Plasma D -Lactate Levels in Diagnosis of Appendicitis

We investigated the possible use of D -lactate as a predictor in the diagnosis of appendicitis. C-reactive protein level (CRP) and leukocyte counts were also evaluated. Venous blood D -lactate, CRP, and leukocyte counts were measured preoperatively in 53 patients undergoing surgery for appendicitis, as well as in 20 healthy subjects. Levels of all three parameters in the surgical patients were significantly higher than in the control group ( p < .05). Previous studies have shown that venous D -lactate is more specific to the intestine than CPR or leukocyte count. Based on our data, venous D -lactate, which had the lowest false-negative rate among these laboratory parameters, may be a useful diagnostic marker for appendicitis. None of these parameters were helpful in identifying the type of the appendicitis.     

The effect of the Tscherne injury pattern on the outcome of operatively treated Lisfranc fracture dislocations

BackgroundLisfranc fracture dislocations cause severe tarso-metatarsal malalignment. The research question of this study was to evaluate the severity of the soft tissue injury on the final clinical outcome and compare that with the effect of various determinants on the disability in daily living activities after open reduction and internal fixation of a Lisfranc injury.MethodsThis study consisted of a retrospective analysis of patients with Lisfranc fracture dislocations who were treated by open reduction and internal fixation beween 2004 and 2009. Evaluation focused mainly on the severity of the soft tissue injury, age, fracture classification, time to operation, posttraumatic osteoarthritis, and the results were compared with American Foot and Ankle Society (AOFAS) scores, and Foot and Ankle Disability Index (FADI). Eight patients had Tscherne Grade 1, 13 had Grade 2, and 11 had Grade 3 soft tissue injuries. Myerson classification revealed 11 type A, 8 type B and 13 type C fractures. Six patients’ operations were delayed beyond 8 h.ResultsOf the 38 patients treated in the study period, 32 patients (11 female, 21 male; <30 y-old: 14, >30 y-old: 18) were available for complete follow-up (average, 55.5 months). The comparison of treatment results revealed that those patients with high grade soft tissue injuries had lower AOFAS and FADI scores (43.8 ± 15.9, 53.7 ± 9.4, respectively) when compared to Tscherne Grade 1 injuries (82.8 ± 6.1, 109 ± 13.9, respectively) (p < 0.001). The overall negative impact of the severity of soft tissue injury on functional outcomes had similar significance with regard to post-traumatic osteoarthritis, and fracture type. There was also a statistically significant difference between outcome measures and post-reduction quality (p = 0.002). Patient age (p = 0.9) and delayed surgery (p = 0.5) had no statistically significant effect on the final outcome.ConclusionsSatisfactory results can be achieved with open reduction for Lisfranc injuries. However, despite this treatment, both the severity of the soft tissue injury and non-anatomic reduction are negative prognostic factors in the treatment of Lisfranc fracture dislocations.     

Sensorial donor site morbidity after saphenous neurocutaneous flap

Neurocutaneous flaps based on the arterial network around the superficial sensory nerves are popular in soft tissue coverage of the lower extremities, and are usually preferred in reconstruction of the lower leg and foot. Although sacrifice of sensory cutaneous nerves is mentioned as one of their major disadvantages to our knowledge the morbidity in the foot and at the donor site has not been properly investigated. We investigated sensorial morbidity in the foot and at the donor site caused by raising a saphenous neurocutaneous flap in 14 patients by using static two-point discrimination test, Semmes-Weinstein monofilament test, vibration test, and by measuring somatosensory evoked potentials in the twelfth postoperative month. Our results suggest that sensory recovery is good and protective sensation is gained in most patients.     

Neutrophil/lymphocyte ratio is associated with thromboembolic stroke in patients with non-valvular atrial fibrillation

BackgroundNeutrophil/lymphocyte ratio (NLR) has been associated with poor outcomes in patients with cardiovascular diseases. However, little is known about the role of NLR in patients with thromboembolic stroke due to atrial fibrillation (AF). We aimed to compare the NLR ratios between non-valvular AF patients with or without thromboembolic stroke.MethodsA total of 126 non-valvular AF patients with or without stroke were included in the study; 126 consecutive patients (52 males and 74 females), mean age, 70 ± 10.2 years old. No patient had a recent history of an acute infection or an inflammatory disease. Baseline NLR was measured by dividing neutrophil count to lymphocyte count. WBC count > 12.000 cells per μL or < 4.000 cells per μL and high body temperature > 38 º are excluded from the study.ResultsMean NLR was significantly higher among persons with stroke compared to individuals without a stroke (5.6 ± 3.4 vs. 3.1 ± 2.1, p = 0.001). There were no significant differences in RDW levels between the two groups (p > 0.05). HAS-BLED and CHADS₂ scores were significantly higher in the stroke group.ConclusionHigher NLR, an emerging marker of inflammation, is associated with thromboembolic stroke in non-valvular AF patients.     

