bluuebunny/crossref_metadata_2025 huggingface dataset:
Book Review: P.M. Joshy and K.M. Seethi, State and Civil Society under Siege: Hindutva, Security and Militarism in India
Authors: Choubey Kamal Nayan
Published: March 2017

P.M. Joshy and K.M. Seethi, State and Civil Society under Siege: Hindutva, Security and Militarism in India, New Delhi, SAGE Publications, 2015, xv + 263 pp., ₹750, ISBN: 9789351503842.
Book Review: Priya Sangameswaran, Neoliberalism and Water: Complicating the Story of ‘Reforms’ in Maharashtra, Farhat Naz, Socio-cultural Context of Water: Study of a Gujarat Village and Aidan A. Cronin, Pradeep K. Mehta and Anjal Prakash (Eds.), Gender Issues in Water and Sanitation Programmes: Lessons from India
Authors: Shree Ruchi
Published: March 2017

Priya Sangameswaran, Neoliberalism and Water: Complicating the Story of ‘Reforms’ in Maharashtra, New Delhi: Orient BlackSwan, 2014, xiv + 323 pp., ISBN 9788125054917 (Hardbound).

Farhat Naz, Socio-cultural Context of Water: Study of a Gujarat Village, New Delhi: Orient BlackSwan, 2014, xxii + 255 pp., ISBN 9788125054306 (Hardbound).

Aidan A. Cronin, Pradeep K. Mehta and Anjal Prakash (Eds.), Gender Issues in Water and Sanitation Programmes: Lessons from India, New Delhi: SAGE Publications, 2015, xviii + 321 pp., ₹995, ISBN 9789351500650 (Hardbound).
The magnitude optimum tuning of the PID controller: Improving load disturbance rejection by extending the controller
Authors: Cvejn Jan , Vrančić Damir
Published: March 2017

The Magnitude Optimum (MO) tuning method for PID controllers, applied on stable and non-oscillating plants, usually gives fast tracking responses and offers very good process output disturbance-rejection performance, even if the process contains significant dead time. On the other hand, when an exogenous disturbance affects the process indirectly, for example, via the plant input, slow disturbance rejection responses may be obtained. The paper proposes a way of removing this problem by means of adding two first-order filters into the control loop, without modifying the controller parameters. The filter parameters are determined so that the disturbance lag is partially compensated and the stability margin properties of the MO tuning are preserved.
Robust adaptive sliding mode control combination with iterative learning technique to output tracking of fractional-order systems
Authors: Ghotb Razmjou Ehsan , Hosseini Sani Seyed Kamal , Sadati Jalil
Published: March 2017

This paper develops a novel controller called adaptive iterative learning sliding mode (AILSM) to control linear and nonlinear fractional-order systems. This controller applies a hybrid structure of adaptive and iterative learning control in to sliding mode method. It can switch between both adaptive and iterative learning control in order to use the advantages of both controllers simultaneously and therefore achieve better control performance. This controller is designed in a way to be robust against the external disturbance. It also estimates unknown parameters of fractional-order system. The proposed controller, unlike the conventional iterative learning control, does not need to apply direct control input to output of the system. It is shown that the controller performs well in partial and complete observable conditions. Illustrative examples verify the performance of the proposed control in presence of unknown disturbances and model uncertainties.
Health Literacy: A Brief Primer for the Otolaryngologist
Authors: Megwalu Uchechukwu C.
Published: March 2017

Health literacy has been shown to affect outcomes in a number of medical conditions. Despite the complexity of care that is often required among otolaryngology patients, the literature on health literacy in this field is sparse. Otolaryngologists need to be aware of issues related to health literacy due to the changing health care environment. The increased complexity of medical care, the greater involvement of patients in shared decision making, and the higher administrative burden on patients have increased their health literacy requirements. Assessing health literacy in clinical practice may help identify patients who might require additional help in navigating the health care system. The Brief Health Literacy Screen and the Newest Vital Sign are 2 measures that are easy to apply in clinical practice.
Plain Language Summary: Benign Paroxysmal Positional Vertigo
Authors: Bhattacharyya Neil , Hollingsworth Deena B. , Mahoney Kathryn , O’Connor Sarah
Published: March 2017

Objective. This plain language summary serves as an overview in explaining benign paroxysmal positional vertigo, abbreviated BPPV. This summary applies to patients ≥18 years old with a suspected or potential diagnosis of BPPV and is based on the 2017 “Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update).” The evidence‐based guideline includes research to support more effective diagnosis and treatment of BPPV. The guideline was developed as a quality improvement opportunity for managing BPPV by creating clear recommendations to use in medical practice.
Overseas investment into London: Imprint, impact and pied-à-terre urbanism
Authors: DeVerteuil Geoffrey , Manley David
Published: March 2017

