The first complete genome of the extinct European wild ass (Equus hemionus hydruntinus).

We present palaeogenomes of three morphologically unidentified Anatolian equids dating to the first millennium BCE, sequenced to a coverage of 0.6-6.4×. Mitochondrial DNA haplotypes of the Anatolian individuals clustered with those of Equus hydruntinus (or Equus hemionus hydruntinus), the extinct European wild ass, secular name 'hydruntine'. Further, the Anatolian wild ass whole genome profiles fell outside the genomic diversity of other extant and past Asiatic wild ass (E. hemionus) lineages. These observations suggest that the three Anatolian wild asses represent hydruntines, making them the latest recorded survivors of this lineage, about a millennium later than the latest observations in the zooarchaeological record. Our mitogenomic and genomic analyses indicate that E. h. hydruntinus was a clade belonging to ancient and present-day E. hemionus lineages that radiated possibly between 0.6 and 0.8 Mya. We also find evidence consistent with recent gene flow between hydruntines and Middle Eastern wild asses. Analyses of genome-wide heterozygosity and runs of homozygosity suggest that the Anatolian wild ass population may have lost genetic diversity by the mid-first millennium BCE, a possible sign of its eventual demise.

Variants in TNF and NOS3 (eNOS) genes associated with sepsis in adult patients.

BACKGROUND: Sepsis is a life-threatening condition caused by a dysregulated host response to infections and is a leading cause of death in hospitalized patients. The present study aimed to elucidate the possible association between sepsis and the tumor necrosis factor (TNF) gene -308G/A (rs1800629) polymorphism, as well as endothelial nitric oxide synthase (eNOS, NOS3) gene -786T/C (rs2070744), 4a/4b (27 bp-VNTR in intron 4, rs61722009) and 894G/T (Glu298Asp, rs1799983) polymorphisms. METHODS: In total, 188 septic adult cases and 188 healthy controls were enrolled. Genomic DNAs from the controls and patients were analyzed by polymerase chain reaction and restriction fragment length polymorphism methods. RESULTS: There were significant associations between the G/G genotype and G allele of the TNF -308G/A (rs1800629) polymorphism in the sepsis group (p < 0.001). The presence of the T/C genotype (p = 0.002) and C allele (p = 0.001) of the -786T/C (rs2070744) was markedly associated with an increased risk of sepsis. However, no significant associations were found with 4a/4b (27 bp-VNTR in intron 4, rs61722009) and 894G/T (Glu298Asp, rs1799983) polymorphisms. Higher 4bGC and lower 4bTT haplotype frequencies were associated with sepsis. CONCLUSIONS: Our results strongly suggest that TNF gene (-308G/A, rs1800629) and NOS3 gene -786T/C (rs2070744) polymorphisms may modify individual susceptibility to sepsis in the Turkish population.

Successful Treatment of Major Abdominal Trauma in a 9-year-old Male due to Bomb Explosion.

The present case report describes a pediatric patient that sustained and survived major abdominal trauma due to an open-air explosion during the Syrian civil war. A 9-year-old male patient was brought to our hospital's paediatric emergency department after a bomb explosion that occurred 8 hours prior to presentation. The patient had a severe flap-like skin defect that extended from the below the umbilicus to the right femur. The defect was embedded with multiple stones, plastic, and soil fragments of varying size. Debridement of the anterior abdominal wall was performed, followed by exploratory laparotomy. Multiple sites of perforation of the small bowel were resected, and anastomosis was performed. Vacuum-assisted closure (VAC) was applied to the large wound area. The VAC dressing was changed every 3 days. Granulation tissue developed post-operatively after 26 days and the defect was repaired using skin grafts harvested from the patient's left leg. The patient was considered fully recovered and was discharged 34 days post-surgery. The presented case shows that despite the severity of the patient's major abdominal injuries, rapid wound debridement, exploratory laparotomy, VAC therapy and a multidisciplinary approach are crucial in preventing death and achieving a full recovery.

Suture Anchor Fixation in Osteoporotic Bone: A Biomechanical Study in an Ovine Model.

