Imaging in paediatric blast injuries: musculoskeletal injuries in the Syrian Civil War.

AIM: To examine the radiological images of children with musculoskeletal injuries and accompanying organ injuries caused by explosions to determine the differences and frequency of injury types and to emphasise the importance of radiology in war injuries. MATERIALS AND METHODS: Seventy-four children with injuries caused by bomb explosions were included in the study. The paediatric trauma scores evaluated in the emergency department on the first admission were recorded. All radiographs and computed tomography (CT) images were evaluated for musculoskeletal injuries and accompanying organ injuries. RESULTS: The highest incidence of fracture in the primary blast injury (PBI) group was skull fracture in 15 (62.5%) patients (p=0.01) and fractures in the other groups were most common in the lower extremities. Amputation was observed in nine (31%) patients in the PBI group (p=0.003); however, there were no patients with amputations in the secondary blast injury (SBI) group (p=0.002). The frequency of pneumothorax (79.3%) and pulmonary contusion (59.4%) was high in the PBI group (p<0.001 and p=0.004, respectively). Skull fractures were observed in 15 (88.2%) of 17 patients with brain injury (p<0.001), and skull fractures were the most common fracture site accompanying pulmonary trauma. The average paediatric trauma score of individuals exposed to shrapnel was found to be high (p<0.001). CONCLUSION: Because paediatric musculoskeletal injuries vary with the type of blast injury and severe trauma can occur in children due to blast effects, radiologists who triage mass injuries should understand the effects of blast injury patterns and the spectrum of injury.

Assessment of serum glucose/potassium ratio as a predictor for delayed neuropsychiatric syndrome of carbon monoxide poisoning.

INTRODUCTION: Carbon monoxide (CO) poisoning is a crucial cause of delayed neuropsychiatric syndrome (DNS). However, most biomarkers are not satisfactory for the prediction of DNS caused by CO poisoning. Thus, we evaluated the adequacy of the serum glucose/potassium (GLU/K) ratio, which may be an easy, quick, and readily available parameter that can be used in the emergency department for predicting DNS. METHODS: We evaluated 281 patients who were admitted to our emergency department between January 2012 and December 2018. The patients were divided into two groups: DNS (+) and DNS (-). The GLU/K was compared for the groups. RESULTS: Glucose, blood urea nitrogen, carboxyhemoglobin, and GLU/K ratios of patients in the DNS (+) group were statistically significantly higher than those patients in DNS (-) group (140 ± 34 vs. 110 ± 24, p < 0.001; 17.58 ± 6.14 vs. 14.27 ± 5.08, p = 0.003; 29 ± 5.1 vs. 18.9 ± 7.6, p < 0.001; and 38.35 ± 10.11 vs. 28.65 ± 6.53, p < 0.001, respectively). The area under the curve for GLU/K to predict DNS was measured as 0.791, and 35.9 as a cut-off value had 63.6% sensitivity and 89.6% specificity. CONCLUSIONS: DNS development in CO poisoning is a serious and feared complication. We suggest that the GLU/K ratio has a high potential as a rapid, easy preliminary marker for the exclusion of patients who will not subsequently develop DNS.

Synergistic effects of quercetin and selenium on oxidative stress in endometrial adenocarcinoma cells.

OBJECTIVE: The effects of quercetin and selenium on oxidative stress in endometrial adenocarcinoma cells are unclear. In this study, the effects of quercetin and selenium on oxidative stress caused by both hydrogen peroxide and UV radiation in endometrial adenocarcinoma cells were examined. METHODS: The viability of endometrial adenocarcinoma cells cultured in vitro and treated with different concentrations of quercetin and sodium selenite was measured using the MTT assay. Malondialdehyde (MDA) levels were investigated, and expression levels of BAD and p53 genes were analysed using real­time quantitative polymerase chain reaction. Acridine orange/ethidium bromide staining technique was applied to detect apoptosis. Mass attenuation coefficient of each quercetin and sodium selenite combinations was evaluated using Monte Carlo simulation. RESULTS: The combination of quercetin and sodium selenite enhanced cell viability, and reduced MDA levels. The expression levels of BAD and p53 genes decreased by combined treatment with quercetin and selenium while showing synergistic effects in terms of gene expression. Fluorescent microscopic examination showed a decrease in apoptotic cells in endometrial adenocarcinoma cells treated with the combination of quercetin and selenium. CONCLUSIONS: For the first time, selenium and quercetin have synergistic cytoprotective and radioprotective effects on oxidative stress caused by hydrogen peroxide in endometrial adenocarcinoma cells for the first time (Tab. 1, Fig. 7, Ref. 39).

