Vascularized Bone Grafting in the Treatment of Scaphoid Nonunion: A Clinical and Functional Outcome Study.

Background A malreduction or missed scaphoid fracture may lead to nonunion or avascular necrosis (AVN). The aim of this study was to analyze the radiological and clinical outcome of patients with scaphoid nonunion (SN), who were treated with 1,2-intercompartmental supraretinacular artery pedicled vascularized bone graft (1,2-ICSRA-VBG) fixed with K-wires or screws between 2014 and 2018. Methods Radiological assessment included posteroanterior, lateral, oblique, and angled posteroanterior projection. The wrist active joint range of motion was assessed with a universal goniometer, and grip and pinch strength with a dynamometer. The disabilities of the arm, shoulder and hand (DASH) questionnaire was used to evaluate functionality. Statistical analysis was performed using SPSS software (v16.0). Results A total of 68 patients (65 male) with a mean age 29.7 ± 8.5 years were evaluated in the study, and union was achieved in 55 (81%). A total of 45 (66%) patients had scaphoid waist fracture and 48 (71%) had AVN. Fixation was achieved with K-wires in 48 of the patients, and with screw in 20. The mean length of follow-up was 31.6 ± 14.6 (12-72) months. The mean radioulnar range of motion and DASH scores improved significantly after treatment ( p < 0.001, p ≤ 0.001). Conclusions The findings of this study showed that scaphoid unions can be treated successfully with high rates of union using the 1,2-ICSRA-VBG. This surgical technique requires special surgical experience. The functional outcome of patients improved after treatment, although smoking was found to be an important factor affecting functional results.

The relationship between the change in serum high sensitivity C-reactive protein levels and IVF success.

The aim of this study was to assess whether the extent of the change in high sensitivity C-reactive protein (hs-CRP) levels is related with in vitro fertilization (IVF) success. A total of 69 IVF cycles using long luteal GnRH agonist protocol at the IVF unit, were prospectively studied. The serum levels of hs-CRP were measured on the day of initiation of gonadotrophin stimulation and 7 days after embryo transfer. CRP ratio was defined as the levels of CRP on day 7 of transfer/day of initiation of ovarian stimulation. Clinical pregnancy rates were examined. The mean concentrations of hs-CRP were not significantly different on the first day of ovarian stimulation and on day 7 after embryo transfer among pregnant and non-pregnant women. There was a significant rise in hs-CRP levels at 7th day after embryo transfer as compared with the first day of gonadotrophin treatment in both groups (10.58 ± 11.35 versus 3.61 ± 2.86 mg/L for pregnant women and 9.14 ± 11.36 versus 3.24 ± 2.68 mg/L for non-pregnant women, p = 0.001). In addition, the mean CRP ratio was not different between the pregnant and non-pregnant groups. Our data show that serum hs-CRP levels increase during IVF treatment, but the extent of the rise in CRP levels is not a predictive marker of IVF success.

The effects of peak and mid-luteal estradiol levels on in vitro fertilization outcome.

PURPOSES: To evaluate the role of peak E2 level and its ratio to mid-luteal E2 level on implantation and clinical pregnancy rates in patients undergoing IVF cycles. METHODS: A retrospective study was designed covering 106 patients who were admitted to IVF Unit between June and October 2008. The patients were divided into two groups with respect to peak E2 levels. Ovulation induction has been done via standard long agonist protocol. Blood samples were drawn on the day of (hCG) administration and 8 days after embryo transfer for serum E2, progesterone measurements. RESULTS: The mean peak E2 level was 2,697.4 ± 1,453 pg/ml (range 684-4,983 pg/ml. The number of retrieved oocytes, luteal E2 level, peak E2 level and E2 ratio were significantly higher in E2 >2,500 group, however, the implantation rate was significantly lower in this group. There were statistically significant differences in peak E2 levels, luteal E2 levels, retrieved oocytes, E2 ratios; of the women who got pregnant and did not get pregnant, all the above parameters were significantly higher in non-pregnant group. According to E2 ratios, the clinical pregnancy rate was highest in group 1 and significantly lowest in group 3. CONCLUSION: This study has shown that the high E2 level and mid-luteal decline of E2 which were defined as peak E2 level/mid-luteal E2 level were predictive for implantation rate in IVF cycles.

