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1.
J Pediatr Orthop B ; 33(2): 178-183, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-37266956

RESUMO

We assessed the radiological and functional results of pediatric both-bone forearm diaphyseal fractures treated using elastic stable intramedullary nails (ESINs), as well as factors affecting the results. In total, 36 patients (33 males and three females; mean age, 11.6 years) were included. The mean follow-up time was 41.5 (18-96) months. Patient demographic characteristics and the details of the surgical techniques were analyzed retrospectively. In addition to standard radiographic evaluations, the ratio between the nail diameter and medullary canal diameter (ND/MCD) was measured, as well as the maximal radial bowing. According to the criteria of Price and Flynn, 28 (77.8%) and eight (22.2%) patients had excellent and good results, respectively. There were no cases of nonunion or delayed union. There was no significant difference in functional or radiological results according to whether titanium nails (24 patients) or stainless steel nails (12 patients) were used (all P  > 0.05). Nail prebending (performed in 19 patients) did not affect the functional or radiological results ( P  > 0.05). Loss of reduction was observed in four patients with an ND/MCD ratio <40%. The maximal radial bowing improved in all patients. The mean change was significantly greater in patients with diastases and 22D/4.1 fractures. Regardless of nail type or prebending status, surgery using ESIN placement effectively treats both-bone forearm diaphyseal fractures; radial bow remodeling outcomes are excellent. We recommend that the ND/MCD ratio should be 40-70%.


Assuntos
Fixação Intramedular de Fraturas , Fraturas Ósseas , Fraturas do Rádio , Masculino , Feminino , Humanos , Criança , Antebraço , Estudos Retrospectivos , Pinos Ortopédicos , Fraturas Ósseas/cirurgia , Fixação Intramedular de Fraturas/métodos , Resultado do Tratamento , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgia , Consolidação da Fratura
2.
J Child Adolesc Trauma ; 16(4): 973-980, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38045854

RESUMO

While there are many studies on the relationship between anxiety disorders and childhood traumas in the literature, there are limited studies on the relationship between separation anxiety disorders and traumatic experiences in early life. It is widely known that trauma and negative cognitive processes are important factors in the etiology and prognosis of psychiatric disorders. In this study, it was aimed to determine the relationship between adult separation anxiety levels and childhood traumas and cognitive distortions, and to examine the mediating role of cognitive distortions in the relationship between childhood traumas and separation anxiety. A total of 366 students attending a private university were included in the study. The scales, which were converted into online questionnaires by the researchers, were sent to the students via e-mail, and were administered online. The participants were evaluated using "Adult Separation Anxiety Questionnaire", "Childhood Trauma Questionnaire", and "Cognitive Distortions Scale". The results of the study indicated that there was a positive and significant relationship between adult separation anxiety levels and childhood sexual abuse while there was no statistically significant correlation between adult separation anxiety levels and physical and emotional abuse, or physical and emotional neglect. A positive and significant relationship was found between separation anxiety levels and the sub-dimensions of cognitive distortions' self-image, self-blame, helplessness, hopelessness, and preoccupation with danger. In addition, it was determined that the helplessness and preoccupation with danger sub-dimensions of cognitive distortions had a full mediator effect on the relationship between sexual abuse and separation anxiety. Our results show that there is a positive relationship between separation anxiety disorder and childhood sexual abuse, and cognitive distortions play a mediating role between both variables.

3.
Ulus Travma Acil Cerrahi Derg ; 29(10): 1191-1198, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37791440

RESUMO

BACKGROUND: The earthquake disaster that occurred on February 06, 2023, caused serious destruction and loss of life in the south of Türkiye. The purpose of this article consisting of two interconnected parts is to report the experience of our orthopedics clinic, which is located just on the border of the disaster area. The subject of the first part of the study is the characteristics of ortho-pedic traumas in earthquake victims and the treatment methods applied. The subject of the second part is the disaster work plan of the clinic and its consequences in practice. METHODS: For the first step, descriptive information, diagnoses, and treatment methods of 204 earthquake victims who were treated by our clinic in the first 10 days after the disaster were compiled from the archives. In terms of the second phase of the study, an in-clinic work plan was created on the morning of the 1st day of the disaster. The teams and working hours in the emergency department, inpatient service, and operating room were determined. Hospital management and other clinics were contacted and hospital facilities were organized for orthopedic trauma victims. RESULTS: The mean age of the patients was 42.3 years. Among the age groups, the smallest group was children under 10 years old (6.4% of all patients). 132 of the patients had at least one fracture in 135 extremities. Most of the injuries involved the lower extrem-ity. 66 patients had crush injury with or without fracture. 181 orthopedic surgical procedures were performed in 144 patients. The most common operations were internal fracture fixation and debridement. The most used implant was the plate-screw combination. Thanks to the in-clinic work plan and the in-hospital assistance and allocation of facilities, we did not experience serious problems in the hospitalization, surgery, and post-operative follow-ups of the patients. Although we received numerous offers of assistance from external institutions, this was not possible due to bureaucratic obstacles. Among our most important problems were the shortage of sterilized powered surgical drills and the lack of a dynamic patient information database. CONCLUSION: Orthopedic clinics should prepare their in-clinic work plans for earthquake disasters and develop their facilities. In order not to encounter bureaucratic obstacles in emergency assistance, orthopedic clinics in different risk regions should be formally matched beforehand. A patient database table that clinical staff can access and revise using their smartphones facilitates the follow-up of large numbers of simultaneously hospitalized patients.


