Does the presence of arthroscopically detected stage 1-2 glenohumeral osteoarthritis have any clinical impact on the outcome of arthroscopic rotator cuff repairs?

MakaleWOS:000941667500026PubMed ID: 36945963Background/aim: Rotator cuff rupture (RCR) and glenohumeral osteoarthritis (GHO) are two common disorders of the shoulder joint. However, there are very few reports that examine the relationship between them. This study aimed to present at least two years' clinical results of arthroscopic rotator cuff repair of full-thickness and massive tears accompanied by arthroscopically detected early-stage osteoarthritis.Materials and methods: From August 2016 to December 2017, three hundred and twenty patients with total or massive rotator cuff tears were evaluated retrospectively. Thirty-five patients who were determined as stage 1 and 2 according to the Outerbridge scale for cartilage lesions were found appropriate for investigation. Patients were assessed using the University of California Los Angeles (UCLA) score, and a visual analog scale (VAS) score before surgery and at the final follow-up. The American Shoulder and Elbow Surgeons (ASES) shoulder score was used to evaluate the final outcomes and compare the UCLA shoulder scores.Results: The UCLA scores increased from the preoperative value of 19.1 +/- 3.2 to 29.8 +/- 4.8 at the last follow-up and increased by an average of 10.7 +/- 6.0 (p < 0.001). The median VAS score decreased from the preoperative value of 3.0 to 1.0 (p < 0.001). Besides, the mean ASES score was found as 80.2 +/- 10.6. An excellent positive correlation was found between postoperative UCLA scores and ASES scores (r = 0.887; p < 0.001).Conclusion: To the best of our knowledge, this is one of the first arthroscopic comparative studies about the effect of early glenohumeral osteoarthritis on clinical outcomes after rotator cuff tear treatment. Finding good and excellent results up to 71% after RCR repair in patients with early-stage osteoarthritis was an indication that arthroscopic repair could be planned as the first-line treatment option for RCR pathologies in patients with early-stage degenerative arthritis without considering the rerupture rate.Department of Public Health, Gazi University Medical Facult

A Case of Cranial Meningioma with Symptoms Similar to Nasopharyngeal Mass

Meningiomas are generally slow-growing benign tumors associated with the dura. They form lumps that mostly grow extra-axially, by repulsing, rather than infiltrating the surrounding neural parenchyma. Majority of meningiomas are intracranial. However, although rare, meningioma formation has been reported in almost all other organs. We report the case of a patient with an extra- neuraxial meningioma presenting as a nasopharyngeal mas

Plyometric exercising of athletes at adolescence periodAdolesan dönemde bulunan sporcularda pliometrik antrenman

Strength is among the most frequently researched subjects in the field of sports sciences. The main reason for strength’s being researched this much in sports is thought to be its being an important motoric characteristic that affects sportive performance  most of the researches focusing on strength have focused on relationship between strength and sportive performance, relationship between strength and the other motoric characteristics, and the effects of different exercising models on strength development.   Among those strength exercises, plyometric trainings have become the mostly preferred exercising models. Plyometric trainings are strength development methods that include jumping drills and pliometric exercises for the upper extremity. While plyometric exercises are the methods used by elite athletes frequently, they have been used on adolescence athletes as well in recent years. However, although there are some reservations on the implementation of plyometric exercises on adolescence athletes, it is also stated that provided that these exercises are done relevant to their aims and in a systematic way, they contribute to a healthy strength development.     This study focused on the content and characteristics of plyometric exercises different from adults, their effect on strength development. ÖzetSpor bilimleri alanında üzerinde en fazla araştırma yapılan konuların başında kuvvet gelmektedir. Sporda kuvvet ile ilgili çok sayıda araştırma yapılmasının temelinde kuvvet özelliğinin sportif performansı etkileyen önemli bir motorik özellik olmasının yattığı düşünülebilir. Kuvvet üzerine yapılan araştırmalarda genellikle kuvveti sportif performans ile ilişkisi, kuvvetin diğer motorik özellikler ile ilişkisi ve uygulanan farklı kuvvet antrenman modellerinin kuvvet gelişimine etkilerinin ele alındığı görülmektedir. Söz konusu kuvvet antrenmanları içerisinde pliometrik antrenmanlar da son yıllarda en fazla kullanılan antrenman modellerinin içerisinde yer almaktadır. Pliometrik antrenmanlar sıçrama drillerinin üst ekstremiteye yönelik pliometrik egzersizlerin yer aldığı kuvvet geliştirme yöntemleridir. Pliometrik antrenmanlar elit düzeyde sporcuların sıklıkla kullandığı bir yöntem iken, son yıllarda adolesan dönemdeki sporcular üzerinde de kullanılmaya başlanmıştır. Ancak literatürde adolesan sporcularda pliometrik antrenmanların uygulanışına yönelik bazı kaygılar bulunmakla beraber, amacına uygun ve sistemli yapılan pliometrik antrenmanların sağlıklı bir kuvvet gelişimine katkı sağladığı da belirtilmektedir. Yapılan bu araştırmada da adolesanlarda pliometrik antrenmanların içeriği, yetişkin antrenmanlarından ayrılan özellikleri ve kuvvet gelişimine etkileri üzerinde durulmuştur

