The mediating role of cognitive distortions in the relationship between problematic social media use and self-esteem in youth.

Self-esteem expresses the individual's approach to himself and affects the whole life in terms of mental health. Another important factor affecting self-esteem, which has a critical importance for the youth period, is social media. In the literature, there are many studies examining the relationship between social media use and self-esteem of young people. In this study, it was aimed to investigate the relationship between problematic social media use and self-esteem in university students and to test the mediating role of cognitive distortions in the relationship between these two variables. The sample of the study consisted of 239 young individuals, 197 (82.4%) female, and 42 (17.6%) males, with a mean age of 20.62 ± 1.92 years, studying at a private university. Participants were evaluated by administering the "Rosenberg Self-Esteem Scale (RSES)", "Social Media Disorder Scale (SMD-9)", and "Cognitive Distortions Scale (CDS)". The scales were administered via an online survey. Results revealed that there was a negative significant relationship between the problematic social media use levels of the participants and their self-esteem. In the model established to evaluate the mediating role of cognitive distortions in the relationship between problematic social media use and self-esteem levels, in the first step, it was found that problematic social media use directly predicted self-esteem negatively. In the second step, it was determined that the use of problematic social media negatively predicted the mediating variable cognitive distortions. In the third step, when cognitive distortions, which are mediator variables, are added to the model in the relationship between problematic social media use and self-esteem; it was determined that cognitive distortions played a partial mediating role in the sub-dimensions of "self-perception", "self-blame", "hopelessness" and "seeing life as dangerous", while the sub-dimensions of "helplessness" and "total scale scores" played a full mediator role. Our findings show that there is a negative relationship between the problematic social media use of young people and their self-esteem levels, and cognitive distortions play a mediating role in the relationship between both variables.

An Evaluation of Bone Mineral Density Using Cone Beam Computed Tomography in Patients with Ectodermal Dysplasia: A Retrospective Study at a Single Center in Turkey.

BACKGROUND The aim of this retrospective study was to compare the measurements of bone mineral density (BMD) combined with volumetric dental tomography measurements taken from three main regions selected on the lower mandible, the right mandibular, medial mandibular, and left mandibular regions, in patients with ectodermal dysplasia and age-matched and gender-matched controls. Measurement of BMD in Hounsfield units (HUs) were evaluated using three-dimensional (3D) cone beam computed tomography (CBCT) imaging. MATERIAL AND METHODS Mandibular bone tomography images were evaluated from 9 women and 5 men diagnosed with ectodermal dysplasia and a control group of 9 women and 5 men. The HU values obtained according to age and gender of the total 28 study participants were measured. Statistical analysis of the data used Student's t-test. RESULTS BMD in the ectodermal dysplasia group was significantly lower compared with the BMD in the control group. Comparison of the left and right mandibular angulus regions showed that the BMD of patients with ectodermal dysplasia was significantly lower when compared with the control group in both regions, but no significant difference was found between the two groups in the BMD of the central mandibular region. CBCT was found to be an effective method for the measurement of BMD. CONCLUSIONS In patients with ectodermal dysplasia, reduced BMD should be taken into consideration when planning surgical interventions involving bone tissue and when planning implant surgery. The results of this study may be of value in dentistry and other fields of medicine.

Three-dimensional evaluation of maxillary sinus volume in different age and sex groups using CBCT.

