What are the Factors that Impact the Outcomes of Arthroscopic Rotator Cuff Repair?

BACKGROUND: The cuff is a complex structure with many factors affecting it. How much it is affected after repair is still being investigated. AIM: The aim of this study was to analyze the functional results of individuals who received arthroscopic rotator cuff repair and assess the various factors that could impact these outcomes. METHODS: The study included 57 patients with a mean age of 58.8 years (range: 39-71) who underwent arthroscopic rotator cuff repair between 2013 and 2020, with a minimum of 6 months after the operation. Functional and clinical outcomes of the patients were evaluated using preoperative and postoperative scores (QDASH, ASES, and VAS). The study also analyzed how demographic factors, type and duration of the tear, comorbidities such as diabetes mellitus (DM) and hypertension (HT), and other pathologies may have affected the patients' scores. RESULTS: The effect of the operation on the scores in rotator cuff tears was highly significant (P < 0.05). Age, gender, tear size, fatty degeneration, anchor configuration, comorbidities, and additional procedures presented variable values on postoperative scores, but were not statistically significant. The effect of DM and HT on VAS scores was statistically significant (P < 0.05). CONCLUSION: The results of rotator cuff repair appear to be influenced by several factors, including the sex of the patient, type and duration of tear, comorbidities, and surgical procedures used. Although these factors had an effect on the scores, they were not statistically significant.

Association between platelet indices and the severity of the disease and mortality in patients with COVID-19.

OBJECTIVE: The aim of the study was to determine the association between platelet indices and disease severity, and outcomes of the patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a secondary hospital. PATIENTS AND METHODS: 722 hospitalized patients who had positive rRT-PCR for SARS-CoV-2 and/or typical findings of COVID-19 at chest computed tomography (CT) were enrolled in this study. Initial platelet count (PLT) and indices, including mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), MPV/PCT, MPV/PLT, PDW/PLT, PDW/PCT on admission and the third day of hospitalization, and their relationship with disease severity and outcomes were evaluated retrospectively. RESULTS: The mean age of the patients was 57.2±15.6 years (range: 16-94) and male/female ratio was 1.22. 81.9% of the patients had moderate and 11.8% had severe disease. 1.8% of the patients had thrombocytopenia at admission. The patients transferred to the intensive care unit (ICU) had significantly lower baseline lymphocyte counts, PLT, PCT, and 3rd day lymphocyte counts when compared with the patients in wards. ICU patients also had higher baseline CRP, LDH, ferritin, MPV/PCT, MPV/PLT, PDW/PLT, PDW/PCT ratios, and 3rd day PDW, CRP, LDH, and ferritin levels than the patients in wards. Mortality was associated with lower baseline lymphocyte counts, PLT, PCT, 3rd day lymphocyte counts and PCT. Higher baseline CRP, LDH, ferritin, MPV/PCT, PDW/PLT, PDW/PCT and 3rd day CRP, LDH, ferritin, procalcitonin, PDW, MPV/PCT, PDW/PLT, and PDW/PCT ratios were also associated with poor prognosis. CONCLUSIONS: Platelet count and ratios were significantly associated with mortality in patients with COVID-19.

Review of Anterior Submuscular Transposition of Ulnar Nerve for Cubital Tunnel Syndrome.

OBJECTIVE: In this study, we report the results of patients who underwent ulnar nerve submuscular anterior transposition surgery due to cubital tunnel syndrome. METHODS: Data of 46 patients who underwent anterior submuscular transposition surgery due to cubital tunnel syndrome between January 2010 and December 2014 were retrospectively reviewed. Twenty-seven patients with preoperative and postoperative complete medical records available and who had completed at least 24 months follow-up were included in the study. RESULTS: According to preoperative McGovan staging system, 1 patient was classified as stage 1, 8 were stage 2A, 3 were stage 2B, and 15 were stage 3. The mean follow-up time was 61.4 (35-88) months. The mean DASH score of the patients was calculated as 19 (0-81.81). Mayo elbow performance score was excellent in 13 patients, good in 7, fair in 6, and poor in 1. CONCLUSION: Anterior submuscular transposition of ulnar nerve had resolved symptoms 89% of our patients. The technique is a successful method with a low recurrence and complication rate.

