Medicine Science

Transverse testicular ectopia (TTE) is a rare scrotal anomaly occurring consequent to the migration of both gonads to the same hemiscrotum. In this case we aim to present a 24 years old male patient who has pain and swelling its diagnosed Transverse Testicular Ectopia in our clinic.

The purpose of this study was to investigate the effects of a progressive 10-wk aquatic resistance training on neuromuscular performance and muscle mass of the knee extensors and flexors in healthy women. Methods: Twenty-four healthy women (34.2 Ϯ 3.9 yr) were randomly assigned into aquatic exercise (N ϭ 12) and control group (N ϭ 12). Maximum knee extension and flexion torques were measured isometrically and at constant angular velocities of 60°•s Ϫ1 and 180°•s Ϫ1 (isokinetic) with simultaneous electromyography (EMG) recordings of the quadriceps and hamstrings. The lean muscle mass (LCSA) of the quadriceps and hamstring muscles was determined by computed tomography scanning. Results: Significant interaction of group by time was observed in each of the measured parameters. The change in extension and flexion isometric/isokinetic torque varied between 8 and 13% and in EMGs between 10 and 27% in the exercise group. The change in the quadriceps LCSA of the exercise group was 4% and in hamstrings 5.5%. Conclusions: The results of the present study showed that 10 wk of progressive aquatic resistance training resulted in significant improvement in muscle torque of the knee extensors and flexors accompanied with proportional improvement in neural activation and with significant increase in the LCSA of the trained muscles. Aquatic training can be recommended for neuromuscular conditioning in healthy persons.

A 20-year-old male patient was admitted to Infectious diseases outpatient clinic with 25 days' history of pain and swelling of the left hand and forearm. He had received a single dose of diphtheria tetanus-diphteria toxoid vaccine (Td; vaccines with reduced content of diphtheria toxoid) in the left deltoid muscle. The patient was diagnosed as Complex regional pain syndrome type 1. He was administered gabapentin (initial dose 1200 mg per day in two divided doses and maintenance dose 1800 mg per day, in three divided doses), etodolac 600 mg per day, acetylcystein 1200 mg per day, 3000 mg calcium carbonate with 8.8 mg colecalciferol at bed time and left upper extremity physiotherapy, including whirlpool, contrast bath and range of movement exercises. As a result, although complex regional pain syndrome type 1 (CRPS I) is a rare entity, it should be recognized in patients with severe pain, swelling and restricted extremity movement that occurred after immunization.

The patient-controlled analgesia (PCA) method is a crucial part of daily anesthesia practice, with different application methods to provide analgesia after orthopedic surgeries. This study aims to assess the effectiveness of intravenous (IV), interscalene, and subacromial PCA in managing postoperative pain in shoulder arthroscopy operations performed at our clinic. Follow-up forms of patients aged between 25 and 85 who were operated on and underwent PCA in the Istanbul Medical Faculty Orthopedics operating room were scanned. The patients who underwent shoulder arthroscopy were divided into three main groups (intravenous, interscalene, and subacromial) according to the PCA application method. Visual Analog Scale (VAS) values at rest and during movement, the presence of nausea and vomiting, and the need for additional analgesia were recorded. Of the 142 patients in whom PCA was used after shoulder arthroscopy, 40 had intravenous, 41 had interscalene, and 61 had subacromial PCA. The demographic characteristics (age, gender, and body mass index) of all three groups were statistically similar. When we look at the percentage of cases with a resting VAS value >3 in patients who underwent intravenous, interscalene, and subacromial PCA, it was found to be 25%, 0.0%, and 32.8%, respectively (p=0.005). The percentage of cases with a movement VAS value >3 was 80%, 12.2%, and 73.8% for the groups, respectively (p<0.001). Additional analgesia was required in 80% of intravenous PCA patients, 52.5% of subacromial PCA patients, and 7.3% of interscalene PCA patients (p<0.001). Vomiting complaints occurred in 50%, 2.4%, and 1.6% of intravenous, interscalene, and subacromial PCA, respectively (p<0.001). Using interscalene PCA instead of intravenous PCA significantly reduced the likelihood of a VAS score at movement of more than 3 and the need for additional analgesic administration (p<0.001). Postoperative pain control after arthroscopic shoulder surgery is important for the patient's comfort and recovery. Patient-controlled analgesia can be applied intravenously, subacromial, or interscalene to control postoperative pain in this patient group. However, interscalene PCA application is a more effective method than intravenous application in terms of both pain control and side effects.

Purpose: To compare the effects of different patterns of regular brisk walking on fitness, risk factors for cardiovascular disease, and psychological well-being in previously sedentary adults. Methods: Twenty-one subjects (14 women), aged 44.5 Ϯ 6.1 yr (mean Ϯ SD) were randomly assigned to two different, 6-wk programs of brisk walking in a cross-over design, with an interval of 2 wk. One program comprised one 30-min walk per day, 5 d•wk Ϫ1 (long bout) and the other three 10-min walks per day, also 5 d•wk Ϫ1 (short bouts). All walking was at 70 -80% of predicted maximal heart rate. Maximal oxygen uptake (V ˙O2max ), body composition, resting arterial blood pressure, fasting plasma lipoprotein variables, and psychological parameters were assessed before and after each program. Results: Overall, subjects completed 88.2 Ϯ 1.1% and 91.3 Ϯ 4.1% of prescribed total walking time in the short-and long-bout programs, respectively. Both programs increased plasma concentrations of high-density lipoprotein cholesterol, and decreased concentrations of triacylglycerol and total cholesterol (all P Ͻ 0.05). There were no changes in body mass, but the sum of four skinfolds, waist circumference, and hip circumference were decreased after both walking programs (all P Ͻ 0.05). Predicted V ˙O2max increased with both programs (P Ͻ 0.05), but this increase was greater with the program based on short bouts (P Ͻ 0.05). Both walking patterns resulted in similar decreases in tension/anxiety (P Ͻ 0.05). Conclusion: These findings suggest that three short bouts (10 min) of brisk walking accumulated throughout the day are at least as effective as one continuous bout of equal total duration in reducing cardiovascular risk and improving aspects of mood in previously sedentary individuals.

To present test-retest 'repeatability' of the DeVilbiss Respiratory Trainer (RT2) for maximal inspiratory pressure (MIP) and time of contraction (Tcont) of the inspiratory muscles (Tcon). METHoDs: Forty male subjects (20.8 ±1.3yrs) participated in the study. An inspiratory maneuver was completed to familiarize the subjects to the equipment. Each subject then performing one set of 3 sustained MIP maneuvers on study day 1, followed by a repetition of the 3 sustained MIP maneuvers 24 hours later (study day 2). For each subject was instructed to exhale to residual volume (RV), and then inhale maximally until total lung capacity (TLC) was reached, creating a single sustained maximum inspiratory effort from RV to TLC. Statistical analysis was performed using t-tests, correlation (r), coefficient of variation (CV), intraclass correlations (ICC) and 95% limits of agreement (95%LOA). Table 1: Statistical Analysis of the Test-Retest Data study Day 1 mean±SD study Day 2 mean±SD Diff mean±SD T-test (p) r CV ICC 95%LoA 0.05±3.12 MIP (cmH 2 O) 122.53±28.37 125.20±25.25 -2.68±9.38 0.657 0.945 3.99 1 -2.68±18.38 A paired t-test demonstrated no significant difference (p>0.05) between study day 1 and 2 for MIP or Tcont. The test-retest data was highly correlated for MIP (r=0.949, ICC=0.99), and Tcont (r=0.855, ICC=1.19). The mean CV was low (<10%) indicating high reliability. The LOA demonstrate the bias of the data (t-test) and also the random measurement error. For both Tcont and MIP, the difference is low (0.05 and -2.68 respectively) but the random measurement error is large (3 sec and 18 cmH 2 O respectively). The data indicate that there is a small bias and a low CV. However, LOA suggests large random measurement error for Tcont and MIP (greater than 10%), suggesting that the RT2 is not repeatable.