AIM: Sinus maxillaris is an important anatomical formation in many branches of dentistry due to its proximity to the field of work. Various methods have been used in literature to measure the maxillary sinus volume (MSV) such as cadavers, stereology, two-dimensional conventional radiographs, computed tomography (CT), magnetic resonance imaging (MRI). The aim of this study is to evaluate the change of maxillary sinus volume according to age and gender with MIMICS 19.0 (Materialise HQ Technologielaan, Leuven, Belgium) which is one of three-dimensional modeling software. MATERIALS AND METHODS: This study was performed in 200 patients selected by a retrospective review of the archives of the Dicle University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology. Patients were divided into five age groups (18-24 years, 25-34 years, 35-44 years, 45-54 years, and ≥ 55 years) and by sex. Cone-beam computed tomography (CBCT) images of the patients were transferred to the MIMICS software and the MSV was measured. All statistical analyses were performed using the SPSS (Statistical Package for Social Sciences, version 21) software. RESULTS: There was no statistically significant difference between the right and left maxillary sinus volume according to the findings obtained from our study, and maxillary sinus volume in males was found to be significantly higher than that of females. Another finding of our study is that the maxillary sinus volume decreases with age increase. Especially it was also found that the sinus volume in males in the 18-24 age group was statistically significantly higher than females. CONCLUSION: Consequently, maxillary sinus volume measurements can be made on CT, CBCT, MRI scans using reconstruction software.

The Relationship between Maxillary Sinus Lateral Wall Thickness, Alveolar Bone Loss, and Demographic Variables: A Cross-Sectional Cone-Beam Computerized Tomography Study.

OBJECTIVES: Sinus floor elevation and augmentation surgery is widely used as a reliable procedure to increase insufficient bone height in the posterior maxillary area. The purpose of the present clinical study was to determine the associations between periodontal bone loss (PBL), maxillary sinus lateral bone wall thickness, age, and gender using cone-beam computerized tomography (CBCT). MATERIALS AND METHODS: The current retrospective study consists of 716 maxillary sinus CBCT images of 358 patients. The CBCT scans were assessed to detect the relationship between lateral wall thickness and PBL. ANOVA and Student t test analysis were used to determine the influence of PBL on sinus lateral wall thickness. RESULTS: Sinus lateral wall thickness was significantly associated with PBL (p < 0.05) at 3, 13, and 15 mm height. There was no significant association between lateral wall thickness and gender (p > 0.05). However, there was a significant association between lateral wall thickness at 3 and 13 mm and age (p < 0.05). There were significant associations between PBL and age (p < 0.001), and PBL and gender (p < 0.05). CONCLUSIONS: PBL might have an association with maxillary sinus lateral bone wall thickness. Further studies are needed to confirm this possible relationship.

Is There Any Difference in Risk Factors between Male and Female Patients in New-Onset Atrial Fibrillation after Coronary Artery Bypass Grafting?

BACKGROUND: We aimed to investigate the risk factors of post-coronary artery bypass grafting (CABG) atrial fibrillation (AF) in male and female patients without any history of AF, to identify the sex-specific risk factors, and to examine the effect of sex-specific risk factors on the overall population. METHODS: This retrospective study was conducted using the hospital database with 4,758 patients who underwent CABG surgery. Among them, 2,836 patients with complete data participated in this study. The female patients were divided into two groups as patients who developed new-onset AF after CABG and those who did not. The relationship between the patients' variables and risk factors of post-CABG AF was examined. RESULTS: The overall incidence of post CABG AF was 12.9% (386/2,836). Sex-specific incidence of AF was similar: 3.2% (91/690) and 12.9% (277/2146) in female and male patients, respectively (p = 0.849). Multiple analysis revealed the independent risk factors for male and female patients, respectively: mean age (odds ratio [OR] = 1.057, OR = 1,076), age over 65 years (OR = 2.156, OR = 2.736), the European System For Cardiac Operative Risk Evaluation Scores (EuroSCORE) (OR = 1.13, OR = 1.218), COPD (OR = 1.589, OR = 1.789), BUN level (OR = 1.026, OR = 1.019), mean cardiopulmonary bypass (CPB) time (OR = 1.007, OR = 1.010), prolonged CPB time (OR = 1.604, OR = 2.309), mean cross-clamp time (OR = 1.009, OR = 1.017), need of inotropic support (OR = 2.249, OR = 2.731), and mean mechanical ventilation time (VT) (OR = 1.026, OR = 1.027).Low left ventricular ejection fraction (LVEF) (OR = 1.419), left ventricular (LV) aneurysm repair (OR = 1.533), carotid artery disease (OR = 1.750), prolonged VT (OR = 1.729), and use of intra-aortic balloon pump (IABP) (OR = 2.436) were found to be the risk factors only for male AF patients.Unstable angina (OR = 1.969), right coronary artery (RCA) disease (OR = 2), prolonged cross-clamp time (OR = 2.152), and the number of grafts per operation (OR = 1.298) were found to be the risk factors only for female AF patients. CONCLUSION: This study suggests that predictors of AF in the overall population may be due to isolated patient groups. Multiple regression analysis and artificial intelligence modelling should be performed on large-scale, isolated groups to make strong AF prediction.

