Is a two-hour monitoring period sufficient and safe for patients undergoing ultrasound-guided percutaneous liver mass biopsy?: A prospective and multicenter experience.

PURPOSE: To investigate whether patients undergoing percutaneous liver mass biopsy (PLMB) can be safely discharged following a two-hour monitoring period. METHODS: A multi-center prospective analysis was conducted for 375 patients (196 males and 179 females), mean age 63 ± 12.45 years (range 37-89) who underwent PLMB between August 2023 and March 2024. Patients were monitored for 24 h, and complications were classified as minor or major. The timing of complications was categorized into three groups: within the first two hours, between the 2nd and 24th hours, and within 1 week after 24 hours. RESULTS: Minor complications occurred in 18.93% (71/375) and major complications in 2.13% (8/375). Most minor complications (80.2%, 57/71) appeared within the first two hours, 12.7% (9/71) between 2 and 24 h, and 7.1% (5/71) after 24 h. All major complications (62.5%, 5/8) except late-onset cases, occurred within the first two hours. No major complications occurred between 2 and 24 h. Late-onset major complications occurred in 37.5% (3/8) after 24 h. CONCLUSION: The two-hour monitoring period did not adversely impact patient management regarding minor complications and is safe for identifying all major complications except for late-onset ones. Extending the post-biopsy recovery period does not significantly improve patient care.

Analysis of Grunting Sound in Infants for Predicting the Severity of Respiratory Distress Syndrome.

OBJECTIVE: Vocalizations from infants, particularly sounds associated with respiratory distress, are fundamental for observational scoring of respiratory tract issues. Listening to these infant sounds is a prevalent technique for decision-making in newborn intensive care units. Expiratory grunting, indicative of the severity and presence of potential conditions, is valuable, however, this evaluative method is subjective and prone to error. This study investigates the potential of computer-aided analysis to offer an objective scale for assessing the severity of respiratory tract problems, utilizing digital recordings of grunting sounds. METHODS: The original data set is formed with a total of 189 grunting sound segments collected from 38 infants. Multiple evaluation approaches were performed to reveal the relation between spectral characteristics of the recordings and the severity or existence of respiratory distress. RESULTS: Three spectral features were evaluated as prominently related to hospital stay duration and respiratory distress. The harmonic ratio of the recordings was graded as the most-related spectral feature that would characterize the severity. CONCLUSIONS: The potential of an innovative and objective grading approach is first investigated for replacing the human ear with a computer-aided evaluation system. The results are promising and the detected relation between expert ear-based scoring and harmonic ratio suggests that the spectral character of the grunting sounds would reflect the nature of respiratory conditions. Moreover, this study underlines those spectral features of digital grunting recordings that would be functional for automated prediction and decision-making.

Comparison of the efficacy of drug-coated balloon angioplasty and conventional balloon angioplasty in the endovascular treatment of thrombosed arteriovenous dialysis fistulas.

INTRODUCTION: To evaluate the efficacy and safety of paclitaxel-coated balloon angioplasty in the treatment of thrombosed arteriovenous fistulas. METHODS: This prospective, randomized, controlled study investigated the use of drug-eluting balloons in the treatment of the thrombosis of arteriovenous fistulas (AVFs) at our center between January 2018 and January 2023. A total of 246 patients were included in the study. The mean age of the patients was 61.3 ± 11.5 years. Of the patients, 150 (61%) were male and 96 (39%) were female. Angioplasty was performed using a plain balloon (PB) in 126 patients (51.2%) and a drug-coated balloon (DCB) in 120 (48.8%). The control images of the patients were obtained at the sixth and 12th months. Patency was evaluated during the follow-up. RESULTS: There was no significant difference between the two groups in terms of age, gender, hypertension, hyperlipidemia, diabetes, fistula location, or stenosis length. No significant difference was observed between the groups regarding the number of complications observed during and after the procedure. At the end of the sixth month, the patency rate was found to be 86.7% in the DCB group and 78.6% in the PB group. The 12th-month patency rate was 77.5% in the DCB group and 57.9% in the PB group. A significant difference was detected between the two groups in relation to the 6th- and 12th-month patency rates (p = 0.034 and p = 0.046, respectively). CONCLUSION: Drug-coated balloon angioplasty is an effective approach to the treatment of thrombosed AVFs, especially in terms of prolonging primary patency and reducing the need for secondary procedures.