Cost-effectivity analysis of one-step versus two-step screening for gestational diabetes.

OBJECTIVE: Early diagnosis of gestational diabetes mellitus (GDM) is important for both maternal and fetal health. The literature has varying recommendations about one-step and two-step tests for GDM screening and diagnosis. The present study aimed to investigate the difference in the cost and duration of hospital stay of a one-step procedure compared to a two-step procedure, which is routinely performed in our hospital. MATERIALS AND METHODS: The two-step procedure was performed in 2,724 pregnant women, and the one-step procedure was performed in 185 pregnant women. The one-step and two-step screening procedures for gestational diabetes were compared with respect to the duration of hospital stay and cost. RESULTS: The test cost per woman was 0.75 TL less in the one-step procedure; however, the duration of the one-step test was 18.6 min longer, and the number of blood sampling procedures was 1.08 times higher. CONCLUSION: The one-step method may be preferred over the two-step (or glucose challenge) test due to its diagnostic value and lower cost.

Knowledge about and acceptance of genetically modified organisms among pre-service teachers: a comparative study of turkey and Slovenia

Genetically modified organisms cannot be regarded as merely a topic for academic debate, since these have serious implications as a research field and for production based on genetic engineering. Public debates rarely base their arguments on elements rooted in scientific arguments and knowledge but are heavily loaded with emotions, opinions and informal reasoning. This study aimed to investigate the knowledge and acceptance of genetically modified organisms among prospective teachers in Slovenia and Turkey. Knowledge of genetic modification was measured with a two-tier instrument. The level of acceptance of genetic modification was measured with a 17-item instrument. Findings revealed that knowledge of genetics and biotechnology barely influenced the acceptability of genetic modification, and correlations are low. The relationship between knowledge and acceptance was not significant among Slovenian students and while significant for the Turkish or combined groups, the r values were only 0.179 and 0.244. It was found that differences in the acceptability of clusters of different kinds of genetically modified organisms do exist between the two countries. In both countries, participants recognized microorganisms and plants that produce something useful as the most acceptable organisms, while at the other end were animals used for consumption or as donors of organs. Practical implications for teaching are discussed and implications for further studies are drawn.

Association of maternal serum high sensitive C-reactive protein level with body mass index and severity of pre-eclampsia at third trimester.

AIM: To assess a maternal serum level of high sensitive C-reactive protein (hs-CRP) as a useful clinical parameter in prediction of pre-eclampsia severity and, to evaluate the correlation between hs-CRP and body mass index (BMI). MATERIAL & METHODS: Using cross-sectional study design, CRP was measured by a high sensitive immunoturbidimetric method between 24 and 40 weeks of gestation in normotensive controls (n = 115), in mild (n = 63) and severe (n = 34) pre-eclamptic patients. The receiver operating characteristic analysis was used to estimate the optimal threshold score of hs-CRP. RESULTS: For disease severity evaluation, a hs-CRP concentration of 9.66 mg/L was determined as cut-off point with 88% sensitivity, 81% specificity, 71% positive predictive value and 92% negative predictive value. When all three groups of patients were adjusted for gestational age [24(°/7) -27,(6/7) 28(°/7) -33,(6/7) 34(°/7) -40(6/7) ] and BMI, hs-CRP levels of severe pre-eclamptic patients were significantly higher than mild ones and controls in the study group with BMI < 25 kg/m(2) (P < 0.001). In the study group with BMI ≥ 25 kg/m(2), only severe pre-eclamptic patients between 28(°/7) and 33(6/7) weeks of gestation had significantly higher hs-CRP levels when compared with control and mild pre-eclamptic group (P < 0.001). When the patients were subgrouped as high (≥ 9.66 mg/L) and low hs-CRP group (< 9.66 mg/L), adverse outcomes for hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome and intrauterine growth-restricted baby were statistically significant higher in high hs-CRP group (P = 0.004 and P < 0.001, respectively). CONCLUSION: Elevated level of hs-CRP is a useful parameter in the severity of clinical risk of pre-eclampsia in patients with BMI < 25 kg/m(2) at third trimester.

High school and university students' knowledge and attitudes regarding biotechnology: A Turkish experience.

