Is Cladophora fracta an efficient tool of accumulating critical raw materials from wastewater and there a potential health risk of use of algae as organic fertilizer?

In this study investigation of accumulations of critical raw materials (cobalt (Co), antimony (Sb), vanadium (V), lanthanum (La) and tungsten (W)) from wastewater by using C. fracta were aimed. Besides, assessment of the potential health risks in terms of the use of organic fertilizer obtained from the macroalga to be harvested from the treatment were also aimed. Highest Co, Sb, V, La and W accumulations by algae in reactor were 125±6.2%, 201.25±10%, 318.18±15%, 357.97±18%, and 500±25%, respectively. When compared with control, Co, Sb, V, La and W in algae increased 2.25, 3.01, 4.18, 4.58, and 6 times, respectively. The algae was very high bioaccumulative for Co and La. Highest MPI was calculated as 3.94. Non-carcinogenic risk of CRMs according to different exposure types (ingestion, inhalation, and dermal) were calculated for man, woman and child. There is not any non-carcinogenic risk from the investigated exposure ways of algae as organic fertilizer.

Does previous arthroscopic Bankart repair influence coracoid graft osteolysis in Latarjet procedure? A case-control study with computed tomography scan data.

BACKGROUND: The Latarjet procedure is commonly performed in the treatment of recurrent shoulder instability and is also indicated as a salvage procedure for recurrence after failed arthroscopic Bankart repair. Although this procedure has shown success, there has been an increased awareness of complications in recent studies, especially graft osteolysis. Most relevant research has focused on the pathophysiology, incidence, or location of graft osteolysis or the risk factors for graft osteolysis; however, the data are limited to primary Latarjet procedures. This study aimed to investigate the effect of previous arthroscopic Bankart repair surgery on coracoid bone graft osteolysis in the Latarjet procedure. METHODS: This retrospective case-control study analyzed data from patients who underwent primary Latarjet procedures or revision Latarjet procedures following failed arthroscopic Bankart repair. Clinical outcome measures included range of motion, the Subjective Shoulder Value, and the Rowe score. Volumetric analysis of each transferred coracoid graft was performed using early postoperative and late postoperative computed tomography scan data, and the amount of graft osteolysis was then calculated as the percentage of volume reduction of each graft. RESULTS: A total of 32 patients who met the inclusion criteria were included in this study, with 24 patients in the primary Latarjet group (group I) and 8 patients in the revision Latarjet group (group II). The mean age of the patients was 32.5 ± 7.7 years, and the mean follow-up duration was 52.1 ± 8.9 months. Both study groups showed significant improvement in the Subjective Shoulder Value compared with baseline (P < .05). Comparison of postoperative clinical outcome measures showed no significant difference in any outcome parameter between the 2 study groups (P > .05). No recurrence was observed during the follow-up period. A positive apprehension sign was present in 6 patients (25%) in group I and 4 patients (50%) in group II (P > .05). Analysis of radiologic data revealed that all patients underwent some degree of graft osteolysis, with varying osteolysis ratios between 12% and 98%. The mean osteolysis ratio of the coracoid graft was 67.3% ± 22.6% in group I and 69.4% ± 25.6% in group II, with no significant difference between the 2 groups (P > .05). CONCLUSION: The findings of this study suggest that a considerable amount of coracoid graft osteolysis is observed after both primary Latarjet procedures and revision Latarjet procedures following failed arthroscopic Bankart repair. Previous arthroscopic Bankart repair did not seem to have a significant influence on the amount of graft osteolysis, and both primary and revision Latarjet procedures showed satisfactory clinical outcomes.

Is Obstructive Sleep Apnea-Associated Adenoid Hypertrophy Linked to Scoliotic Attitudes in Children?