Differential Analysis of Venous Sinus Diameters: Unveiling Vascular Alterations in Patients with Multiple Sclerosis.

BACKGROUND: Alterations in the cerebral venous system have been increasingly recognized as a significant component of the pathophysiology of multiple sclerosis (MS). This study aimed to explore the relationship between venous sinus diameter and MS to understand potential vascular alterations in MS patients compared with controls. We sought to determine whether these alterations were correlated with disease characteristics such as duration, lesion type, and disability score. METHODS: This study included 79 MS patients diagnosed according to the 2017 McDonald criteria and 67 healthy individuals. Magnetic resonance imaging (MRI) scans via a 1.5 Tesla system provided measurements of the superior sagittal sinus, right and left transverse sinus, sinus rectus, and venous structures. Statistical analysis was conducted via SPSS, employing independent sample t tests, ANOVA, chi-square tests, and Pearson correlation analysis, with the significance level set at p < 0.05. RESULTS: This study revealed significant differences in venous sinus diameter between MS patients and controls, with MS patients exhibiting larger diameters. Specifically, patients with brainstem and spinal lesions had larger diameters in certain sinus regions. No significant correlations were found between venous sinus diameter and demographic factors, expanded disability status scale scores, or lesion counts. However, a significant increase in perivenular lesions was noted in patients with longer disease durations. CONCLUSIONS: The findings indicate notable vascular alterations in MS patients, particularly in venous sinus diameters, suggesting a potential vascular component in MS pathology. The lack of correlation with conventional clinical and MRI metrics highlights the complexity of MS pathology. These insights underscore the need for further research, particularly longitudinal studies, to elucidate the role of venous changes in MS progression and their potential as therapeutic targets.

Analysis of the relationship between unregistered employment and occupational accidents in Turkey.

BACKGROUND: Occupational accidents are anticipated to decline when unregistered employment declines because of more regulated working conditions, inspections, and opportunities for legal protection. In the study, the accuracy of this presumption was examined. OBJECTIVE: This study aims to examine how to protective legal regulations generate a relationship between occupational accidents and informal employment such as the Occupational Health and Safety Law in Turkey. METHODS: In the research, which was structured within the framework of the quantitative method, various levels of relationship chains were created between informal employment and occupational accidents using correlation and slope calculations. The official data set was created using secondary data from the Turkish Statistical Institute and the Social Security Institution. RESULTS: It has been determined that the low positive correlation (r = 0.166) between unregistered employment and occupational accidents in 2008-2012 (pre-legislation period) in Turkey changed to the medium-negative direction (r=-0.602) in 2013-2020 (legislation period). While the assumption that unregistered employment would decrease in the first period was confirmed, the hypothesis was falsified by the increase in occupational accidents despite the decrease in informality in the second period. CONCLUSION: This study is unique because it shows that in a developing country where unregistered employment is high, the protective regulations for work accidents do not reflect a decrease in the number of work accidents in the short and medium term.

Use of dose-volume histograms for metabolic response prediction in hepatocellular carcinoma patients undergoing transarterial radioembolization with Y-90 resin microspheres.