Assuntos
Planejamento em Desastres , Desastres , Terremotos , Fraturas Ósseas , Criança , Humanos , Adulto , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/cirurgia , Fixação Interna de Fraturas
4.
Cogn Process ; 24(4): 575-584, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37605077

RESUMO

Self-esteem expresses the individual's approach to himself and affects the whole life in terms of mental health. Another important factor affecting self-esteem, which has a critical importance for the youth period, is social media. In the literature, there are many studies examining the relationship between social media use and self-esteem of young people. In this study, it was aimed to investigate the relationship between problematic social media use and self-esteem in university students and to test the mediating role of cognitive distortions in the relationship between these two variables. The sample of the study consisted of 239 young individuals, 197 (82.4%) female, and 42 (17.6%) males, with a mean age of 20.62 ± 1.92 years, studying at a private university. Participants were evaluated by administering the "Rosenberg Self-Esteem Scale (RSES)", "Social Media Disorder Scale (SMD-9)", and "Cognitive Distortions Scale (CDS)". The scales were administered via an online survey. Results revealed that there was a negative significant relationship between the problematic social media use levels of the participants and their self-esteem. In the model established to evaluate the mediating role of cognitive distortions in the relationship between problematic social media use and self-esteem levels, in the first step, it was found that problematic social media use directly predicted self-esteem negatively. In the second step, it was determined that the use of problematic social media negatively predicted the mediating variable cognitive distortions. In the third step, when cognitive distortions, which are mediator variables, are added to the model in the relationship between problematic social media use and self-esteem; it was determined that cognitive distortions played a partial mediating role in the sub-dimensions of "self-perception", "self-blame", "hopelessness" and "seeing life as dangerous", while the sub-dimensions of "helplessness" and "total scale scores" played a full mediator role. Our findings show that there is a negative relationship between the problematic social media use of young people and their self-esteem levels, and cognitive distortions play a mediating role in the relationship between both variables.

5.
Indian J Psychiatry ; 65(5): 595-600, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37397839

RESUMO

Background: There are many studies examining the relationship between social media and self-esteem. Studies examining the relationships between the self-esteem, social media use, and body image of adolescents are limited in the literature. Aim: This study aimed to examine the relationship between self-esteem and social media addiction levels in adolescents and the mediating role of body image in the relationship between these two variables. Methods: The sample of the study consisted of 204 adolescents, 67 (32.8%) girls and 137 (67.2%) boys, with a mean age of 15.90 ± 1.20 years, who were high school students. The self-esteem levels of the participants were evaluated with the "Rosenberg Self-Esteem Scale", their social media dependency levels were measured with the "Social Media Use Disorder Scale", and their body images were measured using the "Multidimensional Body-Self Relations Questionnaire". Results: No significant relationship was found between the self-esteem levels of the participants and their ages or the education levels of their parents. There was a negative moderate significant relationship between the self-esteem levels of the participants and their social media addiction levels, and a positive moderate significant correlation was found between their self-esteem levels and body images. It was found that the social media addiction levels of the participants negatively predicted their self-esteem and body image levels. It was determined that body image had a partial mediator effect on the relationship between the social media addiction and self-esteem levels of the participants. Conclusion: Our results revealed that there is a negative correlation between self-esteem and social media addiction levels in adolescents. Body image has a partial mediating role in the relationship between social media addiction and self-esteem levels.

