Impact of chronic Helicobacter pylori infection on inflammatory markers and hematological parameters.

OBJECTIVE: Determining a non-invasive method for Helicobacter pylori (H. pylori) induced gastritis will be of great help especially in the field of pediatrics. In this study, we aimed to evaluate impact of chronic H. pylori infection on inflammatory markers and hematological parameters. PATIENTS AND METHODS: 522 patients aged between 2 months and 18 years, with chronic dyspeptic complaints who underwent gastroduodenoscopy were included. Complete blood count, ferritin, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) tests were performed. Platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) values were calculated. RESULTS: From 522 patients 54% had chronic gastritis and 28.6% had esophagitis, while 24.5% of their biopsy samples revealed H. pylori. The mean age of H. pylori  positive patients was significantly higher (p<0.05). Females were in the majority in H. pylori positive and negative groups and in the group with esophagitis. The most common complaint in all groups was abdominal pain. In the H. pylori positive group, a significant increase in neutrophil and PLR values, a significant decrease in the NLR value were found. Ferritin and vitamin B12 values were significantly lower in the H. pylori positive group. No significant difference was found in the parameters we compared between the group with and without esophagitis, except for mean platelet volume (MPV). MPV values were significantly lower in the group with esophagitis. CONCLUSIONS: Neutrophil and PLR values are practical and easily obtainable parameters related to inflammatory phases of H. pylori infection. They may become useful parameters in the follow-up. H. pylori infection is one of the important causes that trigger iron deficiency and vitamin B12 deficiency anemia. Further large-scale randomized controlled studies are needed to confirm our results.

Comparison of Clinical Features and Serum Parameters of Culture-Positive Children with Culture-Negative Children in Septic Arthritis and Acute Osteomyelitis.

PURPOSE OF THE STUDY The aim of this study was to investigate the culture results of children undergoing debridement for suspected septic arthritis or acute osteomyelitis and to compare the laboratory parameters and clinical characteristics of culture-positive and culture-negative patients. MATERIAL AND METHODS Patients who underwent surgery in our hospital for septic arthritis and acute osteomyelitis between 2011 and 2019 were retrospectively analyzed. Seventy-two of 96 patients were included in the study. The patients had documented joint swelling, redness, pain with joint movement and weight-bearing failure. Fever was assessed preoperatively. Sedimentation rate, C-reactive protein level, white blood cell count and the leukocyte count in aspiration material as well as complications were evaluated preoperatively and 3 months postoperatively. RESULTS Twenty patients underwent surgery of the hip; 39 of the knee; 7 of the foot, ankle and distal tibia; 1 of the elbow; and 1 of the distal radius. Additionally, 4 patients had septic arthritis and acute osteomyelitis of the femur. The mean age of the patients was 7.8 years (1-16). The mean follow-up period was 16.2 months (3-42). Preoperative aspiration was performed in 44 of 72 patients. Thirty of 72 patients had positive cultures. No statistically significant difference in age, preoperative duration, C-reactive protein, sedimentation, white blood cell count, preoperative fever or complications was found when compared between patients with culture growth and those without reproduction (p > 0.05). There was a significant difference between the leukocyte count in the aspiration material (p < 0.05). CONCLUSIONS Prediagnosis of septic arthritis or acute osteomyelitis in pediatric patients is important in terms of future joint health and sepsis. According to our findings an inability to obtain bacteria does not exclude septic arthritis as a diagnosis. Empirical antibiotic therapy with a wide postoperative spectrum is important for joint health in these patients. Preoperative serum parameters cannot predict the agent needed for treatment. Key words: septic arthritis, osteomyelitis, pediatric septic arthritis, pediatric joint infection, pediatric infection.

Factors Influencing Complication Rates in the Orthopaedic Theatre.