INTRODUCTION: Voxel-based dosimetry offers improved outcomes in the treatment of hepatocellular carcinoma (HCC) with transarterial radioembolization (TARE) using glass microspheres. However, the adaptation of voxel-based dosimetry to resin-based microspheres has been poorly studied, and the prognostic relevance of heterogeneous dose distribution remains unclear. This study aims to explore the use of dose-volume histograms for resin microspheres and to determine thresholds for objective metabolic response in HCC patients treated with resin-based TARE. METHODS: We retrospectively reviewed HCC patients who underwent TARE with Y-90-loaded resin microspheres in our institution between January 2021 and December 2022. Voxel-based dosimetry was performed on post-treatment Y-90 PET/CT images to extract parameters including mean dose absorbed by the tumor (mTD), the percentage of the targeted tumor volume (pTV), and the minimum doses absorbed by consecutive percentages within the tumor volume (D10, D25, D50, D75, D90). Assessment of metabolic response was done according to PERCIST criteria with F-18 FDG PET/CT imaging at 8-12 weeks after the treatment. RESULTS: This study included 35 lesions targeted with 22 TARE sessions in 19 patients (15 males, 4 females, mean age 60 ± 13 years). Objective metabolic response was achieved in 43% of the lesions (n = 15). Responsive lesions had significantly higher mTD, pTV, and D25-D90 values (all p < 0.05). Optimal cut-off values for mTD, pTV, and D50 were 94.6 Gy (sensitivity 73%, specificity 70%, AUC 0.72), 94% (sensitivity 73%, specificity 55%, AUC 0.64), and 91 Gy (sensitivity 80%, specificity 80%, AUC 0.80), respectively. CONCLUSION: Parameters derived from dose-volume histograms could offer valuable insights for predicting objective metabolic response in HCC patients treated with resin-based TARE. If verified with larger prospective cohorts, these parameters could enhance the precision of dose distribution and potentially optimize treatment outcomes.

Unveiling the potential of strain elastography in perihilar cholangiocarcinoma biopsies.

PURPOSE: This study was conducted to investigate the effectiveness of strain elastography in guiding precise and sufficient tissue sampling for perihilar cholangiocarcinoma (CCA) biopsies. METHODS: Our retrospective analysis included 23 liver biopsies conducted between March 2019 and July 2022 for suspected perihilar CCA. An experienced radiologist performed the biopsies via an ultrasound machine with elastography configuration. Tissue stiffness color maps were used for guiding when the biopsies were performed. Strain index value calculations were made by radiologists on recorded images. RESULTS: Patient demographics revealed a mean age of 65.17 ± 9.25 years, with a gender distribution of six females and 17 males. Gray-scale examinations unveiled diverse echogenic characteristics in liver lesions. Elastography-guided biopsies demonstrated no need for repeats, while gray-scale biopsies necessitated re-biopsy in four patients, resulting in cholangiocarcinoma diagnosis (P = 0.037). Strain index values showcased strong inter- and intra-observer agreements (P < 0.001). Notably, no post-biopsy complications emerged in either study group. CONCLUSION: The diagnostic advantage of elastography, particularly in enhancing accuracy in challenging isoechoic lesions, was demonstrated, although the substantial overlap between strain index values of benign and malignant liver masses limits clinical usefulness of this technique.

Effects of Focal Cerebellar Injury on Fracture Healing and Oxidative Stress in Rat Model: An Experimental Animal Study.

AIM: To examine the effect of cerebellar damage on the process of fracture healing. MATERIAL AND METHODS: A total of forty-two male rats were selected at random and subsequently allocated into three distinct groups. The experimentals were divided into two subgroups within each group, with the intention of sacrificing them during the third and sixth weeks. Group 1 had isolated femoral fracture, Group 2 had femoral fracture after craniotomy, and Group 3 had femoral fracture accompanying cerebellar injury after craniotomy. Left femoral fractures in rats in all groups were treated using an intramedullary Kirschner wire. Radiological, histological, and biochemical evaluations were conducted at 3 and 6 weeks to assess the processes of fracture healing. To determine the effects of fracture healing and cerebellar injury on oxidant-antioxidant systems, catalase (CAT), malondialdehyde, superoxide dismutase (SOD), and glutathione peroxidase (GPx) activities were measured. RESULTS: Between the time frame of 3 to 6 weeks, Group 3 had higher radiography scores, alkaline phosphatase levels, callus/ diaphyse ratio, callus improvement, and bone mineral density in comparison to the other groups. The activity of SOD was found to be statistically negligible in all groups, suggesting that SOD does not have a substantial impact on fracture healing in cerebellar injury. However, notable increases in the activity of GPx and CAT enzymes were observed, showing their considerable involvement in the process of fracture healing. CONCLUSION: Cerebellar injury reduces the oxidative stress in the fracture area and contributes positively to fracture healing by means of radiologically, biochemically and histopathologically.

Lung ultrasound score in the decision of patent ductus arteriosus closure in neonates.

