The Effects of Perioperative Factors on Early Postoperative Morbidity in Bariatric Surgery

Obesity Surgery - This study aims to examine the predictive role of obesity-type-related indexes and perioperative intraabdominal pressure measurements for early postoperative complications...     

The Effect of Strut Allograft and Its Position on Vancouver Type B1 Periprosthetic Femoral Fractures: A Biomechanical Study

The aim of this study is to assess the biomechanical advantage of adding strut allograft and the effect of its position on the construct in Vancouver type B1 fractures. Fifteen forth-generation synthetic femurs were used and created a fracture model at the tip of prosthesis, and subsequently fixated with a lateral plate only, lateral plate and medial strut, lateral plate and anterior strut. Rotational and axial tests were performed. In all loading tests, the plate with medial strut group was stiffer than the other constructs and had higher failure load values and had less displacement in the fracture site. A combination of a plate with a medial strut allograft provides more mechanical stability on periprosthetic femoral fractures near the tip of a total hip arthroplasty.     

Risk of vasovagal syncope and cardiac arrhythmias in children with mitral valve prolapse

OBJECTIVE: Postural phenomena, cardiac arrhythmias and autonomic dysfunction are responsible for presyncope and syncope in patients with mitral valve prolapse (MVP). In this study, arrhythmia and vasovagal syncope incidence were investigated in children with MVP. METHODS: Between April 2005 and December 2006, 37 children with MVP and 26 healthy children were evaluated.Telecardiography, electrocardiography (ECG), echocardiography, Holter monitoring, exercise test and head-up tilt test were performed. RESULTS: The MVP group consisted of 19 boys and 18 girls with a mean age of 11.8 years. The control group was similar with respect to age and gender. Telecardiography, ECG, Holter monitoring, exercise test and QTc of all children were within normal limits.There was a statistically significant difference between the two groups in terms of QT dispersion. The tilt table test was positive in 11 of 37 (29.7%) children with MVP and in 1 of 26 (3.8%) normal healthy children. This difference was statistically significant (P < 0.01). CONCLUSION: Arrhythmia and syncope frequency was found to be higher in children with MVP than in the normal population. The risk of vasovagal syncope indicated by a positive tilt test was found to be increased in children with MVP. Therefore, patients and families must be informed about the conditions that may predispose to vasovagal syncope and caution should be recommended in these patients.     

Tuberculin skin test screening in a military school in Istanbul city center

To investigate the reason of high incidence of annual patients with tuberculosis (TB) in a military school previously known by screening tuberculin skin test (TST) and finding out the proportion of annual infection risk (PAIR), the prevalance of TB infection and the distribution for each grades. Our study is a cross-sectional epidemiologic study made about TB infection. TST were screened for all students in the school. 5 TU PPD was injected to every student and after 72 hours, the results were evaluated by measuring the diameter of enduration. Test was repeated after 10 days for negative reactions. Age, sex, the number of BCG wound, smoking and dwelling for last 5 years were asked from the students and their answers were recorded. More than 10 mm enduration for cases who had no BCG and 15 mm enduration for cases who had BCG were accepted positive. Chest roentgenogram was taken for each student enrolled into the study. Infection prevalance and PAIR were calculated after tests and measurements. The total number of students was 948. Of 917 (96.7%) were male and 31 (3.3%) were female. The mean age was 19.72 +/- 1.25. The mean of TST was 12.79 +/- 5.96 mm for all students. According to the number of BCG scar, the numbers of students, percentage and the mean of TST were like that 70 (7.3%) cases no BCG scar 8.41 +/- 7.87 mm, 393 (41.4%) students one BCG scar, 11.94 +/- 6.26 mm, 343 (36.1%) cases two BCG scars, 13.74 +/- 5.12 mm, 142 (14.9%) students three or more then three scars, 14.97 +/- 4.11 mm. In the students who had no BCG, TST positivity was 50%. TB infection prevalance of entire school and PAIR were 46% and 3.44% (respectively). In this study, we found that increased number of BCG wound associated with the increased diameter of TST enduration. The proportion of unvaccinated students was similar to the same age population in our country but it showed differences in the distribution of regions. The students who started first grade had serious TB infection risk in their first school year. We think that PAIR values derived from TST conversions done in high risky community by screening annual TST could show all aspects of TB infection risk in those community.     

