A rare cause of posterolateral elbow pain: radiohumeral plica syndrome with typical MRI findings

A 17-year-old female swimmer was presented to the department of orthopedics with a history of periodically increasing pain for 3 months on the left elbow. On examination, pain was located on the posterolateral site of the elbow. There was snapping during elbow flexion and extension. There was no history of trauma

Topikal lidokainin bilateral otoplasti sütür alınması klinik modelinde ağrıyı azaltmada etkinliğinin değerlendirilmesi

Amaç: Topikal anestezik maddelerin küçük kutanöz cerrahi girişimler öncesi invazif olmayan yöntemle analjezi sağlamada etkili oldukları gösterilmiştir. Sunulan bu pilot gözlemsel çalışmada topikal lidokain uygulamasının bilateral otoplasti modelinde sütürlerin alınması sırasında hasta ağrısını gidermedeki etkisi araştırılmıştır. Gereç ve Yöntem: Bilateral otoplasti operasyonu yapılan hastaların sütür alınması öncesinde bir kulağa topikal lidokain diğer kulağa saf vazelin uygulanmıştır. Sütür alınması sırasında oluşan ağrıyı karşılaştırmaları istenmiştir.Bulgular: Tüm otoplasti hastaları topikal lidokain uygulamasının saf vazelin ile karşılaştırıldığında sütür alınması sırasında oluşan ağrı hissini azalttığını belirtmişlerdir. Herhangi bir yan etki gelişimi gözlenmemiştir. Sonuç: Erişkin otoplasti sütür alınması modelinin topikal anestezik etkinliğini değerlendirmede etkili bir klinik model olduğu gözlenmiştir. Ayrıca, topikal lidokain pomad kutanöz cerrahi sütür alınması sırasında düşük ağrı eşiği olan hastalarda kullanılmaya uygundu

The antibiotic resýstance of staphylococci ısolated of clinical specimens

Amaç: Bu çalışmada çeşitli klinik örneklerden izole edilen stafilokokların antibiyotik direncinin saptanması amaçlanmıştır. Yöntem: Çalışmaya, klasik yöntemlerle tanımlanan 274 Staphylococcus. aureus (S. aureus) ve 172 koagülaz negatif stafilokok kökeni alınmıştır. Antibiyotik direnci, penisilin, metisilin, eritromisin, klindamisin, kotrimoksazol, siprofloksasin, vankomisin ve fusidik aside karşı Kirby-Bauer disk difüzyon yöntemi ile araştırılmış, metisilin direncinin saptanmasında oksasilin diski kullanılmıştır. Bulgular: Toplam 274 Staphylococcus aureus kökeninin % 92.3'ü penisiline, %10.9'u metisiline, % 21.5 'i eritromisine, % 14.8'i klindamisine %15.8'i ko-trimoksazole, % 7.3'ü siprofloksasine, % 5.7'si fusidik aside dirençli bulunurken, 172 koagülaz negatif stafilokok kökeninin%84.2'si penisiline, %38.8'i metisiline,%54.8'i eritromisine, % 44.4'ü klindamisine, %42.2'si ko-trimoksazole, % 25'i siprofloksasine, % 28.1'i fusidik aside dirençli bulunmuştur.Vankomisin direncine rastlanmamıştır. Sonuç: Koagülaz negatif stafilokok kökenlerinin S. aureusa göre antibiyotiklere daha yüksek oranda dirençli ve tüm stafilokok kökenlerinin vankomisine duyarlı olduğu saptanmıştır.Objective: The aim of this study was to detect the antibiotic resistance of staphylococci strains which were isolatedfromvarious clinical specimens. Methods: This study included 274 Staphylococcus aureus (S. aureus) and 172 coagulase negative staphylococci strains which were identified with classical methods. Antibiotic resistance of strains to penicilline, methicillin, erythromycin, clindamycin, co-trimoxazole, ciprofloxacin, vancomycin and fucidic acid were investigated by Kirby-Bauer disc diffusionmethod, while in the detectionofmethicilline resistance oxacilline discs were used. Results: Amongthe274 S. aureus strains, 92.3% werefoundresistantto penicilline, 10.9% to methicillin, 21.5% to erythromycin 14.8% to clindamycin, 15.8% to co-trimoxazole, 7.3% to ciprofloxacin, 5.7% to fucidic acid. Among 172 CNS strains 84.2% were found resistant to penicilline, 38.8% to methicillin, 54.8% to erythromycin, 44.4% to clindamycin, 42.2% to co-trimoxazole, 25% to ciprofloxacin and 28.1% to fucidic acid. Vancomycin resistance was not detected Conclusion: In this study we found that strains of coagulase negative staphylococci were much more resistant than S. aureus to antibiotics and all staphylococci were susceptible to vancomycin

