Effects of Ozone Disc Nucleolysis in Management of Herniated Lumbar Intervertebral Disc: A Retrospective Single-Center Study of 149 Patients.

BACKGROUND Lower back pain is a common problem in the general population. Medical treatment is the first choice for patients without severe pain and major motor weakness. If patients do not benefit from conservative treatment, minimally invasive treatment is recommended. Ozone nucleolysis has recently been used to reduce pain and inflammation in herniated discs and other spinal conditions. This retrospective study from a single center aimed to evaluate the effects of ozone disc nucleolysis in the management of 149 patients with herniated lumbar intervertebral discs from 2022 to 2024. MATERIAL AND METHODS Between 2022 and 2024, intradiscal ozone nucleolysis was performed under operating room C-arm scopy in 149 patients who received medical treatment and physical therapy without surgical indication but did not benefit, and the results were evaluated retrospectively. Visual Analog Scale (VAS) scores and Oswestry Disability Index (ODI) scores were recorded before the procedure, and at 1 month, 3 months, 6 months, and 1 year. RESULTS The study enrolled 149 patients, comprising 61 males and 88 females, with an overall mean age of 43.9±4.7 years. The procedure was performed as 1 level in 138 patients and 2 levels in 11 patients. Among patients who underwent procedures based on lumbar MRI findings, 15 involved the L3-L4 intervertebral disc, 3 involved both the L3-L4 and L4-L5 discs, 90 involved the L4-L5 disc, and 31 involved the L5-S1 disc. Post-procedure VAS scores were significantly different at 1 month and 6 months (P<0.05). Post-procedure ODI scores were also significantly different at 1 month and 6 months. CONCLUSIONS Due to its low complication rate and effectiveness in treating lumbar disc herniation, ozone chemonucleolysis should be considered for use in patients who do not have a surgical indication or do not accept surgical intervention and did not benefit from medical treatment and physical therapy.

Rheumatoid factor titers, but not Fc fragments, may be strongly associated with drug survival of anti-TNF agents in patients with rheumatoid arthritis.

OBJECTIVE: To investigate the effects of both the Fc fragment in tumor necrosis factor (TNF) inhibitors and rheumatoid factor (RF) titers on treatment survival, disease activity, and laboratory parameters in patients with rheumatoid arthritis (RA). METHODS: In this retrospective cohort study, patients with RA who had started any anti-TNF therapy between January 2017 and March 2020 and who had stayed on this treatment for at least six months were included. The data of the patients were compared separately according to continuation or discontinuation of treatment and the presence or absence of Fc portion in the structure of anti-TNFs. Patients who were taking certolizumab pegol (CZP) without the Fc fragment were placed in the "without Fc group" (wo/Fc), while patients who were taking other drugs (adalimumab, etanercept, golimumab, and infliximab) were placed in the "with Fc group" (w/Fc). RESULTS: Among the 221 RA patients whose data were available, 52 patients met the inclusion criteria and were included in the study. There was a significant difference in the DAS28-CRP score between wo/Fc group and w/Fc group in the third month of treatment (p=0.012). However, this difference did not persist at the sixth month of treatment (p=0.384). According to the cox-regression results, RF titers were determined to have a significant impact on the drug survival of anti-TNF agents when adjustments were made for the effects of other candidate predictors (Hazard ratio: 1.007 (1.002-1.012), p=0.009). CONCLUSION: Our results suggest that compared to the Fc fragment, RF titers were the more important risk factor in survival of anti-TNF drugs.

Comparison of Outcomes between Single-Level and Double-Level Corpectomy in Thoracolumbar Reconstruction: A Retrospective Study of 16 Patients Using Expandable Cages.