Effect of cartilage thickness mismatch in osteochondral grafting from knee to talus on articular contact pressures: A finite element analysis

Objectives: The aim of this study was to investigate the effect of cartilage thickness mismatch on tibiotalar articular contact pressure in osteochondral grafting from femoral condyles to medial talar dome using a finite element analysis (FEA). Materials and methods: Flush-implanted osteochondral grafting was performed on the talar centromedial aspect of the dome using osteochondral plugs with two different cartilage thicknesses. One of the plugs had an equal cartilage thickness with the recipient talar cartilage and the second plug had a thicker cartilage representing a plug harvested from the knee. The ankle joint was loaded during a single-leg stance phase of gait. Tibiotalar contact pressure, frictional stress, equivalent stress (von Mises values), and deformation were analyzed. Results: In both osteochondral grafting simulations, tibiotalar contact pressure, frictional stress, equivalent stress (von Mises values) on both tibial and talar cartilage surfaces were restored to near-normal values. Conclusion: Cartilage thickness mismatch does not significantly change the tibiotalar contact biomechanics, when the graft is inserted flush with the talar cartilage surface

Gastrointestinal quality of life in patients with asymptomatic cholelithiasis after laparoscopic cholecystectomy

To assess the outcome of laparoscopic cholecystectomy for asymptomatic cholelithiasis before and after laparoscopic cholecystectomy using a specific quality of life instrument for gastrointestinal disorders in adults : The Gastrointestinal Quality of Life Index (GIQLI) was used to study the quality of life in patients before and after laparoscopic cholecystectomy : Seventy one patients completed the GIQLI questionnaire both preoperatively and after a minimum postoperative follow-up of three months. Mean preoperative score was 126.8±14.07 out of a theoretical maximum score of 144.After three months, the score had significantly improved to 136.6±9.31, close to the range for the normal population. Not only items assessing gastrointestinal symptoms but also the domains of physical, social, and emotional function improved significantly. The most marked improvements were achieved in patients with the lowest preoperative scores. Laparoscopic cholecystectomy significantly improves the quality of life in patients with cholelithiasis who are asymptomatic or have nonspecific gastrointestinal symptoms that cannot be explained by another gastrointestinal pathology.Bu çalısmada asemptomatik kolelitiyazis olgularının ameliyat öncesi ve ameliyat sonrası hayat kalitesi degerlendirilmistir. Hastaların ameliyat öncesi ve sonrası hayat kalitelerinin ölçümü gastrointestinal hayat kalitesi indeksi parametreleri kullanılarak belirlenmistir. Çalısmaya alınan 71 hasta ameliyat öncesi ve ameliyattan en az 3 ay sonra gastrointestinal hayat kalitesi indeksine göre sorgulanmıstır. Preoperatif dönemde ortalama skor 126.8±14.07, 3 ay sonra yapılan sorgulamada ise ortalama 136.6±9.31 olup normal populasyona yakın bir oranda saptanmıstır. (toplam skor 144). Gastrointestinal semptomlarının yanı sıra fiziksel, sosyal ve duygusal durumlarında da anlamlı düzelme gözlenmistir.Düsük skorlu hastalarda bu iyilesmedaha belirgindir. Asemptomatik kolelitiyazisli hastalarda baska gastrointestinal patolojilerle açıklanamayan nonspesifik semptomların laparoskopik kolesistektomiyle iyilesme gösterdigi, hastaların hayat kalitelerinde anlamlı bir artıs oldugu görülmektedir

A fix and optimize heuristic for transportation planning in a single producer multi buyer problem

