Effect of demographic features on morphometric variables of the knee joint: Sample of a 20 to 40-year-old Turkish population

This study aimed to investigate the relationship between body mass index (BMI), age, and sex and morphological risk factors that may cause internal knee injuries. The magnetic resonance images of 728 participants who met the inclusion criteria and had a mean age of 34.4?±?6.8 years were analyzed retrospectively. Demographic differences were analyzed by measuring 17 morphological parameters known to be associated with internal knee injuries. Men had a higher anterior cruciate ligament length (ACLL), anterior cruciate ligament width, (ACLW) lateral femoral condylar width (LFCW), medial femoral condylar width (MFCW), lateral femoral condylar depth (LFCD), distal femoral width (DFW), and intercondylar femoral width (IFW) than women (P?<?.05). By contrast, the medial meniscus bone angle (MMBA) was lower in men than in women (P?<?.05). Women aged 31 to 40 years had a lower Insall-Salvati index (ISI) and lateral tibial posterior slope (LTPS) than those aged 21 to 30 years (P?<?.05), whereas men aged 31 to 40 years had a lower ISI than those aged 21 to 30 years (P?<?.05). Women with BMI???30 had a higher LFCW and MFCW but a lower ISI than those with BMI?<?30 (P?<?.05). Men with BMI???30 had a higher LFCW, MFCW, DFW, and MMBA than those with BMI?<?30 (P?<?.05). The use of value ranges structured according to demographic characteristics, rather than a single value range for all patient groups, may contribute to the evaluation and treatment of the morphological features that are thought to be effective in the development of internal knee injuries. These values may also shed light on future radiological risk scoring systems and artificial intelligence applications in medicine. Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc

Morphometric risk factors effects on anterior cruciate ligament injury

Objectives: This study aims to compare the morphometric differences between patients with and without an anterior cruciate ligament (ACL) injury and to investigate the anatomical risk factors associated with ACL injury. Patients and methods: Between February 2020 and February 2022, a total of 100 patients (57 males, 43 females; mean age: 36.2 +/- 6.8 years; range, 18 to 45 years) who were operated for isolated non-contact ACL tear as the patient group and a total of 100 healthy individuals (58 males, 42 females; mean age: 35.0 +/- 6.9 years; range, 18 to 45 years) without an ACL tear as the control group were included. Magnetic resonance imaging scans of the knee joint were included in the study. Morphological variables of the ACL, distal femur, proximal tibia, and menisci were measured. Results: The mean ACL inclination angle and medial meniscus bone angle were 37.7 +/- 3.8 and 20.2 +/- 2.9 in the patient group and 48.1 +/- 3.3 and 25.0 +/- 2.9 in the control group. According to the results of multivariate analysis, those with small ACL inclination angle and medial meniscus bone angle were more likely to have ACL tear (odds ratio: 0.128, intraclass correlation coefficient: 0.038-0.430, p= 0.001). Conclusion: Small ACL inclination angle and medial meniscus bone angle can be a risk factor for ACL tear

Molecular characterization of trichophyton verrucosum strains isolated from cattle by PCR-RFLP

