Neglected bilateral congenital dislocation of the patella

Congenital dislocation of the patella is a disorder that presents with dysfunction in extensor mechanism. Although congenital dislocation of the patella mostly occurs in children with genetic disorders, it may also occur in totally healthy children, despite rarely. In this article, we report a 16-year-old male patient who referred to our clinic with complaints of gait disturbance, frequent falls, and muscular weakness in lower extremity. The patient had no complaints during walking, but had difficulty in running and walking up and down the stairs. It was observed that the range of motion of the knee joint was completely painless and the quadriceps muscle strength was evaluated as 3/5. An evaluation of computed tomography and magnetic resonance imaging results showed that the patella was dislocated. It became clear with magnetic resonance imaging that extensor mechanism was continuous but patellar tendon was not attached to its anatomical position. Surgical treatment was not planned because the patient did not describe any pain complaint and there was no limitation of joint movement, he could walk without support and without device and also refused to be operated. The choice of treatment should be based on the patient's preference, and pain and functional status

A case of PICA infarction presenting as vestibuler neuritis

We reported a patient of 50 years old men, who presented with severe acute vertigo and nausea such as vestibuler neuritis without usually symptom or signs of cerebellar dysfunction. Cranial MRI of patient showed acute left infarct in the territory of posterior inferior cerebellar artery (PICA). Clinicians should be aware of the possibility of a cerebellar infarct in patient with acute vestibular syndrome even if the pattern of vertigo and nausea is typical of a vestibular neuritis

Ionic composition of aerosols at Northwestern Turkey

In this study, ionic compositions of 350 aerosol samples collected between April 2006 and May 2008 in a rural area at Northwestern Turkey (Black Sea coast of Turkey) were discussed. Ions accounted for approximately 30% of PM mass. Contributions of secondary aerosol species (NO3-, SO42- and NH4+) were higher than the ions with crustal origin. This indicated that sampling station was under the influence of long range transport because there were no industrial emissions around. Concentrations of ions demonstrated a large variation from day to day. Mann-Whitney W test was applied to compare the medians of summer and winter concentrations of ions. All ions, except for NH4+ and SO42-, showed statistically significant difference between seasons with 95% confidence level. Copyright © 2015 Inderscience Enterprises Ltd

Assessing the risk of asymptomatic dysplasia in parents of children with developmental hip dysplasia

The aim of this study was to investigate whether being the parents of children with developmental hip dysplasia (DDH) is a risk factor for asymptomatic dysplasia

Is it easy to clinically distinguish inflammatory arthritis of bacterial origin from monoarthritis attacks of gout disease?

Acute monoarthritis is a common situation in orthopedic emergency where the patient presents with typical inflamed joint. It is hard to clinically distinguish inflammatory arthritis of bacterial origin from monoarthritis attacks of gout disease. If these two situations, which are the most common causes of acute monoarthritis, are misdiagnosed, outcomes might be catastrophic and costly. Synovial fluid analysis is the most reliable method for confirming the diagnosis although it might not always lead to definitive diagnosis. If there is clinical suspicion for crystal arthropathy, repeated examinations may provide benefits for confirming the diagnosis

The relationship between microscopic hematuria and bladder cancer: Are currently available diagnostic methods reliable? [Mikroskopik hematüri ile mesane kanserinin ilişkisi: Bugün için kullanilan tani yöntemleri güvenilir mi?]

