The effect of knee length and thigh length antiembolism stockings on deep vein thrombosis prophylaxis

WOS: 000317438000010Background: This study aims to evaluate the effect of the length of anti-embolism stockings on the prevention of postoperative deep vein thrombosis. Methods: The sample consisted of 44 male patients who underwent radical prostatectomy and urinary diversion. The patients were randomly divided into two groups, including knee length stockings group (n=22; mean age 61.7 +/- 9.1 years) and thigh length stockings group (n=22; mean age 62.1 +/- 7.0 years). For data collection, the Patient Assessment Form, Deep Vein Thrombosis Symptom Form and Color Doppler Ultrasonography Results of Lower Extremity Deep Venous System were used. Statistical analysis was performed using, the chi-square test, Student t-test and Mann-Whitney U analysis. Results: In the knee length stockings group, the operation time was 174.3 +/- 68.6 min and the duration of using antiembolism stockings was 6.1 +/- 1.3 days, while the operation time was 177.4 +/- 72.9 min in the thigh length stockings group and the duration of using antiembolism stockings was 6.2 +/- 1.4 days. According to the results of the lower extremity color Doppler ultrasonography performed before discharge, deep vein thrombosis was not detected in the patients of any group. When the symptoms associated with deep vein thrombosis were evaluated preoperatively and postoperatively, it was observed that a very small number of patients experienced it, however, the diagnosis of deep vein thrombosis was not verified in any of them. Conclusion: Our study results suggest that there is no difference between knee length and thigh length antiembolism stockings in the prevention of deep vein thrombosis. However, knee length antiembolism stockings are recommended postoperatively to avoid possible complications, due to its ease of use and patient comfort

Effect of Injectable Platelet-Rich Fibrin on Diced Cartilage's Viability in Rhinoplasty

###EgeUn###Diced cartilage is one of the most widely used camouflage technique in rhinoplasty. Its variable resorption rate creates issues in postoperative time period. Platelet-rich fibrin is an autologous concentrated blood derivative containing growth factors that accelerate tissue healing. The authors evaluate the effect of injectable platelet-rich fibrin (I-PRF) on the viability of diced cartilage, which has been used for dorsum camouflage in rhinoplasty. Forty patients were randomly divided into two groups based on dorsal camouflage grafts: diced cartilage with I-PRF (study group) and diced cartilage without I-PRF (control group). Cartilage graft thickness was measured by linear superficial tissue ultrasound at the postoperative first week and the third month in both groups. The mean cartilage graft thickness loss between the first-week and third-month ultrasound measurements was 0.58 +/- 0.21mm in the study group and 0.82 +/- 0.35mm in the control group. There was significant volume loss in the control group. I-PRF was successful in reducing the resorption rate of diced cartilage on nasal dorsum by either increasing the viability or keeping its form. Sticky cartilage is an easily applicable and reliable technique that may be used to camouflage dorsal irregularities in rhinoplasty.European Acad Facial Plast Sur

A novel method for comparison of tissue fibrosis after inferior turbinate surgery: Ultrasound elastography

WOS: 000351717100012PubMed ID: 25590315Background: Ultrasound (US) elastography has been widely used for thyroid, liver, and lymph nodes as a research tool in the current medical practice. It has been described in the inferior turbinates and validated as a reliable, reproducible, noninvasive, and objective method that can detect the fibrosis-related tissue strain. There is no previous study that investigated the amount of fibrosis induced by radiofrequency and bipolar electrocautery in the inferior turbinates in a noninvasive and objective manner. The aim of this study was to assess the amount of inferior turbinate soft tissue fibrosis that was induced by radiofrequency ablation (RFA) and submucosal bipolar diathermy (SBD) by US elastography. Methods: Thirty-eight inferior turbinates of 19 patients were included. RFA was applied to 18 inferior turbinates (group 1) and SBD was applied to 20 inferior turbinates (group 2). US elastography and visual analog scale (VAS) assessments were performed on all patients preoperatively and 6 months postoperatively. Results: Preoperative mean US elastography scores in groups 1 and 2 were 2.55 +/- 0.78 m/s and 2.56 +/- 0.49 m/s, respectively (p 0.05). Conclusion: Both RFA and SBD of the inferior turbinates were effective in inducing scar tissue and, eventually, fibrosis in the soft tissue of inferior turbinates. Cauterization has been found to cause significantly higher amounts of fibrosis than radiofrequency; however, it did not reflect the comparable clinical outcome. This is the first study that objectively and noninvasively evaluates the targeted tissue fibrosis of the inferior turbinate surgeries by the novel inferior turbinate US elastography

The Effect of Platelet-Rich Fibrin on Nasal Skin Thickness in Rhinoplasty

###EgeUn###The study hypothesized the potential positive effects of platelet-rich fibrin (PRF) in postoperative rhinoplasty patients, such as better wound healing, less dead space, and less edema. The authors assessed PRF for nasal dorsum camouflage and studied its potential effects on nasal dorsal skin in rhinoplasty. Thirty-eight patients who underwent open approach primary rhinoplasty were categorized into two groups: nasal dorsal PRF group and control group. PRF membrane was used for nasal dorsum camouflage and laid over the bony dorsum and cartilage framework of the supratip area. Skin and subcutaneous soft tissue thickness were measured by linear superficial tissue ultrasound at the pre- and postoperative first week and the third month in both groups. Mean skin thickness over the supratip area was significantly higher in the control group in the first-week control. There were no significant differences in both first-week and third-month controls' nasal dorsum mean skin thickness measurements between the two groups. Regarding PRF complications, we encountered no complications in either group, including scarring, hematoma, infection, skin discoloration, and acne. The authors present the application of PRF membrane over the bony dorsum and cartilage framework of the supratip area. They observed its positive effect on postoperative edema, especially in the early postoperative period. Long-term investigations have to be performed to evaluate its potential effect on the rhinoplasty procedure. This was a level of evidence 3 study.European Acad Facial Plast Sur