PURPOSE OF THE STUDY The prevalence of complications in surgical units is available in the literature. The aim of this study was to compare the "rotational" (more than one surgeon) and "full-time single surgeon" use of the orthopedic theater. MATERIAL AND METHODS We retrospectively evaluated patients who underwent orthopedic surgery in 2016 in different theaters. A total of 604 of 1973 patients were excluded from the study, and 1369 patients were analyzed. The follow-up period was 1 year. While evaluating the cases, the duration and order of each case, the total operation time on the table, the number of surgeons, the total number of cases, the number of residents, and the experiences of the surgeons were investigated, and the effects of these parameters on the complication rates were analyzed. The Dindo-Clavien system was used to classify the complications. RESULTS When comparing the methods, the complication rate of the full-time single-surgeon method (12.9%) was less than that of the rotational method (21.7%) (p: 0.022). A higher rate of complications (8.5%) was observed in operations with a duration of 115 minutes or more compared to other operations (p <0.001). A higher complication rate (23.7%) was observed in cases lasting more than 345 minutes (p = 0.002). CONCLUSIONS According to our study, full-time use of the orthopedic theater by a single surgeon was found to be safer than rotational use. In addition, the duration of surgeries lasting longer than 115 minutes or longer than 345 minutes during the day increased the rate of surgical complications. Key words: patient safety, surgical planning, operation time, operation order, orthopedic complication.

Oxidized zirconium on ceramic; Catastrophic coupling.

Oxidized zirconium (Oxinium™; Smith & Nephew, Memphis, TN, USA) articulated with polyethylene in total hip arthroplasty (THA) appeared to have the potential to reduce wear dramatically. The thermally oxidized metal zirconium surface is transformed into ceramic-like hard surface that is resistant to abrasion. The exposure of soft zirconium metal under hard coverage surface after the damage of oxidized zirconium femoral head has been described. It occurred following joint dislocation or in situ succeeding disengagement of polyethylene liner. We reported three cases of misuse of Oxinium™ (Smith & Nephew, Memphis, TN, USA) heads. These three cases resulted in catastrophic in situ wear and inevitable failure although there was no advice, indication or recommendation for this use from the manufacturer.

Changing Trends in Treatment of Acute Mania: Experience of a Tertiary Centre Over a Decade.

We investigated trends over a decade in the prescription of lithium, antiepileptics, and antipsychotic agents at discharge for patients hospitalised for acute mania. We conducted a retrospective review of medical records for 165 inpatients with acute mania who had been hospitalised in Cerrahpasa Faculty of Medicine, Department of Psychiatry during 2001-2002 and 2011-2012. Among 165 patients, prescription of olanzapine at discharge increased from 3 to 46 % (p < 0.001), while prescription of haloperidol decreased from 55 to 21 % (p < 0.001). Use of other atypical antipsychotics did not change significantly (risperidone decreased from 14 to 11 %, p = 0.5; quetiapine increased from 10 to 16 %, p = 0.2). Use of valproate, carbamazepine, and lithium did not change significantly. Use of electroconvulsive therapy in acute mania decreased by half from 27 to 13 % (p = 0.02). Typical antipsychotics alone or in combination with antiepileptics were the most common treatment regimen at discharge at 2001-2002; while 10 years later, they had been largely replaced by lithium or antiepileptics combined with second generation antipsychotics. Antipsychotic agents remained to be an important component of acute treatment of mania in our practice.

Distal phalanx fracture in adults: Seymour-type fracture.

Seymour's fracture is an extra-articular, transverse, physeal, and juxta-epiphyseal open fracture of the distal phalanx seen in childhood. In this study, we present 10 adult cases of fractures localized to the metaphyseal region, 1-2 mm distal to the insertion of the extensor tendon. Mean age was 38 years. Four patients were treated conservatively with a mallet finger splint. Closed reduction and osteosynthesis with Kirschner wires (K-wires) was performed in three of the patients. Three of the patients had open fractures in whom closed reduction could not be performed. They underwent open reduction and osteosynthesis with K-wires. We recommend that extra-articular distal phalanx fractures mimicking mallet finger in adults are called Seymour-type fracture to establish a common language among clinicians to define this type of fracture. These fractures generally occur by hyperflexion of the distal phalanx and can be treated by conservative or surgical methods. The outcomes of conservative and surgical management of Seymour-type fractures depend on the appropriate reduction as well as efficient physical therapy.

Posterior fixation of type IV humeral capitellum fractures with fully threaded screws in adolescents.

