Comparison of Intra-articular Hyaluronic Acid and Platelet-Rich Plasma Injection in Knee Osteoarthritis: Do the Results Differ in Geriatric Patients? A Retrospective Observational Study

Çağdaş Pamuk 대한노인병학회 2022 Annals of geriatric medicine and research Vol.26 No.4

Background: The intra-articular application of platelet-rich plasma and hyaluronic acid have gained popularity as treatment options for knee osteoarthritis. Although intra-articular platelet-rich plasma injections have been suggested to be superior to hyaluronic acid injections in the general population of patients with osteoarthritis, the effect of older age on both treatment options has not been thoroughly evaluated. Therefore, this study compared the results of platelet-rich plasma and hyaluronic acid injections in geriatric patients with knee osteoarthritis. Methods: This study evaluated a total of 226 patients treated with intra-articular injections for knee osteoarthritis. The patients were divided into two groups: those who received platelet-rich plasma and those who received hyaluronic acid. All patients attended follow-up appointments at the 1st, 3rd, and 6th months. Results: After applying the exclusion criteria, this study included 202 patients. The clinical results revealed significant improvements in all parameters compared to the baseline assessments in both groups (p<0.05). The inter-group comparisons indicated significantly lower pain in the hyaluronic acid recipients at the first and third months compared to those in patients receiving platelet-rich plasma (p<0.05). Conclusion: Intra-articular platelet-rich plasma and hyaluronic acid injections appear to be effective in patients with knee osteoarthritis. In the geriatric patient population, hyaluronic acid showed superior effects on pain compared to platelet-rich plasma, contrary to the results in the general population.

Association of Syntax Score II with Contrast-induced Nephropathy and Hemodialysis Requirement in Patients with ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Ibrahim Rencuzogullari,Metin Çağdaş,Süleyman Karakoyun,Yavuz Karabağ,Mahmut Yesin,Mustafa Ozan Gürsoy,İnanç Artaç,Doğan İliş,Süleyman Çağan Efe,Kevser Tural,Ibrahim Halil Tanboğa 대한심장학회 2018 Korean Circulation Journal Vol.48 No.1

Background and Objectives Contrast-induced nephropathy (CIN) is a common complication of primary percutaneous coronary intervention (pPCI) and is associated with high mortality and morbidity and long hospital stay in patients with ST elevation myocardial infarction (STEMI). The Syntax Score (SS) has previously been studied in STEMI patients, and it was associated with increased CIN development and long-term mortality. This study investigates a possible relationship between CIN development and Syntax Score II (SSII) and compares SS and SSII by assessing CIN risk in STEMI patients treated with pPCI. Methods A total of 1,234 patients who underwent pPCI were divided into 2 groups according to CIN development. Patients with CIN were further divided into 2 groups according to whether or not they required hemodialysis. Reclassification tables, net reclassification improvement, and integrated discriminative improvement methods were used to assess the additive predictive value of SSII for predicting CIN. Results In the present study, 166 patients (13.5%) had CIN. Although both SS and SSII were significantly higher in CIN patients, only SSII was an independent predictor of CIN (odds ratio [OR], 1.031; 95% confidence interval [CI], 1.012–1.051; p<0.001) and hemodialysis requirement (OR, 1.078; 95% CI, 1.046–1.078; p<0.001). When comparing SSII and SS in their ability to determine CIN risk, we found SSII to have a reclassification improvement of 27.59% (p<0.001) and an integrated discrimination improvement of 9.1% (p<0.001). Conclusions The combination of clinical and anatomic variables can more accurately identify patients who are at high risk for CIN after pPCI. While SSII is harder to calculate than SS, it provides better prediction for CIN and hemodialysis requirement than SS.

Efficiency of MVP ECG Risk Score for Prediction of Long-Term Atrial Fibrillation in Patients With ICD for Heart Failure With Reduced Ejection Fraction

Levent Pay,Ahmet Çağdaş Yumurtaş,Ozan Tezen,Tuğba Çetin,Semih Eren,Göksel Çinier,Mert İlker Hayıroğlu,Ahmet İlker Tekkeşin 대한심장학회 2023 Korean Circulation Journal Vol.53 No.9

