Ultrasonographic evaluation of distal femoral and talar cartilage thicknesses in patients with early rheumatoid arthritis and their relationship with disease activity.

INTRODUCTION: The aims of this study were to compare the distal femoral and talar cartilage thicknesses by ultrasonography (US) between patients with early rheumatoid arthritis (RA) and healthy controls and to investigate the potential relationship of these parameters with disease activity and clinical parameters. METHODS: Fifty-five patients with RA with a disease duration of up to 12 months (RA group), and 55 healthy volunteers (control group) were included in the study. The bilateral distal femur and talus cartilage thicknesses of all participants were measured by US and compared between the groups. The relationship of the results with the clinical data of the patients with early RA was investigated. RESULTS: The distal femur (medial, central, and lateral) and talus cartilage thicknesses of both extremities were significantly lower in the RA group. The tender joint count was found to be slightly to moderately negatively correlated with cartilage thickness. However, no correlation was found between the swollen joint count and cartilage thickness. In addition, the disease activity scores were moderately and inversely correlated with cartilage thickness in certain areas. CONCLUSION: The results of this preliminary study using US indicate that the distal femoral and talus cartilage of patients with RA can be affected in the early period, and the cartilage thickness of patients seems to be associated with disease activity. These results may inspire new studies for the evaluation of femoral and talar cartilage with US. Key Points • The distal femoral and talus cartilage thicknesses seem to be affected in the early period of rheumatoid arthritis. • There may be a relationship between the distal femur and talus cartilage thicknesses and disease activity in patients with early rheumatoid arthritis. • The tender joint count appears to be more associated with cartilage thickness than the swollen joint count in patients with early rheumatoid arthritis.

Use of Embolectomy With Local Anesthesia for Anticoagulation Failure in Radial Artery Thrombosis.

OBJECTIVE: Although prevention of radial artery thrombosis and cardiac complications after interventions using radial access is well investigated, there is yet no clinical study that completely evaluated access-related complications. However, there is still no consensus on what exact treatment should be used in these patients. In clinical practice, analgesic, anticoagulant, and antiplatelet treatments usually improve symptoms in patients with pain; however, in some patients, complaints may persist and may not respond to these treatments. In these patients, low-risk embolectomy with a small skin incision may be beneficial. METHODS: A total of 102 patients with radial artery thrombosis after cardiac catheterization were included in the study between 2016 March and 2018 December. After the patients' initial evaluation, anticoagulation with enoxaparin or tinzaparin and antiplatelet therapy with acetylsalicylic acid and oral/local analgesic/anti-inflammatory and local anesthetic therapy were administered for 1 month. Patients whose symptoms resolved after medical treatment were followed up as outpatients. Embolectomy was performed in consenting patients who did not respond to the medical treatment. RESULTS: Of 102 patients included in the study, 33 underwent embolectomy, whereas 69 received only medical treatment. None of the patients experienced any complications, morbidity, or mortality in the peroperative period and during the medical treatment. The pretreatment symptom scores of patients who actively use their hands in daily life and profession were significantly higher than the scores of patients who are relatively less active (P = .013). Pretreatment symptom scores were negatively correlated with age (r = -0.584); symptom scores increased significantly with the decrease of patient age. No benefit from medical treatment and need for surgery was significantly greater in patients who are younger and use their hands actively in daily life and profession (P = .028). The decrease in symptom scores after treatment was significantly greater in the surgical group than in the medical group (P = .003). CONCLUSION: Radial access should be exercised with care in patients who may develop significant thrombosis-related complaints and it is necessary to decide whether radial access is essential. If patients have ongoing symptoms despite medical treatment, embolectomy can be considered as a treatment option.

Experience of using shear wave elastography in evaluation of testicular stiffness in cases of male infertility.