Dermatofitler, insan ve hayvanlarda keratin içeren dokuları infekte ederek dermatofit infeksiyonuna neden olmaktadırlar. Trichophyton verrucosum sığır dermatofitozis olgularının en yaygın etkenidir. Trichophytosis, bütün dünyada hayvancılık sektöründe önemli ekonomik kayıplara neden olması yanında zoonoz olmasıyla da insan sağlığını tehdit etmektedir. Sığırlardan genellikle T. verrucosum izole edilmektedir. Sığırlar bu etkenin doğal rezervuarıdırlar. Bu çalışmanın amacı, sığırlarda hastalığa neden olan dermatofitlerinin izolasyonu ve izole edilen T. verrucosum suşlarının Internal Transcribed Spacer (ITS) bölgelerinin PCR-RFLP ile moleküler ayrımının yapılmasıdır. Bu amaçla dermatofitozisli sığırlardan 90 adet örnek alınarak kültürleri yapıldı. Bu örneklerin kültürü sonucunda 35 (%38,8) adet T. verrucosum izole ve identifiye edildi. Bu suşların DNA izolasyonu gerçekleştirilerek ITS bölgelerin amplifikasyonu gerçekleştirildi. T. verrucosum suşlarının MvaI ve HinfI enzimleri kullanılarak yapılan Restriction Fragment Lenght Polymorphism (RFLP) analizleri sonucunda bir adet RFLP profiline rastlandı. Sonuç olarak, izole edilen T. verrucosum suşlarının PCR-RFLP sonucunda tek bir profile sahip olduğu, farklı profil örneklerinin saptanması için farklı bölgelerden hatta farklı ülkelerden suşların PCR-RFLP’lerinin yapılması gerektiği kanısına varıldı.Dermatophytes infect tissues containing keratin in humans and animals, causing dermatophytosis infection. Trichophyton verrucosum is the most common agent of bovine dermatophytosis cases. Trichophytosis causes big economic lossess throughout the world and also threatens human health by being a zoonosis. T. verrucosum is usually isolated from cattle. Cattle are the natural reservoirs of this agent. The aim of this study is to isolate disease-causing dermatophytes in cattle and to carry out molecular separation of Internal Transcribed Spacer (ITS) regions of the isolated T. verrucosum strains by PCR- Restriction Fragment Lenght Polymorphism (PCR-RFLP). For this purpose, 90 samples were taken from the cattle with dermatophytosis for cultural examination. As a result of the culture of these samples, 35 (38.8%) T. verrucosum were isolated and identified. DNA isolation of these strains was made and amplification of ITS regions was performed. It was only one RFLP profile was found according to the results of RFLP analysis of T. verrucosum strains using MvaI and HinfI enzymes. At the end of study, it was founded that the isolated T. verrucosum strains showed a single profile by PCR-RFLP analysis and PCR-RFLP was a useful tool for the molecular characterization of the strains. İt was also concluded that PCR-RFLPs of strains from different regions or even from different countries might be necessary in order to detect different profiles of the tested samples

Akut pulmoner embolide senkopun klinik, görüntüleme ve hemodinamik korelasyonları ve prognostik etkisi: Tek merkezli bir çalışma

Background: We aimed to determine the clinical, echocardiographic and hemodynamic correlates of syncope as a presenting symptom in pulmonary embolism and its impact on in-hospital and long-term outcomes. Methods: Between July 2012 and October 2019, a total of 641 patients with PE (277 males, 364 females; median age: 65 years; range, 51 to 74 years) in whom the diagnostic work-up and risk-based management were performed according to the current pulmonary embolism guidelines were retrospectively analyzed. Clinical, laboratory and imaging data of the patients were obtained from hospital database system. Results: Syncope was noted in 193 (30.2%) of patients on admission, and was associated with a significantly higher-risk status manifested by elevated troponin and D-dimer levels, a higher Pulmonary Embolism Severity Index scores, deterioration of right-to-left ventricular diameter ratio, right ventricular longitudinal contraction measures, the higher Qanadli score, and higher rates of thrombolytic therapies (p<0.001) and rheolytic– thrombectomy (p=0.037) therapies. In-hospital mortality (p=0.007) and minor bleeding (p<0.001) were significantly higher in syncope subgroup. Multivariate logistic regression analysis showed that higher Pulmonary Embolism Severity Index scores and right-to-left ventricular diameter ratio were independently associated with syncope, while aging and increased heart rate predicted in-hospital mortality. Malignancy and right-to-left ventricular diameter ratio at discharge, but not syncope, were independent predictors of cumulative mortality during follow-up. Conclusion: Syncope as the presenting symptom is associated with a higher risk due to more severe obstructive pressure load and right ventricular dysfunction requiring more proactive strategies in patients with pulmonary embolism. However, with appropriate risk-based therapies, neither in-hospital mortality nor long-term mortality can be predicted by syncope.Amaç: Bu çalışmada pulmoner embolide başvuru anında senkopun klinik, ekokardiyografik ve hemodinamik korelasyonları ve hastane içi ve uzun dönem sonuçlar üzerindeki etkisi incelendi. Ça­lış­ma pla­nı: Temmuz 2012-Ekim 2019 tarihleri arasında tanı testleri ve risk esaslı tedavisi mevcut pulmoner emboli kılavuzlarına göre yapılan toplam 641 pulmoner emboli hastası (277 erkek, 364 kadın; ort. yaş: 65 yıl; dağılım, 51-74 yıl) retrospektif olarak incelendi. Hastaların klinik, laboratuvar ve görüntüleme verileri hastane veri tabanı sisteminden elde edildi. Bulgular: Başvuru anında hastaların 193’ünde (%30.2) senkop belirlendi ve artmış troponin ve D-dimer düzeyleri, yüksek Pulmoner Emboli Şiddet İndeks skorları, sağ-sol ventrikül çapı oranında ve sağ ventrikülün uzunlamasına kontraksiyon ölçümlerinde kötüleşme, yüksek Qanadli skoru ve yüksek trombolitik tedavi (p<0.001) ve reolitik-trombektomi tedavi (p=0.037) oranları ile belirlendiği üzere anlamlı düzeyde daha yüksek risk durumu ile ilişkili bulundu. Hastane içi mortalitesi (p=0.007) ve minör kanama (p<0.001) senkop alt grubunda anlamlı düzeyde daha yüksek idi. Çok değişkenli lojistik regresyon analizinde, yüksek Pulmoner Emboli Şiddet İndeks skorları ve sağ-sol ventrikül çapı oranı senkop ile bağımsız düzeyde ilişkili bulunurken, yaşlanma ve artmış kalp hızı hastane içi mortalitesinin öngördürücüsüydü. Senkop değil fakat malignite ve taburculuk anında sağ-sol ventrikül çapı oranı, takip süresince toplam mortalitenin bağımsız öngördürücüleri idi. So­nuç: Başvuru semptomu olarak senkop, pulmoner embolide daha proaktif stratejiler gerektiren daha şiddetli tıkayıcı basınç yüküne ve sağ ventrikül disfonksiyonuna bağlı daha yüksek risk ile ilişkilidir. Ancak, riske göre uygun tedaviler uygulandığında ne hastane-içi mortalite ne de uzun dönem mortalite senkop tarafından öngörülebilmektedir

