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Öğe A RARE CASE REPORT IN THE CHILDHOOD AGE GROUP: SALMONELLA OSTEOMYELITIS OF THE RADIUS(Erkan YULA, 2020) Dinçel, Yaşar; Sarı, Abdülkadir; Çetin, Mehmet Ümit; Güney, Melih; Günaydın, Burak; Can, ErdemIntroduction: Salmonella osteomyelitis is a rare condition predominantly seen in hemoglobinopathies such as sickle cell anemia or thalassemia. Very few cases have been reported in the literature in children without predisposing factors. Here, we present a case of Salmonella osteomyelitis developing in the radius of an immunocompetent 6-year-old child without any known predisposing conditions. Case report: A 6-year-old patient applied to the pediatric emergency department with complaints of pain in the left forearm and 39.5 degrees Celcius fever, which has been going on for 20 days after the fall. On radiographs, lytic lesions were detected along the Radius and an infiltrative type lesion was observed in MRI. Samples were taken for bone culture and pathological examination under general anesthesia in the operating room due to suspicion of osteomyelitis or malignant lesions. There was very intensive Salmonella species growth in culture. The patient was given 400 mg vancomycin intravenously every 8 hours, and 1 g ceftriaxone intravenously every 12 hours for 3 weeks after the pediatric consultation. The patient was followed up on an outpatient basis, with 300 mg of oral cefuroxime treatment every 12 hours for 2 weeks. MRI and X-Ray imaging was performed at 6th postoperatively. It was observed that the lytic lesion decreased significantly in the radius. On the 14th postoperative month, MRI imaging showed that the lesion disappeared. Conclusion: Rare pathogens should be considered in the differential diagnosis of patients with prolonged insidious symptoms and appropriate bacterial cultures should be taken for specific antibiotic therapy.Öğe Histopathological and histomorphometric investigation of the effects of different irrigation solutions on Achilles tendon healing in rats(Turkish Joint Diseases Foundation, 2023) Dincel, Yaşar Mahsut; Can, Erdem; Karabag, SevilObjectives: This study aimed to examine the effect of irrigation fluids containing povidone-iodine (PVP-I), rifampicin (RF), and chlorhexidine gluconate (CHG) used during surgery on healing on a rat Achilles tendon model. Materials and methods: Twenty-eight male Sprague-Dawley rats (range, 300 to 400 g) were used in the experiment carried out between November 2022 and December 2022. The rats were divided into PVP-I, RF, CHG, and control groups, with seven rats in each group. Following the tenotomy and repair of the right Achilles tendon, the surgical site was irrigated using PVP-I, RF, CHG, or normal saline (the control group) for 2 min. All rats were sacrificed on the 21st postoperative day. The samples were evaluated histomorphometrically using the scoring system modified by Svensson, Soslowsky, and Cook and histopathologically using the Bonar and Movin classifications. Results: The RF group gave better results in all three scoring systems compared to the control, PVP-I, and CHG groups (p=0.008, p=0.002, and p=0.006, respectively). Cellularity, rounding, and tenocyte morphology showed a significant difference in favor of the RF group (p=0.004). While the distribution of ground substance glycosaminoglycans showed a significant difference in favor of the RF group, there was no significant difference among the other groups (p=0.22). Conclusion: Irrigation solutions containing PVP-I, RF, or CHG show no negative effect on Achilles tendon healing. Moreover, the findings suggest that RF irrigation can accelerate the healing process. © 2024, All right reserved by the Turkish Joint Diseases Foundation This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes (http://creativecommons.org/licenses/by-nc/4.0/).Öğe How Many Bundles Does the Anterior Cruciate Ligament Consist of? A Case Report(Kare Publ, 2023) Gunaydin, Burak; Ozcaglayan, Tugba Ilkem Kurtoglu; Sever, Cem; Oznur, Meltem; Cetin, Mehmet Umit; Can, Erdem; Eren, Osman TugrulIn some cases with anterior cruciate ligament (ACL) injury, physical examination and magnetic resolution imaging cannot clearly identify whether the ACL is intact or partially or completely ruptured. A 40-year-old female patient was admitted to our clinic with complaints of knee pain. After the requested examinations, we could not clearly identify whether the ACL was intact or partially or completely ruptured. Arthroscopic knee surgery was planned for the patient. In diagnostic arthroscopy, it was also determined that there was a multibundle ACL that was not surrounded by the synovium and was tight in the figure 4 position. The surgery was completed by repairing the meniscal tear. It was seen in the current case report that the ACL was a multibundle structure without overlying synovium around. In such cases, it is difficult to evaluate the ACL, and it should be kept in mind that there may also be variations of the ACL.