Introduction Scoliosis, a multifaceted spinal deformity commonly affecting pediatric and adolescent populations, has spurred extensive scientific inquiry to understand its origins and impacts. Early-onset scoliosis (EOS), characterized by spinal curvature exceeding 10° before the age of 10, presents a unique challenge necessitating a comprehensive understanding of its etiological factors. Within this context, the potential role of hypoxia-induced by adenoid hypertrophy in contributing to the pathogenesis of EOS has emerged as an intriguing avenue of investigation. Materials and methods This retrospective study was conducted focusing on radiological and clinical data pertaining to children below 10 years of age who underwent isolated adenoidectomy for adenoid hypertrophy. Preoperative posteroanterior standing chest radiographs were utilized for scoliosis assessment, with Cobb angles serving as the primary measurement metric. To ensure accuracy and reliability, Cobb angle measurements were independently performed by two experienced observers. Statistical analyses encompassed the Mann-Whitney U test, Spearman correlation analysis, and intraclass correlation coefficient calculations to evaluate interobserver agreement. Results Among the cohort of 218 pediatric adenoidectomy patients, 177 individuals had radiographs suitable for EOS evaluation. The mean age of the participants was 5.72±2 years, with a nearly equal distribution of 52.5% male and 47.5% female patients. Strikingly, the study identified a 10.2% prevalence of coronal plane curvatures exceeding the critical threshold of 10°, indicative of EOS. The robust interobserver reliability was demonstrated by a commendable mean interclass correlation coefficient (ICC) value of 0.926, affirming consistent and accurate Cobb angle measurements between the observers. Conclusion In light of the heightened prevalence of EOS observed in children undergoing adenoidectomy, this study provides a compelling impetus for exploring the potential interrelationship between adenoid hypertrophy, hypoxia, and the emergence of early-onset scoliosis. The study underscores the importance of prospective research to elucidate the complex mechanisms connecting these factors, offering insights into potential risk factors and underlying pathogenic pathways associated with the development of early-onset scoliosis.

Is it the subcoracoid impingement or the subacromial impingement that tears the subscapularis tendon? A comparison of the MRI findings of the operated and healthy shoulders of the patients.

BACKGROUND: : The purpose of this study is to investigate whether the etiological factors accepted as causes of idiopathic subscapularis tears are true or not when the comparison is made with the opposite side healthy shoulder of the patients who underwent arthroscopic repair for an isolated subscapularis tear. METHODS: Sixteen patients who underwent shoulder arthroscopy between February 2016 and January 2018 and were diagnosed with isolated subscapularis tear were evaluated. The coracohumeral distance (CHDax), coracoid overlap (CO), and tuberculum minus cysts (TMC) were evaluated on the axial images of the MRI studies while the acromiohumeral distance (AHDsag), CHDsag, and subscapularis tendon slip number (STSN) on the sagittal oblique images and the AHDcor and SLAP lesion on the coronal oblique images. Degeneration of the coracoacromial ligament was evaluated during arthroscopy. RESULTS: The mean CHDsag (11.26-10.08), CHDax (10.63-9.98), CO (14.2-15.43), AHDsag (8-7.66), and AHDcor (7.65-7.68) measurements (operated side-healthy side, respectively) were statistically similar (p > 0.05). No statistically significant difference was found between TMC and STSN in healthy and operated shoulders (p > 0.05). There was mild coracoacromial ligament fraying in 4 (25%) and obvious coracoacromial ligament fraying in 8 (50%) which indicated subacromial impingement in 75% of the patients. DISCUSSION: The parameters of the coracoid process did not reveal any significant difference between the operated (for an isolated subscapularis tear) and opposite-side healthy shoulders of the patients. However, coracoacromial ligament degeneration was present in 75% of the patients.

Corticosteroid, Platelet-Rich Plasma, and Ozone Injections for Sinus Tarsi Syndrome.

BACKGROUND: Sinus tarsi syndrome is characterized by permanent pain on the anterolateral side of the ankle due to chronic inflammation characterized by fibrotic tissue remnants and synovitis accumulation after repeated traumatic injuries. Few studies have documented the outcome of injection treatments for sinus tarsi syndrome. We sought to determine the effects of corticosteroid and local anesthetic (CLA), platelet-rich plasma (PRP), and ozone injections on sinus tarsi syndrome. METHODS: Sixty patients with sinus tarsi syndrome were randomly divided into three treatment groups: CLA, PRP, and ozone injections. Outcome measures were visual analog scale, American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS), Foot Function Index, and Foot and Ankle Outcome Score before injection compared with 1, 3, and 6 months after injection. RESULTS: At the end of months 1, 3, and 6 after injection, significant improvements were observed in all three groups compared with baseline (P < .001 for all). At months 1 and 3, improvements in AOFAS scores were similar in the CLA and ozone groups; those in the PRP group were lower (P = .001 and P = .004, respectively). At month 1, improvements in Foot and Ankle Outcome Score were similar in the PRP and ozone groups and higher in the CLA group (P < .001). At 6-month follow-up, there were no significant differences in visual analog scale and Foot Function Index results among the groups (P > .05). CONCLUSIONS: Ozone, CLA, or PRP injections could provide clinically significant functional improvement for at least 6 months in patients with sinus tarsi syndrome.

