Video-based digital platforms as an educational resource for the surgical preparation of orthopedic surgeons

SUMMARY OBJECTIVE: The aim of the study was to research the video-based digital platforms that orthopedic specialists in Turkey use as an educational resource in their surgical preparations that they have not seen or done before, the frequency of their use of these platforms, and their trust in these platforms, with a survey study. METHODS: The importance of video-based digital platforms in surgical preparations that surgeons have not seen or done before was measured using the data obtained from 181 orthopedic specialists using a survey prepared on an Internet-based server (docs.google.com). RESULTS: Orthopedists used video-based digital platforms with a ratio of 38.7% among the educational resources in their surgical preparations that they have not seen or done before. There was no significant difference between the specialists with a surgical experience of 1-10 years and more than 10 years of experience in terms of using video-based digital platforms in surgical preparation (p>0.05). A total of 81.2% of the participants used only video-based digital platforms in the preparation of a surgical procedure they have never seen before. The most frequently used digital platform was YouTube, and 62% of the participants considered these platforms reliable. CONCLUSION: Orthopedic specialists in Turkey primarily and frequently use video-based digital platforms as a training resource in their preparations for surgery that they have not seen or done before. The establishment or support of platforms with evidence-based content with references from official orthopedic institutions and organizations can increase the trust of orthopedic specialists in these platforms.

Plasma Calcium Level and C-Reactive Protein Albumin Ratio Affect Severe Bleeding After Coronary Artery Bypass Grafting

ABSTRACT Objective: In this study, we aimed to determine whether plasma calcium level and C-reactive protein albumin ratio (CAR) as well as other demographic and hematological markers are related in predicting severe bleeding after coronary artery bypass grafting (CABG). Methods: A total of 227 adult patients who underwent CABG at our hospital between December 2021 and June 2022 were prospectively studied. Total amount of chest tube drainage was evaluated within the first 24 hours postoperatively or until the patient was re-explored for bleeding. The patients were divided into two groups - Group 1, patients with low amount of bleeding (n=174), and Group 2, patients with severe bleeding (n=53). Univariate and multivariate regression analyzes were performed to determine independent parameters related to severe bleeding within the first 24 hours after surgery. Results: When the groups were compared in terms of demographic, clinical, and preoperative blood parameters; cardiopulmonary bypass time and serum C-reactive protein (CRP) levels were found to be significantly higher in Group 2 compared to the low bleeding group. In addition, lymphocytes, hemoglobin, calcium, albumin, and CAR were found to be significantly lower in Group 2. In multivariate analysis, calcium, albumin, CRP, and CAR were found to be independent predictors of significant association with excessive bleeding. A cut-off value of 8.7 (94.3% sensitivity and 94.8% specificity) for calcium and 0.155 (75.4% sensitivity and 80.4% specificity) for CAR predicted excessive bleeding. Conclusion: Plasma calcium level, CRP, albumin, and CAR can be used to predict severe bleeding after CABG.

A clinical and surgical challenge: Retrorectal tumors

Aims: Retrorectal tumors are rare, mostly benign tumors and named due to their localization. Diagnoses of these tumors are usually delayed because of nonspecific complaints and symptoms. Magnetic resonance imaging has beneficial uses both for diagnosis and treatment. In this study, we reviewed a case series of retrorectal tumors. Subjects and Methods: The patients who were diagnosed with retrorectal tumors between 2008 and 2015 were analyzed. This investigation was conducted at a Tertiary Education and Research Hospital. Sixteen patients were included in this study. Patients' demographic data, imaging workups, surgical operation reports, pathologic examination results, postoperative complications, and follow-up results were examined. Descriptive statistics, median, and standard deviation for continuous variables were used. The primary outcomes measured were diagnostic conflict, knowledge, and preference for surgery. Statistical Analysis Used: Definitive statistical methods (mean, standard deviation, median, frequency, and percentage) were used to evaluate the study data. Results: One patient refused operation and one was in preoperative preparation period. Fourteen of sixteen patients were operated. Two (14.3%) of operated patients have malignant histopathological result (one gastrointestinal stromal tumor, one ganglioneuroblastoma). Rest of the operated patients' histopathological reports was as follows: Four schwannomas, three epidermoid cysts, two tailgut cyst, one dermoid cyst, one teratoma, and one angiomyolipoma. Eight patients were operated by posterior incision, five patients with transabdominal approach, and one patient with combined approach. Conclusions: Retrorectal tumors are rare cases, and treatment of retrorectal tumors is surgery and should be operated in referenced hospitals to avoid diagnostic and therapeutic problems.

Relation between platelet indices and branch retinal vein occlusion in hypertensive patients.

Backgroud: Branch retinal vein occlusion (BRVO) is the second most common retinal vascular disease after diabetic retinopathy. To date, the studies were unable to elucidate the mechanism of the thrombosis leading to the entity; particularly the relation between thrombocyte aggregation and retinal vein occlusion is still unclear. Mean platelet volume (MPV) is a determinant of rate of platelet production and activation, both of which are indices of function of platelets. The relation between MPV and BRVO has not been studied before. The aim was to evaluate MPV in BRVO. Materials and Methods: Forty patients were included in the study. Forty six age and sex matched hypertensive volunteers were recruited as the control group. Results: MPV values were significantly higher in BRVO patients compared with the control subjects (8.01 ± 0.79vs 7.52 ± 0.32fL, respectively; P < 0.001). Conclusion: MPV is significantly higher in patients hypertensive BRVO patients and further investigations regarding its potentially use as a prognostic biomarker in patients with BRVO are needed.