PURPOSE: To evaluate the load to failure strength of anchor techniques suitable for osteoporotic bone. METHODS: Using an osteoporotic ovine model in 72 humeri, 6 fixation techniques were tested. Group 1: two interlocking 5-mm anchors with fewer, wider threads; group 2: one 5-mm anchor; group 3: one 5-mm anchor reinforced laterally by a 6.5-mm cancellous screw; group 4: one 5-mm anchor in an area reinforced with a cancellous plug; group 5: two interlocking 5-mm anchors with smaller threads; group 6: one 5-mm smaller threaded anchor. After a 10-N preload, the specimens were cyclically loaded between 10 N and 30 N for 50 cycles and then destructively tested. Peak-to-peak displacement, cyclic elongation, ultimate load, stiffness, and failure mode were recorded. RESULTS: Group 1 had lower peak-to-peak displacement than group 3 (P = .001), group 5 (P = .001), and group 6 (P = .033). In addition, group 1 showed lower cyclic elongation than group 3 (P = .001), group 5 (P = .035), and group 6 (P = .001). Group 1 had a higher ultimate load than group 2 (P = .002), group 3 (P = .019), and group 6 (P = .006). Group 1 also showed higher stiffness than group 2 (P = .007) and group 3 (P = .022). Mode of failure was predominantly caused by anchor pullout for all of the groups except group 3, which mainly failed by suture rupture. CONCLUSIONS: Two interlocking suture anchors are stronger than a single anchor in osteoporotic bone. The anchor with fewer, wider threads and a smaller core diameter showed greater strength and less elongation than the other constructs. Reinforcement by cancellous autografting increased suture anchor strength. CLINICAL RELEVANCE: Considering concerns about suture anchor pullout from osteoporotic bone, interlocking a second suture anchor with the first increases load to failure resistance. Anchors with small core diameters and fewer but wider threads are more efficient in osteoporotic bone.

Minimial clinically important difference values in distal metaphyseal ulnar shortening for ulnar impaction syndrome and assessment of the relationship between level of the osteotomy and bone union time.

OBJECTIVE: We aimed to define minimal clinically important difference (MCID) values of patient-reported outcome measures (PROMs) for distal metaphyseal ulnar shortening and to assess the relationship between level of the osteotomy and time to bone union. METHODS: 20 patients who had distal metaphyseal ulnar shortening osteotomies due to ulnar impaction syndrome and had at least 6 months of follow-ups were included in this study. The mean follow-up period was 12.3 ± 7.01 months. The PROMs which consisted of patient-rated wrist evaluation (PRWE) and quick disabilities of arm, shoulder, and hand (QDASH) were recorded on the day before the surgery and at follow-up assessments. Grip strength and range of motion were recorded for operated and contralateral wrists at postoperative assessments. Postoperative radiological evaluations of distance of the osteotomy from the distal ulnar articular surface (osteotomy level), the union of osteotomy site; preoperative and postoperative evaluations of styloid-triquetral distance, and ulnar variance were performed using AP wrist x-rays. The MCID values for PRWE and QDASH were calculated using ROC curve analysis. RESULTS: Mean PRWE and QDASH scores decreased statistically significantly. The mean grip strength of contralateral wrists was higher. Mean ulnar variance decreased, whereas styloid-triquetral distance increased postoperatively. Patients with osteotomy levels of greater than 13.7 mm had a longer time from surgery to bone union. Furthermore, patients with time from surgery to bone union shorter than 7 weeks had an osteotomy closer to the ulnar articular surface. The MCID values for PRWE and QDASH were analyzed and calculated through the ROC curve as 22.25 and 20.45, respectively. CONCLUSION: This study has shown us that the osteotomy level affects the time to bone union and an osteotomy closer than 13.7 mm to the ulnar articular surface seems to result in shorter union time. Furthermore, MCID values were defined for PRWE and QDASH as 22.25 and 20.45, respectively. LEVEL OF EVIDENCE: Level IV, Therapeutic Study.

[The evaluation of serum vitamin B12, folic acid and hemoglobin levels in patients with recurrent minor aphthous stomatitis]. / Tekrarlayan minör aftöz stomatitli hastalarda serum vitamin B12, folik asit ve hemoglobin düzeylerinin degerlendirilmesi.