BACKGROUND Reconstruction surgery using titanium vertebral body replacements aids in spinal stability after damage. Functional evaluation includes Nurick and ASIA grading systems. This study compares outcomes of single and double-level corpectomy in patients treated with thoracolumbar reconstruction. MATERIAL AND METHODS Records of 16 patients who underwent vertebral reconstruction with expandable cages after single (n=9) and double (n=8) corpectomy were analyzed retrospectively. Thoracal and lumbar cases were approached posteriorly (n=14). Clinical evaluation was performed by neurological examination, Nurick Scale, American Spinal Injury Association (ASIA) Neurological Scores, and Visual Analog Scale (VAS). Preoperative and postoperative 3-month scores were recorded. Radiological evaluation was performed by calculation of regional angulation and postoperative recovery of vertebral body height. RESULTS Preoperatively, 2 patients had no motor or functional sensory deficits (ASIA grade E) and 6 patients were ASIA grade D. Immediately after surgery, 4 of the ASIA grade D patients improved to ASIA grade E, while 2 patients remained ASIA grade D during follow-up. Four patients were ASIA grade A; their conditions showed no improvement postoperatively. Preoperative and postoperative 3-month Nurick grade was statistically significant (P=0.022). Postoperative Cobb angle improved by a mean of 5.4° (P=0.001). Improvement by at least 1 grade in neurological recovery was observed in 6 (38%) of the cases. Pain scores analyzed using the VAS changed from a mean of 7 to a mean of 2.63 (P<0.001). CONCLUSIONS In our experience, expandable cages are useful in the restoration of different pathologies of the thoracolumbar trunk with low complication and revision rates. With expandable cages it is possible to achieve restoration of the Cobb angle, improvement in Nurick Grade and effective pain palliation.

Epidemiology of geriatric patients presenting to emergency departments in Europe: EGERS study.

BACKGROUND AND IMPORTANCE: Patients aged 65 and above constitute a large and growing part of emergency department (ED) visits in western countries. OBJECTIVE: The primary aim of this European prospective study was to determine the epidemiologic characteristics of elderly patients presenting to EDs across Europe. Our secondary objective was to determine the hospitalization rate, characteristics, and in-hospital mortality rates of geriatric patients presenting to EDs. DESIGN SETTING AND PARTICIPANTS: An observational prospective cohort study over seven consecutive days between 19 October and 30 November 2020, in 36 EDs from nine European countries. Patients aged 65 years and older presenting to EDs with any complaint during a period of seven consecutive days were included. OUTCOME MEASURES: Data were collected on demographics, the major presenting complaint, the presenting vital signs, comorbidities, usual medication, and outcomes after the ED, including disposition, in-hospital outcome, and the final hospital diagnosis. The patients were stratified into three groups: old (65-74 years), older (75-84 years), and oldest age (>85 years). MAIN RESULTS: A total of 5767 patients were included in the study. The median age of the patients was 77 (interquartile range: 71-84) years. The majority presented with a non-traumatic complaint (81%) and about 90% of the patients had at least one comorbid disease and were on chronic medication. An ED visit resulted in subsequent hospital admission in 51% of cases, with 9% of patients admitted to an intensive care unit. Overall in-hospital mortality was 8%, and ED mortality was 1%. Older age was associated with a higher female proportion, comorbidities, need for home care service, history of previous falls, admission rates, length of ED, and hospital stay. CONCLUSION: The characteristics of ED elderly patients and their subsequent hospital stay are reported in this prospective study.

Increased oxidative and chromosomal DNA damage in patients with ankylosing spondylitis: its role in pathogenesis.

Increased DNA damage has been suggested to contribute to the pathogenesis of chronic inflammatory diseases, but controlled studies are lacking in ankylosing spondylitis (AS). Therefore, we assessed oxidative stress, oxidative DNA damage, chromosomal DNA damage, cell proliferation and cell death in the peripheral blood lymphocytes of patients with AS as well as the possible role of DNA damage in the development of the disease. In total, 25 newly diagnosed AS patients who had not received anti-inflammatory agents and 25 healthy controls were recruited. Oxidative DNA damage was assessed by plasma 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels, and chromosomal DNA damage was assessed by the cytokinesis-block micronucleus cytome (CBMN-cyt) method. Compared to controls, the micronucleus (MN) frequencies, nucleoplasmic bridge (NPB) frequencies, nuclear bud (NBUD) frequencies, apoptotic cell frequencies, necrotic cell frequencies and plasma 8-OHdG levels were significantly higher in patients with AS (p < 0.001, p < 0.05, p < 0.01, p < 0.001, p < 0.001, and p < 0.001, respectively), and the metaphase cell numbers, binucleated (BN) cell frequencies and nuclear division index (NDI) values were significantly lower in patients with AS (p < 0.01, p < 0.001 and p < 0.001, respectively). Thus, the present findings suggested that oxidative stress, oxidative DNA damage, and chromosomal DNA damage may be involved in the pathogenesis of AS similar to other chronic inflammatory diseases. In addition, the increased plasma 8-OHdG levels, MN frequencies, NPB frequencies and NBUD frequencies in AS patients may reflect an increased cancer risk.