Associations of alveolar bone loss and interleukin-1ß levels in one- and two-stage surgical procedures: a randomized prospective trial.

OBJECTIVE: Dental implants have been widely and successfully used in recent years as an alternative treatment for removable and fixed dental prostheses. The aim of this randomized prospective study was to determine the alveolar bone loss rate (ABLR) and IL-1ß levels in one- and two-stage surgical procedures. MATERIALS AND METHODS: This study included 40 patients with a single missing tooth in the posterior mandible; dental implants were inserted using a one-stage surgical procedure (Group I) or a two-stage surgical procedure (Group II). All clinical periodontal parameters were recorded; peri-implant crevicular fluid (PICF) samples were collected before loading (T0) and during the third (T1) and sixth (T2) months after loading. ABLR values were evaluated at T0 and T2 by using dental tomography. PICF was analysed after T2 samples were collected. The study was registered through clinicaltrials.gov; identifier NCT03045458. RESULTS: This study found that, the probing pocket depth was found to be significantly higher in Group I than Group II at both T1 and T2 (p < .05). There was no significant difference in other clinical parameters between the groups (p > .05). There was a significant difference between Group I ABLR values at T0 and T2 (p < .05). The PICF IL-1ß levels were not significantly different between groups (p > .05). CONCLUSIONS: Within the limitations of the short observational period and small sample size of this study, two-stage implant placement shows comparable clinical outcomes to implants placed using a one-stage placement protocol.

A cone-beam computed tomography study of root canal morphology of maxillary and mandibular premolars in a Turkish population.

AIM: The aim of this study was to evaluate the root canal number and configuration of maxillary and mandibular premolar teeth by gender, intervals for decades, tooth position and unilateral or bilateral occurrence in a Turkish population using Cone Beam Computed Tomography(CBCT) scanning. METHODOLOGY: CBCT images of 5496 maxillary and mandibular premolars from 849 patients were evaluated. The following was evaluated in all the images: numbers of roots and root canals, the morphology of the root canal configuration according to the Vertucci classification, male-female differences in the tooth position and male-female differences in unilateral or bilateral occurrence. The reliability data were analyzed with a chi-square test. RESULTS: The most prevalent root canal frequency was the two canals (86.2%) and type IV (76.9%) configuration for maxillary first premolar, one canal (59.7%) and type I (54.5%) canal configuration for second premolar. The incidence of one canal was higher in females and the occurrence of two or three canals was more common in males. The incidence of one canal was higher on the left side of maxillary premolars and the incidence of two canals was higher on the right side. Most mandibular first (93.5%) and second (98.5%) premolars had one canal. In general, females had one root canal of the mandibular premolar, whereas males had two or three canals. The type I configuration was most common and the incidence was higher on the right side. There were some differences found in the frequency distribution of the number of root canals and configuration of maxillary and mandibular premolar teeth according to intervals for decades. CONCLUSION: CBCT scanning provides comprehensive information about the root canal morphology of maxillary and mandibular premolar teeth. These data may help clinicians in root canal treatment of premolar teeth.

Evaluation of the relationship between the maxillary posterior teeth and the sinus floor using cone-beam computed tomography.