The purpose was to investigate the effect of a 16-wk intrahospital supervised conditioning program including both resistance and aerobic training and a 20-wk detraining period on measures of aerobic fitness, muscular strength, functional mobility, ankle range of motion, and quality of life (QOL) in children receiving treatment for acute lymphoblastic leukemia (ALL). Methods: Seven children (four boys, three girls; age: 5.1 T 1.2 yr, body mass: 24.0 T 5.8 kg, height: 114.6 T 7.7 cm) in the maintenance phase of treatment against ALL performed three sessions per week for 16 wk of resistance (one set of 8-15 repetitions of 11 exercises) and aerobic training (30 min at 9 70% HRmax) followed by 20 wk of detraining where no structured exercise program was performed. Before training, after training, and after detraining, a treadmill test determining V ˙O2peak and ventilator threshold (VT), muscular strength (6RM), functional mobility (timed up and down stairs test, time up and go 3-m and 10-m tests), passive and dynamic ankle range of motion, and self-reported quality of living were determined. Results: After training, significant increases in V ˙O2peak , VT, upper-and lower-body muscular strength, and all measures of functional mobility were shown (P G 0.05). Muscular strength was well maintained (significantly greater than before training and no significant decrease from after training) during detraining, whereas V ˙O2peak , VT, and functional mobility (not significantly different from before training but no significant decrease from after training) were only partially retained. Conclusion: Young children in the maintenance phase of treatment against ALL can safely perform both aerobic and resistance training. Training results in significant increases in measures of aerobic fitness, strength, and functional mobility. During detraining, strength and functional mobility are well maintained, whereas V ˙O2peak and VT are partially maintained.

Purpose: To examine the influence of footwear on tibialis posterior (TP) activation in persons with pes planus. Methods: Six asymptomatic adults with pes planus (arch index of Յ0.16) participated. Subjects performed a resisted foot adduction with plantar flexion exercise (3 sets of 30 repetitions). The exercise was performed barefoot and shod with foot orthoses. The two testing conditions were separated by a week. Magnetic resonance image signal intensity of the tibialis posterior, tibialis anterior, soleus, medial gastrocnemius, and peroneus longus was measured immediately before and after each exercise. Multivariate analyses of variance followed by paired Student's t-test were performed for the signal intensity of each muscle assessed to determine whether TP was selectively activated during the barefoot and shod exercises. Results: When barefoot, five of the six subjects activated other lower-leg muscles in addition to TP. When wearing the foot orthoses and shoes, all five participants activated only TP. Additionally, activation of TP was higher when exercises were performed in shoes with orthoses than when barefoot (P ϭ 0.019). Conclusion: Wearing the foot orthoses and shoes improved selective activation of the TP in persons with flat feet. In cases where selective activation of TP is desirable, such as persons with flat feet or TP tendon dysfunction, use of shoes and an arch supporting foot orthoses may enhance selective activation of the muscle.

Purpose: To determine which exercise most selectively and effectively activates tibialis posterior. Methods: Five healthy adults (two men, three women; mean age 31 yr) with an Arch Index (AI) within 1 SD from norm performed three exercises, separated by 1-wk intervals. The exercises were: 1) closed chain resisted foot adduction (foot adduction), 2) unilateral heel raise (heel raise), and 3) open chain resisted foot supination (foot supination). Magnetic resonance transaxial images were obtained immediately before and after exercise using a 1.5-T MRI system. Changes in preto postexercise signal intensity were compared across five muscles: tibialis posterior, tibialis anterior, medial gastrocnemius, soleus, and peroneus longus. Postexercise signal intensity was normalized to baseline preexercise signal intensity. Results: Tibialis posterior signal intensity increased after each exercise. The greatest TP increase (50 Ϯ 6%) occurred after foot adduction, whereas the mean increase in the other muscles was less than 5%. After the heel raise exercise, the signal intensity increase in TP was 27% (Ϯ 11%), soleus 39% (Ϯ 8%), peroneus longus 57% (Ϯ 14%), and medial gastrocnemius 99% (Ϯ 12%). The signal intensity of tibialis anterior decreased 4% (Ϯ 2%). After foot supination, the TP signal intensity increased 26% (Ϯ 7%), whereas the mean change in the other muscles was less than 10%. Multivariate analyses of variance revealed a significant difference in muscle activation between exercises. Posthoc analysis showed greater activation of TP during foot adduction than foot supination (P ϭ 0.021). Conclusion: In individuals with a normal AI, TP was activated selectively and most effectively during foot adduction. Knowledge of selective activation of a muscle is necessary to provide an optimal environment for muscle strengthening and/or tendon rehabilitation.

Aim of this study was to identify cause of death and related histological findings, and to find relationship between them in sudden natural deaths (SND) that were subjected to medicolegal autopsy. Totally 209 SND cases were enrolled in the study. After medicolegal autopsy, cause and manner of death were identified. A formula was formed to show the ratio of frequency of histological findings to cause of deaths in systems. By this formula, affected systems were compared. In SND cases, the ratio of extracardiac findings to extracardiac deaths was higher than that of cardiovascular findings to cardiovascular deaths (5.53 versus 2.00). We concluded that cardiovascular pathologies are still the most common in SND. The higher rate of extracardiac histological findings doesn t mean higher rate of SND due to extracardiac causes. Therefore, histological findings must be evaluated with great attention for preventing incorrect conclusions to identify causes of deaths in SND.

A minimal wearable system to monitoring remotely normal free-living activity (e.g. laying, sitting, standing, and slow walking) of patients in their home space is proposed. Owing to its wireless features, the system can represent a useful tool to be implemented in a long-time patient monitoring system. These systems are useful for the clinical out coming or for minor chronic pathologies not requiring hospitalization.

Purpose: Strength athletes often employ the deadlift in their training or rehabilitation regimens. The purpose of this study was to compare muscle activity between sumo and conventional style deadlifts, and between belt and no-belt conditions. Methods: Six cameras collected 60-Hz video data and 960-Hz electromyographic data from 13 collegiate football players who performed sumo and conventional deadlifts with and without a lifting belt, employing a 12-RM intensity. Variables measured were knee angles and EMG measurements from 16 muscles. Muscle activity were averaged and compared within three 30°knee angle intervals from 90 to 0°during the ascent, and three 30°knee angle intervals from 0 to 90°during the descent. Results: Overall EMG activity from the vastus medialis, vastus lateralis, and tibialis anterior were significantly greater in the sumo deadlift, whereas overall EMG activity from the medial gastrocnemius was significantly greater in the conventional deadlift. Compared with the no-belt condition, the belt condition produced significantly greater rectus abdominis activity and significantly less external oblique activity. For most muscles, EMG activity was significantly greater in the knee extending intervals compared with the corresponding knee flexing intervals. Quadriceps, tibialis anterior, hip adductor, gluteus maximus, L3 and T12 paraspinal, and middle trapezius activity were significantly greater in higher knee flexion intervals compared with lower knee flexion intervals, whereas hamstrings, gastrocnemius, and upper trapezius activity were greater in lower knee flexion intervals compared with higher knee flexion intervals. Conclusions: Athletes may choose to employ either the sumo or conventional deadlift style, depending on which muscles are considered most important according to their training protocols. Moderate to high cocontractions from the quadriceps, hamstrings, and gastrocnemius imply that the deadlift may be an effective closed kinetic chain exercise for strength athletes to employ during knee rehabilitation.