This paper focuses on the spatial imprint and social impacts of the emerging geographies of concentrated overseas investment into London’s high-end real estate market, particularly the boroughs of Westminster and Kensington and Chelsea. Framed by literatures on the 1% and the super-rich, and based on a mixed methodological approach of qualitative interviews with intermediaries and a quantitative mapping of overseas investors using 2011 census data, the results speak to the pervasive nature of “safe-haven” seeking in London real estate and its attendant transnational provenance set within a laissez-faire regulatory framework. In so doing, it makes an important contribution to the geographies of the super-rich, the class geographies of London, and the broader sense that overseas investors are producing what we call “pied-à-terre” urbanism which builds on a conventional gentrification framework (exclusionary displacement and a more affluent incoming group) but also exceeds it in several ways, leading to an increasingly socially attenuated landscape. This exceeding relates to: a different kind of rent gap, in that it is not speculative but safe-haven seeking, a guaranteed return on investment, and occurs without previous disinvestment; the agents are not traditional gentrifiers; the transnational nature of the process, with no attachment to particular places like in the traditional gentrification model; and a process focused on super-prime areas and completely independent of the existing gentrification process in London.
Gender Differences in the Prediction of Acute Stress Disorder From Peritraumatic Dissociation and Distress Among Victims of Violent Crimes
Authors: Boisclair Demarble Julie , Fortin Christophe , D’Antono Bianca , Guay Stéphane
Published: March 2017

Peritraumatic dissociation and distress are strong predictors of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) development. However, there is limited data concerning gender differences in these relations, particularly among victims of violent crimes (VVC). The objective of this study is to examine whether peritraumatic dissociation and distress predict the number of ASD symptoms differently for men and women VVC. In all, 162 adults (97 women, M age = 39.6 years), 63% of whom experienced physical assaults, completed the Acute Stress Disorder Interview, the Peritraumatic Dissociative Experience Questionnaire, and the Peritraumatic Distress Inventory. Analyses included t tests and multiple hierarchical regressions models controlling for known PTSD risk factors. The regression model showed dissociation and distress to be significant predictors of ASD for both men and women (β = .349 and β =.312 respectively; all p < .001). A significant three-way interaction was also observed between peritraumatic distress (PDI), past potentially traumatic experiences, and gender. In simple slopes analyses, the combination of high levels of PDI and of a high number of past potentially traumatic events were associated with greater risk of ASD in men only ( b = 3.78, p < .001). However, women experienced greater PDI, t(157) = 5.844, p = .005, than men, and elevated distress was associated with more ASD symptoms independently of past traumatic events. Gender differences were revealed as a function of past potentially traumatic experiences. There is a cumulative impact of past potential traumas and current distress that predicts ASD in men, while in women, it contributes to ASD via increased distress.
Cardiotoxicity evaluation of nine alkaloids from Rhizoma Coptis
Authors: Zhang MY , Yu YY , Wang SF , Zhang Q , Wu HW , Wei JY , Yang W , Li SY , Yang HJ
Published: March 2017

Purpose:

Alkaloids derived from Rhizoma Coptis (RC) has been widely applied to clinical treatments in China. However, the toxicity of RC and the alkaloids from RC remained controversial. The research is designed to clarify the cardiotoxic compounds found in RC.

Methods:

In this study, the real-time cellular analysis cardio system and the high-content analysis were applied to monitor the function of cardiomyocytes (CMs) in the treatment of nine alkaloids in RC. Luciferase-coupled adenosine triphosphate (ATP) assay was used to detect cell viability.

Results:

The results showed that berberine, palmatine, berbamine, and oxyberberine were cardiotoxic, which resulted in arrhythmia and cardiac arrest on CMs in a time- and dose-dependent manner. Meanwhile, berbamine and oxyberberine caused shrinkage and detachment on CMs at 10 μM. Cytotoxicity was induced by these two compounds with decline in cell index and ATP depletion. Cardiotoxicity or cytotoxicity was not observed in the other five alkaloids within 10 μM.

Conclusion:

For the first time, the cardiotoxicity of the nine alkaloids was evaluated to clarify the cardiotoxic components in RC. Furthermore, the experimental evidences were provided to support the safety of drug application.
Book Review: Harinder S. Kohli and Ashok Sharma, A Resilient Asia Amidst Global Financial Crisis: From Crisis Management to Global Leadership
Authors: Dwivedi Amit Kumar
Published: March 2017

Harinder S. Kohli and Ashok Sharma, A Resilient Asia Amidst Global Financial Crisis: From Crisis Management to Global Leadership. New Delhi: SAGE Publications, 2010, 417 pp.
Psychometric Evaluation and Cultural Correlates of the Mate Retention Inventory–Short Form (MRI-SF) in Iran
Authors: Atari Mohammad , Barbaro Nicole , Shackelford Todd K. , Chegeni Razieh
Published: March 2017

The current study investigated the psychometric properties of the Persian translation of the Mate Retention Inventory–Short Form (MRI-SF) in Iran. We also investigated sex differences in the use of mate retention tactics and investigated the relationships between mate retention behaviors and a number of related cultural constructs. Participants ( N = 308) ranged in age from 18 to 57 years. All participants were in a committed romantic relationship, with mean relationship length of 63.5 months ( SD = 73.8). Participants completed the Persian translation of the MRI-SF and measures of religiosity, relationship satisfaction, self-esteem, and socioeconomic status. Cultural measures specific to Iran were also included, such as Mahr (for married individuals), self-perceived Qeiratiness (for men), and self-perceived jealousy (for women). Mahr is a mandatory amount of money or possessions paid or promised to be paid by the groom to the bride at the time of the marriage contract. Qeirati is a male-specific adjective in Persian meaning protective against unwanted attention toward a man’s romantic partner. Female jealousy is usually regarded the counterpart of male Qeiratiness in Iranian culture. The 19 mate retention tactics formed a two-component structure, consistent with previous research. Results demonstrate adequate internal consistency of 2-item assessments of mate retention tactics. Observed sex differences accorded with previous mate retention research and are discussed in reference to evolutionary perspectives on human mating. Several significant associations emerged between mate retention tactics and Iranian culture-specific variables and are discussed from a cross-cultural perspective.
Insights into the role of the intestinal microbiota in colon cancer
Authors: Oke Sofia , Martin Alberto
Published: March 2017