Correlation between Academic Citations in Emergency Medicine Journals and Twitter mentions.

INTRODUCTION: Twitter may be used in disseminating scientific information that can be measured via citations by traditional systems. We aimed to investigate the relationship between Twitter mentions, traditional citations including Google Scholar and Scopus, and the metric value of Altmetric for articles published in emergency medicine journals. METHODS: Articles published in emergency medicine journals between January 2018 and June 2018 were retrospectively analyzed in February 2021. Journals included with an impact factor of >1 and indexed in Q1. Metric data about citations in Google Scholar and Scopus, the metric value of the Altmetric system, and Twitter mentions were obtained. RESULTS: There were 502 articles published in different seven emergency medicine journals. Fifty-four articles (10.8%) were never cited in Google Scholar or Scopus. There were 79 articles (15.7%) without Twitter mention. Twitter mentions as a tweet or no tweet impacted the number of articles with citation (p > 0.05). The number of citations per article was significantly higher in articles with Twitter mentions (p = 0.002 for Google Scholar citations, p = 0.005 for Scopus citations). Altmetric cited articles were significantly higher for articles with Twitter mentions (p < 0.001). There were significant positive correlations between the number of Twitter mentions and citations in Scopus (r = 0.30, p < 0.001), in both Google Scholar and Scopus (r = 0.19, p < 0.001), and in Altmetrics (r = 0.852, p < 0.001). CONCLUSION: There were positive correlations between numbers of Twitter mentions, traditional citations, including Google Scholar and Scopus, and metric values of the Altmetric system. This finding supports that increased social media citations are associated with increased dissemination and disclosure of publications.

Can Ferritin Levels Predict the Severity of Illness in Patients With COVID-19?

OBJECTIVES: This study aimed to investigate whether ferritin level can predict the severity of coronavirus disease 2019 (COVID-19). BACKGROUND: The COVID-19 pandemic has been challenging for both patients and caregivers. Many laboratory markers have been used to better understand the causes of poor outcomes and to improve the management of COVID-19 patients. METHODS: A total of 93 patients who had a positive polymerase chain reaction test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in this study. Demographic features, comorbidities, clinical and laboratory findings were obtained from the hospital database retrospectively. Patients were divided into two groups according to the disease severity as follows: mild group (n = 70) and severe group (n = 23). RESULTS: The median age of the study population was 42.5 (28.3-62.8) with 69.9% male patients. Patients in the severe group were significantly older and showed a higher frequency of hypertension, diabetes mellitus, coronary artery disease, and heart failure in comparison with those in the mild group. In addition, gamma-glutamyl transferase, C-reactive protein, ferritin, interleukin-6, procalcitonin, and neutrophil to lymphocyte ratio were higher whereas albumin level was lower in patients in the severe group. Linear regression analysis demonstrated that ferritin level was the only significant predictor of disease severity (ß = 0.487, t = 2.993, p = 0.004). In receiver operator characteristics curve analysis, ferritin level ≥264.5 ng/mL predicted severe COVID-19 with a sensitivity of 73.9% and specificity of 94.2%. CONCLUSION: Early analysis of ferritin levels in patients with COVID-19 might effectively predict the disease severity.

Application of heat and a home exercise program for pain and function levels in patients with knee osteoarthritis: A randomized controlled trial.