Purpose: Strength athletes often employ the deadlift in their training or rehabilitation regimens. The purpose of this study was to quantify kinematic and kinetic parameters by employing a three-dimensional analysis during sumo and conventional style deadlifts. Methods: Two 60-Hz video cameras recorded 12 sumo and 12 conventional style lifters during a national powerlifting championship. Parameters were quantified at barbell liftoff (LO), at the instant the barbell passed the knees (KP), and at lift completion. Unpaired t-tests (P Ͻ 0.05) were used to compare all parameters. Results: At LO and KP, thigh position was 11-16°m ore horizontal for the sumo group, whereas the knees and hips extended approximately 12°more for the conventional group. The sumo group had 5-10°greater vertical trunk and thigh positions, employed a wider stance (70 Ϯ 11 cm vs 32 Ϯ 8 cm), turned their feet out more (42 Ϯ 8°vs 14 Ϯ 6°), and gripped the bar with their hands closer together (47 Ϯ 4 cm vs 55 Ϯ 10 cm). Vertical bar distance, mechanical work, and predicted energy expenditure were approximately 25-40% greater in the conventional group. Hip extensor, knee extensor, and ankle dorsiflexor moments were generated for the sumo group, whereas hip extensor, knee extensor, knee flexor, and ankle plantar flexor moments were generated for the conventional group. Ankle and knee moments and moment arms were significantly different between the sumo and conventional groups, whereas hip moments and moments arms did not show any significantly differences. Three-dimensional calculations were more accurate and significantly different than two-dimensional calculations, especially for the sumo deadlift. Conclusions: Biomechanical differences between sumo and conventional deadlifts result from technique variations between these exercises. Understanding these differences will aid the strength coach or rehabilitation specialist in determining which deadlift style an athlete or patient should employ.

The purposes of this study were to determine i) if there is a sex difference in the age of the elite marathon runners and ii) if the sex difference in performance altered across the years that women have participated in the marathon. Methods: Age at time of competition and running times of the first five placed male and female runners who competed in the seven marathons of the World Marathon Majors Series were analyzed. Data from as many years as was available online were retrieved so that 410 men and 410 women were included in the analysis. The marathons and years included the Berlin

The main objective of this study was to determine the reliability of measuring treadmill exercise economy (V ˙O2submax ) and the maximal oxygen uptake (V ˙O2max ) in prepubertal girls tested twice, 6 wk apart. We also wanted to examine the percentage of young girls who were able to reach the criteria for achieving V ˙O2max and to describe methods that would allow a high proportion of young children to achieve criteria for reaching a true V ˙O2max . Methods: We studied 61 normal-weight, prepubertal girls with a mean (Ϯ SD) age 7.3 Ϯ 1.3 yr (range 4.8 to 10.3 yr). V ˙O2submax was determined while walking for 4 min at 2.5 mph with 0% grade. V ˙O2max was measured during a progressive, all-out, continuous treadmill test using standardized procedures and criteria. Heart rate (HR) was measured using a Polar monitor. Respiratory rate (RR), respiratory exchange ratio (RER), ventilation (V), and V ˙O2 were measured using a Sensormedics metabolic monitor. Results: There were no significant differences between visits 1 and 2 in mean HR, RR, RER, V, V ˙O2submax (421 vs 422 mL⅐min Ϫ1 , respectively), and V ˙O2max (1036 vs 1049 mL⅐min Ϫ1 , respectively). Intra-individual coefficients of variation (CV) between visits 1 and 2 for submaximal tests were: HR ϭ 5.1%, RR ϭ 12.4%, RER ϭ 7.2%, V ϭ 12.5%, and V ˙O2 ϭ12.4%. Intra-individual CVs for the maximum tests were: HR max ϭ 2.1%, RR max ϭ 10.8%, RER max ϭ 5.3%, V max ϭ 11.7%, and V ˙O2max ϭ 7.5%. A high proportion of the girls reached criteria for V ˙O2max [RERϾ1.00, HRϾ85% of age predicted maximum, and plateauing of V ˙O2max ] in both visits: 99% reached one of three criteria, 92% reached two of three criteria, and 70% reached all three criteria. Twenty girls [mean age 7.2 Ϯ 1.2 yr] reached at least two criteria in both visits, whereas 32 girls [mean (Ϯ SD) age 8.6 Ϯ 1.0 yr] reached three criteria in both visits. Conclusion: Exercise measurements using treadmill testing were reliable in healthy, normal-weight, prepubertal girls. Older girls when compared to the younger girls were able to reach criteria for V ˙O2max more often. Thus, we recommend that one testing should give researchers an accurate measure of walking economy and aerobic capacity, and that two criteria are enough for determining V ˙O2max .

This study was designed to determine whether Exerstriding, a modified form of walking using walking sticks (Exerstriders®), resulted in an augmented cardiorespiratory response and a greater energy expenditure than when walking without Exerstriders®. Female subjects (23.6 + 4.0 yr; 58.5 + 5.5 kg) completed two randomly assigned trials of treadmill walking (6.7 km/h; 0% grade; 30 min.) with Exerstriders® (E) and without Exerstriders® (C Control). Mean oxygen consumption (E = 20.5+ 1.2 ml/min/kg; C = 18.2 + 2.5 ml/min/kg), heart rate (E = 132.5 + 19.2 beats/min; C = 121.5 + 21.2 beats/min) and respiratory exchange ratio (E = .82 + .03; C = .78 + .04) were significantly greater (P< 0.05) while walking with Exerstriders®. Total caloric expenditure was also significantly greater during the Exerstrider® condition (E = 173.7 + 20.9 kcal; C = 140.7 + 27.2 kcal). In contrast, the rating of perceived exertion did not differ significantly between the two conditions. These data suggest that Exerstriding provides a means to increase caloric expenditure during submaximal walking, a factor that may be of critical importance in enhancing health benefits -such as improved body composition and aerobic capacity -typically associated with walking programs.

