The Relationship Between Arthroplasty Surgeons' Experience Level and Optimal Cable Tensioning in the Fixation of Extended Trochanteric Osteotomy

Introduction: In this study, our aim was to examine the relationship between the arthroplasty surgeons' experience level and their aptitude to adjust the cable tension to the value recommended by the manufacturer when asked to provide fixation with cables in artificial bones that underwent extended trochanteric osteotomy (ETO). Materials and Methods: A custom-made cable tensioning device with a microvoltmeter was used to measure the tension values in Newtons (N). An ETO was performed on 4 artificial femur bones. Surgeons at various levels of experience attending the IXth National Arthroplasty Congress were asked to fix the osteotomized fragment using 1.7-mm cables and the tensioning device. The participants' demographic and experience data were investigated and recorded. The surgeons with different level of experience repeated the tensioning test 3 times and the average of these measurements were recorded. Results: In 19 (35.2%) of the 54 participants, the force applied to the cable was found to be greater than the 490.33 N (50 kg) value recommended by the manufacturer. No statistically significant difference was determined between the surgeon's years of experience, the number of cases, and the number of cables used and the tension applied over the recommended maximum value (P = .475, P = .312, and P = .691, respectively). Conclusions: No significant relationship was found between the arthroplasty surgeon's level of experience and the adjustment of the cable with the correct tension level. For this reason, we believe that the use of tensioning devices with calibrated tension gauges by orthopedic surgeons would help in reducing the number of complications that may occur due to the cable

Scheduling surgery after transarterial embolization: does timing make any difference to intraoperative blood loss for renal cell carcinoma bone metastases?

PURPOSEOur purpose is to clarify the optimal timing of surgery after transarterial embolization (TAE) for renal cell carcinoma (RCC) bone metastases.METHODSThis retrospective study included 41 patients with RCC bone metastases embolized between 2013 and 2019. Different-sized particulate and/or liquid embolic agents were used for TAE. Embolizations were categorized into groups 1–3 according to the interval between TAE and surgery (group 1: 3 days). Degree of embolization after TAE was graded visually based on angiographic images (90%). The relationship between the TAE–surgery interval and intraoperative blood loss (IBL) and the correlation between IBL and embolization grade were examined. Lesion sizes and the relationships among lesion localizations and contrast media usage, intervention time, and IBL were also analyzed.RESULTSForty-six pre-operative TAEs (single lesion at each session) were performed in this study (26 in group 1, 13 in group 2, 7 in group 3). Lesion sizes and distributions were similar between groups (p = 0.897); >75% devascularization was achieved in 40 (TAEs 86.96%), but the IBL showed no correlation with the embolization rate (r=0.032, p = 0.831). The TAE–surgery interval was 1–7 days. The median IBL in group 1 (750 mL; range, 150–3000 mL) was significantly lower than those in the other groups (p = 0.002). Contrast media usage (p = 0.482) and intervention times (p = 0.261) were similar for metastases at different localizations. IBL values after TAE were lower for extremity metastases (p = 0.003).CONCLUSIONBone metastases of RCC are well-vascularized, and to achieve lowest IBL values, surgery should preferably be performed <1 day after TAE

Almanya'ya göç eden 1. kuşak Türk işçiler

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2012.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by Selim Tezcan.Tezcan, Selim. HIST 200-01TEZCAN HIST 200-01/2 2011-1

Influence of Abdominal Binder Usage after Cesarean Delivery on Postoperative Mobilization, Pain and Distress: A Randomized Controlled Trial

Objective: The purpose of the present study was to determine the effect of abdominal binder usage on mobilization, postoperative pain, and distress after cesarean delivery

The Diagnostic Value of the Modified mSIS Score in Predicting Sentinel Axillary Lymph Node Positivity in Patients with Early-Stage Breast Cancer

Axillary lymph node metastasis is the most important prognostic factor in breast cancer. No method exists to diagnose the metastasis of the axillary lymph nodes before surgery.  Sentinel lymph node biopsy is a procedure for axillary staging. Hematological parameters and systemic inflammation play a role in cancer metastasis. This study aims to evaluate the modified Systemic Inflammation Score (mSIS) score predicting sentinel axillary lymph node positivity in early breast cancer patients and to determine if there is a need to modify it. This is a retrospective study conducted in Ankara City Hospital General Surgery Department from March 2019 to July 2021.  One hundred fifty-nine patients were analyzed according to age, albumin parameters, Thrombocyte, Lymphocyte and Monocyte count, histopathological type of cancer, and lymph node metastasis status. The collected information was entered into SPSS 24.0 program. Lymph node metastasis was detected in 51 of these 159  patients. Results showed no significant difference between the lymph node metastasis group and no lymph node metastasis group after applying the mSIS score to each group. This result is due to normal albumin levels in early breast cancer patients. Platalet lymphocyte ratio (PLR) is associated with lymph node metastasis in breast cancer. PLR is applied to mSIS score instead of albumin.The  new modified early-stage breast cancer SIS(mebcSIS) was established as follows: Score 0: LMR ≥ 5.7 and PLR &lt; 141, Score 1: LMR &lt; 5.7 or PLR ≥ 141, Score 2: LMR &lt; 5.7 or PLR ≥ 141. The relationship between mebcSIS and LNM was statistically significant (p = 0.003). There is a positive correlation between mebcSIS score and lymph node metastasis in early breast cancer patients.

