Assessment of the quality and reliability of the information on lateral epicondylitis surgery on YouTube

Aim: To investigate the quality and reliability of videos related to lateral epicondylitis (LE) surgery on YouTube® and to define a new scoring system that can be used to assess online information about LE. Method: To conduct the study, a search on YouTube® using the words "lateral epicondylitis surgery" and "tennis elbow surgery" was conducted on February 15, 2022. The first 100 videos that appeared upon the search were included in the study. The videos were classified based on the type of publishing source as a medical doctor, medical center, and Commercial/Medical media agency. Two authors independently analyzed the videos. The quality and reliability of the videos were examined using DISCERN score, Journal of the American Medical Association (JAMA) score, Health on the Net (HON) score, and a novel YouTube® LE-score (LES). Video Power Index (VPI) and View Ratio (VR) were used to assess the popularity of videos. Results: A total of 29 videos were included in the study. There was no significant difference between the groups in terms of DISCERN, JAMA, HON, and LES scores. Although the group of medical doctors had much higher VRs and VPIs, there was no significant difference between the groups. LES score was found to be positively correlated with DISCERN, JAMA and HON (rho 0.879, p< 0.001; rho 0.709, p < 0.001; rho, 0.838, p < 0.001, respectively). Conclusion: The quality and reliability of the online information made available by YouTube® concerning LE surgery had an average level of quality and reliability. In addition, the LES scoring system created by us was highly compatible with the DISCERN and JAMA scoring systems accepted in the literature. It can be used as evaluation scoring in searches about lateral epicondylitis

Characterization of greater middle eastern genetic variation for enhanced disease gene discovery

The Greater Middle East (GME) has been a central hub of human migration and population admixture. The tradition of consanguinity, variably practiced in the Persian Gulf region, North Africa, and Central Asia1-3, has resulted in an elevated burden of recessive disease4. Here we generated a whole-exome GME variome from 1,111 unrelated subjects. We detected substantial diversity and admixture in continental and subregional populations, corresponding to several ancient founder populations with little evidence of bottlenecks. Measured consanguinity rates were an order of magnitude above those in other sampled populations, and the GME population exhibited an increased burden of runs of homozygosity (ROHs) but showed no evidence for reduced burden of deleterious variation due to classically theorized ‘genetic purging’. Applying this database to unsolved recessive conditions in the GME population reduced the number of potential disease-causing variants by four- to sevenfold. These results show variegated genetic architecture in GME populations and support future human genetic discoveries in Mendelian and population genetics

Lateral imaging technique of the femoral neck in a supine-semilithotomy position without a fracture table

Treatment of proximal femoral fractures in the supine position poses has certain challenges, especially due to difficulties in lateral imaging of the femoral neck in cases where there is no fracture table, such as prolonging the surgery time and increasing the dose of radiation exposure. The purpose of this study is to present the lateral imaging technique of the femoral neck by fluoroscopy on the conventional operating table in the treatment of proximal femoral fractures. We applied proximal femoral nail by positioning the healthy leg in a semilithotomy position to facilitate lateral imaging of the femoral neck by fluoroscopy while the patients were in the supine position.The study analyzed 22 patients (12 women, 10 men) with femoral pertrochanteric and basicervical fractures with the following types of fractures (9 patients had AO type 31-A1, 9 patients had AO type 31-A2, 4 patients had AO type 31-B2.1), and with a mean age of 62.1 years (33-75 years). The preparation time of the supine-semilithotomy position was about 2 minutes, and the reduction was finished within 9 intraoperative fluoroscopy exposure times. No patient suffered from a postoperative complication. The mean surgery time was 20 minutes (18-22 minutes), the average number of scopy shots was 8 (7-9), and the mean hospital stay duration was 2 days (2-2 days). We believe that the supine-semilithotomy technique is a suitable treatment option for proximal femoral intramedullary nailing and cannulated screw application. Since the lateral view of the femoral neck is obtained quickly and clearly with this technique, fluoroscopy does not need to be performed repeatedly, so fluoroscopy time and the number of shots are reduced, and the time spent by the patient and the surgical team in the surgery is shortened. [Med-Science 2020; 9(4.000): 1061-4

