Aim: This study analyzed outcomes after short-segment pedicle screw-based semi-rigid stabilization with Poly (etheretherketone)
(PEEK-polymer) rods in elderly patients with degenerative lumbar scoliosis. To date, there is no high level of evidence (Level-I) in the
relevant literature. Therefore, this is the initial report about use of PEEK-polymer rods in elderly patients with degenerative lumbar
scoliosis.
Material and Methods: From January 2015 to June 2017, 31 patients aged over 60 years with degenerative lumbar scoliosis,
who underwent pedicle screw-based semi-rigid stabilization with PEEK-polymer rods were investigated. All medical records and
radiological images were reviewed to evaluate surgery-related complications and clinical outcomes.
Results: Patients demonstrated clinically significant functional improvement (Oswestry Disability Index) with an average of 69.3%
during an average follow-up of 36.1 months (range, 24–54 months) after surgery. Patients displayed significant Visual Analog Scale
(VAS) improvements when comparing pre- and postoperative scores at an average change of 76% and 80% for VAS for back pain and
leg pain, respectively. No neurological deficit was observed after surgery.
Conclusion: Satisfactory percentage in functional and pain improvement as well as low rate of instrument-related complications
was obtained after pedicle screw-based stabilization with PEEK-polymer rods. This system can now be considered a viable option
in elderly patients with the degenerative lumbar scoliosis.
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Aim: The etiology of neural tube defect (NTD) is still not clear enough. In our study, we aimed to evaluate plasma heavy metal levels
of pregnant women with NTD and to determine whether there is a relationship between heavy metal levels and NTD severity.
Material and Methods: TThis study was conducted in Adıyaman University, Department of Gynaecology and Obstetrics. The study
included 38 pregnant women with NTD and 42 pregnant women with healthy infants. Pregnant women who have NTD were divided
into two groups as NTD Type 1 and NTD Type 2 according to the anomaly type. Levels of heavy metals such as Mercury (Hg),
Cadmium (Cd), Cobalt (Co), Lead (Pb), Manganese (Mn) and Arsenic (As) were compared between groups.
Results: Plasma Hg, Co, Cd and Pb levels were higher in NTD group than control group. (p values, respectively; p <0.001, p = 0.001, p
<0.001, p <0.001). As and Mn levels were not statistically different between the two groups (p values; p = .519, p = .819, respectively).
In the NTD group, Hg was found to be higher in NTD Type 1 than NTD Type 2 (p <0.001).
Conclusion: It is obvious that some histomorphological changes are formed in the cardinal ligaments of patients with uterine
prolapse due to pressure on the uterus. We believe that the increase in the number of extravasated erythrocytes and the thickness
of the vascular wall and peripheral nerve should be supported by further studies.
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Aim: In this study, we aimed to evaluate the relationship between survival of patients with lymphoma who were considered to be
negative for bone marrow (BM) infiltration and BM FDG uptake on PET / CT.
Material and Methods: This retrospective study included 55 patients diagnosed with lymphoma (33 HL and 22 NHL), with no BM
infiltration (by biopsy or clinically negative) and having pre-treatment PET / CT. According to the pattern of BM FDG uptake on PET
/ CT the patients were divided into three groups as; those with focal FDG uptake (F-FDG), those with diffuse increased FDG uptake
(D-FDG) and those with normal FDG uptake (N-FDG). The overall survival (OS) and progression-free survival (PFS) curves of the
patients were plotted with Kaplan Meier method. The OS and PS of patients who were grouped according to the pattern of BM FDG
uptake on PET / CT, gender, disease stage and lymphoma type were compared with Log Rank test.
Results: The mean follow-up period of our study was 23.7 ± 2.1 months (1-53 months). The mean OS was 41.9 ± 2.8 months, and
the mean PFS was 37.8 ± 3 months. Ten patients showed focal or multifocal FDG uptake of BM on PET / CT (F-FDG). 28 patients
had diffuse increased FDG uptake in the BM (D-FDG). In 17 patients, BM FDG uptake was within normal limits (N-FDG). There was
no significant difference between OS and PFS of patients grouped according to gender, stage of disease, type of lymphoma and BM
FDG uptake pattern (p> 0.05). Older age was associated with shorter OS and PFS.
Conclusion: In our study, no significant relationship was found between BM FDG uptake on PET / CT and survival of patients with
lymphoma with negative BM infiltration. However, although PET / CT does not completely replace BM biopsy, it may be helpful in
detecting early infiltration of BM.
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Aim: Aim of the present study is to indicate the incidence of os fabella in our population and to evaluate the side and gender related
differences.
Material and Methods: 500 patients (224 females, 276 males) who underwent Magnetic Resonance Imaging (MRI) for various
indications were enrolled in the present study. Patients had no history of trauma or surgery. MR images of the patients were evaluated
retrospectively.
