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71.
Yunus Atici Yunus Emre Akman Mehmet Bulent Balioglu Deniz Kargin Mehmet Akif Kaygusuz 《European spine journal》2016,25(8):2461-2470
Purpose
To evaluate the efficacy of two level pedicle substraction osteotomies (PSOs) planned preoperatively with a computer software, in the patients with severe fixed sagittal plane deformities.Methods
In the literature, there are studies indicating that two level PSOs may be required in severe cases. However, the results of two level PSOs preoperatively planned with computer software-assistance have not yet been reported in the English literature. Severe fixed sagittal plane deformities of 11 patients are described. Preoperative surgical planning was done with the aid of a computer software. Two level PSOs were indicated after the process. After the application of the indicated surgical technique, clinical and radiological results were evaluated in the preoperative, the early postoperative periods and during the last follow-up.Results
The mean sagittal vertical axis was found as 190.5 (range 161–220) mm in the preoperative period, 23.5 (range ?27 to 61) mm in the early postoperative period (P < 0.001) (87.7 % correction) and 34.5 (range ?3 to 55) mm during the last follow-up (P < 0.001). The mean pelvic tilt (PT) significantly decreased from 38.3° (range 21°–63°) preoperatively to 23.8° (range 18°–42°) postoperatively (P = 0.008) and to 27.5° (range 17°–42°) during the last follow-up (P = 0.042). The mean lumbar lordosis (LL) was 2.8° (range ?29° to 20°) preoperatively, ?35.6° (range ?54° to 23°) early postoperatively (P < 0.001) and ?33.6° (range ?52° to 20°) during the last follow-up (P < 0.001). The average amount of bleeding was 5345 (range 2600–7415) ml.Conclusion
Although a statistically significant correction was obtained, the mean PT and PI–LL value could not be restored in physiological limits during the last follow-up. Thus, two level PSOs performed after computer software (surgimap) assisted preoperative planning failed to correct severe fixed sagittal plane deformities. Besides, this procedure is of possible risks for major complications such as a result of excessive bleeding. We recommend that two level PSOs should be rarely indicated, but preferred as an alternative technique only in the most severe cases.72.
73.
Purpose
The aim of this study is to provide an overview of the studies investigating a possible association between thrombophilia and assisted reproductive technology (ART) outcome.Methods
This is a literature review.Results
Congenital thrombophilias (CoT) are reported to be associated with pregnancy loss. However, the association between CoT and early pregnancy loss is weak and does not necessarily support causation. CoT are more likely to be associated with late fetal loss. Even though data pooled from case-control and cohort studies suggest an increased risk of ART failure in women with CoTs, there seems no association when the analysis is confined to better quality cohort studies. The evidence supporting anticoagulation to improve ART outcome in CoT carriers is weak. Likewise, studies on antiphospholipid antibodies (APAs) and ART outcome suffer from multiple methodological limitations and a detrimental impact of APA positivity is controversial. Empirical administration of heparin or low molecular weight heparin to women with recurrent ART failures is supported by weak evidence. Importantly, thrombophilias are likely to increase thrombotic complications after ovarian stimulation for ART.Conclusions
Current evidence does not support routinely testing for or treatment of thrombophilia in the setting of ART nor in couples with implantation failure. A careful personal and family history should be obtained and a risk assessment for thrombotic complications should be made in every woman undergoing ovarian stimulation. If positive, testing for thrombophilia is warranted.74.
75.
Celalettin Cevik Kaan Sozmen Bulent Kilic 《The European journal of general practice》2018,24(1):74-83
Background: Turkish health reforms began in 2003 and brought some significant changes in primary care services. Few studies in Turkey compare the shift from health centres (HC) to family physicians (FP) approach, which was initiated by reforms.Objectives: This study compares health status indicators during the HC period before reforms (2003–2007) and the FP period after reforms (2008–2012) in Turkey.Methods: This study encompasses time series data consisting of the results of a 10-year assessment (2003–2012) in Manisa district. All the data were obtained electronically and by month. The intersection points of the regression curves of these two periods and the beta coefficients were compared using segmented linear regression analysis.Results: The mean number of follow-up per person/year during the HC period in infants (10.5), pregnant women (6.6) and women (1.8) was significantly higher than the mean number of follow-up during the FP period in infants (6.7), pregnant women (5.6) and women (0.9). Rates of BCG and measles vaccinations were significantly higher during the FP period; however, rates of HBV and DPT were same. The mean number of outpatient services per person/year during the FP period (3.3) was significantly higher than HC period (2.8). Within non-communicable diseases, no difference was detected for hypertension prevalence. Within communicable diseases, there was no difference for rabies suspected bites but acute haemorrhagic gastroenteritis significantly decreased. The infant mortality rate and under five-year child mortality rate significantly increased during the FP period.Conclusion: Primary care services should be reorganized and integrated with public health services. 相似文献
76.
77.
