The ovarian cancers in geriatric population: the validity of inflammatory markers, malignancy risk indices 1, 2, 3, 4, and CA-125 levels in malignancy discrimination of adnexal masses.

PURPOSE: To investigate the predictive value of the Risk of Malignancy Index (RMI), CA-125, and inflammatory markers in discriminating ovarian cancers (OCs). MATERIALS AND METHODS: The postmenopausal (PM) women (n= 139) with adnexal masses who un- derwent surgery were included. The predictive value of CA-125, RMI (1, 2,3, and 4) and inflammatory markers [neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR)] were calculated in geriatric (G) and non-geriatric women. RESULTS: OCs had significantly increased NLR and PLR. RMI models were highly reliable in PM (Kappa: 0.642-0.715; AUC: 0.907-0.934). CA-125 measurement alone had good accuracy and moderate reliability in PM (kappa: 0.507-0.587), excellent accuracy and moderate reliability in G, NLR, and PLR predicting OCs, showed fair agreement in the PM, while PLR had a moderate agreement with G. CONCLUSION: RMI algorithms were the best models for malignancy prediction. However, the rise of PLR and CA-125 levels in a G population may be used as refer- ring adnexal masses to gynecologic oncologists.

Abdominal wall endometriosis in the cesarean section surgical scar: a potential diagnostic pitfall.

AIM: The abdominal wall is an uncommon site of extrapelvic endometriosis. It usually develops in a previous surgical scar and should be considered in the differential diagnosis of any abdominal swelling. Classical symptoms of endometriosis may resemble abdominal wall lesions such as an incisional hernia, hematoma, granuloma, abscess or various soft tissue tumors; therefore, a definitive preoperative diagnosis is not always easy to determine in every case. The aim of this article is to review the clinical findings, imaging results and histopathology of those of our patients who have had cesarean scar endometriosis. METHODS: Patients diagnosed with abdominal wall endometriosis in their surgical scars from February 2008 to March 2010 were documented. The age, parity, symptoms, previous surgeries, initial diagnosis, diagnostic modalities, definitive operation, postoperative complications, histopathological evaluations and recurrences were recorded and analyzed. RESULTS: There were 18 patients with a mean age of 34.5 ± 9.6 years. All (100%) had a gradually growing nodular abdominal mass in or adjacent to their cesarean incision scars. This was often associated with pain (83.3%), either noncyclical (26.6%) or cyclical (73.3%) in nature. Ultrasonography (100%), computerized tomography with intravenous contrast (22.2%) and/or magnetic resonance imaging (66.6%) were performed on the patients. All patients underwent surgery and their masses were completely excised. The mean diameter of the removed masses was 3.9 ± 1.4 cm. The final pathological diagnosis for each case was abdominal wall endometriosis. Biannual follow-up examinations for two years revealed that each patient had a complete and uneventful recovery without recurrence. CONCLUSION: Abdominal wall endometriosis should be considered in the differential diagnosis of masses located at cesarean section incision scars, which should be excised for definitive diagnosis and treatment.

Opinions of American and Swedish orthodontists about the role of erupting third molars as a cause of dental crowding.

OBJECTIVE: To compare the opinions of Swedish orthodontists and American orthodontists regarding the association between third molar eruption and dental crowding. MATERIALS AND METHODS: A survey was distributed to Swedish orthodontists (n = 230) asking their views on the force exerted by erupting third molars, its relationship to crowding, and their recommendations for prophylactic removal. Results were compared with those from a similar study conducted in the United States. Chi square analysis was used to determine differences in responses to questions between Swedish and American orthodontists. P < or = .05 was considered significant. RESULTS: Both Swedish and American orthodontists believed that lower third molars were more likely than upper third molars to cause force (65% and 58% for Swedish and American orthodontists, respectively) and crowding (42% and 40%, respectively). No statistically significant differences were seen between the answers of American and Swedish orthodontists regarding the role of upper and lower third molars in causing crowding. Although only 18% of Swedish orthodontists "generally" or "sometimes" recommended prophylactic removal of mandibular third molars, 36% of American orthodontists "generally" or "sometimes" recommended removal (P < .0001). CONCLUSIONS: Most orthodontists in the United States and Sweden do believe that erupting lower third molars exert an anterior force; however, they also believe that these teeth "rarely" or "never" cause crowding of the dentition. The reason that more American orthodontists recommend prophylactic removal of mandibular third molars remains unexplained.