Results: 140 patients with os fabella were reported (28%). 52 of the 140 patients were females (37%) 88 were males (63%). Male
predominance in this study was statistically significant. (p= 0.003). Bilaterality incidence of os fabella was 25.71%. There was no
statistically significant incidence difference between left and right sides. (p = 0.1005) Difference between genders according to
length and width of os fabella was evaluated in 96 patients who underwent bilateral knee MR imaging. Length of right sided os
fabella was greater in males than in females (p = 0.003).
Conclusion: Proper understanding of anatomy and variations of knee region is important for diagnosis and treatment of patients
with knee problems. Os fabella is one of the variations in the knee region which has clinical importance and may cause diagnostic
pitfalls and surgical complications.
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Aim: To assess the characteristics of severe head trauma in the pediatric age group and to analyze its results under the current
guideline.
Material and Methods: Eighty pediatric patients (<18 years) admitted to our hospital with the diagnosis of severe head trauma and
treated by neurosurgery and the pediatric intensive care unit (ICU) between 2014 and 2018 were analyzed retrospectively. Of these,
68 patients who met the study criteria were selected. Besides the demographic data of the patients, the presenting neurologic, clinic,
radiologic and laboratory findings were recorded. Then the association between these variables and 1-year Glasgow Outcome Scale
(GOS) scores was analyzed.
Results: There is a correlation between the presenting GCS scores and 1-year GOS scores of the patients when grouped as favorable
(4-5) and unfavorable (1-3). Regarding the other admission findings, the patients with hypothermia, the patients with hyperglycemia,
the patients to whom CPR was applied, the patients with pupillary areflexia, the patients with hypoxia and the patients with neurological
deterioration have lower 1-year GOS scores. There was no difference between the gender, age, type of injury, type of trauma (isolated
head trauma or multiple trauma), presence of shock on admission, having hematoma surgery, having decompressive craniectomy,
treatment with ICP monitoring and 1-year GOS scores. The overall mortality rate was 29.4% (20 patients), and the rate of poor
prognosis (GOS 1-3) was 48.5% (33 patients).
Conclusion: Children with severe head trauma should be treated at centers that are experienced in the field per updated guidelines.
Since the morbidity and mortality rates of severe head trauma are still high, efforts toward improving preventive measures should
also be considered.
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Aim: Cerebral palsy (CP) is the most common neuromuscular disorder of the childhood for which various therapeutic modalities
available, which range from conservative approach to surgery. In the present study, we aimed to evaluate the efficacy of robot
assisted gait training in patients with cerebral palsy following botulinum toxin injections in the lower extremity.
Material and Methods: The study enrolled children (4 to 16 years of age) diagnosed with CP presenting to the Physical Therapy
outpatient clinic who had level 1 to 4 walking difficulty associated with lower extremity spasticity according to the GMFCS (Gross
Motor Function Classification System) and received botulinum toxin injections to the lower extremity within the previous month.
CP patients received robot-assisted gait training five times a week over 3 weeks for a total of 15 sessions by two physiotherapists
under the supervision of a physician. Study assessments included measurements of the range of motion (ROM) of the joints and the
popliteal angle, GMFCS-88, Berg Balance Scale (BBS) and the and Pediatric Functional Independence Measure (WeeFIM) which were
conducted before and after treatment.
Results: A total of 14 pediatric patients (8 girls, 6 boys) were included in the study. The mean age of the children was 9.93±3.54
years. A statistically significant reduction in the popliteal angle was found at post-treatment assessments compared to baseline.
Berg Balance Scale, WeeFIM and GMFCS-88scores were significantly improved following treatment.
Conclusion: Robot-assisted gait training following botulinum toxin injections were found to provide marked improvements in motor
functions, balance, spasticity and functional status in children with CP.
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Aim: To report demographic, clinical and laboratory findings with clinical outcome in childhood-onset systemic lupus erythematosus
(cSLE)
Material and Methods: Charts of all children with cSLE followed at pediatric rheumatology clinic of Gaziantep University between
2000-2016 were reviewed. Demographic data, history, age at diagnosis, physical examination, laboratory investigations, diagnostic
criteria, follow-up duration and all therapeutic regimens were noted. The pediatric adaptation of the Systemic Lupus International
Collaborating Clinics American College of Rheumatology Damage Index (PedSDI) has been used to evaluate the disease outcome.
Results: The study population was consisted of 39 patients, 31 girls and 8 boys who were under 18 years at the time of diagnosis.
Female: male ratio was 4.7:1. The mean age at disease onset was 10.5±4.56 years, and the mean follow-up duration was 26.4±
17.8 months. At the end of the follow-up period, fifteen patients (38.5%) had accrued damage (PedSDI≥1). We observed that renal,
neuropsychiatric and musculoskeletal damage was the most frequent types of damage (38.5%). The damage score was higher in
patients having increased number of diagnostic criteria at presentation (p:0.001).
