The role of body composition and appetite-regulating hormones in idiopathic central precocious puberty and their changes during GnRH analog therapy.

PURPOSE: It was aimed to compare circulating levels of ghrelin, leptin, peptide YY (PYY), and neuropeptide (NPY) between girls with idiopathic central precocious puberty (ICPP) and prepubertal girls, as well as to evaluate alterations in these hormone levels and body composition during leuprolide acetate treatment in girls with ICPP. METHODS: This prospective study was conducted on girls with isolated premature thelarche (IPT), girls with ICPP, and age-matched prepubertal controls. Anthropometric measurements, body composition analysis and appetite-regulating hormone level measurements were performed in each group and also at the 6th and 12th months of the leuprolide acetate treatment for the girls with ICPP. RESULTS: Seventy-three girls participated in the study (24 girls with ICPP, 28 with IPT, and 21 prepubertal controls). No significant differences were observed in ghrelin, leptin, PYY, and NPY levels among the three groups. Leuprolide acetate treatment resulted in increased leptin, decreased PYY and NPY levels, and no significant changes in ghrelin. Despite no significant change in body mass index standard deviation score (BMI SDS), body fat percentage increased during treatment. CONCLUSION: While appetite-regulating hormones do not seem to directly contribute to precocious puberty pathogenesis, puberty blockade was shown to lead to altered levels of these hormones along with changes in body composition.

Elucidation of effect of spinopelvic parameters in degenerative disc disease.

INTRODUCTION: This study aims to find out if there is any relationship between disc pathology and spinopelvic morphology, respectively. METHODS: A total of 152 patients who complained about low back pain were assessed retrospectively. Patients were divided into three groups based on the presence of disc pathology: non-degenerative (ND) (n=34), degenerative disc disease (DDD) (n=80), and lumbar disc herniation (LDH) (n=38). Spinopelvic parameters were measured on the lateral standing radiographs using Surgimap® Software. The degree of degeneration of each disc was evaluated using T2-weighted images according to the Pfirmann classification. Correlation analyses were performed. RESULTS: No significant difference was observed between the three groups in terms of sagittal spinal and pelvic parameters. Age and BMI were positively correlated with DDD and LDH. PI and proximal lombar lordosis (PLL) were the only effective variables in predicting DDD. PT and distal lumbar lordosis (DLL) were found to be effective variables in predicting LDH. PI and PT values in patients with L1, L2, and L3 DDD were statistically significantly higher than those without degeneration (P<0.05). Although there were no statistical differences between PI and PT values (P>0.05), DLL values in L4 and L5 DDD patients were significantly lower than those without degeneration (P=0.041; P=0.046; P<0.05). CONCLUSIONS: The sagittal morphology of the spine directly influences the extent of lumbar disc degeneration. As the values of PI and PT increase, disc degeneration tends to occur at higher levels (L1-2-3). Disc degeneration at lower levels (L4-5) was associated with low DLL levels. LEVEL OF EVIDENCE: Level III, retrospective study.

High-level disinfection with 2% alkalinized glutaraldehyde solution for reuse of laparoscopic disposable plastic trocars.

The reusability of disposable plastic trocars after high-level disinfection by alkalinized 2% glutaraldehyde solution was examined in a prospective study from the point of view of infection risk in order to determine the safety and economic benefits. For this purpose, 45 laparoscopic cholecystectomy cases were analyzed microbiologically and clinically. In 30 cases, trocars subjected to 15 min of disinfection by glutaraldehyde were used. In the remaining 15 cases, new trocars were used and a control group was established. In total, eight culture samples were taken from trocars, laparoscope (as it is disinfected by the same method), glutaraldehyde solution and umbilicus of the patients preoperatively; and from the bile in the gallbladder, peritoneal lavage fluid, and epigastric and umbilical incisions postoperatively. Only one of the disinfected trocars yielded a culture-positive result. No culture-positive results were found in the samples taken from laparoscope, glutaraldehyde, and epigastric incisions. Culture-positive results were obtained in 11 cases at the umbilicus, in one case at the peritoneal lavage and in one case at the umbilical incision. None of the patients had infection at the wound site or intra-abdominally. In conclusion, we have shown that disposable plastic trocars subjected to high-level disinfection can be reused safely without infection risk and that cost can be reduced.