Results of Allografts and Synthetic Grafts in Humeral Simple Bone Cysts.

PURPOSE OF THE STUDY: Simple bone cysts (SBCs) are the most common benign bone lesions in childhood. There are many different methods in the treatment of SBCs. There is no consensus on which method to use in the treatment. In this study, we compared the results of allogeneic bone graft or synthetic bone graft in addition to fl exible intramedullary nail (FIN) for SBC located in the humerus. MATERIAL AND METHODS: This retrospective study comparing the data of 19 (group 1: 8 curettage, allograft and FIN; group 2: 11 curettage, synthetic graft and FIN) patients with a mean age of 11.4 (6 to 26; seven female, twelve male) who were surgically treated in our hospital for humeral SBC between April 2014 and January 2020. Patient data included age, sex, anatomical side, stage of the cyst, pathological fracture, previous treatments and complications. RESULTS: The mean follow-up period was 33.7 months (12 to 61). The average last follow-up Musculoskeletal Tumor Society functional scores for groups 1 and 2 were 27.8 (20 to 30) and 28.6 (21 to 30) (P > 0.05). Complete or signifi cant partial radiographic healing rates were achieved in group 1 (75%) compared with group 2 (81.9%). The reoperation rates for groups 1 and 2 were 62.5% (5/8; three for nails removed, two for recurrence) and 36.3% (4/11; two for nails removed, two for recurrence). One patient in group 2 had a 15° varus deformity due to recurrence. No other complications were observed. CONCLUSIONS: The combination of curettage-grafonage FIN is a common treatment method in recent years, as it provides early cyst healing and limb mobilization in SBCs located in the upper extremity. For defects after curettage of the bone cysts, allogeneic or synthetic grafts (granule b-tricalcium phospate) which have similar results in terms of healing can be used as an alternative to each other. KEY WORDS: allografts, bone cysts, bone nails, synthetic grafts, humerus.

Effects of cardiac rehabilitation on obese hypertensive patients: A controlled trial / Efectos de la rehabilitación cardíaca en pacientes hipertensos obesos: un ensayo controlado

Introduction: The relationship between obesity and hypertension is clearly known and cardiac rehabilitation (CR) is shown as an effective treatment method in both obese and hypertensive patients. The aim of this study is to reveal the effect of CR on obese hypertensive patients by comparing them with non-obese hypertensive patients. Methods: Eighty eligible, volunteer participants with hypertension (SBP ≥140mmHg and/or DBP ≥90mmHg) were enrolled in this study. The patients were divided into 2 groups according to their BMI values: obese (BMI ≥30kg/m2) hypertensive patients and non-obese (BMI <30kg/m2) hypertensive patients. The CR program, in which aerobic exercise training was the main part, was performed on the patients. At the end of the 10-week CR program, the resting SBP and DBP values were measured. Results: A total of 74 patients (37 obese and 37 non-obese) completed the study. After CR significant improvements were achieved in all evaluated parameters compared to pre-CR values. When the amounts of changes before and after CR were compared, the decrease in SBP was found to be significantly higher in obese patients compared to non-obese patients (p=.003). Higher BMI was associated with more reduction in SBP (r=0.287, p=0.013). Conclusions: Exercise-based CR effectively reduced SBP in obese and non-obese hypertensive patients. However, it was more effective in obese patients compared to non-obese patients. (AU)

Introducción: La relación entre obesidad e hipertensión es claramente conocida y la rehabilitación cardiaca (RC) se muestra como un método de tratamiento eficaz tanto en pacientes obesos como hipertensos. El objetivo de este estudio es revelar el efecto de la RC en pacientes hipertensos obesos comparándolos con pacientes hipertensos no obesos. Métodos: Ochenta participantes voluntarios elegibles con hipertensión (PAS≥140mmHg y/o PAD≥90mmHg) se inscribieron en este estudio. Los pacientes se dividieron en 2 grupos según sus valores de IMC: pacientes hipertensos obesos (IMC≥30kg/m2) y pacientes hipertensos no obesos (IMC<30kg/m2). A los pacientes se les realizó el programa RC, en el que el entrenamiento con ejercicios aeróbicos fue la parte principal. Al final del programa RC de 10 semanas, se midieron los valores de PAS y PAD en reposo. Resultados: Un total de 74 pacientes (37 obesos y 37 no obesos) completaron el estudio. Después de RC, se lograron mejoras significativas en todos los parámetros evaluados en comparación con los valores previos a RC. Cuando se comparó la cantidad de cambios antes y después de la RC, se encontró que la disminución de la PAS fue significativamente mayor en pacientes obesos en comparación con pacientes no obesos (p=0,003). Un IMC más alto se asoció con una mayor reducción de la PAS (r=0,287; p=0,013). Conclusiones: La RC redujo efectivamente la PAS en pacientes hipertensos obesos y no obesos. Sin embargo, fue más efectivo en pacientes obesos en comparación con pacientes no obesos. (AU)