Recent advances in the understanding of severe cutaneous adverse reactions.

Severe cutaneous adverse reactions (SCARs) encompass a heterogeneous group of delayed hypersensitivity reactions, which are most frequently caused by drugs. Our understanding of several aspects of SCAR syndromes has evolved considerably over the last decade. This review explores evolving knowledge of the immunopathogenic mechanisms, pharmacogenomic associations, in vivo and ex vivo diagnostics for causality assessment, and medication cross-reactivity data related to SCAR syndromes. Given the rarity and severity of these diseases, multidisciplinary collaboration through large international, national and/or multicentre networks to collect prospective data on patients with SCAR syndromes should be prioritized. This will further enhance a systematized framework for translating epidemiological, clinical and immunopathogenetic advances into preventive efforts and improved outcomes for patients.

Effects of benzodiazepine on neuromuscular activity performance in archers.

AIM: The aim of the study was to investigate the effects of benzodiazepine on shooting performance and its components in archers. In order to evaluate the possible effects of benzodiazepine, performance related parameters of body sway, mechanical clicker reaction time, aiming behavior and heart rate values were measured. METHODS: Subjects were 24 (10 females and 14 males) archers competing at international events and trained at least 4 years. Each archer was requested to perform under normal, placebo, and the influence of benzodiazepine (diazepam 5 mg, oral). Thus, each archer competed as control, placebo and benzodiazepine under double blind crossover design. The competition was especially designed to simulate competition environment by having archers shooting in doubles each time, on a specifically designed platforms. One platform was mounted on two force plates, where all the data related to shooting and body swaying was collected. The second platform was a dummy platform, to provide the second subject with similar feelings as the subject on the first platform. With this set of data collection, the archers were asked to compete 6 times each in changing rounds, where they had 24 shots in each competition. Repeated measure of ANOVA was used to compare the differences between control, placebo and benzodiazepine shots. RESULTS: Results showed that there was no difference in shooting scores, resting heart rate, shooting heart rate, aiming behavior (aiming displacement in x and y axis on the target), the amount of changes in the center of pressure both in terms of displacement and velocity (front and rear foot), clicker reaction time between control, placebo and 5 mg diazepam administration shots. CONCLUSION: It can be concluded that the use of 5 mg diazepam has no effect on shooting performance and related parameters on archers in an artificially conducted competition environment.

Nosocomial diarrhea and Clostridium Difficile associated diarrhea in a Turkish University Hospital.

BACKGROUND: Clostridium difficile (C. difficile) is a well-established cause of nosocomial diarrhea. The aim of our study was to define the incidence of nosocomial diarrhea in our hospital and to determine the role of C. difficile. Additionally, the risk factors for nosocomial diarrhea and Clostridium difficile associated diarrhea (CDAD) were investigated. METHODS: We included all patients, 18 years of age or more, who were admitted to the Uludag Teaching Hospital between October 1, 2004 and February 1, 2005, and developed diarrhea at least three days after hospital admission. A case-control study was performed. RESULTS: The total incidence of nosocomial diarrhea was 0.6 per 1,000 hospitalization-days and 5 per 1,000 patients' admissions. Previous use of chemotherapy was found to be an important predisposing factor for nosocomial diarrhea. The incidence of CDAD was 0.26 per 1,000 hospitalization-days and 2.1 per 1,000 admissions, comparable with incidence rates in Europe. CDAD was diagnosed in 43% of patients with nosocomial diarrhea. No severe cases of CDAD were diagnosed. A correlation was found between CDAD and antibiotic use before admission and during admission in univariate analysis. PCR ribotyping revealed four strains of PCR ribotype 002 and 1 strain of ribotype 012 out of 5C. difficile strains available for extensive identification. CONCLUSION: The incidence rates of nosocomial diarrhea and CDAD are not different than the usual incidence rates in Europe. C. difficile was the causative agent in 43% of patients with nosocomial diarrhea.