The intestinal microbiota consists of a dynamic organization of bacteria, viruses, archaea, and fungal species essential for maintaining gut homeostasis and protecting the host against pathogenic invasion. When dysregulated, the intestinal microbiota can contribute to colorectal cancer development. Though the microbiota is multifaceted in its ability to induce colorectal cancer, this review will focus on the capability of the microbiota to induce colorectal cancer through the modulation of immune function and the production of microbial-derived metabolites. We will also explore an experimental technique that is revolutionizing intestinal research. By elucidating the interactions of microbial species with epithelial tissue, and allowing for drug screening of patients with colorectal cancers, organoid development is a novel culturing technique that is innovating intestinal research. As a cancer that remains one of the leading causes of cancer-related deaths worldwide, it is imperative that scientific findings are translated into the creation of effective therapeutics to treat colorectal cancer.
Parry–Romberg syndrome: conventional and advanced MRI follow-up in a boy
Authors: Rigamonti Paolo , Squarza Silvia , Politi Marco , Sangermani Roberto , Cariati Maurizio , Uggetti Carla
Published: March 2017

We studied a 9-year-old boy, affected with the Parry–Romberg syndrome, during a period of 32 months, by means of clinical evaluations and neuroradiological magnetic resonance imaging. Over this time we observed a clinical progression of the cutaneous disease without a simultaneous progression of the neurological alterations. Conventional and advanced magnetic resonance imaging techniques showed white matter alterations which proved to be stable during the follow-up.
From chronic immune thrombocytopenia to severe aplastic anemia: recent insights into the evolution of eltrombopag
Authors: Gill Harinder , Wong Raymond S. M. , Kwong Yok-Lam
Published: March 2017

Thrombopoietin (TPO) is the most potent cytokine stimulating thrombopoiesis. Therapy with exogenous TPO is limited by the formation of antibodies cross-reacting with endogenous TPO. Mimetics of TPO are compounds with no antigenic similarity to TPO. Eltrombopag is an orally-active nonpeptide small molecule that binds to the transmembrane portion of the TPO receptor MPL. Initial trials of eltrombopag have centered on immune thrombocytopenia (ITP), which is due to both increased destruction and decreased production of platelets. Eltrombopag at 25–75 mg/day has been shown to be highly effective in raising the platelet count in ITP with suboptimal response to immunosuppression and splenectomy. These successful results led to the exploration of eltrombopag in other thrombocytopenic disorders. In hepatitis C viral infection, eltrombopag raises the platelet count sufficiently enough to allow treatment with ribavirin and pegylated interferon. Because MPL is expressed on hematopoietic cells, eltrombopag use in myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) might enhance leukemic proliferation. Clinical trials of eltrombopag in MDS and AML, however, have shown amelioration of thrombocytopenia without promoting disease progression. In severe aplastic anemia (SAA) not responding to immunosuppression with anti-thymocyte globulin (ATG) and cyclosporine, eltrombopag as a single agent at 150–300 mg/day results in an overall response rate of 40–70%. At high doses, adverse effects including pigmentation, gastrointestinal upset and hepatic derangement have become evident. Current studies have examined the first-line use of eltrombopag in combination with ATG in SAA. In a recent study, eltrombopag used at 150 mg/day with horse ATG resulted in an overall response rate of 90% in newly diagnosed SAA patients, with a complete response rate of about 50%. Clonal karyotypic aberrations are, however, found in 10–20% of SAA patients treated with eltrombopag. The safety and efficacy of eltrombopag in SAA require further evaluation, particularly when it is used with less intensive immunosuppression.
Therapeutic plasmapheresis for hypertriglyceridemia-associated acute pancreatitis: case series and review of the literature
Authors: Joglekar Kiran , Brannick Ben , Kadaria Dipen , Sodhi Amik
Published: March 2017

Background:

Severe hypertriglyceridemia (HTG) is the third leading cause of acute pancreatitis (AP) in the United States. The current standard of care includes management of HTG using pharmacological therapy. More recently, plasmapheresis has been proposed as a therapeutic tool for decreasing triglyceride (TG) levels, especially in critically ill patients. Few studies are available to ascertain overall benefits of plasmapheresis over traditional management.

Objective:

To analyze the outcomes of patients treated with plasmapheresis for severe HTG-associated pancreatitis.

Methods:

We conducted a retrospective chart review of three patients with severe HTG- associated (TGs greater than 1000 mg/dl; 11.29 mmol/l) AP at the Methodist University Hospital. All the patients underwent plasmapheresis as part of their treatment.

Results:

The average TG level before plasmapheresis was 3532 mg/dl (range: 2524–4562 mg/dl; 39.9 mmol/l; range: 28.5–51.6 mmol/l). All patients made a full recovery, with a significant improvement in TG levels after plasmapheresis. The mean number of sessions was 1.3 (range 1–2), and mean TG level after plasmapheresis was 1051 mg/dl (range: 509–1771 mg/dl; 11.9 mmol/l; range: 5.8–20 mmol/l). After the first session, the average reduction of TG level was 2481 mg/dl (range 753–3750 mg/dl; 28 mmol/l; range: 8.5–42.4 mmol/l) or approximately 70%. None of the patients developed complications related to plasmapheresis.