Purpose: To determine the association between prerace plasma vitamin E concentration and performance in sled dogs competing in the 1998 Iditarod Race. Methods: Prerace blood samples were collected from 670 dogs. Samples were analyzed for plasma vitamin E concentration while controlling for selected hematological and biochemical variables and signalment. Starting in teams of 16, exercise consisted of running up to 1159 miles pulling a laden sled and musher via checkpoints. The records of dogs that were withdrawn from the race for health reasons, fatigue, or strategic or technical reasons, and those of dogs that finished the race were analyzed. Multiple logistic regression and Cox proportional hazards analysis were used to determine factors associated with endurance. Multiple linear regression analysis was used to determine factors associated with team speed. Results: A total of 323 dogs (48%) were withdrawn from racing at various distances from the start. Median time to finish for 39 teams was 11.5 d and the winning time was 9.2 d. Dogs with prerace plasma vitamin E concentrations Ͼ 40.7 g•mL -1 were 1.9 times more likely to finish (P ϭ 0.0006) and had 1.8 times less of a risk of being withdrawn for every mile ran (P ϭ 0.03) than were dogs with plasma vitamin E concentrations between 16.3 and 40.7 g•mL -1 . Neither a team's mean prerace vitamin E concentration, nor the proportion of dogs within a team with high (Ͼ40.7 g•mL -1 ) vitamin E concentration was associated with team speed. Conclusions: Dogs with higher plasma vitamin E concentrations have enhanced endurance compared with dogs with lower plasma vitamin E concentrations, but the plasma vitamin E status of a team is not associated with team speed.

Post high-intensity exercise lymphocytopenia is well documented, but its underlying mechanisms have not been fully elucidated. A possible mechanism is a reactive oxygen species-induced DNA damage after high-intensity exercise. Furthermore, lymphocyte apoptosis related to DNA damage might contribute to exercise-induced lymphocytopenia. Purpose: This study examined lymphocytopenia, lymphocyte oxidative DNA damage, and apoptosis in young healthy sedentary males after acute high-intensity exercise. Method: Fifteen subjects exercised on bicycle ergometers for 1 h at 75% of their V ˙O2max . Venous blood samples were taken before exercise (PRE) and hourly after exercise until 4 h (P0-P4). Lymphocyte counts, oxidative DNA damage evaluated using the Comet assay with human 8-oxoguanine DNA glycosylase, and serum lipid peroxide (LPO) concentration were measured. Furthermore, lymphocyte superoxide, Fas receptor (CD95), and Annexin-V-positive lymphocyte apoptosis cells were measured in 10 subjects who exercised and gave blood samples as described above. Results: Lymphocyte counts became significantly lower than the PRE value (P G 0.05): 20.4% at P1, 24.3% at P2, and 16.3% at P3. Moreover, LPO significantly increased by P2 (P G 0.05): 1.6-fold. The % DNA in tail, indicating oxidative DNA damage, was significantly higher at P3 (54.3 T 12.8%) than at PRE (42.6 T 11.1%, P G 0.05). The lymphocyte superoxide level was significantly higher (51.3%) than the PRE value (P G 0.05). Neither CD95 nor Annexin-V-positive cells were significantly different than the PRE value. Conclusion: Results of this study suggest that lymphocyte oxidative DNA damage can relate to lymphocytopenia, although DNA damage was not associated with apoptosis in healthy young sedentary males.

Epidemiyolojik ve in vitro çalışmalarında bor bileşiklerinin anti karsinojenik olabilecekleri gösterilmiştir. Sitogenetik yönden stabil olan hücre hatlarında kromozom aberasyonları, kardeş kromatit değişimi gibi testlerle yapılan çalışmalarda borun herhangi bir genotoksik etkisi ortaya konulmamıştır. Bu çalışmada ise farklı bor bileşikleri olan BA (borik asit), BP (boraks pentahidrat) ve DPD (disodyum pentaborat dekahidrat)' ın 250, 500 ve 1000µM dozlarında uygulanmasıyla, sitogenetik olarak stabil olmayan CCL 62 (He La kontaminant) hücre hattındaki arında var olan sitogenetik bozulma üzerine olan etkilerinin araştırılması amaçlanmıştır. Bu amaçla hücre hatlarına bor bileşikleri uygulamasını takiben sitotoksisite için hücre canlılık testi (MTT) ve genotoksisite için kromozom aberasyonu (KA) ve mikroçekirdek (MÇ) testleri uygulanmış ve bor bileşiklerinin her bir dozunda meydana gelen KA'larının ve MÇ'lerin frekansları hesaplanmıştır. Tür, doz ve süreye bağlı olarak bor bileşiklerinin CCL-62 (insan amniyotik epitelyal) hücre hatlarının proliferasyonunu etkilediği görülmüştür. KA ve MÇ analizi verilerine göre ise; herhangi bir bor bileşiği uygulanmayan kontrol grubu hücrelerle, bor bileşikleri uygulanan hücrelerin KA ve MÇ sayıları karşılaştırıldığında kontrol grubu ve bor bileşiklerinin uygulandığı gruplar arasında anlamlı fark saptanamamıştır (p>0,05). Sonuç olarak bileşik türü, doz ve süreye bağlı olarak BA, BP ve DPD' nin CCL 62 hücre hatlarının proliferasyonunu etkilediği, diğer taraftan bu hücre hatlarında var olan sitogenetik bozulma üzerine arttırıcı ya da azaltıcı bir etkisi olmadığı gösterilmiştir.

In this study, we aimed to investigate the properties of events of isolated cecal necrosis related with diverticulum, the difficulties of diagnosis and the risk factors. In physical examination of a male patient presented to the emergency department of Tepecik Training and Research Hospital with right lower quadrant abdominal pain, the findings were evaluated as acute abdomen. The patient had chronic renal failure, chronic low blood pressure, ischemic heart failure, acromegaly and diabetes mellitus, and he was operated urgently. Isolated cecal necrosis was observed peroperatively. Right hemicolectomy and ileocolic anastomosis was performed as a surgical procedure. He was followed up in the intensive care unit postoperatively with active fluid -electrolyte resuscitation and appropriate antibiotherapy. The patient with various comorbidities died fifteen day after surgery. Isolated cecum necrosis should be considered in the differential diagnosis of elderly patients and patients with comorbid disease presenting with acute abdomen. Physical examination findings of right lower quadrant abdominal pain could be misdiagnosed as acute appendicitis.

Purpose: This study examined the effects of heavy resistance training on the relationships between power loss and surface EMG (sEMG) indices and blood metabolite concentrations on dynamic exercise-induced fatigue with the same relative load as in pretraining. Methods: Twelve trained subjects performed five sets consisting of 10 repetitions in the leg press, with 2 min of rest between sets before and after a strength training period. sEMG variables (the mean average voltage, the median spectral frequency, and the Dimitrov spectral index of muscle fatigue) from vastus medialis and lateralis muscles and metabolic responses (i.e., blood lactate, uric acid, and ammonia concentrations) were measured. Results: The peak power loss after the posttraining protocol was greater (61%) than the decline observed in the pretraining protocol (46%). Similar sEMG changes were found for both protocols, whereas higher metabolic demand was observed during the posttraining exercise. The linear models on the basis of the relations found between power loss and changes in sEMG variables were significantly different between pretraining and posttraining, whereas the linear models on the basis of the relations between power loss and changes in blood metabolite concentrations were similar. Conclusions: Linear models that use blood metabolites to map acute exercise-induced peak power changes were more accurate in detecting these changes before and after a short-term training period, whereas an attempt to track peak power loss using sEMG variables may fail after a strength training period.

