Statistical shape analysis of the lentiform nucleus of children of different age groups: a retrospective study.

The basal nuclei are important during infancy because of the significant development of motor skills. The main aim of this study was to evaluate the shape differences of the lentiform nucleus between different age and gender groups. A total of 126 children's axial magnetic resonance image series were included in the presented study. These images were grouped between 1 and 5 yr old. Right and left lentiform nuclei are marked with selected landmarks using TPSDIG v2.04. Statistical shape analyses were examined by a Generalized Procrustes Analysis. Our results showed that there was no statistically significant difference in lentiform nucleus shape between genders. However, there was a difference between the shapes of the right and left lentiform nuclei between the 1-yr and 5-yr age groups. These results demonstrated the shape changes in the lentiform nucleus during the first 5 yr of life. Further clinical studies based on our results may be used to gather more detailed information about movement disorders and neuronal development.

Assessing the accuracy and completeness of artificial intelligence language models in providing information on methotrexate use.

We aimed to assess Large Language Models (LLMs)-ChatGPT 3.5-4, BARD, and Bing-in their accuracy and completeness when answering Methotrexate (MTX) related questions for treating rheumatoid arthritis. We employed 23 questions from an earlier study related to MTX concerns. These questions were entered into the LLMs, and the responses generated by each model were evaluated by two reviewers using Likert scales to assess accuracy and completeness. The GPT models achieved a 100% correct answer rate, while BARD and Bing scored 73.91%. In terms of accuracy of the outputs (completely correct responses), GPT-4 achieved a score of 100%, GPT 3.5 secured 86.96%, and BARD and Bing each scored 60.87%. BARD produced 17.39% incorrect responses and 8.7% non-responses, while Bing recorded 13.04% incorrect and 13.04% non-responses. The ChatGPT models produced significantly more accurate responses than Bing for the "mechanism of action" category, and GPT-4 model showed significantly higher accuracy than BARD in the "side effects" category. There were no statistically significant differences among the models for the "lifestyle" category. GPT-4 achieved a comprehensive output of 100%, followed by GPT-3.5 at 86.96%, BARD at 60.86%, and Bing at 0%. In the "mechanism of action" category, both ChatGPT models and BARD produced significantly more comprehensive outputs than Bing. For the "side effects" and "lifestyle" categories, the ChatGPT models showed significantly higher completeness than Bing. The GPT models, particularly GPT 4, demonstrated superior performance in providing accurate and comprehensive patient information about MTX use. However, the study also identified inaccuracies and shortcomings in the generated responses.

The predictive factors that total laser energy consumed during retrograde intrarenal surgery (RIRS): stone area and density.

Holmium: YAG (Ho: YAG) laser lithotripsy with flexible ureterorenoscopy can be used with high stone-free and low complication rates for renal stones. This study aimed to determine the factors affecting the total laser energy in cases with provided stone-free status after a single session of retrograde intrarenal surgery (RIRS). Data of 222 patients who underwent RIRS between October 2017 and March 2020 were evaluated retrospectively. After exclusion criteria, the study was carried out with 184 stone-free cases. All cases were performed without using a ureteral access sheath (UAS), and dusting was preferred as the lithotripsy method. The effects of age, gender, body mass index (BMI), previous RIRS history, previous shock wave lithotripsy (SWL) history, stone localization, number of stones, stone surface area, and stone density on total laser energy were analyzed. There was no significant correlation between total laser energy with gender, BMI, previous RIRS history, previous SWL history, stone localization, and the number of stones (p:0.347, p:0.482, p:0.119, p:0.167, p:0.907, p:0.933 respectively). There was a significant correlation between age and total laser energy (p = 0.032), but it was not observed when the effect of the stone surface area was removed (p = 0.354). There were significant correlations between total laser energy and stone surface area, stone density, and total laser time (p<0.001, p<0.001, and p <0.001, respectively). Stone area and stone density affect the total energy consumed during laser lithotripsy. Urologists should consider the stone area, stone density, and the power of the laser device to determine which surgical technic to prefer.

Development and validation of a simple risk scoring system for a COVID-19 diagnostic prediction mode.