Background and Objectives: The morphology-voltage-P-wave duration (MVP) electrocardiography (ECG) risk score is a newly defined scoring system that has recently been used for atrial fibrillation (AF) prediction. The aim of this study was to evaluate the ability of the MVP ECG risk score to predict AF in patients with an implantable cardioverter defibrillator (ICD) and heart failure with reduced ejection fraction in long-term follow-up. Methods: The study used a single-center, and retrospective design. The study included 328 patients who underwent ICD implantation in our hospital between January 2010 and April 2021, diagnosed with heart failure. The patients were divided into low, intermediate and high-risk categories according to the MVP ECG risk scores. The long-term development of atrial fibrillation was compared among these 3 groups. Results: The low-risk group included 191 patients, the intermediate-risk group 114 patients, and the high-risk group 23 patients. The long-term AF development rate was 12.0% in the low-risk group, 21.9% in the intermediate risk group, and 78.3% in the high-risk group. Patients in the high-risk group were found to have 5.2 times higher rates of long-term AF occurrence compared to low-risk group. Conclusions: The MVP ECG risk score, which is an inexpensive, simple and easily accessible tool, was found to be a significant predictor of the development of AF in the long-term follow-up of patients with an ICD with heart failure with reduced ejection fraction. This risk score may be used to identify patients who require close follow-up for development and management of AF.

Comparison of ultrasonography guided serratus anterior plane block and thoracic paravertebral block in video-assisted thoracoscopic surgery: a prospective randomized double-blind study

( Merve Sena Baytar ),( Canan Yılmaz ),( Derya Karasu ),( Çağdaş Baytar ) 대한통증학회 2021 The Korean Journal of Pain Vol.34 No.2

Background: Various truncal block techniques with ultrasonography (USG) are becoming widespread to reduce postoperative pain and opioid requirements in video-assisted thoracoscopic surgery (VATS). The primary aim of our study was to determine whether the USG-guided serratus anterior plane block (SAPB) is as effective as the thoracic paravertebral block (TPVB) in VATS. Our secondary aim was to evaluate patient and surgeon satisfaction, block application time, first analgesic time, and length of hospital stay. Methods: Patients in Group SAPB received 0.4 mL/kg bupivacaine with a USG-guided SAPB, and patients in Group TPVB received 0.4 mL/kg bupivacaine with a USG-guided TPVB. We recorded the pain scores, the timing of the first analgesic requirement, the amount of tramadol consumption, and postoperative complications for 24 hours. We also recorded the block application time and length of hospital stay. Results: A total of 62 patients, with 31 in each group (Group SAPB and Group TPVB) completed the study. Between the two groups, there were no significant differences in rest and dynamic pain visual analog scale scores at 0, 1, 6, 12, and 24 hours after surgery. The total consumption of tramadol was significantly lower in the TPVB group (P = 0.026). The block application time was significantly shorter in Group SAPB (P < 0.001). Conclusions: An SAPB that is applied safely and rapidly as a part of multimodal analgesia in patients who undergo VATS is not inferior to the TPVB and can be an alternative to it.

Expression of prostate-specific membrane antigen in the neovasculature of primary tumors and lymph node metastasis of laryngeal squamous cell carcinomas

Gamze Erkılınç,Hasan Yasan,Yusuf Çağdaş Kumbul,Mehmet Emre Sivrice,Meltem Durgun 대한병리학회 2022 Journal of Pathology and Translational Medicine Vol.56 No.3

Background: Prostate-specific membrane antigen (PSMA) expression is encountered in tumor-associated neovascularization. Methods: PSMA-antibody was applied to the paraffin blocks of 51 patients who were diagnosed with squamous cell carcinoma of the larynx and underwent laryngectomy and one who underwent lymph node dissection. The percentage of vascular expression in tumoral and extratumoral stroma and lymph nodes and intensity score in tumoral epithelium were evaluated and divided into groups according to the level of PSMA expression. Final PSMA expression was determined by multiplying intensity and percentage scores. Results: The mean age was 61 ± 10 years. Patients with perineural invasion, cartilage invasion, and local invasion exhibited higher PSMA expression scores. Age, tumor differentiation, tumor diameter, perineural invasion, tumor localization, capsular invasion, depth of invasion, surgical margin status, local invasion, nodal metastasis, TNM classification, and stage were similar in high and low PSMA expression groups. There was no PSMA expression in extratumoral vascular stroma. Significantly higher PSMA expression was observed in the vascular endothelium of metastatic lymph nodes compared with reactive lymph nodes. Patients with advanced-stage disease exhibited higher PSMA vascular expression scores compared to those with earlier stages (p < .001). PSMA expression was not correlated with overall survival, disease-specific survival, or disease-free survival (p > .05). Conclusions: Our study suggests that higher PSMA expression is associated with cartilage invasion, local invasion, and advanced-stage of disease. PSMA expression can be utilized for detection of lymph node metastasis and has some predictive role in cases of neck metastasis.