Effects of cardiac rehabilitation on obese hypertensive patients: A controlled trial.

INTRODUCTION: The relationship between obesity and hypertension is clearly known and cardiac rehabilitation (CR) is shown as an effective treatment method in both obese and hypertensive patients. The aim of this study is to reveal the effect of CR on obese hypertensive patients by comparing them with non-obese hypertensive patients. METHODS: Eighty eligible, volunteer participants with hypertension (SBP ≥140mmHg and/or DBP ≥90mmHg) were enrolled in this study. The patients were divided into 2 groups according to their BMI values: obese (BMI ≥30kg/m2) hypertensive patients and non-obese (BMI <30kg/m2) hypertensive patients. The CR program, in which aerobic exercise training was the main part, was performed on the patients. At the end of the 10-week CR program, the resting SBP and DBP values were measured. RESULTS: A total of 74 patients (37 obese and 37 non-obese) completed the study. After CR significant improvements were achieved in all evaluated parameters compared to pre-CR values. When the amounts of changes before and after CR were compared, the decrease in SBP was found to be significantly higher in obese patients compared to non-obese patients (p=.003). Higher BMI was associated with more reduction in SBP (r=0.287, p=0.013). CONCLUSIONS: Exercise-based CR effectively reduced SBP in obese and non-obese hypertensive patients. However, it was more effective in obese patients compared to non-obese patients.

Inflammatory markers and neopterin levels in relation to mild COVID-19.

OBJECTIVE: The immunopathology of acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection involves an excessive inflammatory response. Approximately 80% of patients with coronavirus disease 2019 (COVID-19) have a mild illness, 20% require hospitalization, and approximately 5% require intensive care. Neopterin is a macrophage activation marker produced by monocytes and macrophages following activation by interferon-gamma (IFN-γ). It is crucial to determine neopterin levels and evaluate them together with inflammatory, coagulation, and biochemical markers in moderate/mild SARS-CoV-2 infection. PATIENTS AND METHODS: The present study compared plasma neopterin and inflammatory as well as biochemical markers of 50 patients with COVID-19 and 38 healthy volunteers without COVID-19. RESULTS: The data of 38 participants did not show statistically significant differences in serum neopterin levels between the mild/moderate COVID-19 and control groups (p=0.259). White blood cell (WBC), neutrophil, lymphocyte, platelet (PLT), hemoglobin (HGB), procalcitonin (PCT), ferritin, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR) and lymphocyte CRP ratio (LCR) values were significantly different between the study groups (p<0.001, p=0.001, p=0.001, p<0.001, p=0.014, p<0.001, p=0.001, p<0.001, p=0.004, p<0.001, p<0.001, respectively). According to the ROC analysis, the WBC, PT, Na, and LCR values exceeding the cutoff values may be predictive of COVID-19. CONCLUSIONS: Although there were no significant differences in serum neopterin levels between the groups, there were high values in patients with severe SARS-CoV-2 infection in previous studies and these values were maintained for a long time. The present study found that neopterin levels were not elevated in mild/moderate COVID-19 patients.

Prevalence of neonatal calf diarrhea caused by Escherichia coli and investigation of virulence factors, serotypes, and antibiotic susceptibility.