Preliminary assessment of health risks associated with consumption of grapevines contaminated with mining effluents in Turkey: Persistent trace elements and critical raw materials.

In this study, some persistent trace elements and critical raw materials were investigated in grapevines contaminated with Pb-Zn mining effluents. The persistent trace elements under certain conditions remain without any change in form in the environment over long periods. The critical raw materials are the ones that have economic importance and have the risks associated with their supply. The health risks of persistent trace elements and critical raw materials in the leaves of grapevine that are consumed by humans were determined. The highest persistent trace elements concentrations followed the order of root > stem > leaf for Mn, Cu, Cd, Ni, and Cr while root > leaf > stem for Zn and leaf > root > stem for Pb. The maximum critical raw material concentrations for Co and V followed the order of root > stem > leaf. For Sb and La, these were leaf > root > stem and root > stem > leaf, respectively. The maximum critical raw materials concentrations for W was leaf > stem = root. The total maximum carcinogenic value was 0.146 for Cd while the total minimum carcinogenic value was 0.0054 for Pb. In this study, potential carcinogenic risk values in terms of ingestion of contaminated soil (Cr, Cd, and Ni) and dietary take of grapevine leaves (Ni, Cr, Cd, and Pb) are higher than acceptable levels (1 × 10-4 - 1 × 10-6 ). Maximum cancer risk on human health was determined as dietary intake of grapevine leaves. When hazard quotient for dietary (HQdie ), hazard quotient for ingestion (HQing ), and hazard quotient for inhalation (HQinh ) values ​​of critical raw materials were examined, the maximum values ​​were observed for children. Also, the highest hazard quotient for dermal (HQder ) value was determined for men. The hazard index and total hazard index values were >1 for critical raw materials. As a result, values >1 indicated potential non-carcinogenic human health risk associated with the consumption of grapevines contaminated with mining effluents. Actual region-specific exposure estimates for consumption of grapevines, however, were not evaluated. Integr Environ Assess Manag 2022;18:517-527. © 2021 SETAC.

Assessment of heavy metal accumulations and health risk potentials in tomatoes grown in the discharge area of a municipal wastewater treatment plant.

Some heavy metals were detected in organs of the tomatoes grown in the discharge area of effluents of a municipal wastewater treatment plant. Also, the health risk potentials of heavy metals in the tomatoes consumed by human were investigated. The highest concentrations for Cu, Ni, Cr, Mn and Pb were followed the order of root>leaf>stem>fruit. When the bioconcentration factors values calculated for bioconcentration of metals from effluent to stem and root were examined, the highest values were determined for Cu. When translocation factors values are examined, the highest translocation from root to leaf was determined for Cd. The highest translocation from stem to leaf was determined for Pb. The estimated total exposure dose for male, female and children was listed as Zn>Mn>Cu>Cr>Ni>Pb>Cd. In terms of dietary, we can list the non-carcinogenic risks of heavy metals as children> female> male. The highest carcinogenic risk was calculated for Cr via dietary intake.

Potential human health risks of toxic/harmful elements by consumption of Pseudevernia furfuracea.

