3%), 7 (14.6%), 1 (2.1%) and 1 (2.1%) respectively. The aortic distensibility did not differ in cases with and without saphenous graft occlusion (p > 0.05). Also left internal mammary artery (LIMA) graft patency was not related to the distensibility of the aorta (p > 0.05). We also evaluated the data for cut-off values of 50 and 70 mmHg of pulse pressure and did not see any significant difference between the groups in terms of saphenous or LIMA grafts.</p> <p>Conclusion</p> <p>In this study we failed to show association of angiographically determined aortic distensibility with coronary bypass graft patency in consecutive 53 patients with coronary artery bypass graft surgery (CABG).</p

Effects of kefir on symptoms and quality of life in patients with irritable bowel syndrome

İrritabl barsak sendromu (İBS), semptomatik tedavilerin kullanıldığı kronik bir hastalıktır. Probiyotikler, tüm İBS alt tiplerinde kullanılabilen güvenli bir tedavi seçeneğidirler. Biz bu çalışmada, bir probiyotik olan kefirin, İBS hastalarındaki semptomlar ve hayat kalitesi üzerindeki etkilerini araştırmayı amaçladık. Roma III kriterlerine göre İBS tanısı konan 55 hasta 4 hafta süreyle günde iki kez 200 cc kefir veya ayran almak üzere randomize edildi. Karın ağrısı/rahatsızlığı, şişkinlik, defekasyon sayısı ve gaita kıvamı parametrelerini içeren semptom günlüğü ile takip edilen hastalar, tedavi döneminin başlangıcında ve sonunda, İBS semptom skorlama sistemi (İBS-SS) ve İBS– 36 hayat kalitesi ölçümü ile değerlendirildi. Tedavi grubunda, kontrol grubuna göre hem İBS-SS hem de İBS–36 ölçümlerinde anlamlı iyileşme olduğu saptandı (sırasıyla, %64 ile %23 ve %66 ile %21, p<0.001). İBS-SS ve İBS–36 skorları açısından yanıt veren hasta sayıları da tedavi grubunda daha fazlaydı. Bu sonuçlar semptom günlüğünden elde edilen verilerle korelasyon gösteriyordu. Tedavi grubundaki konstipasyon dominant hastalarda gaita kıvamında anlamlı düzelme saptandı. Çalışmamızdan elde ettiğimiz verilere göre düzenli kefir kullanımı İBS hastalarında, semptomlar ve hayat kalitesinde kısa dönemde düzelmeye yol açabilir. Ayrıca, tedavi yanıtını değerlendirmek için farklı metodlar kullanmak, sonuçları karşılaştırarak doğrulamak için yararlı olabilir. Ancak kesin sonuçlara varmadan önce daha geniş hasta popülasyonlarında yapılan uzun süreli çalışmalara ihtiyaç vardır.Irritable bowel syndrome (IBS) is a chronic disorder in which symptomatic treatments are used. Probiotics are a safe therapeutic option in IBS for all subtypes. In this study, we aim to investigate effects of kefir which is a probiotic, on symptoms and quality of life in patients with IBS. Fifty five patients with a diagnosis of IBS according to Rome III criteria were randomized to receive kefir 200 cc bid or ayran for 4 weeks. Patients that monitored by a symptom diary that includes parameters as abdominal pain/discomfort, bloating, defecation frequency and stool consistency, were evaluated by IBS symptom severity scoring system (IBS-SS) and IBS-36 quality of life measure at the beginning and the end of the treatment phase. Both IBS-SS and IBS-36 measures were significantly improved in treatment group according to control group (64% vs 23% and 66% vs 21% respectively, p<0.001). The number of responders for IBS-SS and IBS-36 scores was also higher in treatment group. These results were correlated with data collected from symptom diary. In patients with constipation, there was a significant improvement in stool consistency. According to data from our study, regular kefir usage may improve both symptoms and quality of life in short term in patients with IBS. Also we think that it may be useful to evaluate treatment response by different methods to verify results with each other. But there is a need for trials in larger patient populations with longer duration before having certain conclusions.Eker Süt Ürünleri A.Ş

Magnetic resonance imaging-based diagnosis of occult osseous injuries in traumatic knees

Background: Occult osseous knee injuries, such as bone bruises, can produce persistent pain and functional loss. Although bone bruises cannot be identified through direct examination or traditional radiographs, magnetic resonance imaging (MRI) has emerged as an effective diagnostic method. Nevertheless, the natural history of these injuries remains to be fully defined. Therefore, we used MRI to detect and follow bone bruise injuries secondary to knee trauma. Methods: We retrospectively reviewed knee MRIs from patients with bone bruising caused by trauma. Occult injuries were initially identified by MRI and subsequently rescanned for follow-up at 3 and 9 months. All patients underwent physical examinations, direct radiological imaging, and MRI. Results: Although direct radiographs showed no abnormalities, we used MRI to identify a total of 22 patients (age range: 19–42 years; mean: 28 years) with bone bruising. After 3 months, injuries remained detectable in 68.2% of the subjects, whereas 18.2% displayed bone bruising after 9 months. The majority of Type I lesions resolved spontaneously, whereas 80% of Type II injuries remained following 3 months, and 30% persisted at 9 months. Ligament and meniscal lesions were observed in 63.6% of patients with bone bruising and appeared to hinder recovery. Conclusion: Bone bruises generally resolved within 3 to 9 months in subjects with no soft tissue lesions and minor trauma. However, ligament and meniscal lesions were observed in the majority of patients, and these individuals required longer treatment and recuperation. Overall, these findings can contribute to improving the management of occult osseous knee injuries