Bu çalışmada birden fazla bölgede coğrafi olarak dağılmış bulunan bayiler ya da müşterilere ulaştırılacak ürünlerin taşıma planlaması ele alınmaktadır. Üretici ürünlerin dağıtımını lojistik firmalarına yaptırmaktadır. Dağıtımda ya firmalardan kamyon kiralanmakta veya parsiyel taşıma şeklinde ürünler müşterilere parsiyel kargo taşıyıcı firmalar kanalıyla ulaştırılmaktadır. Müşterilerin farklı ürünlere olan talepleri belirli bir planlama periyodu boyunca bilinmektedir. Müşterilere talepleri, talep edilen periyoda kadar taşınmak zorundadır. Müşteriler belirli bölgelere ayrılmışlardır. Ürünlerin taşındığı kamyonların tiplerine göre kapasiteleri vardır ve bu kapasiteler bilinmektedir. Taşıma planlaması yapılırken bir kamyon tarafından ziyaret edilen müşteri başına maliyet, aracın kullanılmasına ve gittiği bölgeye bağlı sabit maliyet ve parsiyel taşıma maliyeti olarak taşınan ürünlerin toplam maliyeti hesaplanmaktadır. Herhangi bir bölgeye ulaşım maliyeti o bölgenin merkeze uzaklığına göre değişmektedir. Çalışılan problem, bölge bazlı ve mesafe bazlı maliyet yapısı olmak üzere iki durumda incelenmektedir. Bir gerçek hayat probleminden yola çıkarak oluşturulan bu problem için literatürdeki sabitle ve optimize et sezgisel metodu uyarlanarak kullanılmıştır. Sezgisel metodun matematiksel modele göre performansı rassal olarak üretilen problem setleri üzerinden değerlendirilmiştir.We address the transportation planning problem for a producer who supplies products to geographically dispersed customers with known demands for a finite planning horizon. The problem originated from a real case which involves a producer of dry pulses, who serves entire Turkey from two production plants. The producer uses services of logistic companies in transporting goods in the form of both renting trucks from a company and using parcel transportation service from a carrier. The decisions that the producer has to make in each period are which customers' demand to load to which trucks, and for which customers' demand to use parcel carrier service. Total cost of transportation is the summation of the fixed renting cost of sending a truck to a zone, a cost depending on the total number of customers visited, and parcel cost. We introduced a mathematical programming model of this problem for the first time in the literature, and suggested a fix and optimize type heuristic solution procedure. We showed the effectiveness of the suggested heuristic on a set of random problem

Investigation of the relationship of osteoarthritis and osteoporosis radiologically and pathologicly in total knee arthroplasty patients

Amaç: Bu çalışmada popülasyonun yaşlanması ile sıklıkları giderek artmakta olan osteoartrit ve osteoporozun ilişkisi ve trabeküler kalınlığın bu hastalıkların mekanizmasındaki yerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Bu çalışma hastanemize başvuran ve primer osteoartrit tanısı konularak eklem rekonstrüksiyonu yapılan hastalarla yapılmıştır. Hastalar radyolojik görüntüleri ile Kellgren Lawrence sınıflandırmasına göre gruplandırılmıştır. Hastalara kemik mineral yoğunluğu ölçümü yapılmış ve cerrahi işlem sırasında kemik örneği alınarak osteoporoz incelemesi yapılmak üzere patoloji laboratuvarına gönderilmiştir. Kemik doku incelemesi konusunda uzman iki ayrı patolog tarafından çift kör olarak yapılmıştır. İstatistiksel analizlerde Ki-kare, Kruskal-Wallis testleri kullanılmıştır. Bulgular: Çalışmaya yaşları 50 ile 84 arasında değişen toplam 62 hasta dâhil edilmiştir. Yaş arttıkça osteoporoz seviyesinin de arttığı tespit edilmiş (p: 0,031) ve vücut kitle indeksi fazla olan hastalarda ise osteoporoz istatistiksel olarak daha az tespit edilmiştir (p: 0,033). Osteoartrit seviyesi ile trabekül kalınlığı karşılaştırıldığında ise trabekül kalınlığı ortalamanın üzerinde olan deneklerin sayısının osteoartrit seviyesi arttıkça arttığı görülmüştür (p: 0,045). Tartışma: Denekler radyolojik olarak incelendiğinde %35,3’ü osteoporotik %52,9’u ise osteopenik seviyede çıkmıştır. Osteoporozun osteoartrit hasta grubunu da es geçmediği görülmektedir. Çalışmada yapılan ölçümlerde osteartritin erken evrelerinde trabeküler kalınlığın ince olduğu tespit edilmiş ve bu sonuç bize osteoartritin tüm subkondral bölgede trabeküler mikro mimarinin 82 bozulması ile başlıyor olabileceğini düşündürmüştür. Bifosfonatların erken evre osteoartrit olgularında ağrı ve progresyonu yavaşlatması da böylece açıklanabilir.Objective: Osteoarthritis and osteoporosis prevelances are increased with the aging of population. It was aimed to investigate relation between osteoarthritis and osteoporosis also mechanism of trabecular thickening. Material and Method: This study was performed on patients who had joint reconstruction with primary osteoarthritis were included. Patients grouped according to Kellgren Lawrence classification. Bone mineral density of the patient was measured; subchondral bone sample was taken during the surgery and sent to pathology laboratory for examination. Specimen was analysed by two pathologist with double blind tecnique. Chi-square and Kruskal-Wallis tests were used as analysis method. Result: A total of 62 patients, aged between 50 and 84 years, were included in the study. It was determined that osteoporosis level increased with aging (p: 0,031) and decreased in patients with higher body mass index (p: 0.033). When osteoarthritis level and trabecular thickness were compared, it was seen that the number of subjects, above the mean of trabecular thickness, increased as the level of osteoarthritis increased (p: 0,045). Discussion: When the subjects were examined radiologically, 35.3% of the patients were osteoporotic and 52.9% of the patients were osteopenic. It is understood that osteoporosis is frequently seen in the osteoarthritis patient group. It was determined that the trabecular thickness was thin in early stages of osteoarthritis and the result showed to us that osteoarthritis may be starting with the disruption of the trabecular micro-architecture in the entire subchondral region. It can also be explained that bisphosphonates retard pain and progression in early stage osteoarthritis cases