Öğe Papaverin'in aşil tendon tamiri yapılan ratlarda tendon iyileşmesi ve adezyon üzerine etkisi (Deneysel çalışma)(Tekirdağ Namık Kemal Üniversitesi, 2023) Can, Erdem; Dinçel, Yaşar MahsutTendon yaralanmaları sık görülür ve güncel tekniklere rağmen hasarlı tendonlar yavaş iyileşir ve bunun yanında sağlıklı bir tendonun yapısal bütünlüğünü ve mekanik gücünü nadiren korur. Bu durum genellikle klinik zorluklara ve hastaya, ailesine ve topluma yük olarak geri döner. Vücutta aynı zamanda en güçlü tendon olan Aşil tendon yaralanmaları en sık görülen tendon yaralanmasıdır. Papaverin vazodilatör etkili fosfodiesteraz inhibitörü bir opioid analoğu ilaçtır. Çalışmamızda 48 adet rat üzerinde sağ alt ekstremitede Aşil tendon tamiri yapılarak sistemik olarak ve lokal olarak Papaverin uygulanmıştır. 15. ve 30. günlerde alınan numunelerin yarısı için Soslowsky, Svensson ve Cook kriterleri ile histopatolojik inceleme yapılmış, diğer yarısı biyomekanik çekme testine tabi tutulmuştur. Histopatolojik olarak 15. gün erken sonuçları göz önüne alındığında gruplar arası anlamlı farklılık görülmemiştir. 30. gün geç dönem dikkate alındığında ise lokal Papaverin grubunun Hücresellik, Kartilaj oluşumu ve toplam skor bakımından kontrol grubundan anlamlı üstün bulunmuştur (p<0.05). Adezyon bakımından gruplar arası farklılık görülmemiştir. Biyomekanik analiz sonucunda kopma öncesi en yüksek kuvvet değerleri bakımından erken dönemde lokal Papaverin ve geç dönemde hem sistemik, hem lokal Papaverin grubunda istatistiksel olarak kontrol grubuna göre anlamlı üstünlük gösterilmiştir. Numunelerin maksimum gerilme ve elasitisite modülü değerlerine bakıldığında ise erken dönemde lokal Papaverin grubunda ortalama değerlerde daha iyi olmak üzere her iki grupta da anlamlı üstünlük görülürken, geç dönemde sadece lokal Papaverin grubunda anlamlı farklılık görülmüştür. Elde edilen veriler ışığında ve özellikle geç dönem histopatolojik ve biyomekanik verilerin korelasyonu göz önüne alındığında lokal olarak uygulanan Papaverin'in tendon iyileşmesine olumlu etki edeceği kanaatindeyiz.Öğe Plantar Dislocation of the Middle Cuneiform Bone With Medial Cuneiform Subluxation: A Case Report(Springernature, 2023) Can, Erdem; Dincel, Yasar M.The middle cuneiform is the keystone of the transverse arch and is located between the medial cuneiform and lateral cuneiforms. Isolated middle cuneiform plantar dislocations are rare injuries due to their shape and ligamentous structural connections. A 20-year-old female patient was admitted to the emergency service of another clinic after a 70 kg iron tractor piece fell on her foot 20 days before she was referred to our clinic. Conservative treatment with a short leg circular cast was applied, considering that there was a fracture in the cuneiforms on X-ray imaging. The patient, who was re-evaluated at the second-week follow-up, was referred to our hospital considering the complex injury of the cuneiforms. There was tenderness over the cuneiform in the physical examination. X-ray and computed tomography images of the patient revealed plantar dislocation of the middle cuneiform bone. with subluxation of the medial cuneiform. Open reduction and internal fixation were performed for the middle cuneiform. During the six-month follow-up, the patient had no complaints and was able to do routine work. No lucency or arthritic changes were observed in the X-ray at the 22-month control. Plantar middle cuneiform dislocations are rare and late diagnosis can lead to poor results. This case is presented to emphasize the importance of considering this rare injury and using advanced imaging studies when necessary, considering the mechanism of injury.Öğe The effect of papaverine on tendon healing and adhesion in rats following Achilles tendon repair(Turkish Joint Diseases Foundation, 2024) Can, Erdem; Dincel, Yasar Mahsut; Karabulut, Derya; Karabag, Sevil; Arslan, Yunus ZiyaObjectives: The study aimed to examine the histopathological and biomechanical effects of papaverine administered intraperitoneally and locally on Achilles tendon healing in a rat model. Materials and methods: Forty-eight adult male SpragueDawley rats (range, 300 to 400 g) were used in this study conducted between October and November 2022. The rats were divided into three groups, with each group further subdivided into two for sacrifice on either the 15(th) (early period) or 30(th) (late period) day after surgery. The first (control) group received no treatment following Achilles tendon repair, while papaverine was intraperitoneally administered every other day for 10 days in the second group and locally in the third group after surgery. On the 15(th) and 30(th) days, the rats were sacrificed, and their Achilles tendons were subjected to biomechanical testing and histopathological evaluation. Results: Histopathologically, there were no significant differences among the groups on the 15 th day. However, on the 30 th day, the locally applied papaverine group exhibited superior histopathological outcomes compared to the control group (p<0.05). Concerning the highest tensile strength values before rupture, the biomechanical assessment showed that the group receiving local papaverine treatment in the early period and both the group with systemic papaverine treatment and the one with local papaverine treatment in the late period displayed a statistically significant advantage compared to the control group (p<0.05). Conclusion: Locally administered papaverine has positive biomechanical effects in the early period and exhibits a positive correlation both histopathologically and biomechanically in the late period. Novel therapeutic options may be provided for patients through these findings.