Diabetic neuropathy (DN) is the most common complication of diabetes mellitus. It causes microvascular and macrovascular damages and diagnosis can easily be overlooked by most physicians. Generally; the diagnosis of DN can be omitted by physicians dealing with diabetes treatment since it starts with non-specific findings, shows slow progression and can be confused with complaints in many diseases. It is estimated that there will be 578 million people diagnosed with DN in the world in 2030. Chronic hyperglycemia, microvascular insufficiency, oxidative and nitrosative stress, impaired neurotropism and autoimmunity are some of the factors that cause nerve destruction. Paresthesias such as tingling, burning, electrical shock-like sensations, numbness, throbbing, compression, pinpricks to the skin, complaints are the most common symptoms. There is no treatment for pathogenetic mechanisms in diabetic neuropathy that completely eliminates neuronal damage. The purposes of treatment is slowing down the progression of the disease, controlling the pain, preventing complications, quick and adequate treatment of occurred complications, maintaining the functional capacity of the patient. In this review, we aimed to comprehensively address the general approach to diabetic neuropathy, diagnosis and treatment.

Coronavirus infection has become an important public health concern because of its increasing prevalence, serious complications and mortality. The previous pathogenic coronaviruses severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) were mortal virus infections in past 15 years. Today the current epidemic caused by a new coronavirus (SARS-COV-2) is called coronavirus disease of 2019 (COVID-19). The virus causes different illness, from upper respiratory tract infections like the common cold, to lower respiratory tract infections such as bronchitis, pneumonia, and SARS. The coronavirus can be transmitted through small infected droplets from a person with COVID-19 during coughs or exhales. Additionally, it can also be transmitted from contaminated environment or objects. A number of precautions to prevent transmission of COVID-19 have been applied to stop the current outbreak. There is no certain treatment of the disease but the studies on vaccines and treatment continue. In this review, we aimed to give a brief information about COVID-19.

The term gray literature refers to printed or electronic research that is either unpublished or has been published in non-commercial form. Many systematic reviews and meta-analyzes do not include gray literature sources and studies published in languages other than English. Their inclusion increases accuracy and can reduce systematic errors. it is very important to include the gray literature in the screening among the sources while conducting scientific studies, in order to obtain evidence-based results. Acta Medica Alanya journal includes gray literature especially in its compilation and editorial writings and supports citing articles from our country including Turkish in its research articles.

Aim: To examine the association between plasma levels of β-2 microglobulin (β-2M), a protein previously associated with atherosclerosis, and the presence of coronary slow flow phenomenon (CSFP). Material and Methods: 124 subjects who admitted to cardiology outpatient clinic with chest pain and directed to coronary angiography were investigated. Sixty-six of them had healthy coronary arteries and the others coronary slow flow. Venous blood samples were obtained to determine β-2M levels. TIMI frame count (TFC) was used to assess the classification of slow flow.Results: Patients with coronary slow flow had higher levels of β-2M levels than healthy controls (2042.0 ± 660.2 and 1692.7 ± 403.4 ng / mL respectively) and the difference was statistically significant (p<0.001). β-2M levels were positively correlated with TFC (r=0.262, p= 0.003). Although groups were different in terms of β-2M, LDL and total cholesterol, Receiver operating characteristic (ROC) curve analysis demonstrated stronger predictive value of β-2M compared to LDL or total cholesterol in predicting the presence of CSF in our study population (area under curve [AUC] 0.748, 0.632 and 0.581; p<0.001, p=0.025 and p= 0.061 respectively). Conclusion: High serum β-2M levels can be used as a biomarker to evaluate the slow flow.

Aim: This study aims to compare biomarkers related to endothelial function during selective antegrade cerebral perfusion with moderate hypothermic lower body circulatory arrest with that of standard cardiac surgery.Material and Methods: Thirty-six consecutive patients who underwent selective antegrade cerebral perfusion with moderately hypothermic lower body circulatory arrest at 28°C (study group) for aneurysms of the ascending aorta were prospectively compared with 36 patients who underwent standard cardiac surgery (control group) with conventional cardiopulmonary bypass. Nitric oxide, asymmetric dimethylarginine, hydrogen sulfide and total antioxidant capacity status and lactate levels in blood specimens obtained from the vena cava inferior were studied. Clinical results and biochemical parameters were evaluated.Results: Biomarkers related to endothelial function were found to be similar between the groups except for asymmetric dimethylarginine. The asymmetric dimethylarginine levels were lower, while lactate levels were significantly higher compared to the control group. When the patients with coronary artery disease were excluded from the analysis to rule out the predominance of coronary artery disease patients in one group as a confounding factor, the asymmetric dimethylarginine levels were found to be similar between the two subgroups.Conclusion: Low plasma levels of asymmetric dimethylarginine in the study group may have a protective role in endothelial nitric oxide synthesis. When patients with coronary artery disease were excluded from both group, biomarkers related to endothelial function were similar in both groups. We consider that endothelial functions are not affected adversely during short periods of moderately hypothermic lower body circulatory arrest.