PURPOSE: We aimed to investigate the role of lung ultrasound (LUS) score in the closure of hemodynamically insignificant patent ductus arteriosus (PDA) and the clinical findings of the patients before and after closure. METHODS: The study groups (107 preterm neonates under 34 gestational weeks) were classified as hemodynamically significant PDA (group 1), hemodynamically insignificant PDA with closure therapy (group 2), hemodynamically insignificant PDA without closure therapy (group 3), and no PDA group (group 4) based on the echocardiography. 6- and 10-region LUS scores were compared for each group. RESULTS: There was a significant difference between groups 1 and 3 on first, third, and seventh days. In contrast, groups 1 and 2 had similar LUS scores on the first, third, and seventh days. There was a negative correlation between LUS scores on the first and third days and gestational age, birth weight, the first- and fifth-minute APGAR scores, and there was a positive correlation between aortic root to left atrium ratio, and PDA diameter/weight ratio. CONCLUSION: We observed that LUS scores in patients with hemodynamically insignificant PDA treated with closure therapy were similar to in patients with hemodynamically significant PDA. Thus, LUS score can have role in PDA closure in preterm neonates. However, more comprehensive studies are needed.

Long-term effect of indomethacin on a rat model of neonatal hypoxia ischemic encephalopathy through behavioral tests.

BACKGROUND: Many medical experts prescribe indomethacin because of its anti-inflammatory, analgesic, tocolytic, and duct closure effects. This article presents an evaluation of the enduring impact of indomethacin on neonatal rats with hypoxic-ischemic (HI) insults, employing behavioral tests as a method of assessment. METHODS: The experiment was conducted on male Wistar-Albino rats weighing 10 to 15 g, aged between seven and 10 days. The rats were divided into three groups using a random allocation method as follows: hypoxic ischemic encephalopathy (HIE) group, HIE treated with indomethacin group (INDO), and Sham group. A left common carotid artery ligation and hypoxia model was applied in both the HIE and INDO groups. The INDO group was treated with 4 mg/kg intraperitoneal indomethacin every 24 h for 3 days, while the Sham and HIE groups were given dimethylsulfoxide (DMSO). After 72 h, five rats from each group were sacrificed and brain tissue samples were stained with 2,3,5-Triphenyltetrazolium chloride (TCC) for infarct-volume measurement. Seven rats from each group were taken to the behavioral laboratory in the sixth postnatal week (PND42) and six from each group were sacrificed for the Evans blue (EB) experiment for blood-brain barrier (BBB) integrity evaluation. The open field (OF) test and Morris water maze (MWM) tests were performed. After behavioral tests, brain tissue were obtained and stained with TCC to assess the infarct volume. RESULTS: The significant increase in the time spent in the central area and the frequency of crossing to the center in the INDO group compared with the HIE group indicated that indomethacin decreased anxiety-like behavior (p < 0.001, p < 0.05). However, the MWM test revealed that indomethacin did not positively affect learning and memory performance (p > 0.05). Additionally, indomethacin significantly reduced infarct volume and neuropathological grading in adolescence (p < 0.05), although not statistically significant in the early period. Moreover, the EB experiment demonstrated that indomethacin effectively increased BBB integrity (p < 0.05). CONCLUSIONS: In this study, we have shown for the first time that indomethacin treatment can reduce levels of anxiety-like behavior and enhance levels of exploratory behavior in a neonatal rat model with HIE. It is necessary to determine whether nonsteroidal anti-inflammatory agents, such as indomethacin, should be used for adjuvant therapy in newborns with HIE.

A Prospective Randomized Trial: Does Full Weight Bearing Improve Functional Outcomes in Elderly Patients With Proximal Intramedullary Nailing After an Intertrochanteric Femur Fracture?

