A new radiographic acetabular cup anteversion measurement method in total hip arthroplasty: a clinical study.

BACKGROUND: The acetabular cup positioning is one of the most crucial steps affecting stability and wear rates in total hip arthroplasty. Different methods have been described for determining the anteversion of the acetabular cup in the literature. But there is still not a widely accepted method to assess the acetabular anteversion radiography. The aim of this study is to measure the acetabular anteversion angle on a single pelvis AP radiography with our method which was proven with an experimental study before. MATERIALS AND METHODS: A total of 15 patients (8 males, 7 females) who underwent total hip arthroplasty and have had a pelvis computed tomography scans in our outpatient clinic were evaluated retrospectively. The anteversion angle was calculated in all of pelvis CT scans. For radiological measurement, the formula defined by the authors in an experimental model previously was used. RESULTS: Statistically significant difference was not determined between radiographic and CT-based measurements (p = 0.207; p > 0.05). A statistically significant agreement was observed at a level of 98.8% between radiographic and CT-based measurements (ICC = 0.988; 95% CI 0.966-0.996; p < 0.01). CONCLUSION: Assessment of the acetabular cup anteversion is very important to predict the possible complications after total hip arthroplasty. Although many methods have been defined for this purpose, each of these has advantages and disadvantages. In particular, with computed tomography method, the patient is exposed to excessive radiation, whereas we think that our method is a preferred method due to features not requiring additional equipment, low radiation exposure, being simple, cost-effectiveness, easily applicable and almost 100% accurate.

Numerical investigation of mechanical effects caused by various fixation positions on a new radius intramedullary nail.

Fracture of the radius diaphysis is an unusual injury in adults. Open reduction and plate osteosynthesis has been recommended by most of the authors. However, this trend has started to change with the recent introduction of newly designed interlocking intramedullary (IM) nails. New generation of IM nails are developed in order to utilise the advantages of IM nails against plates. Because of its anatomical structure, the radius bone has a complex geometry. Therefore, the callus structure, which forms during the healing period, should not be affected from external effects, such as excessive loads or motion. In this study, effects of radial styloid process (RSP), dorsal side and ulnar notch edge fixations of a new design radius IM nail on the healing period were numerically investigated. A three-dimensional solid model of radius was obtained from computed tomography images of a volunteer and callus structure model, was placed accordingly and different fixations of implants were performed. The models were analysed under axial loads transferring from the wrist to the radius bone using finite element method. As a result of the analysis, fixation of IM nail from RSP was found to be beneficial on healing period in terms of both callus motion and emerging stresses.

Prevalencia de trastornos de la piel en niños que asisten a la escuela primaria en Diyarbakir, Turquía / Prevalence of skin disorders among primary school children in Diyarbakir, Turkey

Antecedentes. El objetivo de este estudio fue determinar la prevalencia de dermatosis pediátricas en Diyarbakir, provincia ubicada en la región sudeste de Turquía. Materiales y métodos. Este fue un estudio transversal realizado en abril de 2008 en alumnos que asistían a ocho escuelas primarias públicas de Diyarbakir seleccionadas al azar. Se examinó a los alumnos y se les administró un cuestionario para determinar el nivel socioeconómico y las características sociodemográficas. Resultados. Los dermatólogos evaluaron, en total, a 1932 alumnos. De ellos, 953 (49,32%) eran niñas, con una media de edad de 11,06 ± 2,13 años (rango: 6-17 años). La prevalencia puntual global de trastornos de la piel fue del 59,1%. En esta muestra, 776 niños (40,2%) tenían solamente una enfermedad de la piel, mientras que 299 (15,5%) tenían dos, y 67 (3,5%), al menos tres. La prevalencia puntual de los trastornos de la piel fue del 33,1% en los alumnos de primer grado y del 78,9% en los alumnos de octavo grado (p < 0,05). Las enfermedades de la piel más frecuentes fueron en primer lugar el eccema (32,8%), seguido de los trastornos de la pigmentación (17,2%), las infecciones cutáneas (13,4%), los trastornos del cuero cabelludo (10,1%) y el acné vulgar (9,6%). Las infecciones cutáneas, los trastornos de la pigmentación, los trastornos del cabello y del cuero cabelludo y el acné vulgar fueron mucho más frecuentes en las niñas que en los varones (p < 0,05). Además, las infecciones cutáneas fueron mucho más habituales en los alumnos pupilos que en los medio pupilos (p < 0,05). Conclusión. Los trastornos de la piel afectaron al 59,1% de los niños estudiados, y se observaron con mayor frecuencia en las niñas y en los pupilos. Es necesario prestar mayor atención a estos grupos a la hora de formular medidas preventivas.(AU)