Neonatal calf diarrhea (NCD) is one of the most important concerns in cattle production. Escherichia coli is the most important bacterial agent of NCD. Although vaccination and antibiotic treatment are common in NCD, the high antigenic diversity of E. coli and the increase in antibiotic resistance cause difficulties in the control. The study aimed to investigate the rate of E. coli in calf diarrhea, isolate an agent of the NCD E. coli strain, determine antimicrobial resistance, and find out about some surface antigens. Fecal samples (n=115) were analyzed to isolate pathogenic E. coli strains with nine mixed infections; sixty-one strains isolate from fifty diarrhoeic calves. Among the isolates from diseased animals, 22 K99+STa+F41, 3 K99+STa, 3 strains F41, 2 strains Stx1, one strain K99, one strain eae, and one strain Stx2+eae were detected. 27 strains of F17- associated fimbriae have been identified. 17 strains F17a, 6 strains F111, 3 strains F17c, one strain carrying the F17a and F17c gene regions, whereas subfamily typing of one strain could not be performed. Serotypes were determined by molecular and serological methods: 32/61 (52.5%) isolates were O101 and 2/61 (3.3%) isolates were O9 serotypes. But 27 strain serotypes could not be detected. The antibiotic resistance profiles of the isolates were determined by the disc diffusion method. The resistance rates to antibiotics were trimethoprim- sulphamethoxazole 91.7%, ampicillin 86.7%, enrofloxacin 86.7%, gentamicin 45%, tobramycin 41.7%, cefotaxime 3.3%, and ceftazidime 1.7%. Due to increasing antibiotic resistance, prophylaxis is gaining importance. In further research, E. coli surface antigenic structures should be examined in detail, and it should form the basis for vaccine and hyperimmunization studies to be developed.

Evaluation of the relationship between speckle tracking echocardiography and arrhythmia markers Tp-e interval and Tp-e/QTc in patients with arterial hypertension.

OBJECTIVE: The prolongation of the Tp-e interval, which is defined as the interval from the peak to the end of the T wave on electrocardiography (ECG), is considered a non-invasive predictor of malignant ventricular arrhythmia development. In our study, we aimed to compare the Tp-e interval and Tp-e/QTc ratios on ECG and subclinical myocardial dysfunction evaluated by left ventricular global longitudinal strain (LV-GLS) imaging in patients receiving treatment for hypertension. PATIENTS AND METHODS: Two-dimensional speckle tracking echocardiography was performed in 102 consecutive hypertensive patients with blood pressure values regulated by treatment. The normal left ventricular global longitudinal strain (LV-GLS) limit was accepted as < -18%. The patients were divided into two groups: those with normal (≥ -18%) LV-GLS and those with impaired LV-GLS (< -18%). Comparisons between the groups were made by measuring ventricular repolarization parameters, such as QT, QTc, and Tp-e intervals, and Tp-e/QT and Tp-e/QTc ratios. RESULTS: While the mean age of the patients with impaired LV-GLS was 55±6 years, the mean age of the normal LV-GLS group was 58±9 years (p=0.101). The Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were significantly higher in the impaired LV-GLS group than in the normal LV-GLS group (p<0.05 for all). A positive correlation was observed between the ventricular repolarization parameters and LV-GLS values. This positive correlation was statistically significant in terms of the Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios. CONCLUSIONS: The Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were increased in hypertensive patients with impaired LV-GLS, and therefore a close follow-up in terms of increased arrhythmia risk is required in this patient group.

Detection and classification of COVID-19 by using faster R-CNN and mask R-CNN on CT images.

The coronavirus (COVID-19) pandemic has a devastating impact on people's daily lives and healthcare systems. The rapid spread of this virus should be stopped by early detection of infected patients through efficient screening. Artificial intelligence techniques are used for accurate disease detection in computed tomography (CT) images. This article aims to develop a process that can accurately diagnose COVID-19 using deep learning techniques on CT images. Using CT images collected from Yozgat Bozok University, the presented method begins with the creation of an original dataset, which includes 4000 CT images. The faster R-CNN and mask R-CNN methods are presented for this purpose in order to train and test the dataset to categorize patients with COVID-19 and pneumonia infections. In this study, the results are compared using VGG-16 for faster R-CNN model and ResNet-50 and ResNet-101 backbones for mask R-CNN. The faster R-CNN model used in the study has an accuracy rate of 93.86%, and the ROI (region of interest) classification loss is 0.061 per ROI. At the conclusion of the final training, the mask R-CNN model generates mAP (mean average precision) values for ResNet-50 and ResNet-101, respectively, of 97.72% and 95.65%. The results for five folds are obtained by applying the cross-validation to the methods used. With training, our model performs better than the industry standard baselines and can help with automated COVID-19 severity quantification in CT images.