Horizontol dissemination of TEM- and SHV-typr beta-lactamase genes-carrying resistance plasmids amongst clonical isolates of Enterobacteriaceae / Disseminação horizontal de plasmídios de resistência contendo genes de beta-lactamase dos tipos TEM e SHV entre isolados clínicos de Enterobacteriaceae

The extended-spectrum â-lactamase (ESBL)-producing bacteria have been isolated at increasing frequency worldwide. Expression of ESBL is often associated with multidrug resistance and dissemination by resistance plasmids. During a two-month period in 2000, 133 clinical isolates of enterobacterial strains were randomly collected from outpatients and inpatients at a university hospital in Turkey. The ESBL producing strains were determined by double-disk synergy (DDS) testing. Twenty ESBL producing strains (15 percent) including Escherichia coli (n = 9), Klebsiella pneumoniae (n = 7), Klebsiella oxytoca (n = 2) and Enterobacter aerogenes (n = 2) were detected and further analyzed for their resistance transfer features, plasmid profile and nature of the resistance genes. Plasmid transfer assays were performed using broth mating techniques. TEM- and SHV- genes were analyzed by polymerase chain reaction (PCR) and hybridization using specific probes. EcoRI restriction enzyme analyses of R plasmids were used in the detection of epidemic plasmids. Fourteen plasmid profiles (A, B1, B2, C1, and C2 to L) were obtained with EcoRI restriction enzyme analysis. Most of these plasmids were detected to carry both TEM- and SHV-derived genes by PCR, and confirmed by localizing each gene by hybridization assay. Epidemiological evidence indicated that there was an apparent horizontal dissemination of conjugative R plasmids among multidrug-resistant enterobacterial genera and species in this hospital

O isolamento de bactérias produtoras de beta-lactamases de espectro expandido (ESBL) está aumentando no mundo todo. Freqüentemente, a expressão de ESBL está associada com resistência a múltiplas drogas e disseminação por plasmídios de resistência. Durante um período de dois meses em 2000, 133 isolados clínicos de cepas de enterobactérias foram obtidos aleatoriamente de pacientes internos e externos de um hospital universitário na Turquia. As cepas produtoras de ESBL foram identificadas pelo teste de sinergia em disco-duplo (DDS). Foram detectadas vinte cepas produtoras de ESBL, entre as quais Escherichia coli (n=9), Klebsiella pneumoniae (n=7), Klebsiella oxytoca (n=2) e Enterobacter aerogenes (n=2), que foram posteriormente analisadas quanto a suas características de transferência de resistência, perfil plasmidial e natureza dos genes de resistência. Os testes de transferência de plasmídios foram realizados empregando técnicas de conjugação em caldo. Os genes TEM e SHV foram analisados pela reação da polimerase em cadeia (PCR) e hibridização com sondas especificas. A detecção de plasmídios epidêmicos foi feita por análise dos plasmídios R com a enzima de restrição EcoRI. Através desta análise, foram obtidos catorze perfis plasmidiais (A, B1, B2, C1 e C2 até L).Observou-se pela PCR que a maioria dos plasmidios carregavam genes derivados de TEM e SHV, confirmados através da detecção dos genes pelos testes de hibridização. As evidencias epidemiológicas indicaram que havia uma aparente transferência horizontal dos plasmídios R conjugativos entre as enterobactérias multiresistentes neste hospital.

Association between mental stress & some antioxidant enzymes of seminal plasma.

BACKGROUND & OBJECTIVE: Mental stress, which is responsible for various disorders, is one of the most important medical and social problems. It is reported that mental stress causes abnormality in sperm quality. Most of the previous investigations done to study the association between mental stress and infertility were carried out with infertile men. Infertility itself and/or its therapy may lead to stress. Further, most studies investigating the association between psychological stress and semen quality have lacked information on biochemical parameters. In the present study, we investigated the effect of mental stress due to final exams on two important antioxidant enzymes of the seminal plasma, superoxide dismutase (SOD) and catalase in normal healthy medical students. METHODS: Semen samples were collected from 27 healthy male volunteers, who were third semester students of a medical school, just before (stress period) and 10.19+/-0.83 wk after (non-stress period) the final examinations. Psychological stress of participants was measured by the State Trait Anxiety Inventory. After standard semen analysis, semen samples were centrifuged at 10,000 x g for 15 min. Superoxide dismutase (SOD) and catalase activities were measured in the seminal plasma. RESULTS: During stress period, stress scores and SOD activities increased significantly compared to the non-stress period. Catalase activities showed no change. Spermatozoa concentrations, motility index and percentage of rapid progressive motility decreased under stress. INTERPRETATION & CONCLUSION: Our results indicated that mental stress negatively affected semen quality. Increase in SOD activities led to poor quality of semen parameters.