AIM: The aim of this study was to evaluate the relationship between each root of maxillary premolars and molars and the maxillary sinus floor according to sex, sinus position, and age by decade in a Turkish population by using cone-beam computed tomography (CBCT) scanning. METHODOLOGY: We evaluated a database of 5,166 (2,680 maxillary premolars and 2,486 maxillary molars) CBCT scans obtained from 849 patients. The vertical relationship between each root of the molar and premolar teeth to the sinus floor was classified into three types: type 1, the roots penetrated into the sinus floor; type 2, the roots contacted the sinus floor; and type 3, the roots extended below the sinus floor. RESULTS: The results of the classification of each root in relationship to the sinus floor were as follows: type 3 occurred most frequently in the first (92.4 %) and second (71.6 %) premolar teeth, type 1 (34.2 %) occurred most frequently in the palatinal roots of the first molar teeth, type 3 occurred most frequently in the mesiobuccal (39.9 %) and distobuccal (39.7 %) roots of the first molar teeth, and type 2 (36.7 %) occurred most frequently in the mesiobuccal roots of the second molar teeth. No significant differences were found between the left and right sides, but several differences were found between males and females. The relationship between the posterior teeth and the sinus floor differed according to the age decade interval (p < 0.05). CONCLUSIONS: The maxillary first premolars have no relationship with the maxillary sinus floor, but the maxillary second molars are closer to the sinus floor. Also the second decade and males were most susceptible to undesirable results.

Technical aspects that may affect the outcomes of pediatric patients with both-bone forearm diaphyseal fractures treated using elastic stable intramedullary nails.

We assessed the radiological and functional results of pediatric both-bone forearm diaphyseal fractures treated using elastic stable intramedullary nails (ESINs), as well as factors affecting the results. In total, 36 patients (33 males and three females; mean age, 11.6 years) were included. The mean follow-up time was 41.5 (18-96) months. Patient demographic characteristics and the details of the surgical techniques were analyzed retrospectively. In addition to standard radiographic evaluations, the ratio between the nail diameter and medullary canal diameter (ND/MCD) was measured, as well as the maximal radial bowing. According to the criteria of Price and Flynn, 28 (77.8%) and eight (22.2%) patients had excellent and good results, respectively. There were no cases of nonunion or delayed union. There was no significant difference in functional or radiological results according to whether titanium nails (24 patients) or stainless steel nails (12 patients) were used (all P  > 0.05). Nail prebending (performed in 19 patients) did not affect the functional or radiological results ( P  > 0.05). Loss of reduction was observed in four patients with an ND/MCD ratio <40%. The maximal radial bowing improved in all patients. The mean change was significantly greater in patients with diastases and 22D/4.1 fractures. Regardless of nail type or prebending status, surgery using ESIN placement effectively treats both-bone forearm diaphyseal fractures; radial bow remodeling outcomes are excellent. We recommend that the ND/MCD ratio should be 40-70%.

Adult Separation Anxiety and Childhood Traumas: The Mediating Role of Cognitive Distortions.

While there are many studies on the relationship between anxiety disorders and childhood traumas in the literature, there are limited studies on the relationship between separation anxiety disorders and traumatic experiences in early life. It is widely known that trauma and negative cognitive processes are important factors in the etiology and prognosis of psychiatric disorders. In this study, it was aimed to determine the relationship between adult separation anxiety levels and childhood traumas and cognitive distortions, and to examine the mediating role of cognitive distortions in the relationship between childhood traumas and separation anxiety. A total of 366 students attending a private university were included in the study. The scales, which were converted into online questionnaires by the researchers, were sent to the students via e-mail, and were administered online. The participants were evaluated using "Adult Separation Anxiety Questionnaire", "Childhood Trauma Questionnaire", and "Cognitive Distortions Scale". The results of the study indicated that there was a positive and significant relationship between adult separation anxiety levels and childhood sexual abuse while there was no statistically significant correlation between adult separation anxiety levels and physical and emotional abuse, or physical and emotional neglect. A positive and significant relationship was found between separation anxiety levels and the sub-dimensions of cognitive distortions' self-image, self-blame, helplessness, hopelessness, and preoccupation with danger. In addition, it was determined that the helplessness and preoccupation with danger sub-dimensions of cognitive distortions had a full mediator effect on the relationship between sexual abuse and separation anxiety. Our results show that there is a positive relationship between separation anxiety disorder and childhood sexual abuse, and cognitive distortions play a mediating role between both variables.

