Intraocular Hemorrhage due to use of Sildenafil in a Patient with Diabetes

Sildenafil is one of the most commonly used drugs for sexual dysfunction or to increase libido, and it regulates endothelial nitric oxide synthase enzyme via selective phosphodiesterase-V inhibition. Sildenafil can be easily obtained without a medical indication or prescription yet it is not considered as a completely safe medication. Hemoptysis and hemorrhagic stroke are some important adverse effects of sildenafil. The case of the current report was a 67-year-old diabetic patient with simultaneous anterior and posterior segment hemorrhage after the use of 100 mg sildenafil citrate. Anterior chamber clearance and pars plana vitrectomy were performed for the patient because the hyphema and vitreous hemorrhage did not resolve during the follow-up period. There are very limited data available in the literature suggesting an increase in the risk of hyphema or vitreous hemorrhage due to the use of sildenafil. This is the first report that reveals the bleeding effect of sildenafil use in a patient with type 2 diabetes

The Relationship of Neutrophil to Lymphocyte Ratio with Vitreomacular Traction Syndrome

This study was conducted to reveal the role of systemic low-grade inflammation by calculating the Neutrophil/Lymphocyte Ratio (NLR) in Vitreomacular Traction Syndrome (VMTS) of different etiologies. A retrospective examination was made of the medical records at a tertiary referral hospital. The study included 31 patients with diabetic VMTS, 27 patients with idiopathic VMTS, and 35 healthy subjects as the control group. The White Blood Cell (WBC) counts and Neutrophil-to-Lymphocyte Ratio (NLR) was compared. There were  insignificant differences between the groups in terms of mean age and female/male ratio (P>0.05). The mean ± Standard Deviation (SD) of NLR was calculated as 2.43 ± 0.83 in the diabetic VMTS group, 2.38 ± 0.96 in the idiopathic VMTS group, and 1.83 ± 0.52 in the control group (P=0.007). The values of the diabetic and idiopathic VMTS groups were significantly higher than those of the control group (P=0.002 and P=0.032, respectively). However, differences between the diabetic and idiopathic VMTS groups were insignificant (P=0.651). This study found significantly higher NLR in patients with diabetic and idiopathic VMTS than the control group. Elevated NLR could therefore be a potential indicator of VMTS, irrespective of the etiology

Quality and reliability of trigger finger youtube videos

Introduction. Orthopedic video contents published on YouTube are not scanned and do not go through an editorial evaluation process. It is important to determine the quality and content accuracy of health-related videos. Trigger finger is a common disease and the deterioration in quality of life. However, the quality, content and adequacy of YouTube videos as a source of information about this disease have not been evaluated. The aim of this study is to investigate the quality and adequacy of the medical content of the videos on YouTube about trigger finger disease. Methods. In September 2022, the phrase “trigger finger” was entered in the YouTube search bar and the 50 most watched videos were included in the study, provided that the language of the video was English. Who uploaded the videos, real or animated content, number of views, upload date, number of comments, number of like-dislikes and video length were recorded. 3 orthopedic surgeons and 1 hand surgeon watched the videos simultaneously and separately. JAMA, DISCERN and GQS scores were calculated. Results. Average length of 50 videos is 321 seconds, number of views is 244,150, number of days from upload date to evaluation date is 1,789 days, VPI was 94, view ratio was 300. The average scores of 4 different surgeons from the parameters used for the quality and relevance analysis of the videos: JAMA 2, DISCERN 36, and GQS 2. The scores of 4 different surgeons were statistically compatible with each other (p = 0.000). The interclass correlation coefficient (ICC) was 0.906 for the JAMA score, 0.889 for the DISCERN score, and 0.831 for the GQS score. Conclusions. YouTube videos about trigger finger were low quality and unreliable. In the light of our study and other studies, the possibility of high-quality and reliable videos for patients can be increased by the evaluation and inspection of videos present-ed by YouTube

Connective tissue growth factor in human gingiva, and studies of lysyl oxidase processing proteinases

