Tendon Structure and Classification

Tendons play an important role in the movement by transmitting the contraction force produced by the muscles to the bone they hold, and their contribution to stability to the joints is extremely important. Tendons generally have a very complex structure; they are actually heavily composed of connective tissue and have a small number of cells and rich extracellular matrix, similar to other connective tissue structures. The tendons are mainly composed of three parts: the tendon itself, the muscle-tendon junction, and the bone insertion. The simplest classification for the tendons classified according to their shapes, settlements, and anatomical structures is the classification made according to their shapes. Tendons can be classified in many ways according to their location, but the most logical one is the tendon classification in relation to the functions they see as intraarticular and extraarticular. According to their anatomy, the tendons can also be classified as sheathed or synovial-coated or unsealed or paratenon-coated. According to their functions, tendons can be classified as energy storage or positional tendons

Simultaneous bilateral spontaneous pneumomediastinum and pneumothorax in a cannabis user

Cannabis – the most commonly used illegal drug – also has some medical applications. Cannabis is being legalised more and more in the Western world, however it is not a safe substance as many people think. It can cause detrimental acute and chronic lung injuries such as bullous lung disease, chronic bronchitis, chronic obstructive pulmonary disease, pneumothorax, pneumomediastinum, pulmonary emphysema. A clear mechanism for acute pulmonary pathologies has not been established, but pneumothorax and/or pneumomediastinum can be considered as a typical presentation in cannabis users. We present a cannabis user case with simultaneous pneumomediastinum and bilateral spontaneous pneumothorax

Attitudes and practices against COVID-19 vaccines in Turkiye

OBJECTIVE: Vaccination is the primary way to mitigate the COVID-19 pandemic. Vaccine hesitancy and refusal are one of the most important challenges against to reach herd immunity. The aim of this study is to examine the reasons for not get-ting vaccinated and the attitudes toward vaccines by people in Turkiye, who were not vaccinated, even though a COVID-19 vaccine was available for them.METHODS: This cross-sectional study is conducted in Eyupsultan district of Istanbul. The study population is 12,540. A questionnaire consisted of three sections as sociodemographic characteristics, attitudes toward COVID-19 vaccines, and Vaccination Attitudes Examination (VAX) scale was used. Among the sample size, participation rate is 69.4%.RESULTS: About 50.2% of the participants (n=259) are male, 80.3% are married, 13.1% are university graduates, and 44.0% are working in a job. About 32.8% of the participants have COVID-19 history. About 34.4% of the participants stat-ed that they would be vaccinated against COVID-19. Although those who define themselves as vaccine refuser are 5.4%, those who still refuse to be vaccinated for COVID-19 are 20.1%. In addition to this, those who are hesitant about COVID-19 vaccines are 45.6%. The most frequently preferred vaccine is comirnaty (41.7%). About 13.1% of the participants stated that "if we had a domestic COVID-19 vaccine, I would have it." The most common sources of information about vaccines are television with 78.4%, and health workers are in the last place with 14.7%. "Concerns about side effects" are the most frequently cited (85.9%) reason for not vaccinating. The mean score of the VAX scale is 42.34 +/- 10.93, and the "mistrust of vaccine benefit" is higher among primary school graduates than other educational status groups (p=0.001).CONCLUSION: Anti-vaccination attitudes have increased with the COVID-19 vaccines during pandemic. Our study is valu-able in terms of examining the reasons of individuals who have not gotten vaccinated even though they had no access prob-lems. Prominent concerns of the population should be approached seriously. Otherwise, vaccine hesitancy can be a decisive factor that would prevent the success of the struggle against pandemic

Anti-neuronal antibodies associated with headache with neurological deficits and cerebrospinal fluid lymphocytosis

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Sick euthyroid syndrome is associated with poor prognosis in patients with ST segment elevation myocardial infarction undergoing primary percutaneous intervention

Background: Concomitant thyroid and heart disease are frequently encountered in clinical practice. There are many studies evaluating thyroid function in acute and critical conditions. Information on thyroid dysfunction in ST-segment elevation myocardial infarction (STEMI) is limited; its correlation with short and long-term outcome is not fully known.Methods: Four hundred and fifty seven patients diagnosed with STEMI in our emergency department were included in the study. Patients were divided into two groups: patients with normal thyroid function (euthyroid) and patients with thyroid dysfunction. STEMI was diagnosed with 12 derivation surface electrocardiogram. Thyroid hormone levels (TSH, free T3 and free T4) were measured. Patients with other acute coronary syndromes and endocrine pathologies except diabetes mellitus were excluded. Two patient groups were compared in terms of in-hospital and long-term outcome.Results: Out of 457, 72 (15%) patients with thyroid dysfunction were detected. The other patients were euthyroid and constituted the control group. In-hospital cardiogenic shock (15% vs. 3% in the control group; p < 0.01) and death (7% vs. 1% in the control group; p < 0.01) were more frequently observed in the thyroid dysfunction group. In the subgroup analysis, it was observed that patients with sick euthyroid syndrome have the poorest outcome. Other markers for poor outcome were anemia and renal failure.Conclusions: Thyroid dysfunction, particularly sick euthyroid syndrome, was found to be related to in-hospital and long term mortality in patients with STEMI undergoing primary percutaneous intervention

Peroneal Tendon Rekonstrüksiyonunda Otogreft Olarak Hamstring Tendonları Kullanılabilir mi? Kadavra Çalışması

Amaç: Kronik peroneal tendon yırtıklarının rekonstrüksiyonunda tendon transferleri ve otogreftler kullanılabilir. Bu kadavra çalışmasında peroneal tendonların rekonstrüksiyonu için otogreft hamstring tendonlarının kullanımının çap uygunluğu açısından değerlendirilmesi amaçlandı. Gereç ve Yöntem: Çalışmada 13 (4 kadın, 9 erkek) taze donmuş kadavra alt ekstremitesinden otogreft olarak 13 adet makroskopik yaralanması ve dejenerasyonu olmayan, hamstring tendonları (gracilis, semitendinosus) standart yöntemler ile elde edildi ve ölçüme alındı. Ardından aynı kadavraların peroneal tendonları (peroneus longus, peroneus brevis) standart yöntemler ile elde edilerek ölçüme alındı. Tendon çap ölçümleri tendonların en kalın olduğu orta bölgesinden dijital mikro kumpas yardımıyla yapıldı. Ölçümler sonucunda hamstring tendonları ile her iki peroneal tendon kalınlıkları istatistiksel olarak değerlendirildi. Bulgular: Çalışmaya dahil edilen kadavraların yaş ortalaması 74,07±12,25 (minimum: 51, maksimum: 94) yıl iken vücut kitle indeksi ortalaması 25,38±6,07 olarak bulundu. Çapları değerlendirilen tendonlar ile cinsiyet arasında istatistiksel olarak anlamlı bir fark bulunmadı (her biri için p>0,05). Hamstring tendonları (grasilis ve semitendinosus) boyutları ile, peroneus longus ve brevis tendonları arasında pozitif bir korelasyon mevcuttu (her biri için p<0,01). Ayrıca tendon orta çap değerlendirmesi sonucuna göre semitendinozus tendon çap ortalamasının peroneal tendonların çap ortalamasına daha yakın olduğu tespit edilmiştir. Sonuç: Kronik peroneal tendon yırtıklarının rekonstrüksiyonunda otogreft olarak, her iki peroneal tendonun rekonstrüksiyonu için semitendinozus tendonunun kullanılması tendon orta çapları değerlendirmesine göre daha uygun olabileceği kanaatine varıldı