OBJECTIVES: This study aims to evaluate the serum levels of hemoglobin, vitamin B12 and folic acid in patients with recurrent minor aphthous stomatitis. PATIENTS AND METHODS: Between June 2010 and January 2012, a total of 112 patients including 57 with recurrent aphthous stomatitis (study group; 30 males 27 females; mean age 36.7±13.9 years; range 13 to 74 years) and 45 with chronic tinnitus patients without recurrent aphthous stomatitis (control group; 18 males 27 females; mean age 39.7±15.1 years; range 20 to 80 years) who were admitted to our clinic were included in this study. The serum hemoglobin, vitamin B12 and folic acid levels of the patients were measured and statistically compared. RESULTS: There was no significant difference in serum levels of hemoglobin and folic acid between the groups. Serum levels of vitamin B12 were significantly lower in the study group, compared to the control group (p<0.05). Serum levels of hemoglobin and folic acid were significantly lower in women compared to men in both groups (p<0.05). CONCLUSION: Vitamin B12 deficiency, but not lower levels of folic acid and hemoglobin, may play a role in the underlying etiology of aphthous stomatitis. Vitamin B12 supplements may be added to the treatment of recurrent aphthous stomatitis.

COMPARISON OF SINGLE- AND DOUBLE-PLATE FIXATION TECHNIQUES IN THE TREATMENT OF NONUNIONS OF THE HUMERAL SHAFT.

Introduction: Humerus shaft fractures may be treated conservatively or surgically. In 2.5% to 13% of cases, nonunion is observed, and it leads to severe pain and morbidity. Plate osteosynthesis has become popular in the treatment of nonunion of the humeral shaft. In this study, we compared the clinical outcomes of patients with humerus shaft nonunion whom we treated with single- or double-plate fixation. Materials and Methods: Fifty-three patients diagnosed with aseptic humeral shaft nonunion and treated with plate fixation were included in the study. Patients were evaluated according to the number of plates (single vs. double plates). The two groups were subjected to statistical evaluation according to their clinical and radiographical results. Results: The average age of the patients was 53 years (range: 1-86); 28 (52.8%) were female and 25 (47.2%) were male. The union rate was 90.32% for single plate and 90.91% for double plate fixation. There was no statistically significant difference between single and double plates in the clinical and radiographical results (union time, union rate, Q-DASH score) (p > 0.05). There was a significant correlation between age and union times / Q-DASH scores according to the Spearman correlation test (p < 0.05). Transient radial nerve neuropraxia developed in 2 patients and 1 patient suffered from an infection that was treated with debridement and antibiotic therapy. Conclusion: In our study, similar good results were obtained with single and double plates. In treatment of humeral shaft nonunions, a second plate is not needed if enough stability is provided with single plate fixation. Level of evidence III, Retrospective comparative study.

Introdução: As fraturas do corpo do úmero podem ser tratadas de modo conservador ou cirúrgico. Em 2,5% a 13% dos casos, observa-se pseudoartrose, que causa dor intensa e morbidade. A osteossíntese com placas tornou-se popular para tratamento da não união da diáfise do úmero. Neste estudo, comparamos os resultados clínicos de pacientes com pseudoartrose do corpo do úmero que tratamos com fixação de placa simples ou dupla. Materiais e Métodos: Cinquenta e três pacientes com diagnóstico de pseudoartrose asséptica do corpo do úmero tratados com placa de fixação foram incluídos no estudo. Os pacientes foram avaliados de acordo com o número de placas (placa simples vs. dupla). Os dois grupos foram submetidos à avaliação estatística de acordo com seus resultados clínicos e radiográficos. Resultados: A média de idade dos pacientes foi de 53 anos (variação: 1 a 86); 28 (52,8%) eram do sexo feminino e 25 (47,2%) do sexo masculino. A taxa de união foi de 90,32% para placa simples e 90,91% para placa dupla. Não houve diferença estatisticamente significante entre a osteossíntese com placas simples ou duplas nos resultados clínicos e radiográficos (tempo de união, taxa de consolidação e escores do Q-DASH) (p > 0,05). Houve correlação significativa entre idade e tempo de união/escores do Q-DASH, de acordo com o teste de correlação de Spearman (p < 0,05). A neuropraxia transitória do nervo radial desenvolveu-se em dois pacientes e um paciente teve infecção tratada com desbridamento e antibioticoterapia. Conclusões: Em nosso estudo, resultados igualmente bons foram obtidos tanto com placas simples quanto duplas. No tratamento de pseudoartroses do corpo do úmero, uma segunda placa não é necessária se houver estabilidade suficiente com a fixação com placa única. Nível de evidência III, Estudo comparativo retrospectivo.