Nomadic Sheep Breeding in Western Anatolia and the Role of Animal Breeding Programs

Bu çalışmada, Denizli ve Isparta illerinde göçer küçükbaş hayvancılık yapan ailelerin hayvancılık faaliyetleri hakkında ayrıntılı bilgilerin sunulması amaçlanmıştır. Gözlem, görüşme formu ve anket tekniklerinin kullanıldığı bu çalışma, bir alan araştırmasıdır. Denizli ve Isparta illerinde araştırma materyalini oluşturan işletmeler kışın iklimin daha yumuşak olduğu yörelere göç etmektedirler. Göçer koyuncular genellikle İzmir, Aydın, Muğla gibi Güney Ege illerine göç etmektedirler. Ekonomik açıdan bakıldığında görece yüksek bir gelir getirmesi yanı sıra, sosyolojik olarak da yüzyıllardır sürdürülen geleneksel bir yaşam tarzıdır. Bunun yanı sıra göçer koyunculuk birçok sorunu da beraberinde getirmektedir. Bu nedenle bu üretim sistemi için devlet eliyle ciddi politikaların devreye sokulması gerekmektedir.In this study, detailed information about nomadic families in Denizli and Isparta Province dealing with stockbreeding activities was given. The study was based on field activities consisting of observations, interviews and questionnaire techniques. Nomadic sheep breeders, which consist of the research material in Denizli and Isparta, migrate from regions with cold climate in winter to temperate regions. Nomadic sheep breeders has been migrated to Southern Aegean region such as İzmir, Aydın, Muğla etc. in general. Besides economically important due to relative higher income opportunity, the nomadic life is also sociologically important as a traditional life style surviving by centuries. As well as, nomadic sheep production brings with many problems. Therefore, for this production system, the introduction of policies by the government is need

Comparison of laparoendoscopic single-site (LESS) surgery and conventional multiport laparoscopic (CMPL) surgery for hysterectomy: long-term outcomes of abdominal incisional scar

There is scarcity of data about the long-term results such as port-site hernia, body image scale and cosmesis scale outcomes between laparoendoscopic single-site (LESS) surgery and conventional multiport laparoscopy (CMPL) for hysterectomy. Eighty women, who underwent total hysterectomy by the LESS (n = 40) and CMPL (n = 40) technique due to benign and malign gynecological disorders, were evaluated with a cosmesis and body image questionnaire in an age-matched cohort study. Median follow-up time was 25 (6–30) months in both groups. The mean age of the patients was 49.3 ± 6.3 years. The mean body image scale scores were 5.3 ± 0.6 and 5.5 ± 1.2 in the LESS and CMPL groups, respectively (p = 0.268). The mean cosmesis and scar scale scores were significantly higher in the LESS group compared to the CMPL group (p = .011 and p < .001, respectively). Port-site hernia was detected in two patients in the LESS group, but not in the CMPL group. There was no cuff dehiscence in the LESS nor in the CMPL group. The LESS technique provides better cosmesis when compared with the CMPL technique. The body image perceptions in the two groups were similar. Women who wish to undergo the LESS surgery should be informed about the risk of incisional hernia.Impact statement What is already known on this subject? Short-term results of LESS hysterectomy such as complication rates, additional port requirement, conversion to CMPL or laparotomy, pain score and analgesic use were evaluated in various studies. Several studies have been published on the safety and efficacy of single-port laparoscopic hysterectomy (LH); however, it has been unclear whether single-port LH offers benefits over multiport LH regarding long-term patient satisfaction and cosmetic satisfaction. What do the results of this study add? In this prospective cohort study, we aimed to compare long-term results (at least six months) of abdominal incisional scar between LESS and CMPL surgery for hysterectomy. The LESS technique provides better cosmesis when compared with the CMPL technique, although, the body image perceptions in the two groups were similar. What are the implications of these findings for clinical practice and/or further research? LESS technique can be offered as an option for hysterectomy since it provides better long-term cosmesis compared to CMPL

The neglected value of phosphate ion for respiratory functions in cardiac surgery

Objective: Hypophosphatemia can cause a chain of chemical reactions leading to acute respiratory failure. Therefore it is of potential with regard torelevance with postoperative respiratory complications. The aim of our study was to evaluate the correlation between the serum phosphate level and pulmonary functions after cardiac surgery. Material: A total of 66 patients who had a normal initial phosphate level and who had cardiac surgery under cardiopulmonary bypass in a tertiary healthcare hospital between November 2013 and May 2014 were enrolled in our study. All of their data was retrospectively evaluated. Method: All the operations were performed by the same surgical team. Patients were grouped according to postoperative serum phosphate levels as group A with normal level and group B with low level. Results: The demographic and pre-operative variables were found to be similar between both groups (p > 0.05). Intraoperative and postoperative comparisons of the two groups showed that the postoperative phosphate level (p = 0.001) and postoperative use of inotropic agent (p = 0.047) differed significantly. Correlation analyses showed a significant negative correlation between postoperative phosphate levels and time of mechanical ventilatory support (r = -0.367; r(2) = 0.135; p = 0.002). Conclusions: Hypophosphatemia was found to be an independent risk factor for prolonged mechanical ventilatory support. Postoperative measuring of phosphate serum levels should not be underestimated after cardiac surgery