Evaluation of maternal serum and umbilical cord brain-derived neurotrophic factor (BDNF) levels in COVID-19-infected pregnancies.

OBJECTIVE: COVID-19 is a disease that affects and damages the neurological system. The aim of this study was to evaluate the fetal neurodevelopmental status through maternal serum and umbilical cord BDNF levels. PATIENTS AND METHODS: In this prospective study, 88 pregnant women were evaluated. Demographic and peripartum characteristics of the patients were recorded. Samples were collected from pregnant women for maternal serum and the umbilical cord BDNF levels during delivery. RESULTS: In this study, 40 pregnant women hospitalized with COVID-19 formed the infected group and 48 pregnant women without COVID-19 formed the healthy control group. Demographic and postpartum characteristics were similar in both groups. Maternal serum BDNF values were significantly lower in the COVID-19 infected group (1597.0 ± 337.3 pg/ml) than in the healthy group (1783.2 ± 394.1 pg/ml) (p=0.019). Fetal BDNF levels were 1794.9 ± 440.3 pg/ml in the healthy group and 1691.0 ± 368.6 pg/ml in COVID-19 infected pregnant women group and statistically similar between groups (p=0.232). CONCLUSIONS: Results showed that while maternal serum BDNF levels decreased in the presence of COVID-19, there was no difference in umbilical cord BDNF levels. This may be an indication that the fetus is not affected and is protected.

A rare disease: a single-center experience of cerebral alveolar echinococcosis in 12 operated patients.

OBJECTIVE: In this study, we have evaluated 12 patients with cerebral alveolar echinococcosis (AE). All patients underwent surgery for cerebral AE. We aimed to demonstrate the relationship between the demographic properties of patients and surgical outcomes as well as surgical suggestions about surgical approaches. PATIENTS AND METHODS: Patients were analyzed according to demographic properties, hepatic/ pulmonary AE lesion existence, symptoms, neurological and radiological examination, histopathological findings, and outcome after treatment. RESULTS: Preoperative diagnosis based on the history of the patient, neurological examination, serological tests, and radiology. When enhanced radiological imaging like MR-Tractography and intraoperative neuromonitoring is combined with precision surgical methods cerebral AE is treatable. Ten of twelve cerebral AE patients had favorable outcomes after surgery. CONCLUSIONS: AE of the brain is a rare but life-threatening parasitic disease. Wherever the primary focus is, surgery for cerebral involvement of AE is challenging but safe with appropriate surgical techniques and the help of radiological examination.

Assessment of silicon, glass, FR4, PDMS and PMMA as a chip material for acoustic particle/cell manipulation in microfluidics.

In the present study, the capabilities of different chip materials for acoustic particle manipulation have been assessed with the same microfluidic device architecture, under the same actuator and flow conditions. Silicon, glass, epoxy with fiberglass filling (FR4), polydimethylsiloxane (PDMS) and polymethyl methacrylate (PMMA) are considered as chip materials. The acoustophoretic chips in this study were manufactured with four different fabrication methods: plasma etching, chemical etching, micromachining and molding. A novel chip material, FR4, has been employed as a microfluidic chip material in acoustophoretic particle manipulation for the first time in literature, which combines the ease of manufacturing of polymer materials with improved acoustic performance. The acoustic particle manipulation performance is evaluated through acoustophoretic focusing experiments with 2µm and 12µm polystyrene microspheres and cultured breast cancer cell line (MDA-MB-231). Unlike the common approach in the literature, the piezoelectric materials were actuated with partitioned cross-polarized electrodes which allowed effective actuation of different family of chip materials. Different from previous studies, this study evaluates the performance of each acoustophoretic device through the perspective of synchronization of electrical, vibrational and acoustical resonances, considers the thermal performance of the chip materials with their effects on cell viability as well as manufacturability and scalability of their fabrication methods. We believe our study is an essential work towards the commercialization of acoustophoretic devices since it brings a critical understanding of the effect of chip material on device performance as well as the cost of achieving that performance.

Thoracic benign cystic mesothelioma.