Two-stage treatment of extremity deformities associated with thrombocytopenia-absent radius syndrome.

OBJECTIVE: The aim of this study was to evaluate the results of 2-stage treatment of upper and lower extremity deformities in patients with thrombocytopenia absent radius syndrome. METHODS: Four patients (3 female, 1 male) with a mean age of 1.8 years (range 1-4) were included in the study. The patients were followed up for an average of 5.5 years. All 4 patients had bilateral radial longitudinal deficiency, whereas only 2 patients had bilateral fixed knee contractures. A 2-stage surgical procedure was implemented. The surgical procedure performed for radial longitudinal deficiency consisted of distraction with an Ilizarov frame in the first stage, followed by centralization performed in the second stage. Knee contractures were first treated using an Ilizarov frame, followed by a hamstring tendon transfer in the second procedure. Radiological evaluation of the radial longitudinal deficiency was done by measuring hand-forearm angle, hand-forearm position, and ulnar bowing preoperatively and at postoperative follow-ups. Knee contracture was evaluated by measuring the angle preoperatively and at postoperative follow-ups. RESULTS: The mean hand-forearm angle values of patients at preoperative assessment, early postoperative period, and at the last follow-ups were 82.60, 5,80, and 11.10, respectively (P < .001). The hand-forearm position values were -14.25 mm, +11, and +7.1 mm, respectively (P < .001). The ulnar bowing values were 7.3°, 4.5°, and 2.9°, respectively (P < .001). Recurrence of the radial longitudinal deficiency deformity requiring surgery occurred in 1 patient. In the other 3 patients, some deformity recurred but did not require surgical intervention. In addition, 1 patient with knee flexion contracture had a recurrence of the contracture that did not require surgical intervention. There was no circulatory disorder or skin necrosis in the lower or upper extremities of the patients. CONCLUSION: This study has shown us that two-stage treatment is a reliable method for lower and upper extremity deformities accompanying thrombocytopenia absent radius syndrome. However, recurrence is still a major problem. LEVEL OF EVIDENCE: Level IV, Therapeutic Study.

The load transfer effect of monopolar and bipolar radial head prosthesis designs on capitellar cartilage: A comparative biomechanical cadaver study.

OBJECTIVE: The aim of this study was to determine whether bipolar radial head arthroplasty may transfer less load to the capitellum than monopolar radial head arthroplasty and native radial heads. METHODS: Six human elbow joints were obtained from six fresh frozen cadavers (3 males, 3 females; mean age = 78 years, age range = 66-80). None of the elbow joints had a previous osseous injury, a chondral defect, osteoarthritis, or instability. In group 1, load transfer of the native radial head was measured in each specimen under 100 N of compression force using a custom-made load cell at 0°, 30°, 60°, 90°, and 120° flexion of the elbow in supination, neutral rotation, and pronation, respectively. After excision of the radial heads, the same testing protocol was first applied for monopolar radial head arthroplasty (Group 2) and then for bipolar radial head arthroplasty (Group 3). RESULTS: The mean load transfer on the capitellum was significantly higher in each forearm rotation and all angles of the elbow flexion in the arthroplasty groups than the native radial head group. Mean load transfer values of bipolar prostheses were between the values of native radial heads and monopolar prostheses in all positions. Bipolar prostheses showed similar load transfer characteristics compared to those of the native radial head in supination at 60° flexion; in neutral rotation at 0°, 30°, 60°, and 120° flexion; and in pronation at 90° and 120° flexion. CONCLUSION: The results of this study have revealed that bipolar radial head arthroplasty transfers similar loading as the native radial head on the capitellum in certain forearm positions and at elbow flexion angles. No significant differences could be found between load transfer values of bipolar head design and monopolar head design except in the pronation at full extension.