Conclusions:

Plasmapheresis can be an effective and rapid treatment option in patients with severe HTG and complications. However, further research, including randomized controlled studies, is necessary.
ePortfolio as pedagogy: Threshold concepts for curriculum design
Authors: Lewis Lyn
Published: March 2017

The ePortfolio has been used in initial teacher education for its storage and presentation functions; however, its use as a pedagogic tool to enhance learning outcomes is less common. This study explored students’ perceptions of ePortfolio and their learning in a Bachelor of Education (primary) programme at a New Zealand university. The research sought to identify courses in which learning had been enhanced by ePortfolio use and the related reasons. Data were collected through document analysis, a survey questionnaire and a focus group discussion. The findings indicate a relationship between students’ perceptions of their enhanced learning through ePortfolio and a number of threshold concepts in curriculum design. These ePortfolio-related concepts include its purpose for learning, design of constructivist learning activities, social pedagogy for co-construction of knowledge and the constructive alignment of ePortfolio concepts for enhanced learning outcomes. An argument is made for course designers and developers to deeply understand the nature of these threshold concepts when planning to incorporate ePortfolio into curriculum processes.
Primary repair for spontaneous quadriceps tendon rupture in patients with hemodialysis
Authors: Birişik Fevzi , Ekinci Mehmet , Erşen Ali , Bayram Serkan , Ergin Ömer Naci , Şahinkaya Türker , Aşık Mehmet
Published: March 2017

Spontaneous quadriceps tendon rupture is not rare in patients with chronic renal failure needing dialysis due to the impaired collagen maturation in tendons. With transpatellar tunnel technique, the repair of the impaired tendon and successful healing are reported. The aim of this study is evaluate the functional results, strength and endurance of the quadriceps tendons after repair with transpatellar tunnel technique in hemodialysis patients with spontaneous quadriceps tendon ruptures. Primary repair with transpatellar tunnel technique is performed in 15 spontaneously ruptured quadriceps tendons of 9 patients with the mean age of 50,1 (6 bilateral, 3 unilateral ruptures). After a mean follow-up of 48.7 months, patients were evaluated with Lysholm score for functional evaluation. Isokinetic quadriceps strength and endurance measurements were performed with computerized dynamometer (CYBEX HUMAC–USA) and compared with a control group of 10 volunteers with chronic renal failure needing hemodialysis without quadriceps rupture history. The demographics of the study group and the control group were comparable in terms of age, body weight and dialysis year. 1 patient was deceased during follow-up due to end-stage renal failure. Of the 13 repairs evaluated, 1 repair failed after 3 months and needed revision surgery. Although at the latest follow-up all patients were doing active knee extension against gravity with their repaired quadriceps tendons and walk independently, the Lysholm score of the repair group (mean 75.3) was significantly lower than the control group (mean 93,2) (p: 0.009). The strength (peak torque) of the repaired quadriceps tendon was 43,6 Nm and was significantly lower than the control group (90,6 Nm) (p: 0.001). The endurance of the repaired tendon was also found to be significantly lower than the control group. 259 Nm and 625 Nm respectively (p: 0.001). Primary repair with transpatellar tunnel technique after spontaneous quadriceps ruptures in hemodialysis patients can provide acceptable functional results with active knee extension and independent walking ability. However the strength and endurance of the repaired tendon might be significantly lower than a impaired but unruptured quadriceps tendon.
The incidence of medial plica in the knees operated on because of reasons other than the medial plica alone and the cartilage damages caused by it
Authors: Bombaci Hasan , Aydoğmuş Suavi , Keçeci Tolga , Gündüz Çağdaş Deniz
Published: March 2017

Introduction:

The aim of this study is to analyse the incidence of medial plica (MP) and the damage which has been caused on the medial femoral condyle in the 700 knee of 651 patients who were operated on because of the complaints resulting from intra-articular pathologies unrelated to the MP in particular.

Patients and Methods:

Medial plicas were detected in the 65 of 700 knees operated on consecutively because of the complaint of pain or catching in the knee. The mean age of 34 male and 28 female patients was 46 (range; 16-82). In 25 knees the lesions were in the right, 34 patients in the left side and in three patients, bilateral. The MP was classified according to the Sakakibara classification, the lesion caused by the MP on the medial femoral condyle, according to the Outerbridge classification. All medial plicas were excised arthroscopically.

Results:

Medial plicas were classified as type B in eight knees, type C in 52 and type D in five according to the Sakakibara classification. The cartilage lesion related to the MP were classified as type I in 12 knees, type II in 20 and type III in 24 according to the Outerbridge classification. There were no lesions present in nine knees.

Discussion and Conclusion:

Although the incidence of MP is much higher, the incidence of “MP syndrome” has been reported as 3.8% to 5.5% in the English literature. In the present study, we found that the incidence of MP was 9.28% associated with the rate of 86% type I-III cartilage damage related to the MP itself. Although the symptoms of MP are not specific, there may be some tenderness between the medial condyle and inferior-medial edge of patella. Furthermore a thickened cord-like plica can be palpated at the medial side of the patella, with crepitus or popping sensation during flexion –extension movement of the knee. If the patients suffer from meniscus tear or chondromalasia which affects at least two compartments of the knee, the symptoms of MP cannot be apparent primarily. These findings show that MP is quite significantly associated with other intra-articular pathologies in the knee. However, the common symptoms of MP with the long lasting pathologies in the knee (i.e chondromalasia unrelated to MP) can prevent early diagnosis which would prevent irreversible chondral pathologies developing at a later stage.
Is the present classification of discoid meniscus sufficient?
Authors: Bombaci Hasan , Gökel Fatma , Geçgel Emrah , Aydoğmuş Suavi
Published: March 2017