Self-esteem and social media addiction level in adolescents: The mediating role of body image.

Background: There are many studies examining the relationship between social media and self-esteem. Studies examining the relationships between the self-esteem, social media use, and body image of adolescents are limited in the literature. Aim: This study aimed to examine the relationship between self-esteem and social media addiction levels in adolescents and the mediating role of body image in the relationship between these two variables. Methods: The sample of the study consisted of 204 adolescents, 67 (32.8%) girls and 137 (67.2%) boys, with a mean age of 15.90 ± 1.20 years, who were high school students. The self-esteem levels of the participants were evaluated with the "Rosenberg Self-Esteem Scale", their social media dependency levels were measured with the "Social Media Use Disorder Scale", and their body images were measured using the "Multidimensional Body-Self Relations Questionnaire". Results: No significant relationship was found between the self-esteem levels of the participants and their ages or the education levels of their parents. There was a negative moderate significant relationship between the self-esteem levels of the participants and their social media addiction levels, and a positive moderate significant correlation was found between their self-esteem levels and body images. It was found that the social media addiction levels of the participants negatively predicted their self-esteem and body image levels. It was determined that body image had a partial mediator effect on the relationship between the social media addiction and self-esteem levels of the participants. Conclusion: Our results revealed that there is a negative correlation between self-esteem and social media addiction levels in adolescents. Body image has a partial mediating role in the relationship between social media addiction and self-esteem levels.

First 10 days after the 6th of February 2023 earthquake disaster: experience of an orthopedic clinic on the border of the disaster zone.

BACKGROUND: The earthquake disaster that occurred on February 06, 2023, caused serious destruction and loss of life in the south of Türkiye. The purpose of this article consisting of two interconnected parts is to report the experience of our orthopedics clinic, which is located just on the border of the disaster area. The subject of the first part of the study is the characteristics of ortho-pedic traumas in earthquake victims and the treatment methods applied. The subject of the second part is the disaster work plan of the clinic and its consequences in practice. METHODS: For the first step, descriptive information, diagnoses, and treatment methods of 204 earthquake victims who were treated by our clinic in the first 10 days after the disaster were compiled from the archives. In terms of the second phase of the study, an in-clinic work plan was created on the morning of the 1st day of the disaster. The teams and working hours in the emergency department, inpatient service, and operating room were determined. Hospital management and other clinics were contacted and hospital facilities were organized for orthopedic trauma victims. RESULTS: The mean age of the patients was 42.3 years. Among the age groups, the smallest group was children under 10 years old (6.4% of all patients). 132 of the patients had at least one fracture in 135 extremities. Most of the injuries involved the lower extrem-ity. 66 patients had crush injury with or without fracture. 181 orthopedic surgical procedures were performed in 144 patients. The most common operations were internal fracture fixation and debridement. The most used implant was the plate-screw combination. Thanks to the in-clinic work plan and the in-hospital assistance and allocation of facilities, we did not experience serious problems in the hospitalization, surgery, and post-operative follow-ups of the patients. Although we received numerous offers of assistance from external institutions, this was not possible due to bureaucratic obstacles. Among our most important problems were the shortage of sterilized powered surgical drills and the lack of a dynamic patient information database. CONCLUSION: Orthopedic clinics should prepare their in-clinic work plans for earthquake disasters and develop their facilities. In order not to encounter bureaucratic obstacles in emergency assistance, orthopedic clinics in different risk regions should be formally matched beforehand. A patient database table that clinical staff can access and revise using their smartphones facilitates the follow-up of large numbers of simultaneously hospitalized patients.