The potential human health risks of some toxic/harmful elements related to the consumption of Pseudevernia furfuracea (L.) Zopf. were investigated. The toxic/harmful elements (cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), manganese (Mn), nickel (Ni), and zinc (Zn)) were determined in P. furfuracea. According to the analysis result, the maximum (max.) toxic/harmful element value was 62 ± 3.1 mg/kg for Mn and minimum (min.) value was 0.19 ± 0.01 mg/kg for Cd. The estimated daily exposure doses (EDEXDs) for men, women and children were dietary (bread) > dietary (tea) > dermal. For dietary (bread) and dietary (tea) non-carcinogenic (HQ) risk was children > women > men. For dermal, HQ risk was women > children > men. Hazard index (HI) value for men was >1 for Cr. HI value for men was 1.36 for Cr. HI value for women was >1 for Cr and Mn. HI values for women were 1.54 for Cr and 1.01 for Mn. Also, the HI value for children was >1 for Cr, Mn, and Pb. HI values for children were 3.44 for Cr, 2.24 for Mn, and 1.66 for Pb. This situation showed that there was a non-carcinogenic risk. Carcinogenic risk values were dietary (bread) > dietary (tea) > dermal. The total max. carcinogenic value was 1.97E-03 for Cr while the total min. carcinogenic value was 1.31E-05 for Pb. As a result, it has been determined that there may be a risk of cancer due to the consumption of lichen as bread and this situation may adversely affect human health.

Simultaneous versus staged surgeries for the treatment of bilateral developmental hip dysplasia in walking age: A comparison of complications and outcomes.

OBJECTIVES: This study aims to compare the radiological outcomes and rate of complication between single-stage and staged operation for the treatment of bilateral developmental dysplasia of the hip (DDH). PATIENTS AND METHODS: A total of 100 patients (13 males, 87 females; mean age: 18.1±2.1 months; range, 12 to 36 months) with bilateral DDH who were older than 15 months of age and treated with open reduction (OR) or Pemberton pericapsular osteotomy (PPO) were retrospectively analyzed. Of the patients, 48 were operated with OR and 52 were operated with PPO. Improvements in acetabular indices, presence of avascular necrosis, radiological results, and other complications were noted. RESULTS: There was no statistically significant difference in the preoperative acetabular indices, range of International Hip Dysplasia Institute (IHDI) classification, follow-up period, and age at the time of operation between the groups (p>0.05). There was no statistically significant difference in the acetabular indices, rate of avascular necrosis, and radiological results at the end of 24 months of follow-up between the groups (p>0.05). CONCLUSION: Our study results show no significant difference in the radiological outcomes and complications between simultaneous and staged surgeries for the treatment of bilateral DDH in children in the walking age.

Investigation of the potential human health risk of toxic mercury determined in the grapevine exposed to mine gallery waters.

In the present study, mercury was selected because of its toxicity. It was detected in the grapevines exposed to mine gallery waters. The potential health risk of mercury in leaves of grapevine those are consumed by human worldwide was investigated. The grapevines were harvested and separated into organs of roots, stems, and leaves. The concentrations of mercury were determined in roots, stems, and leaves. The translocation and bioconcentration factors were calculated. Maximum concentrations of mercury were stem < root < leaf. The health risk potential of mercury on human health was calculated. The estimated daily exposure doses of mercury followed an order for children and adults: dietary > ingestion > inhalation > dermal. The HQ values calculated for exposure ways of dietary, ingestion and inhalation were male < female < children. As a result, it was determined that grapevine exposed to mine gallery waters that cause environmental contamination may cause non-carcinogenic risks on human health.

Assessment of potential health risk associated with the use of Cladophora fracta as mulch.

In this study, cadmium, copper, nickel, zinc, chromium, manganese and lead were determined in Cladophora fracta present in Lake Hazar (Turkey). The health risks (non-carcinogenic and carcinogenic) of heavy metals associated with the use of Cladophora fracta as mulch were also determined. Bioconcentration factor (BCF) and metal pollution index (MPI) were calculated. When compared with reference value (1.5 mg/kg for Cr and 200 mg/kg for Mn), the highest accumulation by Cladophora fracta was seen in the month of June as 1442 ± 7.2% (23.13 mg/kg) for Cr and the lowest accumulation calculated in the month of July as 5 ± 0.2% (210 mg/kg) for Mn. In our study, the highest MPI value was 13.69 in September. The magnitude of MPI values of heavy metals determined during April to September appeared in the following order September > August > July > June > May > April. The HQing (hazard quotient due to ingestion) and HQinh (hazard quotient due to inhalation) in all months were chidren > female > male while the order of HQder (hazard quotient due to dermal) was determined as male > female > children. Non-carcinogenic risk (HQ) and Hazard Index (HI) values in terms of ingestion, inhalation and dermal ways were lower than 1. Also, total HI values were < 1. As a result, there was not non-carcinogenic and carcinogenic risks associated with usage of Cladophora fracta as mulch.