Objective: This study aimed to evaluate the sensitivity and specificity of radiological diagnostic methods, urinary biomarkers and urine cytology for patients with microscopic hematuria in the diagnosis of bladder cancer. Materials and methods: A total of 150 patients with the initial diagnosis of microscopic hematuria were included in the study. Patients were prospectively evaluated in terms of urinary symptomatology, physical examination, smoking habits, intravenous pyelography (IVP), abdominal ultrasonography (USG), Nuclear Matrix Protein 22 (NMP22), urine cytology and NMP22 BladderChek® test. The cut-off point for NMP22 test was accepted as 10 U/mL. Results: Mean age of the study population was 49.8±10.79 years with a male to female ratio of 1.08 (78/72). Overall, 10.7% (n=16) of patients had pathological diagnosis of bladder cancer, whereas 89.5% of the study population had no etiology for microhematuria. IVP was considered as the most sensitive and specific test in the diagnosis of bladder cancer. However, voided urine cytology was the least sensitive test, although it has the same specificity with IVP. The best sensitivity and specificity values were demonstrated when NMP22 and abdominal USG were used in double-test combinations. Conclusion: In microscopic hematuria, the combination of radiological methods with tumor markers such as NMP22 BladderChek® test, provides 100% sensitivity, and protects nearly half of cases from unnecessary cystoscopies

Determination of apropriate concrete mixtures in concrete lined irrigation canals used in the gap region [GAP bölgesi sulama kanal kaplamalarinda kullanilabilecek uygun beton karişim oranlarinin belirlenmesi]

This research was aimed at determining appropliate concrete ratios in concrete lined irrigation channels used under the climatic conditions of Şanliurfa region. Firat river's aggregates, brought from Samsat (Adiyaman) region, were used in preparation of concrete. According to the results obtained, it was found that aggregates used was suitable for concrete production. Different ratios of cement used in the mixture, were prepared through mixing with aggregates with fly ash and chemical admixture called Sika-AER. Amounts of cements in the mixture were decreased in ratios of 0, 10, 15, 20 and 25% by weight and was replaced instead with, fly ash from Afşn-Elbistan Thermal Power Station. The best concrete mixture was found with 15% fly ash. Basic characteristics of this concrete were found as following: compressive strength of 232 kgf/cm2, water absorption of 3.75%, specific weight of 2.41 kg/dm3, relative dynamic elasticity module of 77.13 %, ratios of pore 8.75 %. Sika-AER was added in ratios of 0.05,0.10 and 0.15% of cement in weight. The most suitable cement was obtained with Sika-AER of 0.05 %. And the resulting, concrete mixture had a compressive strengt of 186 kgf/cm2, water absorption of 3.43 %, specific weight of 2.32 kg/dm3, relative dynamic elasticity module of 106.28 %, ratios of pore 8.00 %. At the result fly ash and Sika-AER added were bettened the concrete quality and those type of adding can be used in the GAP region successfully

Long-term fluoroquinolone use before the prostate biopsy may increase the risk of sepsis caused by resistant microorganisms

Objectives: To evaluate the effect of long-term fluoroquinolone treatment before the biopsy in terms of post procedure sepsis. Three-week fluoroquinolone management before the biopsy may lower serum prostate specific antigen (PSA) levels and prevent unnecessary biopsies. Methods: A total of 558 patients were referred to our clinic for transrectal ultrasound (TRUS)guided prostate biopsy. Of the patients, 205 had received levofloxacin 500 mg once a day for 3 weeks before the biopsy to lower the serum PSA levels (group 1). A total of 353 patients had not received any antibiotics before the procedure (group 2). In terms of the postbiopsy sepsis rate, group 1 and group 2 as well as patients who underwent biopsies in the early period and the latter period of the study were compared. Results: Sepsis was diagnosed in 17 patients (3.0%) after biopsy. Of these patients, 11 (5.4%) and 6 (1.7%) were in group 1 and group 2, respectively (P =.0297, OR: 3.28, 95% CI: 1.10-10.13). Sepsis was diagnosed in 7 patients (1.9%) and 10 patients (5.0%) in the early and the latter period of the study, respectively (P =.0771, OR: 0.38, 95% CI:.13-1.09). Escherichia coli was the causative agent in all patients with a positive culture. In addition, 1 patient also had meticillin-resistant Staphylococcus epidermidis (MRSE). All of the E. coli isolates were resistant to fluoroquinolones, and 55.6% were positive for extended spectrum ß-lactamases (ESBL). Conclusions: Long-term fluoroquinolone use to prevent unnecessary prostate biopsy may result in postbiopsy sepsis caused by fluoroquinolone resistant microorganisms. © 2011 Elsevier Inc