Titanium versus Hydroxyapatite Prostheses: Comparison of Hearing and Anatomical Outcomes after Ossicular Chain Reconstruction

Objective:This study aimed to compare hearing and anatomical outcomes after ossicular chain reconstruction with titanium or hydroxyapatite prostheses.Methods:In this study, patients who underwent tympanoplasty and ossicular chain reconstruction with titanium or hydroxyapatite prostheses at a university hospital from January 2007 to February 2013 were retrospectively reviewed; they had a minimum follow-up period of 6 months. Patients were divided into 4 groups according to the type of prostheses. The surgical procedure, follow- up examinations, preoperative, and postoperative audiometry results were noted and evaluated for partial and total prostheses. The results were compared both for titanium and hydroxyapatite prostheses.Results:The study subjects included 51 patients. Titanium had better hearing results in partial prostheses (p0.05). The extrusion rate was 5.8% for all patients.Conclusion:Both types of prostheses had satisfactory functional and anatomical results and no preponderance could be stated, except for the hearing results of partial titanium prostheses

Placental Characteristics Classification of Various Native Turkish Sheep Breeds

Simple Summary The aim of this study was to classify placental characteristics of Akkaraman, Morkaraman, Karayaka, Awassi, Malya, and Bafra native sheep breeds using the hierarchical clustering method. As a result, six breeds were separated into three clusters: the first cluster consisted of Bafra, Karayaka, and Awassi breeds; the second consisted of Akkaraman and Malya breeds; and the third cluster included only the Morkaraman breed. The aim of this study was to classify placental characteristics of Akkaraman, Morkaraman, Karayaka, Awassi, Malya, and Bafra sheep breeds using the hierarchical clustering method. In total, 240 individual data records were used as experimental material. Placental characteristics such as total cotyledon surface area, small and large cotyledon length, small cotyledon depth, etc. were used as explanatory variables to classify the breeds' characteristics. Hierarchical clustering was used with the nearest neighbour method with Euclidean distance in order to classify the sheep breeds' variations. As a result, six breeds were separated into three clusters: the first cluster consisted of Bafra, Karayaka, and Awassi breeds; the second consisted of Akkaraman and Malya breeds; and the third cluster included only the Morkaraman breed. Bafra and Karayaka were pointed as the nearest breeds, with a similarity of 98.7% in terms of placental characteristics. The similarity rate of the Akkaraman and Malya breeds was at a level of 97.5%, whereas it was 96.8% for Bafra, Karayaka, and Awassi breeds. The similarity of Akkaraman, Karayaka, Awassi, Malya, and Bafra sheep breeds was estimated as 95.7%. The overall similarity was found to be at a level of 93.2% among sheep breeds. The outcomes of the study might be useful as a selection tool for reproductivity and can be used to select the breed to be reared

Can Intratympanic Steroid Be Initial Therapy for Sudden Sensorineural Hearing Loss?

Objective:To evaluate the efficacy of intratympanic steroid treatment with concurrent systemic steroids as an initial therapy for sudden sensorineural hearing loss (SSNHL).Methods:Patients who were diagnosed as idiopathic SSNHL and received no therapy were included in the study. Patients were divided into control and study groups. Patients in the study group received concurrent intratympanic steroid treatment with systemic steroid therapy. Patients in the control group received standard systemic steroid treatment alone. The duration of time before the treatment was evaluated for all the patients. Pure tone audiometry (PTA) was performed for all the patients in the pre-treatment and post-treatment period in order to record the responses for both in terms of the individual frequencies and the pure tone average.Results:Twenty nine patients (16 female and 13 male) with a mean age of 43.6 years were enrolled in the study. There was 15 patients in the study group and 14 patients in the control group. The mean duration of time for the initial therapy was 4 days for the control group and 6.5 days for the study group (p=0.125). The mean recovery in PTA for the control group was 10.29±4.10 decibel (dB) (0-15) while it was 19.40±18.84 dB (3-68) for the study group (p=0.003).Conclusion:At the end of treatment, significantly better hearing results were obtained for the patients in the study group when compared to the control group both for PTA and all the frequencies individually. We suggest that concurrent intratympanic steroids with systemic steroid therapy gives better hearing results than the standard systemic therapy alone