The effect of platelet-rich plasma on chronic pain in osteoarthritic knees

Platelet-rich plasma (PRP) is an autologous blood product with widespread use in recent years to increase regeneration in many joints and tissues. Knee osteoarthritis is a degenerative process increasing with age and causing chronic pain. Therefore, the aim of the study was to investigate the short-term effectiveness of intra-articular PRP injection, used to provide cartilage regeneration, on chronic pain in osteoarthritic knees. 60 patients with stage 1-4 knee osteoarthritis according to the Kellgren-Lawrence grading scale (K-L) were included in the study. Three doses of PRP were injected into the knee joint once every three weeks. All three initial measurements were made before injection. Chronic pain of the patients was evaluated using visual analog scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) scales on Day 1, Week 3, Week 6, Week 12, and Month 6. 6 months of follow-ups for all 60 patients were completed. Mean baseline values were measured as follows: VAS 8.63 ± 1.0, and KOOS Pain 22.11 ± 13.7, KOOS Sympt 24.80 ± 18.3, KOOS Function 24.90 ± 15.7, KOOS Sport 13.00 ± 11, 6, KOOS QoL 16.16 ± 10.2. Mean values measured during the last follow-up were as follows: VAS 2.30 ± 1.0, and KOOS Pain 81.20 ± 11.7, KOOS Sympt 81.78 ± 12.5, KOOS Function 78.08 ± 10.9, KOOS Sport 73.58 ± 11.7, KOOS QoL 68.91 ± 10.7 values. Significant improvements were observed in VAS and KOOS values after injection compared to the baseline values (p = 0.001 for all). Treatment of knee osteoarthritis (OA) with PRP injection is safe in terms of adverse reactions. PRP seems to be effective in managing pain and improving quality of life in all osteoarthritis stages, especially in patients with K-Lgrade 1-2 knee OA. [Med-Science 2021; 10(2.000): 299-303

Tranexamic acid has positive effect in early period of tenaon healing by stimulating the tumor necrosis factor-alpha and matrix metalloproteinase-3 expression levels

Objectives: This study aims to evaluate the effect of tranexamic acid (TXA) application in tendon healing by using its immunohistochemical effects on tumor necrosis factor-alpha (TNF-alpha), matrix metalloproteinase-3 (NIMP-3), and transforming growth factor-beta (TGF-beta) expression; and to identify if TNF-alpha, MMP-3, and TOF-beta can be used to monitor and evaluate tendon healing or not in tenotomized rat Achilles tendons

Effects of tranexamic acid on the recovery of osteochondral defects treated by microfracture and acellular matrix scaffold: an experimental study

Abstract Background Microfracture and scaffold application in the treatment of osteochondral defects is still one of the most frequently used methods in the clinic. The most important step in this treatment method is the stabilization of fibrin clot. Tranexamic acid (TA) is an antifibrinolytic agent commonly used in orthopedic surgery in recent years. This study evaluated the effect of local TA application on healing of experimentally induced osteochondral defects on rabbits. Methods This paper contains an animal in vivo data and histological outcomes on the effect of TA. Eighteen New Zealand white rabbits were treated unilaterally and cylindrical defects having a width of 4 mm and depth of 5 mm were created in the weight-bearing surfaces of the medial and lateral condyles of the right femur. They were divided into two groups, as group 1 study and group 2 control groups, respectively. One milliliter (ml) of TA was injected into the knee joints of the subjects in group 1. All animals were sacrificed for the extraction of the femur condyles for histologic study at the fourth and eighth weeks after surgery. Histological evaluations were performed by Brittberg and O’Driscoll scores to all samples. Data were organized in a Standard Statistical Package System v.22 software package (SPSS/PC Inc., Chicago, IL.) and reported as mean and median (min-max). Repeated measures ANOVA test was used to compare groups and condyle effects together for each week. p values below 0.05 were considered as statistically significant. Results Samples were taken in the fourth and eighth weeks. The regularity of the surface in group 1 was smoother, and the tissue stability was more robust. Mean Brittberg scores in both weeks were statistically higher in group 1 when compared with group 2. In the microscopic evaluation, it was observed that the regeneration of subchondral and cartilage tissues were more rapid and organized in group 1, and the mean O’ Driscoll scores in both weeks were statistically higher in group 1. Conclusions Application of TA improves the healing time and tissue stability in osteochondral defects which are implanted a-cellular scaffold after microfracture and should be applicable to humans for the treatment of osteochondral defects