Radixin expression in microglia after cortical stroke lesion

Stroke induces extensive tissue remodeling, resulting in the activation of several cell types in the brain as well as recruitment of blood‐borne leucocytes. Radixin is part of a cytoskeleton linker protein family with the ability to connect transmembrane proteins to the actin cytoskeleton, promoting cell functions involving a dynamic cytoskeleton such as morphological changes, cell division and migration which are common events of different cell types after stroke. In the healthy adult brain radixin is expressed in Olig2⁺ cells throughout the brain and in neural progenitor cells in the subventricular zone. In the current study, we detected a 2.5 fold increase in the number of radixin positive cells in the peri‐infarct cortex two weeks after the induction of cortical stroke by photothrombosis. Similarly, the number of Olig2⁺ cells increased in the peri‐infarct area after stroke; however, the number of radixin⁺/Olig2⁺ cells was unchanged. Neural progenitor cells maintained radixin expression on their route to the infarct. More surprising however, was the expression of radixin in activated microglia in the peri‐infarct cortex. Seventy percent of Iba1⁺ cells expressed radixin after stroke, a population which was not present in the control brain. Furthermore, activation of radixin was predominantly detected in the peri‐infarct region of oligodendrocyte progenitors and microglia. The specific location of radixin⁺ cells in the peri‐infarct region and in microglia suggests a role for radixin in microglial activation after stroke.     

Resonance frequency analysis of orthodontic miniscrews subjected to light-emitting diode photobiomodulation therapy

The aim of this prospective experimental study was to evaluate the effect of light-emitting diode (LED) photobiomodulation therapy (LPT) on the stability of immediately loaded miniscrews under different force levels, as assessed by resonance frequency analysis (RFA). Sixty titanium orthodontic miniscrews with a length of 8 mm and a diameter of 1.4 mm were implanted into cortical bone by closed flap technique in each proximal tibia of 15 New Zealand white adult male rabbits (n = 30). The animals were randomly divided into irradiated and control groups under different force levels (0, 150, and 300 cN). OsseoPulse? LED device (Biolux Research Ltd.) 618 nm wavelength and 20 mW/cm(2) output power irradiation (20 minutes/day) was applied to the miniscrews for 10 days. The RFA records were performed at miniscrew insertion session (T1) and 21 days after surgery (T2). Wilcoxon and Mann-Whitney U-tests were used for statistical evaluation at P < 0.005 level. It was found that initial primer stability of all miniscrews was similar in all groups at the start of the experimental procedure. Statistically significant differences were found for changes in implant stability quotient (ISQ) values between LED-photobiomodulated group and the control (0 cN, P = 0.001; 150 cN, P < 0.001; and 300 cN, P < 0.001). Significant increase was found in ISQ values of LPT applied miniscrews under 0 cN (+11.63 ISQ), 150 cN (+10.50 ISQ), and 300 cN (+7.00 ISQ) force during observation period. By the increase of force levels, it was determined that ISQ values decreased in non-irradiated control miniscrews. Within the limits of this in vivo study, the present RFA findings suggest that LPT might have a favourable effect on healing and attachment of titanium orthodontic miniscrews.     

Inferior Vena Cava Filter Evaluation and Management for the Diagnostic Radiologist: A Comprehensive Review Including Inferior Vena Cava Filter-Related Complications and PRESERVE Trial Filters

Inferior vena cava filters are commonly encountered devices on diagnostic imaging that were highlighted in a 2010 Food and Drug Administration safety advisory regarding their complications from long-term implantation. The Predicting the Safety and Effectiveness of Inferior Vena Cava Filters (PRESERVE) trial is an ongoing after-market study investigating the safety and utility of commonly utilized filters in practice today. While most of these filters are safe, prompt recognition and management of any filter-associated complication is imperative to prevent or reduce the morbidity and mortality associated with them. This review is aimed at discussing the appropriate utilization and placement of inferior vena cava filters in addition to the recognition of filter-associated complications on cross-sectional imaging. An overview of the PRESRVE trial filters is also provided to understand each filter's propensity for specific complications.     

Developing the Cyberostracism Scale and Examining its Psychometric Characteristics

International Journal of Mental Health and Addiction - This study aims to develop the Cyberostracism Scale (CS) to assess university students’ perceptions of virtual social exclusion....     

Circulating irisin levels reflect visceral adiposity in non-diabetic patients undergoing hemodialysis

Background: Recent evidence suggests that increased visceral adiposity is a strong independent risk factor for cardiovascular death and all-cause mortality in hemodialysis (HD) patients. Irisin, which is a novel myokine, can play critical roles in diabetes and adiposity. The purpose of our study was to investigate whether serum irisin levels are associated with body mass index, waist circumference (WC), and total fat mass in non-diabetic patients undergoing maintenance HD.

Methods: This cross-sectional study included 108 non-diabetic HD patients and 40 age- and sex-matched apparently healthy subjects. Serum irisin concentrations were determined using an enzyme-linked immunosorbent assay. Body fat composition (TBF-410 Tanita Body Composition Analyzer) was measured and calculated.

Results: Serum irisin levels did not differ between HD patients and the healthy controls (523.50?±?229.32 vs. 511.28?±?259.74, p?=?0.782). Serum irisin levels were associated with age (r?=?0.314; p?=0.006), HOMA-IR (r?=?0.472; p?=?0.003), WC (r?=?0.862; p?r?=?0.614; p?β?=?1.240, p?β?=?0.792, p?=?0.015) were the variables that were significantly associated with irisin concentrations (R^2?=^?0.684, p?Conclusions: These results suggest that serum irisin levels are related to visceral adiposity in non-diabetic HD patients.