Is Bone Grafting Unnecessary in the Treatment of Cystic Scaphoid Pseudoarthrosis?

PURPOSE OF THE STUDY: The basic aim of the treatment of cystic nonunion is to provide stable fi xation and mechanical compression to increase union, but there is no consensus on whether to perform bone grafting in the cystic area or not. The aim of this study was to compare the clinical and radiological results of patients with cystic scaphoid non-union who received open grafting, and internal fi xation and those treated with percutaneous fi xation without grafting. MATERIAL AND METHODS A retrospective evaluation was made of patients included those determined radiologically with Slade and Dodds grade IV scaphoid cystic non-union. Two different surgical procedures were performed. Percutaneous screw fi xation was carried out on the patients in group 1. Open curettage-grafting and screw fi xation were performed on the patients in group 2. Group 1 was comprised of 16 patients treated with percutaneous screw fi xation, and group 2 was comprised of 17 patients who had open curettage-grafting and screw fi xation. RESULTS In the radiological evaluation at the fi nal follow-up examination, union was determined in 12 of the 16 (75%) patients in group 1 and 15 of the 17 (88%) patients in group 2. There was no statistically signifi cant difference between the two groups in terms of union, functional outcomes and complication rates. DISCUSSION In the current study, the union rate was higher in the patients who had open curettage-grafting and fi xation with a headless screw (88%) than in those with percutaneous screw without grafting (75%), but the difference was not determined to be statistically signifi cant. The union rate of the group that received grafting was similar to the rates reported in the literature. CONCLUSIONS We think that both of these techniques may be successfully used for cystic scaphoid nonunions but percutaneous technique should be preferred as it is minimally invasive. Nevertheless, there is a need for further prospective, randomised studies with larger series to have better comparisons. KEY WORDS: scaphoid bone, nonunion, fracture fi xation, internal, bone grafting, bone screws.

Comparison of interfragmentary pinning versus the extension block technique for acute Doyle type 4c mallet finger.

The aim of this study was to compare the closed reduction interfragmentary pinning method (IPM) with the extension block technique (EBT) for bony mallet finger. Patients who underwent mallet finger operations were screened retrospectively for the following inclusion criteria: Doyle type 4c, age between 18 and 75 years, less than 4 weeks to surgery, and more than 1 year of follow-up time. Group I underwent a closed reduction IPM, and group II underwent the EBT. Lateral radiographs taken during the preoperative and final examination were used to evaluate the size and amount of displacement from the distal interphalangeal (DIP) joint and the dorsal fragment as well as the articular surface. Operation times were compiled from patient records. During the final examination, pain and DIP joint range of motion (ROM) were assessed and complications were recorded. The Crawford criteria were used for functional results. Fifteen patients in group I (8 men, 7 women) and 17 patients in group II (10 men, 7 women) were evaluated. Age, gender, time to surgery and follow-up time showed no statistically significant differences between the two groups. The differences in fragment size, preoperative and postoperative joint displacement, amount of dorsal displacement and DIP joint ROM were not statistically significant between the two groups. However, the operation time was significantly shorter time in group I than in group II (p=0.000). The average time to fracture union was significantly longer in group I (7.3 weeks) than in group II (6 weeks) (p=0.013). The EBT has faster time to union and is a safer method with lesser risk of arthritis and fragmentation. The IPM can be an alternative with shorter operation time, less pin bed infection and nail bed damage, especially in Doyle type 4c cases with large fragments.

Prognostic utility of CURB-65 and E-CURB-65 scoring systems in healthcare associated pneumonia patients: Short- and long-term mortality.

BACKGROUND: The aim of our study is to evaluate whether the CURB-65 or expanded-CURB-65 score can be used in healthcare-associated pneumonia (HCAP) and subgroups of HCAP patients at the same efficiency. Thirty and 90-day mortality rates of the patients and predictive values of CURB-65 and E-CURB-65 scores were compared. PATIENTS AND METHODS: This is a retrospective study of patients who presented to the Emergency Department between January 2015 and January 2016. All patient charts above 18 years of age were evaluated according to American Thoracic Society and the Infectious Diseases Society of America (ATS/IDSA) pneumonia diagnostic criteria and pneumonia diagnoses were confirmed. RESULTS: 167 pneumonia patients (27.8%) of all pneumonia cases were grouped as HCAP and 433 (54.4%) were grouped as community-acquired pneumonia (CAP). 43% (n = 72) of HCAP patients were classified as nursing home-associated pneumonia (NHAP) and 57% (n = 95) were classified as HCAP (except NHAP) group. NHAP patients were older than the other groups. HCAP (except NHAP) group had somehow more comorbid diseases when compared with the other groups. However, the NHAP group had more unstable vital signs and confusion rates. Hospital and ICU admissions, 30-90-day mortality rates were all significantly higher in NHAP group E-CURB-65 was found to have better predictive values than CURB-65 for 30-day and 90-day mortalities overall. CONCLUSION: According to our results, commonly used scoring systems, CURB 65 and E-CURB 65, are not suitable for HCAP, NHAP, and HCAP (except NHAP) patients. NHAP patients have significant worse prognosis compared with CAP and HCAP (except NHAP) in terms of admission to intensive care and 30 and 90-day mortality rates.