Introduction: In a resource-constrained situation, a clinical risk stratification system can assist in identifying individuals who are at higher risk and should be tested for COVID-19. This study aims to find a predictive scoring model to estimate the COVID-19 diagnosis." Materials: Patients who applied to the emergency pandemic clinic between April 2020 and March 2021 were enrolled in this retrospective study. At admission, demographic characteristics, symptoms, comorbid diseases, chest computed tomography (CT), and laboratory findings were all recorded. Development and validation datasets were created. The scoring system was performed using the coefficients of the odds ratios obtained from the multivariable logistic regression analysis." Result: Among 1187 patients admitted to the hospital, the median age was 58 years old (22-96), and 52.7% were male. In a multivariable analysis, typical radiological findings (OR= 8.47, CI= 5.48-13.10, p< 0.001) and dyspnea (OR= 2.85, CI= 1.71-4.74, p< 0.001) were found to be the two important risk actors for COVID-19 diagnosis, followed by myalgia (OR= 1.80, CI= 1.08- 2.99, p= 0.023), cough (OR= 1.65, CI= 1.16-2.26, p= 0.006) and fatigue symptoms (OR= 1.57, CI= 1.06-2.30, p= 0.023). In our scoring system, dyspnea was scored as 2 points, cough as 1 point, fatigue as 1 point, myalgia as 1 point, and typical radiological findings were scored as 5 points. This scoring system had a sensitivity of 71% and a specificity of 76.3% for a cut-off value of >2, with a total score of 10 (p< 0.001). Conclusions: The predictive scoring system could accurately predict the diagnosis of COVID-19 infection, which gave clinicians a theoretical basis for devising immediate treatment options. An evaluation of the predictive efficacy of the scoring system necessitates a multi-center investigation.

Increased radiosensitivity and impaired DNA repair in patients with STAT3-LOF and ZNF341 deficiency, potentially contributing to malignant transformations.

STAT3 plays an important role in various complex and sometimes contradictory pathways such as proliferation, differentiation, migration, inflammation, and apoptosis. The transcriptional activity of the STAT3 gene is controlled by a transcription factor called ZNF341. There is insufficient data on radiation sensitivity and post-radiation DNA repair in STAT3- loss-of-function (LOF) patients. We aimed to investigate the radiosensitivity in patients with STAT3-LOF and ZNF341 deficiency. Twelve patients with STAT3-LOF and four ZNF341-deficiency patients were recruited from three clinical immunology centers in Turkey and evaluated for radiosensitivity by the Comet assay, comparing to 14 age- and sex-matched healthy controls. The tail length (TL) (µm), percentage of DNA in the tail (TDNA%), and olive tail moment (OTM) (arbitrary units) were evaluated at the same time for baseline (spontaneous), initial (immediately after 2 Gy irradiation), and recovery (2 h after irradiation) periods by using a computerized image-analysis system, estimating DNA damage. Except for a patient with ZNF341 deficiency who developed nasal cell primitive neuroendocrine tumor and papillary thyroid cancer during the follow-up, there was no cancer in both groups. During the recovery period of irradiation, TL, TDNA%, and OTM values of healthy controls decreased rapidly toward the baseline, while these values of patients with STAT3-LOF and ZNF341 deficiency continued to increase, implying impaired DNA repair mechanisms. Increased radiosensitivity and impaired DNA repair were demonstrated in patients diagnosed with STAT3-LOF and ZNF341 deficiency, potentially explaining the susceptibility to malignant transformation.

Clinical preferences and treatment attitudes among urologists, gynecologists, and geriatricians: An independent online questionnaire survey for comparison of treatment choices in the management of overactive bladder.