AIM: This study aimed to determine the effect of application of superficial local heat and a home exercise program on pain and function levels to patients with bilateral knee osteoarthritis. METHODS: This study was conducted in Turkey between January 2014 and February 2015. The sample group of the study consisted of 62 patients with osteoarthritis; 15 assigned to heat application, 15 to exercise, 15 to exercise after heat application, and 17 for the control group. While the patients in the control group received routine treatment only, the patients in the intervention group were treated with heat application, exercise, or exercise after heat application, suggested for 5 days a week for 4 weeks in addition to routine treatment. RESULTS: In this study, all of the intervention groups had decreases in Visual Analogue Scale Pain and Western Ontario and McMaster Universities Osteoarthritis Index pain, stiffness, and function scores when compared with the control group. It was found that this decrease in Visual Analogue Scale Pain and Western Ontario and McMaster Universities Osteoarthritis Index scores was mostly in the exercise group, but this condition was not statistically significant. CONCLUSIONS: As a result, it is recommended that nurses train patients with osteoarthritis on heat application and home exercises and encourage them to apply these practices.

Priapism With Methylphenidate Use in a Preschool-Aged Boy Resolved With Switching to Atomoxetine.

BACKGROUND: Priapism is a persistent unwanted erection that is not linked with sexual stimulation. A number of previous case reports have shown priapism with methylphenidate (MPH) use, especially in adolescence and preadolescence period. In all of these cases, the unwanted erections ceased after the medication was discontinued and no further attention-deficit hyperactivity disorder medication was initiated. Hereby, we present the case of a boy who had priapism episodes with MPH, which resolved with switching to atomoxetine (ATX). CASE REPORT: A 5-year, 10-month-old medically healthy boy was diagnosed with attention-deficit hyperactivity disorder and was prescribed methylphenidate immediate-release (10 mg/d). Two weeks later, his family communicated and reported penile erection episodes since the initiation of MPH. With the suspect of a medication-induced adverse reaction, MPH was discontinued and priapism resolved within a week. Thereafter, 10 mg/d of ATX was initiated. Four-week follow-up with ATX treatment revealed that the medication was tolerated well, and priapism or any other adverse effect was not reported. CONCLUSIONS: This case report suggests that ATX may be safely used in some children who experienced priapism with MPH. Future studies are needed to clarify the risk factors and etiologic mechanisms of this adverse reaction.

BLUE protocol ultrasonography in Emergency Department patients presenting with acute dyspnea.

OBJECTIVE: Dyspnea is a common Emergency Department (ED) symptom requiring prompt diagnosis and treatment. The bedside lung ultrasonography in emergency (BLUE) protocol is defined as a bedside diagnostic tool in intensive care units. The aim of this study was to investigate the test performance characteristics of the BLUE-protocol ultrasonography in ED patients presenting with acute dyspnea. METHOD: This study was performed as a prospective observational study at the ED of a tertiary care university hospital over a 3-month period. The BLUE-protocol was applied to all consecutive dyspneic patients admitted to the ED by 5 emergency physicians who were certified for advanced ultrasonography. In addition to the BLUE-protocol, the patients were also evaluated for pleural and pericardial effusion. RESULTS: A total of 383 patients were included in this study (mean age, 65.5 ±â€¯15.5 years, 183 (47.8%) female and 200 (52.2%) male). According to the BLUE-protocol algorithm, the sensitivities and specificities of the BLUE-protocol are, respectively, 87.6% and 96.2% for pulmonary edema, 85.7% and 99.0% for pneumonia, 98.2% and 67.3% for asthma/COPD, 46.2% and 100% for pulmonary embolism, and 71.4% and 100% for pneumothorax. Although not included in the BLUE-protocol algorithm, pleural or pericardial effusion was detected in 82 (21.4%) of the patients. CONCLUSION: The BLUE-protocol can be used confidently in acute dyspneic ED patients. For better diagnostic utility of the BLUE-protocol in EDs, it is recommended that the BLUE-protocol be modified for the assessment of pleural and pericardial effusion. Further diagnostic evaluations are needed in asthma/COPD groups in terms of the BLUE-protocol.

Prevalence of Rheumatoid Arthritis and Spondyloarthritis in Turkey: A Nationwide Study.