Effects of Soybean Extract and L-Tryptophan on 2, 4-Dichlorophenol Induced Testicular Toxicity in Mice

Two, 4-Dichlorophenol (2, 4-DCP), an environmental pollutant has been in agriculture and synthetic chemical industry. The aim of present study was to analyse the testicular toxicity of 2, 4-DCP, which caused biochemical, spermatological and histological changes in male mice and to evaluate the possible ameliorative effect of soybean extract and L-Tryptophan (L-TRP). Soybean extract (25 mg/kg bw/day) and L-TRP (150 mg kg(-2) bw/day) were given by intraperitoneal (ip) route for 14 days. 2, 4-DCP was administered to male mice with drinking water at dose of 1000 ppm for 14 days. Biochemical parameters in serum ((glucose, creatinine, Blood Urea Nitrogen (BUN), Aspartate Transaminase (AST), Alanine Transaminase (ALT), Lactate Dehydrogenase (LDH)), spermatological and histological changes were investigated at the end of the 14 days comparatively with control group. We conclude that soy extract and L-tryptophan alleviate 2, 4-DCP testicular toxicity

Piccolo in transcatheter PDA closure multi-centre study from premature to adolescent children.

In this multi-centre study, the mid- to long-term efficacy and safety of the Amplatzer Piccolo Occluder in patent ductus arteriosus closure in premature and term infants as well as children were discussed. Methods. Between 2016 and 2021, 645 patients, 152 of whom were less than 1 month old, underwent ductus closure with the Piccolo device from five different centres in Turkey. The median age of the patients was 2.2 years, and the mean narrowest point of duct diameter was 1.8 mm. Sixty-two patients weighed ≤ 1.5 kg, 90 patients 1.5-3 kg, and the mean follow-up was 20.4 months. In 396, the duct was closed by the retrograde route. Ductal anatomy was Type A in 285, C in 72, E in 171, and F in 64 patients. Fluoroscopy duration was 6.2 min. The procedure success rate was 99.1%. Device embolisation occurred in 13 patients (2%), and 11 were retrieved with a snare. Cardiac perforation and death developed in one premature baby. The left pulmonary artery and the descending aorta stenosis were observed in 3 (0.4%) and in 5 patients (0.5%). Results. Piccolo device is safe and effective in closing ductus in all age groups. It has low profile for use in premature and newborn babies, a small embolisation risk, and a low residual shunt rate after closure. Conclusion. The Piccolo device can be considered as close an ideal occluder. The lower profile, smaller delivery catheter size, and symmetry of this device allow for a venous or arterial approach

Once-monthly continuous erythropoietin receptor activator (CERA) for haemoglobin maintenance in haemodialysis patients with chronic renal anaemia

BACKGROUND: This study was conducted to evaluate the efficacy and safety of once-monthly continuous erythropoietin receptor activator (CERA) for maintenance of stable haemoglobin (Hb) levels in adult chronic renal anaemia patients on dialysis according to local clinical judgment in Turkey. METHODS: This was a prospective, open-label, single-arm, multi-centre study conducted in 20 centres in Turkey. After a 4-week screening period, eligible patients receiving conventional erythropoiesis-stimulating agents were converted to monthly intravenous CERA and entered a 16-week CERA dose-titration period (DTP) followed by an 8-week efficacy evaluation period (EEP) and a 4-week safety follow-up. The primary endpoint was the proportion of patients whose Hb concentration remained stable within ±1.0 g/dL of their reference Hb and within the range of 10.0–12.0 g/dL during the EEP. RESULTS: A total of 173 patients were screened, 132 entered the DTP and 84 completed the study. Thirty-nine patients [46.4% (95% confidence interval: 35.5–57.7%)] maintained stable target Hb concentrations. The mean change in time-adjusted average Hb concentration was 0.29 ± 1.08 g/dL between baseline and the EEP. The mean CERA monthly dose was 112.4 ± 76.78 µg during the EEP, and the CERA dose was adjusted in 39 patients (36.4%). Eleven patients (8.4%) reported 13 treatment-related adverse events, the most frequent adverse events being infections and infestations, gastrointestinal and vascular disorders. CONCLUSIONS: Once-monthly CERA maintains stable Hb concentrations in chronic renal anaemia patients on dialysis in Turkey. The study results confirm the known efficacy and safety profile of CERA