A Rare Cause of Pituitary Deficiency: Pituitary Stalk Interruption Syndrome and Magnetic Resonance Imaging Findings

Pituitary stalk interruption syndrome is a rare disease characterized by a deficiency of adenohypophyseal hormones. Clinical presentation usually occurs in childhood or in the second decade of life. The severity of hormonal deficiency is variable. It may be isolated or be accompanied by extra–pituitary anomalies. Magnetic resonance imaging findings are considered as an absent pituitary stalk, absent or smaller adenohypophysis, absent or ectopic neurohypophysis. Contrast-enhanced imaging is essential in evaluating the presence and morphology of the pituitary stalk. In the presence of clinical findings, evaluation of the hypothalamic–pituitary region using magnetic resonance imaging is necessary for diagnosis. Early diagnosed cases can maintain their normal lives with hormone replacement. In this article, we aimed to present pituitary stalk interruption syndrome and its magnetic resonance imaging findings with a case presentatio

Magnetic Resonance Sialography Findings of Submandibular Ducts Imaging

Purpose. We aimed to assess the problem solving capability of magnetic resonance sialography (MR sialography), a noninvasive method for imaging submandibular gland ducts and determining duct-related pathologies, by comparing diseased and healthy cases. Materials and Methods. We conducted radiological assessment on a total of 60 submandibular glands (mean age 44.7) in 20 cases and 10 volunteers. MR sialography examinations were conducted with single-shot fast spin-echo sequence by using a surface coil placed on the submandibular gland. Each gland was evaluated in terms of the length, width and stricture of the main duct, as well as the difference between the intraparenchymal duct width, and the main duct width. Statistical analysis was performed. Results. In the MR sialography the primary duct mean length was determined as 51 mm (40–57 mm) in all submandibular glands. On the MR sialography imaging, the visualization ratio of the ductal system of submandibular gland was evaluated in the cases and volunteers. Conclusion. MR sialography is an effective and a noninvasive method in imaging submandibular gland ducts, demonstrating the presence, location and degree of stricture/dilatation, and elucidating the disease etiology

Clinical Study Comparison of Efficiencies of Michigan Neuropathy Screening Instrument, Neurothesiometer, and Electromyography for Diagnosis of Diabetic Neuropathy

Aim. This study compares the effectiveness of Michigan Neuropathy Screening Instrument (MNSI), neurothesiometer, and electromyography (EMG) in detecting diabetic peripheral neuropathy in patients with diabetes type 2. Materials and Methods. 106 patients with diabetes type 2 treated at the outpatient clinic of Ankara Numune Education and Research Hospital Department of Endocrinology between September 2008 and May 2009 were included in this study. Patients were evaluated by glycemic regulation tests, MNSI (questionnaire and physical examination), EMG (for detecting sensorial and motor defects in right median, ulnar, posterior tibial, and bilateral sural nerves), and neurothesiometer (for detecting alterations in cold and warm sensations as well as vibratory sensations). Results. According to the MNSI score, there was diabetic peripheral neuropathy in 34 (32.1%) patients (score ≥2.5). However, when the patients were evaluated by EMG and neurothesiometer, neurological impairments were detected in 49 (46.2%) and 79 (74.5%) patients, respectively. Conclusion. According to our findings, questionnaires and physical examination often present lower diabetic peripheral neuropathy prevalence. Hence, we recommend that in the evaluation of diabetic patients neurological tests should be used for more accurate results and thus early treatment options to prevent neuropathic complications

National curriculum review reports

National Curriculum Review Reports will be produced for each consortium country in M8. This deliverable will draw on the content/textual analysis of school curricula and textbooks on subjects covering issues of national history, cultural heritage, identity and citizenship

Soft tissue tumor imaging in adults: European Society of Musculoskeletal Radiology-Guidelines 2023-overview, and primary local imaging: how and where?

