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

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

Support vector machines in structural engineering: a review

Recent development in data processing systems had directed study and research of engineering towards the creation of intelligent systems to evolve models for a wide range of engineering problems. In this respect, several modeling techniques have been created to simulate various civil engineering systems. This study aims to review the studies on support vector machines (SVM) in structural engineering and investigate the usability of this machine learning based approach by providing three case studies focusing on structural engineering problems. Firstly, the concept of SVM is explained and then, the recent studies on the application of SVM in structural engineering are summarized and discussed. Next, we performed three case studies using the experimental studies provided. Applicability of SVM in structural engineering is confirmed by these case studies. The results showed that SVM is superior to various other learning techniques considering the generalization capability of produced model

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

Bebeklerde meme başından kanlı akıntı

Bloody nipple discharge is extremely rare in children. The etiology and pathophysiology remain uncertain, with the most common cause being mammary ductal ectasia. Despite its stressful course to the parents, it is generally a benign condition with a spontaneous resolution. A 3-monthold and a 6-month-old female infants were admitted to our clinic because of bloody discharge from the nipples. Bilateral fibrocystic changes were detected in the ultrasonographic examination of the infants, whose physical examination and hemogram, prothrombin time, aPTT, estradiol levels were normal. The hemorrhage ended within one month in the follow-up of both cases, but in our 6-month-old patient, bleeding recurred once again after 10 months. As a conclusion, in cases of bloody nipple discharge, which is seen rarely during infancy, the bleeding usually disappears spontaneously without any intervention. After detailed evaluation of the cases, they should be followed conservatively.Çocuklarda meme ucu kanlı akıntısı çok nadir görülmekte olup, etyolojisi ve patofizyolojisi bilinmemektedir. En sık neden duktal ektazidir. Ebeveynleri endişelendirmesine rağmen sıklıkla spontan olarak gerileyen selim bir durumdur. Memeden kanlı akıntı nedeniyle kliniğimize başvuran 3 ve 6 aylık iki kız bebeğin yapılan fizik muayenelerinde özellik saptanmadı. Hemogram, aPTT, prothrombin zamanı ve estradiol değerleri normal bulunan olguların yapılan ultrasonografilerinde duktal ektaziye bağlı bilateral fibrokistik değişiklikler görüldü. Her iki olgunun takibinde kanamaların bir ay içinde kaybolduğu saptanırken, 6 aylık olan olgumuzda 10 ay sonra bir kez daha kanama tekrar etti. Sonuç olarak sıklıkla duktal ektazi sonucu gelişen meme ucu kanlı akıntısında kanama, tedaviye gerek kalmadan kendiliğinden kaybolmaktadır. Olgular detaylı bir şekilde değerlendirildikten sonra konservatif olarak takip edilmelidir