Introduction:

Although uncommon, the discoid meniscus is quite prone to injury due to its abnormal shape and abnormal histology. The weak or absent peripheral attachment of the discoid meniscus causes instability even after partial meniscectomy. Therefore, recently, after resection of the central part of the meniscus, in which tears develop most frequently, the remnant of the meniscus is preferred to repair. In that time, the Watanabe classification, which classifies the discoid meniscuses in three groups, is used to plan treatment. However, discoid meniscus can develop in the different forms from these three main shapes. In the present study we aimed to analyse the discoid meniscuses, which we encountered during arthroscopic procedures in the knee, according to Watanabe classification.

Patients and methods:

The lateral discoid meniscuses in the 36 knees of 35 patients, who were operated on because of meniscus tear of either the discoid lateral meniscus itself or the normal medial meniscus, were classified according to Watanabe classification.

Results:

While the lateral discoid meniscuses were classified as “complete” in 13, “incomplete” in 15 knees, the meniscuses were very thin or absent in the central (one knee) or in the postero-lateral regions (seven knees) of discoid meniscus ( Figure 1 ). In this series this opening was next to the popliteus tendon except in one case. In these cases, the continuity of the meniscus between middle and posterior horn frequently was not possible after central partial meniscectomy (CPM). On the other hand, posterior horn has stable peripheral attachment unlike the Wrisberg type discoid meniscus. Of the 36 discoid meniscuses, CPM was performed in 21 knees, CPM with anterior horn repair in three, CPM with posterior horn repair in one and anterior horn repair without meniscectomy in two patients. In nine patients the lateral discoid meniscus was left alone. [Figure: see text]

Discussion and conclusion:

When meniscus sparing methods are intended to perform, both to decide the amount of resection and repair of the remnant, besides the shape of meniscus tear, the stability of discoid meniscus is crucial. This study shows that the Watanabe classification cannot be sufficient to include some specific type of lateral discoid meniscus. We believe that to add the discoid meniscuses, with opening in postero-lateral region next to the popliteus tendon, to the Watanabe classification might be useful to decide the amount of resection or repair of the discoid lateral meniscus.
Effect of Thrombocyte-rich Plasma on Prevention of Tunnel Enlargement in Anterior Cruciate Ligament (ACL) Reconstruction
Authors: Sözkesen Serkan , Karahan Hüseyin Gökhan , Yağdı Serhan , Kurtulmuş Ahmet , Kayalı Cemil , Altay Taşkın
Published: March 2017

This study was conducted to 44 patients, to whom both hamstring tendon autograft and transtibial ACL reconstruction were applied, having treatment in Clinic of Orthopedics and Traumatology in İzmir Bozyaka Training and Research Hospital between dates of March 2014 and July 2015. Treatment group (18 patients, subjected to PRP) and control group (26 patients) selected with random method were taken. Minimum age in the treatment group was 16 and maximum age was 38, having an average of (26±6,96). Minimum age in the treatment group was 14 and maximum age was 43, having an average of (26,54±7,93). In this group, 27 patients have had operation on right knee (61%), 17 patients on left knee (39%). Follow up period after surgery is at least 4 months, at most 16 months, with an average period of 12 months. Injury reason of ACL was sport injury for 36 patients, injury of falling down from height for 1 patient and injury of occupational accident for 6 patients. Reasons of application of these patients are distrust for 30 patients, pain for 10 patients and locked-in findings for 4 patients. General physical examinations of these patients were performed prior to surgery, and direct graphy and MR imaging method was used for the patients. The patients were evaluated with IKDC score, Lysholm score, Tegner activity scale, KT-1000 arthrometer device and multi-slice tomography in preoperative and postoperative methods. The same physical treatment protocol was applied for all patients. Measurements carried out for tomography standardization of the patients were evaluated on coronal, sagittal and axial plans after 64-slice MSCT scanning. BT slice thickness was calculated as 1 mm using automatic software with 0.75 mm retrorecons. Measurements were evaluated by the same radiology expert. On comparison of radiological data between both groups, although tunnel enlargement is less in PRP-administered group for femoral tunnel, the result was not significant statistically. No difference was seen between clinical examination results and used grading scales. It was seen that PRP use was not effective in preventing or decreasing femoral and tibial tunnel enlargement in patients having ACL reconstruction with Hamstring. There was a decrease in tunnel enlargement in case of the use of PRP, however, this decrease was not clinically significant. In line with these data, routine use of PRP is not recommended for the prevention of tunnel enlargement after ACL reconstruction. KeyWords: Thrombocyte-rich plasma (PRP), Tunnel enlargement, ACL reconstruction, BT scan
Minimum 6-Year Follow-Up of Arthroscopic Medial Reefing for Patellar Instability
Authors: Civan Osman , Sançmış Mesut , Topçuoğlu Nazım , Özenci Alpay Merter
Published: March 2017

Introduction:

Purpose of this study was to evaluate the results of arthroscopic medial reefing for patellar instability at long term.