PURPOSE: The purpose of this study was to determine quantitative testicular tissue stiffness values in normal and infertile men using shear wave elastography (SWE), and to evaluate the relationship between infertility and testicular stiffness value. METHODS: In total, 100 testes of 50 infertile patients with abnormal semen parameters were classified as group A, and 100 testes of 50 control subjects were classified as group B. These two groups were compared in terms of age, testicular volume, and SWE values. The group B testes were randomly chosen from patients who had applied for ultrasonography for any reason, and who had no testis disease and no history of infertility. RESULTS: The mean age of the patients was 27.83 years, and no significant difference in age was found between the groups (P = 0.133). No significant difference in testicular volume was found between the groups (P = 0.672). The SWE values were significantly higher in group A than in group B (P = 0.000 for both m/s and kPa values). SWE values had a negative correlation with mean testicular volume in group A (for m/s values: P = 0.043; for kPa values: P = 0.024). CONCLUSION: SWE can be a useful technique for assessing testicular stiffness in infertile patients to predict parenchymal damage in testicular tissue that leads to an abnormality in sperm quantity. In addition, decreased testicular volume, together with increased SWE values, can reflect the degree of parenchymal damage.

Is Nasal Septal Body Size Associated With Inferior Turbinate Hypertrophy and Allergic Rhinitis?

Nasal septal body is a thickened mucosal area of nasal septum with an unknown certain role. In this study, the authors aimed to investigate the association between the area, length, and width of the nasal septal body with inferior turbinate hypertrophy (ITH) and allergic rhinitis (AR). A total of 106 patients with ITH (54 with AR and 52 without AR), and 49 patients without ITH and AR (control group) were included in this study. Using axial and coronal paranasal computed tomography scans, the area, length, and width of nasal septal body were measured, and the mean values between the groups were compared. Mean area, length, and width of nasal septal body significantly differed among 3 groups (P < 0.001). Septal body area was significantly greater in ITH with AR group, compared to ITH without AR group (P < 0.001) and the control group (P < 0.001). Also, it was significantly greater in ITH without AR group compared to the control group (P < 0.001). Septal body width was significantly greater in ITH with AR group, compared to ITH without AR group (P < 0.001) and the control group (P < 0.001). Also, it was significantly greater in ITH without AR group compared to the control group (P < 0.001). Patients with ITH had a greater nasal septal body area, length, and width, compared to the patients without. Moreover, AR had an additional increasing effect on the area and width of the nasal septal body.

Does paranasal sinus development affect olfactory fossa depth and lateral lamella length?

OBJECTIVES: To investigate the olfactory fossa depths and lateral lamella lengths of patients with different types of developmental disorders of paranasal sinuses in comparison with normal controls. STUDY DESIGN: Retrospective, archival, radio-anatomical study. METHODS: We included 58 patients with maxillary sinus hypoplasia, 50 patients with frontal sinus hypoplasia/aplasia, 50 patients with sphenoid sinus hypoplasia/aplasia, and 40 normal controls. Reviewing paranasal computerized tomography scans, we noted the olfactory fossa depths and lateral lamella lengths of all the groups and compared between the hypoplasia groups and the control group. RESULTS: Compared with the normal controls, the maxillary hypoplasia group (P < 0.001), frontal hypoplasia/aplasia group (P = 0.004), and sphenoid hypoplasia/aplasia group had significantly deeper olfactory fossa (P = 0.003). The mean lateral lamella lengths in the type 1, type 2, and type 3 hypoplastic maxillary sinus groups were significantly greater compared with that in the control group (P < 0.001). Additionally, the mean lateral lamella lengths in the hypoplastic frontal sinus, aplastic frontal sinus, and hypoplastic sphenoid sinus groups were significantly greater compared with that in the control group (P < 0.001). CONCLUSION: The patients with pneumatization defects of the maxillary, frontal, and sphenoid sinuses had deeper olfactory fossa and longer lateral lamella related to increased risk of skull base injury during endoscopic sinus surgery. LEVEL OF EVIDENCE: 3 Laryngoscope, 129:2458-2463, 2019.

Verb-based prediction during language processing: the case of Dutch and Turkish.