6.
ACS Appl Mater Interfaces ; 14(37): 41819-41833, 2022 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-36066351

RESUMO

The use of wire cerclage after sternal closure is the standard method because of its rigidity and strength. Despite this, they have many disadvantages such as tissue trauma, operator-induced failures, and the risk of infection. To avoid complications during sternotomy and promote tissue regeneration, tissue adhesives should be used in post-surgical treatment. Here, we report a highly biocompatible, biomimetic, biodegradable, antibacterial, and UV-curable polyurethane-acrylate (PU-A) tissue adhesive for sternal closure as a supportive to wire cerclage. In the study, PU-As were synthesized with variable biocompatible monomers, such as silk sericin, polyethylene glycol, dopamine, and an aliphatic isocyanate 4,4'-methylenebis(cyclohexyl isocyanate). The highest adhesion strength was found to be 4322 kPa, and the ex vivo compressive test result was determined as 715 kPa. The adhesive was determined to be highly biocompatible (on L-929 cells), biodegradable, and antibacterial (on Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus bacteria). Finally, after opening the sternum of rats, the adhesive was applied to bond the bones and cured with UV for 5 min. According to the results, there was no visible inflammation in the adhesive groups, while some animals had high inflammation in the cyanoacrylate and wire cerclage groups. These results indicate that the adhesive may be suitable for sternal fixation by preventing the disadvantages of the steel wires and promoting tissue healing.


Assuntos
Sericinas , Adesivos Teciduais , Acrilatos , Adesivos , Animais , Antibacterianos/farmacologia , Fios Ortopédicos , Cianoacrilatos , Dopamina , Inflamação , Isocianatos , Polietilenoglicóis/química , Poliuretanos/química , Ratos , Sericinas/farmacologia , Aço , Esterno/cirurgia , Adesivos Teciduais/farmacologia
7.
Acta Orthop Traumatol Turc ; 55(1): 28-32, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33650507

RESUMO

OBJECTIVE: This study aimed to compare the clinical and radiological findings of radical reduction (open reduction and Salter innominate osteotomy combined with femoral osteotomy) for children of walking age, younger and older than 4 years in the treatment of with developmental dysplasia of the hip (DDH). METHODS: In this retrospective study, children of walking age with DDH who underwent radical reduction between 2008 and 2014 were identified. They were then divided into 2 groups according to the age at which the surgery was performed: before and after the age of 4 years. Improvement in the acetabular index was examined on follow-up radiographs. The presence of avascular necrosis (AVN) was determined and classified on the basis of the Kalamchi-MacEwen classification on final follow-up radiographs. Clinical assessment was performed with the modified McKay criteria at the final follow-up appointment. RESULTS: A total of 19 children (14 girls, 5 boys; mean age=37.5±21 months) (25 hips) were included. Their mean age was 27.9±4.9 and 63.3±19.7 months in children operated before and after the age of 4 years, respectively. The mean follow-up time was 29.9±19 and 19.6±5 months in children operated before and after the age of 4 years, respectively. No significant difference was observed in improvements in the acetabular index between children younger than 4 years (24±6.9°) and those older than 4 years (20.7±6.7°) (p=0.25). According to the modified McKay criteria, all the children younger than 4 years exhibited excellent or good clinical results compared with those operated after the age of 4 years (67%) (p=0.013). At the final follow-up, 64% of all patients demonstrated no radiographical sign of AVN. The rates of AVN were significantly higher in children operated after the age of 4 years (33%) than in those operated before the age of 4 years (19%) (p=0.049). CONCLUSION: Better clinical and radiographical results can be expected from radical reduction in children undergoing surgery before the age of 4 years. LEVEL OF EVIDENCE: level III, Therapeutic Study.


Assuntos
Acetábulo , Fatores Etários , Displasia do Desenvolvimento do Quadril/cirurgia , Fêmur , Osteonecrose , Osteotomia , Complicações Pós-Operatórias , Acetábulo/diagnóstico por imagem , Acetábulo/cirurgia , Pré-Escolar , Feminino , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Humanos , Masculino , Osteonecrose/diagnóstico , Osteonecrose/etiologia , Osteotomia/efeitos adversos , Osteotomia/métodos , Avaliação de Processos e Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Radiografia/métodos , Estudos Retrospectivos
8.
ACS Omega ; 4(7): 12342-12356, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31460352

RESUMO

This work reports on the synthesis of three new l-lysine-based organogelators bis(N2-alkanoyl-N6-l-lysyl ethylester)oxalylamides, where alkanoyls are lauroyl, myristoyl, and palmitoyl. The gels of these gelators were prepared with high yields in eco-friendly solvents commonly used in cosmetics such as ethyl and isopropyl esters of lauric and myristic acids, liquid paraffin, 1-decanol, and 1,2-propanediol. Fourier transform infrared measurements revealed the involvement of intermolecular hydrogen bonds in the gelation. Scanning electron microscopy images of xerogels indicated different morphologic patterns with regard to the alkanoyl chain length and the solvent employed in their preparation. The gel formation was supported by rheological measurements. Three gels prepared in liquid paraffin were loaded with naproxen (Npx) with a quite high loading capacity (up to 166.6% as percentage of gelator) without gel disruption. The release of Npx from the gel matrix into the buffered solution at physiologic pH was evaluated using UV-vis spectroscopy. The results revealed that the release rate of Npx from the organogels significantly retarded with increasing organogelator concentration, whereas it enhanced with increasing Npx concentration. The rate was also found to be pH-dependent; the lower the pH, the lower the rate. Furthermore, molecular dynamic calculations performed on the octamer of myristoyl-bearing gelator (N 2 M/N 6 Lys) in 1,2-propanediol provided useful information regarding the structural properties of the gels, which may be of interest to interpret the structure of the gel matrix. Altogether, this work provided valuable outcomes, which may be relevant to the pharmaceutical industry. It may be suggested that l-lysine-based gels have potentials in the delivery of nonsteroidal anti-inflammatory drug molecules. Besides, the release of the drug can be fine-tuned by the correct choice of gelator-solvent combination.

