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Objective: Epilepsy and electroencephalography (EEG) abnormalities are more commonly seen in autism spectrum disorder (ASD). The aim of the present study is determine the risk factors that cause epilepsy, seizures and EEG abnormalities in cases with EEG examination who were followed with the diagnosis of ASD. Method: A total of 166 cases diagnosed with ASD according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition in Dokuz Eylül University Faculty of Medicine Hospital Clinic of Child Psychiatry and whose neurological evaluations and examinations were performed in the pediatric neurology clinic, were included in the study. We retrospectively recorded and analyzed the cases' clinical features, the results of physical examination, imaging and EEG, comorbidities and medications they used. Results: Of the cases, 74.4% were male. The mean age of cases with epilepsy diagnosis, at least one seizure and epileptic discharges on EEG was higher (p

Abstract Background Because of the broad anatomic variation in the course of the axillary nerve, several cadaveric studies have investigated the acromion-axillary nerve distance and its association with the humeral length to predict the axillary nerve location. This study aimed to analyze the acromion-axillary nerve distance (AAND) and its relation to the arm length (AL) in patients who underwent internal plate fixation for proximal humerus fractures. Methods The present prospective study involved 37 patients (15 female, 22 male; the mean age = 51 years, age range 19–76) with displaced proximal humerus fractures treated by open reduction and internal fixation. After anatomic reduction and fixation were achieved, the following parameters were measured in each patient before wound closure without making an extra incision or dissection: (1) the distance from the anterolateral edge of the acromion to the course of the axillary nerve was recorded as the acromion-axillary nerve distance and (2) the distance from the anterolateral edge of the acromion to the lateral epicondyle of the humerus was recorded as arm length. The ratio of AAND to AL was then calculated and recorded as the axillary nerve index (ANI). Results The mean AAND was 6 ± 0.36 cm (range 5.5–6.6), and the mean arm length was 32.91 ± 2.9 cm (range 24–38). The mean axillary nerve ratio was 0.18 ± 0.02 (range 0.16 to 0.23). There was a significant moderate positive correlation between AL and AAND (p = 0.006; r = 0.447). The axillary nerve location was predictable in only 18% of the patients. Conclusion During the anterolateral deltoid-splitting approach to the shoulder joint, 5.5 cm from the anterolateral edge of the acromion could be considered a safe zone to prevent possible axillary nerve injury.

Aim:Most of the childhood elbow area fractures constitute supracondylar humerus fractures. The treatment approach in Gartland type II fractures is controversial. The purpose of our study was to compare the effectiveness of cast and splint in conservative treatment of type II supracondylar humerus fractures.Methods:Sixty-nine pediatric patients admitted to our clinic due to gartland type II supracondylar humerus fractures between 2015 and 2020 were retrospectively evaluated. Closed reduction upper-elbow cast was applied to 26 patients, and closed reduction upperelbow splint treatment was applied to 43 patients. Radiological results of the patients were compared.Results:The mean age of the patients participating in the study was 4.86±2.61. Forty-two of 69 patients were male and 27 were female. Neurovascular deficit and compartment syndrome were not observed in any of the patients. When compared radiologically, no significant difference was found between the two groups.Conclusion:Type II supracondylar humerus fractures, where conservative treatment is planned, the upper elbow casting or splint selected for immobilization shows similar effectiveness in protecting reduction.

Background: Subacute sclerosing panencephalitis (SSPE) is a chronic, progressive disease caused by a persistent infection of the measles virus. Despite extensive efforts, the exact neurodegeneration mechanism in SSPE remains unknown. MicroRNAs (miRNAs) have emerged as an essential part of cellular antiviral defense mechanisms and can be modulated by antiviral cytokines Such as interferon-beta (IFN-β). Aims and Objectives: In this study, we aimed to elucidate the role of antiviral miRNAs in the pathogenesis of SSPE and analyze the interaction between host antiviral miRNAs and virus genes. Materials and Methods: Thirty-seven patients who were followed with SSPE and age-matched healthy children were included in the study. Peripheral blood mononuclear cell levels of miR-196b, miR-296, miR-431, and miR-448 were analyzed using quantitative polymerase chain reaction. Target predictions and pathway constructions of deregulated miRNAs were assessed. Results: Here, we showed that IFN-β-modulated miR-196b, miR-296, and miR-431 were significantly upregulated in patients with SSPE compared with healthy controls. Besides, sequence complementarity analysis showed that miR-296 and miR-196b predicted binding regions in measles virus genomic RNA. Conclusion: Our findings suggest that antiviral miRNAs are upregulated in patients with SSPE, which could be a part of the host antiviral defense mechanism.