BACKGROUND: Benign cystic mesotheliomas (BCMs), also known as multilocular mesothelial inclusion cysts, inflammatory inclusion cysts or multicystic mesothelial proliferation, are frequently observed in females and are localised localised in the pelvic peritoneum. They are rarely present in the thoracic and mediastinal areas; however, these locations have been reported in a few cases in the literature. CASE PRESENTATION: We present the case of a woman with an intrathoracic BCM. A 28-year-old female patient presented with a cystic mass of 8 × 6 × 6 cm in the left hemithorax shown by computed tomography of the thorax. The patient underwent cystic mass excision with video-assisted thoracoscopic surgery (VATS), which was completed without complications. The diagnosis was confirmed histopathologically after the surgical resection. CONCLUSIONS: Due to BCMs' non-specific clinical symptoms and radiological imaging, preoperative diagnosis is difficult, and they are often confused with pericardial cysts. There is no standard treatment protocol; however, VATS and en bloc resection are the most frequently used treatment options for mediastinal localization. Since these lesions slow proliferation rates have the potential for local recurrence and low malignant transformation, close follow-up is recommended. In this case report, we aimed to present a rare BCM case with intrathoracic paracardiac localization was completely excised through VATS. No recurrence has been detected in three years of follow-up.

Cerebrovascular radiological features of COVID-19 positive patients.

OBJECTIVE: To investigate acute cerebrovascular diseases (stroke and intracranial hemorrhage) by cranial radiologic examinations of patients infected with coronavirus disease 2019 (COVID-19) and with neurological signs. PATIENTS AND METHODS: Between March 2020 and May 2021, patients who were admitted to the Emergency Department and had a positive reverse transcription-polymerase chain reaction (RT-PCR) test and underwent Multidetector Computed Tomography (MDCT) and/or Magnetic Resonance Images (MRI), and/or diffusion MRI due to neurological findings were included in the study. RESULTS: The study reviewed a total of 925 patients, including 404 (43.67%) female and 521 (56.32%) male patients. The distribution of imaging methods was as follows: 805 (71%) patients had cranial MDCT, 71 (6.35%) patients had MRI, and 241 (21.57%) patients had diffusion MRI. Of the total 925 patients, 128 (13.8%) patients were detected with cerebrovascular diseases, 92 (9.9%) patients were detected with ischemic or hemorrhagic stroke, 37 (4%) patients were detected with intraparenchymal hemorrhage, 10 (1.1%) patients were detected with subarachnoid hemorrhage, and four (0.43%) patients were detected with subdural hemorrhage. There was no statistically significant difference in the incidence of subdural, subarachnoid, parenchymal hemorrhage, and stroke in terms of gender. While there was a significant difference in stroke according to age, there was no statistically significant difference in subdural, subarachnoid, and parenchymal hemorrhagic. Three (0.32%) patients were diagnosed with acute disseminated encephalomyelitis (ADEM)'s-like demyelinating lesions. CONCLUSIONS: Cerebrovascular diseases, which may cause severe disability and even threaten the patient's life, should be kept in mind, especially in COVID-19 patients who present with neurological symptoms.

Isolation and characterization of thermophilic Campylobacter species from geese raised in Kars region (Turkey) using cultural, molecular and mass spectrometry methods.

Background: Thermophilic Campylobacters are found in the digestive tract of wild and domestic poultry and can be transmitted to humans following their fecal discharges. Aims: This study aimed to isolate thermophilic Campylobacter by culture from cloacal swabs of geese, commonly breeding in Kars region, and to identify the isolates by PCR and mass spectrometry. Antibiotics susceptibility and resistance genes of the isolates were also analysed. Methods: The study included 400 cloacal swab samples of clinically healthy geese. The samples were cultured on mCCDA medium following the pre-enrichment in Preston broth. Identification of the isolates was performed by phenotypic methods, PCR, and MALDI-TOF MS. Antibiotic susceptibility and resistance genes of the isolates were analysed with the disc diffusion method and PCR, respectively. Results: Thermophilic Campylobacter spp. were isolated from 157 (39.3%) samples. 151 (96.2%) isolates were identified Campylobacter jejuni and 6 (3.8%) Campylobacter coli by the phenotypic tests and PCR. Among 125 isolates analysed by MALDI-TOF MS, 119 (95.2%) were identified C. jejuni and 6 (4.8%) C. coli. The isolates' resistance to ampicillin, tetracycline, ciprofloxacin, gentamicin, and azithromycin were found 33.8%, 41.4%, 75.2%, 12.1%, and 7.6%, respectively. The distributions of bla OXA61, tetO, gyrA, and aphA-3 genes were 3.2%, 90.8%, 50.8%, and 52.7%, respectively. Conclusion: Since geese are raised in pastures in the Kars region, protecting and not polluting the existing natural environment and preventing their contact with wild birds will prevent the spread of these microorganisms.