Surgical management of displaced adolescent Tillaux Fractures with the mini-open technique.

BACKGROUND: There is no consensus on the optimal treatment of Tillaux-Chaput fractures. The results of our cases treated with mini-open surgery (open reduction and internal fixation) concerning efficacy and complications, we aim to compare other procedures (open, percutaneous, and arthroscopy-assisted) with the literature data and to look for an answer to the question of whether the primary treatment can be mini-open surgery. METHODS: Between the years 2014 and 2017, 22 of 30 patients with Tillaux-Chaput fractures were treated using mini-open surgery, open reduction and internal fixation with one cannulated screw. These cases were retrospectively examined concerning age, sex, side, surgery duration, complications, and American Orthopedic Foot and Ankle Score (AOFAS). Functional results were statistically evaluated 12 months after the injury. Follow-up included a clinical examination, imaging and AOFAS. RESULTS: Of the patients, 14 were male (63.6%) and eight were female (36.4%). The mean age of the patients was 13.8 years. The mean surgery duration was 21 minutes. All fractures healed after an average of 14 weeks. No complications were observed in any of the cases. The mean follow-up time was 24.7 months. The mean preoperative AOFAS score was 53.3 and the mean postoperative AOFAS score was 93.6, which was a statistically significant difference. At the last follow-up, the AOFAS score was perfect for all cases. CONCLUSION: Contrary to what is stated in the literature, the mini-open surgical procedure has many advantages. The operation is very short and the risk of nerve injury is very low. This study showed that Tillaux-Chaput fractures could be safely and efficiently treated with mini-open surgery. We recommend mini-open surgery, complete anatomical reduction, and internal fixation for successful results.

Impact of presence of ossific nucleus on results of closed reduction in treatment of developmental dysplasia of the hip (302 hips).

Closed reduction is an effective treatment method for developmental dysplasia of the hip (DDH). Still, there are certain controversial issues regarding the timing of the treatment. In this study, we investigated the results of closed reduction and Outcomes of 302 hips of 218 patients treated with closed reduction have been analyzed retrospectively. One hundred fifty-two hips that had ossific nucleus [ossific nucleus (+)] during reduction have been compared with 150 hips that had no ossific nucleus [ossific nucleus (-)] during reduction. Also, the patients have been divided into two groups, the patients treated with closed reduction before the sixth month and the patients treated with closed reduction after the sixth month. Groups have been compared between themselves in terms of avascular necrosis (AVN) and redislocation. Seventy-seven of the 112 hips treated with closed reduction in the first six months were ossific nucleus (-), and AVN has been noted in 5 (6%) patients. However, although no AVN has been seen in any of the 35 ossific nucleus (+) hips, no statistically significant difference has been found between two groups. Seventy-three of the 190 hips treated with closed reduction after the sixth month were ossific nucleus (-), and AVN has been seen in 13 (17%) of these hips. AVN has been seen in 9 (7%) of the 117 ossific nucleus (+) hips. The AVN ratio was found significantly lower in the ossific nucleus (+) hips (P < 0.034). Although the presence of ossific nucleus does not provide extra protection against AVN in before the sixth month, the presence of ossific nucleus is protective against AVN after the sixth month.

The new ultralow dose CT protocol for the diagnosis of fractures of the ankle: A prospective comparative study with conventional CT.

PURPOSE: Computerized tomography (CT) imaging is increasingly being used to evaluate patients with ankle trauma. However, conventional CT (C CT) has a significantly higher radiation dose (RD) than plain radiography. This study aimed to evaluate the diagnostic accuracy and reliability of ultra-low-dose CT (ULDCT) protocol for ankle fractures. METHODS: Ninety-eight consecutive patients who had ankle CT for suspected ankle fracture were included in our prospective study. C CT and ULDCT protocols were simultaneously performed on these 98 patients. Two observers independently evaluated ULDCT and C CT images. The effective RD of the ULDCT and C CT groups was calculated. RESULTS: The interobserver agreement was 1 (perfect). ULDCT and C CT group images showed no significant difference in image quality. The effective RD of the ULDCT was significantly lower than the C CT (p < 0.001). CONCLUSIONS: By evaluating the results of this study, ULDCT proved to be a reliable diagnostic imaging method for fractures of the ankle. The satisfactory diagnostic image quality of the ULDCT protocol provides promising results. LEVEL OF EVIDENCE: Level II/lesser quality RCT or prospective comparative study.