OBJECTIVE: Overactive bladder (OAB) is a common clinical problem with associated morbidities both in men and women. Although real-life management strategies have been examined among urologists (URO), treatment choices may differ between different specialties. In the present study, an online survey was conducted to determine and compare the management strategies and clinical preferences of UROs, obstetricians/gynecologists (OB/GYN), and geriatricians (GER) in the treatment of OAB in their daily practices. METHODS: Between December 2020 and February 2021, an online questionnaire was sent to URO, OB/GYN, and GER specialists/residents. Current strategies and attitudes toward treatment of OAB in patients <65 years were compared between URO and OB/GYN, whereas the responses were compared between all three specialties in patients ≥65 years. RESULTS: A total of 733 specialists/physicians (433 URO, 236 OB/GYN, and 64 GER) completed the online survey. Patients with OAB were more likely to present to URO compared to OB/GYN and GER (p = 0.001). A combination of behavioral modification and pharmacotherapy (antimuscarinics and/or beta-3 agonists) were chosen for the initial treatment of patients with OAB in both specialties with a significantly higher proportion by URO than by OB/GYN (51.9% vs. 38.1%; p = 0.001). Antimuscarinics were the most frequently prescribed medications by both the URO and OB/GYN specialties (81.8% vs. 78.4%; p = 0.27). Combination therapy with antimuscarinics was preferred more often by URO (91.5% vs. 77.1%; p = 0.001) when no or an inadequate response after initial treatment occurred. Multiple medication use, comorbidities, and risk of cognitive side effects affected medication preference by all specialists, especially by GER (p = 0.018). CONCLUSIONS: Patients with OAB present to UROs, OB/GYN and GER more frequently compared to other specialities. Although antimuscarinics and beta-3 adrenoceptor agonists are equally recommended as first-line pharmacotherapy for OAB, antimuscarinics were preferred for most patients as the initial molecule by all specialties. Beta-3 agonists are increasingly preferred for elderly patients.

Statistical shape analyses of corpus callosum changes at preoperative and postoperative scaphocephaly patients.

PURPOSE: Scaphocephaly is the premature closure of the sagittal suture. The treatment strategies mainly focus on correcting the shape of the head, but there are very limited studies examining changes in brain structure. This study aimed to investigate shape differences in the shape of corpus callosum regarding the pre-treatment and post-treatment term at scaphocephaly patients. METHODS: Cranium shape data were collected from the two-dimensional digital images. The generalized Procrustes analysis was used to obtain mean shapes in the pre- and postoperative phases. The shape deformation of the corpus callosum from the pre- to postoperative phases was evaluated using the thin plate spline method. RESULTS: There is an enlargement of the splenium part of corpus callosum in the late group. In the early group, corpus callosum genu and body enlargement were observed in the postoperative period compared to the preoperative period, followed by a narrowing of the isthmus region. CONCLUSION: This study showed structural deformations in the corpus callosum in scaphocephaly patients using head shape with the landmark-based geometric morphometric method by taking into consideration the topographic distribution. An enlargement at the splenium part of corpus callosum exposes after the cranial vault expansion depending on time.

The association between hematologic parameters and intracranial injuries in pediatric patients with traumatic brain injury.

OBJECTIVE: Analyzing the association between hematologic parameters and abnormal cranial computerized tomography (CT) findings after head trauma. MATERIAL AND METHODS: A total of 287 children with isolated traumatic brain injury (TBI) were divided into the 'normal' (NG), 'linear fracture' (LFG) and 'intraparenchymal injury' groups (IPG) based on head CT findings. Demographical/clinical data and laboratory results were obtained from medical records. RESULTS: The neutrophil-lymphocyte ratio was markedly higher in the LFG (p = 0.010 and p = 0.016, respectively) and IPG (p = 0.004 and p < 0.001, respectively) compared with NG. Lower lymphocyte-monocyte ratio (p = 0.044) and higher red cell distribution width-platelet ratio (RPR) (p = 0.030) were associated with intraparenchymal injuries. Patients requiring neurosurgical intervention had higher neutrophil-lymphocyte ratio (p = 0.026) and RPR values (p = 0.031) and lower platelet counts (p = 0.035). Lower levels of erythrocytes (p = 0.005), hemoglobin (p = 0.003) and hematocrit (p = 0.002) were associated with severe TBI and unfavorable outcome (p = 0.012, p = 0.004 and p = 0.006, respectively). CONCLUSIONS: Hematologic parameters are useful in predicting the presence of abnormal cranial CT findings in children with TBI in association with injury severity; surgery need and clinical outcome.

Geometric morphometric analysis of the pharyngeal airway during treatment of Class III malocclusion.