Materials-Methods:

15 patients (16 knees) with patellar instability were consecutively treated by arthroscopic medial reefing between 2005- 2010. At final follow-up 11 patients (12 knees) were available to evaluate. Average age was 18,6 (range, 12-37 years). Average follow-up was 90 months (range, 71-115). History of patellar dislocation episode was reported by all patients. Arthroscopic medial reefing was applied through three standard portals. At least 3 sutures were tied according to medial laxity. Post-operatively all patients were allowed to bear weight on the operated leg immediately and full knee flexion was allowed by the third week. At last follow-up patients were evaluated according to the Tegner and Lysholm scales. Paired t test was used to detect the statistical differences and p<0.05 was considered significant.

Results:

Two patients reported re-dislocations after the operation. Re-dislocation rate was 16.6% (2 in 12 knees). In general, patients reported significant improvement in pain, swelling, crepitus, and physical activity. The most common complaint was the anterior knee pain. The average pre and post-operative Tegner scores were 3.66 and 4.0, respectively. The average preoperative Lysholm score was 72 and postoperatively improved to 87.8 (p=0. 017).

Discussion:

Arthroscopic medial reefing for patellar instability is a viable option for young patients with ligamentous insufficiency without major bony abnormalities. The most significant advantages are that the epiphyseal plates are protected in young patients, no skin incision applied, and no autografts are harvested.
Risk factors of recurrence after an arthroscopic stabilisation procedure performed for traumatic anterior shoulder instability in pediatric population
Authors: Özer Mustafa , Ayanoğlu Tacettin , Ataoğlu Muhammet Baybars , Çetinkaya Mehmet , Kanatlı Ulunay
Published: March 2017

Arthroscopic stabilisation of traumatic anterior shoulder instability is being performed also in pediatric age group, and reports associated with risks of recurrent instability have been presented. The aim of the current study was determining the risk factors of recurrence after the arthroscopic anatomic repair preformed in pediatric age group. 46 patients who underwent arthroscopic Bankart repair for traumatic anterior shoulder instability with the mean age of 17 ±0.8 (15-18) were included in this study. After an average follow-up time of 40.4± 22.7(24-155) months age, gender, dominant side, number of dislocations before surgery, participation in contact sports, Rowe and Oxford shoulder scores, labral lesion type, number of anchor used, and capsular laxity were assessed, and their correlation with recurrence were investigated. Recurrence was encountered in 9 (19,5%) patients, on average, 16.1 ±13.43 months after surgery. The only risk factor of recurrence was found to be the history of five or more times of dislocation before surgery (p=0,006). Although statistically insignificant, when evaluated separately, it was found that patients with contact sports history had double times of recurrence rate if they had ALPSA or SLAP lesion and triple times of recurrence rate if they had capsular laxity. The recurrence rate was found to be 38,4% when accompained by capsular laxity, 50% when accompained by both capsular laxity and ALPSA lesion, and 100% when accompanied by all capsular laxity, ALPSA lesion and contact sports history. Arthroscopic stabilisation of traumatic anterior shoulder instability in pediatric population is an appropriate technique, especially in those with less than five times of dislocation because of the low recurrence rate (3.4%). Surgical procedures that are non-anotomic, such as coracoid transfer or anterior glenoid bone block, should be considered in patients with high risk of recurrence rate after an arthroscopic anatomic repair because of the risk factors like history of five or more times of dislocation, being accompanied by an ALPSA, SLAP lesion, or a capsular laxity and participation in contact sports.
A comparison of wrist isokinetic muscle strength in wheelchair table tennis and wheelchair basketball players
Authors: Akınoğlu Bihter , Kocahan Tuğba , Yıldırım Necmiye Ün , Soylu Çağlar , Apur Ufuk , Hasanoğlu Adnan
Published: March 2017

Aim:

The aim of this study was to compare isokinetic muscle strength of wrist flexor and extensor muscles in paralympic athletes.

Methods:

This study was carried out with the participation of 9 (4 females and 5 males) wheelchair (WC) table tennis players aged 24+3 and 8 male WC basketball players aged 26+3, met the criteria and voluntarly participate in the study. Body weight, height, body mass index and dominant extremity of the study subjects were recorded. İsokinetic measurement were performed with Isomed 2000® device. İsokinetic testing protocol; before the test all players performed the wrist flexion and extension isokinetic test with the 5 repeating at 90º/sec as a warm-up and comprehending the test. Then, wrist flexion and extension concentric-concentric strength measurements were performed with the 5 repeating at 60º/sec and with the 15 repeating at 240º/sec with the angle between 50 degrees of wrist flexion and 60 degrees of wrist extension and peak torque, peak torque/kg values and flexion/extension ratios were recorded. Mann-Whitney U test was used to compare isokinetic muscle strength quantitative variables in athletes.

Findings:

Isokinetic muscle strength of wrist flexors and extensors was higher in both sides in WC table tennis players with 60º/sec speed (p<0,05). İsokinetic muscle strength of wrist flexors and extensors was higher in both sides in WC basketball players with 240º/sec speed (p<0,05). There was no significant difference statistically between the groups in isokinetic wrist flexion and extansion peak torque/kg ratio in all speeds (p>0,05). Wrist flexion/extension peak torque ratios were similar in both groups. When examining the athletes flexion/extension ratios, wrist extensor muscles were weaker than flexor muscles and flexor muscles were average twice stronger than extensor muscles in both sports ( Table1 ). [Table: see text]

Results:

We thought that imbalance of muscle strength in the wrist may have occurred because of the use of a WC and requiring the intensive wrist flexors in playing sports. In both groups wrist ekstansor muscles were found to be weaker than wrist flexors and flexor/extensor ratio was found to be imbalance. We believe that all athletes using WC such as WC table tennis and WC basketball players have a strenght imbalance in the muscle of the wrist and as a result, this situation will increase the possibility of injury. Therefore, our study showed that weakness of wrist extensors and imbalance of muscle stenght should be taken into account in WC athletes in athletic training and exercise programs.
Minimal Clinically Important Difference of Patient Reported Outcome Measures of Lower Extremity Injuries in Orthopedics
Authors: Çelik Derya , Çoban Özge , Kılıçoğlu Önder
Published: March 2017

Purpose:

MCID scores for outcome measures are frequently used evidence-based guides to gage meaningful changes. To conduct a systematic review of the quality and content of the the minimal clinically important difference (MCID) relating to 16 patient-rated outcome measures (PROM) used in lower extremity.