OBJECTIVES: Early, accurate diagnosis is crucial for the prognosis of patients with soft tissue sarcomas. To this end, standardization of imaging algorithms, technical requirements, and reporting is therefore a prerequisite. Since the first European Society of Musculoskeletal Radiology (ESSR) consensus in 2015, technical achievements, further insights into specific entities, and the revised WHO-classification (2020) and AJCC staging system (2017) made an update necessary. The guidelines are intended to support radiologists in their decision-making and contribute to interdisciplinary tumor board discussions. MATERIALS AND METHODS: A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries. Statements were scored online by level of agreement (0 to 10) during two iterative rounds. Either "group consensus," "group agreement," or "lack of agreement" was achieved. RESULTS: Eight sections were defined that finally contained 145 statements with comments. Overall, group consensus was reached in 95.9%, and group agreement in 4.1%. This communication contains the first part consisting of the imaging algorithm for suspected soft tissue tumors, methods for local imaging, and the role of tumor centers. CONCLUSION: Ultrasound represents the initial triage imaging modality for accessible and small tumors. MRI is the modality of choice for the characterization and local staging of most soft tissue tumors. CT is indicated in special situations. In suspicious or likely malignant tumors, a specialist tumor center should be contacted for referral or teleradiologic second opinion. This should be done before performing a biopsy, without exception. CLINICAL RELEVANCE: The updated ESSR soft tissue tumor imaging guidelines aim to provide best practice expert consensus for standardized imaging, to support radiologists in their decision-making, and to improve examination comparability both in individual patients and in future studies on individualized strategies. KEY POINTS: • Ultrasound remains the best initial triage imaging modality for accessible and small suspected soft tissue tumors. • MRI is the modality of choice for the characterization and local staging of soft tissue tumors in most cases; CT is indicated in special situations. Suspicious or likely malignant tumors should undergo biopsy. • In patients with large, indeterminate or suspicious tumors, a tumor reference center should be contacted for referral or teleradiologic second opinion; this must be done before a biopsy

A STUDY ON PERCEIVED SERVICE QUALITY AT UNIVERSITY SPORTS CENTERS VIA STRUCTURAL EQUATION MODELING(SEM)