9.
Med Sci Monit ; 25: 3503-3509, 2019 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-31079139

RESUMO

BACKGROUND The aim of this retrospective study was to compare the measurements of bone mineral density (BMD) combined with volumetric dental tomography measurements taken from three main regions selected on the lower mandible, the right mandibular, medial mandibular, and left mandibular regions, in patients with ectodermal dysplasia and age-matched and gender-matched controls. Measurement of BMD in Hounsfield units (HUs) were evaluated using three-dimensional (3D) cone beam computed tomography (CBCT) imaging. MATERIAL AND METHODS Mandibular bone tomography images were evaluated from 9 women and 5 men diagnosed with ectodermal dysplasia and a control group of 9 women and 5 men. The HU values obtained according to age and gender of the total 28 study participants were measured. Statistical analysis of the data used Student's t-test. RESULTS BMD in the ectodermal dysplasia group was significantly lower compared with the BMD in the control group. Comparison of the left and right mandibular angulus regions showed that the BMD of patients with ectodermal dysplasia was significantly lower when compared with the control group in both regions, but no significant difference was found between the two groups in the BMD of the central mandibular region. CBCT was found to be an effective method for the measurement of BMD. CONCLUSIONS In patients with ectodermal dysplasia, reduced BMD should be taken into consideration when planning surgical interventions involving bone tissue and when planning implant surgery. The results of this study may be of value in dentistry and other fields of medicine.


Assuntos
Densidade Óssea/fisiologia , Tomografia Computadorizada de Feixe Cônico/métodos , Displasia Ectodérmica/fisiopatologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Mandíbula/anatomia & histologia , Mandíbula/fisiologia , Estudos Retrospectivos , Turquia , Adulto Jovem
10.
Eur Arch Otorhinolaryngol ; 276(5): 1493-1499, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30879193

RESUMO

AIM: Sinus maxillaris is an important anatomical formation in many branches of dentistry due to its proximity to the field of work. Various methods have been used in literature to measure the maxillary sinus volume (MSV) such as cadavers, stereology, two-dimensional conventional radiographs, computed tomography (CT), magnetic resonance imaging (MRI). The aim of this study is to evaluate the change of maxillary sinus volume according to age and gender with MIMICS 19.0 (Materialise HQ Technologielaan, Leuven, Belgium) which is one of three-dimensional modeling software. MATERIALS AND METHODS: This study was performed in 200 patients selected by a retrospective review of the archives of the Dicle University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology. Patients were divided into five age groups (18-24 years, 25-34 years, 35-44 years, 45-54 years, and ≥ 55 years) and by sex. Cone-beam computed tomography (CBCT) images of the patients were transferred to the MIMICS software and the MSV was measured. All statistical analyses were performed using the SPSS (Statistical Package for Social Sciences, version 21) software. RESULTS: There was no statistically significant difference between the right and left maxillary sinus volume according to the findings obtained from our study, and maxillary sinus volume in males was found to be significantly higher than that of females. Another finding of our study is that the maxillary sinus volume decreases with age increase. Especially it was also found that the sinus volume in males in the 18-24 age group was statistically significantly higher than females. CONCLUSION: Consequently, maxillary sinus volume measurements can be made on CT, CBCT, MRI scans using reconstruction software.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Interpretação de Imagem Assistida por Computador , Imageamento Tridimensional , Seio Maxilar/anatomia & histologia , Seio Maxilar/diagnóstico por imagem , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Bélgica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Software , Adulto Jovem
11.
Acta Orthop Traumatol Turc ; 53(1): 50-55, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30482589