Amaç: Bibliyometrik analizler; bilimsel dergilerin iç değerlendirilmesinin yapılması ve etki değerinin arttırılmasına yönelik editöryal politikaların belirlenmesi açısından önemlidir. Bu makalede Eklem Hastalıkları ve Cerrahisi (EHC) Dergisinin bibliyometrik verilerin tanımlanması ve atıf almasını etkileyen faktörler araştırılmıştır. Gereç ve Yöntem: Retrospektif bibliyometrik olarak dizayn edilen bu çalışmada: Yayımlandığı ilk sayısından bu yana 30 yılık süreçteki EHC tüm makaleleri gözden geçirildi. Çalışmanın bu ilk bölümünde SCI-E öncesi dönem araştırıldı. Makalelerin yazar, kurum, çeşit ve konu özellikleri değerlendirildi. Atıf almayı etkileyen faktörler analiz edildi. Kategorik veriler için ki-kare, sayısal veriler için Anova testi ve posthoc karşılaştırmada t testi kullanıldı. Bulgular: Değerlendirilen toplam 688 makaleden 134 ü (%19,5) en az bir atıf almıştır. Bu çalışmada atıf almayı etkileyen en önemli faktör; makalelerin tam metinine internetten ulaşılabilmesi olmuştur (p<0,01). Ayrıca makale dili de atıf almada anlamlı bulundu (p=0,026). Makale başına ortalama yazar sayısı 3,8 ve atıf sayısı 0,7 olarak bulundu. Makalelerin en çok Üniversitelerden gönderildiği tespit edildi. Sonuç: Bilimsel bir derginin gelişim süreci içerisinde bazı mesafeler kat etmesi gerekmektedi. Dergide yayımlanan makalelerin tam metinlerine web ortamında erişilebilir olması, atıf almada önemli bir etkendir. Ayrıca özgün araştırma ve derleme türü makalelerin daha çok atıf alabileceği değerlendirilmiştir. Bununla birlikte iyi seçilmiş bir olgu sunumu da atıf alabilir. Son olarak uluslararası atıf açısından yurtdışı ve İngilizce makaleler avantajlı olabilir.

Torasik Outlet Sendromu (TOS); torasik çıkımdaki vasküler ve nörojenik yapıların basıya maruz kalmasıyla karakterize klinik semptomlar kompleksidir. TOS da altın standart bir tanı kriteri yoktur. Tanıda anamnez ve fizik muayenenin önemi büyüktür. Destekleyici ve ayırt edici tetkikler sıklıkla elektromiyolografi, direk servikal grafi ve boyun MR ıdır. Tedavide öncelik medikal tedavi ve fizik tedaviden oluşan konservatif tedavilerdir. Son seçenek 1.kostanın ve varsa servikal kostanın çıkarılması ve skalen anterior ve skalen medius kaslarının kesilmesinden oluşan cerrahi tedavidir. Vasküler yapılara bası sonucu gelişen TOS da cerrahi tedavi sonrasında düzelme bulguları çok kısa sürede ortaya çıkarken, nörojenik yapılara bası sonucu oluşan TOS bulguları ortalama 6 ay ile 1 yıl arasında düzelmektedir. Biz nörojenik yapılara bası bulgularıyla kliniğe yansıyan TOS vakamıza literatürde en fazla rastlanan transaksiller girişim yöntemiyle 1. kosta rezeksiyonu uyguladık. Literatürden farklı olarak vakamızın şikayetleri 1 hafta içerisinde tamamen kayboldu. Operasyondan 1 ay sonra ise EMG bulguları tamamen normale döndü.