Conclusion: Although our study showed less damage index than patients from other countries, it has been well known that the
damage accrual in SLE is higher in long term period, and mean follow-up period of our patients is lower than previous reports. We
conclude that damage mainly affects renal, neurophyschiatric and musculoskeletal systems, and increased number of diagnostic
criteria at presentation may cause much more damage.
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Aim: Long term control of glucotoxicity was shown to increase the secretion of insulin and C-peptide (Cp). We aimed to investigate
the change in Cp levels after short term glycemic control in patients with uncontrolled type 2 diabetes mellitus (DM).
Material and Methods: Patients with type 2 DM with uncontrolled hyperglycemia were included. Basal fasting Cp levels were
measured both at admission (Cp-admission) and after control of hyperglycemia prior to discharge (Cp-discharge). Cp-difference
was calculated as (Cp-discharge)-(Cp-admission). The patients were divided as group 1 (positive Cp-difference) and group 2
(negative Cp-difference), and group A (Cp-difference ≥+0.5) and group B (Cp-difference ≤-0.5).
Results: Of the patients (n=123), 61.8% had positive Cp-difference, and mean Cp-differences were 0.16 (±1.59), 0.96 (±1.03), and
-1.11 (±1.51) in all patients, group1 and 2; respectively (p=0.001). Mean body weight, creatinine and Cp-discharge were higher in
group 1(p=0.045, p=0.013, p=0.001; respectively). Mean age, body mass index(BMI), diabetes duration, hospitalization, proteinuria,
fasting and postprandial glucose, glucose-discharge, HbA1c, lipids, TSH, free T4, Cp-admission were similar in group 1 and 2.Cpdifference was correlated positively with Cp-discharge(p=0.001), negatively with Cp-admission (p=0.001). There were no significant
differences between subgroups (age, BMI, diabetes duration, use of secretagogue, diabetic ketaoacidosis history, HbA1c (<10 or
≥10%), hyperlipidemia, microvascular complication) regarding to Cp-difference. Positive predictors of positive Cp-difference were
cardiovascular disease (p=0.004; Odds Ratio(OR)=3.006) and higher Cp-discharge(p=0.001; OR=6.420);positive predictors of Cpdifference ≥+0.5 were male, lower Cp-admission and higher Cp-discharge.
Conclusion: Our results indicate that short-term glycemic control has little but significant positive effect on basal Cp. Having
cardiovascular disease was positive predictor for positive Cp-difference.
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Ectodermal dysplasia (ED) is a hereditary disease characterized by anomalies in the structures of ectodermal origin. This report aims
to determine the oral features of patients with ED syndrome and to present treatment approaches. Because of nutrition, speech and
aesthetical problems due to the lack of teeth 22 patients with ED syndrome referred to faculty dentistry clinic. Facial physiognomy
was typical for ED and the facial height was decreased due to the vertical dimension and the delalet exfoliation of primary teeth.
Also anodontia, hypodontia, delayed eruption, diffuse enamel hypoplasia, conical tooth structure, talon cusps, microdontia, and,
transposition in teeth were seen in patients. In most cases, prosthesis were applied to improve the facial aesthetics, speech and oral
function due to the common hypodontia. The primary goals of the dental treatment of patients with ED are enhancing aesthetics and
improving masticatory function. The oral rehabilitation of the patients’ needs multidisciplinary dental treatment.
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Abstract
Aim: The aim of this study was to evaluate the clinical efficacy and safety of intravesical botulinum neurotoxin-A injection in patients with refractory overactive bladder to conservative treatment and anti-muscarinic drugs.
Material and Methods: The data of 62 patients, who received botulinum neurotoxin-A (BonTA) injection (100 U) for overactive bladder (OAB) between 2015 and 2019, were reviewed retrospectively. For 55 patients included into the study, the urinary frequency and urgency, the number of incontinence and nocturia episodes, the maximum flow rate (Qmax), the post-void residual volume (PVR), and the Urinary Incontinence Quality of Life (I-QoL) scores were evaluated before the treatment and at the third month after the treatment.
Results: The comparison of the pre-treatment and posttreatment 3rd-month follow-up data revealed a statistically significant decrease in the urinary frequency and urgency, and the number of incontinence and nocturia episodes (p <0.05). There were no statistically significant differences in Qmax and PVR in the posttreatment 3rd month (p> 0.05). The mean I-QoL score increased significantly in the posttreatment 3rd month compared to the pre-treatment scores (43.62 ± 11.2 and 75.2 ± 12.6, p = 0.001, respectively). After the treatment, hematuria developed in 3 female and 2 male patients and urinary tract infections developed in 4 females and 2 male patients.
Conclusion: BonTA injection significantly improves the daily urinary frequency, incontinence, and quality of life scores in patients with OAB.
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