MTaxi: A comparative tool for taxon identification of ultra low coverage ancient genomes.

A major challenge in zooarchaeology is to morphologically distinguish closely related species' remains, especially using small bone fragments. Shotgun sequencing aDNA from archeological remains and comparative alignment to the candidate species' reference genomes will only apply when reference nuclear genomes of comparable quality are available, and may still fail when coverages are low. Here, we propose an alternative method, MTaxi, that uses highly accessible mitochondrial DNA (mtDNA) to distinguish between pairs of closely related species from ancient DNA sequences. MTaxi utilises mtDNA transversion-type substitutions between pairs of candidate species, assigns reads to either species, and performs a binomial test to determine the sample taxon. We tested MTaxi on sheep/goat and horse/donkey data, between which zooarchaeological classification can be challenging in ways that epitomise our case. The method performed efficiently on simulated ancient genomes down to 0.3x mitochondrial coverage for both sheep/goat and horse/donkey, with no false positives. Trials on n=18 ancient sheep/goat samples and n=10 horse/donkey samples of known species identity also yielded 100% accuracy. Overall, MTaxi provides a straightforward approach to classify closely related species that are difficult to distinguish through zooarchaeological methods using low coverage aDNA data, especially when similar quality reference genomes are unavailable. MTaxi is freely available at https://github.com/goztag/MTaxi.

A genomic snapshot of demographic and cultural dynamism in Upper Mesopotamia during the Neolithic Transition.

Upper Mesopotamia played a key role in the Neolithic Transition in Southwest Asia through marked innovations in symbolism, technology, and diet. We present 13 ancient genomes (c. 8500 to 7500 cal BCE) from Pre-Pottery Neolithic Çayönü in the Tigris basin together with bioarchaeological and material culture data. Our findings reveal that Çayönü was a genetically diverse population, carrying mixed ancestry from western and eastern Fertile Crescent, and that the community received immigrants. Our results further suggest that the community was organized along biological family lines. We document bodily interventions such as head shaping and cauterization among the individuals examined, reflecting Çayönü's cultural ingenuity. Last, we identify Upper Mesopotamia as the likely source of eastern gene flow into Neolithic Anatolia, in line with material culture evidence. We hypothesize that Upper Mesopotamia's cultural dynamism during the Neolithic Transition was the product not only of its fertile lands but also of its interregional demographic connections.

Double standard for traditional value of virginity and premarital sexuality in Turkey: a university students case.

This study investigates the prevalence of myths regarding virginity and the hymen and their associations with sexuality prior to marriage. This study was conducted with 534 single, heterosexual male and female students from various faculties of Dicle University in Turkey. The findings demonstrated that the rates of masturbation (11.1%) and premarital sexual intercourse (4.3%) were much lower in women than in men (87.7% and 44.2% respectively) who were traditionally expected to maintain their virginity until marriage. A higher degree of commitment to religious faith was associated with a lower rate of masturbation and sexual contact experience. Also, the myth that the hymen symbolized virginity was slightly more prevalent among male students (74.2% vs. 72.1%). Female virginity was significantly more important among male students (76.7%) than females (11.1%), and male students more frequently (30.1% vs. 11.1%) stated that "the blood-stained bed sheet" should be displayed to the family on the day of marriage. Although some myths about virginity were frequently reported by females, less significance was attributed to virginity by females than by males. In conclusion, the traditional social structure that incites sexual double standards still prevails over the sexual attitudes and behaviors of university students in Turkey.

Oxford Shoulder Score: cross-cultural adaptation and validation of the Turkish version.