Deep learning-based approach for detecting COVID-19 in chest X-rays.

Today, 2019 Coronavirus (COVID-19) infections are a major health concern worldwide. Therefore, detecting COVID-19 in X-ray images is crucial for diagnosis, evaluation, and treatment. Furthermore, expressing diagnostic uncertainty in a report is a challenging duty but unavoidable task for radiologists. This study proposes a novel CNN (Convolutional Neural Network) model for automatic COVID-19 identification utilizing chest X-ray images. The proposed CNN model is designed to be a reliable diagnostic tool for two-class categorization (COVID and Normal). In addition to the proposed model, different architectures, including the pre-trained MobileNetv2 and ResNet50 models, are evaluated for this COVID-19 dataset (13,824 X-ray images) and our suggested model is compared to these existing COVID-19 detection algorithms in terms of accuracy. Experimental results show that our proposed model identifies patients with COVID-19 disease with 96.71 percent accuracy, 91.89 percent F1-score. Our proposed approach CNN's experimental results show that it outperforms the most advanced algorithms currently available. This model can assist clinicians in making informed judgments on how to diagnose COVID-19, as well as make test kits more accessible.

Rapidly Progressive Pulmonary Kaposi Sarcoma After Bilateral Sequential Lung Transplant: A Case Report.

Skin cancers are among the rarely seen complications after solid-organ transplant. Kaposi sarcoma invasion to an allograft is an uncommon condition. In this study, we present a case of Kaposi sarcoma in a 58-year-old patient diagnosed at 8 months after bilateral sequential lung transplant due to chronic obstructive pulmonary disease. Kaposi sarcoma showed rapid progression despite immunosuppressive drug modification, resulting in lung involvement and respiratory failure. Rapid and complete improvement was achieved with rapid diagnosis and aggressive treatment that included combined chemotherapy after surgery. The patient presented with no complications from Kaposi sarcoma at month 26 after transplant.

No association of anti-osteoporosis drugs with COVID-19-related outcomes in women: a nationwide cohort study.

This study was performed to evaluate whether the use of drugs in the treatment of osteoporosis in women is associated with COVID-19 outcomes. The results showed that the risk of hospitalization, intensive care unit admission, and mortality was not altered in individuals taking anti-osteoporosis drugs, suggesting no safety issues during a COVID-19 infection. INTRODUCTION: Whether patients with COVID-19 receiving anti-osteoporosis drugs have lower risk of worse outcomes has not been reported yet. The aim of this study was to evaluate the association of anti-osteoporosis drug use with COVID-19 outcomes in women. METHODS: Data obtained from a nationwide, multicenter, retrospective cohort of patients diagnosed with COVID-19 from March 11th to May 30th, 2020 was retrieved from the Turkish Ministry of Health Database. Women 50 years or older with confirmed COVID-19 who were receiving anti-osteoporosis drugs were compared with a 1:1 propensity score-matched COVID-19 positive women who were not receiving these drugs. The primary outcomes were hospitalization, ICU (intensive care unit) admission, and mortality. RESULTS: A total of 1997 women on anti-osteoporosis drugs and 1997 control patients were analyzed. In the treatment group, 1787 (89.5%) women were receiving bisphosphonates, 197 (9.9%) denosumab, and 17 (0.9%) teriparatide for the last 12 months. Hospitalization and mortality rates were similar between the treatment and control groups. ICU admission rate was lower in the treatment group (23.0% vs 27.0%, p = 0.013). However, multivariate analysis showed that anti-osteoporosis drug use was not an independent associate of any outcome. Hospitalization, ICU admission, and mortality rates were similar among bisphosphonate, denosumab, or teriparatide users. CONCLUSION: Results of this nationwide study showed that preexisting use of anti-osteoporosis drugs in women did not alter the COVID-19-related risk of hospitalization, ICU admission, and mortality. These results do not suggest discontinuation of these drugs during a COVID-19 infection.

A tissue-bioengineering strategy for modeling rare human kidney diseases in vivo.