Introduction This study aimed to compare the functional outcomes and degree of independence in activities of daily living in patients aged >65 years who were treated with a proximal femoral nail (PFN) after an intertrochanteric femur fracture (ITFF) and underwent full and partial load-bearing in the early stage. Methods Overall, 133 patients who were hospitalized for ITFF and treated with PFN between August 2018 and March 2021 were randomly assigned to two groups. During the follow-up period, 45 patients who underwent partial load bearing (Group 1) and 40 patients who underwent full load bearing (Group 2) were prospectively evaluated. The Harris hip score was used for functional evaluation, and the Barthel index was used to evaluate the degree of independence in activities of daily living. Results The mean age of the patients included in the study was 76.67 ± 8.62 years. Regarding the comparison among groups in terms of age, sex, direction of fracture, reduction quality, fracture type, tip-apex distance, and surgical risk, there was no statistically significant difference between the two groups (p ≥ 0.05). Moreover, regarding the comparison in terms of calcium, phosphate, alkaline phosphatase, vitamin D, and keratin levels, which affect bone metabolism, no statistical difference was observed (p ≥ 0.05). We found that the mean Harris hip score was significantly higher in Group 1 than in Group 2 (Group 1: 76.82 ± 12.48; Group 2: 67.80 ± 15.34; p = 0.004). Moreover, 73.3% (n=33) and 42.5% (n=17) of patients in Groups 1 and 2 were fully independent or mildly dependent, respectively. We also found that the independence status was significantly better in Group 1 (p = 0.004). Conclusion Mobilization of older patients treated with PFN after ITFF using partial load-bearing protocols in the early postoperative period positively impacts hip function and the ability to perform activities of daily living independently.

Comparison of the complications and long-term results of heparin-coated and non-heparin-coated symmetric-tip hemodialysis catheters.

BACKGROUND: Tunneled catheters are effectively used in patients receiving chronic dialysis due to end-stage renal disease. However, the dysfunction of catheters caused by infection or thrombus requires repetitive procedures. In this study, we aimed to compare the long-term results of heparin-coated and non-heparin-coated tunneled dialysis catheters. METHOD: The study included a total of 161 patients who underwent tunneled dialysis catheter placement. Heparin-coated and non-heparin-coated tunneled catheters were placed in 81 and 80 patients, respectively. Of all the patients, 89 (55.3%) were male and 72 (44.7%) were female. The mean age of the patients was 64.3 ± 15.3 years. The patients were followed up for 12 months. RESULTS: Catheter infection developed in 10 (6.2%) of the cases, of which seven (70%) resolved with antibiotic therapy and the remaining three (30%) required catheter replacement. There was no significant difference between the groups in terms of the catheter infection rate (p = 0.84). Fibrin sheaths developed in nine (5.5%) patients. Fibrin sheath development was found to be significantly higher in the non-heparin-coated catheters (p = 0.017). There was no significant difference in fibrin sheath formation between the patients with and without systemic antiaggregant use (p = 0.864). The mean catheter durability time was determined to be 11 months in both groups (p = 0.704). Catheter survival was similar in heparin-coated and non-heparin coated catheters. CONCLUSION: This study showed that the rate of fibrin sheath development was significantly lower in heparin-coated tunneled catheters than non-heparin-coated catheters. There was no significant difference between the two catheters in terms of the rates of infection and mechanical complications.

Smith c/b ratio and teardrop figure measurements; Can it be used in the follow-up of patients who underwent salter innominate osteotomy?

BACKGROUND: This study aimed to investigate the effectiveness of radiological parameters used in the follow-up of patients who underwent salter innominate osteotomy (SIO) for the treatment of developmental dysplasia of the hip. METHODS: Acetabular index, c/b ratio, teardrop width, femoral head teardrop distance (TDD), and acetabular teardrop angle were measured on anteroposterior pelvic radiographs of patients who underwent SIO between 2017 and 2020. The patients were divided into 2 groups according to their preoperative Tönnis stage. Twenty-five (51%) hips of 23 patients with Tönnis stage 2 were classified into group 1, and 24 (49%) of 17 patients with Tönnis stages 3 and 4 were classified into group 2. Changes in radiologic parameters over time and between the groups were statistically evaluated. RESULTS: The study included 49 hips of 40 patients (37 female and 3 male). The age at surgery was 26.53 (18-53) months. After a mean follow-up period of 33.7 ± 12.8 months, there was no statistically significant difference between Groups 1 and 2 in terms of clinical, radiological and femoral head avascular necrosis results (P = .591, P = 956, P = .492). The changes in radiological parameters over time and between groups were statistically significant. (P < .001). Only the TDD and c/b ratio were significantly different between groups 1 and 2 (P = .002 and P < .001, respectively). CONCLUSION: In our study, along with acetabular index, the c/b ratio, teardrop width, TDD, and acetabular teardrop angle significantly changed after SIO and could be used as a guide for patient follow-up.