BACKGROUND: The Oxford Shoulder Score (OSS) is a questionnaire developed to evaluate patients with certain shoulder problems. This study aimed to translate and culturally adapt a Turkish version of the OSS and validate its use for assessing Turkish patients with shoulder pathology. PATIENTS AND METHODS: OSS was translated and culturally adapted according to the guidelines in the literature. Eighty-four patients (mean age 49.26 ± 11.92 years) with shoulder problems participated. Patients completed the Turkish OSS, the Short Form 36 (SF-36), and the Shoulder Pain and Disability Index (SPADI). Internal consistency was tested using Cronbach α coefficient. Reproducibility was assessed by asking patients to complete another OSS 48 h after the first test. Correlation between the total results of both tests was determined by the Pearson correlation coefficient and ICC. Validity was assessed by calculating the Pearson correlation coefficient between the OSS and SPADI and SF-36 scores. Floor and ceiling effects were analyzed. RESULTS: The internal consistency was high (Cronbach's α 0.92). The reproducibility tested by two different methods showed no significant difference. Correlation between the OSS and SPADI and SF-36 physical component summary score were -0.7, and 0.6, respectively (p < 0.001). There was no floor or ceiling effect in total OSS score. CONCLUSION: The Turkish version of the OSS proved to be valid, reliable and reproducible instrument as demonstrated by high Cronbach α and Pearson Correlation Coefficients. The application and evaluation of the instrument was feasible and minimally time consuming for use in clinical trials in Turkish-speaking patients with shoulder problems.

Comparison of Expandable and Locked Intramedullary Nailing for Humeral Shaft Fractures.

Introduction In this study, we clinically and radiologically investigated whether the application of expandable nails for surgical treatment of humeral shaft fractures has an advantage over locked intramedullary nails. Methods Patients treated with intramedullary fixation due to humeral shaft fractures in our clinic were investigated retrospectively. Patients with fractures of type 12A and 12B according to the AO classification in the middle 1/3 shaft region of the humerus were divided into two groups as those receiving fixation with expandable nails and with locked intramedullary nails. The union rate, union time, Q-DASH scores, duration of surgery, and complication rates were statistically compared between the two groups. Results The study included 38 patients with clinical follow-up from among 47 patients; 20 patients received fixation with locked intramedullary nails and 18 with expandable nails. The mean age of the patients was 56.92 (19-91) years and 53% (n=20) were men while 47% (n=18) were women. During statistical evaluation, a statistically significant difference was found between the groups for union (100% and 72.2%) and complication rates (6% and 13%). More union and lower complication rates were found in patients treated with locked intramedullary nails. In comparing the mean of surgical times (71.1 and 30.2 min), expandable nails had a shorter surgical time. However, there was no statistically significant difference between the union time and Q-DASH scores between the two groups. Conclusion Locked intramedullary nails are a better fixation method than expandable nails due to the low complication rate and high rate of union. However, due to shorter surgery time, expandable nailing is an alternative method in limited cases.

Scapular spine base fracture with long outside-in superior or posterior screws with reverse shoulder arthroplasty.

BACKGROUND: The purpose of the present study was to determine how long superior screws alone or in combination with posterior placement of metaglene screws protruding and penetrating into the scapular spine in reverse total shoulder arthroplasty affect the strength of the scapular spine in a fresh cadaveric scapular model. METHODS: Seven fresh cadaver scapulas were allocated to the control group (short posterior and superior screws) and seven scapulars to the study group (spine base fixation with a four long screws, three with both long superior and long posterior screws). RESULTS: The failure load was lower in the spine fixation group (long screw, 869 N vs. short screw, 1,123 N); however, this difference did not reach statistical significance (p>0.05). All outside-in long superior or superior plus posterior screws failed due to scapular spine base fracture; failures in the short screw group were due to acromion fracture. An additional posterior outside-in screw failed to significantly decrease the failure load of the acromion spine. CONCLUSIONS: The present study highlights the significance of preventing a cortical breach or an outside-in configuration when a superior or posterior screw is inserted into the scapular spine base.

Archaeogenetic analysis of Neolithic sheep from Anatolia suggests a complex demographic history since domestication.

