THE PREVALENCE OF POLYNEUROPATHY IN THE PRE-DIABETES PERIOD.

Objective: This study aims to determine the prevalence of neuropathy in the prediabetic period. Design Subjects and Method: Informed consent was attained from the patients who volunteered to participate in the study after ethics committee approval was obtained. Patients under the age of 18, having vitamin B12 or folic acid deficiency, history of collagen tissue-rheumatological disease, chronic kidney failure, cirrhosis, ethylism, thyroid disease, autoimmune disease, malignancy, tuberculosis, type 1 or 2 diabetes mellitus and pregnant women were excluded from the study. Patients diagnosed with prediabetes were evaluated by the DN4 neuropathy complaint questionnaire. Neuropathy was diagnosed in patients having a score of four or more. For the statistical analyses Student t-test, Pearson chi-square test, and Fisher's exact test were performed using the NCSS program. Results: A total of 224 volunteers, 167 women and 57 men, were included in the study. The mean age of the participants was 51 and the mean level of hemoglobin A1C was 5.9. Neuropathy was detected in 45% of the cases. Especially in women, there was a significant increase in the frequency of neuropathy compared to men. The most common complaints found in our study were burning sensation and numbness in the extremities. Conclusions: Similar to diabetic patients, prediabetic patients also have a high rate of neuropathy. For the early diagnosis of neuropathy and to be treated promptly, screening tests such as DN4 should be performed for all prediabetic patients. According to the test results, advanced examinations such as EMG or biopsy should be performed earlier.

Clinical Performance of Complete-Arch Implant- Supported Rehabilitations Using Monolithic Lithium Disilicate Restorations Bonded to CAD/CAM Titanium and Zirconia Frameworks up to 5 Years.

This clinical study evaluated the survival of monolithic lithium disilicate (ML) (IPS Emax, Ivoclar Vivadent) restorations bonded to complete-arch CAD/CAM made titanium or zirconia frameworks. Between August 2007 and December 2009, 15 patients (7 female, 8 male; mean age: 56.8 years old) received 30 implant-supported screw-retained rehabilitations with ML restorations cemented to CAD/CAM made titanium (T) (n=6) or zirconia (Z) frameworks (n=24) adhesively (Multilink Automix, RelyX Unicem) and followed up until December 2015. The evaluation protocol involved technical failures (chipping, debonding or fracture of crown/framework, screw loosening), Californian Dental Association (CDA) quality criteria (Romeo: Excellent; Sierra: Acceptable; Tango: Retrievable; Victor: Not acceptable) and biological failures (mucositis, peri-implantitis). Mean observation time was 60.3 months. No implants were lost, and all the prostheses were in situ. Four mechanical failures occurred in the form of minor chipping (n=3 in ML-Z, n=1 in ML-T) and major fracture in ML crown (n=1 in ML-Z). Romeo scores (N=370) decreased until final observation (N=347) and 23 Sierra scores were given to the restorations. Mucositis was observed in 3 patients and peri-implantitis in one patient. Complete-arch implant-borne FDPs made of monolithic lithium disilicate bonded to titanium or zirconia frameworks could be a promising alternative.

The effects of high intensity-interval training on vaspin, adiponectin and leptin levels in women with polycystic ovary syndrome.

AIM: We aimed to investigate the metabolic effects of HIIT exercise on PCOS patients and how it affects adiponectin, vaspin and leptin. MATERIAL AND METHODS: Twenty women with PCOS were included in the study and were divided into two groups. HIIT program was applied for 10 PCOS and Medium Intensity Continuous Training (MICT) program was applied for other 10 PCOS. At the beginning and at the end of the study, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride(TG), insulin, Adiponectin, Leptin, Vaspin levels of both PCOS groups were evaluated. RESULTS: When PCOS patients by performed HIIT exercise for 12 weeks, we found that the levels of leptin and vaspin did not change while adiponectin levels increased. Moreover serum levels of insulin, TG, total cholesterol, LDL-C decreased but levels of HDL-C increased. CONCLUSION: HIIT increased in the adiponectin levels in women with PCOS and provided more weight loss.

