Purpose: The main purpose of this study is to evaluate prognostic factors that affected the patients’ early (<30 days) and late (six months, one year, and overall) postoperative mortality following hip fracture surgery. Materials and Methods: This retrospective study included 515 patients older than 75 years old with surgically treated osteoporotic hip fracture. The demographic data, American Society of Anesthesiologists (ASA) classification, type of anesthesia, duration of hospital stay, and history of intensive care unit (ICU) stay were collected.An analysis of laboratory values was also performed to determine their relationship with mortality. The primary outcome was survival, determined as the time from the surgery to death or the end of the study. The patients were divided into four groups according to survival time: at the first month, six months, first year, and overall survival. An analysis of demographic and laboratory values was performed to determine their validity as prognostic factors for each group. Results: Postoperative C-reactive protein (CRP) level showed an independent association with a poor survival at the first month. ASA classification, admission to the ICU, and preoperative CRP levels showed an independent association with a poor survival for the first six months. Preoperative CRP level showed an independent association with a poor survival for the first year. ASA classification, admission to the ICU, and the preoperative CRP levels showed an independent association with a poor overall survival. Conclusion CRP level, a high ASA classification, and postoperative ICU admission were related to poorer overall survival rate following hip fracture surgery in the elderly.

BACKGROUND: Familial Mediterranean fever (FMF) is an autoinflammatory disease that has self-limiting inflammatory attacks during polyserositis. Hepcidin is a protein, and interleukin-6 stimulation increases hepcidin levels. Calprotectin (CLP) is a recently defined cytokine released from monocytes and neutrophils in response to tissue trauma and inflammation. There are studies in the literature showing that it can be used as a biomarker in rheumatic diseases such as ankylosing spondylitis and rheumatoid arthritis. Here, we compared the levels of hepcidin and CLP in healthy individuals and FMF patients during an attack-free period and show its relation to genetic mutations.METHODS: This is a cross-sectional study. Between July 2017 and December 2017, 60 patients diagnosed with FMF an admitted to the Cumhuriyet University Faculty of Medicine Department of Internal Medicine Rheumatology as well as 60 healthy volunteers without any rheumatic, systemic, or metabolic diseases were enrolled in this study. Blood was collected from a peripheral vein to measure serum CLP and hepcidin levels. Blood tests were examined by ELISA; the study protocol was approved by the local ethics committee.RESULTS: Median serum hepcidin level was 468.1 (210.3–807.8) pg/mL in FMF group and 890.0 (495.0–1,716.9) pg/mL in the healthy control (HC) group. There was a statistically significant difference between the two groups (P < 0.001). The median serum levels of CLP in the FMF group were measured as 1,331.4 (969.3–1,584.6 pg/mL and 73.8(45.0–147.9) pg/mL in the HC group. There was a statistically significant difference between the two groups (P < 0.001). Receiver operating characteristic analysis showed that the sensitivity was 66.7% and the specificity was 71.7% at serum hepcidin < 581.25 pg/mL (P < 0.05); the sensitivity was 96.7% and specificity was 100% at CLP > 238 pg/mL (P < 0.05). There was no significant difference between serum hepcidin and CLP levels in FMF patients with M694V homozygous and M694V heterozygous (P > 0.05). There was no significant difference in serum hepcidin levels between FMF patients with and without arthritis, proteinuria, and amyloidosis (P < 0.05). There was no significant correlation between laboratory findings, gender, age, and serum CLP and hepcidin levels (P > 0.05, r < 0.25).CONCLUSION: Serum CLP levels in FMF patients during an attack-free period are significantly higher than in the HC groups. Serum hepcidin levels in FMF patients are significantly lower than in the HC group. Low levels of hepcidin may be explained by including FMF patients during an attack-free period in the study. CLP may be an important biomarker in FMF. A better understanding of the role of these biomarkers in the diagnosis of FMF is needed to evaluate the results in a more comprehensive way.

Purpose: To test whether Crowe type is related to femoral alignment and leg length discrepancy by evaluating the preoperative lengths and coronal alignment of femurs, pelvic parameters and hip morphology of patients who underwent primary hip arthroplasty due to coxarthrosis secondary to developmental dysplasia of the hip (DDH). Materials and Methods: Medical records of patients with coxarthrosis secondary to DDH who were treated with total hip arthroplasty at Department of Orthopaedics and Traumatology, Istanbul University Faculty of Medicine between 2008 and 2017 were reviewed. The mechanical axis of lower limbs was analyzed; pelvic height and femoral and tibial lengths were measured. All femurs were classified according to the Dorr classification. Results: A total of 97 patients were eligible for analysis and were diagnosed with unilateral DDH (n=51) or bilateral DDH (n=46). In those diagnosed with unilateral DDH, the affected pelvis, femur, and tibia were often shorter than the unaffected side. In those diagnosed with bilateral DDH, femoral and pelvic lengths were unpredictable. In the femoral coronal alignment test, data varied widely but were within normal limits. The difference in the Dorr types of femurs was significant between dysplastic and normal sides of patients with unilateral DDH (P=0.001) but not those with bilateral DDH. Conclusion Especially in patients with unilateral DDH, pelvic heights and femoral and tibial lengths on the affected side may be shorter compared with unaffected side regardless of the Crowe type. Femoral coronal alignment is unpredictable for both groups. Careful preoperative analyses of femoral coronal alignment and pelvic length are advised.

