PubMed Health⌕ Search

Biomedical subjects

Berna Goker

Publications and source records attributed to Berna Goker.

8 recordsLinked to original sources
PubMed2005

Risk of contralateral avascular necrosis (AVN) after total hip arthroplasty (THA) for non-traumatic AVN.

The risk of developing bilateral disease progressing to total hip arthroplasty (THA) among patients who undergo unilateral THA for non-traumatic avascular necrosis (AVN) remains poorly understood. An analysis of the time-course to contralateral THA, as well as the effects of underlying AVN risk factors, is presented. Forty-seven consecutive patients who underwent THA for AVN were evaluated. Peri-operative and annual post-operative antero-posterior pelvis radiographs were examined for evidence of contralateral involvement. Patient age, weight, height, underlying AVN risk factor(s), date of onset of contralateral hip pain if occurred, and date of contralateral THA if performed, were recorded. Bone scan, computerized tomography and magnetic resonance imaging data were utilized when available. Twenty-one patients (46.6%) underwent contralateral THA for AVN within a median of 9 months after the initial THA (range 0-93, interquartile range 28.5 months). The median follow-up for patients without contralateral THA was 75 months (range 3-109, interquartile range 69 months). Thirty-four patients had radiographic findings of contralateral AVN at study entry; 25 were symptomatic bilaterally at entry and 7 developed contralateral symptoms within a mean time of 12 months (median 10 months, interquartile range 12 months). None of the 13 patients who were free of radiographic evidence of contralateral AVN at study entry developed evidence of AVN during the follow-up. AVN associated with glucocorticoid use was more likely to manifest as bilateral disease than either idiopathic AVN or ethanol-associated AVN (P=0.02 and P=0.03 respectively). Radiographically-evident AVN in the contralateral hip at THA is unlikely to remain asymptomatic for a prolonged period of time. Conversely, asymptomatic contralateral hips without radiographic evidence of AVN are unlikely to develop clinically significant AVN.

Adult↗
PubMed2005

The effects of minor hip flexion, abduction or adduction and x-ray beam angle on the radiographic joint space width of the hip.

OBJECTIVE: Joint pain may cause patients to hold their limbs in mild flexion, abduction or adduction to minimize pain, regardless of the extent of articular pathology, and these positional changes may have substantial effects on the interpretation of radiographic joint space. We aimed to study the impacts of minor degrees of flexion, abduction or adduction of the hip, as well as the angle of the x-ray beam on the radiographic joint space width (JSW) of the hip joint. METHODS: In the first part of the study, 65 patients (44 males, 21 females, mean+/-SD age 49+/-17) without clinical evidence of hip osteoarthritis (OA) who underwent intravenous pyelography (IVP) were studied. The hips were differentially positioned during the sequential radiographs required for the IVP procedure. Baseline radiographs were taken at 15 degrees internal rotation of the hips [the standard position for anteroposterior (AP) pelvis radiography]; additional positions included the hips at 15 degrees and/or 30 degrees flexion, and 15 degrees adduction and/or 30 degrees abduction. Radiographic JSWs were measured at three sites using a dial caliper: superomedial, superolateral, and the point of narrowest JSW. In the second part, 15 patients without clinical evidence of hip OA who underwent supine abdominal radiography for non-rheumatological indications were evaluated by standard (AP) pelvis x-ray in the same setting and JSW measurements were made as described above. RESULTS: When the average of the three measurements of the JSW was taken for each hip, baseline JSW was 4.38+/-0.55 mm (mean+/-SD). Positioning of the hip significantly (P<0.01) affected the radiographic JSW, with apparent widening during adduction and 30 degrees flexion, (JSW 4.56+/-0.51 mm and 4.53+/-0.58 mm, mean+/-SD), respectively, but narrowing during abduction (4.17+/-0.59 mm, mean+/-SD). Fifteen degree flexion of the hip did not result in statistically significant change in JSW measurements. Upon comparison of the AP pelvis view with the supine abdominal view, neither the average JSW nor the point of narrowest JSW differed significantly, although the superolateral JSW was significantly greater on the AP pelvis view (P=0.02). CONCLUSIONS: Subtle positional changes in the hip, such as may occur during pain or in OA, may artifactually alter the measured radiographic JSW. Thus, longitudinal studies which employ hip JSW to assess disease progression may yield biased results due to changes in pain rather than structure unless care is taken to ensure constant positioning of the hip.