Background. The purpose of this study was to determine the prevalence of childhood dermatoses in Diyarbakir, which is located in the southeastern region of Turkey. Material and Method. This cross-sectional study was carried out in April 2008 among students of eight randomly selected public primary schools in Diyarbakir. Students were examined and questionnaire was applied to determine socioeconomic levels and socio-demographic features. Results. A total of 1932 students were examined by dermatologists. Nine hundred and fifty three (49.32%) girls, mean age was 11.06±2.13 (range 6-17). The overall point prevalence of skin disorders was 59.1%. Among this sample 776 children (40.2%) had only one skin disease whereas 299 (15.5%) had two and 67 (3.5%) had at least three. The point prevalence of skin disorders was 33.1% among students in grade 1 and 78.9% among students in grade 8 (p<0.05). The most common skin disease was eczema (32.8%), followed by pigmentation disorders (17.2%), skin infections (13.4%), scalp disorders (10.1%) and acne vulgaris (9.6%). Infectious skin problems, pigmentation disorders, hair and scalp disorders and acne vulgaris were more common among girls compared to boys (p<0.05). In addition, infectious skin problems were more common among boarders (p<0.05) compared to day students. Conclusion. Skin disorders affected 59.1% of the studied children. Skin disorders were more common among girls and boarders in this study, this group of children should be given specific attention in formulating preventive measures.(AU)

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.

Prevalence of skin disorders among primary school children in Diyarbakir, Turkey. / Prevalence of skin disorders among primary school children in Diyarbakir, Turkey.

BACKGROUND: The purpose of this study was to determine the prevalence of childhood dermatoses in Diyarbakir, which is located in the southeastern region of Turkey. MATERIAL AND METHOD: This cross-sectional study was carried out in April 2008 among students of eight randomly selected public primary schools in Diyarbakir. Students were examined and questionnaire was applied to determine socioeconomic levels and socio-demographic features. RESULTS: A total of 1932 students were examined by dermatologists. Nine hundred and fifty three (49.32

) girls, mean age was 11.06±2.13 (range 6-17). The overall point prevalence of skin disorders was 59.1

. Among this sample 776 children (40.2

) had only one skin disease whereas 299 (15.5

) had two and 67 (3.5

) had at least three. The point prevalence of skin disorders was 33.1

among students in grade 1 and 78.9

among students in grade 8 (p<0.05). The most common skin disease was eczema (32.8

), followed by pigmentation disorders (17.2

), skin infections (13.4

), scalp disorders (10.1

) and acne vulgaris (9.6

). Infectious skin problems, pigmentation disorders, hair and scalp disorders and acne vulgaris were more common among girls compared to boys (p<0.05). In addition, infectious skin problems were more common among boarders (p<0.05) compared to day students. CONCLUSION: Skin disorders affected 59.1

of the studied children. Skin disorders were more common among girls and boarders in this study, this group of children should be given specific attention in formulating preventive measures.

The association between high parity and obesity in women living in South-eastern Turkey.