BACKGROUND: Familial Mediterranean fever (FMF) is an autoinflammatory disease that has self-limiting inflammatory attacks during polyserositis. Hepcidin is a protein, and interleukin-6 stimulation increases hepcidin levels. Calprotectin (CLP) is a recently defined cytokine released from monocytes and neutrophils in response to tissue trauma and inflammation. There are studies in the literature showing that it can be used as a biomarker in rheumatic diseases such as ankylosing spondylitis and rheumatoid arthritis. Here, we compared the levels of hepcidin and CLP in healthy individuals and FMF patients during an attack-free period and show its relation to genetic mutations. METHODS: This is a cross-sectional study. Between July 2017 and December 2017, 60 patients diagnosed with FMF an admitted to the Cumhuriyet University Faculty of Medicine Department of Internal Medicine Rheumatology as well as 60 healthy volunteers without any rheumatic, systemic, or metabolic diseases were enrolled in this study. Blood was collected from a peripheral vein to measure serum CLP and hepcidin levels. Blood tests were examined by ELISA; the study protocol was approved by the local ethics committee. RESULTS: Median serum hepcidin level was 468.1 (210.3–807.8) pg/mL in FMF group and 890.0 (495.0–1,716.9) pg/mL in the healthy control (HC) group. There was a statistically significant difference between the two groups (P < 0.001). The median serum levels of CLP in the FMF group were measured as 1,331.4 (969.3–1,584.6 pg/mL and 73.8(45.0–147.9) pg/mL in the HC group. There was a statistically significant difference between the two groups (P < 0.001). Receiver operating characteristic analysis showed that the sensitivity was 66.7% and the specificity was 71.7% at serum hepcidin < 581.25 pg/mL (P < 0.05); the sensitivity was 96.7% and specificity was 100% at CLP > 238 pg/mL (P < 0.05). There was no significant difference between serum hepcidin and CLP levels in FMF patients with M694V homozygous and M694V heterozygous (P > 0.05). There was no significant difference in serum hepcidin levels between FMF patients with and without arthritis, proteinuria, and amyloidosis (P < 0.05). There was no significant correlation between laboratory findings, gender, age, and serum CLP and hepcidin levels (P > 0.05, r < 0.25). CONCLUSION Serum CLP levels in FMF patients during an attack-free period are significantly higher than in the HC groups. Serum hepcidin levels in FMF patients are significantly lower than in the HC group. Low levels of hepcidin may be explained by including FMF patients during an attack-free period in the study. CLP may be an important biomarker in FMF. A better understanding of the role of these biomarkers in the diagnosis of FMF is needed to evaluate the results in a more comprehensive way.

Autologous fat injection was first described roughly a century ago and has been used in surgery ever since. In addition to its use in many surgical fields, it is also frequently used for both aesthetic and reconstructive purposes in breast surgery. Since the application of fat grafting in breast surgery has steadily increased, studies investigating its reliability have simultaneously become increasingly common. Previous studies have reported that the use of fat grafting in breast surgery is reliable, but some pending questions remain about its routine use. In order to use fat grafts successfully in breast surgery, it is necessary to be familiar with the structure and content of adipose tissue, the efficacy of adipose stem cell-enriched fat grafts, the oncological safety of fat grafts, and the problems that may occur in the radiological follow-up of patients who undergo fat grafting procedures. In this literature review, we aim to discuss the use of fat grafts in breast surgery by investigating these common problems.