Comprehensive analysis of the volume of bone for grafting that can be harvested from iliac crest donor sites.

Our aim was to calculate the volumes of cancellous, cortical, and corticocancellous bone that can be harvested as a graft from the anterior and posterior iliac crests using 3-dimensional computed tomography (CT) and software in a living adult population. We selected random CT scans of the pelvis from 31 men and 29 women from the Department of Radiology imaging database. CT data in DICOM file format were imported into Mimics software. The anterior iliac crest and posterior iliac crest bone graft-harvested boundaries were measured. The volume of the 3-dimensional cortical and cancellous bone grafts was measured using the Mimics software. There were significant differences in all comparisons between the anterior and posterior iliac crest, except for volumes of cortical bone. More cancellous and total corticocancellous bone can be harvested from the posterior than the anterior iliac crest, together with similar or smaller volumes of cortical bone. Sex, but not age, is an important factor in terms of the amount of bone that can be harvested, with a wide range of volumes individually from both iliac crests.

Role of matrix metalloproteinases and tissue inhibitor of matrix metalloproteinases-1 in Crimean-Congo hemorrhagic fever disease.

AIM: Crimean-Congo hemorrhagic fever is a potentially fatal viral disease in humans caused by CCHF virus. We aimed to demonstrate change in serum levels of matrix metallopeinase/tissue matrix metalloproteinase inhibitor (MMP/TIMP) associated with CCHF. PATIENTS AND METHODS: Blood specimens were collected in acute and convalescence periods from the patients presented to Cumhuriyet University Hospital, Department of Emergency and Infection Diseases with presumed as CCHF between May 2010 and September 2010. Forty-one age and gender matched healthy individuals had not any viral, bacterial, acute or chronic disease were enrolled as the controls. Blood specimens were centrifuged at 4000 rpm for 5 min with in "Hettich universal 32" centrifuge. Serum samples obtained were kept at -80°C. All the specimens were brought to room temperature during the study and MMP-1, 2, 7, 9, 10 and TIMP-1 tests were studied at one time using "RayBiotech" brand kit in "Grifols" brand "Triturus" model ELISA device. Acute, convalescence and control groups were compared in terms of the serum levels of MMP-1, 2, 7, 9, 10 and TIMP-1. RESULTS: There was a statistically significant increase in serum levels of MMP-1, 7, 9, 10 and TIMP-1 in the convalescence period (p < 0.05) compared to the controls, while the increase in levels of MMP-2 was not statistically significant (p > 0.05). In acute period of CCHF, mean TIMP-1 levels of severe patients was significantly lower than that of the non-severe patients (207913 ± 31051 versus 231300 ± 13267, respectively, p = 0.023). CONCLUSIONS: High serum levels of MMP and TIMP in CCHF disease were found to decrease as progressed to convalescence from the acute period. It is thought MMP and TIMP plays a significant role in pathogenesis of CCHF.

Patients with psoriasis have an increased amount of epicardial fat tissue.

BACKGROUND: Psoriasis is associated with coronary artery disease, and ischemic heart disease is associated with increased amounts of epicardial fat tissue (EFT). There has as yet been no study published on the accumulation of EFT in patients with psoriasis. AIM: To compare epicardial fat accumulation and coronary artery calcium score (CACS) in patients with psoriasis and controls. METHODS: We enrolled 38 patients with psoriasis and 38 controls matched for age and gender. Epicardial fat area (EFA) and CACS were evaluated by multidetector computed tomography. RESULTS: Mean EFA in patients with psoriasis was significantly higher than in controls (13.8 ± 8.4 vs. 9.7 ± 6.4 cm(2) , respectively, P = 0.02), but mean CACS did not differ significantly between the two groups (55.2 ± 65.4 vs. 27.8 ± 29.3; P > 0.05). Multiple linear regression analyses indicated that EFA was significantly associated with waist circumference and presence of coronary artery calcification in both patients and controls, whereas EFA was significantly associated waist circumference and age in patients only (P < 0.05). CONCLUSIONS: Patients with psoriasis had a higher level of EFA compared with controls, and EFA was independently associated with the presence of CAC in all study subjects.

A simple fluid-mechanical model for the prediction of the stress-strain relation of the male urinary bladder.

The non-linear, viscoelastic behavior of the male urinary bladder complicates the formulation of suitable stress-strain relations for the quasi-static filling process and the unsteady voiding process. In particular, the voiding process-which, in addition, is affected by contraction of muscles leading to generation of bladder wall tension-makes it difficult to obtain quantitative results. In the present study, a simple model is developed that uses certain urological data from cystometry and uroflowmetry to determine the stress-strain relations of the bladder wall during both filling and voiding.