RESUMO

OBJECTIVE: The aim of this study was to determine the alterations of walking energy expenditure and plantar pressure distribution in young adults with patellofemoral pain syndrome (PFPS). METHODS: Thirty five individuals (mean age: 21.31 ± 1.76) with PFPS constituted the patient group and forty healthy participants (mean age: 21.40 ± 2.11) the control group. Preferred walking speeds (PWS) were determined on the over ground. Individuals walked on a treadmill for 7 min at their PWS and 30% above PWS and oxygen consumption was recorded via a metabolic analyzer. Net oxygen consumption was calculated for each walking trial. Borg scale was applied to assess perceived exertion during walking trial. Plantar pressure distributions were measured by a pedobarography device. Plantar area was subdivided into six zones to evaluate the dynamic plantar pressure data. RESULTS: The mean PWS of PFPS and control groups were 4.69 ± 0.51 and 4.52 ± 0.60 km/h, respectively (p > .09). No significant difference was observed in energy expenditure during walking at PWS between 2 groups while oxygen consumption during 30% above PWS was higher in patient group (18.72 ± 3.75 and 16.64 ± 3.27) (p = .007). Net oxygen consumption was also found to be higher in PFPS group (15.12 ± 3.62 and 13.04 ± 3.24) (p = .005). The mean Borg scores were significantly higher in PFPS group at each walking trials (p < .001). No statistically significant difference was found between weight distribution (%) of symptomatic and nonsymptomatic extremity (50.45 ± 3.92% and 49.56 ± 3.93%, respectively) (p = .509). Dynamic pedobarography parameters were not different between 2 groups, and also between symptomatic and nonsymptomatic extremities (p > .05). CONCLUSION: Although, rate of perceived exertion and energy expenditure during walking at 30% above PWS are affected negatively in young adults with PFPS, we may speculate that energy consumption and plantar pressure distribution can be compensated by a physiologic adaptation mechanism during walking at PWS. LEVEL OF EVIDENCE: Level III, Therapeutic Study.


Assuntos
Metabolismo Energético , Consumo de Oxigênio , Síndrome da Dor Patelofemoral , Caminhada/fisiologia , Fenômenos Biomecânicos , Teste de Esforço/métodos , Feminino , Marcha/fisiologia , Humanos , Masculino , Síndrome da Dor Patelofemoral/diagnóstico , Síndrome da Dor Patelofemoral/metabolismo , Síndrome da Dor Patelofemoral/fisiopatologia , Turquia , Adulto Jovem
12.
Med Princ Pract ; 28(2): 109-114, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30296784

RESUMO

OBJECTIVES: Sinus floor elevation and augmentation surgery is widely used as a reliable procedure to increase insufficient bone height in the posterior maxillary area. The purpose of the present clinical study was to determine the associations between periodontal bone loss (PBL), maxillary sinus lateral bone wall thickness, age, and gender using cone-beam computerized tomography (CBCT). MATERIALS AND METHODS: The current retrospective study consists of 716 maxillary sinus CBCT images of 358 patients. The CBCT scans were assessed to detect the relationship between lateral wall thickness and PBL. ANOVA and Student t test analysis were used to determine the influence of PBL on sinus lateral wall thickness. RESULTS: Sinus lateral wall thickness was significantly associated with PBL (p < 0.05) at 3, 13, and 15 mm height. There was no significant association between lateral wall thickness and gender (p > 0.05). However, there was a significant association between lateral wall thickness at 3 and 13 mm and age (p < 0.05). There were significant associations between PBL and age (p < 0.001), and PBL and gender (p < 0.05). CONCLUSIONS: PBL might have an association with maxillary sinus lateral bone wall thickness. Further studies are needed to confirm this possible relationship.


Assuntos
Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/patologia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Perda do Osso Alveolar/cirurgia , Tomografia Computadorizada de Feixe Cônico , Estudos Transversais , Feminino , Humanos , Masculino , Seio Maxilar/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Levantamento do Assoalho do Seio Maxilar , Adulto Jovem
13.
Ulus Travma Acil Cerrahi Derg ; 24(2): 145-148, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29569686

RESUMO

BACKGROUND: Children have a curiosity for climbing walls, stairs, and railings and have an increased risk of falling. Here, we report our experience with railings causing injuries by penetrating the upper extremities, and aim to call attention to spiked railing injuries in children. METHODS: We report on five children with a mean age of 8.8. All of the children were male. The penetrating railing parts were removed in a surgical room. RESULTS: The injured structures repaired immediately were as follows: flexor digitorum profundus tendon, A4 pulley, volar plate of the distal interphalangeal joint, radial digital nerve, ulnar digital artery, and radial digital artery. CONCLUSION: Spiked railings can lead to significant injury that requires further exploration. Boys particularly are at risk, and parents should be alert regarding these type of injuries. We recommend a standard regulation for fence erection, and we wish to warn owners of this type of fence regarding probable legal sanctions.


