Aim: To investigate the pubertal development of Turkish school children, to look for possible secular trends in pubertal development. Methods: 1,562 girls and 1,749 boys (aged 6-16.5 years) from urban and rural schools were studied. Weight and height were measured and body mass index was calculated. Pubertal stages were assessed according to Tanner. Testicular volume was determined using an orchidometer. Menarcheal age was recorded. Results: In girls, mean ages at breast stage (B) were 7.74 ± 1.08 years for Bl, 10.16 ± 0.97 for B2, 11.72 ± 1.29 for B3, 12.97 ± 1.17 for B4, and 13.66 ± 0.89 for B5. Mean ages at pubic hair stage (PH) were 8.72 ± 1.50 years for PHI, 10.57 ± 1.39 for PH2, 12.12 ± 1.10 for PH3, 13.10 ± I.04 for PH4, and 13.87 ± 0.83 for PH5. Mean age at menarche was 12.41 years. Menarcheal age was earlier in overweight and obese children compared with that in normal children. In boys, mean ages at each maturity stage according to testis volume (G) were 8.70 ± 1.38 years for Gl, II.76 ± 1.28 for G2, 12.81 ± 1.0 for G3, 13.17 ± 0.87 for G4, and 13.87 ± 0.98 for G5. Mean ages at PH in boys were 9.39 ± 1.81 years for PHI, 12.02 ± 1.33 for PH2, 13.05 ± 0.88 for PH3, 13.42 ± 0.87 for PH4, and 14.02 ± 0.92 for PH5. Conclusions:The current study provides an upto-date reference of normal sexual maturation of Turkish children. While the mean age at onset of puberty in boys was comparable to that of other populations in the world, girls were found

p < 0.001) as an independent determinant of AVS. Conclusions: Detection of increased arterial stiffness could prevent patients from being mistakenly classified as at low or moderate risk, when they actually are at high risk. Assessment of aortic valve during echocardiography examination may offer the opportunity to identify these subjects. (Cardiol J 2013; 20, 3: 318-322)

Most patients with peripheral arterial disease (PAD) are asymptomatic and have similar vascular morbidity and mortality with patients with symptomatic PAD. Despite being a very highly prevalent disease, physicians underdiagnose and undertreat PAD. A total of 100 participants with aortic valve sclerosis (AVS) and 100 participants without AVS and age-, gender-, and cardiovascular risk factor-matched participants were enrolled. Ankle-brachial index (ABI) and AVS were evaluated by handheld Doppler device and echocardiography, respectively. There was significantly lower ABI in participants with AVS compared with those without AVS (1.04 ± 0.14 v 1.11 ± 0.07, P = .001). There was a negative correlation between ABI and AVS (r = -.29, P < .001). Linear regression analysis demonstrated an independent association between ABI and AVS (95% confidence interval [CI]: -0.91 to -0.27, P < .001) and β-blocker use (95% CI: -0.96 to -0.02, P: .04). Our findings confirm an association between AVS and PAD that may be attributed to shared vascular risk factors.