This study investigated whether cross-linguistic differences affect semantic prediction. We assessed this by looking at two languages, Dutch and Turkish, that differ in word order and thus vary in how words come together to create sentence meaning. In an eye-tracking task, Dutch and Turkish four-year-olds (N = 40), five-year-olds (N = 58), and adults (N = 40) were presented with a visual display containing two familiar objects (e.g., a cake and a tree). Participants heard semantically constraining (e.g., "The boy eats the big cake") or neutral sentences (e.g., "The boy sees the big cake") in their native language. The Dutch data revealed a prediction effect for children and adults; however, it was larger for the adults. The Turkish data revealed no prediction effect for the children but only for the adults. These findings reveal that experience with word order structures and/or automatization of language processing routines may lead to timecourse differences in semantic prediction.

Evaluation of the cytogenetic damage induced by the organophosphorous insecticide acephate.

The organophosphorous insecticide acephate was tested for its ability to induce in vitro cytogenetic effect in human peripheral lymphocytes by using the chromosomal aberrations (CAs), sister chromatid exchange (SCE) and micronuclei (MN) assay. The level of nuclear DNA damage of acephate was evaluated by using the comet assay. Concentrations of 12.5, 25, 50, 100 and 200 mug mL(-1) of acephate were used. All concentrations of acephate induced significant increase in the frequency of CAs and in the formation of MN dose dependently (r = 0.92 at 24 h, r = 0.95 at 48 h for CAs, r = 0.87 for MN). A significant increase was observed in induction of SCE at 50, 100 and 200 mug mL(-1) concentrations during 24 h treatment and at all concentrations (except 12.5 mug mL(-1)) during 48 h treatment period in a dose-dependent manner (r = 0.84 at 24 h, r = 0.88 at 48 h). Acephate did not affect the replicative index and cytokinesis-block proliferation index (CBPI). However, it significantly decreased the mitotic index at all three highest concentrations (50, 100, 200 mug mL(-1)) for 24 h treatment and at all concentrations (except 12.5 mug mL(-1)) for 48 h treatment, dose-dependently (r = 0.94 at 24 h, r = 0.92 at 48 h). A significant increase in mean comet tail length was observed at 100 and 200 mug mL(-1) concentrations compared with negative control in a concentration-dependent manner (r = 0.94). The mean comet tail intensity was significantly increased at only 200 mug mL(-1) concentration. The present results indicate that acephate is a clastogenic, cytotoxic agent and it causes DNA damage at high concentrations in human lymphocytes in culture.

Effects of previously well-developed collateral vessels on left internal mammary artery graft flow after bypass surgery.

Transthoracic Doppler ultrasonography can assess left internal mammary artery patency and flow after coronary artery bypass grafting. We aimed to show, by transthoracic Doppler ultrasonography, the early effects upon left internal mammary artery graft flow of preoperative collateral vessels supplying the left anterior descending artery. Thirty-four consecutive patients undergoing coronary artery bypass were prospectively enrolled: 19 patients with collateral vessels supplying the left anterior descending were compared with 15 patients without collaterals. After bypass, end-diastolic velocity, mean velocity, flow volume, and ejection fraction were significantly greater, and the resistivity index was lower in patients with collateral vessels. The changes in velocities, volume, resistivity index, and pulsatility index were also found to be greater in patients with collateral vessels than in those without collaterals. Collateral vessels were the only factor affecting the changes in end-diastolic volume, mean velocity, flow volume, and resistivity index in multivariate analysis. Three factors affected postoperative left ventricular ejection fraction: collateral vessels, preoperative ejection fraction, and changes in left internal mammary flow volume. We conclude that patients with well-developed collaterals to the left anterior descending have better flow in the left internal mammary graft and more significant improvement in left ventricular function after coronary bypass. The flow volume of the mammary graft and the improvement of ventricular systolic functions after coronary bypass might be presumed with the presence of grade 2 or 3 preoperative collateral vessels.