Göğüs cerrahisi hasta popülasyonunda osteoporoz sıklığı: Toraks bilgisayarlı tomografi tetkiklerinden fırsatçı değerlendirme

Aim: To investigate the frequency of osteoporosis in thoracic surgery patients and highlight the clinical significance for physicians. Methods: Thoracic computed tomographies (CT) of 306 patients were examined for medullary density of the T12 vertebra. Men and women, as well as those under 70 and over 70, were compared in terms of Hounsfield units (HU). To evaluate the diagnostic performance of the age parameter in predicting osteoporosis, receiver operating characteristic (ROC) analysis, and logistic regression analysis were used. The rib cortical defects identified in this study group and their causes were explained. Results: HUs of 51 subjects (or 16.7%) were less than 110 (osteoporosis); 177 people (57.8%) were higher than 160 (normal). HU values ranged from 111 to 159 (borderline) for 78 individuals (25.5%). There was no significant difference between males and females. It was discovered that the difference between the population under 70 and the population over 70 was statistically significant (p<0.001). For predicting osteoporosis, the age exhibited an area under the curve of 0.857 (CI 0.806-0.908). The threshold value was 57 for women and 55 for men. Osteoporosis was shown to be accurately predicted by age with a 95.7 percent accuracy rate (p<0.001). Six patients were determined to have rib cortical defects seen on CT scans during the evaluation for osteoporosis, and two more patients had fractures noted during surgery. Conclusion: Within the 306 patients, only 57.8% had bone density within the normal range. The age parameter is valuable with high accuracy (95%) in predicting osteoporosis. The presence of osteoporosis over the age of 57 in women and over 55 in men should be evaluated and measures should be taken to protect the bones during the operation and postoperative care.Amaç: Göğüs cerrahisi hastalarında osteoporoz sıklığını araştırmak ve doktorlar için klinik önemini vurgulamak. Yöntemler: 306 hastanın toraks bilgisayarlı tomografileri (BT) T12 vertebra medüller yoğunluğu (Hounsfield unit-HU) açısından incelendi. Erkekler ve kadınlar; “70 yaş altı” ve “70 yaş ve üzeri” gruplar karşılaştırıldı. Yaş parametresinin osteoporozu öngörmedeki tanısal performansını değerlendirmek için alıcı işlem karakteristikleri (receiver operating characteristic-ROC) analizi ve lojistik regresyon analizi kullanıldı. Bu çalışma grubunda tespit edilen kosta kortikal defektleri ve nedenleri açıklandı. Bulgular: 51 hastanın (veya %16,7) HU’ları 110’un altında idi (osteoporoz); 177’sinin (%57,8) 160’ın üzerindeydi (normal). 78 kişi (%25,5) için HU değerleri 111 ila 159 (sınır) arasında değişmekte idi. Erkekler ve kadınlar arasında anlamlı bir fark yoktu. 70 yaş altı nüfus ile 70 yaş üstü nüfus arasındaki farkın istatistiksel olarak anlamlı olduğu belirlendi (p<0,001). Osteoporozu tahmin etmek için yaş, 0.857’lik bir eğri altında kalan alan (CI 0.806-0.908) sergiledi. Osteoporozun yüzde 95,7 doğruluk oranıyla (p<0,001) yaşa göre doğru bir şekilde öngörüldüğü gösterildi. Kadınlarda eşik değer 57, erkeklerde 55 idi. 6 kişide BT taramalarında kosta korteks defektleri görülürken 2 hastada ise ameliyat sırasında kırık meydana geldi. Sonuç: Bu popülasyonun yalnızca %57,8’i normal aralıkta kemik yoğunluğuna sahipti. Yaş, osteoporozu öngörmede yüksek doğruluk ile değerli bir parametre olabilir. Kadınlarda 57, erkeklerde 55 yaş üstü osteoporoz varlığı değerlendirilmeli, operasyon ve postoperatif bakım sırasında kemikleri korumaya yönelik önlemler alınmalıdır

Effects of Tire Crumb Rubber and Steel Fiber on Punching Shear Behavior of Two-way Alkali-activated Concrete Flat Slabs

As a result of the rapid increase in the demand for transportation vehicles recently, the accumulation of waste tires causes environmental problems. One of the methods that can contribute to the reduction of this environmental problem is the recycling of waste tires as a construction material in aggregate form. This research investigated the impacts of waste tire crumb rubber with/out steel fiber (SF) on the two-way punching-shear behavior alkali-activated concrete (AAC) flat slabs and performed center point load tests. In the study, one-type of SF and two kinds of scrap tire waste i.e., crumb rubber (CR) and tire particles, were used on the producing of rubberized AAC slabs obtained by 100% as binder made of ground-granulated blast furnace slag (GGBFS). Also, while both fine crumb rubber (FCR) and coarse crumb rubber (CCR) were used together in the AAC slabs, tire crumb rubber (TCR) was used alone at the same proportion. Additionally, the fine aggregate was substituted with 10% and 15% FCR and CCR, and coarse aggregate was substituted with TCR in the same proportions. Additionally, AAC slabs with recycled tire rubber (RTR) were produced as fibrous and non-fibrous using 1% by volume hook-end SF. In total, nine AAC slabs with sizes of 50 x 50 x 6 cm3 were manufactured for the study. Experimental data showed that the inclusion of RTR only slightly reduced the punching shear strength of AAC slabs and the punching shear strength of the slabs increased when SF was added to the mixtures containing RTR

