Ipsilateral olecranon and distal radius fracture: A case report

WOS: 000397094300056PubMed ID: 25544490INTRODUCTION: Concomitant ipsilateral olecranon and distal radius fracture are rare injuries. Their clinical presentation is unusual and investigation and management is poorly described. PRESENTATION OF CASE: We present a 55-year-old woman patient who fell off sustaining a concomitant distal radius and olecranon fracture in the same extremity. On examination, there was gross swelling of the proximal and distal forearm and no neurovascular deficit. Radiographs confirmed distal radius and olecranon fracture. Patient was treated with open reduction and anatomic locking plate for olecranon and a closed reduction percuteneous K wire fixation with penning fixator for distal radius fracture. After physical therapy program, functional results were good and DASH score was 60. DISCUSSION: Several different combinations of fracture with dislocation have been described, but, to our knowledge, concurrent ipsilateral olecranon and distal radius fracture has not been reported before. In the literature review there are two similar cases in the English literature. CONCLUSION: Ipsilateral olecranon and distal radius fracture is a very rare injury due to different trauma mechanisms. However we should keep in mind that there may be adjacent joints and structures for concomitant injuries

Pediatrik Hastalarda Manyetik Rezonans Ürografi İle İntravenöz Piyelografinin Etkinliğinin Karşılaştırılması

Amaç: İntravenözpiyelografi İVP böbrek fonksiyonlarını ve anatomik özelliklerini gösteren bir yöntemdir. Fakat iyonizan radyasyon içermesi nedeniylepediatrik yaş grubunda kullanılması uygun değildir. Bu nedenle son zamanlarda kullanımı yaygınlaşan manyetik rezonansürografi MRÜ ile üriner patolojiler değerlendirilmeye çalışılmaktadır. Bizde çalışmamızda MRÜ’ninüriner sistem dilatasyonlarını göstermekte İVP ile arasındaki farkları incelemeyi amaçladık.Gereç ve Yöntem: Bu retrospektif çalışmada 40 pediatrik yaş grubundaki hastanın İVP ve MRÜ tetkikleri incelendi.Tetkikler arasındaki pelvikalisiyel sistem dilatasyon dereceleri karşılaştırıldı. Bulgular: MRÜ ile İVP arasında pelvikalisiyel sistem dilatasyon derecelerini saptama konusunda anlamlı farklılık izlenmedi

Diffusion Weighted Magnetic Resonance Imaging for the Characterization of Solitary Pulmonary Lesions

Background: We evaluated the differential diagnosis of solitary pulmonary lesions on magnetic resonance imaging.Aims: To investigate the value of diffusion weighted imaging on the differential diagnosis of solitary pul-monary lesions.Study Design: Randomized prospective study.Methods: This prospective study included 48 solitary pulmonary nodules and masses (18 benign, 30 ma-lignant). Single shot echo planar spin echo diffusion weighted imaging (DWI) was performed with two b factors (0 and 1000 s/mm2). Apparent diffusion coeffi-cients (ADCs) were calculated. On diffusion weighted (DW) trace images, the signal intensities (SI) of the le-sions were visually compared to the SI of the thoracic spinal cord using a 5-point scale: 1: hypointense, 2: moderately hypointense, 3: isointense, 4: moderately hyperintense, 5: significantly hyperintense. For the quantitative evaluation, the lesion to thoracic spinal signal intensity ratios and the ADCs of the lesions were compared between groups.Results: On visual evaluation, taking the density of the spinal cord as a reference, most benign lesions were found to be hypointense, while most of the malignant lesions were evaluated as hyperintense on DWI with a b factor of 1000 s/mm2. In contrast, on T2 weighted images, it was seen that the distinction of malignant lesions from benign lesions was not statistically significant. The ADCs of the malignant lesions were significantly lower than those of benign lesions (mean ADC was 2.02×10-3 mm2/s for malignant lesions, and 1.195×10-3±0.3 mm2/s for benign lesions). Setting the cut-off value at 1.5×10-3, ADC had a sensitivity of 86.7% and a specificity of 88.9% for the differentiation of benign lesions from malignant lesions.Conclusion: DWI may aid in the differential diagnosis of solitary pulmonary lesions. (ClinicalTrials.gov Iden-tifier: NCT02482181

Late Diagnosis of Bladder Injury During Cesarean Section

Intraoperative bladder injury in cesarean deliveries is an important complication that causes maternal morbidity. Bladder adhesions resulting from previous abdominal operations, cesarean section under emergency conditions, cesarean section after prolonged labor or in the second stage of labor are predisposing factors for bladder injury. In order to prevent bladder injury, it is important to be aware of bladder injury during peritoneal incision in risky cases, delivery of the baby, and hysterotomy and fascia closure. In this article, we present the diagnosis and treatment of a patient who was diagnosed with intraperitoneal bladder perforation, intra-abdominal abscess and peritonitis one week after cesarean section, in the light of current literature. In our case, intraoperative diagnosis could not be made, postoperative active hematuria was not observed, the focus was on the diagnosis of postoperative ileus, and intra-abdominal abscesses developed. A multidisciplinary team ensured success in the treatment