The lack of animal models for some human diseases precludes our understanding of disease mechanisms and our ability to test prospective therapies in vivo. Generation of kidney organoids from Tuberous Sclerosis Complex (TSC) patient-derived-hiPSCs allows us to recapitulate a rare kidney tumor called angiomyolipoma (AML). Organoids derived from TSC2-/- hiPSCs but not from isogenic TSC2+/- or TSC2+/+ hiPSCs share a common transcriptional signature and a myomelanocytic cell phenotype with kidney AMLs, and develop epithelial cysts, replicating two major TSC-associated kidney lesions driven by genetic mechanisms that cannot be consistently recapitulated with transgenic mice. Transplantation of multiple TSC2-/- renal organoids into the kidneys of immunodeficient rats allows us to model AML in vivo for the study of tumor mechanisms, and to test the efficacy of rapamycin-loaded nanoparticles as an approach to rapidly ablate AMLs. Collectively, our experimental approaches represent an innovative and scalable tissue-bioengineering strategy for modeling rare kidney disease in vivo.

Factors affecting Baker cyst volume, with emphasis on cartilage lesion degree and effusion in the young and middle-aged population.

BACKGROUND: The principal aim of this study was to investigate the presence of factors affecting Baker's cyst volume in young and middle-aged populations. METHODS: Open cyst excision with valve and capsule repair, as well as knee arthroscopy, were used to treat eighty-five patients. The cases were categorized in terms of age, effusion, chondral lesion degree, meniscal tear degree, and Lindgren scores. An ultrasonography (USG) device was used to calculate the cyst volume. The IBM-SPSS 22 program was used for statistical analysis and to assess the relationships between variables using Spearman's correlation tests. RESULTS: The degree of chondral lesion was moderately and positively correlated with cyst volume in the total population (correlation coefficient: 0.469; p < 0.05). The degree of the chondral lesion was moderately and positively correlated with the degree of effusion (correlation coefficient: 0.492; p < 0.005). The cyst volume was weakly and positively correlated with the degree of effusion (correlation coefficient: 0.20; the correlation was at the limits of statistical significance p = 0.07 < 0.08). CONCLUSIONS: This study revealed that an increase in chondral lesion severity increases the amount of effusion and cyst volume.

Headache service quality evaluation: implementation of quality indicators in primary care in Europe.

BACKGROUND: Lifting The Burden (LTB) and European Headache Federation (EHF) have developed a set of headache service quality indicators, successfully tested in specialist headache centres. Their intended application includes all levels of care. Here we assess their implementation in primary care. METHODS: We included 28 primary-care clinics in Germany (4), Turkey (4), Latvia (5) and Portugal (15). To implement the indicators, we interviewed 111 doctors, 92 nurses and medical assistants, 70 secretaries, 27 service managers and 493 patients, using the questionnaires developed by LTB and EHF. In addition, we evaluated 675 patients' records. Enquiries were in nine domains: diagnosis, individualized management, referral pathways, patient education and reassurance, convenience and comfort, patient satisfaction, equity and efficiency of headache care, outcome assessment and safety. RESULTS: The principal finding was that Implementation proved feasible and practical in primary care. In the process, we identified significant quality deficits. Almost everywhere, histories of headache, especially temporal profiles, were captured and/or assessed inaccurately. A substantial proportion (20%) of patients received non-specific ICD codes such as R51 ("headache") rather than specific headache diagnoses. Headache-related disability and quality of life were not part of routine clinical enquiry. Headache diaries and calendars were not in use. Waiting times were long (e.g., about 60 min in Germany). Nevertheless, most patients (> 85%) expressed satisfaction with their care. Almost all the participating clinics provided equitable and easy access to treatment, and follow-up for most headache patients, without unnecessary barriers. CONCLUSIONS: The study demonstrated that headache service quality indicators can be used in primary care, proving both practical and fit for purpose. It also uncovered quality deficits leading to suboptimal treatment, often due to a lack of knowledge among the general practitioners. There were failures of process also. These findings signal the need for additional training in headache diagnosis and management in primary care, where most headache patients are necessarily treated. More generally, they underline the importance of headache service quality evaluation in primary care, not only to identify-quality failings but also to guide improvements. This study also demonstrated that patients' satisfaction is not, on its own, a good indicator of service quality.