The purpose of this study was to investigate the effects of creatine (Cr) supplementation on force generation during an isometric bench-press in resistance-trained men. Methods: 32 resistance-trained men were matched for peak isometric force and assigned in double-blind fashion to either a Cr or placebo group. Subjects performed an isometric bench-press test involving five maximal isometric contractions before and after 5 d of Cr (20 g•d Ϫ1 Cr ϩ 180 g•d Ϫ1 dextrose) or placebo (200 g•d Ϫ1 dextrose). Body composition was measured before and after supplementation. Subjects completed 24-h urine collections throughout the study period; these were subsequently analyzed to provide total Cr and creatinine excretion. Results: The amount of Cr retained over the supplementation period was 45 Ϯ 18 g (mean Ϯ SD), with an estimated intramuscular Cr storage of 43 (13-61) mmol•kg Ϫ1 •dry weight muscle (median [range]). Four subjects in the Cr group were classified as "nonresponders" (Յ21 mmol•kg Ϫ1 •dry weight muscle increase following Cr supplementation) and the remaining 17 subjects were classed as "responders" (Ն32 mmol•kg Ϫ1 •dry weight muscle). For the Cr group, peak force and total force pre-or post-supplementation were not different from placebo. However, when the analysis was confined to the responders, both the change in peak force [Repetition 2: 59( ) N vs -26(85) N; Repetition 3: 45(59) N vs -26(64) N) and the change in total force (Repetition 1: 1471(1274) N vs 209(1517) N; Repetition 2: 1575(1254) N vs 196(1413) N; Repetition 3: 1278(1245) N vs -3(1118) N; Repetition 4: 918(935) N vs -83( ) N] post-supplementation were significantly greater compared with the placebo group (P Ͻ 0.01). For the Cr group, estimated Cr uptake was inversely correlated with training status (r ϭ Ϫ0.68, N ϭ 21, P ϭ 0.001). Cr significantly increased body weight (84.1 Ϯ 8.6 kg pre-vs 85.3 Ϯ 8.3 kg post-supplementation) and fat-free mass (71.8 Ϯ 6.0 kg pre-vs 72.6 Ϯ 6.0 kg post-supplementation), with the magnitude of increase being significantly greater in the responder group than in the placebo group. Conclusion: Five days of Cr supplementation increased body weight and fat-free body mass in resistance-trained men who were classified as responders. Peak force and total force during a repeated maximal isometric bench-press test were also significantly greater in the responders compared to the placebo group.

Many studies carried out among adolescents in Nigeria generally report the practice of preventive measures against HIV to be poor. This study was carried out to assess the HIV/AIDS preventive measures among adolescents attending secondary schools in an urban community in Southwestern Nigeria. This was a descriptive cross sectional study, carried out among in-school adolescents in Osogbo metropolis, Southwestern Nigeria. The multi-stage sampling technique was used to select the respondents and data was collected with pre-tested, semi-structured questionnaires which were self administered and supervised by trained research assistants. A total of 370 questionnaires were administered and analysed using Statistical Package for Social Sciences (SPSS) version 16. Majority knew that HIV/AIDS could be prevented by not sharing sharp objects (305, 82.4%) and the use of condom (277, 74.9%). Three hundred and twenty nine (88.9%) of the respondents were aware of condom while 205 (55.4%) were aware of HIV Counselling and Testing (HCT). Seventy four (20.0%) respondents were sexually exposed, and only 21 (5.7%) of the respondents had ever used condoms before. Only 15 (4.1%) of the respondents had had HCT before and 189 (51.1%) had had sex education before. Most of the respondents were aware of the disease called AIDS, but their comprehensive knowledge about the disease and its prevention was not correspondingly high. Twenty percent of the respondents were sexually exposed but their HIV preventive practice was generally poor; there was poor and inconsistent condom usage, poor uptake of HCT and sex education and a poor perceived self efficacy among nearly half of the respondents. The stakeholders in adolescent reproductive health should work towards the provision of straightforward and elemental information about sex, and related practical issues that normally affect adolescents, like contraception, abortion and sexually transmitted infections to adolescents.

There are different methods to treat calcaneus fractures. Since it is a weak area especially in terms of soft tissue coverage, an appropriate treatment method should be selected for the patient. Our goal in this study is to compare closed reduction-plastering (CRP) and closed reduction-percutaneous fixation (CRPF) techniques radiologically and functionally in patients unable to have open reduction-internal fixation due to severe soft tissue injury and edema. A total of 116 patients who underwent CRP (65 patients) and CRPF (51 patients) techniques between January 2015 and December 2018 at our clinic were included in the study. These two groups were divided into two subgroups according to the Sanders classification. Patients were evaluated according to follow-up time and fracture type. They were also evaluated radiographically based on fracture healing time and Böhler and Gissane angle measurements before and after treatment, and functionally using the AOFAS, MFS, and NPRS scales. Bot...

There are different methods to treat calcaneus fractures. Since it is a weak area especially in terms of soft tissue coverage, an appropriate treatment method should be selected for the patient. Our goal in this study is to compare closed reduction-plastering (CRP) and closed reduction-percutaneous fixation (CRPF) techniques radiologically and functionally in patients unable to have open reduction-internal fixation due to severe soft tissue injury and edema. A total of 116 patients who underwent CRP (65 patients) and CRPF (51 patients) techniques between January 2015 and December 2018 at our clinic were included in the study. These two groups were divided into two subgroups according to the Sanders classification. Patients were evaluated according to follow-up time and fracture type. They were also evaluated radiographically based on fracture healing time and Böhler and Gissane angle measurements before and after treatment, and functionally using the AOFAS, MFS, and NPRS scales. Both groups had a mean follow-up of 3 years. In the CRPF group, the Böhler and Gissane angles were found to be restored better than in the CRP group, although this was not statistically significant (p=0.421, p=0.554, p=0.751, p=0.698). In functional evaluations with the AOFAS and MFS scales, better scores were calculated in the CRPF group and a statistically significant difference was found (p=0.017, p=0.023). Also, better outcomes were found for Sanders type 2 fractures than type 3 fractures. In patients with severe soft tissue injury and edema, a better reduction of functional outcomes can be achieved with the CRPF technique compared to CRP. This technique is convenient, reliable, and cost-effective. With this technique, more improvement can be achieved in radiological measurements. Finally, the Sanders classification has prognostic significance.

Introduction: Inhaled A 2 -agonists are important therapeutic agents for the treatment of exercise-induced asthma in athletes but are restricted by international antidoping regulations. Purpose: To investigate whether 18 Kg of inhaled formoterol affects endurance performance during running at high altitudes until exhaustion among 20 nonasthmatic male athletes aged 21-35 yr. Methods: In a randomized, double-blind, placebo-controlled crossover study, the athletes performed one screening test and two similar performance tests. Each performance test consisted of 20 min of warm-up and a running test until exhaustion, which lasted 210-300 s in hypobaric conditions equal to 2000 m above sea level. Maximal oxygen consumption (V ˙O2max ) and peak ventilation (V ˙Epeak ) were measured during running, and pulmonary function was measured before and after exercise. The screening test was used to determine running speed on days 2 and 3, with inhaled formoterol or placebo in a randomized manner before exercise. V ˙O2 , V ˙E, arterial oxyhemoglobin saturation (S P O 2 ), and heart rate (HR) were measured during exercise, and maximum plasma lactate concentration was measured after exercise. Results: Inhaled formoterol did not improve running time to exhaustion, V ˙O2 , V ˙E, S P O 2 , or HR (P > 0.05) in hypobaric conditions compared with placebo, although formoterol significantly improved lung function (FEV 1 and FEF 50 ) 15 and 30 min before exercise and 3, 6, 10, and 15 min after exercise. Conclusions: Inhaled formoterol did not improve endurance performance in healthy nonasthmatic athletes at hypobaric conditions equal to 2000 m above sea level. Inhaled formoterol can thus be used by asthmatic athletes in sports under extreme conditions.