Internalized Stigma in Pediatric Psoriasis: A Comparative Multicenter Study

BackgroundInternalized stigma, adoption of negative attitudes and stereotypes of the society regarding persons'' illness, has not been studied previously in pediatric psoriasis patients.ObjectiveWe aimed to investigate the internalized stigma in pediatric psoriasis patients and to determine differences according to factors affecting internalized stigma compared to adult psoriasis patients.MethodsThis multicenter, cross-sectional, comparative study included 125 pediatric (55 female, 70 male; mean age±standard deviation [SD], 14.59±2.87 years) and 1,235 adult psoriasis patients (577 female, 658 male; mean age±SD, 43.3±13.7 years). Psoriasis Internalized Stigma Scale (PISS), Dermatology Life Quality Index (DLQI), Perceived Health Status (PHS), and the General Health Questionnaire (GHQ)-12 were the scales used in the study.ResultsThe mean PISS was 58.48±14.9 in pediatric group. When PISS subscales of groups were compared, the pediatric group had significantly higher stigma resistance (p=0.01) whereas adult group had higher scores of alienation (p=0.01) and stereotype endorsement (p=0.04). There was a strong correlation between mean values of PISS and DLQI (r=0.423, p=0.001). High internalized stigma scores had no relation to either the severity or localization of disease in pediatric group. However, poor PHS (p=0.007) and low-income levels (p=0.03) in both groups, and body mass index (r=0.181, p=0.04) in the pediatric group were related to high PISS scores.ConclusionInternalized stigma in pediatric patients is as high as adults and is related to poor quality of life, general health, and psychological illnesses. Unlike adults, internalized stigma was mainly determined by psoriasis per se, rather than disease severity or involvement of visible body parts, genitalia or folds.     

Curcumin ameliorates impaired insulin/IGF signalling and memory deficit in a streptozotocin-treated rat model

Increased serum insulin levels and reduced peripheral insulin activities seen in insulin resistance syndrome are associated with age-dependent cognitive impairment and Sporadic Alzheimer’s Disease (SAD), suggesting a disturbance in the insulin signalling system in the brain and possibly being one of the causes of dementia. Therefore, the streptozotocin (STZ)-induced animal may be an appropriate model for the investigation of SAD and related dementia. This study was designed to investigate the beneficial effect of Curcumin (CUR), a neuroprotective agent, on intracerebroventricular (ICV) STZ-induced cognitive impairment in rats. For this purpose, adult male Wistar rats were bilaterally ICV injected with STZ (3 mg/kg). An artificial cerebrospinal fluid (aCSF) was given to the control group (SHAM) instead of STZ on days 1 and 3. Learning and memory performance were assessed using the “passive avoidance task” and the “Morris water maze test”. After confirmation of acquisition impairment with these tests, the STZ group was divided into two subgroups: STZ + vehicle (Vh) and STZ + CUR. The rats in the SHAM and STZ + Vh groups were administered intraperitoneally with 0.5 ml Vh and the rats in the STZ + CUR group were treated intraperitoneally with CUR (300 mg kg⁻¹ day⁻¹ in Vh) for 10 days starting from the 25th day after STZ injection. The Morris water maze test was reapplied on the 35th day after STZ injection and all of the rats were sacrificed on day 36 for quantitation of IGF-1 and for histopathological evaluation. Rats in the STZ + CUR group were found to have a higher performance in cognitive tests than rats in the STZ + Vh group (P < 0.01). In parallel with the cognitive tests, IGF-1 levels were decreased in all of the STZ-injected groups (1.78 ± 0.34) compared to the SHAM group (3.46 ± 0.41). In contrast, CUR treatment significantly increased IGF-1 levels (P < 0.001). The degree of neuronal loss decreased after CUR treatment compared to the SHAM group (P < 0.02). These results clearly indicate that CUR treatment is effective in reducing the cognitive impairment caused by STZ in rats, and may be a potential therapeutic agent for altering neurodegeneration in SAD.     