OBJECTIVES: This study aims to estimate the prevalence of rheumatoid arthritis (RA) and spondyloarthritis (SpA) in Turkey using the same telephone questionnaire developed for screening RA and SpA in France and used in Serbia and Lithuania. MATERIAL AND METHODS: The study was performed in two steps. In step I, the French questionnaire was translated into Turkish and validated through a group of 200 patients (80 males, 120 females; mean age 44.0±13.1 years; range 19 to 75 years) followed up at the rheumatology departments of University Hospitals in Antalya and Ankara. In step II, the validated Turkish questionnaire was administered face-to-face to randomly selected 4,012 subjects (1,670 males, 2,342 females; mean age 41.5±16.8 years; range 16 to 97 years) by trained general practitioners across the country, in 25 prov- inces for case detection. The subjects who were suspected of having RA or SpA in accordance with the questionnaire were invited to the nearest university hospital for rheumatologic examination in order to confirm the diagnosis. RESULTS: In step II, a total of 25 subjects (2 males, 23 females) were diagnosed as RA. The standardized RA prevalence for the general population of Turkey was calculated as 0.56% (95% confidence interval [CI]; 0.33-0.79), 0.10% (95% CI; -0.05-0.25) for males and 0.89% (95% CI; 0.51-1.27) for females. A total of 18 subjects (3 males, 15 females) were diagnosed as SpA. The standardized SpA prevalence for the general population of Turkey was 0.46% (95% CI; 0.25-0.67), 0.17% (95% CI; -0.03-0.37) for males and 0.65% (95% CI; 0.32-0.98) for females. The prevalence of RA was highest in the Northern region (2.00%) and the prevalence of SpA was highest in the Central region (1.49%). CONCLUSION: The prevalences of RA and SpA in Turkey are close to each other and there are significant inter-regional variations in prevalences of both RA and SpA.

[Levels of pain and self-efficacy of individuals with osteoarthritis]. / Osteoartritli bireylerin agri ve öz etkililik düzeyleri.

OBJECTIVES: This descriptive study was conducted to determine pain and self-efficacy levels of individuals with osteoarthritis. METHODS: 83 patients, who were hospitalized in and admitted to physical therapy or rehabilitation outpatient clinic and had a primary diagnosis of osteoarthritis, were included in the study. The data of the study were collected by using patient information form, visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and arthritis self-efficacy scale. Pearson correlation analysis, t-test, and one-way analysis of variance were used to assess the data. A p value less than 0.05 was considered as statistically significant. RESULTS: The most frequent complaints of 78.5% of the individuals with osteoarthritis were pain and limitation of movement. The pain experienced by 69.9% affected their daily life activities so much. VAS mean score of the participants was 5.7±2.3, their WOMAC mean score was 56.3±14.8, and their self-efficacy score was 103.7±29.5. Self-efficacy levels of those, who were men, had a higher educational level, were not housewives, were independent in daily life activities and did not have an additional chronic disease, were higher compared to the other groups (p<0.05). In this study, a negative correlation between self-efficacy scores and VAS and WOMAC scores and a positive correlation between VAS and WOMAC scores were found (p<0.05). CONCLUSION: It was determined that self-efficacy of the individuals with osteoarthritis was moderate and gender, educational level, status of independence, pain, and functional level affected self-efficacy.

Long-term effect of radiofrequency turbinoplasty in nasal obstruction.

The aim of this retrospective study is to investigate long term (two years) effect of radiofrequency tissue volume reduction (RFVTR) on nasal obstruction associated with inferior turbinate hypertrophy, which is not respond to medical treatment. This retrospective study carried out on 98 patients with nasal obstruction treated by RFVTR (56 males, 42 females, from 17 to 70 years of age). Visual analogue scales (VAS) and nasal endoscopic view score (NES) were used for nasal obstruction to evaluate the efficacy of the treatment. Results of one, three, six, twelve and twenty four months after RFVTR treatment were compared with pre-exposure values. Turbinate edema and nasal obstruction in the treated patients were recovered after one month of treatment (p < 0.01). Maximum improvement were determined at the end of third month (p < 0.01). However, eficacy of RFVTR declined twelve months after treatment. Final percentage of imrovement was found as 51 % at the end of second year of treatment because of co-factors was not eliminated by some patients. On the other hand, no statistical significant difference was observed between the right and left nasal cavity (p < 0.001). In conclusion, the result of this study indicated that patients who have not eliminate co-factors such as smoking, obesity and allergic rhinitis may need re-application of RFTVR. However, further studies on radiofrequecy energy level and elimination of other co-factors are necessary to illuminate the eficacy of RFVTR.

Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis?