BACKGROUND AND AIM: One of the major public health problems in Turkey is the high prevalence of obesity, which is particularly frequent among women. As it has been reported that parity affects body fat and BMI, the aim of this study was to evaluate the association between parity number, socioeconomic status and obesity. SUBJECTS AND METHODS: The study involved 286 married or divorced women aged 28- 80 years (mean age: 46.7+/-9.7), who were divided into two groups depending on whether they had experienced three or fewer pregnancies (group 1) or four or more pregnancies (group 2). We measured their body weight and height, and waist and hip circumferences, calculated their BMI, and determined their body fat percentage and fat mass by means of bioelectric impedance. RESULTS: The women in group 2 had a higher BMI, a greater fat percentage and fat mass, a larger waist circumference and higher waist/hip ratio values than those in group 1, and their mean age and illiteracy ratio were also higher. There was a significant correlation between parity number and body weight, BMI and hip circumference. CONCLUSIONS: Among other risk factors, a high parity number and socioeconomic indices may be associated with obesity in women.

Breastfeeding beliefs and practices among migrant mothers in slums of Diyarbakir, Turkey, 2001.

BACKGROUND: A qualitative investigation and a population survey were conducted to explore the breastfeeding beliefs and practices of mothers who were forced to migrate from their original villages and were currently living in the slums of Diyarbakir in Turkey. METHODS: Qualitative data collection on breastfeeding beliefs was conducted using in-depth interviews. In-depth interviews were tape-recorded. Quantitative data on breastfeeding practices were collected using a structured questionnaire. RESULTS: Mothers generally have a positive attitude towards breastfeeding, but colostrum is usually perceived negatively. No woman was found to feed her infant exclusively by breastfeeding. Only 9.9% of mothers initiated breastfeeding within the first hour of birth. Forty per cent of mothers started solid foods before 4 months. Mother's education appeared as a significant factor influencing the introduction of colostrum to the newborn. Mothers with lower education generally believed that the colostrum should not be fed to the infant and that a pregnant woman's milk is unhealthy for the baby. There was also a belief that 'working under the sun' decreased the quality of milk of a mother. CONCLUSION: Cultural beliefs have a significant influence on breastfeeding practices. Some of these practices are potentially harmful to newborns. Health education programmes should address these beliefs and practices in culture sensitive ways.

Vaccination coverage in the South-East Anatolian Project (SEAP) region and factors influencing low coverage.

OBJECTIVES: To determine the vaccination coverage of children living in the South-east Anatolian Project (SEAP) region; whether the vaccination coverage was similar to formal reports, other studies and other countries; and which factors influence vaccination, in order to indicate how vaccination coverage can be improved. STUDY DESIGN: A descriptive cross-sectional study conducted in nine provinces of the SEAP region in order to determine public health problems and their causes. METHODS: A population-based sample of 1150 houses was selected from rural and urban areas of the SEAP region and visited by the researchers. Questionnaires were applied in 2001 and 2002. RESULTS: In the SEAP region, only 30% of children had received a complete set of vaccines. The vaccination coverage was 76.7% for Bacille Calmette-Guérin; 62.0% for the third doses of diphtheria, tetanus toxoid, pertussis and polio vaccine; 62.7% for measles; 44% for the third dose of hepatitis B vaccine in children aged 12-23 months; and 13.3% for the second dose of tetanus toxoid in women who gave birth in the last 5 years. In logistic regression analysis, residence type, number of siblings, birth interval, follow-up visits of midwives, and maternal level of education were found to influence whether children were completely vaccinated. CONCLUSIONS: The findings of this study indicate that vaccination coverage is not acceptable in the SEAP region. Efforts must focus on family planning services, education of women, follow-up visits and strengthening health facilities, especially in rural regions, to improve vaccination.

Family planning in the Southeast Anatolian Project Region.