Assuntos
Traumatismos do Braço , Ferimentos Penetrantes , Acidentes , Criança , Estudos de Coortes , Humanos , Masculino
14.
Thorac Cardiovasc Surg ; 66(6): 483-490, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29510430

RESUMO

BACKGROUND: We aimed to investigate the risk factors of post-coronary artery bypass grafting (CABG) atrial fibrillation (AF) in male and female patients without any history of AF, to identify the sex-specific risk factors, and to examine the effect of sex-specific risk factors on the overall population. METHODS: This retrospective study was conducted using the hospital database with 4,758 patients who underwent CABG surgery. Among them, 2,836 patients with complete data participated in this study. The female patients were divided into two groups as patients who developed new-onset AF after CABG and those who did not. The relationship between the patients' variables and risk factors of post-CABG AF was examined. RESULTS: The overall incidence of post CABG AF was 12.9% (386/2,836). Sex-specific incidence of AF was similar: 3.2% (91/690) and 12.9% (277/2146) in female and male patients, respectively (p = 0.849). Multiple analysis revealed the independent risk factors for male and female patients, respectively: mean age (odds ratio [OR] = 1.057, OR = 1,076), age over 65 years (OR = 2.156, OR = 2.736), the European System For Cardiac Operative Risk Evaluation Scores (EuroSCORE) (OR = 1.13, OR = 1.218), COPD (OR = 1.589, OR = 1.789), BUN level (OR = 1.026, OR = 1.019), mean cardiopulmonary bypass (CPB) time (OR = 1.007, OR = 1.010), prolonged CPB time (OR = 1.604, OR = 2.309), mean cross-clamp time (OR = 1.009, OR = 1.017), need of inotropic support (OR = 2.249, OR = 2.731), and mean mechanical ventilation time (VT) (OR = 1.026, OR = 1.027).Low left ventricular ejection fraction (LVEF) (OR = 1.419), left ventricular (LV) aneurysm repair (OR = 1.533), carotid artery disease (OR = 1.750), prolonged VT (OR = 1.729), and use of intra-aortic balloon pump (IABP) (OR = 2.436) were found to be the risk factors only for male AF patients.Unstable angina (OR = 1.969), right coronary artery (RCA) disease (OR = 2), prolonged cross-clamp time (OR = 2.152), and the number of grafts per operation (OR = 1.298) were found to be the risk factors only for female AF patients. CONCLUSION: This study suggests that predictors of AF in the overall population may be due to isolated patient groups. Multiple regression analysis and artificial intelligence modelling should be performed on large-scale, isolated groups to make strong AF prediction.


Assuntos
Fibrilação Atrial/epidemiologia , Ponte de Artéria Coronária/efeitos adversos , Doença da Artéria Coronariana/cirurgia , Adulto , Idoso , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/fisiopatologia , Comorbidade , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/fisiopatologia , Bases de Dados Factuais , Feminino , Disparidades nos Níveis de Saúde , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Fatores de Tempo , Resultado do Tratamento , Turquia/epidemiologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-29029989

RESUMO

OBJECTIVES: The purpose of this study was to evaluate the prevalence of sinus mucosal thickening (MT) and mucosal appearance (MA) in a patient population as detected with cone beam computed tomography (CBCT) and to determine the effects of various disease and demographic factors on MT and MA. STUDY DESIGN: The retrospective study consisted of CBCT images of 1000 maxillary arches in 500 patients. The arches were divided into 3 groups (atrophic, partially atrophic, and nonatrophic) according to the type of the maxillary dental crest. The CBCT scans were assessed to detect the prevalence of maxillary sinus MT and MA. χ2 analysis was used to determine the significance of association of periodontal bone loss (PBL), periapical (PA) status, alveolar crest type, age, and gender on sinus MT and MA. RESULTS: MT was significantly associated with PBL (P = .004), PA status (P = .001), and gender (P < .01). MA was significantly associated with PBL (P = .038), PA status (P = .009), and gender (P < .020). There were no significant associations between age or crest type and either MT or MA. CONCLUSIONS: Periodontal bone loss, PA lesions, and gender may have an association with MT of the maxillary sinus.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Mucosa Nasal/diagnóstico por imagem , Mucosa Nasal/patologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Perda do Osso Alveolar/diagnóstico por imagem , Atrofia , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Turquia
16.
Acta Odontol Scand ; 75(8): 608-615, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28826290