Evaluation of Multidisciplinary Treatment Relationship between Orthodontics and Periodontology Departments by Examining Inter-Departmental Consultation Notes.

AIMS: The aim of this study is to evaluate the multidisciplinary treatment relationship between the two specialties of Dentistry, Departments of Periodontology and Orthodontics, by examining consultation request notes between the two departments. MATERIALS AND METHODS: The consultation request notes of 1685 patients who were treated at Erciyes University Faculty of Dentistry were included in the study. All notes were analyzed retrospectively and divided into categories. While the consultation request notes of 446 patients from the Department of Periodontology (DP) to the Department of Orthodontics (DO) were evaluated, the consultation request notes of 1239 patients from DO to DP were evaluated. Pearson's Chi-Squared test was used in the cloud-based TURCOSA statistical software for the statistical analysis of the obtained data. RESULTS: The highest number of requests for consultation from DP to DO was due to "Evaluation of the patient for orthodontic treatment (n = 203; 45.5%)," and the highest number of requests from DO to DP was "Gingival/Periodontal Treatment and Providing Motivation of Oral Hygiene (n = 558; 45.0%)". It was observed that most patients for whom consultation was requested were women (P < 0.05). CONCLUSIONS: This study determined the most common reasons for consultation requests between DP and DO and the sex which was the most prevalent. It was concluded that requests were made for the expertise of the other department for problems that could not be solved by the first department.

Metazoan Parasites of Common Sole (Solea Solea) and Scaldfish (Arnoglossus Laterna) (Pleuronectiformes) from Sinop Coast of Black Sea.

The metazoan parasites were investigated of two flatfish the common sole, Solea solea (n:140) and the scaldfish, Arnoglossus laterna (n: 22) in the Sinop coast of Black Sea from June 2015 to June 2017. A total of 15 metazoan parasite species belonging to Digenea (6), Cestoda (3), Acanthocephala (1), Nematoda (4) and Isopoda (1) taxonomic groups were identified. Solea solea was found to be infected by Condylocotyla pilodora, Proctoeces maculatus, Opecoelidae gen. sp., Metadena sp., Stephanostomum sp., Progrillotia sp., Capillaria gracilis, Cucullanus campanae, Solearhynchus rhytidotes and Nerocila orbignyi. Arnoglossus laterna was found to be infected by Lecithochirium musculus and Grillotia erinaceus. Scolex pleuronectis, Hysterothylacium aduncum and Dichelyne minutus were determined in both flatfish. Infection prevalence and mean intensity values were recorded for each parasite species. Infection values for each parasite species in relation to season and fish size were also determined and compared as comparatively. This study is the first one assessing the metazoan parasites both of S. solea and A. laterna collected from the Turkish coast of Black Sea. While Condylocotyle pilodora and Capillaria gracilis are new parasite records for S. solea, Grillotia erinecaus is new parasite record for A. laterna. Moreover, this paper is the first report on occurrence of Opecoelidae gen. sp., Metadena and Stephanostomum genera in S. solea.

Zero-valent aluminum-mediated degradation of Bisphenol A in the presence of common oxidants.

The use of a commercial, nano-scale zero-valent aluminum (ZVA) powder was explored for the treatment of aqueous Bisphenol A (BPA). The study focused on the (i) activation of hydrogen peroxide (HP) and persulfate (PS) oxidants with ZVA to accelerate BPA degradation, (ii) comparison of the treatment performance in pure and real surface water (SW) samples, (iii) effects on toxicity and (iv) reuse potential of ZVA nanoparticles after ZVA/HP and ZVA/PS treatments. In pure water, ZVA coupled with HP or PS provided an effective means of BPA treatment particularly when PS was employed as the oxidant. On the other hand, in BPA-spiked SW, the ZVA/HP treatment combination outperformed ZVA/PS oxidation in terms of BPA removal, whereas ZVA/PS oxidation was superior in terms of organic carbon removal. According to the bioassays conducted in pure and real SW samples with the marine photobacteria Vibrio fischeri and the freshwater microalgae Pseudokirchneriella subcapitata, the toxicity response of BPA and its oxidation products was sensitive to the test organism and water matrix. The inhibitory effect of the reaction solution increased at the early stages of ZVA/PS treatment. The reuse potential of the ZVA/HP treatment system was higher than that of the ZVA/PS treatment system.

Myxosporean parasites of Ceratomyxa merlangi and Myxidium gadi in whiting Merlangius merlangus: a comparative epizootiological analysis based on samples from two localities off southern and northern coasts of the Black Sea.