OBJECTIVES: The aim of this study was to evaluate contraceptive use by women of reproductive age in the Southeast Anatolian Project Region and the promotion of the use of family planning services. METHODS: An optimum sample size to represent the rural and urban area of the region was determined and the sample was chosen by sampling method proportional to the size. A total of 1126 houses were visited and questions about reproductive health were asked of 1019 ever-married (currently married, widows and divorced) women. RESULTS: The study showed that 48.2% of the ever-married women of reproductive age had never used any method of family planning; 37.4% were currently using a family planning method, and 14.4% had used a family planning method in the past. Of the women who were currently using a family planning method, 73.1% were using an effective method. The result of the logistic regression analysis showed that educational level, knowledge of Turkish, type of residence, and total number of living children were the main variables that affected the use of family planning methods. CONCLUSIONS: Use of family planning methods in the region was not at the expected level. In order to decrease the barriers to family planning in developing countries, we must provide obtainable, acceptable, integrated health services.

Lengthening of short stumps for functional use of prostheses.

The length of a stump plays an important role when using a prosthesis. It is essential to have an adequate length in the stump in order to apply the prosthesis. Therefore, it is necessary to attempt to lengthen short stumps. The authors have reviewed the results in 2 patients who had such lengthening of stumps one due to traumatic amputation of the forearm at 6.25 cm distally from the elbow and the other due to congenital deficiency of the radius and ulna treated by the Ilizarov techinque to improve the fitting of prostheses. Sixty percent (60%) and 40% lengthening was achieved respectively. At the end of the lengthening process, sufficient stump length for the prosthesis was achieved. There were no major complications. As a result, it is believed stump lengthening is a valuable method for cosmetic and functional use of the prosthesis. The Ilizarov Technique is an effective method of lengthening of a stump and it does not require a tissue expander in selected patients. Patients have been able to use their prosthesis 6 months after surgery.

Etude comparative de la mortalite perinatale des premiers et deuxiemes jumeaux (a propos de 198 cas colliges a la maternite du CHU de Cocody)

Notre travail est une etude transversale prospective et analytique realisee a la maternite du CHU de Cocody du 1er Fevrier 2002 au 31 Janvier 2003. Son but est d'apprecier les facteurs de risque de la mortalite perinatale dans l'accouchement gemellaire. Nous avons analyse 198 accouchements gemellaires de parturientes ayant accouche les deux jumeaux ou le deuxieme jumeau a la maternite du CHU de Cocody et compare le pronostic neonatal du premier et deuxieme jumeau.Nous constatons une influence nefaste sur le pronostic neonatal des facteurs suivants:-Absence de surveillance prenatale-Toxemie gravidique-Diagnostic tardif de la grossesse gemellaire-Prematurite-Presentations dystociques-Manoeuvres obstetricales sur le deuxieme jumeau-Allongement du delai entre les deux naissances-Faible poids de naissanceL'amelioration du pronostic neonatal passe par une surveillance prenatale obligatoire et rigoureuse; une realisation des accouchements gemellaires dans les centres specialises et equipes; une education sanitaire de nos gestantes

Prevalence of asthma and other allergic disorders among schoolchildren in Diyarbakir, Turkey.

This study was performed to describe the prevalence rates of allergic diseases among children in southeast Anatolia. A questionnaire survey of children six to 15 years old was conducted using a modified version of the Turkish translated ISAAC protocol, with additional questions concerning sociodemographic and environmental characteristics of children that could be potential risk factors for allergic disorders. Questionnaires were distributed to parents of all children aged below 11 years and to children themselves aged over 11 for completion. A total of 3,040 children returned the questionnaires. The lifetime prevalence rates of asthma, wheezing, allergic rhinitis and atopic dermatitis were 14.1%, 22.4%, 12.9%, and 7.8%, respectively. The prevalence of wheezing, rhinitis and chronic rash in the last 12 months were 14.7%, 39.9%, and 11.8%, respectively. The prevalence rates of symptoms and diagnoses of allergic disorders were similar in boys and girls. Passive smoking, pet ownership, number of household and socioeconomic status were not significant risk factors for allergic diseases. Family history of atopy was the most prominent risk factor for all types of allergic diseases, high prevalence rates of asthma, rhinitis and eczema exist among schoolchildren in southeast Anatolia.