Gemcitabine-associated digital necrosis in metastatic breast cancer.

INTRODUCTION: Gemcitabine is a nucleoside analog antimetabolite used in various malignancies, including metastatic breast cancer. Objective response rates in its use as a single agent in the treatment of metastatic breast cancer are not to be underestimated. Cutaneous, hematological, pulmonary, and vascular side effects are well-known side effects. Venous thromboembolism may occur with antineoplastics, such as platinum compounds. Arterial thromboembolism is rare in cancer, almost rare with chemotherapy. Here, we present a metastatic breast cancer patient who had digital necrosis due to arterial occlusion with gemcitabine monotherapy. CASE REPORT: A 54-year-old metastatic breast cancer female patient had digital ischemia and necrosis in the left hand's fifth finger after the second course of single-agent gemcitabine as the fourth line setting. Gemcitabine was discontinued, and medical treatment was started. Thrombus was detected in the left subclavian artery digital angiography. Balloon angioplasty and stenting were applied. However, digital amputation had to be performed since tissue necrosis had not regressed despite radiological interventions and medical treatment. MANAGEMENT AND OUTCOME: Gemcitabine was discontinued. Low molecular weight heparin and acetylsalicylic acid were started. The distal phalanx was amputated due to necrosis during follow-up. Gemcitabine was permanently stopped. DISCUSSION: Gemcitabine-related vascular events, including arterial thrombosis, may also occur in cancer patients, especially those with higher tumor burden. Therefore, predisposing factors for hypercoagulability and vascular occlusion should be questioned in more detail even before starting antineoplastics which are known to have a lower risk for thrombosis, such as gemcitabine monotherapy.

The Impacts of Clozapine Use on the Risk and Outcomes of COVID-19 Disease in Patients with Schizophrenia.

Introduction: Clozapine may affect the outcome of severe COVID-19 infection due to its anti-inflammatory and immunosuppressant effects. This study aimed to investigate whether the risk of COVID-19 changed in schizophrenic patients using clozapine and to compare patients using clozapine with other antipsychotics in terms of COVID-19 severity. Methods: A total of 732 patients who were registered and followed up with a diagnosis of schizophrenia were included in the study. These patients' sociodemographic data, smoking status, medications, comorbidities, COVID-19 PCR results, and COVID-19 outcomes (inpatient care admission, intensive care unit admission, death) were retrospectively analyzed. Results: Of the 732 patients included in our study, 177 were using clozapine. Ninety-six of 732 patients were diagnosed with COVID-19, and 34 of these were being treated with clozapine. We found that clozapine use was an independent risk factor for COVID-19 positivity (OR=1.81 95% CI=1.13-2.90), inpatient care admission (OR=3.01, 95% CI=1.12-8.06). Conclusion: In our study, clozapine use was associated with an increased risk of COVID-19 positivity and inpatient care admission; however, it was not associated with ICU admission or death. Due to the frequent follow-up of patients using clozapine and the effects of clozapine on immunity, the frequency and/or identification of COVID-19 may be increased in these patients. Clozapine toxicity, granulocytopenia or agranulocytosis during the COVID-19 infection may have increased these patients' hospitalisation frequency.

Mutation Spectrum of ß-Thalassemia in Some Ethnic Groups of North Maharashtra, India.

Beta-thalassemia is the most common inherited single-gene disorder in the world, caused by more than 200 known mutations in the HBB gene. In India, the average prevalence of ß-thalassemia carriers is 3-4%. Several ethnic groups have a much higher prevalence, about 8% in the tribal groups, according to the 2011 census. The study's main goal is to identify common ß-thalassemia mutations and the frequencies of different haplotypes in various communities in North Maharashtra. Nashik district had the highest prevalence of ß-thalassemia (34%), followed by Ahmednagar (29%), Jalgaon (16%), Dhule (14%), and Nandurbar (7.0%). Prevalence of ß-thalassemia was highest in the schedule caste community (SC) (48%), followed by (17%) in Muslims, (14%) in other backward classes (OBC), (13%) in Schedule Tribe (ST), and (8.0%) in the general population The six most common ß-thalassemia mutations detected in this study are IVS 1 > 5 (G→C), Cd 15(G→A), Cd 41/41 (-TCTT), Cd 8/9(+G), IVS 1 > 1(G→T) and Cap + 1(A > G). Among these mutations, IVS 1 > 5 (G > C) was the most common type of mutation found in ß-thalassemia patients in the North Maharashtra population. Type-I haplotype was the most prevalent among all communities. Nashik and Ahmednagar districts were highly affected by ß-thalassemia. Among different ethnic groups, the SC and Muslim communities were the worst affected with a higher proportion of ß-thalassemia and increased frequency of mutations.

