Outcomes of Treatment in Patients with Elderly Postmenopausal Osteoporosis: Comparision of Oral and Parenteral Bisphosphonates

Objective: In this study, we aim to compare the efficacy of oral and parenteral bisphosphonates used in postmenopausal osteoporosis (OP)treatment. Materials and Methods: Between 2010 and 2015, patients older than 65 years who were diagnosed with postmenopausal OP and treated with oral or parenteral bisphosphonate were included in the study. According to treatment, 72 patients receiving oral bisphosphonate and 52 patients receiving parenteral bisphosphonate were divided into two groups as group O and group P respectively. The results of the second year treatment of 124 patients who were treated regularly and at least two years follow up were evaluated and compared. Results: According to the pre-treatment state in both groups; bone mineral density (BMD) of vertebral and femoral, and T-scores showed significant improvement. The mean improvement in vertebral and femoral T-scores and femoral BMD values was better in group P and there was statistically significant difference. In the oral bisphosphonate group, there was a statistically significant difference between the groups in favor of alendronate in the femoral T-score and the improvement in the vertebral and femoral T-score in the parenteral bisphosphonate group was better in the zoledronate subgroup and statistically significant. Conclusion: The results of this study demonstrate that oral and parenteral bisphosphonates are effective in the treatment of postmenopausal OP. Nevertheless, parenteral bisphosphonates were found to be more effective in terms of vertebral and femoral T-scores and femoral BMD average improvement

A Child with Acute Appendicitis Secondary to Blunt Abdominal Trauma: A Case Report and Review of the Literature

We present a child with abdominal pain and vomiting after blunt abdominal trauma (BAT). He had tenderness, guarding and rebound on the bilateral lower quadrant of the abdomen. He had no abrasion on the abdominal skin surface. He had marked leukocytosis and increased C-reactive protein level. Contrast-enhanced abdominal computed tomography revealed inflamed appendicitis. He was operated by pediatric surgeons and, an perforated appendix was illustrated on pathological examination. BAT and acute appendicitis (AA) are independently very frequent issues. In pediatric emergency departments, BAT and AA are very frequent issues, however, coexistence of these two condition in the same patient is rare. This case report and review of the literature showed that occurrence of AA after BAT should be considered by emergency physicians

Effectiveness of coating implant with poly-(D,L)lactic acid (PDLLA) including fosfomycin in the prophylaxis of methicillin-resistant staphylococcus aureus (MRSA) experimental rat osteomyelitis model