Amaç: Postoperatif kusma genel anestezi sonrasında en sık karşıla-şılan problemlerden biridir. Etiyolojide pek çok faktörün tek başı-na veya birlikte etkili olduğu bilinmektedir. Akupunktur, Dünya Sağlık Örgütünün tamamlayıcı tedavi metodu olarak kabul ettiği bir medikal tekniktir. Burada çocuk hastalarda adenoidektomi ve/ veya tonsillektomi sonrasında görülen kusmanın tedavisi amacıyla Akupunktur deneyimimiz sunulmaktadır.Yöntemler: Çalışmaya genel anestezi altında adenoidektomi ve/ veya tonsillektomi uygulanan, 2-14 yaş arasında, ASA I-II, (n=70) hastalar dahil edildi. Hastalar çalışma ve kontrol grubu olarak, rastgele iki gruba ayrıldılar. Çalışma grubunda, akupunktur iğnesi intraoperatif dönemde 20 dakika P6 noktasında uygulandı. Gruplara postoperatif dönemde antiemetik herhangi bir tedavi verilmedi. Hastalar postoperatif dönemde grupları bilmeyen hemşireler tarafında takip edildi. Bulgular: Yaş, cinsiyet, girişim türü, anestezi süresi, girişim süresi, cerrahi uygulama ve ASA skorları göz önüne alındığında gruplar arasında istatistiksel olarak anlamlı farklılık saptanmadı. Grupların kusma sayıları karşılaştırıldığında ise anlamlı farklılık olduğu saptandı. Akupunktur uygulanan grupta kusma sıklığının diğer gruba göre 0,28 kat daha az olduğu görüldü.Sonuç: Çalışmamızın sonuçları, akupunktur uygulamasının postoperatif kusmayı azaltmada açık bir etkinliği olduğunu gös-termektedir. Akupunkturun rutin kullanımı postoperatif hasta konforuna katkıda bulunmanın yanısıra tedavi veya profilaksi amacıyla ilaç kullanımını azaltacaktır.Anahtar kelimeler: Akupunktur, postoperatif kusma, adenoidektomi, tonsillektomi Objective: Postoperative vomiting (POV) is one of the most common problems following general anaesthesia, and many factors, either solely or in combination, may play a role in aetiology. Acupuncture is a technique that the World Health Organization has accepted as a complementary treatment. This study presents our experience with acupuncture for POV treatment in a study of paediatric tonsillectomy cases. Methods:The study included ASA I-II patients (n=70) aged 2-14 years who underwent tonsillectomy and/or adenoidectomy under general anaesthesia. The patients were randomly divided into the following two groups: control and study group. In the study group, an acupuncture needle was intraoperatively applied to the P6 acupuncture point for 20 min. Antiemetics were not administered to either group because of the standard applications in the preoperative period. The patients were postoperatively evaluated by nurses who were unaware about the techniques used in either group.Results: No statistically significant difference was determined between the groups with regard to age, sex, nature of the operation, duration of anaesthesia, duration of the operation, surgical method and ASA scores. A statistically significant difference was determined between the groups with respect to vomiting rates. The acupuncture group presented with 0.28-times fewer vomiting episodes than the control group. Conclusion:The results of the stud...

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Objective: The aim of this study was to investigate the association between earlobe crease (ELC) and cardio-ankle vascular index (CAVI) in asymptomatic hypertensive subjects. Materials and Methods: A total of 75 subjects with ELC and 75 age- and gender-matched patients without ELC were prospectively selected from subjects admitted to the Outpatient Cardiology Clinic. ELC was assigned to a person with a crease stretching obliquely from the outer ear canal towards the border of the earlobe of at least one ear. CAVI was assessed by a VaSera VS-1000 instrument. Results: There were statistically significant higher CAVI values in ELC subjects (9.8 ± 2.1 vs. 8.6 ± 1.6, p < 0.001). There was a significant and positive association between CAVI and age (r = 0.42, p < 0.001), ELC (r = 0.31, p < 0.001), BMI (0.20, p < 0.001) and male gender (r = 0.21, p = 0.04). Linear regression analysis demonstrated ELC (95% confidence interval, CI, 0.61-1.74, p = 0.009), age (95% CI 0.03-0.09, p < 0.001) and male gender (95% CI 0.48-1.55, p = 0.03) as independent determinants of CAVI. Also, there was a higher prevalence of ELC in subjects with subclinical atherosclerosis (CAVI ≥9) than in normal subjects (CAVI <9). Conclusion: Patients with ELC had higher CAVI than normal subjects. This observation of ELC is simple, adds no cost and can be easily made by most physicians, and it may provide important predictive information of arterial stiffness and subclinical atherosclerosis in asymptomatic hypertensive subjects.

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A previously healthy 38-year-old man presented to our hospital with sudden-onset dyspnea, sharp, stabbing chest pain, and a clinical picture of cardiogenic shock. Echocardiography revealed a severely dilated ascending aorta beyond the sinotubular junction (A, Online Video 1), with moderate aortic insufficiency (Online Video 2). There was a large pericardial effusion with thrombus inside (Online Videos 1 and 3). Computed tomographic angiography was performed, with a presumptive diagnosis of aortic dissection with rupture into the pericardium, and demonstrated a dilated ascending aorta 100 mm in diameter (B, C) compressing the right atrium, with no visible intimal tear or flap.The patient underwent an emergent Benthall procedure. Intraoperatively, no intimal tear or dissection was noted. Pathology revealed predominantly lymphoplasmacytic inflammatory cell infiltrates around the vaso vasorum of the adventitia (D) in the resected aortic segment, suggesting that tamponade resulted from tearing of the adventitial vessels. Blood work was positive for Treponema pallidum hemagglutination antibody. A diagnosis of tertiary syphilis complicated by aortic aneurysm was made.