Tubularized incised plate repair in 473 primary distal hypospadias cases: An evaluation of outcomes according to coverages and stent types.

AIM: We have previously employed the tubularized incised plate (TIP) repair technique in distal hypospadias cases with a few modifications because of its excellent cosmetic results. In this study, we aimed to evaluate the effects of spongioplasty and dorsal dartos flaps, in addition to short urethral stents on the outcomes of TIP repair. MATERIALS AND METHODS: Only distal hypospadias cases were involved in this study. Eligible patients were divided into two groups: group A included patients repaired with both spongioplasty and dorsal dartos flap placement, while group B included patients repaired with dorsal dartos flap placement alone. Group A was further divided into two subgroups according to the type of catheter used (bladder catheter or short urethral stent). RESULTS: A total of 473 patients were included in this study. There was no statistically significant difference observed in the complication rates between the two groups. In Group A, a bladder catheter was used in 107 patients and a short urethral stent was used in 135 patients. When the results of the two groups were compared, there was no statistically significant difference. CONCLUSIONS: Spongioplasty could be combined with dorsal dartos flap placement to reduce the need for dorsal plication rather than to reduce the fistula rate. Short urethral stents can be used safely with no postoperative effects in children who have completed toilet training.

Irritable temperament profile prevails among patients with boxer fractures.

OBJECTIVE: The purpose of this prospective study was to examine the temperament dimensions of the patients with boxer fracture and compare them with age- and sex-matched controls. METHODS: We performed a prospective analysis investigating affective temperaments of the 102 patients with boxer fractures and compared them with 100 sex- and age-matched controls that were referred to the emergency department due to incidental soft-tissue trauma. Affective temperament of the patients was evaluated by Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A). Both incidences of dominant affective temperaments of boxer fracture cases with previously validated normal Turkish population and controls and differences between mean values of temperament scores were analyzed. RESULTS: The mean age of the patients with boxer fractures was 25.6 (range 17-47) and 27.7 years (range 17-49) for controls. We found that dominant irritable temperament (n = 10; 9.7%) had significantly higher incidence from both control group and normal Turkish population (p < 0.001). In addition, there was significant difference between anxious temperament scores of two groups (p = 0.013). CONCLUSION: The understanding of mood of patients with boxer fractures will help us to enhance treatment plan and may prevent further intentional injuries by providing an insight into better controlling physical health of the patients.

Frailty prevalence and related factors in the older adult-FrailTURK Project.

Frailty is one of the geriatric syndromes and has an important relationship with mortality and morbidity. The aim of this study is to present the characteristics, prevalence, and related factors of frailty in older adults in our country. The study included 1126 individuals over 65 years of age from 13 centers. Frailty was evaluated using the Fried Frailty criteria, and patients were grouped as "frail," "pre-frail," and "non-frail." Nutritional status was assessed with "Mini Nutritional Test," psychological status with the "Center for Epidemiological Studies Depression Scale-CES-D," and additional diseases with the "Charlson Comorbidity index." Approximately 66.5 % of the participants were between 65 and 74 years of age and 65.7 % were women. Some 39.2 and 43.3 % of the participants were rated as frail and pre-frail, respectively. The multinomial logistic regression analysis was used to determine the factors associated with frailty. It was observed that age, female gender, low education level, being a housewife, living with the family, being sedentary, presence of an additional disease, using 4 or more drugs/day, avoiding to go outside, at least one visit to any emergency department within the past year, hospitalization within the past year, non-functional ambulation, and malnutrition increased the risk of frailty (p < 0.05). Establishing the factors associated with frailty is highly important for both clinical practice and national economy. This is the first study on this subject in our country and will provide guidance in determining treatment strategies.

Educational status and knowledge level of pre- and postmenopausal women about osteoporosis and risk factors: a cross-sectional study in a group of Turkish female subjects.

BACKGROUND: Most women are unaware of the risk factors for osteoporosis (OP). In an effort to prevent the development of OP, women need to have a raised awareness on this issue. The aims of this study were to determine any differences in the level of awareness and knowledge about OP between pre- and postmenopausal women. METHODS: Three hundred and six women who presented to the outpatient clinic of the Physical Medicine and Rehabilitation Department were included into the study. Demographic characteristics of the subjects were recorded. The participants were interviewed via an OP awareness questionnaire, which was designed to determine their knowledge of OP and risk factors. RESULTS: The mean ages of the 126 pre- and 180 postmenopausal women were 41.3 ± 5.9 and 58.9 ± 8.1 years, respectively. Thirty-two percent of premenopausal and 51% of postmenopausal women had heard about OP (p< 0.001), but the mean scores of OP knowledge according to the OP questionnaire were not different between the groups (p> 0.05). Both pre- and postmenopausal women with a higher level of education demonstrated better knowledge of OP based on their awareness questionnaire score (p< 0.001). CONCLUSION: Although half of the pre- and postmenopausal women reported having some awareness of OP, their level of knowledge was poor, particularly with regard to the risk factors associated with the condition and its complications. Having information about the risks of OP and a better understanding of the health beliefs of those at risk are important, as both may play a major role in influencing an individual's OP-preventing behaviors.

Investigation of the effects of experimental cryptorchidism formed in prepubertal rats during the postpubertal and adult periods.

