Hip Fracture Mortality: Is It Affected by Anesthesia Techniques?

We hypothesized that combined peripheral nerve block (CPNB) technique might reduce mortality in hip fracture patients with the advantage of preserved cardiovascular stability. We retrospectively analyzed 257 hip fracture patients for mortality rates and affecting factors according to general anesthesia (GA), neuraxial block (NB), and CPNB techniques. Patients' gender, age at admission, trauma date, ASA status, delay in surgery, followup period, and Barthel Activities of Daily Living Index were determined. There were no differences between three anesthesia groups regarding to sex, followup, delay in surgery, and Barthel score. NB patients was significantly younger and CPNB patients' ASA status were significantly worse than other groups. Mortality was lower for regional group (NB + CPNB) than GA group. Mortality was increased with age, delay in surgery, and ASA and decreased with CPNB choice; however, it was not correlated with NB choice. Since the patients' age and ASA status cannot be changed, they must be operated immediately. We recommend CPNB technique in high-risk patients to operate them earlier

Diagnosis and Treatment of Multiseptate Gallbladder with Recurrent Abdominal Pain

Laparoscopic cholecystectomy is usually performed for gallstones or polyp of the gallbladder. Multiseptate gallbladder is a rare congenital malformation. Although several asymptomatic cases have been described, patient usually present with right upper abdominal pain. We present a 29-year-old female patient with multiseptate gallbladder, cholecystectomy was performed, and her abdominal pain and gastrointestinal complaints have resolved

Comparison of Different Surgical Options in the Treatment of Pilonidal Disease: Retrospective Analysis of 175 Patients

Pilonidal sinus disease is a benign disorder with an unidentified etiology and is observed mainly in young adults. It is an important health problem because it causes work loss. Although various nonsurgical treatment options have been tried up to date, there is a consensus on surgical intervention to treat the disease today. The optimal surgical method should be simple, associated with short hospital stay and low recurrence rates. In this study, patients who have undergone different surgical treatment methods due to pilonidal disease were retrospectively analyzed. The medical records of 175 patients who were operated on between 2002 and 2005 at the General Surgery Departments of Gaziosmanpasa University Medical School and Bartin State Hospital for pilonidal disease were reviewed for treatment option, postoperative complications, hospitalization time, work-off periods, and recurrence rates. The patients consisted of 150 (85.3%) males with a mean age of 26.47 ± 7.78 years. Marsupialization was applied to 82 (46.9%), unroofing to 20 (14.7%), primary closure to 29 (16.6%), and Limberg flap to 44 (25.1%) patients. The longest hospitalization period of 3.61 ± 1.08 days was observed in the Limberg flap group. The longest return to work period (20.12 ± 5.1 days) was observed in the marsupialization group. Both differences were significant. The highest complication rate was observed among the primary closure group (31%) followed by the patients treated by Limberg flap technique (15.8%). In the primary closure group, infection was detected in five (17.2%) and wound dehiscence in four (13.8%) individuals. The highest complication rates (31.03%) and recurrences (13.8%) were observed in the primary closure group. Various operative methods utilized in the treatment of pilonidal disease are associated with a number of advantages and disadvantages. Postoperative complication rates of unroofing and marsupialization are low, but require long wound care. In our study, we did not observe any recurrence among the patients treated by unroofing, but experienced a high recurrence ratio among subjects treated by marsupialization. In addition, there were high complication rates in the primary closure and Limberg flap groups. So, the best option is to explain the advantages and disadvantages of the available surgical methods and respect the patient's decision

Formation of Two-Way Shape Memory Effect in NiTi Alloy Using Pulsed Laser Irradiation

Shape memory alloys (SMAs) are a unique class of smart materials and they were employed in various applications in engineering, biomedical, and aerospace technologies. Here, we report an advanced, efficient, and low-cost direct imprinting method with low environmental impact to create thermally controllable surface patterns. Patterned microindents were generated on Ni50Ti50 (at. %) SMAs using an Nd:YAG laser with 1064 nm wavelength at 10 Hz. Laser pulses at selected fluences were focused on the NiTi surface and generated pressure pulses of up to a few GPa. Optical microscope images showed that surface patterns with tailorable sizes can be obtained. The depth of the patterns increases with laser power and irradiation time. Upon heating, the depth profile of SMA surfaces changed where the maximum depth recovery ratio of 30 % was observed. Recovery ratio decreased and saturated at about 15 % when the amount of time and thus the indent depth was increased. Laser-induced shock wave propagation inside the material was simulated and showed a good agreement with the experimental results. The stress wave closely followed the rise time of the laser pulse to its peak value and initial decay. Rapid attenuation and dispersion of the stress wave were observed

Scalable Patterning Using Laser-Induced Shock Waves

An advanced direct imprinting method with low cost, quick, and minimal environmental impact to create a thermally controllable surface pattern using the laser pulses is reported. Patterned microindents were generated on Ni50Ti50 shape memory alloys and aluminum using an Nd: YAG laser operating at 1064 nm combined with a suitable transparent overlay, a sacrificial layer of graphite, and copper grid. Laser pulses at different energy densities, which generate pressure pulses up to a few GPa on the surface, were focused through the confinement medium, ablating the copper grid to create plasma and transferring the grid pattern onto the surface. Scanning electron microscope and optical microscope images show that various patterns were obtained on the surface with high fidelity. One-dimensional profile analysis indicates that the depth of the patterned sample initially increases with the laser energy and later levels off. Our simulations of laser irradiation process also confirm that high temperature and high pressure could be generated when the laser energy density of 2  J/cm2 is used

Splenic infarction as a complication of celiac artery thromboembolism: an unusual cause of abdominal pain

Splenic infarction is a relatively uncommon diagnosis and this clinical presentation can mimic other causes of acute abdominal pain. Cardiologic and hematologic disorders are common reasons for this entity. There have been a few series and single case reports of splenic infarction published in peer-reviewed medical journals. We report a 53-year-old patient who had splenic infarction caused by celiac artery thromboembolism. The importance of this case, without any etiological predisposing factors, is that this kind of clinical situation should be considered in the differential diagnosis of abdominal pain