Reappraisal of the transthoracic echocardiographic algorithm in predicting pulmonary hypertension redefined by updated pulmonary artery mean pressure threshold

BACKGROUND: Although an adopted echocardiography algorithm based on tricuspid regurgitation jet peak velocity and suggestive findings for pulmonary hypertension has been utilized in the non-invasive prediction of pulmonary hypertension probability, the reliability of this approach for the updated hemodynamic definition of pulmonary hypertension remains to be determined. In this study, for the first time, we aimed to evaluate the tricuspid regurgitation jet peak velocity and suggestive findings in predicting the probability of pulmonary hypertension as defined by mean pulmonary arterial pressure > 20 mm Hg and > 25 mm Hg, respectively. METHODS: Our study group was comprised of the retrospectively evaluated 1300 patients (age 53.1 ± 18.8 years, female 62.1%) who underwent right heart catheterization with different indications between 2006 and 2018. All echocardiographic and right heart catheterization assessments were performed in accordance with the European Society of Cardiology/European Respiratory Society 2015 Pulmonary Hypertension Guidelines. RESULTS: Although tricuspid regurgitation jet peak velocity showed a significant relation with mean pulmonary arterial pressure in both definitions, suggestive findings offered a significant contribution only in predicting mean pulmonary arterial pressure ≥ 25 mm Hg but not for mean pulmonary arterial pressure > 20 mm Hg. In predicting the mean pulmonary arterial pressure > 20 mm Hg, tricuspid regurgitation jet peak velocity and suggestive findings showed an odds ratio of 2.57 (1.59-4.14, P 3.4 m/s were associated with 70% and 84% probability of mean pulmonary arterial pressure > 20 mm Hg and 60% and 76% probability of mean pulmonary arterial pressure ≥ 25 mm Hg, respectively. CONCLUSIONS: In contrast to those in predicting the mean pulmonary arterial pressure ≥ 25 mm Hg, suggestive findings did not provide a significant contribution to the probability of mean pulmonary arterial pressure > 20 mm Hg predicted by tricuspid regurgitation jet peak velocity solely. The impact of the novel mean pulmonary arterial pressure threshold on the echocardiographic prediction of pulmonary hypertension remains to be clarified by future studies

Maternal and fetal outcomes in pregnant women with pulmonary arterial hypertension: A single-center experience and review of current literature