Surgical management of Rockwood type 3 acromioclavicular joint injuries: a retrospective comparison of outcomes of suture anchor fixation and double-button fixation techniques.

The treatment of type 3 acromioclavicular joint injuries has still controversial issues. In this retrospective study, we aimed to compare the radiological and functional outcomes of the suture anchor and double-button fixation methods for the treatment of type 3 acromioclavicular joint injuries.This study included 20 patients who underwent suture anchor (9 patients) and double-button fixations (11 patients) for isolated type 3 acromioclavicular dislocation. Injuries were classified according to the Rockwood Classification System. Coracoclavicular(CC) distances and anterior translation have been measured pre-operatively and at the 12th month follow-up. Functional evaluation was performed using the DASH, and Constant-Murley scores of the patients were recorded at the12th-month follow-up.The mean age of the patients was 37 (22-50) years in Group 1(double-button group) and 39 (24-56) years in Group 2(suture anchor group). All of the patients were male. There was no statistically significant difference between the DASH and Constant-Murley scores of the 2 groups (P > .05). The mean DASH score of the patients evaluated at the postoperative 12th month was 6.65 (0-38.3) in Group 1 and 2.48 (0-4.2) in Group 2. The mean Constant-Murley score of the patients evaluated at the postoperative 12th month was 89,6 (50-98) in Group 1 and 93,6 (90-98) in Group 2. Comparison of the pre- and post-operative CC distances and pre- and post-operative anterior translation distances of both groups revealed that there was no statistically significant difference between groups regarding postoperative CC distances and anterior translation distances (P > .05).Suture anchor and double-button techniques are reliable treatment methods that are not superior to one another and can yield excellent functional outcomes.

Phycoremediation of Precious Metals by Cladophora fracta From Mine Gallery Waters Causing Environmental Contamination.

We have presented a study to determine the possibility for the usage of Cladophora fracta as bioaccumulator of the metals (Au) and silver (Ag) both have characteristics of pollutant and precious in mine water. The highest concentrations accumulated by C. fracta were determined as 5.8 ± 0.3 and 5323 ± 75 µg/kg for Au and Ag, respectively. The results showed that the accumulation of the metals measured followed the order of Ag > Au. The Metal Pollution Index (MPI) values calculated between 39.37 × 10-3 and 175.7 × 10-3 were used to determine the pollution degree of C. fracta. As a result, it was determined that C. fracta highly accumulated the precious metals from the gallery water. Therefore, C. fracta was a good bioaccumulator for the remediation of Au and Ag in mine gallery waters. In this way, it is possible to minimize or eliminate the environmental risks of the precious metals in the gallery waters.

Comparison of total cost and outcomes between single-stage open reduction and Pemberton periacetabular osteotomy operation and two separate consecutive operations in treatment of bilateral developmental hip dysplasia in children at walking age.

Open reduction and Pemberton periacetabular osteotomy (PPO) is one of the most preferred techniques for the treatment of developmental hip dyslaplasia (DDH) after the walking age. Performing the surgery as a one-stage operation or two separate consecutive operations is a controversial issue. In this study, we aimed to compare the outcomes, length of hospitalization and total cost between the patients whom had single-stage open reduction and PPO or two consecutive operations due to bilateral DDH in the walking age children. One hundred thirty patients with bilateral DDH had undergone open reduction and PPO for both hips. Seventy-five patients had one-stage open reduction and PPO for both of the hips, whereas 55 patients have two separate consecutive operations. Total time of exposure to anesthetics, blood loss and duration of operation were noted. Hospitalization period and total treatment costs were also noted for each patient. There was no statistically significant difference between the groups regarding the preoperative and postoperative AIs (P > 0.05). Comparing the total cost, length of hospitalization, exposure to anesthetics, perioperative blood loss, there was statistically significant difference between the groups (P < 0.005). Single-stage surgery had favorable outcomes. Major benefits of single-stage surgery for treatment of bilateral DDH are the reduced costs, anesthesia duration, intraoperative blood loss and hospitalization period. Also it can be presumed that prolonged immobilization can lead to loss of bone strength and resulting in fragility fractures. So single-stage open reduction and PPO for bilateral DDH can be preferred in experienced clinics.