Thesis (D.Sc.D)--Boston University, Henry M. Goldman School of Dental Medicine, 2001 (Oral Biology)Includes bibliographical references (leaves 67-86).The first part of our studies is focused on gingival overgrowth. Gingival overgrowth is characterized by excess extracellular matrix (ECM) accumulation. TGF-J31 regulation of connective tissue growth factor (CTGF) was assessed for the first time in human gingival cells and tissues. CTGF protein is strongly induced by TGF-J31 in human gingival fibroblasts. Exogenous addition of CTGF to gingival fibroblasts stimulates production of lysyl oxidase enzyme activity up to 1.5-fold after 48 hours, and 50 ng/ml CTGF stimulated insoluble collagen accumulation by only 1.5 to 2.0 fold after 4 to18 days of treatment. Thus, although CTGF itself contributes to increased insoluble collagenous extracellular matrix accumulation, CTGF does not mediate more potent effects of TGF-J31. Gingival overgrowth samples obtained from patients undergoing therapy with phenytoin, nifedipine, and cyclosporin A and control tissues from systemically healthy donors were subjected to immunohistochemistry by staining with CTGF, and TGF-J3 l antibodies. The results indicate for the first time increased levels of CTGF protein in overgrown gingival tissues, particularly in phenytoin induced gingival overgrowth. The second part of our studies is focused on the Bmpl-related genes. The Bmpl gene encodes bone morphogenetic protein 1 (BMP-1) and mammalian Tolloid-like (mTLD), both of which have procollagen C-proteinase activity. Two BMP-1/mTLD­related protease genes named mammalian Tolloid-like 1 and 2 (Till and Tll2) have recently been described. The present study determines and compares the abilities of recombinant BMP-1, mTLD, mTLL-1, and mTLL-2 to process a recombinant pro-lysyl oxidase fusion protein in vitro. Results suggest that recombinant BMP-1, mTLD, and mTLL-1 productively cleave pro-lysyl oxidase at the correct physiological site in vitro, and that BMP-1 itself appears to be the most efficient lysyl oxidase processing activity while mTLL-2 was shown to process pro-lysyl oxidase slowly in vitro. These studies suggest that pro-lysyl oxidase processing may depend principally on the presence of Bmpl gene products, and that mTLL-1, and mTLL-2 may contribute to pro-lysyl oxidase processing

Relationship Between Chronic Obstructive Pulmonary Disease and Severity of Diabetic Retinopathy

The negative effects of chronic obstructive pulmonary disease (COPD) on diabetes mellitus (DM) patients are known. For these reasons, we aimed to investigate the effect of COPD on the severity of diabetic retinopathy (DRP) in patients with DM. Materials and Methods: This prospective cross-sectional study included one-hundred and fifty-six eyes of 156 patients with COPD and DM. Multinomial logistic regression models were applied to evaluate the independent relationships between DRP and COPD, including adjusting for patients’ characteristics. Results: After adjustment for potential confounders, patients with low-level COPD were found to have less PDR and severe PDR. (RRR 0.01 95% CI 0.01-0.03, RRR 0.01 95% CI 0.01-0.08, respectively). Conclusion: The findings suggest an increased risk of DRP severity in patients with severe COPD. Ophthalmologists following these patients should consider the relationship between COPD and DRP

Interdental Alveolar Distraction In an Adult Patient with a Unilateral Wide Alveolar Cleft: Case Report

Aim:To demonstrate treatment of an adult patient with a wide unilateral cleft by segmental alveolar distraction using a hyrax screw.Subjects and Methods:An 18 year-old boy presented with a right complete cleft lip and palate; collapsed lateral segments; a retruded position of the premaxilla; and a Class III relationship. Tollowing orthodontic expansion and alignment of the upper teeth the residual width of the cleft was too wide to successfully grafting and it was decided to mesialize the right buccal segment surgically by means of callus distraction using an intraoral tooth-anchored hyrax screw under local anesthesia. After three weeks of activation and a 12 weeks retention period bone grafting was performed.Results:After alveolar grafting the cleft was found to have an osseous closure with adequate soft tissue coverage and the integrity of the maxilla was provided. However, as the skeletal relation was not appropriate for the space closure of the missing lateral incisor the disuse atrophy of the grafted bone could not be prevented.Conclusion:Segmental alveolar distraction can be a good choice in the treatment of adult patients with wide residual alveolar clefts. But, teeth movement is the most important factor in the long term success of the grafted bone