Comparison of two surgical techniques for Lisfranc injuries; closed reduction and fixation versus primary partial arthrodesis.

BACKGROUND: This study reviewed the outcomes of Lisfranc injuries treated by primary partial arthrodesis (PPA) or closed re-duction and internal fixation (CRIF). METHODS: A retrospective review was made of patients who underwent PPA or CRIF for a Lisfranc injury after low-energy trauma, and follow-up was assessed according to radiographic, and clinical outcomes. A total of 45 patients with a median age of 38 years were followed up for an average of 47 months. RESULTS: The average American orthopaedic foot and ankle society (AOFAS) score was 83.6 points in the PPA group and 86.2 points in CRIF group (p>0.05). The mean pain score was 32.9 in the PPA group, 33.7 in the CRIF group (p>0.05). Secondary surgery for symptomatic hardware was required in 78% of the CRIF group and in 42% of the PPA group (p<0.05). CONCLUSION: Treatment of low-energy Lisfranc injuries with either PPA or closed reduction and fixation produced good clinical and radiological outcomes. The total AOFAS scores were comparable between two groups. However, the function and pain scores were seen to improve more with closed reduction and fixation while there was a greater requirement for secondary surgery in the CRIF group.

Etiology of genetic muscle disorders induced by mutations in fast and slow skeletal MyBP-C paralogs.

Skeletal muscle, a highly complex muscle type in the eukaryotic system, is characterized by different muscle subtypes and functions associated with specific myosin isoforms. As a result, skeletal muscle is the target of numerous diseases, including distal arthrogryposes (DAs). Clinically, DAs are a distinct disorder characterized by variation in the presence of contractures in two or more distal limb joints without neurological issues. DAs are inherited, and up to 40% of patients with this condition have mutations in genes that encode sarcomeric protein, including myosin heavy chains, troponins, and tropomyosin, as well as myosin binding protein-C (MYBPC). Our research group and others are actively studying the specific role of MYBPC in skeletal muscles. The MYBPC family of proteins plays a critical role in the contraction of striated muscles. More specifically, three paralogs of the MYBPC gene exist, and these are named after their predominant expression in slow-skeletal, fast-skeletal, and cardiac muscle as sMyBP-C, fMyBP-C, and cMyBP-C, respectively, and encoded by the MYBPC1, MYBPC2, and MYBPC3 genes, respectively. Although the physiology of various types of skeletal muscle diseases is well defined, the molecular mechanism underlying the pathological regulation of DAs remains to be elucidated. In this review article, we aim to highlight recent discoveries involving the role of skeletal muscle-specific sMyBP-C and fMyBP-C as well as their expression profile, localization in the sarcomere, and potential role(s) in regulating muscle contractility. Thus, this review provides an overall summary of MYBPC skeletal paralogs, their potential roles in skeletal muscle function, and future research directions.

Percutaneous treatment of giant hydatid cysts: a single-center experience of 58 cysts.

PURPOSE: The aim of this study is to evaluate the efficacy of percutaneous treatment in hydatid cysts (HCs) with at least one diameter larger than 10 cm. MATERIALS AND METHODS: 58 CE1 or CE3a HCs with at least one diameter larger than 10 cm which were treated with catheterization between September 2016 and December 2021 were retrospectively analyzed. RESULTS: Mean age was 40 ± 17.7 (18-80). Majority of HCs were in the liver (89.6%). Median follow-up was 28 months. Technical success rate was 100%; however, a second procedure was needed in 13 cysts due to recollection (n = 4), infection (n = 6), and recurrence (n = 3). CONCLUSIONS: Giant HCs can be effectively treated with catheterization with low complication rates.