The aim of this study was to compare the efficacy of sodium hyaluronate (SH) injection with the most common treatment methods, intraarticular steroid injection and physical therapy modalities in patients with adhesive capsulitis (AC). A total of 95 shoulders of 90 patients were included in the study and were randomized in four groups. The patients were treated with SH injection (group 1), triamsinolone acetonide (group 2) or physical therapy modalities (group 3). Group 4 patients were served as controls. Pain severity, passive ranges of motion and functional considerations were measured before, and 15 days and 3 months after the treatments. In all treatment groups, there were significant improvements at both the 15th day and third month in all parameters (for each, p<0.001). The passive abduction values on the 15th day was found significantly higher in group 3 when compared with group 1 and controls (for each, p<0.001). At the third month, the passive abduction values of the groups 2 and 3 were improved when compared with the control group (p<0.001). Constant score was higher in group 3 on 15th day when compared with group 1. At the third month, all treatment groups were improved significantly compared with control group (p<0.001). We provided the best results in physical therapy modalities applied group for AC treatment. However, we think that SH injection may be administered as an alternative treatment method.

Investigation of protein oxidation and lipid peroxidation in patients with rheumatoid arthritis.

We aimed to determine the importance of neutrophil activation and the source of oxidative stress in the pathogenesis of rheumatoid arthritis (RA) by quantification of advanced oxidation protein products (AOPP) and total thiol levels as markers of oxidative protein damage, malondialdehyde (MDA) levels as a marker of lipid peroxidation and myeloperoxidase (MPO) activity as a marker of neutrophil activation in patients with RA. Fifty-seven rheumatoid arthritis patients were included in the study and sub-grouped according to disease activity (active, n = 31; inactive, n = 26) and compared with healthy controls (n = 25). Serum MPO activity, AOPP, MDA, and thiol levels were measured by an enzymic spectrophotometric method. Serum MPO activity (p < 0.001), AOPP (p < 0.001), MDA (p < 0.001) and levels of thiol (p < 0.002), were higher in the patient group than the controls. Active and inactive RA groups were compared with the control group and there were significant differences between each parameter. MPO activity, AOPP, MDA and thiol levels were significantly higher in both active and inactive RA patients than the controls. On the other hand, when a comparison was made between active and the inactive stage, a statistically significant difference was present only in MDA (p < 0.05) and AOPP levels (p < 0.05). There was also a significant positive correlation between all parameters. These data strongly suggest that neutrophils, which constitute the most important source of chlorinated oxidants due to their high MPO content, may be involved in serum AOPP formation and therefore the production of a novel class of pro-inflammatory mediators of oxidative stress in RA patients and that protein oxidation could play an important role in the pathogenesis of RA as does lipid peroxidation.

Assessment of paraoxonase 1 activity and malondialdehyde levels in patients with rheumatoid arthritis.

OBJECTIVES: We aimed to evaluate antioxidant paraoxonase 1 activity together with malondialdehyde (MDA) (an oxidative stress parameter) levels in patients with rheumatoid arthritis. DESIGN AND METHODS: Fifty-seven rheumatoid arthritis patients were included in the study and subgrouped according to disease activity (active, n = 31; inactive, n = 26) and compared with healthy controls (n = 25). Serum paraoxonase 1 activity and MDA levels were measured according to an enzymatic spectrophotometric method. RESULTS: Serum MDA level was higher (P = 0.001) whereas paraoxonase 1 activity was lower (P = 0.001) in the patient group than the controls. When active and inactive subgroups were compared with the control group, there was a statistically significant difference between each parameter. Serum MDA levels were significantly higher, while paraoxonase 1 activity was lower in the active and inactive rheumatoid arthritis groups than the control group. But there was not any difference between active and inactive patients with RA. There was a negative correlation between MDA levels and paraoxonase 1 activity. CONCLUSIONS: Increased reactive oxygen species levels in rheumatoid arthritis may result in a pro-oxidation environment, which in turn could result in decreased antioxidant paraoxonase 1 activity and increased MDA levels.

[Is there any alteration in bone mineral density in patients with depression?]. / Depresyonlu Hastalarda Kemik Mineral Yogunlugunda Degisiklik Var mi?