Clinical findings of vertebral osteomyelitis: Brucella spp. versus other etiologic agents.

We aimed to evaluate patients with vertebral osteomyelitis (VO) in our region and to compare the clinical and laboratory parameters of brucellar and non-brucellar VO patients (NBVO). This retrospective study included 80 patients with VO followed in our hospital between August 2004 and September 2010. The distribution of gender was 43 females (53.8%) and 37 males (46.2%) with average age of 52.5. Patients with brucellar vertebral VO (BVO; n = 30) accounted for 37.5% of all patients, and the rest (n = 50) were with NBVO. Co-morbidities existed in 32.5% of patients. In statistical comparison of VO patients who had the Brucella spp. as the infectious agent with patients of VO by non-brucellar pathogens, the following factors were found out to be significantly associated with BVO; low Charlson score (P = 0.0001), lower co-incidence with chronic renal failure (P = 0.001), high frequency of constitutional symptoms (P = 0.006), fever (P = 0.005), low-level inflammatory markers (WBC; Neutrophil; ESR; CRP, P values 0.006; 0.001; 0.022; 0.002, respectively), low-rate surgical treatment (P = 0.02) and culture positivity (P = 0.0001) and higher hemoglobin, total protein, albumin values (P = 0.002; 0.032; 0.016, respectively). VO may be strongly associated with brucellosis in patients presenting with fever and symptoms, low Charlson score and indistinct inflammatory markers.

Forty-five-degree or higher insertion angles are required to penetrate the opposite cortex in bicortical applications of Kirschner wires: an in vitro study on sheep bones.

PURPOSE: Slippage of the wires over the opposite cortex from the endosteal side is frequent and can lead to insufficient stability. This in vitro biomechanical study was planned to investigate the angle of wire insertion that leads to trans cortex perforation. METHODS: Long bones of sheep were cut longitudinally into two pieces and half bones were stabilised on a frame. Three orthopaedic surgeons performed the experiment using ten wires of four different diameters at two different drilling speeds. Each wire was introduced from the endosteal side at angles starting at 30° in 5° increments until perforation. When perforation was achieved, the angle was recorded. To determinate the critical angle of perforation, receiver operating characteristic (ROC) curve analyses was performed. Two-way factorial analysis of variance (ANOVA) and Kruskal-Wallis tests were used for statistical comparisons. RESULTS: Kirschner-wire insertion angles of ≥ 45° provided perforation with a percentage of 83.9 %. Wire diameter, drilling speed and surgeon variables had no effect on perforation angles (p > 0.05). CONCLUSION: If preoperative evaluation of fractures to be fixed by K wires reveals the need for oblique wire insertion angle < 45°, a standard trocar-tip K wire application would lead to slippage of the wire tip on the endosteal surface of the opposite cortex. According to this study, the operative plan should be changed if such obliquity of the K wire is mandatory during bicortical applications.

Fast Curing Multifunctional Tissue Adhesives of Sericin-Based Polyurethane-Acrylates for Sternal Closure.

The use of wire cerclage after sternal closure is the standard method because of its rigidity and strength. Despite this, they have many disadvantages such as tissue trauma, operator-induced failures, and the risk of infection. To avoid complications during sternotomy and promote tissue regeneration, tissue adhesives should be used in post-surgical treatment. Here, we report a highly biocompatible, biomimetic, biodegradable, antibacterial, and UV-curable polyurethane-acrylate (PU-A) tissue adhesive for sternal closure as a supportive to wire cerclage. In the study, PU-As were synthesized with variable biocompatible monomers, such as silk sericin, polyethylene glycol, dopamine, and an aliphatic isocyanate 4,4'-methylenebis(cyclohexyl isocyanate). The highest adhesion strength was found to be 4322 kPa, and the ex vivo compressive test result was determined as 715 kPa. The adhesive was determined to be highly biocompatible (on L-929 cells), biodegradable, and antibacterial (on Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus bacteria). Finally, after opening the sternum of rats, the adhesive was applied to bond the bones and cured with UV for 5 min. According to the results, there was no visible inflammation in the adhesive groups, while some animals had high inflammation in the cyanoacrylate and wire cerclage groups. These results indicate that the adhesive may be suitable for sternal fixation by preventing the disadvantages of the steel wires and promoting tissue healing.