Arthroscopic versus Mini-Open Rotator Cuff Repair: Should We Ignore the Mini-Open Surgery?

PURPOSE OF THE STUDY To compare the functional and radiological results of the total arthroscopic treatment (TAT) performed due to the rotator cuff (RC) tear problem with the results of the arthroscopically assisted mini-open surgery (AAMOS). MATERIAL AND METHODS This study conducted over a two-year period included all had TAT or AAMOS. Patients were included in the study if they had undergone arthroscopic or mini-open rotator cuff repair, with a minimum of 2 years' follow-up. Patients were divided into two groups in terms of the surgical technique performed. Patients who had TAT was included into the group 1 and, AAMOS group 2. Exclusion criteria included other significant intra-articular pathology such as SLAP lesions or glenohumeral arthrosis, previous rotator cuff surgery, massive rotator cuff tears (>5 cm), and neurologic disorders such as brachial plexopathy or suprascapular neuropathy. Every patient underwent magnetic resonance imaging evaluation before surgery and at last follow-up after surgery. Acromion typed of patients were recorded. Patients were questioned for ASES and Constant score. RESULTS Fifty-eight shoulders were included in the study. Twenty-eight patients were female and 30 were male. The mean age was 55.63 ± 8.06 years. Both groups had 29 patients per each. Mean follow-up period was 26.26 ± 11.46 months. There was no statistically significant difference between the mean age and gender distribution of the groups (p > 0.05). No statistically significant difference in the follow-up period between two groups (p > 0.05). No statistically significant difference was found between the postoperative ASES measurements between the two groups (p > 0.05). There was no statistically significant difference in postoperative Constant measurements between the two groups (p > 0.05). There was no statistically significant difference between the Acromion types between the two groups (p > 0.05). No statistically significant difference was found between the both groups in terms of accompanying shoulder pathology and AC joint degeneration (p > 0.05). In the postoperative MRIs of the patients, 7 patients in the Group 2 and 6 patients in the Group 1 were found to have recurrent tears. No statistically significant difference was found (p > 0.05). DISCUSSION When compared their patients who underwent RC repair by AAMOS intervention with those treated with TAT intervention and stated that the results were satisfactory for both groups and close to each other during their 2-year follow-up regardless of the tear diameter. Rotator cuff repairing with TAT is becoming a popular method of shoulder surgery. Initial reports of outcomes with this technique have indicated similar results when compared with open techniques, with less perioperative morbidity. Patients with RC tears treated by TAR, the shoulder range of motion was achieved in a shorter time and the rate of development of fibrous ankylosis was found to be lower. We performed the same configuration for the repair technique that may avoid to differ the results. Additionlay, all patients in study had the same rehabilitation protocol not to differ the results. Our study demonstrated similar results, with no differences noted in clinical outcomes between the TAT and the AAMOS for all scoring scales evaluated. Our experience with TAT notes a steep learning curve for proper technique. Certainly, surgeons may attempt a TAT, knowing that the patient's long-term outcome will not differ if the AAMOS is needed. CONCLUSIONS It must be kept in mind that both surgical methods may provide satisfactory results; the decision regarding which method should be used must be based on the skills, experience and technical oppurtunities of the orthopedic surgeon. However, any of the surgical technique is chosen, smilar excellent clinical results can be achieved. Key words: rotator cuff, mini-open surgery, total arthroscopic repair, cuff tear, Constant score, ASES score.

Is Thiol/Disulphide homeostasis important in prostate cancer diagnosis? / Es importante la homeostasis del Tiol/Disulfito en el diagnóstico del cáncer de próstata?