Adult↗
PubMed2004

Radiographic hip osteoarthritis and acetabular dysplasia in Turkish men and women.

The prevalence of hip osteoarthritis (OA) varies with different regions, and the reasons for this remain unclear. Mild acetabular dysplasia has been considered a risk factor for hip OA, but recent studies have not confirmed this. In Turkey, the prevalence of significant radiographic hip OA, i.e. Kellgren-Lawrence (K-L) grades 3 and 4, is lower than in Western populations. We aimed to investigate the potential effects of radiographic measures of acetabular dysplasia on this discrepancy. Ninety-two Turkish patients (65 males, 27 females) aged 55 and over were studied. Plain supine abdominal radiographs and intravenous pyelographs were evaluated. Centre-edge (CE) angle and acetabular depth (AD) of each hip were measured, and K-L grading was done. The mean CE angles +/- SD of right and left hips were 34+/-7 degrees and 35+/-7 degrees (range 14-52 and 18-50), respectively. The mean AD+/-SD of right and left hips was 13.7+/-3.4 and 13.6+/-3.4 (range 6-23 and 8-25), respectively. Mean CE angle or acetabular depth of the hips with K-L grade 2 did not differ from those with grades 0 and 1. There was no patient with grade 3 or 4. The prevalence of acetabular dysplasia based on a CE angle of <25 degrees was 9.8% in both right and left hips. When it was defined as having an AD of <9 mm, the prevalence was 4.3% and 1.1% in the right and left hips, respectively. Overall, 10.4% of the hips (13% of the men and 3.7% of the women) had acetabular dysplasia based on at least one of these measurements. Mild acetabular dysplasia appears to be relatively common among Turks aged 55 and over. However, it does not seem to play a major role in the development of radiographic hip OA.

Acetabulum↗
PubMedDate not supplied

Current therapy for Behçet's disease.

Classified among the vasculitides, the clinical spectrum of Behçet's disease (BD) ranges from a mild mucocutaneous disease to a life-threatening systemic vasculitis, characterized by remissions and recurrences. The major morbidity is recurrent eye inflammation that may lead to blindness, but severe central nervous system, gastrointestinal, or vascular involvement may occur and might be fatal. In contradistinction to most other vasculitides, the venous system is commonly affected in BD. The treatment of BD is usually symptomatic and palliative. This includes topical steroids for orogenital ulcers, nonsteroidal antiinflammatory agents for joint involvement, and colchicine as prophylaxis against disease flares (although evidence that colchicine prevents recurrences of oral and genital ulcers is restricted to female patients). Immunosuppressives and cytotoxic agents are used for more severe involvement, and thalidomide and interferon have attracted attention in recent years.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Polymyositis and hepatitis concurrent with breast cancer.

OBJECTIVE: To present a rare case of breast cancer associated with both inflammatory muscle disease and liver disease as a paraneoplastic syndrome. CLINICAL PRESENTATION AND INTERVENTION: A woman with breast cancer presented with elevated liver enzymes and progressive proximal muscle weakness. Liver biopsy was consistent with hepatitis and muscle biopsy revealed myositis. The start of corticosteroid therapy was followed by relief of the myopathic symptoms and regression of hepatitis histopathologically. CONCLUSION: A case of polymyositis and hepatitis associated with breast cancer and their flare-up with recurrence of malignancy is presented. In this case, the temporal relation with malignancy following its concurrent remission and relapse suggests a paraneoplastic mechanism.

Autopsy↗