Methods:

We conducted a systematic literature review on articles reporting MCID in lower extremity outcome measures and orthopedics from January 1, 1980, to May 10, 2016. We evaluated MCID of the 16 patient reported outcome measures (PROM) which were Harris Hip Score (HHS), Oxford Hip Score (OHS), Hip Outcome Score (HOS), Hip Disability and Osteoarthritis Outcome Score (HOOS), The International Knee Documentation Committee Subjective Knee Form (IKDC), The Lysholm Scale, The Western Ontario Meniscal Evaluation Tool (WOMET), The Anterior Cruciate Ligament Quality of Life Questionnaire (ACL-QOL), The Lower Extremity Functional Scale (LEFS), The Western Ontario and Mcmaster Universities Index (WOMAC), Knee İnjury And Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), Kujala Anterior Knee Pain Scale, The Victorian Institute of Sports Assessment Patellar Tendinosis (Jumper’s Knee) (VİSA-P), Tegner Activity Rating Scale, Marx Activity Rating Scale, Foot And Ankle Outcome Score (FAOS), The Foot Function Index (FFI), Foot And Ankle Ability Measure (FAAM), The Foot And Ankle Disability Index Score and Sports Module, Achill Tendon Total Rupture Score(ATRS), The Victorian İnstitute Of Sports Assesment Achilles Questionnaire(VİSA-A), American Orthopaedic Foot and Ankle Society (AOFAS). A search of the PubMed/MEDLINE, PEDro and Cochrane Cen¬tral Register of Controlled Trials and Web of Science databases from the date of inception to May 1, 2016 was conducted. The terms “minimal clinically important difference,” “minimal clinically important change”, “minimal clinically important improvement” “were combined with one of the PROM as mentioned above.

Results:

A total of 223 abstracts were reviewed and 119 articles chosen for full text review. Thirty articles were included in the final evaluation. The MCID was mostly calculated for WOMAC and frequently reported in knee and hip osteoartritis, knee and hip atrhroplasties, femoraasetabular impingement syndrome and focal cartilage degeneration. In addition, Receiver Operating Characteristic (ROC) analysis was the most used method to report MCID.

Conclusions:

MCID is an important concept used to determine whether a medical intervention improves perceived outcomes in patients. Despite an abundance of methods reported in the literature, little work in MCID estimation has been done in the PRAM related to lower extremity. There is a need for future studies in this regard.
Outcome of the treatment of chronic isolated and combined posterolateral corner knee injuries with 2- to 6-year follow-up
Authors: Görmeli Gökay , Görmeli Cemile Ayşe , Elmalı Nurzat , Karakaplan Mustafa , Ertem Kadir , Ersoy Yüksel
Published: March 2017

Introduction:

Injuries of the posterolateral corner (PLC) of the knee are rare. They are difficult to diagnose and can cause severe disability. This study presents the 20- to 70-month clinical and radiological outcomes of the anatomical reconstruction technique of LaPrade et al. Materials and methods Twenty-one patients with chronic PLC injuries underwent anatomical PLC reconstruction. The anatomical locations of the popliteus tendon, fibular collateral ligament, and popliteofibular ligament were reconstructed using a 2-graft technique. The patients were evaluated subjectively with the Tegner, Lysholm, and International Knee Documentation Committee (IKDC) subjective knee scores and objectively with the IKDC objective scores; additionally, varus stress radiographs were taken to evaluate knee stability.

Results:

Significant (p\0.05) improvements were observed in the postoperative Lysholm, IKDC-s, and Tegner scores compared with preoperatively. The IKDC objective subscores (lateral joint opening at 20_______________of knee extension, external rotation at 30_______________and 90_______________, and the reverse pivot-shift test) had improved significantly at the time of the final 40.9 ± 13.7-month follow-up.Lateralcompartment opening on the varus stress radiographs had decreased significantly in the postoperative period. However, there was still a significant difference compared with the uninjured knee. There was no significant improvement in the IKDC-s, Lysholm, or Tegner scores between the nine patients with isolated PLC injuries and twelve with multiligament injuries.