OBJECTIVES: To assess the relationship between prostate cancer and thiol/disulphide homeostasisas an important indicator of oxidative stress. METHODS: After ethics committee approval (546/2015); 388 patients aged between 46-75 years who underwent transrectal ultrasound guided prostatebiopsy in three different centers between July 2015-2016 owing to serum prostate specific antigen (PSA) levels ≥2.5 ng/ml and/or abnormal digital rectal examination were involved in this study. The plasma levels of thiol/disulphide homeostasis parameters were compared in patients with and without prostate cancer. RESULTS: The mean age of the patients was 62.9±7 years. In patients with prostate cancer (n=130, 33.5% ) the mean plasma levels of native thiol and total thiol were lower (332.9 vs 362.1 µmol/L and 363 vs 392.6 µmol/L, p=0.001). Plasma disulphide levels were not statistically different between the groups (15 vs 15.3 µmol/L, p=0.936). In prostate cancer group; patients with Gleason score ≥7 had lower plasma native thiol levels than patients with Gleason score<7 (321.3  vs 342.6 µmol/L, p=0.029) while there were no significant differences in total thiol and disulphide levels (352.3 vs 371.9 µmol/L, ptotal Thiol =0.064 and 15.5 vs 14.6 µmol/L, pdisulphide =0.933). CONCLUSIONS: Lower plasma levels of thiol in patients with prostate cancer and high Gleason score is an oteworthy result. We believe that our results should be supported by further studies.

OBJETIVOS: Establecer la relación entre cáncer de próstata y la homeostasis del tiol/disulfito como un importante indicador de estrés oxidativo.MÉTODOS: Con la aprobacion del comité ético (546/2015), 388 pacientes entre 46 y 75 años que recibieron una biopsia transrectal prostática ecoguiada en diferentes centros entre julio 2015 y 2016 por un PSA superior a 2,5 ng/ml o tacto rectal anómalo, fueron incluidos en este estudio. Los niveles plasmáticos de la homeostasis de tiol/disulfito se compararon en pacientes con y sin cáncer de próstata. RESULTADOS: La edad media de los pacientes fue de 62,9 =/- 7 años. En pacientes con cáncer de próstata (n=130, 33,5%) el nivel plasmático de tiol nativo y tiol total fue menor (332,9 vs 362,1 µmol/L y 363 vs 392,6 µmol/L, p=0,001). Los niveles de disulfito en plasma no fueron estadísticamente diferentes entre los grupos (15 vs 15,3 µmol/L, p=0,936). En el grupo con cáncer de próstata; pacientes con Gleason 7 o más tuvieron niveles menores de tiol nativo en relación a los pacientes con Gleason menor de 7 (321,3 vs 342,6 µmol/L, p=0,029), mientras no hubo diferencias en eltiol total y los disulfitos (352,3 vs 371,9 µmol/L, ptotaltiol =0,064 y 15,5 vs 14,6 µmol/L, pdisulfito =0,933). CONCLUSIONES: Niveles bajos de tiol en pacientes con cáncer de próstata y Gleason alto es un resultado notable. Creemos que nuestros resultados deberian tenerse en cuenta para otros estudios.

Effects of ABO incompatibility in allogeneic hematopoietic stem cell transplantation.

INTRODUCTION: The impact of ABO mismatch on outcomes following allo-HSCT remains controversial. In this study, our aim is to define the effect of ABO mismatch on post-transplant outcomes, engraftment kinetics and complications in a large cohort. PATIENTS AND METHODS: We retrospectively identified 1000 patients who underwent allo-HSCT from either bone marrow or peripheral blood stem cells at our center between 1988 and 2016. P<0.05 was considered statistically significant. RESULTS: Five hundred and ninety (59%) patient-donor pairs were ABO matched, 164 (16.4%) were ABO major mismatched (MM), 191 (19.1%) were ABO minor MM, and 55 (5.5%) were ABO bi-directionally MM. ABO matched pairs were more common in transplants from related donors (P<0.001) and using bone marrow as a stem cell source (P<0.001). In minor ABO MM transplantations, mild delayed hemolytic reaction occurred more frequently compared to major and bidirectional ABO MM transplantations (47% vs 35% and 18%, P<0.001). Neutrophil engraftment was slightly delayed in ABO MM patient-donor pairs when compared ABO matched donor pairs according to median engraftment time in all group (167/410, 41% vs 204/590, 35%, P=0.046). Pure red cell aplasia was diagnosed in 6 patients (1%). Higher risk of death was shown in ABO MM transplants compared to ABO matched transplants in overall survival (OS) analysis (HR:1.201, 95% CI:1.004-1.437, P=0.045). The non-relapse mortality (P=0.546) and cumulative incidences of acute graft versus host disease (aGVHD) and chronic (c) GVHD were comparable between ABO MM and ABO matched patient-donor pairs (for aGVHD, P=0.235; for cGVHD, P=0.137). CONCLUSION: ABO MM transplants were associated with decreased OS and slightly delayed neutrophil engraftment. NRM and the risk of GVHD were not related to ABO incompatibility.