Effects of irrigation temperature on heat control in vitro at different drilling depths

Purpose: Thermal injury during implant bed preparation has a major influence on implant osseointegration and survival. This study investigated the effectiveness of the temperature of the saline solution used for heat control during drilling.
Material and methods: Fresh frozen edentulous segments of bovine mandibles were sectioned into 12 × 6 cm pieces. Thermoresistors were placed 0.5 mm from the drilling cavity walls, at depths of 3, 7, and 12 mm. Signals from the three thermoresistors were analyzed using ORIGIN 5.0 software.
Results: The maximum temperatures during drilling without irrigation were 50.9, 47.4, and 38.1°C at depths of 3, 7, and 12 mm, respectively. With irrigation using saline at 25 and 10°C, the maximum temperatures at a depth of 12 mm were 37.4 and 36.3°C, respectively. All other measurements with both 25 and 10°C saline were below body temperature.
Discussion and conclusion: This experimental in vitro study showed that more heat was generated in the superficial part of the drilling cavity than at the bottom. Therefore, external irrigation at room temperature can provide sufficient cooling during drilling. Lower temperature saline was more effective in cooling the bone, and irrigation of the site should be continued between the drilling steps.     

Magnification-corrected photodynamic therapy

Background To present a method for performing photodynamic therapy (PDT) with a constant predictable light fluence based on actual laser spot magnification. Methods A calibrated Gullstrand-type model eye with a scale of half circles in the centre of the artificial fundus was used for this study. The axial length of the model eye was set to different values ranging from 20 to 31 mm, and the actual laser spot magnification of four indirect condensing laser lenses were determined using a PDT laser unit. Results Equations for determining the actual laser spot magnification were calculated for each laser lens. The total change in laser spot magnification from hyperopia (axial length 20 mm) to myopia (axial length 31 mm) was −20% to +24.8% for Mainster Standard lens (Ocular Instruments Inc, Bellevue, Washington, USA), −15.7% to +27.7% for Mainster Wide Field lens (Ocular Instruments Inc), −16.3% to +33.1% for Volk Transequator lens (Volk Optical Inc, Mentor, Ohio, USA), and −19.2% to +24.4% for Volk PDT Laser lens (Volk Optical Inc). Conclusions Axial length of the eye has a considerable effect on PDT laser spot magnification when an indirect laser lens is used. By calculating the actual laser spot magnification in conjunction with knowledge of the true greatest linear dimension of the neovascular lesion, the clinician may be able to deliver a constant predictable amount of light fluence to the fundus independent of the axial length of the PDT treating eye. No Grant/Financial Support. The authors have no financial interest in any of the products discussed in this article.     

Results of fundus perimetry after resorbed premacular hemorrhages under the internal limiting membrane in 10 patients

BACKGROUND: During their acute phase, premacular hemorrhages under the internal limiting membrane induce an absolute scotoma. It is generally suspected that extravasal blood has a toxic effect on the neuroretina. The objective of this study is to investigate whether one can indeed detect sensoric defects after resorbed hemorrhages under the internal limiting membrane. MATERIALS AND METHODS: Our patient group consisted of 10 patients with resorbed premacular hemorrhages, which had been caused by either Vasalva-Manouver or arterial macroaneurysms. In order to avoid visual field defects due to other causes, patients with diabetes, retinal vein occlusion and glaucoma were excluded from this study. The investigation was carried out with the Scotometry Programme Vers. 2.01 of the Rodenstock Scanning Laser Ophthalmoscope. Furthermore, fundus photographs were taken. RESULTS: Under condition of no pre-existing retinal pathologies, no scotomas could be revealed at the site of the preretinal hemorrhage after full resorption. Relative or absolute scotomas could only be found in cases of pre-existing epiretinal gliosis, pigmentepitheliumdefect, persistent subretinal hemorrhages or scars. CONCLUSION: Since no sensoric defects of the retinal receptors could be detected, the hypothesis of the extravasal blood having a direct toxic effect on the neuroretina, could not be confirmed in this patient group.