Purpose: With a focus on dislocation rates, this study aims to compare the posterior or posterolateral approach (PLA) with the piriformis-sparing approach (PSA) in elderly patients undergoing cementless hemiarthroplasty for displaced femoral neck fractures. Materials and Methods: This retrospective study included 194 patients who met the eligibility criteria and underwent surgery using the PLA (n=140) or the PSA (n=54). Patient data were reviewed for age, sex, body mass index, postoperative dislocation rate, presence of neurological conditions or other comorbidities, surgical duration, length of hospital stay, follow-up period, infection rate, admission to the intensive care unit (ICU), and mortality rate. Results: In Group 1 (PLA), 12 out of 140 patients (8.6%) experienced dislocation within a postoperative period of 1 to 5 years. Dislocations occurred in three out of 54 patients (5.6%) in Group 2 (PSA). Although the difference was not statistically significant (P=0.565), a significant difference was observed between the groups in terms of mortality (P=0.015) and surgical duration (P=0.0001). Conclusion In terms of functional outcomes and postoperative pain management, the advantages of modified PLA have been highlighted in recent studies. Although no statistically significant difference was found in this study, a 3% lower dislocation rate was demonstrated by the PSA as compared to the PLA.

OBJECTIVE: The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are markers that can determine the presence of systemic inflammatory response. In this study, we examined the NLR and PLR levels in patients with heroin dependence compared to healthy controls. METHODS: The study sample included 90 male patients with heroin dependence aged 18 to 45 years and 60 healthy subjects who had similar socio-demographic characteristics as the patient group. The diagnoses of heroin dependence and other Axis I psychiatric disorders in the patient and control groups were screened with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I). The extent of heroin addiction was assessed with the Addiction Severity Index (ASI). RESULTS: The mean NLR and PLR levels of patients with heroin dependence were significantly higher than the control subjects (p=0.031 and p < 0.001, respectively). Positive correlations were found between NLR, PLR and duration of the disorder. CONCLUSION: Our results indicate that inflammatory processes may play a role in the pathophysiology of heroin dependence.
Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Healthy Volunteers ; Heroin Dependence ; Heroin* ; Humans ; Male* ; Prospective Studies*

PURPOSE: Our aim was to investigate the predictive factors indicating strangulation, and the requirement for surgery in patients with acute mechanical intestinal obstruction due to adhesions. METHODS: This study retrospectively evaluated the records of patients with adhesive acute mechanical intestinal obstruction. The surgical treatment (group S), conservative treatment (group C), intraoperative bowel ischemia (group I), and intraoperative adhesion only (group A) groups were statistically evaluated according to the diagnostic and surgical parameters. RESULTS: The study group of 252 patients consisted of 113 women (44.8%), and 139 men (55.2%). The mean age was 62.79 +/- 18.08 years (range, 20-98 years). Group S consisted of 50 patients (19.8%), and 202 (80.2%) were in group C. Group I consisted of 19 patients (38%), where as 31 (62%) were in group A. In group S, the prehospital symptomatic period was longer, incidence of fever was increased, and elevated CRP levels were significant (P < 0.05). Plain abdominal radiography, and abdominal computerized tomography were significantly sensitive for strangulation (P < 0.05). The elderly were more prone to strangulation (P < 0.05). Fever, rebound tendernes, and urea & creatinine levels were significantly higher in the presence of strangulation (P < 0.05, P < 0.05, and P < 0.05, consecutively). CONCLUSION: Fever, rebound tenderness, urea & creatinine levels, plain abdominal radiography, and abdominal computerized tomography images were important indicators of bowel ischemia. Longer prehospital symptomatic period was related with a tendency for surgical treatment, and the elderly were more prone to strangulation. CRP detection was considered to be useful for the decision of surgery, but not significantly predictive for strangulation.
Adhesives ; Aged ; Creatinine ; Female ; Fever ; Humans ; Incidence ; Intestinal Obstruction* ; Ischemia ; Male ; Radiography, Abdominal ; Retrospective Studies ; Tissue Adhesions ; Urea