Efficacy and acceptability of risedronate 5 mg daily compared with 35 mg once weekly for the treatment of postmenopausal osteoporosis.

OBJECTIVE: Risedronate is a bisphosphonate used in the treatment of osteoporosis. It has a strong effect in inhibiting osteoclast activity. The primary objective of this study was to evaluate the effectiveness and adverse events of two different forms of risedronate (5 mg and 35 mg) using a rapid biochemical marker for comparison of C-terminal telopeptide (CTx) type I collagen cross-links. METHODS: The study was designed at Bakirkoy Dr. Sadi Konuk Education & Research Hospital, between January and June 2004. A total of 123 postmenopausal osteoporotic women were randomly assigned in blocks of three to one of the following groups: control, risedronate 5 mg/day and risedronate 35 mg once a week. RESULTS: Of the 123 women enrolled, 103 (83.7%) completed the study. Adverse events were experienced by 53.6% in the control group, 56% in the risedronate 5 mg/day group and 53.6% in the group receiving risedronate 35 mg once per week. The most common adverse events were gastrointestinal (21.9% of subjects in group 1, 29.2% of subjects in group 2, 24.3% of subjects in group 3). The women in groups receiving risedronate either 5 mg/day and 35 mg once per week had similarly decreased levels of CTx but the control group was not as effective. CONCLUSION: The results support the hypothesis that risedronate 35 mg given once per week has the same therapeutic efficacy and safety as a daily 5 mg regimen. Taking the medicine once a week is likely to be easier and more satisfactory than the daily regimen. However, patients taking a once-a-week regimen may forget to take it due to the 7-day break without medicine.

Crystallographic characteristics of plasma-sprayed calcium phosphate coatings on Ti-6Al-4V.

The purpose of this study was to investigate the crystallographic characteristics of 3 sets of plasma-sprayed hydroxyapatite (HA) coatings prepared with different degrees of crystallinity on Ti-6Al-4V substrates. X-ray diffraction analyses were performed on the coatings to determine mean percent crystallinity, calcium phosphate phases present, average crystallite size, and residual strain. The mean percent crystallinity for the 3 sets of coatings ranged from 49 to 60%. The coatings that achieved the highest crystallinity consisted almost entirely of HA. As the coating crystallinity decreased, increasing amounts of alpha- and beta-tricalcium phosphate and tetracalcium phosphate were detected. The mean HA crystallite size for the 3 sets of coatings ranged from 0.02 to 0.05 micron. Differences in mean interplanar spacing for selected crystallographic planes of HA, compared with the pure ICDD (International Center for Diffraction Data) powder standards, implied that the coatings were in an uneven state of tensile strain.

Microstructures of plasma-sprayed hydroxyapatite-coated Ti-6Al-4V dental implants.

The purpose of this study was to investigate the microstructure of plasma-sprayed hydroxyapatite coatings and the elemental composition near the coating-substrate interface for two commercial implants, using the scanning electron microscope. Both coating surfaces and cross-sectioned specimens were examined. The results indicated that while the surface microstructures of both implants were consistent with the plasma-spraying process, the scale of the constituents was much finer for one product. In cross-section, both coatings exhibited minimal porosity and intimate contact with the titanium alloy substrate. It was found that limited interdiffusion of titanium and calcium occurred near the interface.

Evaluation of tubal patency by transvaginal sonosalpingography.

OBJECTIVE: To evaluate tubal patency by transvaginal sonosalpingography. DESIGN: Comparative study of transvaginal sonosalpingography with chromolaparoscopy in subjects with unknown tubal function. SETTING: Outpatient infertility clinic at Zeynep Kamil Maternity Hospital in Istanbul, Turkey. PATIENTS: Forty-two cases of unknown tubal function with infertility complaints were included. INTERVENTIONS: Isotonic saline was injected into the uterine cavity through a catheter. MAIN OUTCOME MEASURES: Transvaginal sonosalpingography is a safe, easy, and cost-effective procedure for screening tubal status. RESULTS: The results obtained from transvaginal sonosalpingography and laparoscopy were completely consistent for 29 cases (76.32%) and partially consistent for 8 cases (21.05%). Transvaginal sonosalpingography accurately showed patency in 26 patients and bilateral nonpatency in 3 patients. CONCLUSIONS: Transvaginal sonosalpingography, with its accuracy and safety, is a promising screening and diagnostic technique in the evaluation of tubal patency on ambulatory basis.