Solvent-free synthesis of chiral Schiff-base ligands based on ferrocene under microwave irradiation and application to enantioselective nitroaldol (Henry) reaction.

Chiral Schiff-bases 3a-f based on ferrocene were designed and synthesized using solvent-free methods by mixing ferrocene carbaldehyde 1 with amino alcohols and amines 2a-f under microwave irradiation and classical method for the enantioselective nitroaldol (Henry) reaction. The Schiff-bases were obtained in shorter reaction times and improved yield under microwave irradiation method over classical method. The highest enantioselectivity was observed in ligand 3e (95% ee) when CH(2)Cl(2) was used as solvent.

Anterior cruciate ligament reconstruction improves the metabolic energy cost of level walking at customary speeds.

PURPOSE: The metabolic energy cost of walking is altered by pathological changes in gait. It is thought that anterior cruciate ligament (ACL) deficiency alters the energy requirement for level walking through its effect on gait pattern. In this study, it is hypothesised that the metabolic energy cost of walking would improve after ACL reconstruction. METHODS: Eight patients who were undergoing ACL reconstruction for an isolated rupture were included in this prospective study. Clinical examinations, Lysholm scores and metabolic tests were performed preoperatively and at 3, 6 and 12 months after ACL reconstruction using autologous quadruple hamstring tendons. For the metabolic evaluation, net oxygen cost was calculated while walking on a treadmill at 50-, 70- and 90-m/min velocities. A two-way factorial ANOVA was performed in order to evaluate the primary effects and interactions of the time point and velocity variables on net oxygen cost. RESULTS: All patients had positive Lachman and anterior drawer tests preoperatively that became negative postoperatively and remained negative until the last follow-up point. The mean preoperative Lysholm score was 66, whereas the mean postoperative follow-up scores were 85, 91 and 94, respectively. The interaction between follow-up time point and velocity was not significant. Regardless of the selected velocity, the net oxygen cost was lower than that at preoperative levels at each postoperative time point (p < 0.05). CONCLUSION: The results of the present study indicate that the energy cost of level walking in chronic ACL-deficient patients improves after ACL reconstruction. Cause-effect-based studies with correlation evaluations that compare kinetic, kinematic and electromyographic data and metabolic cost calculations should facilitate more accurate analyses. LEVEL OF EVIDENCE: Therapeutic study, Level 4.

Open reduction and Salter innominate osteotomy combined with femoral osteotomy in the treatment of developmental dysplasia of the hip: Comparison of results before and after the age of 4 years.