Report of a serious reportable communicable disease at a major sporting event.

A European Youth Olympic Sports Festival (EYOF), in Jaca, Northern Aragon, Spain, involving 1500 athletes, from 43 countries was held in January for 7 days. The event was marred by a case of type B Neisseria meningitidis. The usual care of the patient was performed in a local hospital. He eventually made a full recovery. The case was reported to the Local Health Authority and the National Public Health authority of the patient's country. Their advice was to treat the core case, give prophylactic therapy to the inner circle (28 athletes and officials) and surveillance of the other close contacts (84 total) with temperature and symptom review daily. They advised against further information being given to the rest of the athletes and officials, in case it might give rise to a panic situation. The dilemma of the responsible physicians was that 1500 athletes were traveling back to 43 countries within the incubation period of the bacterial meningitis. It was decided that informing each country was appropriate. This was done at the event by informing the Chef of the Missions and writing to the Secretary Generals of each National Olympic Committee attending. This was the first serious contagious disease at a major sporting event. The way in which the wider dispersing attendees were informed at the event should form the basis of management at sporting events in the likelihood of a serious communicable disease.

Changes in blood haemorheological parameters after submaximal exercise in trained and untrained subjects.

The blood stream is affected by viscosity and many other haemorheological factors such as lipid peroxidation in the plasma and red blood cells. The aim of this study was to investigate the changes of haemorheological parameters after submaximal exercise in trained and untrained subjects. The results indicated that heart rate, lymphocyte count, erythrocyte deformability, plasma lipid peroxide levels and erythrocyte glutathione peroxidase activity are increased after submaximal exercise.

Changes in serum creatine kinase, lactate dehydrogenase and aldolase activities following supramaximal exercise in athletes.

While it is well known that prolonged intense exercise raises serum enzyme activities, the effects of short duration intense exercise on enzyme activity changes have not been clearly described. Three successive standard 30 s Wingate anaerobic cycle ergometer tests separated by 6-8 min rest intervals were performed by competitive male middle- and long-distance runners or cyclists (no. = 33), and matched healthy control subjects (no. = 30). Immediately before and 6 h after the tests, blood samples were before and 6 h after the tests, blood samples were taken to assess the effects of exercise on serum creatine kinase (CK), lactate dehydrogenase (LD) and aldolase (ALS) enzyme activities. Serum CK activities were found to be significantly higher in athletes than in the controls, both before and 6 hours after the test (p < 0.001), as were ALS activities (p < 0.01 before and p < 0.05 after the test), whereas LD activities were significantly higher (p < 0.05) in the athletes only after the test. Following the test, increases in LD activities (p < 0.01) were observed in athletes and rises in CK activities (p < 0.05) were seen in the controls. Significant correlations between pre- and post-exercise serum enzyme activities were established for both groups. In conclusion, following a supramaximal exercise test, increases in serum LD activities of athletes and in CK activities of controls appear to be more pronounced, and increases in serum CK, LD and ALS activities seem to depend more on the duration of exercise than on its intensity.

The relationship of maximal alactacid anaerobic power to somatotype in trained subjects.

The purpose of the present study was to investigate the relationship between somatotype components and maximal alactacid anaerobic power (MAAP) in trained subjects. The somatotype components (endomorphy: means = 2.66, S.D. = +/- 0.78; mesomorphy: means = 5.45, S.D. = +/- 1.12; ectomorphy: means = 2.46, S.D. = +/- 0.88) and total MAAP were measured in 40 male fencers (aged, means 21.79, S.D. = +/- 3.97) in order to determine the correlations. The results did not show any correlations between the parameters. It can be concluded that the MAAP of an individual does not depend on the somatotype; but it may also be assumed that MAAP show changes with the percentage of fibre type, enzymatic activity in these fibres involved by large muscle groups which are relatively related to musculo-skeletal development (second component of somatotype) and neuro-muscular properties of the subjects, all having a genetic basis.