Prognosis and risk factors of nerve injuries in displaced pediatric supracondylar humerus fractures.

BACKGROUND: Supracondylar humerus (SCH) fractures are serious injuries due to the neighborhood of critical neural and vascular structures. One of the most devastating complications of SCH fractures is neurological damage, since it may cause permanent disability. The aim of this study is to categorize neurological complications, to report long-term functional outcomes, and to determine risk factors associated with childhood SCH fractures. METHODS: The records of 375 children were reviewed retrospectively. Data about amount and direction of displacement, the shape of the fracture, age at the time of fracture, gender, time from impaction to surgery, time of surgery, type of neurological injury, and recovery time were recorded. RESULTS: Neurological complications were seen in 37 (9.85%) children. Thirteen (35.1%) of the children had an iatrogenic nerve injury. All iatrogenic injuries were fully recovered in this study. However, 2 children who had combined neurological injury of radial, ulnar, and median nerves did not recover. Nearly 95% of all children who had neurological injury recovered fully. An anterior long and sharp bone fragment (spike) was observed in most of the children with neurological injury, and this spike was seen in 14 (58.3%) patients who had a trauma-related injury (n = 24). CONCLUSION: The prognosis of these nerve injuries is excellent, especially the iatrogenic ones. A long and sharp bone fragment (spike) may be responsible for nerve injuries in some children. Surgical exploration is not necessary after an iatrogenic nerve injury when there is no neurotmesis. Patience and care are utmost needed to handle neurological complications.

Effects of the incision preference in acetabular surgery on the postoperative functional outcomes.

BACKGROUND: Many factors are known to affect the functional outcomes of the acetabular surgery. The aim of this study is to evaluate the effects of incision preferences and number of incision on scores and clinical functional outcomes. PATIENTS AND METHODS: Forty-seven adult patients who had undergone acetabular surgery and had been followed up for at least 1 year in our clinic were included in the study. Demographic data, trauma type, acetabular fracture type based on the Judet ve Letournel classification, presence of any additional traumatic fractures, time to surgery, operation duration, surgical technique, and postoperative complications were recorded. Range of motion measurements, SF-36 and Harris Hip function scale score, and full weight-bearing times were evaluated on the postoperative first year follow-up and reviewed retrospectively. RESULTS: Our study suggests that use of double incisions in the surgery of associated fractures shortens the full weight-bearing time. The localization and the number of incisions were found to be unrelated with the Harris Functional Hip scale, SF-36 (PCS, physical component score), and SF-36 (mental component score, MCS) scores. CONCLUSION: Incision type and number of incisions must be determined based on the fracture type and fracture localization for better functional outcomes. The factors that have the most effects on the functional outcomes are the type and the localization. In associated fractures, performing multiple incisions reduces the time for full weight bearing and enables patients to return to their daily routine early but have no effect on the functional outcomes.

Laser-assisted management of ectopic eruption of permanent incisors.