ABSTRACT Introduction In this study we investigated the effect of tranexamic acid (TXA) on fracture healing in an established animal model, when used to stop bleeding in orthopedic trauma surgery. Materials and Methods This study was a randomized, controlled, laboratory study. Eighteen Sprague-Dawley rats were randomly assigned to three groups, either receiving TXA intravenously (Group 1), TXA topically (Group 2), or isotonic TXA intravenously and TXA topically in the same amounts for the control group (Group 3). First, a Kirschner wire was inserted retrogradely into the femoral intramedullary canal. Then the femurs were fractured at the midshaft region with blunt guillotine. After 4 weeks, the rats were sacrified and the femurs harvested. Cortical bone volume, callus volume, and bone mineral density were calculated using computer tomography scans. Torsion tests were performed. Groups were compared by maximum torque to failure and callus stiffness. Results There were no statistical differences in torque to failure and stiffness between the 3 groups. There were no differences in mean total bone volume, callus volume, percent bone volume, or callus density between the groups. Conclusions A single dose of topical or intravenous TXA has no negative effect on fracture healing when used in traumatic femur fracture surgery in an animal model. Evidence level II; Randomized controlled experimental study.

Aim:Septic arthritis may represent a direct invasion of joint space by various microorganisms. The aim of this study was to determine the epidemiological characteristics of patients with septic arthritis in our clinic and to discuss the diagnosis, treatment and management.Methods:Thirty-four patients diagnosed with septic arthritis between June 2008 and December 2014 were retrospectively evaluated. Clinical and epidemiological characteristics of the patients, microorganisms causing infection and treatment choice were analyzed.Results:Most patients were male (55.9%) and the mean age of the patients was 42.8 (1-87) years. The knee was the most often affected joint (91.6%). Fever was present in only 17.6% of the cases. Gram staining was positive in only 17.6% of the synovial fluid samples analyzed. Among the 34 patients studied, 10 had positive synovial fluid culture (29.4%). Staphylococcus aureus was the most common pathogen.Conclusion:Gram negative staining, absence of fever and normal leukocyte count do not rule out septic arthritis but only reduce the possibility. Samples should be taken prior to antibiotic treatment to avoid false negative detection of positive samples. Serial needle aspiration, drainage and empirical antibiotherapy should be kept in mind in the treatment of septic arthritis.

Aim: In this study, we aimed to discuss the result of arthroscopic surgery for shoulder instability and we planned to show the value of instability tests for determining success of surgery. Methods: Patients, who were operated for shoulder instability between 2008 and 2013, were included in this study. Visual analogue scale, Rowe and Oxford shoulder scores of the patients were recorded preoperatively and at the final follow-up visit. Physical examination finding were noted at the final follow-up visit. Results were analyzed using SPSS. Results: Twenty one patients were included in this study. Re-dislocation was detected in two patients. There was no re-dislocation in patients with an osseous Bankart lesion. All clinical scores improved in all patients, however those with a negative apprehension test had better clinical scores. Conclusion: Arthroscopic Bankart repair is an effective procedure for the treatment of shoulder instability. Presence of osseous Bankart lesion plays an important role in the prognosis. Apprehension test is useful for assessing shoulder stability in the postoperative follow-up.

Aim: The purpose of this study was to determine the incidence of anterior cruciate ligament (ACL) lesions and osteochondral lesions according to type and localization of the meniscal tear and age, gender in patients who have been arthroscopicaly treated, besides, to make the coexisting lesions more predictable in these patients. Methods: We retrospectively investigated 352 patients under 50 years of age who underwent surgery for a meniscal tear between 2008 and 2012. We scanned the surgical operation notes, preoperative questionnaires and the magnetic resonance imaging findings. We recorded patients who had ACL lesions, such as elongation, partial rupture and total rupture. Osteochondral lesions were classified according to the Outerbridge classification from grade 1 to grade 4. Results: Chondral lesions were present in 77.4% of patients with degenerative meniscal tears and in 63% of patients with radial meniscal tears. One the other hand, osteochondral lesions were observed in only 33.9% of patients with other types of meniscal tears. 46.6% of ACL lesions accompanied by meniscal tears with longitudinal pattern, such as longitudinal tears, bucket handle tears and root tears. For the other types of meniscal tears, this percentage was 20.7. When we excluded degenerative type meniscal tears, the mean age of the patients with radial tears was 40.86±9.03 years and the mean age of the patients with other types of tear was 35.44±9.44 years. The difference was statistically significant. Conclusion: We found close relationship between osteoarthritic chondral lesions and radial tears in the root of the posterior horn of the medial meniscus. On the other side, longitudinal tears were related with ACL lesions. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 177-80)

Aim: This study aimed to determine the short-term clinical and radiologic results of medial unicondylar knee arthroplasty (UKA). Methods: We retrospectively evaluated hospital records of eight patients who have undergone Oxford phase-3 medial UKA between 2011 and 2013. We included seven patients (two males and five females) in the study. The mean age of the patients was 63 years and the mean follow-up period was 17 months. The patients underwent UKA with the Oxford phase 3 cemented mobile insert unicondylar prosthesis using minimally invasive surgery technique. The patients were assessed preoperatively, postoperatively and at final controls according to the Knee Society’s clinical and Functional Scoring system (KSS). The mean anatomic tibiofemoral angle was measured preoperatively and postoperatively and any complication was recorded. Results: The mean knee score according to the KSS was 37.50 preoperatively and was 90.75 at the final follow-up; the mean function score according to the KSS was 31.88 preoperatively and was 93.12 at the final follow-up. The mean anatomic tibiofemoral angle was improved from 4.37 degree varus to 4.75 degree valgus. There was no complication in any patient except one with superficial infection who was treated by simply antibiotic treatment. Conclusion: UKA is a favorable surgical technique for appropriately selected patients with medial unicompartmental knee osteoarthritis. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 191-4)