Determining the Opinions of the Prospective (Candidate) Teachers About Public Personnel Selection Exam (KPSS)

AbstractThe purpose of the study is to determine the views of the pre-service teachers enrolled at faculties of education at some universities in Turkey on the Selection Examination for Professional Posts in Public Organizations which they have to enter in order to be assigned as a teacher and get the required score. The study of group of the study was composed of 799 pre-service teachers who were at the senior class of faculties of education at Gazi University, Zonguldak Karaelmas University, Ahi Evran University and Kastamonu University in Turkey. These pre-service teachers were given three choices as the Selection Examination for Professional Posts in Public Organizations (KPSS), an examination that measure the Field + Teaching Profession knowledge proficiency level and other and they were asked why they preferred that choice. The written views of the pre-service teachers were read by the researcher and pre-determined and main problems and themes observed during the analysis were determined. When the findings of the study were examined, it was found that 207 pre-service teacher stated that KPSS was required in order to be assigned as a teacher, 540 pre-service teachers stated that they wanted to be assigned through an examination that measure Field + Teaching Profession Knowledge levels. When the views of the pre-service teachers on KPSS were examined, it was seen that most of the pre-service teachers wanted to be assigned through an examination that measure Field + Teaching Profession knowledge level and they listed the reasons for this as KPSS was a nonsense and unnecessary examination; the teachers that were assigned without measuring their knowledge on the field were not qualified and efficient; entering an exam including General Culture and General Ability parts which were unrelated to their fields might decrease the achievement; and they thought that KPSS could not measure the professional proficiency. It was also found that some of the 52 pre-service teachers that choose the other choice stated that some applications like personality test, interview, etc. should be implemented and some of them stated that there was no need for an examination in order to be assigned as a teacher

An Extensive Warfarin-Induced Jejunal Hematoma

The most common adverse event associated with oral anticoagulation (OAC) is bleeding in general that is seen in 5 to 48% of patients and gastrointestinal bleeding (GIB) in particular which occurs in 2–4% of patients. Intramural hematoma (IMH) is a rare variant of GIB, occurring in 1 in every 2500 patients and is treated with OACs. IMHs are rarely fatal and the current data suggest conservative medical therapy and clinical follow-up for management of IMHs. GIB and intestinal IMH is becoming a more common clinical problem because of increasing number of patients taking OACs. This report describes a 91-year-old woman who was presented with abdominal discomfort for 2 days. The patient had been under anticoagulant therapy with warfarin because of atrial fibrillation. She was found to have an inappropriately prolonged international normalized ratio level of 8.1. IMH was confirmed with abdominal ultrasound and computed tomography (CT) scan. The patient was treated conservatively with fluid resuscitation, nasogastric decompression, bowel rest and reversal of anticoagulation. Follow-up CT scans, approximately one month after medical treatment, demonstrated complete resolution of the IMH. Intestinal IMH should be considered in the differential diagnosis of acute abdomen in any anti-coagulated patient with abdominal complaints

Olfactory Neuroblastomas: An Experience of 24 Years

Objective. The aim of this study was to evaluate clinicopathological findings and the efficacy of the treatment modalities used in patients with olfactory neuroblastomas. Study Design. Retrospective record review. Setting. Istanbul University, Cerrahpasa Medical Faculty, medical oncology outpatient clinic. Subjects and Methods. There were 3 stage A tumors, 5 stage B and 11 stage C according to the Kadish staging system. There were 5 grade I/II and 12 grade III/IV according to the Hyams' histopathologic system. Involvement to orbita was detected in eight patients at the time of diagnosis. Results. The median follow-up period was 23.7 months. The 5-year survival rate for the whole group was 26%. The stage A/B groups exhibited a better survival rate than the C group with 2-year survival rates being 25 versus 71% respectively (P = .008). The grade I/II groups exhibited a better survival rate than the grade III/IV groups with 2-year survival rates being 50 versus 16% respectively (P = .001). The group who had orbital involvement exhibited a poor survival rate than the group of patients who had no involvement of the orbital. Conclusion. In our study, tumor stage, histopathologic grading, involvement of the orbita, brain and bone marow metastases were the statistically significant prognostic factors