Clinical Study Effects of Zoledronate on Mortality and Morbidity after Surgical Treatment of Hip Fractures

We aimed to evaluate the effects of intertrochanteric femoral fractures on mortality, morbidity, and cost of zoledronate treatment in elderly patients treated by osteosynthesis. Based on Evans classification, 114 patients with unstable intertrochanteric femoral fractures were treated with osteosynthesis. After the surgical treatment of intertrochanteric fractures, the treatment group (M/F, 24/32; mean age, 76.7 ± SD years) received zoledronate infusion, and the control group (M/F, 20/38; mean age, 80.2 ± SD years) received placebo. Postoperative control visits were performed at 6-week, 3-month, 6-month, and 12-month time points. Functional level of patients was evaluated by the modified Harris hip score and Merle d' Aubigné hip score. By 12 months, the mean HHS in treatment and control groups was 81.93 and 72.9, respectively. For time of death of the patients, mortality was found to be 57.1% (16/28) on the first 3 months and 92.9% (26/28) on the first six months. The mortality rate in the treatment and control groups was 14.3% (8/56) and 34.5% (20/58), respectively. The use of zoledronic acid after surgical treatment of intertrochanteric femoral fractures in osteoporotic elderly patients is a safe treatment modality which helps to reduce mortality, improves functional outcomes, and has less side effects with single dose use per year

Does pelvic injury trigger erectile dysfunction in men?

WOS: 000442089500008PubMed ID: 26764545Purpose: Pelvic ring fractures constitute 3%-8% of all fractures of the skeletal system and are generally related with high energy trauma. Sexual dysfunction following pelvic fracture has a high incidence, and affects the male patients both physically and psychologically. In this study, we aimed to investigate the impact and frequencies of comorbidities such as erectile dysfunction (ED) with adverse sociocultural and psychological consequences for the patient who had a pelvic ring fracture. Methods: This study included 26 men who corresponded to the inclusion criteria and agreed to participate our study. Results: According to fracture types, most of our cases were Tile type A1 and type A2. Severe and moderate ED were detected in 46.1% (12/26) of these patients via the International Index of Erectile Function-5 questionnaire. Conclusion: ED develops following pelvic fractures, especially in Tile type B and C pelvic fractures

Turkish translation, validation, and reliability analysis of pediatric eosinophilic esophagitis symptom severity module version 2.0

The Paediatric Eosinophilic Esophagitis Symptom Severity Modules Version 2.0 (T-PEESv2.0) was developed in English as a valid, reliable questionnaire for follow up. This work aimed to develop a Turkish version of T-PEESv2.0 via translation and cultural adaptation and then to test its validation and reliability. Methods: The PEESv2.0 was translated into Turkish by standardized procedural steps completed in cooperation with the Mapi Research Trust. The final version of the questionnaire was submitted to eosinophilic oesophagitis patients or their parents at 2 times point separated by 1 week. An age-matched control group was used to test the discriminant validity. Construct validity was tested using the Wilcoxon test, and internal consistency was tested using Cronbach's alpha. Test-retest reliability was measured with Cohen's kappa and intraclass correlation coefficient. Results: One hundred twenty-eight participants (70 patients, 58 parents) were enrolled. Fifty-eight (39.1%) of them completed T-PEESv2.0-parent by proxy and 70 (54.7%) were T-PEESv2.0. The Cronbach's alpha coefficient and intraclass correlation coefficient for test-retest reliability were >0.70 for both questionnaires and for all domain (frequency and severity) and total scores. For discriminant validity analysis, subscale (frequency and domain) and total scores of the patient group were compared with those of the control group. The subscale and total scores were significantly different between the groups (P < 0.05). Conclusion: T-PEESv2.0 appeared to be valid and reliable, ready to be introduced as a clinical and research tool for the assessment of patients with eosinophilic oesophagitis

Comparison of CYFRA 21-1, CEA, CA 19-9 and CA 72-4 levels in gastric cancer

Objective: Gastric cancer is the fourth most common malignancy,and the second most common cause of cancermortality worldwide. The aim of this study was to investigatethe role of biomarkers CYFRA 21-1, CA 19-9, CEA,CA72.4 at diagnosis and throughout the follow-up in patientswith gastric cancer.Methods: 30 patients with gastric cancer diagnosed and31 healthy people as a control group were included in thisstudy. According to the TNM staging system, there were16 patients with stage II and 14 patients with stage III inthe group of patients with gastric cancer. CEA, CA 19-9,CA 72-4 and CYFRA 21-1 levels were studied by elektrochemiluminescenceimmunasay (ECLIA) method in theCobas e 601 instrument.Results: Statistically the level of CA 72-4, CA 19-9, CEAand CYFRA 21-1 gastric cancer groups was found significanthigh accaording to healthy control group (p<0.01).Statistically compared with II stage patient group, the levelof CA 19-9, CEA and CYFRA 21-1 of III stage patientgroup was found significant high (p<0.01). The diagnosticcut-off, sensitivity and specificity for CEA were 4.15 ng/mL, 46 % and 96%, respectively; for CA 19-9 were 24.50U/mL, 17 % and 96 %; for CA 72-4 were 2.46 U/mL, 53% and 96% and for CYFRA 21-1 were 3.36 ng/mL, 46%and 100%.Conclusion: Our study demonstrates that the associationof biomarkers CYFRA 21-1, CEA, and CA72.4 providesa valuable contribution in the follow-up of gastriccancer patients.Key words: Gastric cancer, tumor markers, CYFRA 21-