Evaluation of Hepatosplenomegaly and Liver Function Tests in 102 Brucellosis Cases

Introduction: Brucellosis is a systemic infection which in volves many organs including liver. In this study, it was aimed to review the hepatosplenic findings in allcases followed up in our clinic with the diagnosis of brucellosis. Materials and Methods: Allcases, we followed up in our clinic between July 2006 and October 2014 with the diagnosis of brucellosis, were reviewed retrospectively. Cases with microbiological culture confirmation and/or Wright agglutination test positivity with a titer of 1/160 or higher were considered brucellosis. Results: There were a total of 102 cases meeting the inclusion criteria (43 female (42.2%), 59 male (57.8%), aged 47.1 ± 16). Eighty-two (80.3%) patients had a titer of 1/160 or more Wright agglutination test positivity. Three patients had negative Wright agglutination test but had anti-humanglobulin test positivity. Seventeen (16.7%) patients were diagnosed with only blood culture. The most common three symptoms were fever (63.7%), weakness (48%) and back pain (48%). Hepatomegaly and splenomegaly were determined with ultrasonography in 16 (15.8%) and 19 (18.8%) cases, respectively. About 23.8%, 24.8%, 26.8%, 36.6%, and 12.9% of the patients had elevated levels of AST, ALT, ALP, GGT and total bilirubin, respectively. Forty-two (41.2%) patients had no remarkable pathology in the liver. Mean age of the cases without a remarkable liver pathology was 51.1 ± 14.9; whereas, mean age of the rest of the cases was 44.3 ± 16.3 (p= 0.035). Liver function tests improved in all cases with treatment. There was no severe adverse drug reaction during treatment. Conclusion: Brucellosis is a zoonotic disease that primarily affects the reticuloendothelial system, and may cause liver damage. Its response to treatment is high. However, there was no pathology in ultrasonography in majority of the cases. In a brucellosis endemic country such as Turkey, it must be kept in mind that the disease may present without significant liver involvement

The Relationships between Serum sTWEAK, FGF-23 Levels, and Carotid Atherosclerosis in Renal Transplant Patients

WOS: 000313670000013PubMed ID: 23101788Background: Cardiovascular disease is the main cause of mortality after renal transplantation. Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and fibroblast growth factor-23 (FGF-23) are two novel molecules that have been associated with atherosclerosis in different populations. In this cross-sectional study, we investigated the associations between sTWEAK, FGF-23, and carotid artery intima-media thickness (CA-IMT) in renal transplant patients. Methods: A total of 117 renal transplant patients were studied. CA-IMT was determined by B-mode Doppler ultrasonography. Serum sTWEAK and FGF-23 were measured by a commercially available enzyme-linked immunosorbent assay (ELISA). Results: Mean age was 39.6 +/- 9.6 years and 51% of the patients were male. Mean sTWEAK level was 595 +/- 225 pg/mL (158-1140), FGF-23 level was 92 +/- 123 RU/mL (9.6-1006), and CA-IMT level was 0.62 +/- 0.11 mm (0.40-0.98). sTWEAK level was positively correlated with CA-IMT. There was no association between sTWEAK and FGF-23 levels. FGF-23 was also associated with CA-IMT. In adjusted models using linear regression analysis, only age and serum TWEAK levels were predictors for CA-IMT. Conclusion: There is a positive correlation between CA-IMT and sTWEAK, but not with FGF-23 levels in renal transplant patients.Loo and Hans Ostermans Foundation; Swedish research councilSwedish Research CouncilJuan Jesus Carrero acknowledges support from the Loo and Hans Ostermans Foundation and the Swedish research council. The others declare no conflict of interest. The authors alone are responsible for the content and writing of the paper

Effect of Shorter Antimicrobial Prophylaxis and Pre-Intervention Measures on Infections Developing After Transrectal Prostate Biopsies

Introduction: Transrectal prostate biopsy (TPB) is currently a commonly used invasive procedure for the diagnosis of prostatic diseases. Due to increasing infectious complications after TPBs in our institute, it was decided to change antimicrobial prophylaxis regimens and pre-intervention measures. The aim of this study was to evaluate the effects of shorter antimicrobial prophylaxis, intestinal cleansing and single use sterile gels on infections developing after TPBs in our tertiary-care educational hospital. Materials and Methods: Infections developing in the last six months after TPB were evaluated retrospectively by using records of microbiology, radiology and urology departments. Sterilization and disinfection, antimicrobial prophylaxis regimens, intestinal decontamination procedures and routine biopsy procedures were reevaluated in cooperation with the corresponding clinics. Afterwards, it was decided to implement three changes in the TPB practice: 1) Shortening the antimicrobial prophylaxis, 2) Intestinal cleansing one day before the intervention by using enema, and 3) Using sterile gel (single patient use only) during biopsy. Patients were diagnosed as clinical or microbiologically confirmed healthcare-associated infection according to the "Centers for Disease Control and Prevention" criteria. The preintervention period was 2007 July-December and the intervention period was 2008 January-July. Results: Overall infection/infectious complication rate (10.5% vs. 3.8%; p=0.007), overall clinically defined infection rate (4.8% vs. 1.1%; p=0.028) and overall microbiologically defined infection rate (5.8% vs. 2.7%; p=0.002) decreased significantly in the post intervention period. Conclusions: Our findings suggest that shorter antimicrobial prophylaxis regimens, using sterile gels and intestinal cleansing may be useful in the control of infections developing after TPB