Keles GC Cetinkaya BO Ayas B Isildak I Diraman E Koprulu H Acikgoz G 《Clinical oral investigations》2007,11(4):369-376
The hypothesis, a relationship between gingival tissue platelet activating factor (PAF) levels and healing after periodontal
surgery, was tested by measuring PAF levels in gingival tissues collected from sites that had undergone flap surgery and guided
tissue regeneration (GTR) or flap surgery alone. Using a split-mouth design, 20 intrabony defects were randomly assigned to
treatment with flap surgery and GTR (group 1) or with flap surgery alone (group 2). Gingival tissue samples were obtained
at surgery (baseline) and at 6-month follow-up evaluation visit. One half of each sample was used for analysis of PAF levels
by high-performance liquid chromatography, and the other half of the sample was used for histomorphometric analysis that included
measurements of number and diameter of blood vessels. PAF levels and diameter of blood vessels were significantly decreased
(p < 0.01), and the number of blood vessels was significantly increased (p < 0.05) in both groups after 6 months compared to the baseline values. Postoperative number of blood vessels were significantly
higher in group 1 (p < 0.05), whereas there was no significant difference in postoperative PAF levels between the two groups (p > 0.05). Based on the reported results, it is suggested that a decrease in gingival PAF levels might be found after conventional
and regenerative periodontal surgery. 相似文献
78.
Cetinkaya BO Keles GC Ayas B Aydin O Kirtiloglu T Acikgoz G 《Clinical oral investigations》2007,11(1):61-68
Guided tissue regeneration is based on preventing the more rapidly proliferating epithelium from growing into the periodontal
defect after surgical procedures incorporating barrier membranes. The aim of this study was to compare the proliferative activity
of gingival epithelium using proliferating cell nuclear antigen (PCNA) as a marker of cell proliferation after surgical treatments
with bioactive glass graft material and bioabsorbable membrane. Using split mouth design, 20 intrabony defects were randomly
assigned treatments with bioactive glass (BG group) or bioabsorbable membrane (BM group). Gingival biopsies were taken at
preoperative and postoperative 12 weeks. After histological processing, the number of the inflammatory cells was measured
in hematoxylin and eosin-stained sections; PCNA expression was determined in immunohistochemically-stained sections. At postoperative
12 weeks, the number of the inflammatory cells was significantly decreased (p < 0.01), PCNA expression was significantly increased (p < 0.001) in both treatment groups compared to baseline data. There was no significant difference in PCNA expression between
baseline values of two groups (p > 0.05), while at postoperative 12 weeks, increase in BG group was significantly greater than that in BM group (p < 0.001). These results suggest that epithelial cell proliferation is more prominent after treatment of intrabony defects
with bioactive glass compared to the treatment with bioabsorbable membrane. 相似文献
79.
Yazici M Ozdemir K Altunkeser BB Yazici R Kayrak M Ulgen MS Alihanoglu Y Gok H 《Pacing and clinical electrophysiology : PACE》2007,30(12):1493-1498
BACKGROUND: The purpose of this study was to examine the effects of exercise on maximum QTc interval (QTcmax) and QTc dispersion (QTcd) in diabetic patients without clinically evident heart disease. METHODS: Seventy-six diabetic patients who had no coronary artery disease or hypertension (group I; mean age 48 +/- 9 years old) and 40 healthy volunteers (group II; mean age 46 +/- 13 years old) were enrolled in the study. Cases with clinically evident heart disease were excluded from the study. Resting 12-lead electrocardiogram (ECG) and maximal treadmill exercise test (according to Bruce protocol) were performed in all cases. The QTcmax interval was determined at rest (RQTcmax) and during peak exercise (PQTcmax). Also, the QTcd was measured at rest (RQTcd) and during peak exercise (PQTcd). Autonomic neuropathy was assessed by measuring the heart rate variability (HRV). RESULTS: There was no significant difference between clinical characteristics of two groups. In group I, HRV parameters were significantly lower than group II. RQTcd, PQTcd, RQTcmax, and PQTcmax were significantly longer in group I (56 +/- 16 vs 34 +/- 11; P< 0.001, 62 +/- 22 vs 40 +/- 15; P < 0.001, respectively). In diabetic patients, there was no significant difference between RQTcmax and PQTcmax (428 +/- 19 vs 420 +/- 31; P > 0.05), and no significant difference was present between RQTcd and PQTcd (56 +/- 16 vs 62 +/- 22; P > 0.05, respectively). CONCLUSION: Exercise does not affect QTcd in patients with diabetes mellitus and without clinically evident heart disease. 相似文献
80.
Renda Circi MD Emre Boysan MD Bulent Behlul Altunkeser MD Nazif Aygul Kumral Cagli Kerim Cagli MD Erol Sener MD 《Journal of cardiac surgery》2020,35(4):942-945
Pulmonary artery aneurysm (PAA) is a rare entity with fatal complications. Its silent course contributes to large aneurysms with compression symptoms. We present a 39-year-old female idiopathic pulmonary arterial hypertension patient with a giant PAA causing severe pulmonary regurgitation (PR) and symptomatic left main coronary artery compression (LMCA). Since she had a failed LMCA stenting attempt, she underwent surgery. A valve-sparing David-like pulmonary trunk reconstruction and coronary artery bypass were performed. This case illustrates that David-like reconstruction procedure can be applied to the PAA with severe PR. 相似文献