RESUMO

OBJECTIVE: Dental implants have been widely and successfully used in recent years as an alternative treatment for removable and fixed dental prostheses. The aim of this randomized prospective study was to determine the alveolar bone loss rate (ABLR) and IL-1ß levels in one- and two-stage surgical procedures. MATERIALS AND METHODS: This study included 40 patients with a single missing tooth in the posterior mandible; dental implants were inserted using a one-stage surgical procedure (Group I) or a two-stage surgical procedure (Group II). All clinical periodontal parameters were recorded; peri-implant crevicular fluid (PICF) samples were collected before loading (T0) and during the third (T1) and sixth (T2) months after loading. ABLR values were evaluated at T0 and T2 by using dental tomography. PICF was analysed after T2 samples were collected. The study was registered through clinicaltrials.gov; identifier NCT03045458. RESULTS: This study found that, the probing pocket depth was found to be significantly higher in Group I than Group II at both T1 and T2 (p < .05). There was no significant difference in other clinical parameters between the groups (p > .05). There was a significant difference between Group I ABLR values at T0 and T2 (p < .05). The PICF IL-1ß levels were not significantly different between groups (p > .05). CONCLUSIONS: Within the limitations of the short observational period and small sample size of this study, two-stage implant placement shows comparable clinical outcomes to implants placed using a one-stage placement protocol.


Assuntos
Perda do Osso Alveolar/metabolismo , Implantes Dentários , Líquido do Sulco Gengival/imunologia , Mediadores da Inflamação/análise , Interleucina-1beta/análise , Adulto , Idoso , Prótese Dentária Fixada por Implante , Feminino , Seguimentos , Humanos , Masculino , Mandíbula/imunologia , Pessoa de Meia-Idade , Estudos Prospectivos
17.
Int. j. morphol ; 35(1): 62-71, Mar. 2017. ilus
Artigo em Inglês | LILACS | ID: biblio-840934

RESUMO

To reveal the detailed morphological features of the fibular collateral (fibular) ligament, popliteus tendon, popliteofibular ligament and the synovial components regarding to achieve data for surgical and biomechanical utilization. Knees of 10 formalin-fixed male cadavers were dissected bilaterally. Bursae around the lateral collateral ligament and the relation of popliteus tendon with lateral collateral ligament at the femoral attachment site were noted. The positional relation between both ends of popliteofibular ligament was evaluated statistically. The PT exceeded the anterior margin of lateral collateral ligament in 11 sides, the posterior margin of lateral collateral ligament in 3 sides and exceeded both the anterior and posterior margins of lateral collateral ligament in 5 sides. The shape of lateral collateral ligament was narrower at the lower part than the upper in 14 sides. The width of lower part of lateral collateral ligament was found narrower in the cases with sheath-like bursa (vagina synovialis). The relation between both ends of popliteofibular ligament was as followed: the more anteriorly the fibular head attachment was located, the more anteriorly popliteofibular ligament was attached to the popliteus tendon. To resolve the posterolateral corner of the knee with regard to surgical anatomy and biomechanics, individual and concerted morphometric characteristics of lateral collateral ligament, popliteus tendon and PF should be evaluated together with accompanied synovial structures.


El objetivo de este trabajo consistió en descubrir las características morfológicas detalladas del ligamento colateral fibular, del tendón del músculo poplíteo (TMP), del ligamento popliteofibular y de los componentes sinoviales relacionados con la obtención de datos para la aplicación quirúrgica y biomecánica. Se disecaron bilateralmente rodillas de 10 cadáveres de sexo masculino fijados con formalina. Se identificó la bursa alrededor del ligamento colateral fibular y la relación del tendón del músculo poplíteo con el ligamento colateral fibular en el sitio de la inserción femoral. La relación posicional entre ambos extremos del ligamento popliteofibular se evaluó estadísticamente. El TMP excedió el margen anterior del ligamento colateral fibular en 11 casos, el margen posterior del ligamento colateral fibular en 3 casos y superó los márgenes anterior y posterior del ligamento colateral fibular en 5 casos. La forma del ligamento colateral fibular fue más estrecha en la porción inferior que en la porción superior en 14 casos. El ancho de la porción inferior del ligamento colateral fibular fue más estrecha en los casos con bursa del tipo vaina (vagina synovialis). La relación entre ambos extremos del ligamento popliteofibular fue la siguiente: cuanto más anteriormente se localizó la inserción de la cabeza fibular, más anteriormente el ligamento popliteofibular se unió al TMP. Para intervenir el ángulo posterolateral de la rodilla con respecto a la anatomía quirúrgica y la biomecánica, se deben evaluar las características morfométricas individuales y concertadas del ligamento colateral fibular, el TMP y el ligamento popliteofibular, junto con las estructuras sinoviales correspondientes.