INTRODUCTION: The pharyngeal airway is important during diagnosis and treatment planning in orthodontics. This study aimed to compare the changes in the shape of the pharyngeal airway in patients with Class III malocclusion treated with a facemask (FM) with a removable maxillary appliance and modified tandem traction bow appliance (MTTBA). METHODS: This study consisted of pretreatment and posttreatment lateral cephalograms of 35 subjects with skeletal and dental Class III malocclusion. In the first group, 20 patients (12 males, 8 females; mean age, 10.2 years) were treated with MTTBA. The mean treatment time was 12 months. In the second group, 15 patients (10 males, 5 females; mean age, 10.3 years) were treated with FM. The mean treatment time was 11.7 months. Nineteen pharyngeal landmarks were considered from the image corresponding to the midsagittal plane and marked using tpsDig software (version 2.04; Stony Brook, NY). Pharyngeal airway shape difference between the groups was assessed by performing a Generalized Procrustes analysis. The shape deformation of the pharyngeal airway from the pre- to posttreatment periods was evaluated using the thin-plate spline method. RESULTS: There were no differences between MTTBA and FM groups according to airway shape for pretreatment and posttreatment periods. However, there were some deformities using the enlargement of the nasopharyngeal area in the FM group and oropharyngeal area in the MTTBA group according to pretreatment periods. CONCLUSIONS: There were no differences between the groups according to the mean pharyngeal airway shapes when the posttreatment periods of the FM and MTTBA groups were examined.

Social media awareness among non-urogynecologists regarding the current mesh discussions in urogynecology: a survey study.

INTRODUCTION AND HYPOTHESIS: There has been a great deal of discussion about mesh complications in urogynecology in recent years. However, awareness of other doctors who are not urogynecologists is unknown. This study was aimed at determining the level of awareness of mesh discussions among medical doctors whose specialty is not urology or gynecology. METHODS: A survey study was administered, and all medical doctors, except gynecologists and urologists, were invited. Respondent doctors were classified into four groups: King's College Hospital (KCH), UK; Uludag University Hospital (UUH), Turkey; the United States (USA); and the world (WORLD). The primary outcome was the awareness of mesh discussion in urogynecology, and the secondary outcome was the social media awareness of the mesh discussion. RESULTS: 1231 doctors responded to the survey. The awareness of the current mesh problems among the respondent doctors was 15.8% in KCH, 15.4% in UUH, 26.9% in the USA, and 16.2% in WORLD. The social media awareness about mesh problems was 20.8% in KCH, 20.3% in UUH, 32.8% in the USA, and 20.6% in WORLD. Although there were no differences among three of the groups with regard to primary and secondary outcomes, the USA group score was statistically significantly higher than the others. CONCLUSIONS: Social media can influence doctors' thinking on controversial academic issues. In this survey study, non-urogynecologist doctors in the USA cohort have higher awareness levels and a higher social media awareness level than other groups.

Comparison of endoscopic and pathological findings of the upper gastrointestinal tract in transplant candidate patients undergoing hemodialysis or peritoneal dialysis treatment: a review of literature.

BACKGROUND: Dyspepsia is a common disorder in kidney transplant recipients, and the risk of post-transplant complications is increased in candidates with upper gastrointestinal disease. We evaluated gastrointestinal lesions of kidney transplant candidates on dialysis. METHODS: In this study, endoscopic and pathological findings in hemodialysis (HD) and peritoneal dialysis (PD) patients with gastrointestinal symptoms on the waiting list were compared. RESULTS: The most common non-ulcerous lesions in the endoscopic examination were gastritis (62.3%), erosive gastritis (38.7%), duodenal erosion or duodenitis (18.9%) and esophagitis (13.2%). The ulcerous lesion was present in only 3 patients. Gastroesophageal reflux disease, ulcerated lesion and non-ulcerated lesion rates were similar in both dialysis groups. Histopathological examination revealed Helicobacter pylori (HP) positivity in 28.3% of patients. HP positivity rate was significantly higher in PD patients than in HD patients (38.7% vs. 13.6%, p = 0.046). Chronic gastritis (75.5%) was the most common pathological finding. HP positivity rate was 37.5% in patients with chronic gastritis, but HP was negative in patients without chronic gastritis. In multivariate analysis, male gender, urea and albumin levels were associated with the presence of pathological chronic gastritis. The presence of gastritis, total cholesterol and ferritin levels were found significant for HP positivity. A total cholesterol > 243 mg/dL was significantly related to an increased risk of the presence of HP positivity. CONCLUSIONS: Gastrointestinal lesions and HP infection are common in dialysis patients. Dialysis modality may affect the frequency of some lesions. It may be useful to have an endoscopic examination before entering the transplant waiting list for all candidates.

A Meshless Practical Laparoscopic Sacrohysteropexy Modification and Long-term Outcomes.