Aim: In this study, we aimed to determine the risk factors for hip fractures in elderly patients in order to contribute to efforts to reduce the incidence of hip fractures. Methods: We evaluated 54 patients aged 79.12±8.83 (range: 55-95) years, who presented to our emergency department due to hip fractures (Group 1) and 52 hospitalized patients aged 69.04±7.66 (range: 60-83) years, without a hip fracture (Group 2). We compare the groups in terms of neuropathy symptom score (NSS), neurological impairment score (NIS), accompanying diseases, foot deformities, dermal and nail problems, body mass index (BMI), osteoporosis, and use of walking aid devices. Results: The mean BMI score was 24.81±3.67 and 27.67±4.86 in Group 1 and in Group 2, respectively. The difference was statistically significant (p=0.001). The mean NSS and NIS in Group 1 was 2.87±2.89 and 2.06±1.17, respectively, while the mean NSS was 1.83±2.84 and NIS was 0.6±0.82 in group 2. The two scores were higher in group 1 than in Group 2, however, the difference in NISs between the groups was statistically significant (p

Aim: The purpose of this study was to explore the frequency of pediatric supracondylar humerus fractures, and to determine the effects of age of on the number of pins used for osteosynthesis and the surgery techniques for reduction. Methods: 149 patients with Gartland type II and type III supracondylar humerus fractures, who were surgically treated in our clinic, were included in this study. The subjects were divided into two groups according to the type of treatment (open versus closed reduction), and any correlation between the type of reduction and patients’ age was investigated. Results: There was positive correlation between age and the total number of pins used (p=0.000). Open reduction frequency was higher in older children (p=0.005). Conclusion: Closed reduction and fixation with 2 K wires (either cross fixation or divergent configuration) is an effective treatment, but for the older children, it is difficult to obtain anatomic fixation with closed reduction, therefore, we need three or more K wires to provide stable fixation. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 43-6)

Metabolic myopathies due to disorders of lipid metabolism are a heterogeneous group of diseases. Newborns may present with hypotonia and convulsions, while progressive proximal muscle weakness or recurrent episodes of muscle weakness accompanied by rhabdomyolysis/myoglobinuria may be seen in older ages. There is little knowledge on detection of disorders of lipid metabolism by acylcarnitine profile (ACP) analysis by tandem mass spectrometry outside the neonatal period particularly in cases with recurrent rhabdomyolysis first presenting in adolescence and adulthood. Two adolescent female cases presented with episodes of rhabdomyolysis and muscle weakness. A 13-year-old patient had five episodes of rhabdomyolysis triggered by infections. Tandem mass spectrometry was normal. A 16-year-old female patient was hospitalized eight times due to recurrent rhabdomyolysis. Increased levels of C14:2, C14:1, and C14 were determined in tandem mass spectrometry. Final diagnoses were carnitine palmitoyltransferase II (CPT II) deficiency and very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency. Increased serum levels of long-chain acylcarnitine can guide to the diagnosis of lipid metabolism disorders. Serum ACP should be performed before enzyme assay and genetic studies.

Shapiro syndrome is an extremely rare condition consisting the clinical triad of recurrent hypothermia, hyperhydrosis and agenesis of the corpus callosum. On the other hand, reverse Shapiro′s sydrome is characterized periodic hyperthermia and agenesis of the corpus callosum. Here, we describe a 3.5-year-old girl with complete agenesis of corpus callosum presenting with recurrent fever and vomiting. She also had hypothermia attacks with accompanying diaphoresis. To the best of our knowledge, there is no described case with episodes of hyperthermia, hypothermia, and vomiting associated with agenesis of the corpus callosum. Recurrent vomiting may be a newly defined symptom associated with these syndromes.

Aicardi syndrome (AS) is an X-linked inherited disorder characterized by infantile spasms, chorioretinal lacunae, and agenesis or hypogenesis of the corpus callosum. The syndrome is more frequently seen in females but is observed in XXY male patients. Central nervous system, ocular, and costovertebral malformations may also seen in AS. Eye findings are of a considerable diagnostic importance; the chorioretinal lacunae are pathognomonic for AS and are generally bilateral. The outcome of the disease is generally severe, with a high mortality rate and poor developmental outcome. It is not clear which characteristics of the syndrome are related to a good prognosis in terms of psychomotor development, epileptic seizures, and survival. The purpose of this report was to demonstrate the spectrum of the clinical findings and the course of AS in two Turkish patients with different ocular and cranial MRI findings.