Operative treatment in non-emergency sports injuries: a sports medicine clinic experience.

PURPOSE: To elucidate referrals from sports medicine clinic (SMC) to orthopedics, consensus rates among physicians and surgeons on surgical need in these patients, and reasoning of the patients who refused to have surgery despite the recommendations by both groups in non-emergency sports injury patients. METHODS: We conducted a retrospective cohort analysis by using the administrative and referral records of a sports medicine clinic for the 15 months between October 2017 and January 2019. Gender, age, diagnosis, and type of sport were compared between two groups (patients referred to orthopedics vs patients treated in SMC). Agreement between orthopedics and SMC on surgical need in those patients who were referred to orthopedics was evaluated. We additionally screened the hospital archive for surgery reports of patients recommended surgery, and, if a patient did not have a surgery record, we investigated the reasons by telephone interview and categorized these reasons. RESULTS: Surgical evaluation needed for 4.7% (n = 155) of the patients. Patients referred to orthopedics were younger (median: 22.0 years), mostly male (n = 119, 76.8%), and involved in contact sports (n = 108, 69.7%) (p < 0.001 for all) compared to patients treated conservatively. Majority of the consultations were made owing to certain diagnoses such as cruciate/collateral ligament sprain (n = 70, 45.2%), meniscal tear (n = 21, 13.5%), and cartilage injuries (n = 15, 9.7%). Most of the patients diagnosed with Achilles tendon rupture (n = 2, 100%) and patellar instability (n = 13, 81.3%) were referred to surgery. Orthopedics agreed with the sports medicine physicians' opinions in most cases (n = 110, 71.0%). Thirty-four patients (30.9%) recommended surgery by the surgeon postponed/refused the treatment for various reasons or had surgery in another hospital. CONCLUSION: Most non-emergency sports injuries can be treated conservatively. Young and male patients participating in contact sports are more likely to need surgical treatment. Non-surgeon musculoskeletal health-care providers may consider referring patients to orthopedics considering the data demonstrated in this study. Nevertheless, patient's motivation to undergo an operation should be considered before referring to orthopedics.

Wattle fencing improved soil aggregate stability, organic carbon stocks and biochemical quality by restoring highly eroded mountain region soil.

Eroded bare land stabilization is important to reduce soil erosion and stimulate soil carbon (C) sequestration for improved soil biogeochemical quality in hillslope soils. This study investigated the effectiveness of wattle fencing as a bioengineering tool to improve soil stabilization, soil physico-chemical properties and soil organic C dynamics and reduce soil erodibility in the Boyabat mountain regions of Turkey with rough and over-steepened slope (50-70%). Wattle fence treatments were developed in the area of 50 ha in the spring season of 2010 and surface (0-20 cm) and subsurface soil (20-40 cm) samples were taken in Spring, 2015. Results revealed that, compared to control with bare slope, wattle fencing significantly improved some soil physico-chemical, and microbial properties and erodibility indices by increasing clay ratio, dispersion ratio and aggregate stability index in surface and subsoils. Wattle fencing enhanced plant available water contents more in surface than in subsoils. Wattle fencing also increased microbial biomass C contents by 55% and 43% in surface and subsurface soils, respectively. Soil organic C followed similar trends; however, they were indifferent between sampling depths for the control soils. Soil organic C stocks and aggregate stability index were significantly positively correlated and seemed to be better predictor of positive effects of wattle fencing on soil structural stability, erodibility and associated properties. We found positive effects of soil organic C contents on microbial biomass C and soil-water relations suggesting restoration of soil biological functions and favorable influence on soil water retention following wattle fencing. Although sparse vegetation was observed in the research area, our study emphasizes performing further research to understand the effects of wattle fencing along with afforestation with native vegetation on soil erosion rates on a long-term basis by considering the variability in edaphic and environmental factors.

Pain during walking and ascending stairs before hyaluronic acid injection was common in patients with knee osteoarthritis: a qualitative study

Background/aim: Knee osteoarthritis (OA) is a common pathology characterized by degeneration of the articular cartilage. The aim of the research was to ask patients how they decided to make the injection, what treatments they received, their complaints prior to and after the injection and how they feel at the moment, and whether they are currently exercising or not. Thus, to demonstrate the patients' outcomes with their own expression. Materials and methods: A total of 92 knee OA patients completed semistructured interviews, which included six open-ended questions. Results: A total of 92 patients (66 female, 26 male) aged between 36 and 95 years (mean 65.511.14) were included. Before the injection, the majority of the OA patients had pain complaints when walking (72.8%) and stair climbing (70.7%). One to four years after intraarticular injection, 45.2% of patients felt a decrease in their complaints. The majority of patients did not consider diet and exercise as a treatment option. In addition, almost all patients declared that they decided on hyaluronic acid injection treatment with the physician's recommendation. Conclusion: Pain during walking and stair climbing before hyaluronic acid injection was common in knee OA patients. Overall the patients felt a decrease in the symptoms after injection. Patients did not consider diet and exercise as a treatment option despite the recommendation by a physician.

Trabecular bone score of postmenopausal women is positively correlated with bone mineral density and negatively correlated with age and body mass index.