Ectopic eruption originates from the malpositioning of a tooth bud ending in the eruption of the tooth in an improper direction. This anomaly is a consequence of ectopic development of the tooth germ. This condition gives rise to significant aesthetic and occlusal issues in the early mixed dentition stage. The most frequently influenced teeth are the maxillary first molars, accompanied by the maxillary cuspids. Ectopic eruption is seldom seen and might derive from traumatic injury. In some cases, hyperplastic and fibrotic gingival tissue may lead to ectopic eruption of a permanent incisor. Managing ectopically erupting teeth generally rests on several reasons including extraction of supernumerary tooth, removal of cyst and excision of hyperplastic tissue and subsequent to orthodontic movement of tooth if necessary. In this case, the use of Er, Cr: YSGG lasers for the correction of hyperplastic soft tissues involving ectopically erupting permanent incisors are depicted considering two cases.

From epidemiology and neurodevelopment to antineoplasticity. Medroxyprogesterone reduces human glial tumor growth in vitro and C6 glioma in rat brain in vivo.

OBJECTIVE: Glial tumor growth may accelerate during gestation, but epidemiological studies consistently demonstrated that parousity reduces life long risk of glial tumors. Pregnancy may also accelerate growth of medulloblastoma and meningioma, but parousity does not confer protection against these tumors. We were the first to show that medroxyprogesterone acetate (MPA) reduces rat C6 glioma growth in vitro. Now we aimed to determine the effects of MPA on human brain cancers (particularly glioblastoma) in vitro and C6 glioma in vivo. PATIENTS AND METHODS: We evaluated the effects of MPA on: i) monolayer growth of human U87 and U251 glioblastoma, ii) 3D-spheroid growth and invasion of C6 rat glioma and human U251 glioma, iii) interactions with PI3-Kinase inhibitors and coxsackie-adenovirus receptor (CAR) in modifying 3D-spheroid invasion of glioma. RESULTS: MPA at low doses (3.25-13 µM) insignificantly stimulated and at high doses (above 52 µM) strongly suppressed the growth of human U87 and U251 cells in vitro. MPA also binds to glucocorticoid receptors similar to dexamethasone (Dex) and unexpectedly, PI3-Kinase inhibitors at low doses suppressed anti-invasive efficacies of MPA and Dex. MPA exerted higher invasion-inhibitory effects on CAR-expressing human glioma cells. Lastly, MPA suppressed growth of C6 glioma implanted into rat brain. CONCLUSION: Progesterone analogues deserve to be studied in future experimental models of high grade glial brain tumors.

Endocan is markedly overexpressed in severe erectile dysfunction.

This study aimed to measure the serum endocan level of patients with erectile dysfunction (ED) and to investigate the possible association between this and vasculogenic severe ED. We performed a prospective analysis of 86 consecutive patients affected by ED. Patients were divided into severe ED (IIEF-5 score < 7) and mild or moderate ED (IIEF-5 score > 7). A strong negative correlation was found between serum endocan levels and peak systolic velocity (p < .001 and r = -.665) in men with severe ED. Univariate logistic regression analysis demonstrated that tobacco consumption (p < .05), serum total 25-hydroxyvitamin D (p < .01), serum endocan levels (p < .01), peak systolic velocity (p < .01), hypertension (p < .001), dyslipidaemia (p < .001), metabolic syndrome (p = .026) and a history of a cardiovascular event (p < .001) significantly increase the risk of severe ED. In the multivariate logistic regression model, we also found that age, hypertension, metabolic syndrome, cardiovascular events and higher serum endocan levels were independently associated with severe ED. Circulating endocan may be used in daily practice as a new marker that correlates with cardiovascular risks and the severity of ED disease.

Adjuvant everolimus in high-risk diffuse large B-cell lymphoma: final results from the PILLAR-2 randomized phase III trial.

