First detection of Ehrlichia chaffeensis, Ehrlichia canis, and Anaplasma ovis in Rhipicephalus bursa ticks collected from sheep, Turkey.

Anaplasmosis and ehrlichiosis are important tick-borne rickettsial diseases of medical and veterinary importance that cause economic losses in livestock. In this study, the prevalence of Anaplasma ovis, Ehrlichia canis and Ehrlichia chaffeensis was investigated in ticks collected from sheep in various farms in Van province, which is located in the Eastern Anatolian Region of Turkey. The ticks used in this study were collected by random sampling in 26 family farm business in 13 districts of Van province. A total of 688 ticks were collected from 88 sheep and 88 tick pools were created. All ticks identified morphologically as Rhipicephalus bursa. Phylogenetic analysis of Chaperonin and 16S rRNA gene sequences confirmed A. ovis, E. canis and E. chaffeensis in this study. Of the 88 tick pools tested, 28.41% (25/88) were positive for at least one pathogen. Anaplasma DNA was detected in five of the 88 pools (5.68%), E. canis DNA was detected in 19 of the 88 pools (21.59%), and E. chaffeensis DNA was detected in one of the 88 pools (1.14%) of R. bursa ticks. To our knowledge, this is the first report describing the presence of A. ovis, E. canis, and E. chaffeensis in R. bursa ticks collected from sheep in Turkey. Further studies are needed to investigate other co-infections in sheep in Turkey.

Comparison of ultra-congruent anterior-stabilized vs. a posterior cruciate substituting total knee arthroplasty for osteoarthritis with severe varus knee deformity: comparable 2 year outcomes with two design.

OBJECTIVE: In this retrospective study, we compared the functionality and clinical outcomes of patients with severe varus knees who underwent total knee arthroplasty (TKA) that used prostheses with either a posterior stabilized (PS) design or an ultra-congruent (UC) design. PATIENTS AND METHODS: Primary TKA was performed in 161 patients; the UC device was used in 82 (51%) cases and the PS device in 79 (49%). Preoperatively and at the final follow-up examination, all patients were evaluated by orthoroentgenography. The mechanical axis angle and radiolucent lines were evaluated according to the Knee Society Roentgenographic Evaluation System on preoperative and 5-year follow-up radiographs. Total Knee Society Score (KSS) (knee score/function score) and Visual Analog Scale scores were obtained at the final follow-up examination. Demographic and surgical data and revision rates were evaluated for all patients. RESULTS: Postoperative angle values were significantly decreased in both the UC and PS groups (p<0.001 and p<0.001, respectively). Postoperative flexion range of motion values were significantly increased in both the UC and PS groups (p<0.001 and p<0.001, respectively). The postoperative KSS function scores were not significantly different between the groups (p=0.194). The mean surgical time of the PS group (54.99±4.18 minutes) was significantly higher than that of the UC group (46.02±4.48 minutes) (p<0.001). CONCLUSIONS: No notable differences were found between the UC and PS groups with respect to the clinical and functional parameters examined. Based on these results, UC TKA can be considered a safe alternative to PS TKA in severe varus knees.

Use of the Deniz™ rigid stone basket for treating ureteral calculi.

OBJECTIVE: Advancements in ureteroscope and stone basket design have introduced ureteroscopy to the forefront of surgical stone management. However, different issues, such as stone migration and ureteral injury, remain a challenge among urologists. The Deniz™ rigid stone basket is a patented product (patent number: TR 2016 00421 Y) manufactured in Turkey. Herein, we report our initial experience with the Deniz™ rigid stone basket for managing urinary calculi and compare the use of this device with other methods to optimize ureteroscopic stone management. PATIENTS AND METHODS: Fifty patients undergoing ureteroscopic laser lithotripsy for urinary calculi were retrospectively evaluated by two surgeons. The Deniz™ rigid stone basket was utilized to prevent retrograde ureteral stone migration or to facilitate fragmentation and extraction of ureteral calculi. RESULTS: In total, 29 men and 21 women, with a mean age of 46.5 (range: 21-69) years, were treated for upper (n = 30), medium (n = 7), and lower (n = 13) ureter calculi. The mean stone diameter was 13.08 (range: 7-22) mm; the mean operative time, 46 (range: 20-80) min; the mean energy utilization, 2.98 (range: 1.5-3.5) kJ; and the mean laser frequency, 6.96 (range: 6-12) hz. None of the patients developed complications, and 46 (92%) patients who underwent ureteroscopic laser lithotripsy using the Deniz™ rigid stone basket were declared stone-free. Four patients had residual stones measuring < 3 mm on post-operative imaging. CONCLUSIONS: The Deniz™ rigid stone basket is safe and effective for preventing stone migration and facilitating ureteroscopic laser lithotripsy procedure and stone extraction.

Minimally invasive implantation of a novel flexible intramedullary nail in patients with displaced midshaft clavicle fractures.

PURPOSE: We report our initial experiences with use of a new technique we developed for implantation of Sonoma Crx intramedullary rod in patients with displaced clavicle fractures. METHODS: A total of 35 patients (mean age 41.82 ± 13.65, male:female ratio = 21:14) having Robinson Types 1b, 2b and 3b displaced midshaft fractures with >2 cm clavicle shortening were included into the study. A single small incision (~1 cm) was made over the anteromedial aspect of the involved clavicle and an appropriate sized intramedullary nail was inserted in reverse (mirror) configuration of that has been suggested by the manufacturer. Functional assessment was made using Constant shoulder and disability of the arm shoulder and hand scoring. RESULTS: Mean time of operation was 51.20 ± 10.56 min and mean time of fluoroscopy was 2.33 ± 1.12 min. One patient had implant failure 2 months after the operation and was revised to a new implant. Superficial or deep wound infection, hematoma, neurovascular complication, substance irritation or implant failure did not occur. Follow-up ranged from 12 to 45 months (mean 28.5 ± 9.95 months). At the latest follow-up, mean Constant shoulder score was 93.14 ± 4.06 (ranging from 84.00 to 100.00) and mean disability of the arm shoulder and hand score was 3.68 ± 1.73 (ranging from 0.0 to 6.80). CONCLUSION: The technique we described herein provided successful procedural outcomes, eliminated the need for deep dissection of the fracture site and reduced the operation time. Further study on larger populations is warranted to confirm these findings.