Sheep were among the first domesticated animals, but their demographic history is little understood. Here we analyzed nuclear polymorphism and mitochondrial data (mtDNA) from ancient central and west Anatolian sheep dating from Epipaleolithic to late Neolithic, comparatively with modern-day breeds and central Asian Neolithic/Bronze Age sheep (OBI). Analyzing ancient nuclear data, we found that Anatolian Neolithic sheep (ANS) are genetically closest to present-day European breeds relative to Asian breeds, a conclusion supported by mtDNA haplogroup frequencies. In contrast, OBI showed higher genetic affinity to present-day Asian breeds. These results suggest that the east-west genetic structure observed in present-day breeds had already emerged by 6000 BCE, hinting at multiple sheep domestication episodes or early wild introgression in southwest Asia. Furthermore, we found that ANS are genetically distinct from all modern breeds. Our results suggest that European and Anatolian domestic sheep gene pools have been strongly remolded since the Neolithic.

[Examination of anger reactions and psychiatric diagnoses in terms of gender in a group of university students having difficulty with anger control]. / Öfke Kontrolünde Zorluk Yasayan Bir Grup Üniversite Ögrencisinde Öfke Tepkileri ve Psikiyatrik Tanilarin Cinsiyet Açisindan Incelenmesi.

OBJECTIVE: We aimed to determine axis-I and axis-II diagnoses and identify gender difference in anger reactions among young adults who have difficulty controlling their anger. METHOD: Students from various faculties who had difficulty controlling their anger were invited to the psychiatry department. The SCID-I, SCID-II, Multidimensional Anger Scale, Childhood Trauma Questionnaire, Social Comparison Scale, Boratav Depression Screening Scale, and Beck Hopelessness Scale were administered to consecutive admissions of 50 males and 50 females. RESULTS: Axis-I diagnoses were present in 60% of males and 74% of females. Axis-II diagnoses were present in 28% of males and 36% of females. Somatoform disorders and impulse control disorder were higher in males, whereas anxiety disorders and mood disorders were higher in females. Depression was diagnosed in 10% of males and 36% of females. "Not being taken seriously" was the most prominent reason for anger among females. The "Revenge reactions" score was strongly correlated with the education level of the mother in both genders (in females r=0.472, p=0.001; in males r=-0.396, p=0.006). The best predictor of an axis-I diagnosis in women was the "anger symptoms" total score, whereas it was the "thoughts related to anger" subscale score in males. On the other hand, the best predictors of an axis-II diagnosis were "anxious behavior" in females and "smoking" in males. CONCLUSION: Anger is an important component of psychiatric disorders. Reaction styles and underlying psychiatric disorders vary according to gender.

A Basic Algorithmic Surgical Approach for Nicolau Syndrome.

BACKGROUND: Nicolau syndrome (NS) is a rare complication that develops after the administration of intramuscular diclofenac sodium. The etiology and surgical treatments of 11 patients with NS were evaluated and studies in the literature were examined. The aim of this study was to compose a basic algorithm for surgical approaches to treat NS. MATERIALS AND METHODS: Eleven patients were evaluated for NS between December 2013 and January 2018. Two patients did not accept treatment, and nine patients underwent surgical debridement of necrotic tissues. The tissue defects of five patients were closed with a fasciocutaneous flap and, in four patients, the defects were repaired primarily. RESULTS: No complications, such as wound infection, wound dehiscence, seroma, or flap necrosis, were encountered. Of the seven patients who received concurrent antibiotic therapy, no patient had any problems at their follow-up (2-30 months). The results were satisfactory from an aesthetic and functional point of view. CONCLUSION: NS was more frequent in women with a high body mass index and high fat in gluteal regions. We considered that any kind of medication could lead to NS. Different methods are discussed for treatment.

Trauma type, gender, and risk of PTSD in a region within an area of conflict.

The relation between trauma type, gender, and risk of posttraumatic stress disorder (PTSD) still remains unclear. The authors investigated the association among gender and trauma type and risk of PTSD among people living within an area of conflict. Traumatic experiences and PTSD symptoms among 708 participants were assessed. It was determined that more men (53%) were exposed to traumatic events than women (44%). They also found no difference in PTSD prevalence according to gender. However, the authors found that there was a different risk of PTSD among men and women who experienced similar traumatic events: the risk of PTSD for those who experienced military conflict was higher among men than it was among women.