Ortopedik cerrahi alanında implant kaynaklı enfeksiyonların azaltılması her geçen gün daha fazla önem kazanmaktadır. Bu çalışmada MRSA suşu kullanılarak yapılan deneysel sıçan osteomyeliti modelinde implantın fosfomisin içeren Poli-(D,L)laktik asit ile kaplanmasının profilaksideki etkinliğinin araştırılması amaçlanmaktadır. Araştırma için Hayvan Deneyleri Etik Kurulu onayı alındı. Araştırma için 40 adet Wistar Albino cinsi sıçanların sol tibialarına 103cfu/10µL olacak şekilde bakteri süspansiyonu enjekte edilerek osteomiyelit oluşturuldu ve rastgele dört gruba ayrıldı. Grup 1'e kaplamasız Kirschner teli (Kontrol), Grup 2'ye PDLLA kaplı Kirschner teli (Kontrol), Grup 3'e gentamisin içeren PDLLA kaplı Kirschner teli, Grup 4'e fosfomisin içeren PDLLA kaplı Kirschner teli implante edildi. Tüm deneklerin birinci gün , 3., 7., 14., 21., 28., 35. ve 42. günlerde ölçülen rektal vücut sıcaklıkları ve vücut ağırlıkları kaydedildi. Radyolojik görünümler An ve arkadaşları tarafından modifiye edilen skorlama sistemine göre birinci gün , 7., 14., 21., 28., 35. ve 42. günlerde değerlendirildi. Deneklerden intrakardiyak enjeksiyon ile birinci gün , 14., ve 42. günlerde alınan kan örnekleri rutin laboratuar parametreleri açısından incelendi. 42. gün çıkarılan Kirschner telleri %5 koyun kanlı agara ekildi ve takiben 5ml Tryptic Soy Broth (TSB) solüsyon içine kondu. Histopatolojik inceleme için deneklerin tibialarından elde edilen örnekler rutin işlemler sonrası hemotoksilen eozin ile boyandı. Petty ve arkadaşları tarafından tanımlanan değişkenlere göre semikantitatif olarak değerlendirildi. İstatistiksel analizler SPSS 15 programı kullanılarak yapıldı. Grup 3'teki deneklerin ortalama radyoloji skorları diğer gruptaki deneklere göre anlamlı olarak düşük olup bu fark 42. günde en yüksek düzeye ulaşmıştı. (p<0.001). Mirobiyolojik incelemede ise Grup 3'te hem koyun kanlı agarı, hem de TSB solüsyonunda %20 üreme görülürken, Bu oran Grup 4'te ise %80 oranında olmuştur. Grup 1 ve 2'de bütün kültürlerde üreme oluşmuştur. Grup 3'te patoloji skoru, diğer gruplara göre anlamlı olarak daha düşüktü (p=0.005). MRSA ilişkili implant enfeksiyonunun profilaksisi bakımından, PDLLA kaplamasına fosfomisin eklenmesi gentamisin eklenmesinden daha üstün değildi. Fosfomisin eklenen PDLLA kaplamanın sadece kaplamasız grupdan daha üstün olabileceği bulundu.Reduction of implant–associated infections is becoming more and more important in orthopedic surgery. The aim of this study is to investigate effectiveness of coating implant with Poly-(D,L)lactic acid (PDLLA) including fosfomycin in the prophylaxis of experimental rat osteomyelitis model occured by using Methicillin-resistant Staphylococcus aureus (MRSA). This study was approved by Animal Research Ethics Committee. For this study, osteomyelitis was established by 103cfu/10µL bacteria suspension injection to the left tibias of forty Wistar albino rats and divided into four groups randomly. Uncoated Kirschner wire was implanted to group 1 (Control), PDLLA coated Kirschner wire was implanted to Group 2 (Control), PDLLA which include gentamicine coated Kirschner wire was implanted to Group 3, PDLLA which include fosfomycin coated Kirschner wire was implanted to Group 4. Body weight and rectal body temperature were recorded for all subjects on the first, 3rd, 7th, 14th, 21st, 28th, 35th and 42nd day. Radiographs were taken on the first, 7th, 14th, 21st, 28th, 35th and 42nd day and assessed according to a modified score defined by An et al. Blood samples taken from the subjects with intracardiac injection on the first, 14th and 42nd day were analyzed for routine laboratory parameters. Kirschner wire was removed on the 42nd day and swapped on to 5% sheep blood agar and than is incolated with 5ml TSB solution agar. For histopathological examination, samples obtained from rats tibias were stained with hematoxylin-eosin (HE) after routine procedures. They were evaluated semiquantitatively according to the variables described by Petty et al. Statistical analyzes were performed using SPSS 15 software (IBM,ABD). Mean radiology scores of subjects in Group 3 was significantly lower than the other groups and this difference was more evident on the day 42. (p <0.001) In microbiological evaluations, %20 bacterial growth was observed in Group 3 which was %80 in Group 4 in both of sheep blood agar and TSB solution. Bacterial growth is observed in all culture mediums in Group 1 and 2. Pathology score in group 3 was significantly lower than other grup. (p=0.005). At the end of study, we found that adding fosfomycin instead of Gentamycin is not effective to prevent MRSA infection in rats. It was just better than uncoating

SONOGRAPHIC AND FLUOROSCOPIC PERITONEAL DIALYSIS CATHATER PLACEMENT, POST PROCEDURAL OUTCOMES

SONOGRAPHIC AND FLUOROSCOPIC PERITONEAL DIALYSIS CATHATER PLACEMENT, POST PROCEDURAL OUTCOMES&nbsp;&nbsp;Purpose: Peritoneal dialysis (PD) cathaters may be inserted surgically, blindly or&nbsp; by fluoroscopic approach. Adding ultrasound-assistance&nbsp; to fluoroscopic technique ensures entry into abdominal cavity under direct ultrasound visualization. In this way, complications such as intestinal perforation due to puncture or damage to the superficial epigastric vessels can be significantly prevented. The aim of our<span class="NormalTextRun SCXW237730061 BCX4" style="margin: 0px; padding: 0px; -webkit-user-select: text; -webkit-user-drag: none; -webkit-nbsp-mode: