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The aim of this retrospective study was to compare the effectiveness of hyaluronic acid (HA) and injectable platelet-rich fibrin (i-PRF) in the management of Wilkes stage III internal derangement, and to evaluate the biosupplementation capacity of i-PRF. The records of all 54 relevant patients with Wilkes stage III internal derangement confirmed by magnetic resonance imaging and treated with arthrocentesis alone or in combination with HA or i-PRF were selected. The outcome variables were pain intensity at rest (VASr) and in function (VASf), evaluated with a visual analogue scale, and maximum mouth opening (MMO), evaluated in millimetres; assessments were made preoperatively, immediately after the procedure, and at 1 week, 1 month, and 3 months postoperatively. When compared to the HA and arthrocentesis groups, the i-PRF group showed significantly better improvements in MMO at 1 and 3 months (P=0.024 and P=0.006, respectively), VASr at 1 and 3 months (both P<0.001), and VASf at 1 week (P=0.019) and 1 and 3 months (both P<0.001) postoperatively. In all groups, better MMO, VASr, and VASf values were observed compared to the preoperative status. The application of i-PRF after arthrocentesis is more effective than arthrocentesis alone or with HA in the short term. HA was found not to provide significant additional benefits over arthrocentesis alone.

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BACKGROUND: The aim of this study was to evaluate the accuracy and quality of the information content of popular YouTube™ videos about genioplasty. MATERIALS AND METHODS: The keywords "genioplasty, sliding genioplasty and genioplasty surgery" were searched on YouTube™. It was filtered by the view count and the first 70 videos that met the inclusion criteria were evaluated. Each video was scored as ranging from 0 to 8 point and the videos were classified as bad, poor, good and excellent content. Kruskal-Wallis test was performed for statistical analysis. Intra-observer and inter-observer agreement were calculated Cohen's Kappa index. RESULTS: The videos uploaded by the individuals were significantly higher total video duration (P<0.001), number of comments (P=0.048) and viewing rate (P=0.036) than the others and the videos generally included their treatment journey. Most of the videos included bad information content. The number of likes (P=0.037), dislikes (P=0.037) and the interaction index (P=0.026) of the bad information content videos were significantly higher than the others. The other parameters did not show a significant difference (P>0.05). CONCLUSION: The results of this study would suggest that YouTube™ is not currently an appropriate source of information about genioplasty for the patients.

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BACKGROUND: The aim of this study was to investigate the effects of concentrated growth factors (CGF) and advanced platelet-rich fibrin (A-PRF) on edema, pain, and trismus after mandibular third molar surgery. MATERIAL AND METHODS: Patients were randomly divided into A-PRF, CGF and control groups. After extraction of the third molars, A-PRF and CGF were prepared and applied to the extraction sockets in study groups, while nothing was applied to the control group. Edema was measured from 5 reference points, including tragus, labial commissure, soft tissue pogonion, lateral corner of the eye/lateral canthus and angulus mandible. Trismus measured as the distance between the right lower and upper central incisors. Trismus and edema were measured preoperatively, and on postoperative 2nd and 7th days. Pain evaluated using the visual analogue scale (VAS) between 6th hour and 7th day after surgery. RESULTS: A total of 75 patients, 25 in each group, were included in the study. The change in tragus to labial commissure measurements showed a significant difference between baseline-7th days among control and CGF groups (P=0.038). Significant differences observed between the tragus to pogonion measurements at baseline-7th days among the control-CGF groups (P=0.014), and A-PRF-CGF groups (P=0.038). Secondary outcome variables trismus, pain, and analgesic consumption showed no significant differences among the groups (P>0.05). CONCLUSIONS: Based on the results of this study, it can be concluded that A-PRF and CGF seem to have no positive effects on pain, edema, and trismus after third molar surgery.

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AIM: The aim of this study was to investigate the effect of different types of anesthesia on stress hormones. MATERIALS AND METHODS: The study was included 60 ASAI-II cases scheduled for major lower extremity surgery. The cases were randomized into 2 groups: The EA group was administered epidural anesthesia and the GA group was administered standard general anesthesia. In order to evaluate the surgical trauma - related stress response, CRP, TSH, cortisol, and fasting blood sugar(FBS) levels were measured preoperatively, 30 min after surgical incision, and 24 h post surgery. RESULTS: Between-group comparisons; Preoperative values were not significantly different between the groups.( P > 0,05) Pulse rate and cortisol values significantly higher in general group at 30 min. ( P < 0,05), and the FBS values were significantly higher in the epidural group at 24 h.( P < 0,05) There were not found differences for other parameters at evaluation times. CONCLUSION: No differences were observed between the two anesthesia methods, in terms of minimizing the stress response due to surgical trauma during major low extremity surgery.

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INTRODUCTION: The present study compared the effect of bupivacaine and bupivacaine + sufentanil on hemodynamic parameters and characteristics of spinal anesthesia in elderly patients undergoing transurethral resection of the prostate (TURP) under spinal anesthesia. TECHNICAL CONSIDERATIONS: The study included 40 American Society of Anesthesiologists (ASA) I-III patients scheduled to undergo TURP. Patients were blindly and randomly divided into two groups. Group B (n = 20) received 10 mg of intrathecal bupivacaine and group BS (n = 20) received 7.5 mg of bupivacaine + 5 µg of sufentanil. Sensory and motor block characteristics, hemodynamic changes, side effects, and time to first analgesic requirement were recorded. No differences in mean arterial pressure or heart rate, time for sensory blockade to reach the T10 level, and maximum sensory level were observed between the two groups. The time to first analgesic request was longer in group BS (P < 0.05). Motor block was significantly higher in group B (P < 0.05). In terms of side effects, no statistically significant differences occurred between the groups. CONCLUSIONS: Similar hemodynamic stability and sufficient level of sensory blockade were provided by bupivacaine and bupivacaine + sufentanil used for spinal anesthesia in patients undergoing TUR. Due to the fact that less motor block was observed and the time to first analgesic request was longer, the combination of bupivacaine + sufentanil might be appropriate for patients undergoing TUR.

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PURPOSE: We aimed to determine the effect of intravenous thrombolytic therapy on QT dispersion (QTd) and its role in the prediction of reperfusion arrhythmias. MATERIALS AND METHODS: Twenty patients with acute myocardial infarction (MI) were enrolled in the study. Measurements of QTd were carried out prior to thrombolytic therapy and before discharge. The patients were examined for ventricular arrhythmias with 24-h Holter electrocardiography monitoring after treatment and the relationship between ventricular arrhythmias and the QTd values in the early phase of MI was investigated. RESULTS: The values of QTd were significantly higher during the early phase of MI (60 ± 5.32 ms) than those in the late phase (53.35 ± 4.07 ms) (P = 0.032). There was no correlation between isolated, bigeminal, trigeminal and total ventricular premature beats, accelerated idioventricular rhythm (AIVR) with QTd values. However, the patients with sustained ventricular tachycardia (VT), prolonged VT and sustained AIVR had higher corrected QTd (92 ms 1/2 , 97.8 ms 1/2 , 81.7 ms 1/2 , respectively) than the patients without these arrhythmias (74 ms 1/2 , 56.3 ms 1/2 , 58.28 ms 1/2 , respectively) (P = 0.022, 0.013, 0.018). CONCLUSION: The values of QTd may be significantly reduced in the 1 st week of acute MI and measurement of QTd in the early phase of MI may have a correlation with the following reperfusion arrhythmias: Sustained VT, prolonged VT and AIVR.

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OBJECTIVE: The purpose of this study was to determine the attitudes and the approach of the people living in the southeastern anatolia region and the impact of the lack of education on them. MEASUREMENTS: We used questionnaires consisting of 15 questions that were given to 145 people to be completed in 2 hours. The questionnaire assessed their knowledge, attitudes, and awareness of organ donation. RESULTS: We asked whether they were well-informed about organ donation; 50% did not feel well-informed. CONCLUSIONS: These data confirm the great lack of knowledge about organ donation in the southeastern anatolia region.

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BACKGROUND: Peripheral nerve injury may result in chronic neuropathic pain, which is characterized by spontaneous pain, hyperalgesia, and allodynia. Intrathecal administration of opioids and α2-adrenoceptor agonists produces spinal analgesia by activation of opioidergic and noradrenergic systems. In our study, we have compared the synergistic antiallodynic interaction and side-effects of intrathecal morphine and dexmedetomidine in a rat model of neuropathic pain. METHODS: Male Wistar rats, weighing 380-440 g, were treated with tight ligation of left L5-6 spinal nerves and a chronic catheter was implanted intrathecally. Morphine and dexmedetomidine were administered intrathecally to obtain the dose-response curves and the 50 % effective doses (ED50) for each drug and fractional analysis of the ED50 of each drug administered concurrently was performed to examine the interaction. Mechanical allodynia was measured by using application of von Frey filaments to the hindpaw. RESULTS: Intrathecal administration of morphine and dexmedetomidine alone and in combination resulted in a dose-dependent antiallodynic effect, and the combination produced a synergistic effect-state magnitude. Moreover, the incidence of side-effects was higher when morphine or dexmedetomidine were administered in high doses alone and extremely low when these two drugs were used in combination. These results are suggestive of a synergistic effect at lower doses of both drugs. CONCLUSIONS: These findings may provide a rationale for combining such drugs for the improvement of human postoperative or neuropathic pain treatment in the future.