Conclusions:

Significant improvement in the objective knee stability scores and clinical outcomes with anatomical reconstruction showed that this technique can be used to treat patients with chronic PLC injured knees. However, longer-term multicentre studies and studies with larger groups comparing multiple techniques are required to determine the best treatment method for PLC injuries.
Mobilisation of Joint-resident Mesenchymal Stromal Cells for Articular Cartilage Regeneration
Authors: Khan Alam Khalil , Baboolal Thomas , Wall Owen , Jone Elena , Mcgonagle Dennis
Published: March 2017

Background and Objectives:

Microfracture is a recognized procedure used to treat isolated cartilage injuries or defects, in which bone marrow mesenchymal stromal cells (BM-MSCs) are thought to migrate into the resulting blood clot, leading to subsequent cartilage repair via fibrocartilage formation. The discovery of MSCs in the synovium and synovial fluid (SF) provides a potential mechanism for repairing cartilage from the top down via their migration and homing to the microfracture site, however SF-MSCs low in number and usually lost with joint irrigation. The purpose of this work was threefold; first to test the hypothesis that SF-MSCs can be replaced, and also their numbers further increased by synovial agitation, second that these cells were capable of rapid adhesion to clots and third that the clot composition improve MSC migration.

Materials-Methods:

Ex-vivo mechanical agitation of human superficial synovium and in vivo intra-operative agitation of synovium in patients undergoing arthroscopy were performed using a Cytology brush and custom designed Synovial brush. Colony-forming unit-fibroblast (CFU-F) assay was performed to quantify released MSCs. Adhesion to clots was studied by comparing Platelet Rich Plasma (PRP), Whole Blood (WB) and Fibrin Glue (FG). Migration studies were performed using passage 2-4 synovial MSCs in trans-well migration assay. MSC migration, over a five hour period, was compared between PRP and pooled human Platelet Lysate (hPL).

Results:

Ex-vivo mechanical agitating of the synovium with the cytology brush compared to irrigation alone increased MSC number 2.7-fold (n=10, p=0.002). Irrigation during arthroscopy was seen to effectively remove the majority of CFU-Fs for the synovial fluid. Use of a custom designed synovial brush, compared to the cytology brush resulted in a median 65-fold increase in the number of CFU-Fs (n=8, p=0.0148). Trilineage differentiation of released synovial MSCs was at least comparable to donor match synovial fluid MSCs. These MSCs adhered to clots within 30 minutes with no difference seen between clot compositions. Released synovial MSCs demonstrated a trend for a better migration towards hPL compared to PRP.

Conclusions:

Existing surgical procedures wash away SF-MSCs. Using a novel brushing technique and a custom designed synovial brush, synovial MSCs can be mechanically released in vivo, and these cells were capable of migration and rapid adhesion to clots. Collectively these findings aid in the rapid replenishment of endogenous minimally manipulated MSCs, and provide a one-stage procedure combining synovial brushing with microfracture, as a strategy for cost effective joint repair.
Portal-site tract delayed closure in knee arthroscopy
Authors: Acar Nihat , Karaarslan Ahmet Adnan
Published: March 2017

Objectives:

knee arthroscopy done usually through two punctures (anteromedial and anterolateral). We aimed to record the impact of delayed tract closure on the post-operative sub-acute and chronic anterior knee pain.

Design:

Ultrasonography was used to evaluate the healing pattern of portal-site tracts.

Setting and Participants:

104 operated patients, followed up for one year. Puncture wounds were divided into two groups, (1) anteromedial group and (2) anterolateral group. Each group contains 104 portal-site tract.

Main Outcome Measures:

VAS was used to measure pain related to delayed tract healing and its association with the post-operative sub-acute and chronic knee pain.

Results:

Anteromedial and anterolateral tracts average total healing time was (47 days, 28 days) respectively. The median VAS of anteromedial tract after 2 weeks, one month, three months, six months and one year was (8.2, 6.3, 4, 1.9, 0.6) respectively, and for the anterolateral tract was (7.4, 5.5, 2.8, 1.2, 0.2) respectively. A statistical significance was detected between the two groups at the first and third months with P values 0.042 and 0.0035 respectively.

Conclusions:

Anteromedial tracts closed later than anterolateral tracts. Both portal-site tracts delayed closure is a potential for post-operative sub-acute and chronic anterior knee pain after arthroscopic surgery. [Figure: see text][Figure: see text]
Consistency Between Posterior Condylar Axis (+3˚ external rotation) Line and Clinical Transepicondylar Axis Line in Primary Total Knee Arthroplasty
Authors: Taşdemir Zeki , Çevik Hüseyin Bilgehan , Elmalı Nurzat , Baysal Özgür
Published: March 2017

Objectives:

Purpose of this study is to as certain consistency between posterior condylar axis (PCA) + 3˚ external rotation line and clinical transepicondylar axis (cTEA) line in primary total knee arthroplasty cases.

Materials-Methods:

During surgery, following distal femoral cut PCA +3 degree external rotation line and cTEA line drawn on the distal femoral cutting surface by ruler and pencil. The both lines on distal femur were recorded by digital camera and relationship between lines was ascertained in reference to PCA +3 degree external rotation [parallel (P), Internal rotation (IR) and External Rotation (ER)].

Results:

9 knees of 9 patients [1 men, 8 women; average age 67 (59-80 age)] were constituted the study group. Evaluation results of the photographs revealed that clinical TEA line in comparison PCA +3 degrees external rotation line was ER in 9 knees (100%) whose mean angles 2.7˚ (1-6) and detected external roation with mean angle 4.7˚ (2-7) in 9 knees.

Conclusion::

For determination of FC rotation in surgery setting, different results between cTEA and PCA + 3 degrees techniques possibly may due to disadvantages of techniques and anatomic variation of distal femur. Thus, using both techniques for check each other’s results seems unsafe. In custom made prosthesis, which can be done in the future it will be measured by CT.

Keywords:

Total knee arthroplasty, femoral component, rotational alignment, femoral transepicondylar axis, posterior condylar axis