The association of silicosis severity with pectoralis major muscle and subcutaneous fat volumes and the pulmonary artery/aorta ratio evaluated by CT

PURPOSESilicosis is an incurable occupational disease that sometimes rapidly progresses with fatal outcomes. We aimed to evaluate the association between disease severity and the change in the pectoralis major muscle volume (PMV), subcutaneous fat volume (SFV), and the pulmonary artery/aorta (P/Ao) ratio in patients with silicosis using computed tomography (CT).METHODSThe study included 41 male silicosis patients and 41 control group subjects with available chest CT images. Using dedicated software, we measured PMV and SFV from the axial CT images. We calculated the P/Ao ratio and obtained body mass index (BMI) and forced expiratory volume/forced vital capacity (FEV1/FVC) results from hospital records. We used the chest X-ray profusion score according to the International Labor Organization (ILO) classification to evaluate the severity of the silicosis.RESULTSThe mean age was 33.5±4.4 and 34.7±4.7 years in the silicotic and control groups, respectively. The mean BMI, PMV, SFV, and P/Ao values significantly differed between the study and control groups (P = 0.0009, P < 0.0001, P < 0.0001, and P = 0.0029, respectively). According to the ILO classification, there were 12 silicosis patients in category 1, 13 in category 2, and 16 in category 3. A significant difference was found between disease categories in terms of PMV, SFV, P/Ao, BMI, and FEV1/FVC values (P = 0.0425, P = 0.0341, P = 0.0002, P = 0.0492, and P = 0.0004, respectively).CONCLUSIONDisease severity had a stronger association with decreased PMV and SFV and increased P/Ao ratios than BMI in patients with silicosis caused by denim sandblasting. Thus, CT evaluation might be a useful indicator of disease severity

Comparisons between ultrasonographic screening results and risk factors of developmental dysplasia of the hip

Amaç: Çalışmamızın amacı ultrasonografik taramanın seçilmiş hastalarda mı (risk faktörleri ya da muayene bulguları olan) ya da genel popülasyon üzerinde mi yapılması gerektiğini değerlendirmektir. Gereç ve Yöntem: Kliniğimize 2010-2012 gelişimsel kalça displazisi (GKD) taraması amacıyla başvuran 634 bebek çalışmaya dâhil edildi. Risk faktörleri olarak aile öyküsü, makat gelişi, tortikollis, ilk gebelik, oligohidramniyos, çarpık ayak, kız cinsiyet olarak belirlendi. Graf metodu ile yenidoğan kalçaları taranarak, hastalardaki risk faktörleri ve klinik muayene bulguları istatistiksel olarak duyarlılık ve özgüllük açısından karşılaştırıldı. Bulgular: Çalışmaya alınan 634 bebeğin 403'ü kız, 231'i erkekti. Hastaların ortalama yaşı 87,45±49,6 gündü. Ortalama anne yaşı 29,6±5,4 yıldı. Ultrasonografik tarama sonucunda 66 bebeğin 71 kalçası displazik bulundu. Bu kalçalardan 30'u Tip 2b, 8 kalça Tip 2c, 3 kalça Tip d, 23 kalça Tip 3, 7 kalça Tip 4 olarak tespit edildi. Sonuç: Çalışmamızda klinik bulguların GKD taraması açısından yeterli olmadığı sonucuna ulaşılmıştır. Bu nedenle de özellikle ülkemiz gibi GKD prevelansının sık görüldüğü ülkelerde seçilmiş hastalara ultrasonografik tarama yapmaktansa tüm popülasyonun ultrasonografik taramasının yapılması gerektiği düşüncesindeyiz.Objective: The aim of the study is to evaluate the efficacy of ultrasonographic screening in general population and selected patients (who had risk factors or clinical findings) for developmental dysplasia of the hip (DDH).Material and Methods: 634 babies who had been admittted to our clinic between 2010 and 2012 were included in the study. Family history, breech presentation, torticollis, first child, oligohydramnios, club foot, and female gender were accepted as risk factors. The newborns patients were evaluated with Graf method. Risk factors and clinical findings of the patients were compared with these results for sensitivity and specificity. Results: 403 patients were female and 231 patients were male. The mean age of the patients were 87.45&plusmn;49.6 days and the mean maternal age was 29.6&plusmn;5.4 years. In the screeening of the patients 66 babies with 71 hips were dysplasic (30 hips Type 2b, 8 hips Type 2c, 3 hips Type d, 23 hips Type 3, and 7 hips Type 4).Conclusion: According to our study, clinical examination of the patients is not sufficient for the screening of the babies for DDH. We think that the ultrasonographic screening of the babies for DDH is recommended for general population of high risk countries like Turkey