Öğe The effect of papaverine on tendon healing and adhesion in rats following Achilles tendon repair(2024) Can, Erdem; Dincel, Yasar Mahsut; Karabulut, Derya; Karabağ, Sevil; Arslan, Yunus ZiyaObjectives: The study aimed to examine the histopathological and biomechanical effects of papaverine administered intraperitoneally and locally on Achilles tendon healing in a rat model. Materials and methods: Forty-eight adult male Sprague- Dawley rats (range, 300 to 400 g) were used in this study conducted between October and November 2022. The rats were divided into three groups, with each group further subdivided into two for sacrifice on either the 15th (early period) or 30th (late period) day after surgery. The first (control) group received no treatment following Achilles tendon repair, while papaverine was intraperitoneally administered every other day for 10 days in the second group and locally in the third group after surgery. On the 15th and 30th days, the rats were sacrificed, and their Achilles tendons were subjected to biomechanical testing and histopathological evaluation. Results: Histopathologically, there were no significant differences among the groups on the 15th day. However, on the 30th day, the locally applied papaverine group exhibited superior histopathological outcomes compared to the control group (p<0.05). Concerning the highest tensile strength values before rupture, the biomechanical assessment showed that the group receiving local papaverine treatment in the early period and both the group with systemic papaverine treatment and the one with local papaverine treatment in the late period displayed a statistically significant advantage compared to the control group (p<0.05). Conclusion: Locally administered papaverine has positive biomechanical effects in the early period and exhibits a positive correlation both histopathologically and biomechanically in the late period. Novel therapeutic options may be provided for patients through these findings.Öğe What Information is Provided in Turkish Videos about Osteoporosis and Does YouTube Provide Reliable and High-quality Information: A Systematic Analysis of YouTube Videos(Galenos Publishing House, 2022) Dinçel, Yaşar Maksut; Can, Erdem; Amiry, M.; Genç, Erdinç; Çağlar, Sever; Morina, Mekkedin; Kaval, BurakObjective: This study aims to evaluate what information is given in Turkish videos about osteoporosis on YouTube and to determine the quality and reliability of the videos. Materials and Methods: The first 50 Turkish videos about osteoporosis on YouTube were evaluated in terms of quality, reliability, and information level. Two searches were conducted for related content on YouTube and two orthopedics surgeons evaluated the videos simultaneously. The Global Quality score (GQS) (1-5) and DISCERN (15-75) scoring systems were used to assess the quality of the video content. With the Osteoporosis Specific scale (1-29), it was questioned what information specifically about osteoporosis was given in the videos while the accuracy of the video source information was evaluated with the Journal of American Medical Association (JAMA) score (1-4). Descriptive data regarding the number of views, comments, likes, dislikes were recorded, as well as the upload date to YouTube and the duration of the videos. The popularity of videos was evaluated with the video power index. Results: Considering the messages given in the videos, the most frequent information was “decrease in bone mass” with 41 videos. This was followed by “osteoporosis is a risk of fracture” and “there are risk factors for osteoporosis.” The Osteoporosis Specific score was low 8.92. The mean DISCERN score was 25.020 (15-75) and the mean GQS was 1.98 (0-5), indicating low quality. The JAMA score (1-4) for which the video source was questioned showed a low level of reliability of 1.66. Videos about osteoporosis prepared by people other than healthcare professionals were more popular (82.25 vs. 56.80) (cc=0.296, p=0.037). Conclusion: The content of the videos on YouTube osteoporosis is generally inadequate or inaccurate. Higher quality and informative videos based on international guidelines can contribute to patient compliance and increase public awareness of osteoporosis. ©Copyright 2022 by the Turkish Osteoporosis Society / Turkish Journal of Osteoporosis published by Galenos Publishing House.