Phytoremediaton of priority substances (Pb and Ni) by Phragmites australis exposed to poultry slaughterhouse wastewater.

The aim of the work was to evaluate the ability of Phragmites australis to uptake lead and nickel from the stream taking the treated poultry slaughterhouse wastewater (PSW). Pb and Ni concentrations, which are the priority substances of the water frame directive, were detected separately at the root, stem and leaf of P. australis at 50 m and 100 m from the downstream of discharge point. The uptake of Pb and Ni by P. australis followed the order of root > leaf > stem. The Ni uptake was higher than Pb uptake in P. australis exposed to poultry wastewater. As a result, P. australis exposed to PSW were found to have the ability to uptake Pb and Ni. It has been determined that P. australis can be used for removal and phytoremediation of Pb and Ni metals from PSWs.

Surgical treatment of pediatric forearm fractures with intramedullary nails: is it a disadvantage to leave the tip exposed?

Elastic intramedullary nailing is the main treatment method in the surgical treatment of pediatric forearm fractures. In this study, we compared the clinical outcomes of intramedullary nailing of forearm fractures with leaving the tips exposed and with placing the tip of the nails under the skin. We aimed to present the clinical outcomes of intramedullary nailing and determine the advantages and disadvantages of leaving the tips of the nails exposed. One hundred and ninety-two children with both-bone forearm fracture who were treated with titanium elastic nailing (TEN) in the Department of Orthopedics at Erzurum Regional Training and Research Hospital between January 2009 and December 2016 were included in the study. All cases had been followed up for at least 1 year. The tips of the TENs were left exposed in 74 and buried subcutaneously in 118 children. Union was achieved in all cases. Delayed union was observed in just one case. Skin irritation was observed in 11 (5.7%) of the exposed TEN cases. Superficial infection developed in two (1%) cases with exposed TEN tips. Migration developed during the follow-up of 11 (5.7%) cases with buried tips. The mean time to removal of TEN was 7.9 weeks in cases with exposed and 26.2 weeks in cases with buried cases. Refracture was observed in six buried (3.1%) cases and four exposed TEN (2.1%) cases in the first year after the removal of the nails. Perfect outcomes were achieved in 146 (76%) cases and good outcomes in 36 (19%) cases in our study. On comparing the rate of complications and clinicaloutcomes, leaving the TEN exposed seems to be safe.

Outcomes of Surgical Management of Acetabular Fractures Treated with Anterior Approaches.

OBJECTIVE: In this study we aimed to evaluate the outcomes of anterior and combined approaches for treatment of acetabular fractures. MATERIALS AND METHODS: Thirty-seven acetabular fractures in 35 patients treated with an anterior approach were evaluated retrospectively. Fractures were classified according to Judet-Letournel. Early and final radiological evaluation was based on Matta's criteria. Modified Merle d'Aubigne and Postel criteria were used for functional assessment. RESULTS: Eleven (30%) fractures were simple type and 26 (70%) were mixed type. Two (18%) of the simple fractures were transverse and 9(82%) were anterior column fractures. Fourteen (54%) of the mixed type fractures were both column fractures, 5 (19%) were transverse+posterior wall, 5 (19%) were T shaped and 2 (8%) were anterior column+posterior hemitransverse fractures. Surgical approach was ilioinguinal in 15 (43%) patients, Stoppa in 9 (26%) and combined11 (31%). Our functional outcomes were perfect in 10 (27%) hips, good in 20 (54%), moderate in 4 (10%) and poor in 3 (8%). Our radiological results were perfect in 15 (40.5%) hips, good in 15 (40.5%), moderate in 4 (11%) and poor in 3 (8%). CONCLUSION: Anterior surgical approaches provide satisfactory outcomes in appropriate fracture types. Posterior approach can be combined in certain fracture types. We think that rate of the requirement for a concomitant posterior approach for certain fractures of the acetabulum will decrease as experience increases.