Aim of this study is to compare endoscopic endolaser dacryocystorhinostomy (DCR) with bicanalicular silicone tube intubation (BSTI) and external DCR results. The records of patients who underwent DCR operation were retrospectively evaluated. Patients were invited to the controls in the postoperative period. In their follow-ups, changes in symptoms and findings, the duration of the tubes remain in place were recorded. 132 eyes of 124 patients were included in the study. 63 eyes of 61 patients were applied endolaser DCR (Group 1) and 69 eyes of 63 patients were applied external DCR (Group 2) (p>0.05). Patients were followed 6.6 months (2-11 months) and 5.9 months (2-7 months) in groups 1 and 2, respectively (p>0.05). Mean age of patients was 51.2 years old (range between 27-81 years) and 48.5 years old (range between 25-82 years), respectively (p>0.05). Irritative symptoms and findings were regressed and no recurrence was observed during follow-up in 54 patients (85.7%) and 64 patients (92.8%) in groups 1 and 2, respectively (p>0.05). Endolaser DCR + BSTE application seems to be an effective method in lacrimal stenosis.

Treating acute stroke in the early period can lead to reperfusion and minimize the loss of neurological function. In this study, our aim is to analyze the prognosis of our patients who underwent intravenous thrombolytic and/or mechanical interventional treatment in the last one year in our newly opened stroke center and evaluate our clinical experience. A total of 166 patients with a mean age of 68.7±11.3 who underwent intravenous r-tPA ± mechanical thrombectomy in our stroke center were included in the study. The mean time from symptom-to-door was 138.6±48.3 min, and the mean NIHSS score on admission was 10.9±4.1. Intravenous r-tPA was preferred for treatment in 59.6% (99) patients. The mortality rate was 25.3% ( ) for all patients. The mortality rate was 15.1% (15/99) for patients receiving intravenous r-tPA, and based on this finding, the mortality risk was found to be significantly higher in patients who did not receive intravenous r-tPA (p < 0.001). The mortality rate was 40% (6/15) for patients undergoing only mechanical thrombectomy (p: 0.145). The mRS score of the patients who received intravenous r-tPA was 3.18 in the first month, whereas the score of the patients who did not receive intravenous r-tPA was 3.74 (p:0.010). As a result, mortality and sequelae rates have been significantly reduced with the use of thrombolytic therapy and interventional neurovascular procedures. Although our center is newly opened, it shows promise for the upcoming years.

The aim of this research was to investigate the causes of the emergence of sports injuries and to explain the differences in psychological response with regard to the severity of the injury. We examined 68 competing Slovene athletes with surgically treated knee injury. The estimated time of rehabilitation of the more severely injured athletes was six months, while those who sustained less severe injuries faced a monthlong rehabilitation. We measured the athletes' personality traits, their athletic identity, coping with pain, rehabilitation beliefs, motivation and social support provided by their family and their coach as well as their colleagues. The results showed that the group of more severely injured athletes demonstrated behaviour that is less inhibited in response than the group of athletes with less severe injuries. The psychological response proved to be almost the same in both groups, except for the higher levels of catastrophizing, and a higher individual coping response found in the group of more severely injured athletes. Furthermore, masculinity was found to predict self-efficacy and the individual coping response, the strength of athletic identity predicted motivation and rehabilitation value, while emotional lability predicted catastrophizing and self-efficacy. Athletes with lower athletic identity, lower masculinity and higher emotional lability are more exposed to adjustment difficulties after sustaining an athletic injury. In our opinion, the strategies for successful rehabilitation after a sports injury should be aimed at the identification of athletes with personality traits that pose a higher risk of experiencing adjustment difficulties, at promoting adequate motivation, increasing coach support and at the application of cognitive-behavioural strategies.

The effect of triathlon competitions on death of lymphocytes from elite athletes was investigated. Material and Methods: Blood was collected from sedentary volunteers and triathletes at rest and after a short-duration triathlon (SDT) and after a long-duration triathlon (LDT-half Ironman) competitions. The athletes had lowered lymphocyte proliferation capacity compared with sedentary volunteers either at rest or after the competitions. There was no difference in the parameters associated with lymphocyte death when sedentary volunteers were compared with triathletes at rest. Lymphocytes from triathletes after SDT competition showed an increase in DNA fragmentation, phosphatidylserine externalization, and mitochondrial transmembrane depolarization and did not alter membrane integrity when compared with cells from athletes at rest. In contrast, the LDT competition raised the proportion of lymphocytes with loss of membrane integrity when compared with cells from athletes at rest and did not change the apoptotic parameters. The LDT competition induced an increase of reactive oxygen species (ROS) production by lymphocytes compared with triathletes at rest. The SDT competition did not alter ROS production by lymphocytes when compared with cells from triathletes at rest. ROS production by lymphocytes after LDT competition was 60% higher than in SDT. Conclusions: Evidence is presented herein that an LDT competition caused lymphocyte death by necrosis, whereas an SDT induced lymphocyte apoptosis. The mechanism for lymphocyte death induced by the triathlon competitions may involve an increase in ROS production at different extents.

Aim: We have conducted this study to determine the attitudes of intensive care nurses towards evidencebased nursing. Materials: The data of this study which has been conducted with a descriptive and sectional pattern between June and July 2016 have consisted of 70 volunteer nurses who work in a public hospital in the north-west region of Turkey. We have collected the data using Nurse Introduction Form and Attitude Towards Evidence-Based Nursing Questionnaire. In the evaluation of the data we have used number, percentage, average and standard deviation, One-way Analysis of Variance (ANOVA), and Independent tTest among descriptive statistical analysis. We have taken the statistical significance value as 0.05. Findings: Total mean score of the Attitude Towards Evidence-Based Nursing Questionnaire has been found to be 57.20±9.06. It is seen that the highest score of attitude (26,97±5,50) is in the sub-dimension of beliefs and expectations towards evidence-based nursing. When we have com...

Hypertension is epidemic in worldwide nonetheless, approximately five million men and six million women are hypertensive in Turkish society. This study was aimed to determine hypertension prevalence and related factors in primary-secondary school teachers. This cross-sectional study was conducted among teachers working in pimary-secondary levels of public schools in Çorum province. The study was completed by 500 teachers. A 50-item questionnaire form was generated to question socio-demographic and occupational characteristics, health-illness status, behavioral health factors and measurements of blood pressure levels of and Body Mass Index. The prevalence of hypertension was 21.4% among teachers. Blood pressure was normal in the 53.4% and was prehypertension level in 38.6% of participants. In hypertensives, blood pressure levels were significantly higher. According to various features such as age groups, gender, occupations of partners, years of seniority and Body mass index, blood pressure levels showed significant differences. The risk of hypertension was 2fold higher between the age of 35-49 and 4.5 -fold higher between the age of 50-64 than the 25-34 age groups. The risk of hypertension was 3.5 fold higher in men than in women. One of every five teachers were found to be hypertensive. This result was important to remember that teachers were a specific group of physical health problems. Ensuring appropriate primary care systems and public health services for teachers should be a priority for lifestyle changes and early medical invention in school environment.