STUDY OBJECTIVE: To describe a new modification of laparoscopic sacrohysteropexy without using a mesh and report the 3-year outcomes. DESIGN: A prospective cohort study. SETTING: Minimally Invasive Gynecology Unit, Bursa Uludag University Hospital, Turkey. PATIENTS: Women who were diagnosed with ≥ stage 2 uterine prolapse. INTERVENTIONS: A laparoscopic sacrohysteropexy modification using a polyester fiber suture instead of a standard polypropylene mesh. MEASUREMENTS AND MAIN RESULTS: The primary outcome was the anatomic success of the repair, with success defined as objective parameters using the pelvic organ prolapse quantification system. The secondary outcomes were subjective outcomes, which were assessed using the quality-of-life scales. Forty-seven women who underwent the procedure were followed up for a minimum of 3 years. Forty-four of the 47 patients had stage 0 or 1 prolapse at the end of the second year, according to the primary outcomes. The anatomic success rate was 93.6%. In the secondary outcomes, 2 patients were not satisfied with their pelvic floor after the second year. The subjective cure rate was 95.7%. There was a statistically significant improvement in both pelvic organ prolapse quantification and quality-of-life scores in the third postoperative year. The mean operating time was 84.6 minutes, and the mean estimated blood loss was 21.3 mL. There were no bladder or bowel complications in the perioperative or postoperative period. CONCLUSION: Laparoscopic sacrohysteropexy can be performed safely with this meshless modification in uterine prolapse as an alternative.

Statistical shape analyses of trigonocephaly patients.

PURPOSE: Surgery is the first treatment option for patients with metopic craniosynostosis. Fronto-orbital advancement is the preferred method for correction of isolated trigonocephaly, but it is hard to understand whether surgery has been successful mainly in an early period. We aim to investigate the shape differences in the head shapes of trigonocephaly patients compared between preoperative and postoperative term. METHODS: Cranial shape data were collected from the two-dimensional digital images. The Generalized Procrustes analysis was used to obtain mean shapes of the preoperative and postoperative term. The shape deformation of the frontal calvarium from preoperative to the postoperative term was evaluated using the thin-plate spline (TPS) method. RESULTS: There was significant cranial shape difference between preoperative and postoperative term. The high-level deformations for preoperative to postoperative term determined seen in TPS graphic. Highest deformation was observed at the bifrontal dimension especially at nasion and posterior edge of the forehead. CONCLUSIONS: In this study, we showed that the shape difference and structural deformation of the calvarium were correlated with the metopic craniosynostosis. The present study also shows that preoperative and postoperative head shapes of patients with trigonocephaly can be compared using the landmark-based geometrical morphometric method by taking into consideration the topographic distribution.

The efficacy of the 3-dimensional vibe-caipirinha-dixon technique in the evaluation of pancreatic steatosis

Background/aim: CAIPIRINHA is a new technique in abdominal imaging. Pancreatic steatosis (PS) is a subject of increasing scientific interest. The aim of this study was to investigate the efficacy of the isotropic 3D-VIBE- CAIPIRINHA -DIXON technique on a new generation 3-tesla MR unit in the evaluation of PS. Materials and methods: In this retrospective study, the imaging findings of 49 patients with PS and 41 control subjects were examined. The pancreas-to-spleen ratio (PSR), pancreas-to-muscle ratio (PMR), and pancreatic signal intensity index (PSII) were defined as 3 new parameters and these indexes were calculated from the in-phase/out of phase 3D-VIBE- CAIPIRINHA-DIXON images. Results: The PSR, PMR, and PSII values were significantly different between the patient and control groups (P = 0.001, P = 0.009, P < 0.001, respectively). Statistically significant differences were observed between patient and control groups for ROI measurements of fatty areas on these sequences/images: subtraction (in-out) (P < 0.001), T2W HASTE (P < 0.001), DIXON-fat (P < 0.001), fat-suppressed T1W (P = 0.002), and subtraction (out-in) (P = 0.010). Conclusion: Evaluation of PS with the 3D-VIBE-CAIPIRINHA-DIXON technique can be made rapidly and effectively.

Long-term follow-up of laparoscopic sacrocolpopexy: comparison of two different techniques used in urology and gynecology.