PURPOSE: Humeral capitellum fractures comprise approximately 1% of all elbow fractures. In this study, we examined the clinical, radiographic, and functional outcomes following operative stabilization of Bryan and Morrey type IV fractures of the capitellum in adolescents. We applied headless cannulated screws in a posteroanterior direction without damaging the articular cartilage surface of the fractures. METHODS: Eight adolescent patients (six male, two female) with a mean age of 15 ± 2.1 years (range 13-18 years) were treated for type IV (McKee) humerus capitellum fractures. In the preoperative radiological evaluation, anteroposterior and lateral radiographs and computed tomography (CT) images were performed. A lateral surgical approach was used, and cannulated fully threaded headless screws were applied in a posteroanterior direction as fixation materials in the fracture reduction. The Mayo Elbow Performance Score was used in the evaluation of elbow joint functions. RESULTS: Patients were followed up for a mean of 24.6 months. Fracture union was achieved at a mean of 5 ± 0.92 weeks (range 4-6 weeks). The mean elbow extension flexion arc was 135° ± 13.47° (range 110°-150º) and the mean pronation supination arc was 156° ± 4.43° (150°-160°). In one patient, there was nonconformity in the humerus trochlea and in another patient, there was keloid formation on the surgical scar. All patients attained excellent results according to the Mayo Elbow Performance Score. CONCLUSIONS: In the treatment of type IV capitellum fractures in adolescents, open reduction with a lateral surgical approach and fixation using posteroanterior directed, cannulated, fully threaded, headless screws is a reliable method to achieve a pain-free functional elbow joint.

DNA cleavage by homo- and heterotetranuclear Cu(II) and Mn(II) complexes with tetrathioether-tetrathiol moiety.

Novel homotetranuclear Cu(II) and heteronuclear Cu(II)-Mn(II) complexes with tetrathioether-tetrathiol moiety have been prepared and their DNA relaxation activities with plasmid pCYTEXP (5kb) were electrophoretically established. The cleavage products analyzed by neutral agarose gel electrophoresis indicated that the interaction of the metal complexes with supercoiled plasmid DNA yielded linear, nicked or degraded DNA. The relaxation activities of both homo- and heterotetranuclear (SK4) complexes are time- and concentration-dependent. The findings suggest that SK4 with potent nucleolytic activity is a good nuclease substitute in the presence ofcooxidant. Furthermore, the observation of induction of DNA into smaller fragments by SK4 is also significant.

Investigation of erythrocyte membrane lipid peroxidation and antioxidant defense systems of patients with coronary artery disease (CAD) documented by angiography.

In the present study, erythrocyte membrane lipid peroxidation, erythrocyte superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and serum vitamin C levels of subjects with and without coronary artery disease (CAD) documented by coronary angiography have been determined. Patients consisted of 42 subjects (31 male, 11 female) aged between 41 and 77 years and controls consisted of 35 subjects (21 male, 14 female) aged between 40 and 69 years. Erythrocyte lipid peroxidation of the patients was significantly higher (P < 0.005) whereas erythrocyte SOD, GSH-Px activities and serum vitamin C levels were lower than those of controls. Our results show significant alteration in erythrocyte membranes and antioxidant status of patients with CAD. However, whether such alterations are a primary cause or consequence of CAD and whether these alterations can be used in the diagnosis and management of the disease needs further investigation.

[The lignolytic activity of some white-rot fungi of the genus Pleurotus]. / Bazi Pleurotus cinsi beyaz - çürükçül funguslarin lignolitiketkinligi üzerine çalismalar.

In this study, phenoloxidase activities of some fungi, Pleurotus sajorcaju, P. sapidus, P. astreatus and Phanerochaete chrysosporium which are usually considered in white - rot fungal group, were measured. The Phenoloxidase activities of all the species in Pleurotus genus were found to be higher than that of P. chrysosporium. When the lignolytic activities of P. sajor - caju and P. chrysosporium were compared, P. sajor - caju was found to have higher activity than that of P. chrysosporium.

[Microbial production of glucose/fructose syrups]. / Glukoz/fruktoz suruplarinin mikrobiyal üretimi.

With the ever-increasing demand for sugar and the trend in rising price, rapid progress in research on new and/or alternative sweeteners has been inevitable during the past decade or so. Pure glucose, glucose/fructose, glucose/maltose syrups are often called "isosyrups". Isosyrups have been recognized as a good alternative sources of sugar. These are used today in the manufacture of soft drinks, jams and jellies, confectionary, baking fermentation, dietetic and infant food, ice-cream, pharmaceutical processes, etc. Isosyrups are produced by hydrolysis of starch and cellulocis raw materials have been utilized for the production of isosyrups.