Totally 690 and 423 whiting Merlangius merlangus samples were collected from two localities off Southern (Sinop) and Northern coasts (Balaklava Bay) of the Black Sea, respectively, and examined for myxosporeans in the period from May 2011 to March 2014. Ceratomyxa merlangi and Myxidium gadi were the only myxosporean parasites identified in the content of gall bladder and their infection indices of prevalence (%) and intensity were calculated for length classes and sex of fish as well as for the seasons at both sampling localities. Overall infection prevalence of C. merlangi was 22.6% in Sinop and 27.9% in Balaklava samples while those values of M. gadi were 18.4% and 28.6% in Sinop and Balaklava samples, respectively. Both parasite species were also found to be co-existed in whiting samples. This is the first comprehensive epizootiological study yielded comparable data on C. merlangi and M. gadi infections in whiting in the southern and northern coasts of the Black Sea.

Levels of infection and seasonal occurrence of Gyrodactylus alviga (Monogenea: Gyrodactylidae) on the whiting Merlangius merlangus off the Turkish and Russian coasts of the Black Sea.

Gyrodactylus alviga is a generalist species reported in many Black Sea fish species, but whiting is known to be its main host. It is the only monogenean parasite that has been reported so far on the skin, fins and gills of whiting Merlangius merlangus in the Black Sea. A total of 690 fish from Turkey and 423 fish from Russia were examined to detect parasites. Infection indices of prevalence, mean intensity and mean abundance values were calculated for length classes and sex of fish, as well as for the seasons. There is a gradual increase in infection indices in relation with increasing host length classes and there are higher infection indices on female fish. Furthermore, despite lower prevalence indices in spring and winter, higher parasite intensity values were determined in these seasons. It is concluded that larger fish provided more space and food for G. alviga, and female fish were more parasitized as they were more active in searching for food, which enables the parasite to switch between hosts. In addition, winter and spring were more appropriate for reproduction of G. alviga.

Evaluation of the intraocular pressure in obese adolescents.

AIM: The aim of this study was to evaluate the intraocular pressure (IOP) levels of children with normal and high Body Mass Index (BMI) and to find out the potential correlation between glaucoma and obesity. METHODS: Thirty obese and thirty healty children were enrolled in this study. Physical examinations and anthropometric measurements of all patients and controls were performed. Obesity was defined as a BMI exceeding the 95th percentile for the patients according to age and sex. All participants were underwent a complete eye examination. The results of these measurements were considered for statistical analysis. RESULTS: Mean age was 13.5±2.1 years in obese group and 13.3±2.0 years in control group. Mean BMIs were 28.1±3.9 kg/m2 and 19.7±1.2 kg/m2 in obese and control groups, respectively. No significant difference was found in mean IOP levels of both right and left eyes between two groups (P=0.837 and P=0.755, respectively). There was no significant difference in cup/disc ratios of each eyes and mean central corneal thickness of both right and left eyes between obese patients and controls. In visual field analysis, no statistically significant difference in mean false negativeness and mean false positiveness were found between two groups. There were not also any significant correlations in both mean deviation of each eyes (P=0.78 and P=0.94, respectively) and pattern standart deviation of right and left eyes (P=0.89 and P=0.90, respectively) between obese cases and controls. CONCLUSION: In this study, there were no significant difference in IOP measurements, central corneal thicknesses, cup/disc ratios and visual field parameters between obese and normal children. No significant correlation was found between obesity and glaucoma or elevated IOP in children.

The role of diffusion weighted MR imaging for differentiation between Graves' disease and Hashimoto thyroiditis.

OBJECTIVE: The aim of this study was to evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DWMRI) for differentation between Graves' disease and Hashimoto's thyroiditis. PATIENTS AND METHODS: Fifty patients (27 Graves diseases and 23 Hashimoto thyroiditis) and twenty healthy volunteers were examined using T1, T2 and DWMRI. The patients were diagnosed on the basis of physical findings and the results of thyroid function tests and serological tests. Circular ROIs were positioned on the bilateral thyroid lobes and isthmus. All measurements were repeated three different b values including 100, 600 and 1000 s/mm2 in all cases. ADC (Apparent diffusion coefficient) maps were calculated automatically with the MR system. RESULTS: Mean ADC values were 2.93 × 10-3, 1.97 × 10-3 and 1.62 × 10-3 mm2/s in the healthy volunteers; 3.47 × 10-3, 2.25 × 10-3 and 1.64 × 10-3 mm2/s in Graves' disease; 2.53 × 10-3, 1.76 × 10-3, 1.28 × 10-3 mm2/s in Hashimoto thyroiditis for b100, b600 and b1000, respectively. The ADC values of the Graves diseases were higher than healty volunteers and Hashimoto thyroiditis. ADC values were statistically significant for differentation between Hashimoto thyroiditis and Graves' disease all b values (p < 0.05). CONCLUSIONS: DWMRI is fast sequence and does not require contrast agent. Quantitative assessment of the lesion is possible using ADC map. So, DWMRI may be useful differentiation of the Hashimoto thyroiditis and Graves' disease.