Assuntos
Humanos , Articulação do Joelho/anatomia & histologia , Ligamentos Articulares/anatomia & histologia , Cadáver , Ligamentos Colaterais/anatomia & histologia , Tendões/anatomia & histologia
18.
Kulak Burun Bogaz Ihtis Derg ; 26(5): 265-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27888823

RESUMO

OBJECTIVES: This study aims to investigate the role of KRAS/BRAF gene mutation in the pathogenesis of oropharyngeal squamous cell carcinoma (OSCC). PATIENTS AND METHODS: A total of 26 OSCC patients (23 males, 3 females; mean age 60 years; range 41 to 77 years) diagnosed between January 2003 and November 2013 were included in the study. The methods used in our study were quantitative fluorescence polymerase chain reaction for KRAS/BRAF mutation analysis. RESULTS: Ten of the tumors were located at the tongue base, 12 in the tonsil and four at the floor of mouth. The mean tumor size was 3.8 cm. Six of the tumors were well differentiated, 18 were moderately differentiated and two were poorly differentiated. All cases were analyzed for KRAS and BRAF gene mutations and none of them showed gene mutations. CONCLUSION: We could not find any relation between OSCC and KRAS/BRAF gene mutations in our short case file. The role of mutations should be analyzed in larger series in OSCC to predict new targeted therapy modalities.


Assuntos
Carcinoma de Células Escamosas/genética , Neoplasias Orofaríngeas/genética , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Adulto , Idoso , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Neoplasias Orofaríngeas/patologia
19.
Turk J Med Sci ; 46(4): 1162-7, 2016 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-27513420

RESUMO

BACKGROUND/AIM: To investigate the effects of pulmonary hypertension on early clinical variables in patients undergoing coronary artery bypass grafting surgery. MATERIALS AND METHODS: The preoperative echocardiographic data of patients who underwent isolated coronary artery bypass surgery were evaluated retrospectively. A total of 1244 patients were included in the study. The patients were divided into two groups: one group consisted of patients with systolic pulmonary artery pressure (SPAP) values equal to or greater than 30 mmHg (Group 1, n = 184), while the other group consisted of patients with SPAP values below 30 mmHg (Group 2, n = 1060). RESULTS: Early mortality was similar in both groups (0% in Group 1 and 1.2% in Group 2; P > 0.05). Comparison of postoperative data indicated that Group 1 had a higher need for inotropic agent treatment, a longer average duration of ventilation, and a longer average duration of stay in the intensive care unit (P < 0.05). For the other variables, no significant differences were identified between patients with and without pulmonary hypertension (P > 0.05). CONCLUSION: Mild pulmonary hypertension (mean SPAP = 37.7 ± 8.4 mmHg) was not associated with a significant difference in the mortality of patients undergoing coronary artery bypass grafting. For patients undergoing this type of coronary bypass surgery, lower morbidity and mortality rates can be achieved through comprehensive preoperative examinations and effective perioperative medical procedures.


Assuntos
Hipertensão Pulmonar , Ponte de Artéria Coronária , Humanos , Pacientes Internados , Complicações Pós-Operatórias , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
20.
Blood Press Monit ; 21(4): 231-7, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27007549

RESUMO

BACKGROUND: White-coat hypertension (WCH) is a disease based on the disparity of a patient's blood pressure measurements between the physician's office and the patient's home environment. The aim of the present study is to evaluate the left atrial (LA) volume and functions in WCH. METHODS: In total, this study included 37 WCH (17 women, 20 men, mean age 48.4±5.7 years) and 30 healthy individuals (18 women, 20 men, mean age 47.9±7.5 years). All patients underwent real-time three-dimensional and comprehensive two-dimensional echocardiography (2DE) with tissue Doppler evaluation to estimate left atrial volumes and mechanical functions. RESULTS: LA diameters were significantly higher in the patients compared with the controls (37±2.8 vs. 35±3.1 mm, P=0.017). LA total systolic volume and LA maximal volume were significantly higher in the patients. (41.1±6.9 vs. 35.5±3.7 ml, P<0.001; 25.8±5.4 vs. 21.3±3.3 ml, P<0.001, respectively). LA volume before LA contraction and LA active stroke volume were significantly higher in the patients with WCH than in the normotensives (24.4±6.3 vs. 20.9±2 ml, P=0.002; 9.1±4.8 vs. 6.7±2.5 ml, P=0.007, respectively). Moreover, the LA expansion index was significantly higher in the patients with WCH than in the normotensives (178.7±53.6 vs. 155.3±36.3, P=0.037). However, the total emptying volume fraction of the LA was similar between the two groups. CONCLUSION: We showed that LA structural functions and volumes were increased in the WCH group. Although increased LA volume has been observed in many diseases, structural changes in LA may be accepted as an early sign for clinical cardiac remodeling in patients with WCH, suggesting the necessity of early intervention for preventing clinical cardiovascular disease.


Assuntos
Ecocardiografia Tridimensional , Hipertensão do Jaleco Branco/diagnóstico por imagem , Hipertensão do Jaleco Branco/fisiopatologia , Idoso , Estudos Transversais , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade
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