Predictive value of systemic immune inflammation index (SII) and prognostic nutritional index (PNI) on mortality after below-knee amputation.

This retrospective cross-sectional study aimed to evaluate the predictive value of SII (Systemic Immune Inflammation Index) and PNI (Prognostic Nutritional Index) with blood ratios on mortality in diabetic foot patients who underwent below-knee amputation. A total of 231 living (n = 71; 30.7%) and exitus (n = 160; 69.3%) patients were evaluated. The mortality group was divided into 3 groups: 30-day mortality (n = 62; 38.8%), 1-year mortality (n = 62; 38.8%), and over-1-year mortality (n = 36; 22.5%). The hemogram, SII, and PNI parameters of the patients were evaluated. Age, some blood count parameters and SII were significantly higher in the exitus group (P < .05). The lymphocyte, monocyte, eosinophil, albumin, and PNI levels were significantly higher in the living group (P < .05). Mortality was significantly predicted by age (B [regression coefficient] = 0.026, P < .05), NLR (neutrophil lymphocyte ratio) (B = -0.065, P < .05), PNI (B = -0.100, P < .01), and SII (B = 0.00000024, P < .01). The predictive values of CAR (C reactive protein albumin ratio), PNI, and SII were 77.3%, 77.0%, and 76.1%, respectively. For CAR of 30.88 cutoff value, the sensitivity and specificity were 79.4% and 64.8%, respectively. For the PNI 22.0143 cutoff value, the sensitivity and specificity were 66.9% and 5.6%, respectively. For the SII 732249.2481 cutoff value, the sensitivity and specificity were 91.9% and 31.0%, respectively. The predictive value of the PNI was significant for mortality time (B = 0.058; P < .01). The predictive value of PNI for 30-day mortality was significant (AUC (area under curve):0.632; P < .01), whereas its predictive value for 1-year mortality and over-1-year mortality after below-knee amputation was statistically insignificant (P > .05). Both the SII and PNI may be evaluated and used to predict mortality after below-knee amputation. The SII had a significant predictive value for 30-day mortality after below-knee amputation.

A Bibliometric Study on Charcot Foot Deformity.

In this study, we investigated the literature's publication trends related to the Charcot foot deformity. Using bibliometric analysis to examine the data of origin, this analysis was carried out by conducting an electronic search of the Web of Science database for research articles between 1970 and March 2023. We used the following search term in the search bar: TI = (Charcot foot OR Charcot foot deformity OR Charcot's foot OR Charcot Osteopathic Arthropathy) with English language and article-format filtering for documents. The bibliometric analysis was carried out using R's "Bibliometrix" package program. A total of 437 articles were found in the electronic search. A total number of 1513 authors from around the world contributed to the Charcot foot literature, with the most articles published (42.1%) originating in the United States. The United States had the highest proportion of citations (3332 citations). The highest number of articles (n = 245) on Charcot foot deformity was in the last decade. 2021 was the year with the most articles (n = 34). The authors from the United States and the United Kingdom had the highest number of international collaborations. The study offers researchers a current overview of essential data and may help direct future research by summarizing the main points and research trends on the topic of Charcot foot deformity.

Limb Ischemia Associated With Covid-19 and Its Treatment With Above-Knee Amputation.

An 84-year-old male patient with no known comorbidity was admitted to the emergency department with complaints of dyspnea and respiratory distress. The patient was referred to the COVID outpatient clinic, laboratory and radiology tests were performed. Thoracic CT scan of the patient showed large peripheral patchy ground glass densities observed in the lower lobes of both lungs. CT imaging findings were evaluated by an experienced radiologist and reported as COVID-19 pneumonia. The patient, who was self-isolated at home for 5 days, presented to the emergency department again on the fifth day with complaints of respiratory distress, fever, bruising with cough, and loss of peripheral pulse in the left lower extremity. Necessary tests were performed on the patient. An above-knee amputation was performed when a diagnosis of limb ischemic necrosis was made and no revascularization attempt was considered by the CVS department. This case study describes the coexistence of sudden lower extremity thrombosis and Covid-19 in our case without a known chronic disease.

Should you fix again? An unusual fracture of a distal epiphyseal radius fracture - A case report.

Currently, Salter-Harris (SH) classification is generally used in physeal fractures, as it is reliable and valuable in many cases. Although this clasification system describes many different fracture configurations, still there is an unclassifed group of fractures. Here, we present the case of an 11-year-old boy who underwent surgery after fracture of distal radial epiphysis,of the type still unclassified according to SH classification. The main reason for ourresearch was that the line of treatment could not be decided initially after the first operation. The current classsifications that are close to SH and essentials on the neccesity of surgical approach were dicussed. Surgery must be attempted in cases in which it cannot be decided whether it is a SH type 2 or 3. Besides this situation, an attempt must be made for the classification of the fracture (Ogden tip 2b, Sferoupulos tip 3). Another important point is to decide where the fracture line goes in the layers of physis.