Reliability of Frozen Section Pathology in Transoral Laser Laryngectomy

Objective:To evaluate the reliability of frozen section analysis in transoral laser laryngectomy (TOLL).Methods:A retrospective analysis was conducted for patients who underwent TOLL in a university hospital between January 2012 and February 2014. The grade of the tumor and the histopathological diagnosis were noted. The results of frozen section pathologies and routine histological examinations were compared.Results:A total number of 84 sections from 21 patients with a mean age of 57.3 years were included in the study. All the patients were operated with superpulse continuous mode carbon dioxide laser with a power of 5–8 watts. Squamous cell carcinoma was histologically diagnosed in all patients. The tumor was grade 1 in 80.95% of the patients, grade 2 in 9.52%, and grade 3 in 9.52%. A routine histopathological examination confirmed the frozen section in 94.04% of the patients.Conclusion:Laser surgery is a commonly preferred treatment modality in early-stage laryngeal carcinomas, in particular. However, a safe surgical margin is a debate in transoral laser surgery. In light of our results, we can conclude that frozen section pathology is a reliable method to achieve safe surgical margins in TOLL

Morphometric Evaluation of Coccyx with Microcomputed Tomography (Micro CT) and Computed Tomography (CT) Technology

Aim%253A We investigated the coccyx anatomy accurately in detail by microcomputed tomography (micro CT) and computed tomography (CT) to contribute to the data related to the coccyx anatomy and the potential clinical contribution of these datas in the treatment of coccyxs pathologies. Material and Methods%253A Twenty coccyges from embalmed cadavers were examined with a micro CT device. The inferior part of the sacrum and coccyx together with the surrounding soft tissue was removed safely. The tissue was scanned with a micro CT device, and all parameters were measured with micro CT image viewer programs. CT images of 29 patients without coccyx pathology were measured with OsiriX programs. Measured morphometric parameters with micro CT and CT were evaluated using statistical methods. Results%253A Generally, the morphometric parameters as mean values were larger in males than in females. Mean values for vertical length and coccyx width were higher for CT compared with micro CT images. Coccyx was more flat in the frontal plane in females. There were statistically significant differences between the micro CT and CT images regarding mean vertical length, width, lateral deviation angle, and sacrococcygeal angle and length of the vertebrae (p lt%253B 0.05). There were no statistically significant differences in number and width of the vertebrae (p gt%253B 0.05). Conclusion%253A We suggest that examining the normal coccyx morphology will help to better understand and treat the pathologic conditions of the coccyx. We believe our findings will contribute to the data related to the coccyx anatomy

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

The relationship between senile hearing loss and vestibular activity

Abstract Introduction: A considerable high number of SNHL patients also suffer from dizziness and related vestibular symptoms. Objective: To evaluate the association of vestibular dysfunction and sensorineural hearing loss (SNHL) in adult patients. Methods: Prospective, double-blinded, controlled studies composed by 63 adult patients without any vestibular symptoms or diagnosed vestibular diseases. Audiological status was measured with pure tone audiometry and the vestibular system was tested with vestibular evoked myogenic potential (VEMP). Patients were divided into two groups: a study group (patients with SNHL) and a control group (patients without SNHL). VEMP results of the groups were calculated and compared. Results: Mean P1 (23.54) and N1 (30.70) latencies were prolonged in the study group (p < 0.001) and the amplitudes of the study group were significantly reduced (p < 0.001). Both parameters of the VEMP test were abnormal in the study group when compared to the control group. Conclusions: These findings suggest that age-related SNHL may be accompanied by vestibular weakness without any possible predisposing factors for vestibulopathy

Genetic Causes of Inner Ear Anomalies: a Review from the Turkish Study Group for Inner Ear Anomalies

Inner ear anomalies diagnosed using a radiological study are detected in almost 30% of cases with congenital or prelingual-onset sensorineural hearing loss. Inner ear anomalies can be isolated or occur along with a part of a syndrome involving other systems. Although astonishing progress has been made in research aimed at revealing the genetic causes of hearing loss in the past few decades, only a few genes have been linked to inner ear anomalies. The aim of this review is to discuss the known genetic causes of inner ear anomalies. Identifying the genetic causes of inner ear anomalies is important for guiding clinical care that includes empowered reproductive decisions provided to the affected individuals. Furthermore, understanding the molecular underpinnings of the development of the inner ear in humans is important to develop novel treatment strategies for people with hearing loss