Periprosthetic joint infection (PJI) due to Salmonella is rare. It frequently occurs patients receiving immunosuppressive medicine. We describe two periprosthetic Salmonella infection of two immunocompromised patients. Both of patients were receiving azathioprine and prednisolone therapy. First patient presented six years after total hip arthroplasty with a huge abscess on her right thigh that was reached to femoral component through the lytic area of lateral femur. Second patient presented with drainage from his hip and he had undergone two-step revision surgery for PJI 3 months ago. There is no consensus in the treatment of periprosthetic salmonella infections. We prefer two-step revision surgery for these infections as previously described in the literature.
Abscess ; Arthroplasty, Replacement, Hip ; Azathioprine* ; Consensus ; Drainage ; Femur ; Hip ; Humans ; Immunocompromised Host ; Joints* ; Prednisolone* ; Salmonella Infections ; Salmonella* ; Thigh

OBJECTIVE: To test the null hypothesis that SmartClip self-ligating brackets are more effective than conventional brackets for initial mandibular alignment and identify influential factors. METHODS: Fifty patients were randomly allocated to two equal treatment groups by using an online randomization program: self-ligating group (SmartClip brackets) and conventional group (Gemini brackets). The archwire sequence was standardized. Changes in anterior irregularity index, intercanine width, and intermolar width were assessed on plaster models at 8th and 16th weeks. Changes in incisor position and inclination were assessed on lateral cephalometric radiographs at 16 weeks. Intragroup and intergroup comparisons were performed with paired t-test and Student's t-test, respectively. Multiple linear regression was performed to identify variables affecting improvement in anterior ambiguity. RESULTS: Data of 46 patients were analyzed; those missing an appointment (n = 2) or showing bracket breakage (n = 2) were excluded. Incisor inclination (p < 0.05), intercanine width (p < 0.05), and intermolar width (p > 0.05) increased at 8 and 16 weeks in both the groups; no significant intergroup differences were noted (p > 0.05). Initial anterior irregularity index and intercanine width change were significantly associated with improvement in anterior irregularity (p < 0.001). CONCLUSIONS: The null hypothesis was rejected. Bracket type has little effect on improvement in anterior ambiguity during initial mandibular alignment.
Humans ; Incisor ; Linear Models ; Prospective Studies* ; Random Allocation

OBJECTIVE: To test the null hypothesis that SmartClip self-ligating brackets are more effective than conventional brackets for initial mandibular alignment and identify influential factors. METHODS: Fifty patients were randomly allocated to two equal treatment groups by using an online randomization program: self-ligating group (SmartClip brackets) and conventional group (Gemini brackets). The archwire sequence was standardized. Changes in anterior irregularity index, intercanine width, and intermolar width were assessed on plaster models at 8th and 16th weeks. Changes in incisor position and inclination were assessed on lateral cephalometric radiographs at 16 weeks. Intragroup and intergroup comparisons were performed with paired t-test and Student's t-test, respectively. Multiple linear regression was performed to identify variables affecting improvement in anterior ambiguity. RESULTS: Data of 46 patients were analyzed; those missing an appointment (n = 2) or showing bracket breakage (n = 2) were excluded. Incisor inclination (p < 0.05), intercanine width (p < 0.05), and intermolar width (p > 0.05) increased at 8 and 16 weeks in both the groups; no significant intergroup differences were noted (p > 0.05). Initial anterior irregularity index and intercanine width change were significantly associated with improvement in anterior irregularity (p < 0.001). CONCLUSIONS: The null hypothesis was rejected. Bracket type has little effect on improvement in anterior ambiguity during initial mandibular alignment.
Humans ; Incisor ; Linear Models ; Prospective Studies* ; Random Allocation

No abstract available.
Folliculitis*

OBJECTIVE: To evaluate the long-term effects of self-ligating brackets (SLBs) on transverse dimensions of arches and skeletal and soft tissues and to quantitatively evaluate the treatment outcome after non-extraction treatment with SLBs. METHODS: The sample consisted of 24 (18 female and six male) subjects, with a mean age of 14.23 +/- 2.19 years, who received treatment with the Damon(R)3 appliances. Complete records including cephalometric radiographs and plaster models were obtained before treatment (T1), immediately after treatment (T2), six months after treatment (T3), and two years (T4) after treatment. Digital study models were generated. Twenty lateral cephalometric, six frontal cephalometric, and eight dental cast measurements were examined. The Peer Assessment Rating index was used to measure the treatment outcome. The Wilcoxon test was applied for statistical analysis of the changes. RESULTS: There were significant increases in all transverse dental cast measurements with active treatment. There was some significant relapse in the long term, particularly in maxillary width (p < 0.05). Statistically significant increases were found in nasal (p < 0.001), maxillary base, upper molar, lower intercanine, and antigonial (p < 0.05) widths in T1-T2. Lower incisors were proclined and protruded in T1-T2. CONCLUSIONS: SLBs correct crowding by mechanisms involving incisor proclination and protrusion and expansion of the dental arches, without induction of clinically significant changes in hard and soft tissues of the face.
Crowding ; Dental Arch ; Female ; Humans ; Incisor ; Molar ; Recurrence ; Treatment Outcome