OBJECTIVE: Trabecular bone score (TBS), an indirect evaluation of skeletal microarchitecture, is calculated from dual-energy X-ray absorptiometry (DXA). This study aimed to determine the mean TBS values in healthy postmenopausal women and overall association between TBS and demographic features, bone mineral density (BMD) of the lumbar spine and femoral neck, and BMD to body mass index (BMI) ratio of the lumbar spine. METHODS: Fifty-three postmenopausal healthy women were enrolled. The BMD of the lumbar spine and femoral neck was measured by DXA. Anteroposterior lumbar spine acquisitions were used to calculate the TBS for L1 to L4. RESULTS: The mean BMD of the lumbar spine and femoral neck was 0.945 ±â€Š0.133 and 0.785 ±â€Š0.112 g/cm, respectively. The mean TBS was 1.354 ±â€Š0.107. There was a significant positive moderate correlation between TBS and total lumbar BMD to BMI ratio (r = 0.595, P < 0.001), and significant positive weak correlations between TBS and BMD of the lumbar spine (r = 0.347, P = 0.011) as well as between TBS and femoral neck (r = 0.305, P = 0.026), whereas significant negative moderate correlations were observed between TBS and age (r = -0.393, P = 0.004) as well as between TBS and BMI (r = -0.333, P = 0.015). CONCLUSIONS: TBS values of postmenopausal women were negatively correlated with age and BMI, and positively with BMD and BMD to BMI ratio.

Studies on the chorology, ecology, morphology and conservation strategies of Orchis anatolica Boiss (Orchidaceae).

Orchis anatolica Boiss. is one of the Mediterranean species, which has wide distribution in Turkey. In this study, plant and soil samples of O. anatolica were taken from 26 natural populations in Turkey. There were one hundred ninety locality records in the Mediterranean region of Turkey, but we recorded two hundred sixteen localities thus adding twenty six new localities to the list. Twenty morphological parameters of O. anatolica were evaluated. The correlation coefficients between generative characters and vegetative characters were lower than the character groups of correlation coefficients between themselves. It is found from sea level upto 1700 m. Most common habitats of O. anatolica are macchie, forest lands and stony soils. The soils are loamy, clayey- loam and sandy-clayey- loam and rich in organic matter. The pH of the soils varies from 5.87 to 7.92. Although O. anatolica has wide distribution in Turkey, different types of land uses are posing a threat for it and restricting its distributional area. Lacking the legal regulations about conservation of the O. anatolica populations is one of the most striking requirement.

Morphological, anatomical and ecological studies on some Orchis (Orchidaceae) taxa of Mediterranean region, Turkey.

In this study, nine species mainly distributed in Mediterranean (+ Aegean region) region of Turkey were investigated in terms of 15 morphological, 16 anatomical and 5 ecological characteristics. Those species are Orchis anatolica Boiss., Orchis italica Poiret, Orchis laxiflora Lam., Orchis morio L. subsp. morio, Orchis provincialis Balbis ex DC., Orchis purpurea Hudson, Orchis sancta L., Orchis simia Lam., Orchis tridentata Scop. In conclusion, we found that O. laxiflora was characterized by the longest plant height and O. purpurea had the biggest tuber; whereas O. italica was identified by the highest number of leafs and O. purpurea had the longest leaf length and widest leaf width. Additionally, the other species which were characterized by different morphological and anatomical parameters are as follow: O. sancta with the longest bract length, O. italica and O. simia with the longest sepal lengths, O. laxiflora with the shortest and widest labellum, O. simia with the longest petal length, O. sancta with longest caudiculum length, O. anatolica with the longest spur length and O. provincialis with the longest ovary length. Particularly, O. laxiflora and O. purpurea species present essential divergence from the aspect of anatomical features of leaf surface in comparison with the other species. Morphological and anatomical traits of the species were attributed to the habitat selections of the species since that character differs along with each species.

Influence of soil compaction on microfungal community structure in two soil types in Bartin Province, Turkey.

Soil compaction negatively influences physical properties of soil (bulk density and pore space), and may consequently limit soil microfungi, which are significant for nutrient bioavailability. We measured microfungal community responses to compaction in a sandy loam and a clay loam soil at picnic sites. Soil bulk density increased significantly in the compacted samples. However, microfungal numbers and community composition were unrelated to changes in soil bulk density. With increases in bulk density from 1.22 to 1.37 g cm(-3) in the clay soil and from 1.38 to 1.54 g cm(-3) in the sandy loam soil, the total number of fungi declined or showed insignificant increases. In the compacted samples as well as the control sites, the most frequently occurring genera in the clay soil were Penicillium, Aspergillus, and Gliocladium. However, the most prominent feature occurring within the sandy loam soil was the exhibition of the greatest increase in the frequency of the Fusarium genus. When comparing compacted and control soils, fungal community composition corresponded more closely within each soil texture. The two microfungal soil communities, therefore, tolerated compaction. In contrast, a difference occurred in the fungal communities between the two soil textures. This is more likely due to the variability in the controlling factors of microfungal abundance and composition, such as soil characteristics, tree species, and competitive ability of fungal genera.