Experimental Study on Direct Shear Strength of Fiber Reinforced Self Compacting Concrete under Acid and Sulfate Attack

This study primary is to investigate the shear strength of self-compacting concrete (SCC) reinforced by steel-fiber (SF) and polypropylene-fiber (PPF) in different environmental conditions: the air, sulfate (MgSO4 with a concentration of 5%) and acid (H2SO4 with a concentration of 5%). The study also examines the effect of fiber volume fraction on the workability, shear strength, compressive strength, and splitting tensile strength of fiber reinforced SCC. The article aims to determine the durability effects of both fibers and their resistance to aggressive environmental conditions. The contribution of this article is an experimental investigation on the shear strength of SCC reinforced by SF as well as PPF in 3 different environmental conditions after 30 days of exposure. The study also investigated the fresh and mechanical properties of 5 different mixtures of SCC with/out 0.1% and 0.2% fibers. The study also concluded that PPF decreased the workability of SCC badly, and special care must be taken when selecting its volume fraction. Also, it was found that generally shear strength of SCC mixes enhanced with increasing SF and PPF volume fraction. Moreover, it was found that both fibers have good durability effects, and resist aggressive environmental conditions, with the best results obtained from samples containing 0.2% SF. In the air condition, while the compressive strength, shear strength and tensile strength results were 52.6MPa, 6.43MPa and 3.91MPa, in the sulfate condition those were 46.37MPa, 6.55MPa and 3.59MPa, and in the acid condition those were 34.4MPa, 5.5MPa and 3.46MPa, respectively

A Detailed Investigation of the Bond Performance of Basalt Fiber-Reinforced Polymer Bars in Geopolymer Concrete

This comprehensive experimental study aimed to determine the bond performance of basalt fiber reinforced polymer (BFRP) bars in geopolymer concrete (GC). The study examined the bond performance of BFRP bars and GC by considering several parameters, including bar diameters of 8, 10, and 12 mm, embedment lengths of 4, 8, and 12 db mm (where db is the diameter of the bar), concrete covers of 20, 40, and 70 mm and compressive strengths of 21.7 and 34.4 MPa. The study also compared the effect of the bar surface and bar type on GC bond performance. Eventually, the results were compared with ordinary concrete (OC). The obtained results indicated that an increase in the BFRP bar diameter results in a decrease in the average bond stress. Similarly, an increase in the length of the bond leads to a reduction in the bond stress. The specimen possessing a short embedment length failed due to bar pullout, while the specimens with a longer embedment length failed as a result of concrete splitting. The outcomes also showed that the strength of bond increases with an increase in compressive strength and cover thickness. Furthermore, the results also indicated that BFRP-reinforced GC has comparable bond performance to steel-reinforced GC and BFRP-reinforced OC and performed better than OC. Last, Comparisons between the existing bond-slip models were offered to demonstrate the best bond stress-slip model for FRP bars and GC for ascending branch up to ultimate bond stress of the bond slip curves and for whole curves

The Effects of Recycled Tire Rubbers and Steel Fibers on the Performance of Self-compacting Alkali Activated Concrete

In this study, the effects of recycled tire rubbers (RTR) and steel fiber (SF) on the fresh and hardened state properties of the self-compacted alkali activated concrete (SCAAC) were investigated. The ground granulated blast furnace slag, 1&nbsp;% hooked-end SF, and two types of RTR were utilized. The crumb rubbers (CR) and tire rubber chips (TCR) were used as a substation to natural aggregates at substation levels of 10&nbsp;% and 15&nbsp;%. The fresh state performances were evaluated by T50 value, slump flow, V-funnel, and L-Box tests, while mechanical performances were assessed through compressive, flexural, and splitting tensile strength tests. Also, detailed crack and microstructural analyses were conducted. The RTR adversely affected the fresh state properties, which reduced more with SF&nbsp;inclusions. Among the RTR, the TR specimens exhibited lower fresh state performance than the CR specimens. Similar mechanical strengths were obtained on the TR and CR specimens under the same replacement ratios. However, TR specimens exhibited higher deformation capacities than the CR specimens, when SF was utilized. The SCAAC specimens with 1&nbsp;% SF and 15&nbsp;% RTR showed more and wider flexural cracks, higher mechanical strength, and deformation capacity, which can be utilized in structural applications, particularly in high seismic zones

Testicular Arteriovenous Malformation: Gray-Scale and Color Doppler Ultrasonography Features