INTRODUCTION AND HYPOTHESIS: Numerous studies have found that the short-term results of laparoscopic sacrocolpopexy for pelvic organ prolapse are safe and effective. This study evaluates the long-term results of the laparoscopic sacrocolpopexy operation between the urology and gynecology branches. METHODS: A prospective study enrolling 206 patients was conducted to evaluate laparoscopic sacrocolpopexy as a surgical treatment for vaginal vault prolapse from 2011 to 2014. Two different surgical branches (urology and gynecology) applied laparoscopic sacrocolpopexy to their patients with their own techniques. The long-term results were assessed postoperatively after 4 years by pelvic examinations, including the Pelvic Organ Prolapse Quantification system (POP-Q) and quality-of-life assessments using validated questionnaires. RESULTS: A total of 190 patients (94 urology and 96 gynecology patients) received a full clinical follow-up examination between April 2014-June 2018. Postoperative pelvic organ prolapse recurrence rates in each compartment were similar in both groups during the 4 years; 87.2% of the urology and 86.5% of the gynecology patients had no prolapse in any compartment according to the POP-Q system. The reoperation rate was 5.3% for the urology and 6.2% for the gynecology group. Mesh erosion was detected in two patients in both groups. Three patients responded to local estrogen therapy, and we removed the mesh vaginally in one patient. The subjective cure rate was 89.4% in the urology and 88.5% in the gynecology group after 4 years. CONCLUSIONS: Although different surgical branches perform laparoscopic sacrocolpopexy with their own techniques, long-term anatomical and functional results are similar between the branches. From a urogynecological point of view, laparoscopic sacrocolpopexy is a gold standard surgical procedure that can be performed by both urologists and gynecologists with similar long-term outcomes.

Statistical Shape Analysis of Cerebellum in Patients With Chiari Malformation I.

The surgical procedure is viewed as a typical treatment choice for patients with Chiari malformation (CM). Decompression is the preferred method for surgery, but it is not always possible to understand whether decompression has been successful especially in an early period. The present study focuses on investigating the shape differences in the cerebellums of Chiari patients compared with healthy controls, and to assess the clinical application of this situation whether if present. The MRI scans were reviewed retrospectively. Cerebellar data were obtained from the digital images and 9 anthropometric landmarks were marked on each image. Shape difference was assessed by performing Generalized Procrustes analysis. The cerebellar shape deformation from control to the patient was evaluated performing the Thin Plate Spline approach. There is a statistically significant cerebellar shape difference between groups. Highest deformation was determined at the cerebellar tonsillar inferior area, posterior of the uvula, and anterior of inferior medullary velum. The present study demonstrated cerebellar shape differences in CM I patients using a landmark-based geometric morphometric approach, considering the topographic distribution of cerebellum for the first time.

The efficacy of new oral contrast mixture for computed tomography enterography.

PURPOSE: To show the reliabilities of the new mixture (composed of water, methylcellulose, lactulose, locust bean gum, and sorbitol) and to compare the luminal distension and radiological confidence scores of this solution with water-lactulose mixture. MATERIAL AND METHODS: Computed tomography enterography (CTE) images in a three-year period were included randomly in our institutional review board-approved and retrospective study. Ninety-one patients drank a lactulose and water mixture (Group 1), and 54 patients drank the new mixture (Group 2). Patients who drank the oral contrast agent were taken to a 64-detector row multiple detector computed tomography machine. Coronal and sagittal reformatted images were also formed. The gastrointestinal tract was divided into 11 segments for scoring. Each segment was graded for distensional and radiological confidence. CTE images were evaluated by two radiologists. RESULTS: Inter- and intra-reader reliabilities were good or excellent for all gastrointestinal segments in both groups (p < 0.001). The best κ values were obtained in sigmoid colon assessments. Lower agreement values were detected in duodenum and jejunum scores. The new mixture group (Group 2) showed better results than Group 1 for ileum and colonic segments according to distension and confidence scorings. CONCLUSIONS: Inter- and intra-reader reliabilities of the new mixture were good or excellent for CTE. The new mixture seems to be more efficient and reliable for ileum and colon. The new mixture can increase bowel distention, radiological confidence, and quality in CTE evaluations.

A new percutaneous technique: N-butyl cyanoacrylate adhesive for the treatment of giant saphenous vein insufficiency.