Amaç: Gingival marjinin mine sement birleşiminden apikale doğru yer değiştirmesi olarak tanımlanan dişeti çekilmesi kök çürüklerine, hassasiyete, erozyona, aşınmaya ve estetik kaygılara neden olabilmektedir. Bu nedenle, bu komplikasyonları azaltmak ya da önleyebilmek adına bu hastalarda serbest dişeti grefti dahil çeşitli periodontal plastik cerrahi seçenekleri uygulanabilmektedir. Ağız sağlığı ile ilgili yaşam kalitesi, bireyin sağlık durumunun psikolojik, sosyal, fonksiyonel faktörler ve orofasiyal problemlerden nasıl etkilendiği hakkında bilgi verir. Bu çalışmanın amacı daha önce serbest dişeti grefti uygulanmış hastaların dişeti cerrahisi sonrası uzun dönem memnuniyetlerini ve bu işlemin ağız sağlığı ile ilişkili yaşam kalitesine etkisini değerlendirmektir. Yöntemler: Bu çalışma, Başkent Üniversitesi Diş hekimliği Fakültesi’ne dişeti çekilmesi şikayeti ile başvuran ve bu sebeple serbest dişeti grefti uygulanmış hastalar üzerinde yürütülmüştür. Hastalar kliniğimize çağırılmış ve hastaların şu anki dişeti durumlarının yaşam kalitesine olan etkisi ve operasyon sonrası memnuniyetlerini belirlemek amacıyla hastalara memnuniyet anketi ve Ağız sağlığı etki profili-14 [Oral Health Impact Profile-14 (OHIP-14)] anketinin Türkçe formu uygulanmıştır. Bulgular: Çalışmaya 28 hasta dahil edilmiştir. Fonksiyonel limitasyon ile fiziksel ağrı (p = 0,031), psikolojik rahatsızlık ve fiziksel yetersizlik arasında pozitif bir korelasyon bulunmuştur (p=0,031). Bununla birlikte toplam OHIP-14 skoru ile fiziksel ağrı arasında güçlü korelasyon tespit edilmiştir. Hastaların yaşları ve operasyon sonrası geçen süre ile OHIP-14 skorları arasında bir ilişki bulunamamıştır (p>0,05). Sonuç: Bu araştırmanın sınırları dahilinde serbest dişeti grefti uygulanmış hastaların uzun dönem yaşam kalitelerine etki eden en önemli faktörün fiziksel ağrı olabileceği ve bu durumun yaş veya operasyon sonrası geçen süre ile ilişkili olmadığı sonucuna varılmıştır

Aim: The aim of this study was to evaluate the clinical progress, type of surgical approach and early results of resection of anterior mediastinal masses. Patients and Methods: We retrospectively reviewed the reports of 25 patients who underwent surgery for an anterior mediastinal mass between 2014 and 2019. Patients’ age, gender, presenting symptoms, preoperative radiological investigations and surgical techniques were recorded. There were eight male and 17 female patients, and their age ranged from 18-89 with a mean of 44.4± 16.9 years. Results: The most frequent presenting symptoms were chest pain (90%) and cough (50%). The most common pathological diagnoses were thymic tumors (n=14, 56%) and lymphoma (n=5, 20%). Surgical approaches applied were median sternotomy in 16 patients, partial sternotomy in five patients and VATS (Video Assisted Thoracic Surgery) in four patients. There were no postoperative deaths or major complications, but eight patients had minor complications. Postoperative stay was 5±5.2 days. Conclusion:Surgery is a safe technique for diagnosis and treatment of anterior mediastinal masses.

Aim: To determine the relation between vitamin D levels and isokinetic muscular strength in athletes, and to compare the muscular strength between athletes with and without vitamin D deficiency. Methods: The records in the sports medicine clinic were examined, where the general medical examinations and performance analyses of the athletes had been conducted. The data of the athletes were examined, whose serum 25-OH vitamin D levels had been determined and isokinetic knee flexion-extension muscular strength test had been conducted. Age, height, body weight, discipline of sports, the year of beginning to sports and training duration per week (hours/week) were recorded for each athlete. The athletes were separated into two groups as vitamin D levels below 20 ng/mL (Group 1) and above 20 ng/mL (Group 2). Results: There was not any statistically significant difference between the demographic data and training data of the groups (p˃0.05). Vitamin D deficiency was found in 44% of all the athletes. The average vitamin D level was 13.8 ng/mL for Group 1, and 27.2 ng/mL for Group 2 (p:0.001). The serum calcium and serum phosphor levels were similar (p˃0.05). The isokinetic muscular strength test did not yield a difference between the two groups. It was found that vitamin D levels did not show any correlation with demographic data, training details and with any parameter of muscular strength (p˃0.05). Conclusion: In this study, there are no difference in effect of vitamin D on muscle strength, but significant results could be obtained in other studies with large participants.