OBJECTIVE: This study aimed to compare the clinical and radiological findings of radical reduction (open reduction and Salter innominate osteotomy combined with femoral osteotomy) for children of walking age, younger and older than 4 years in the treatment of with developmental dysplasia of the hip (DDH). METHODS: In this retrospective study, children of walking age with DDH who underwent radical reduction between 2008 and 2014 were identified. They were then divided into 2 groups according to the age at which the surgery was performed: before and after the age of 4 years. Improvement in the acetabular index was examined on follow-up radiographs. The presence of avascular necrosis (AVN) was determined and classified on the basis of the Kalamchi-MacEwen classification on final follow-up radiographs. Clinical assessment was performed with the modified McKay criteria at the final follow-up appointment. RESULTS: A total of 19 children (14 girls, 5 boys; mean age=37.5±21 months) (25 hips) were included. Their mean age was 27.9±4.9 and 63.3±19.7 months in children operated before and after the age of 4 years, respectively. The mean follow-up time was 29.9±19 and 19.6±5 months in children operated before and after the age of 4 years, respectively. No significant difference was observed in improvements in the acetabular index between children younger than 4 years (24±6.9°) and those older than 4 years (20.7±6.7°) (p=0.25). According to the modified McKay criteria, all the children younger than 4 years exhibited excellent or good clinical results compared with those operated after the age of 4 years (67%) (p=0.013). At the final follow-up, 64% of all patients demonstrated no radiographical sign of AVN. The rates of AVN were significantly higher in children operated after the age of 4 years (33%) than in those operated before the age of 4 years (19%) (p=0.049). CONCLUSION: Better clinical and radiographical results can be expected from radical reduction in children undergoing surgery before the age of 4 years. LEVEL OF EVIDENCE: level III, Therapeutic Study.

Postoperative pain and respiratory function in patients treated with electroacupuncture following coronary surgery.

OBJECTIVES: To evaluate respiratory function and pain score in patients undergoing coronary bypass procedures during the first 7 postoperative days. METHODS: The study was carried out as a case-control study between April 2008 and April 2009 in the Department of Cardiovascular Surgery, Firat University Faculty of Medicine, Elazig, Turkey. Thirty patients, who had undergone a median sternotomy (MS) for coronary artery bypass graft, were randomized to either the electroacupuncture and pharmacologic analgesia (acupuncture) group, or the pharmacologic analgesia alone (control) group. In each group, severity of pain, analgesic intake, respiratory function, and pulmonary complications were recorded. Pethidine hydrochloride and metamizole sodium were administered. RESULTS: Of the 30 subjects, 15 were in the control group and 15 in the acupuncture group. There were no statistically significant differences between the 2 groups in terms of age and gender. Statistically significant differences in metamizole, pethidine, days 3, 5, 6, and 7 visual analogue scale scores were observed between the acupuncture and control groups. Postoperative complications (atelectasia) were observed in 2 (13.3%) patients, one (6.6%) in each group. The postoperative forced expiratory volume in one second/forced vital capacity value was higher than the preoperative value in the acupuncture group. CONCLUSIONS: Electroacupuncture was more effective than control treatments in decreasing pain and limiting opioid and non-opioid medication intake during the first 7 postoperative days following MS.

A comparison of different treatment managements in patients with acute deep vein thrombosis by the effects on enhancing venous outflow in the lower limb.

BACKGROUND: This study aimed at evaluating the benefits of the traditional management of acute deep vein thrombosis (DVT), subcutaneous (sc) administration of low-molecular-weight heparin (LMWH) one dose a day and bed rest, and LMWH with compression stocking and early ambulation compared with LMWH with pneumatic compression (PC) in patients with DVT. MATERIAL/METHODS: Forty-eight consecutive patients with DVT were separated evenly into four groups. Group A received intravenous unfractionated heparin, group B received sc injection of enoxaparin sodium and bed rest, group C received sc injection of enoxaparin sodium and thigh-length compression stockings, and group D received sc injection of enoxaparin sodium and PC for periods of up to 7 days. RESULTS: Comparing days 0 and 7, significant differences were determined in each group regarding differences in circumference of the two legs at the thigh and calf levels and the visual analogue scale (VAS) of pain, and in groups B, C, and D regarding the Lowenberg test for diseased and healthy legs (p<0.001). Between days 0 and 7, significant differences were found in the superficial femoral artery, superficial femoral vein, femoral vein, and the popliteal vein within groups A and D (p<0.05). CONCLUSIONS: Traditional management, sc administration of low-molecular-weight heparin, and pneumatic compression of patients with DVT led to a faster reduction of leg swelling and pain and to increased volume flow through the deep veins of the legs.