OBJECTIVE: Investigation of the effects of experimental cryptorchidism formed in prepubertal rats during the postpubertal and adult periods. MATERIAL AND METHODS: The abdominal cavities of 20 rats in the control group were just opened and closed without any further surgical procedure. The testicles of 20 rats in the experimental group were fixed to the anterolateral wall of the abdominal cavity under general anesthesia. At the 6th month, blood and testis tissue samples of rats were obtained and the rats were sacrificed and the experiment was terminated. Statistical analysis was done by SPSS 15.0 package software. RESULTS: The histopathological evaluation of testicular tissues of rats in the control group was in the normal limits. Of the experimental group, the testicular tissues had injury in nearly half of the rats, in which the testicles were fixed in the abdomen for three months that is the 1st subgroup. FSH levels were statistically significantly elevated in both experimental groups of rats (p<0.01). DISCUSSION AND CONCLUSION: Cryptorchidism formed experimentally causes a partial damage in the testicular tissue of pubertal rats, however the damage increases gradually in the testicles of rats, in which the testicles were descended and left in the scrotum for another three months. The statistically elevated levels of FSH in both experimental groups of rats can be accounted for severe testicular damage. The timing in descending the undescended testicles to the scrotum is essential and should be performed before the puberty and as early as possible in avoiding the risk of infertility (Tab. 3, Fig. 5, Ref. 44).

The relationship between serum trace elements, vitamin B12, folic acid and clinical parameters in patients with myofascial pain syndrome.

BACKGROUND: Myofascial pain syndrome (MPS) is characterized by myofascial trigger points in a palpable taut band of skeletal muscle. OBJECTIVE: We aimed to investigate serum trace elements, vitamin B12, folic acid levels and their correlations with clinical findings and functional status in patients with MPS. METHODS: Thirty eight patients with at least one trigger point located on shoulder muscles, and at least 6 months duration, were included in this study. The demographic data, disease duration of patients were noted. Serum copper, zinc, magnesium and iron levels, vitamin B12 and folic acid levels were measured. Visual analogue scale (VAS) was implemented to estimate daily severity of pain. Pain pressure threshold of subjects and control groups were assessed by using Fischer's tissue compliancemeter. The Turkish version of the Beck Depression Inventory (BDI) was administered for the presence of any depressive disorder. RESULTS: The mean age of patients in MPS group and control group were 33.1 and 37.8 years respectively. Serum levels of zinc (p< 0.006) were significantly decreased in patients with MPS. VAS, total myalgic and BDI scores of patients were significantly higher than the control group (Respectively p< 0.000, p< 0.012, p< 0.000). Association between TMS and magnesium, vitamin B12 levels was found statistically significant. BDI score correlated significantly with the serum zinc level (r:-0.548, p< 0.001) and VAS in patients with MPS (r:0.641, p< 0.000). CONCLUSION: According to the results of this study, it was asserted that trace elements, vitamins may play an important role in the pathophysiology of MPS and psychological factors may also have additional effect.

Muscle performance in patients with fibromyalgia.

INTRODUCTION: Fibromyalgia (FMS) is a syndrome expressed by chronic widespread body pain which leads to reduced physical function and frequent use of healthcare services. This study was performed to examine the muscle performance comprising abdominal and lumbar muscle strength, and measurement of chest expansion in osteoporotic patients with FMS; to evaluate the relation between muscle performance, pain severity, clinical findings and physical activity; and to compare the results with the osteoporotic control group. METHODS: 44 osteoporotic women with FMS and 46 osteoporotic women who were physically inactive underwent measurements of three parameters: abdominal and lumbar muscle strength, and chest expansion. Student's t-test was used for statistical analysis. RESULTS: The strength of lumbar muscles and measurement of chest expansion were significantly decreased in the FMS patients as compared to the controls (p-value is less than 0.001). However, lumbar and abdominal muscles strength was low in both patients and controls. CONCLUSION: Our results indicate that osteoporotic patients with FMS have impairment in strength of lumbar and abdominal muscles and in measurement of chest expansion. Further studies are needed to investigate the mechanism of reduced muscle performance and the effects of aerobic exercise in this patient group.

Solid and cystic tumor of the pancreas: a case report.

A case of a solid and cystic tumor of the pancreas occurring in a 15 year-old girl is reported. This patient was admitted with epigastric and left upper quadrant pain and vomiting. A mass was detected in the pancreas on CT scan and the patient was referred for surgery. A distal pancreatectomy was performed. A pathological diagnosis of solid and cystic tumor of the pancreas was made and the patient was discharged uneventfully.

Morphometric analysis of anatomical relationships of the facial nerve for mastoid surgery.

Surgical anatomical relationships of the facial nerve (FN) with several landmarks used in mastoid surgery were studied in temporal bone axial high resolution CT scans of 90 patients (180 ears). The shortest distances between the FN and external auditory canal (EAC), sigmoid sinus (SS), posterior fossa dural plate (PFD), and joint of the bony EAC with the lateral surface of the mastoid (M) were measured. These measurements were also analysed in respect of pneumatization and side differences. On average, it was found that FN-EAC was 2.9 mm, FN-SS was 10.5 mm, FN-PFD was 7.3 mm and FN-M was 15.3 mm. FN-EAC was found to be longer in poorly pneumatized bones whereas other distances were longer in pneumatized bones. FN-M was found to be longer on the right side.

The evaluation of eustachian tube function in patients with chronic otitis media.

In this study we evaluated eustachian tube function in patients with chronic otitis media and compared the results with normal subjects. Two different eustachian tube function tests were applied to 60 ears of the chronic otitis media group and 146 ears of the control group. While eustachian tube dysfunction was observed in 71.7% of the chronic suppurative otitis media group, it was only seen in 34.9% of the control group.