Intratesticular arteriovenous malformations (AVMs) are extremely rare benign incidental lesions of the testis. Ultrasonography (US) generally reveals a hypoechoic solid mass within the testicular parenchyma. We describe a patient with intratesticular AVM which was found incidentally during workup for infertility. The gray-scale and Doppler US appearance of an intratesticular AVM and the differential diagnosis have been presented. Based on the gray-scale, US appearance differentiation from malignant testicular tumors is difficult. Doppler US examination aids in the diagnosis by demonstrating the vascular nature of the tumor

Vücut kitle indeksi ve yaralanma süresinin menisküs tamiri sonrası sonuçlara etkisi]

Aim: Our study was to assess the outcome of meniscal repair surgery with anterior cruciate ligament reconstruction, focusing in particular on meniscal healing. Material and Method: We analyzed whether the time elapsed between the injury and the surgery affected the activity scores as measured by the Tegner Activity Scale, Modified Lysholm Knee Scoring, and Barrett criteria. Similarly, we analyzed whether body mass index (BMI) affected the activity scores. Result: The average BMI of the patients was 23.99 +/- 3.64 kg/m2 (range: 19.9-34). BMI was graded as underweight (18.5 kg/m2 or less), normal weight (18.5 kg/m2 to 24.99 kg/m2), overweight (25 kg/m2 to 29.99 kg/m2), or obese (30 kg/m2 to 39.99 kg/m2). Patients were divided into two groups. Overweight and obese patients were included in one group, and patients of normal weight or underweight were included in the other group. Out of a total of 34 patients, 3 (8.8%) were underweight, 20 (58.8%) were normal weight, 9 (26.5%) were overweight, and 2 (5.9%) were obese. Based on the BMI there was no significant difference between the two groups for results of the Tegner Activity Scale, Modified Lysholm Knee Score, and Barrett criteria. BMI of the patients was not a risk factor for the post-operative score scale (P>0.05). There was no significant difference between the injury period (the time elapsed between the injury and the surgery) and activity scores (P>0.05). The injury period had no effect on the post-operative scores. Discussion: BMI of the patients and injury time of the meniscus tear had no negative effect on the functional results of the operation. Meniscal lesions with ACL tear should be repaired when diagnosed

Epidemiology, anticoagulant treatment and risk of thromboembolism in patients with valvular atrial fibrillation: Results from Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER)

Background: The aim of this study was to perform a multicenter, prospective investigation regarding the epidemiology, the current effectiveness of therapeutic anticoagulation, and the risk of thromboembolism in patients with valvular atrial fibrillation (AF) based on the records of the Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER) study. Methods: Patients were selected from a total of 2,242 consecutive admissions that presented with AF diagnosed via electrocardiogram. Those diagnosed with non-valvular AF were excluded from the AFTER study population, which left 497 patients with valvular AF for analysis. Results: The etiology of valvular AF in patients was either attributed to rheumatic mitral valve stenosis (n = 217) or possessing a prosthetic heart valve (n = 280). Out of all the patients with valvular AF, 83.1% were taking warfarin for anticoagulation. Only 36.1% demonstrated a therapeutic international normalized ratio (INR), and among those patients it was found that 19.1% exhibited a labile INR. Multivariate analysis revealed that age was the only independent predictor of thromboembolic events in patients with valvular AF. Conclusions: Many valvular AF patients are not maintained at therapeutic INR levels, which poses a threat to patient health as they age and are at greater risk for thromboembolism

Arthroscopic-Assisted Repair in Full-Thickness Rotator Cuff Ruptures: Functional and Radiologic Results of Five-Year Follow-Up

Objective: In our study, we evaluated the post-operative 5-year clinical and radiological results and the ratio of re­current ruptures under magnetic resonance imaging of the patients diagnosed as wide and massive, full-thick­ness rotator cuff rupture and arthroscopic-assisted mini-open rotator cuff repair is applied. Methods: We evaluated the pre-operative and post-op­erative clinical and radiological results of 38 patients with wide and massive, full-thickness rotator cuff rupture and arthroscopic-assisted rotator cuff repair is applied after failure of conservative treatment. Results: Mean post-operative follow-up period was 60.4 months. According to UCLA scoring there were excellent results in 26 patients, good results in 10, and moderate results in 2 patients. According to Constant scoring there were excellent results in 24 patients, good results in 12, and moderate results in 2 patients. 34 of the 38 patients indicated that they were satisfied with the results. The continuity of the rotator cuffs are evaluated with magnetic resonance imaging at the last visits of the patients and there was recurrent ruptures at the 8 patients. Conclusion: Although recurrent rotator cuff rupture rates varies depending on the age of the patients, moderate clinical results are obtained in elder patients. Neverthe­less, despite the rupture rates in the treatment of wide and massive, full-thickness ruptures, satisfactory clinical results can be obtained with arthroscopic-assisted mini-open rotator cuff repair