BACKGROUND: Although pregnancy in women with pulmonary arterial hypertension has been considered a high-risk condition, current data regarding pregnancy with pulmonary arterial hypertension are scarce. In this study, we aimed to evaluate our single-center data on maternal and fetal outcomes in pregnant women with PAH and review currently available risk-based management strategies. METHODS: Our single-center study group comprised 35 women who became pregnant after the diagnosis of pulmonary arterial hypertension or in whom pulmonary arterial hypertension was diagnosed within early post-partum period. Clinical, laboratory, echocardiographic, and hemodynamic characteristics of pregnant and non-pregnant productive women with pulmonary arterial hypertension were compared, and similar comparison was also repeated for survivors and non-survivors in pregnant patient group. RESULTS: Pregnancy was noted in 15% of the 228 females with pulmonary arterial hypertension who were of hormonally productive ages, generally well-tolerated until delivery. Elective abortion and pre-term delivery were documented in 1 (2.8%) and 12 (35.3%) pregnant women, respectively. Switching to sildenafil was the standard medication during pregnancy. Cesarian section was the preferred method of delivery in all pregnant women with pulmonary arterial hypertension and was performed without any complication. Clinic deteoriation within the first week of delivery was observed in 5 (41.6%) patients. Maternal mortality was noted in 13 (37.1%) patients and was documented to cumulate within the first month of delivery. However, any sign predicting post-partum clinical deterioration was not found. No fetal mortality was observed. CONCLUSION: Despite the development of advanced therapies, pregnancy in pulmonary arterial hypertension still carries a high mortality risk and requires multi-disciplinary expert center care with more proactive management strategies

A new index for the prediction of in-hospital mortality in patients with acute pulmonary embolism: The modified shock index

BACKGROUND: Pulmonary embolism severity index, its simplified version, and shock index have been used for risk stratification in acute pulmonary embolism. In this study, we proposed a modification in severity index and evaluated the correlates and prognostic value of modification in severity index in this setting. METHODS: The study group comprised retrospectively evaluated 181 patients with acute pulmonary embolism. Systematic workup including pulmonary embolism severity index, its simplified version, shock index, biomarkers, and echocardiographic and multidetector computed tomography assessments was performed in all patients. Moreover, we calculated modification in severity index by multiplying original shock index (heart rate/systolic blood pressure ratio) and a third component, 1/pulse oxymetric saturation (pSat O2%) ratio. The primary endpoint was defined as all-cause mortality and hemodynamic collapse during the hospital stay. RESULTS: On the basis of initial risk stratification, ultrasound-assisted thrombolysis, systemic tissue-type plasminogen activator, and unfractionated heparin therapies were utilized in 83 (45.9%), 37 (20.4%), and 61 (33.7%) patients, respectively. The primary end-point occurred in 13 (7.2%) patients. Receiver-operating curve analysis revealed that modification in severity index had the highest area under the curve of 0.739 (0.588-0.890, P =.002) compared with shock index, pulmonary embolism severity index, or its simplified version. The modification in severity index > 0.989 predicted primary endpoint with 73% sensitivity and 54% specificity. CONCLUSIONS: The modification in severity index seems to be a simple, quick, and compre-hensive risk assessment tool for bedside evaluation at initial stratification, in monitoring the clinical benefit from therapies, and decision-making for escalation to other reperfusion strategies in patients with acute pulmonary embolism. However, the prognostic value of modification in severity index needs to be validated with further studies

A novel composed index to evaluate the right ventricle free-wall adaptation against ventricular wall stress in acute pulmonary embolism

Background: Pulmonary embolism severity index and simplified pulmonary embolism severity index have been utilized in initial risk evaluation in patients with acute pulmonary embolism. However, these models do not include any imaging measure of right ventricle function. In this study, we proposed a novel index and aimed to evaluate the clinical impact. Methods: Our study population comprised retrospectively evaluated 502 patients with acute pulmonary embolism managed with different treatment modalities. Echocardiographic and computed tomographic pulmonary angiography evaluations were performed at admission to the emergency room within maximally 30 minutes. The formula of our index was as follows: (right ventricle diameter × systolic pulmonary arterial pressure-echo)/(right ventricle free-wall diameter × tricuspid annular plane systolic excursion). Results: This index value showed significant correlations to clinical and hemodynamic severity measures. Only pulmonary embolism severity index, but not our index value, independently predicted in-hospital mortality. However, an index value higher than 17.8 predicted the long-term mortality with a sensitivity of 70% and specificity of 40% (areas under the curve = 0.652, 95% CI, 0.557-0.747, P = .001). According to the adjusted variable plot, the risk of long-term mortality increased until an index level of 30 but remained unchanged thereafter. The cumulative hazard curve also showed a higher mortality with high-index value versus low-index value. Conclusions: Our index composed from measures of computed tomographic pulmonary angiography and transthoracic echocardiography may provide important insights regarding the adaptation status of right ventricle against pressure/wall stress in acute pulmonary embolism, and a higher value seems to be associated with severity of the clinical and hemodynamic status and long-term mortality but not with in-hospital mortality. However, the pulmonary embolism severity index remained as the only independent predictor for in-hospital mortality