Background We have made a retrospective evaluation of the results of the cyanoacrylate ablation technique which has recently started to be used in the treatment of giant saphenous vein insufficiency today and in which tumescent anesthesia is not required. Methods Giant saphenous vein was treated in 50 patients between September 2015 and September 2016 by using endovenous cyanoacrylate ablation. In the procedure, tumescent anesthesia and varsity socks were not used. Control duplex ultrasound evaluation was performed in the post-procedural 1st, 6th and 12th months. Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire scores were evaluated. Results In the 50 patients who were treated, full closure was observed in giant saphenous vein in 47 (94%) patients in the 12th month control duplex ultrasound. The mean age of the patients was 46.4 (20-70) and 30 (60%) of them were female. The median Venous Clinical Severity Score scores in the 1st, 6th and 12th months were 3, 2 and 1, respectively ( p < 0.001); the median Aberdeen Varicose Vein Questionnaire scores in the 1st, 6th and 12th months were 7, 5 and 4, respectively ( p < 0.001). In the access site, two (4%) patients developed phlebitis and one (2%) developed ecchymosis. However, deep venous thrombosis, pulmonary embolism and paresthesia were not observed. Conclusion Considering the early period results in the treatment of giant saphenous vein insufficiency, cyanoacrylate ablation makes a more reliable alternative than endovenous thermal ablation methods in that it does not require tumescent anesthesia and it has a low incidence of adverse effects.

Platelet indices in preterm premature rupture of membranes and their relation with adverse neonatal outcomes.

AIM: Preterm premature rupture of membranes (PPROM) is not only the most common distinguishable cause of preterm delivery, but is also associated with adverse neonatal outcomes. We determined the platelet indices in PPROM cases and evaluated their relationship to adverse neonatal outcomes. METHODS: Fifty patients with PPROM and 50 patients who experienced spontaneous preterm labor at < 37 gestational weeks were evaluated. Complete blood counts, birth weights, Apgar scores, presence of sepsis and respiratory distress syndrome (RDS) and neonatal intensive care unit admission were recorded. RESULTS: Patients with PPROM had increased mean platelet volumes (9.40 vs 10; P = 0.01), plateletcrit (0.19 vs 0.21; P = 0.03) and a higher frequency of neonatal sepsis (18% vs 38%; P = 0.02). Platelet indices in the patient group were compared according to the development of RDS. Plateletcrit values were higher in the RDS positive group (0.23 ± 0.05 vs. 0.21 ± 0.04; P = 0.04). The cut-off value for plateletcrit was determined as > 0.22, and the probability of RDS increased 5.86 times when plateletcrit values exceeded 0.22 (odds ratio 5.86, 95% confidence interval 1.01-32.01; P = 0.04). A one-unit increase in platelet distribution width resulted in a 1.33-fold increase in the risk of RDS (odds ratio 1.33, 95% confidence interval 1.01-1.77; P = 0.04). CONCLUSION: Mean platelet volumes and plateletcrit significantly increased and plateletcrit had a predictive value for RDS in PPROM cases. Monitoring plateletcrit may be promising for predicting the development of RDS, one of the most common and serious complications of PPROM rupture.

Evaluation of age estimation in forensic medicine by examination of medial clavicular ossification from thin-slice computed tomography images.

Forensic age estimation, a recent topic of research in forensic medicine, is of primary importance to criminal and civil law. Previous studies indicate that the observation of medial clavicular ossification allows for age discrimination along the completed 18th and 21st years of life. Experts recommend that the Schmeling and Kellinghaus methods be used together. In this study, we used these staging methods to retrospectively analyze 725 case studies (385 males, 340 females) of thin-slice computed tomography (CT) images, ranging from 0.6 to 1 mm in thickness, from individuals aged 10 to 35 years. Stage 1 was found at 18 years of age maximum for males, whereas it was found at 17 years of age for females. Stage 2a was found at 18 years of age maximum for both genders. Stage 3c was initially observed at 18 years for both genders. Stage 4 was initially found at 21 years for males and 20 years for females. Stage 5 was initially observed at 25 years for both genders. Of note, stage 3c was found close to 19 years of age for both genders (18.92 years for male, 18.99 years for female), and it may be employed to differentiate along the age majority cutoff. The data obtained from our study were consistent with previous studies. We believe that such a comprehensive database will greatly contribute to future studies focusing on medial clavicular ossification based on thin-slice CT. Moreover, we also recommend that if medial clavicular ossification based on CT is to be examined for forensic age estimation, both methods should be employed together.