Background: Patients with diffuse large B-cell lymphoma (DLBCL) with an International Prognostic Index (IPI) ≥3 are at higher risk for relapse after a complete response (CR) to first-line rituximab-based chemotherapy (R-chemo). Everolimus has single-agent activity in lymphoma. PILLAR-2 aimed to improve disease-free survival (DFS) with 1 year of adjuvant everolimus. Patients and methods: Patients with high-risk (IPI ≥3) DLBCL and a positron emission tomography/computed tomography-confirmed CR to first-line R-chemo were randomized to 1 year of everolimus 10 mg/day or placebo. The primary end point was DFS; secondary end points were overall survival, lymphoma-specific survival, and safety. Results: Between August 2009 and December 2013, 742 patients were randomized to everolimus (n = 372) or placebo (n = 370). Median follow-up was 50.4 months (range 24.0-76.9). Overall, 47% of patients were ≥65 years, 50% were male, and 42% had an IPI of 4 or 5. 48% and 67% completed everolimus and placebo, respectively. Primary reasons for everolimus discontinuation versus placebo were adverse events (AEs; 30% versus 12%) and relapsed disease (6% versus 13%). Everolimus did not significantly improve DFS compared with placebo (hazard ratio 0.92; 95% CI 0.69-1.22; P = 0.276). Two-year DFS rate was 77.8% (95% CI 72.7-82.1) with everolimus and 77.0% (95% CI 72.1-81.1) with placebo. Common grade 3/4 AEs with everolimus were neutropenia, stomatitis, and decreased CD4 lymphocytes. Conclusions: Adjuvant everolimus did not improve DFS in patients already in PET/CT-confirmed CR. Future approaches should incorporate targeted agents such as everolimus with R-CHOP rather than as adjuvant therapy after CR has been obtained. ClinicalTrials.gov: NCT00790036.

Nivolumab for relapsed or refractory Hodgkin lymphoma: real-life experience.

BACKGROUND: Reed-Sternberg cells of classical Hodgkin's lymphoma (cHL) are characterized by genetic alterations at the 9p24.1 locus, leading to over-expression of programmed death-ligand 1 and 2. In a phase 1b study, nivolumab, a PD-1-blocking antibody, produced a high response in patients with relapsed or refractory cHL, with an acceptable safety profile. PATIENTS AND METHODS: We present a retrospective analysis of 82 patients (median age: 30 years; range: 18-75) with relapsed/refractory HL treated with nivolumab in a named patient program from 24 centers throughout Turkey. The median follow-up was 7 months, and the patients had a median of 5 (2-11) previous lines of therapy. Fifty-seven (70%) and 63 (77%) had been treated by stem-cell transplantation and brentuximab vedotin, respectively. RESULTS: Among 75 patients evaluated after 12 weeks of nivolumab treatment, the objective response rate was 64%, with 16 complete responses (CR; 22%); after 16 weeks, it was 60%, with 16 (26%) patients achieving CR. Twenty patients underwent subsequent transplantation. Among 11 patients receiving allogeneic stem-cell transplantation, 5 had CR at the time of transplantation and are currently alive with ongoing response. At the time of analysis, 41 patients remained on nivolumab treatment. Among the patients who discontinued nivolumab, the main reason was disease progression (n = 19). The safety profile was acceptable, with only four patients requiring cessation of nivolumab due to serious adverse events (autoimmune encephalitis, pulmonary adverse event, and two cases of graft-versus-host disease aggravation). The 6-month overall and progression-free survival rates were 91.2% (95% confidence interval: 0.83-0.96) and 77.3% (0.66-0.85), respectively. Ten patients died during the follow-up; one of these was judged to be treatment-related. CONCLUSIONS: Nivolumab represents a novel option for patients with cHL refractory to brentuximab vedotin, and may serve as a bridge to transplantation; however, it may be associated with increased toxicity.

Extracorporeal photochemotherapy in mycosis fungoides.