Carbon Nanotube-, Boron Nitride-, and Graphite-Filled Polyketone Composites for Thermal Energy Management

In order to improve the thermal conductivity of 30 wt % synthetic graphite (SG)-filled polyketones (POKs), conductive fillers such as multiwall carbon nanotubes (CNTs) and hexagonal boron nitride (BN) were used in this study. Individual and synergistic effects of CNTs and BN on 30 wt % synthetic graphite-filled POK on thermal conductivity were investigated. 1, 2, and 3 wt % CNT loading enhanced the in-plane and through-plane thermal conductivities of POK-30SG by 42, 82, and 124% and 42, 94, and 273%, respectively. 1, 2, and 3 wt % BN loadings enhanced the in-plane thermal conductivity of POK-30SG by 25, 69, and 107% and through-plane thermal conductivity of POK-30SG by 92, 135, and 325%. It was observed that while CNT shows more efficient in-plane thermal conductivity than BN, BN shows more efficient through-plane thermal conductivity. The electrical conductivity value of POK-30SG-1.5BN-1.5CNT was obtained to be 1.0 × 10-5 S/cm, the value of which is higher than that of POK-30SG-1CNT and lower than that of POK-30SG-2CNT. While BN loading led to a higher heat deflection temperature (HDT) than CNT loading, the hybrid fillers of BNT and CNT led to the highest HDT value. Moreover, BN loading led to higher flexural strength and Izod-notched impact strength values than CNT loading

An appropriate way to predict fetal gender at first trimester: anogenital distance

Tokgoz, Vehbi Yavuz/0000-0002-4113-385X; sipahi, mehmet/0000-0001-8344-9863WOS: 000461363000014PubMed: 29298531Background: Using anogenital distance to determine fetal sex is a new method. There is only one study in the literature. We predict that it will pass through the literature as a new method that can be used in determining fetal sex especially in first trimester. Introduction: Determination of fetal gender before birth has been a matter of curiosity for both the family and the clinician. In the presence of gender-linked genetic disease, it becomes an obligation instead of an interest. The aim of this study was to determine the fetal gender accurately at first trimester with anogenital distance (AGD) and to investigate the correlations of nuchal translucency (NT), fetal heart rate (FHR), and crown-rump length (CRL) with AGD. Materials and methods: In this prospective cross-sectional study, AGD measurement was performed in 111 patients with singleton pregnancy from 11 to 13 weeks and 6 days (CRL 45-84 mm). Measurements of AGD >= 4.8 mm were identified for males, and AGD Results: Genders were demonstrated accurately for males as 76.7% and for females as 97.1%. The mean value of AGD was 3.6 mm for females and 5.1 mm for males. There were no relations between fetal gender and FHR and also NT. Conclusions: Gender can be detected with great accuracy in gestations between 11 to 13 weeks and 6 days by using AGD. CRL and gestational week (GW) were determined as nonsignificant predictors of fetal gender by AGD measurement. In order to obtain more accurate results with AGD, consideration of further studies with larger series in different races is recommended