The effect of magnetic field therapy and electric stimulation on experimental burn healing

Tıpta Uzmanlık TeziÇalışmamızda manyetik alan tedavisinin ve elektrik stimulasyonun yanık yarası üzerindeki etkileri, ratlar üzerinde yapılan deneysel bir çalışma ile morfolojik, histolojik ve mikrobiyolojik olarak karşılaştırmayı amaçlanmıştır. Deney 23 Sprague-Dawley türü, dişi rat üzerinde yapıldı. Ratların sırt bölgelerinde ikinci derece yanık oluşturuldu. Oluşturulan yanık yaraları üç gruba ayrılarak, birinci gruba antibakteriyel pomat, ikinci gruba pulse elektromanyetik alan tedavisi ve antibakteriyel pomad, üçüncü gruba elektrik stimulasyonu ve antibakteriyel pomat 14 gün boyunca uygulandı. Makroskobik olarak pulse elektromanyetik alan tedavisi ve elektrik stimülasyonu grubunda, kontrol grubu ile karşılaştırıldığında epitelizasyon daha erken gözlenirken, yara alanının daha küçük olduğu, ödem ve hipereminin ise daha az olduğu sonucuna varıldı. Histopatolojik olarak ise, pulse elektromanyetik alan tedavisi ve elektrik stimulasyonunda kontrol grubu ile karşılaşrtırıldığında vaskülarizasyon, kollajenizasyon, granülasyon dokusu oluşumu, hücre çoğalması ve inflamatuar hücre yanıtını daha fazla artırdığı sonucuna varıldı. Yapılan mikrobiyolojik değerlendirmede sonucunda kontrol grubunda hiç anlamlı üreme (enfeksiyon etkeni) olmazken pulse elektromanyetik alan tedavisinde 5 ratta, elektrik stimulasyonunda 4 ratta üreme görüldü. Sonuç olarak yanık iyileşmesinde pulse elektromanyetik alan tedavisi daha etkin olmak üzere pulse elektromanyetik alan tedavisi ve elektrik stimulasyonun yanık iyileşmesinde etkin olduğu sonucuna vardık. Fakat pulse elektromanyetik alan tedavisi ve elektrik stimulasyonun yanık yarası mikrobiyolojik üremesini baskılamada etkisiz olduğu sonucuna vardık.AbstractIn our study, we aimed to compare morphologic, histological and microbiological differences between magnetic field therapy and electric stimulation therapies on an experimental rat burn injury model.Twenty tree Sprague-Dawley female rats were used in this study. Second degree burns was performed on back areas of the rats. All the rats in the study divided in to three therapy groups; the first burn group was treated with antibacterial pomade (control group), second group was treated with both antibacterial pomade and pulsed electromagnetic field therapy, third group was treated with antibacterial pomade and electric stimulation for 14 days.Earlier reepitalization, smaller wound area, less amount of edema and hyperemia was observed in pulsed electromagnetic fields and electric stimulation therapy groups against control group macroscopically. Neovascularization, collagen density, granulation tissue formation, cell proliferation and inflammatory cell response of the pulsed electromagnetic fields and electric stimulation group was increased compared with the control group in histopathological evaluation. None of the rats in control group has infectious agent microbiologically but 5 rats in pulsed electromagnetic fields group and 4 rats in electric stimulation group had proliferation of infectious agent.As a result, the positive healing affect of electric stimulation and pulsed electromagnetic fields on burn injury was found. More positive sign of healing was observed in pulsed electromagnetic fields therapy group rather than electric stimulation group. But there was an in effective suppression on microbiological proliferation was found in pulsed electromagnetic fields and electric stimulation group