OBJECTIVES: Extracorporeal photo-chemotherapy (ECP, photopheresis) is an approved treatment modality for mycosis fungoides (MF). Our aim is to present our ECP data for MF. METHODS: We retrospectively evaluated 50 MF patients who received ECP for clinical activity, toxicity, and response and outcome rates, and we compared these with combination therapies. RESULTS: The overall response rate (ORR) was 42% (21/50), while the median time to response was 11months (range, 3-48months). Ten of the responders (48%) had 3 or more treatment lines prior to ECP. Eight patients (16%) had adverse events related to ECP. The overall survival (OS) of 50 patients was 72months (range, 3-211). There was no statistically significant difference in the OS in early-stage vs late-stage patients (77 vs 69months, P=0.077). The stage 3 and 4 patients received an average of 31 cycles compared to 55 cycles in stage 1 and 2 patients (P=0.006). The increased extent of ECP was not correlated with the response. Combined treatment with ECP significantly improved the OS (84months vs 62months, P=0.005). DISCUSSION: A low frequency of side effects and improved OS observed in combination therapy makes ECP a favorable option for treating MF.

Sexual dysfunction of male, after pelvic fracture.

PURPOSE: Pelvic fractures are usually the result of high-energy trauma, and sexual dysfunction after a pelvic fracture is an often complication. Though organic pathologies can be the reason for sexual disorders, psychological factors following a trauma may also be linked to sexual problems. We aimed to evaluate the frequency of sexual dysfunction after pelvic fractures, and help these patients with their usually undisclosed sexual problems, and offer them support. MATERIALS AND METHODS: During a 4-year period, between June 2008 and May 2012, 40 male patients (out of 57) with a mean age of 42.6 years (range 18-65 years) were evaluated retrospectively. Patients having organic pathologies (vascular, neural, and urogenital system pathologies) were excluded from the study. Patients were requested to complete the Arizona Sexual Experience Scale (ASEX), which is a 5-item self-evaluation scale. According to the results of the questionnaire, patients needing supportive treatment were referred to the psychiatry department. RESULTS: Twenty-two patients (55 %) scored 10 points or less in the ASEX questionnaire (normal). Eighteen patients (45 %) had 11 points or more (can be problematic). Four of these 18 patients had a score of 19 points or more (needing psychiatric evaluation). Patients with a score of ≥19 points, for any one item with a score of 5 or 6 points, or any three or more items with a score of 4 points were considered to have a high probability of sexual dysfunction after psychiatric evaluation. CONCLUSION: The frequency of sexual dysfunction in pelvic fractured patients was tested, and the need for investigating sexual disorders is stressed. This study attracts attention to sexual dysfunction after pelvic fractures and the necessity of referring these patients to the related clinics, for treatment. LEVEL OF EVIDENCE: Retrospective case series.

The effects of freezing on long-term storage of canine erythrocytes.

Human medicine studies have so far demonstrated that erythrocytes may be preserved and stored at low temperatures for decades retaining their metabolic and biochemical properties. However, detailed studies regarding this problem are not yet available in veterinary medicine. Therefore, the objective of the current study was to investigate time-dependent effects of long-term frozen storage of canine red blood cells. Twelve healthy adult dogs meeting the criteria for blood transfusion were used in the study. Whole blood samples (450 ± 45 ml) collected from each dog were centrifuged by a cryogenic microcentrifuge and packed RBC suspensions were obtained. The samples were prewashed three times in 0.9% NaCl solution and were allocated into three groups to be evaluated at three different time points (day 0 and month 4 and 6). The samples to be frozen were subjected to glycerolization and then stored at -80°C for 4 and 6-month periods. At the end of this period the packed RBC samples were thawed, centrifuged and then washed in a consecutive series of dextrose solutions. 2,3-Diphosphoglycerate (2,3-DPG), Adenosin triphosphate (ATP), supernatant hemoglobin (SupHb), sodium (Na+) and potassium (K+) levels, residual glycerol concentrations and hemograms were evaluated and compared. Sterility tests were performed on all samples for bacterial contamination. A statistically significant decrease was noted in potassium levels, which was the natural outcome of deglycerolization process. No significant change was observed in terms of other parameters due based on different time points. In conclusion, long-term frozen storage had no negative effect on the quality parameters of canine erythrocytes.

The Effect of Autologous Platelet Rich Plasma in the Treatment of Achilles Tendon Ruptures: An Experimental Study on Rabbits.