The spleen is the primary organ of lymphoma in only 1-2 % of all lymphoma patients. We presented three cases of primary splenic involvement of lymphoma that were treated. Presentation of cases: In the first case, four solid lesions were detected, and in the second case, a hypodense lesion of 3 cm was detected in the spleen. Two cases underwent splenectomy. No complication and recurrence were observed during 22 -21 months followup, respectively. In the third case, a splenic mass invading pancreas was detected. Splenectomy and distal pancreatectomy were performed. No recurrence was observed during 8-year follow-up. In postoperative period, all cases were treated with cyclophosphamide, vincristine, doxorubicin, prednisone plus rituximab for 6 cycles. Primary splenic lymphoma refers to the involvement of the spleen only or with splenic hilar lymph node or local invasion without liver involvement. The pathologic diagnosis was diffuse large B-cell non-Hodgkin's lymphoma in the all cases. Splenic mass biopsy has some complication risks. Aspiration biopsy of splenic mass was performed in one of the three cases. Invasions should be evaluated in terms of malignity during splenectomy, and liver biopsy and biopsies of lymph nodes can be performed in case of lymphoma. Additionally diagnosis should be confirmed via postoperative bone marrow biopsy and positron emission tomography screening. Primary splenic involved lymphoma must be kept in mind for differential diagnosis in cases with splenic mass. Splenectomy is one of the most common modality for primary splenic lymphomas in terms of both diagnostic and curative treatment.

Our study aim was to measure the urinary N-acetyl-β-D-glucosaminidase/creatinine (NAG/UCr) index in epileptic children who received levetiracetam (LEV) treatment at least for 6 months, and compare it to healthy children. Thirty five children with epilepsy were enrolled in this prospective study. NAG was studied using the calorimetric method and NAG levels were expressed in units per liter (U/L) and NAG/UCre levels were determined in U/mmol creatinine. There were no statistically significant differences for the urine NAG and NAG/UCr index before and after LEV treatment in the epileptic group (p>0.05, for each). There were no significant correlations between the serum concentration of LEV and urinary NAG levels (r=0.258, p=0.135) and NAG/UCr levels (r=0.164, p=0.346) before treatment. Our study demonstrated that LEV treatment was safe and did not interfere in renal tubular function in epileptic children.

This study was aimed to investigate possible harmful effects of formaldehyde (FA) exposure on the morphology of fetus liver and kidney development during pregnancy and also to determinate possible protective role of chrysin (CH) against these harmful effects. For this aim, after pregnancy was induced, 58 female rats were divided into 6 groups. Serum physiologic (SF) was injected to the Group I rats intraperitoneally (i.p.). 20 mg/kg CH was given to the Group II via gavage. 0.1 mg/kg FA was applied to the Group III (i.p.), 1 mg/kg FA was injected to Group IV (i.p.) 0.1 mg/kg FA was given to Group V i.p., and 20 mg/kg CH was given to the same group via gavage. 1 mg/kg FA was applied to Group VI i.p., and 20 mg/kg CH was given to the same group via gavage. Fetuses were taken from each pregnant rat with cesarean section on the 20th day of the pregnancy. The morphological analyses of the fetuses, liver and kidney; biochemical and histological analyses of the liver and kidney were performed. The fetal body, liver and kidney weight of the FA groups demonstrated a statistically significant decrease the compared to control group. Also the FA-1 group were observed histopathological changes on the fetus liver and kidneys. FA exposure causes harmful effects on fetus the liver and kidneys. CH reduces the negative effect on morphological variables statistically. Although CH is insufficient to fix the histopathological changes that occur in the liver, damaging effects that occur in the kidney decreased statistically.

researchers assumed that sensory processing would influence the balance ability in children. Attention-deficit/hyperactivity disorder (ADHD) is one of the most pervasive neurobehavioral disorders in school-age children. Except for its core symptoms, previous studies claimed that approximately a half of children with ADHD may have various motor difficulties, such as balance. Also, some researchers found the difficulties of sensory processing in children with ADHD. However, studies exploring the relationship between sensory processing and balance remained rare. Our study aimed to clarify the difficulties of sensory processing ability in children with ADHD and its relationship with balance. We hypothesized that worse sensory processing ability would correlate with worse balance ability in children. Subjects included two groups: (1) ADHD group (N=11); (2) typically developing children group (N=7). Their balance abilities were measured by the balance subtests of Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) and Movement Assessment Battery for Children (M-ABC). A parent questionnaire, Sensory Profile (SP), was completed by the parent or caregiver of each recruited child to evaluate the sensory processing ability. Mann-Whitney U test was conducted to compare the group difference of sensory processing and balance. Pearson's Correlation was used to analyze the relationship between sensory processing and balance. The sensory processing and balance abilities in the ADHD group were statistically significant worse than their peers (p<0.05). The relationship between scores of SP and balance subtests of MABC was significantly correlated (p<0.05). Although the correlation between scores of SP and balance subtests of BOTMP was also consistent with our hypothesis, this relationship was not statistically significant. Our study confirmed a positive correlation between the ability of sensory processing and balance in children. Also, children with ADHD have more difficulties than their peers in sensory processing and balance.

Although, osteochondroma is the most common bone tumor, metacarpal involvement is quite uncommon and usually accompanies multiple hereditary exostoses. Herein, we described a patient with solitary ostechondroma of the fourth metacarpal bone, and discussed the differential diagnosis of bony spurs that can be seen in hand.

The aim of the study was to evaluate the type of trauma, additional injury, age, additional diseases, need for ICU and blood transfusion, postoperative complications, mid-term patient satisfaction and hip functions of the patients who underwent surgical treatment for acetabulum fracture in our clinic. A total of 17 patients (15 males, 2 females, mean age 40,7 years ) who admitted to the emergency department between 2013 and 2016, and treated surgically due to acetabulum fractures were included in the study. According to Judet Letournel classification, 7 anterior wall fractures, 4 anterior column fractures, 3 posterior column fractures and 3 both column fractures were determined. Mean hospital stay was 14.5 days (range 3-45 days) and mean follow-up was 26 months (14 to 57 months). ICU needed in 3 (17.6%) cases, mean stay was 10.3 days (range 1-29 days). 6 (35.2%) patients required blood transfusion, mean amount was 4.1 units (range 2-6 units). Harris hip scores were excellent -good in 12 cases (70.5%) and 5 cases (29.5%) had moderate -poor results at 12th month. There was no statistically significant relationship between severity of trauma, type of injury, age, additional diseases, intensive care and blood transfusion requirements, postoperative complications and patient satisfaction (p> 0.05). In selected acetabular fracture cases with proper planning according to fracture type, in early period, surgery may lead to satisfactory results in terms of patient satisfaction and hip functions.