Biotechnology has a considerable importance in Turkish biology curriculum. This study was designed to explore or indicate Turkish high school and university students' knowledge and attitudes toward biotechnology. A total number of 352 high school and 276 university students were invited to the study. The Biotechnology Knowledge Questionnaire (BKQ) with 16 items and Biotechnology Attitude Questionnaire (BAQ) with 37 items were used as data collection instruments. The statistically significant correlation was observed between the level of biotechnology knowledge and the subdimensions of attitudes toward biotechnology. We found no statistically significant difference between high school and university students' knowledge of biotechnology. In contrast, university students showed more positive attitudes toward biotechnology than did high school students. However, the effect of gender was equivocal; therefore, it did not support a "gender paradox" hypothesis. Our results suggest that although students' appreciation of (agricultural) biotechnology is relatively positive, the understanding of biotechnology processes is superficial and attitudes toward shopping genetically modified products are therefore negative. The possible impact of current science and biology curriculum, and also biotechnology news given in media on Turkish students' views of biotechnology is discussed.

Randomized comparison of second trimester pregnancy termination utilizing saline moistened or dry misoprostol.

OBJECTIVE: The aim of this randomized prospective study was to compare efficacy and side effects of saline moistened misoprostol with dry misoprostol, administered 800 mug intravaginally every 6 h up to a maximum of 3 doses in 24 h for second trimester pregnancy termination. MATERIALS AND METHODS: A total of 81 women seeking termination of second trimester pregnancy (55 fetal death, 17 fetal structural anomaly, 5 chromosomal abnormality, 4 other reasons) were randomly assigned to one of two treatment groups: (1) intravaginal non-moistened (dry) misoprostol in group A (n = 40) or (2) misoprostol moistened with 3 ml of saline in group B (n = 41). RESULTS: All of the patients in either group aborted within 48 h (100% success rate). Delivery was achieved in a median (interquartile range) of 13 (40) h with the group A protocol and 12 (36) h with the group B protocol (P = 0.652). Delivery with first dose, delivery within 12 h and delivery within 24 h were similar (P > 0.05) in group B (34.1, 87.5 and 60%, respectively) and group A (25, 82.9, 46.3, respectively). Both treatment regimens were tolerable and with similar side effects. CONCLUSION: Misoprostol moistened with saline was not more effective than dry misoprostol for second trimester pregnancy termination.

Misoprostol moistened with acetic acid or saline for second trimester pregnancy termination: a randomized prospective double-blind trial.

BACKGROUND: This study was conducted to evaluate the efficacy and side effects of a new regimen of 800 microg misoprostol administered intravaginally every 6 h up to a maximum of three doses in 24 h for second trimester pregnancy termination. METHODS: A total of 66 women seeking termination of second trimester pregnancy (30 fetal structural anomaly, six chromosomal abnormality and 30 fetal death) were randomly assigned to one of two treatment groups: (i) intravaginal misoprostol moistened with 3 ml of 5% acetic acid in group A (n = 33); or (ii) intravaginal misoprostol moistened with 3 ml of saline in group B (n = 33). RESULTS: The overall median (range) induction-abortion interval was 10 h (2-46) [10 h (4-35) in 36 live fetuses and 9 h (2-46) in 30 dead fetuses, P = 0.515]. All of the patients in both groups aborted within 48 h (100% success rate). The median (range) induction-abortion interval revealed a significantly faster delivery time (P < 0.001) in group A [8 h (2-24)] than in group B [14 h (3-46)]. CONCLUSIONS: This new regimen of 800 microg of vaginal misoprostol every 6 h for a maximum of three doses in 24 h was an effective alternative method for second trimester abortion. In addition, misoprostol moistened with acetic acid was significantly more effective than misoprostol moistened with saline.

Reproductive outcome of women with unicornuate uterus.

This study was undertaken to examine the reproductive impact of unicornuate uterine abnormalities cases in a group of 571 women with a uterine anomaly. Hospital records of 1784 patients who presented to the infertility outpatient clinic with infertility, recurrent pregnancy loss, pain or acute abdomen during the study period between January 1991 and January 2001, were reviewed retrospectively. The reproductive performance of women with unicornuate uterus was poor, with a live birth rate of only 29.2%, prematurity rate of 44%, miscarriage rate of 29%, and an ectopic pregnancy rate of 4%.