BACKGROUND: Achilles tendon ruptures are characterized by a long recovery period, high re-rupture rate and late return to work. To overcome these difficulties and augment tendon repair, many agents have been used. AIMS: To determine the effect of autologous platelet rich plasma (PRP) in the treatment of Achilles tendon ruptures in rabbits. STUDY DESIGN: Animal experimentation. METHODS: The study included 14 New Zealand albino rabbits that were divided randomly into 2 groups, A and B, each containing seven rabbits. On day zero, all 28 Achilles tendons were tenotomized and repaired. In group A, the tendons were injected with PRP post-surgery, whereas those in group B were left untreated. On day 28, the right tendons in both groups were examined histopathologically via both light and electron microscopy, and the left tendons were subjected to biomechanical testing. RESULTS: The histological and biomechanical findings in both light and electron microscopy in group A were better than those in group B, but the difference was not significant. According to Tang's scale, the mean value in Group A was 3.57, while it was 3.0 in Group B. The mean value of Group A for the length of collagen bands was 48.09 nm while the mean value of Group B was 46.58 nm (p=0.406). In biomechanical tests, although stiffness values were higher in group A, the difference between groups was not significant. In addition, maximum load values did not differ between groups A and B. CONCLUSION: PRP had no effect on the healing process 28 days post-Achilles tendon rupture.

The impact of vitamin E supplementation on semen parameters and pregnancy rates after varicocelectomy: a randomised controlled study.

In this study, we aimed to investigate the impact of vitamin E supplementation on semen parameters and pregnancy after varicocelectomy. Forty-five infertile male patients who were diagnosed with varicocele and underwent subinguinal varicocelectomy were included in the study. After performing subinguinal varicocelectomy, the patients were randomised into two groups: 22 receiving vitamin E for 12 months, and 23 as the control group without receiving any supplementation. The pre-operative parameters of semen analyses and pregnancy rates of both groups were compared with those of post-operative parameters. There were no statistically significant differences between the groups in terms of sperm count and motile sperm percentage, in pre-operative, post-operative 3rd month, post-operative 6th month and post-operative 12th month periods. Repeated-measures anova was performed, and sperm count, percentage of change in sperm count, motile sperm count and percentage of change in motile sperm count of the groups were compared. The administration of vitamin E increased all of these parameters; however, they were not found to be statistically significant. In conclusion, vitamin E supplementation might improve the sperm parameters after varicocelectomy; however, further studies including larger number of samples are needed to make a proper decision on vitamin E supplementation after varicocelectomy.

Brentuximab vedotin for relapsed or refractory Hodgkin lymphoma: experience in Turkey.

Current treatment modalities can cure up to 70-80 % of patients with classical Hodgkin lymphoma. Approximately, 20-30 % of patients require further treatment options. Brentuximab vedotin has been approved for the treatment of relapsed and refractory Hodgkin lymphoma. In the present study, we report the experience with brentuximab vedotin as single agent in 58 patients with relapsed or refractory Hodgkin lymphoma. The objective response rate was 63.5 % with 13 complete responders (26.5 %) among 49 patients evaluated at the early phase of treatment (2-5 cycles). Upon treatment prolongation (≥6 cycles), 37 patients achieved a final objective response rate of 32.4 % with 21.6 % of complete and 10.8 % of partial response. Overall survival at 12 months was 70.6 %, and progression-free survival at 12 months was 32.8 %. Median overall survival could not be reached and median progression-free survival was 7 months. While the median duration of response was 9 months in the whole cohort, it was 11.5 months in the complete responders. Complete response rates in patients treated with >3 chemotherapy regimens before brentuximab vedotin were significantly lower (p = 0.016). Fourteen patients were subsequently transplanted. In conclusion, brentuximab vedotin provided a bridge to transplantation in approximately one quarter of the patients. The declining response rates during the course of treatment suggest that transplantation should be implemented early during brentuximab vedotin treatment.