The rotator cuff tear etiology is still unclear. Especially for atraumatic ruptures, degenerative processes come into prominence. This study aims to correlate between four most commonlyseen sleeping positions and patients with rotator cuff pathology. 87 patients who applied to the institute for suffering from shoulder pain for more than 6 months without a trauma and 93 voluntary people (as control group) above the age of 50 who applied to the institution for reasons other than shoulder pain included in the study. Rotator cuff ruptures and acromion types of the patients are diagnosed via magnetic resonance imaging. In face-to-face interviews, all the patients are asked to show their favorite sleeping positions on the visual cards and also questioned about their smoking habits and overhead activities. There are not any statistically substantive parameters between the patients and the control group in terms of age and sex. 83.9% of the patients with rotator cuff rupture have stated preferring lateral decubitus position while this rate is 61.3% among the control group (p=0.003). Atraumatic rotator cuff tears are increase with age. The increase pressure in the subacromial space can lead distribution in microvascular circulation of rotator cuff. Decrease in the microvascular circulation also affects the regeneration potential of rotator cuff. Laboratory studies demonstrated that lateral decubitus position has the most prominent increase in the subacromial pressure over all sleeping positions. We consider that sleeping in the lateral decubitus position causes long-term high subacromial pressure, leading to a microcirculatory disorder in the rotator cuff, which is a risk factor for the rotator cuff etiology.

The purpose of this study was to examine the independence and relative strengths of association between coronary heart disease (CHD) risk status and both body fatness and cardiorespiratory (C-R) fitness in 12-and 15-yr-old adolescents. Methods: The study cohort consisted of 1015 schoolchildren aged 12 and 15 yr (251 12-yr-old boys, 258 12-yr-old girls, 252 15-yr-old boys, and 254 15-yr-old girls), representing a 2% random sample of each population group. For each child, height, weight, sexual maturity (pubertal status), skin-fold thicknesses (4 sites), blood pressure (random zero sphygmomanometer), nonfasting serum total, and high density lipoprotein (HDL)-cholesterol and C-R fitness (20-m shuttle run; 20-MST) were determined under standardized conditions. Socioeconomic status and habitual physical activity were also determined from questionnaire information. Multiple regression analyses were carried out to examine relationships between five CHD risk factors, and fitness and fatness and to examine the relative strengths of fitness and fatness on CHD risk status, correcting for potential confounding variables. Results: Our main findings were: 1) Relationships between fatness and CHD risk factors are invariably stronger than between fitness and the same risk factors. For example, partially adjusted standardized regression coefficients for 12-yr-old boys revealed significant relationships between all five CHD risk factors and fatness, compared with three of five for fitness. The corresponding figures for 12-yr-old girls were three of five (fatness) and one of five (fitness). Broadly similar results were apparent for 15-yr-olds. 2) Although relationships between fitness and CHD risk factors do not survive further adjustment for fatness, the relationships between fatness and CHD risk are more robust and are unaffected by further adjustment for fitness. Conclusion: Our results indicate that the observed relationships between C-R fitness and CHD risk status in adolescents are mediated by fatness, whereas the observed relationships with fatness are independent of fitness. Primary prevention of CHD during childhood should therefore concentrate upon preventing or reversing undue weight gain.

The aim of the study was to investigate the awareness of residents in Saudi Arabia toward in-home drug storage and the using habits of their medications. This is a descriptive study that involved an electronic survey about drug storage and utilization habits. It was developed, pretested, and distributed via the social media among the population in Saudi-Arabia. About 1400 persons participated in this study. Around 84.4%, 96.6% and 58.3% of participants stored their insulin syringes, antibiotic or cough-syrup after opening in there frigerator, respectively. Moreover, most of them avoided use or discard their products upon exposure to the sun or forgetting them in the car for the whole day. 87.5% disclosed that they usually check the expiration date on drug products before using and 49.7% added they always follow the instructions regarding duration-of-use compared with 45.85% who said sometimes they follow it. 99.7% of them reported that they avoid using products upon change in color or formulation. Finally, variable-correlation was found between the age distribution of participants and their responses. The results revealed that the participants exhibited promising awareness toward the in-home drug storage in Saudi Arabia

To examine the factors used by Coroners to distinguish between suicide and accidental death among young men in Merseyside and Cheshire. Design -Retrospective epidemiological survey of deaths due to external causes. Data sources included Coroner's Inquest, GP and hospital data. Logistic regression was carried out to determine the multiple effect of individual factors on defining Coroner's verdict. Setting -Merseyside and Cheshire, United Kingdom. Males aged 15-39 years who died from unnatural causes during 1995 in Merseyside and Cheshire. Main outcome measure Coroner's verdict. An active mode of death was by far the strongest predictor of a suicide as opposed to an accident verdict. Other significant differentiating factors included expressed intent, behavioural change, deliberate self-harm and psychiatric contact. The validity of using method of death as a predictor of intent is questionable. Evidence left by drug users who kill themselves may differ from that left by nondrug users and may need to be sought in less conventional ways. There may be a discrepancy between those factors deemed important by health professionals as indicators of suicide, such as deliberate self-harm, and those given most weight by the Coroner. It may be more pragmatic, in terms of public health policy development, to challenge the concept that self-destructive behaviour can be categorized as being either intentional or unintentional. There is some evidence suggesting that deaths due to suicide and accidents both result from elements of self-destructive behaviour and therefore, the practice of categorizing deaths as either suicides or accidents could be misleading.

INTRODUCTION-Month-to-month variation in physical activity levels in a cohort of postmenopausal women participating in a single site clinical trial undergoing lifestyle intervention was investigated prior to and after lifestyle intervention. were Caucasian and African-American women (mean age 57.0 ± 3.0) from the Women On the Move through Activity and Nutrition (WOMAN) study. Physical activity was measured subjectively by questionnaire and objectively by pedometer at baseline and at the 18-month follow-up. -At baseline, prior to intervention, pedometer steps were highest in the summer months (7,616 steps/day), lower in the fall (6,293 steps/day), lowest in winter (5,304 steps/day), and then rebounded in the spring (5,850 steps/day). Physical activity estimates from the past-week subjective measure followed the same seasonal pattern. After 18-months, the lifestyle change group significantly increased their pedometer step counts when compared to the health education group (p<0.0001). At 18-months, pedometer step counts for the health education group followed a pattern similar to that found in the entire group prior to intervention, whereas, month-to-month step counts for the lifestyle change group appeared to remain consistent throughout the year. CONCLUSIONS-These results confirm previous reports that suggest physical activity levels fluctuate throughout the year. Lifestyle intervention, which includes a physical activity component, not only increases step counts, but appears to reduce some of variation in physical activity levels over the course of a year in post-menopausal women.

Diabetic retinopathy (DR) is a complication of diabetes mellitus (DM) that may causes blindness. The vitreous is an extracellular matrix and it may have changes through liquefaction and syneresis in patients with DM, even in those without apparent DR. Diffusion-weighted imaging (DWI) is a new technique provide tissue contrast relying on difference with the diffusion of water molecules among tissues, which can be measured by the apparent diffusion coefficient (ADC) value. We aimed to investigate the vitreous of patients in different stages of DR using diffusion-weighted imaging technique. This prospective study included a group of 100 patients with DR and 100 members of an age-and gender-matched control group. All groups were tested using a head coil in conduction with a Achieva 1.5T magnetic resonans imaging (MRI) system (Philips Medical Systems, Best, The Netherlands). The mean ADC values were calculated and used for statistical comparisons. Mean duration of diabetes was 12.22±10.13 years in patients. Compared to controls, both eyes of the DR group had statistically and significantly lower values of ADC (p=0.025 and p=0.002, respectively). No significant correlations were found among the ADC values and central macular thickness, disease duration and stage of DR (all p>0.05) in patients. Mean ADC values revealed no significant differences among the subgroups of patients at different stages of DR (all p>0.05). Decreased ADCs in the vitreous of diabetes patients seem to be associated with the presence of diabetic retinopathy.