Bu arastırma, spor tesisleri avantajlarına göre seçilmis üniversitelerin spor merkezlerinde ki hizmet kalitesini akademik ve idari personelin algılarına göre yapısal esitlik modeli ile belirlemek, kisisel özelliklerin algılanan hizmet kalitesi üzerindeki etkilerini arastırmak ve algılanan hizmet kalitesi boyutları arasındaki nedensellik iliskisini ortaya koymak amacıyla yapılmıstır. Arastırmanın evrenini 2009 yılı itibariyle Türkiye’deki spor tesisleri avantajlarına göre belirlenmis dokuz kamu üniversitesinde görev yapan 37578 akademik ve idari personel olusturmaktadır. Anket 1 Haziran-30 Temmuz tarihleri arasında yayınlanmıs ve bu süre zarfında 1520 kisi internet üzerinden ankete katılmıstır. Örnekleme hatası 0,0246 olarak hesaplanmıstır. Arastırmada veri toplama aracı olarak, SERVQUAL hizmet kalitesi ölçeğinden esinlenerek gelistirilen “Algılanan Hizmet Kalitesi Ölçeği” kullanılmıstır. Akademik ve idari personelin algılarına göre ölçme aracında yer alan bağımsız değiskenler açıklayıcı faktör analizi yöntemi ile daha anlasılır yapılara dönüstürülmüstür. Yapısal esitlik modeli (YEM) yardımıyla, Hizmet kalitesi modelinin analizi yapılmıs ve kuramsal modele iliskin hipotezlerin sonuçları arastırılmıstır. Yapısal esitlik modellemesi kapsamında ele alınan doğrulayıcı faktör analizi yaklasımı öncelikle kullanılarak ölçüm modelinin geçerliliği ve güvenirliliği ele alınmıstır. Daha sonra hizmet kalitesini belirlemede önemli rol üstlendikleri varsayılan 5 faktörün (fiziki görünüm faktörü, güvenilirlik faktörü, heveslilik faktörü, yeterlilik faktörü, duyarlılık faktörü) hizmet kalitesini açıklamada ki etkinlikleri ve içsel iliskileri arastırılmıstır. Arastırmanın sonuçlarına göre; katılımcıların spor tesislerini kullanmada öncelikli amaçlarının “sağlıklı bir yasam sürdürme” olduğu ve tesisleri genellikle haftada 1-2 kez kullandıkları belirlenmistir. Algılanan hizmet kalitesine etki eden faktörlerden tesislerin fiziki görünümü faktörü, katılımcılar tarafından hizmet kalitesi en yüksek faktör olarak algılanmaktadır. Spor tesisi kullanıcılarının çalısanların dıs görünüsünden daha çok fiziki ortam ve donanıma önem verdikleri sonucu elde edilmistir. Servqual‘ in diğer iki boyutu olan duyarlılık ve güvenilirlik istatistiksel olarak anlamlı bulunmus ancak heveslilik ve yeterliliğe göre göreceli olarak önemsiz olduğu saptanmıstır. Algılanan hizmet kalitesine etki eden faktörlerden fiziki görünüm faktörünün hizmet kalitesi açısından diğer hizmet unsurlarına göre daha az öneme sahip olarak ortaya çıkması, mevcut spor tesislerinin kullanıcılar açısından uygun fiziki özelliklere ve yeterliliğe sahip olduğu sonucunu ortaya koymaktadır. Ölçüm modelinde yer alan hizmet faktörleri arasındaki en yüksek nedensellik iliskisinin “yeterlilik” faktörü ile “heveslilik” faktörü arasında olduğu hesaplanmıstır. Bu nedenle spor tesisleri için “heveslilik” ve “yeterlilik” hizmet boyutlarının çok önemli olduğu belirlenmistir.The purpose of this study is to determine the service quality of the sports centers at the universities chosen with regard to the advantages of sports facilities with the structural equation modeling according to the perceptions of the academic and the administrative staff, to find out the effects of personal qualities on the percieved service quality, and to reveal the causal relation between the dimensions of the perceived service quality. The population of the study consists of 37578 academic and administrative staff at nine state universities in Turkey chosen with respect to the advantages of their sports facilities in 2009. The questionnaire was published between June 1st and July 30th, and within this period 1520 people took the questionnaire on the Internet. Sampling error was calculated as 0,0246. In the study, as data gathering tools “Perceived Service Quality Scale” which was developed from SERVQUAL service quality scale have been used. According to the perceptions of the academic and administrative staff, the independent variables which take place in the 124 scale have been turned into more comprehensible structures with the exploratory factor analysis. With the help of structural equation model (SEM), service quality model has been analysed and the results of the hypotheses related to the theoretical model have been researched. The approach of confirmatory factor analysis dealt within the framework of the structural equation modeling has been used first to evaluate the validity and the reliability of the scale. Subsequently, five factors (physical characteristics factor, reliability factor, enthusiasm factor, adequacy factor, sensitivity factor) which are assumed to play a great role in determining the service quality have been studied in terms of their effectiveness in revealing the service quality and their internal relationship. According to the results of the study, the prior purpose of the participants in using sports facilities is to “lead a healthy life” and it has been determined that they use these facilities once or twice a week. It has been also determined that physical characteristics factor,one of the factors which affect the perceived service quality, is perceived as the most important service quality factor. It has been found out that the users of sports facilities give more importance to the physical environment and equipment of the place rather than the physical appearance of the staff working there. Sensitivity and the reliability which are the other two dimensions of Servqual have been found to be statistically significant; however, they have been found to be relatively insignificant compared to enthusiasm and adequacy. Furthermore, it has been determined that the physical characteristics factor which affects the perceived service quality has been stated to possess less importance compared to the other service factors, which reveals the fact that the present sports facilities have proper physical qualities and efficiency. The evaluation of the data has also revealed that the highest causal relation among the service factors which take place in the scale model is between the “adequacy” factor and the “enthusiasm” factor. Because of this, it has been determined that the “enthusiasm” and “adequacy” service dimensions have the utmost importance