OBJECTIVE: Depression is associated with some alterations in behavior and hypothalamic-pituitary-adrenal axis function that may be risk factors for decreased bone mineral density (BMD). There is considerable inconsistency as to whether depressed patients really have decreased BMD or not. Decreased BMD has been reported in patients suffering from major depression in some studies, but not in some others. Moreover, few studies have investigated BMD in male depressed patients. The aim of this study was to investigate BMD in patients with major depression, including male ones. METHOD: BMD was investigated in forty-two inpatients that fully met the DSM-IV criteria for major depressive disorder (21 women, 21 men; mean age+/-SD: 37.57+/-8.70) and compared with that in twenty-three healthy controls (12 women, 11 men; mean age+/-SD: 33.73+/-7.16). The severity of clinical symptomatology was assessed by the Montgomery-Asberg Depression Rating Scale (MADRS). BMDs of lumbar vertebrae (L1-L4) and femur neck were measured using dual energy X-ray absorptiometry. RESULTS: We found no difference in the values of BMDs of lumbar vertebra (L1-L4) and femur neck between depressive patients and controls among women or men. However, BMDs of the males in the control group were higher than those of the healthy females for both regions investigated; this gender difference was not observed in the depressive patients. CONCLUSION: Major depression is not associated with any alteration in BMD either in women or in men.

A comparative study of the effects of electrical stimulation and laser treatment on experimental wound healing in rats.

We investigated the effects of electrical stimulation (ES) and laser treatment on wound healing in rats. A randomized-controlled trial, conducted at the Experimental and Clinical Research Centre of Erciyes University (Kayseri, Turkey), divided 124 healthy female Swiss-Albino rats into four groups. A 6 cm linear incision was made at the dorsal skin of all rats. Group 1 was given a constant direct current of 300 microA for 30 min per day. The current was applied in negative polarity for the first 3 days and in positive polarity for the next 7 days. Group 3 received a full-contact, continuous gallium-arsenide (GaAs) laser therapy, with a wavelength of 904 nm, an energy density of 1 J/cm2, and an average power of 6 mW for 10 min per day. The remaining two groups (Groups 2 and 4) were considered the control groups and received sham treatment. All groups were treated for 10 days. Histopathologic and biochemical evaluations were conducted on 10 rats from each group on the 4th and 10th days, and wound breaking strength was measured for biomechanical evaluation on the 25th day of the study. Both ES and laser treatment proved significantly effective in the inflammatory phase compared with control groups (p < 0.05); however, the ES was even more effective than laser treatment, with more significant results (p < 0.05). In the proliferation and maturation phases, while ES and laser treatment were both found to be significantly effective treatment methods compared with the control groups, no statistically significant difference was observed between the two treatment groups (p > 0.05). Although ES and laser treatment both were effective in the maturation phase, increasing wound breaking strength compared with their control groups (p < 0.05), there was no statistically significant difference between the two treatment groups (p > 0.05). We conclude that ES and laser treatment both have beneficial effects during the inflammatory, proliferation, and maturation phases of a wound. Both ES and laser treatment can be used successfully in decubitis ulcers and chronic wounds, in combination with conventional therapies such as daily care and debridement of wounds; however, ES has more beneficial effects during the inflammatory phase in some parameters than laser treatment.

Comparison of the effects of laser and ultrasound treatments on experimental wound healing in rats.

A randomized controlled study investigated the effects of ultrasound and laser treatments on wound healing in rats. The duration of the inflammatory phase decreased with both laser and ultrasound treatments; however, laser was more effective than ultrasound, with more significant results. The proliferation phase showed, for both treatments, an increase in the level of hydroxyproline and the number of fibroblasts, as well as stimulation of the collagen synthesis and the composition. Laser treatment was again more effective than ultrasound. The wound breaking strength was significantly higher with both treatments, and no statistically significant difference emerged between the laser and ultrasound groups, although laser treatment provided a much greater increase in the wound breaking strength than ultrasound. Both treatments have beneficial effects on the inflammatory, proliferation, and maturation phases of wound healing. Both can be used successfully for decubitis ulcers and chronic wounds, in conjunction with conventional therapies such as debridement and daily wound caring. However, laser treatment was more effective than ultrasound in the first two phases of wound healing.