Original Research
Comparison of patellar height measurements using three different imaging modalities
Patellar height
Levent Karakaş, Tuna Demirbaş
Department of Radiology, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ECAM.10125 Received: 2025-06-12 Accepted: 2025-08-04 Published Online: 2025-08-31 Printed: 2025-09-01
Abstract
Aim: To evaluate whether the universally accepted normal ranges of patellar height ratios established on radiographs using the Insall-Salvati (IS) and Blackburne-Peel (BP) methods can be reliably applied to computed tomography (CT) and magnetic resonance imaging (MRI) assessments.
Materials and Methods: A total of 90 knees from 84 patients (30 men, 54 women; age range, 18–68 years; mean age, 40 ± 19 years) who underwent three different imaging modalities, radiography (X-ray), CT, and MRI, were included in the study. Knee imaging had been performed for various clinical indications. Patellar height measurements were conducted by two independent observers, each blinded to the other’s measurements and the corresponding measurements from the other imaging modalities.
Results: There were small but statistically significant differences in patellar height ratios among X-ray, CT, and MRI. To achieve comparable results with the IS method, an adjustment of +0.12 for MRI and +0.09 for CT is required relative to X-ray measurements. For the BP ratio, a correction of +0.08 is needed when comparing MRI to X-ray, whereas no adjustment is necessary between X-ray and CT. Notably, these adjustments were found to be independent of patient gender. Inter-observer reproducibility was excellent across all imaging modalities for both the IS and BP methods, with intraclass correlation coefficients (ICC) ≥ 0.92.
Discussion: While radiographic thresholds for patella alta and baja require slight adjustments when applied to CT and MRI, patellar height measurements remain highly reproducible across all imaging modalities.
Keywords: computed tomography, imaging modality, insall–salvati ratios, magnetic resonance imaging, patella, radiograph
Corresponding Author: Levent Karakaş, Department of Radiology, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey. • E-Mail: drleventkarakas@hotmail.com • P: +90 507 260 86 70 • Corresponding Author ORCID ID: https://orcid.org/0000-0001-5485-9337
Other Authors ORCID ID: Tuna Demi̇rbaş, https://orcid.org/0000-0003-0934-2640
This study was approved by the Ethics Committee of Gaziosmanpaşa Training and Research Hospital (Date: 2022-10-05, No:129)
How to cite this article: Levent Karakaş, Tuna Demirbaş. Comparison of patellar height measurements using three different imaging modalities. Eu Clin Anal Med 2025;13(3):56-60
This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of the license, visit https://creativecommons.org/licenses/by-nc/4.0/
The effect of written information before undescended testicle surgery on parental anxiety
Written education and parental anxiety
Mustafa Tuşat 1, Sevilay Taburoğlu 2
1 Department of Pediatric Surgery, 2 Department of Pediatrics, Faculty of Medicine, Aksaray University, Aksaray, Turkey
DOI: 10.4328/ECAM.10126 Received: 2025-07-07 Accepted: 2025-08-07 Published Online: 2025-08-25 Printed: 2025-09-01
Abstract
Aim: Preoperative parental anxiety is commonly observed and is associated with adverse outcomes in children during the perioperative period. This study aims to evaluate the effect of written informational material provided to the parents of children undergoing surgery for undescended testis on their anxiety levels concerning the anomaly and the perioperative process.
Materials and Methods: In this study, the parents of children scheduled for surgery due to undescended testis were consecutively assigned to Group 1 and Group 2. While Group 1 received verbal information only, the parents in Group 2 were given both verbal information and a written brochure. The parents were asked to complete an information form and the State-Trait Anxiety Inventory-1 (STAI-1) to assess state anxiety. The same STAI-1 was readministered to the same parent three hours postoperatively.
Results: The postoperative STAI-1 anxiety scores were significantly lower in Group 2, where written information was provided (p < 0.001). Among parents in Group 2, postoperative STAI-1 scores were significantly lower in those with a university degree (p < 0.001), those residing in urban areas (p = 0.007), and those with prior surgical experience (p = 0.003).
Discussion: The written informational brochure was found to be an effective means of communication tool in reducing anxiety among parents of children undergoing surgery for undescended testis. It is recommended that this approach be more widely adopted in pediatric surgical practice.
Keywords: undescended testis, parental anxiety, children, state-trait anxiety inventory
Corresponding Author: Mustafa Tuşat, Department of Pediatric Surgery, Faculty of Medicine, Aksaray University, Aksaray, Turkey. • E-Mail: mustafatusat42@hotmail.com • P: +90 382 502 20 25 • Corresponding Author ORCID ID: https://orcid.org/0000-0003-2327-4250
Other Authors ORCID ID: Sevilay Taburoğlu, https://orcid.org/0000-0001-9469-4936
This study was approved by the Ethics Committee of Aksaray University Health Sciences Scientific Research (Date: 2024-05-23, No:2024/035)
How to cite this article: Mustafa Tuşat, Sevilay Taburoğlu. The effect of written information before undescended testicle surgery on parental anxiety. Eu Clin Anal Med 2025;13(3):61-65
Evaluation of the accuracy and quality of YouTube videos as an information source on septic arthritis
Accuracy and quality of YouTube videos on septic arthritis
Muhammed Enes Karatas 1, Betül Yıldız Karatas 2
1 Department of Orthopaedics and Traumatology, Istanbul Medeniyet University, 2 Department of Infectious Diseases and Clinical Microbiology, Istanbul Sureyyapasa Chest Diseases Training and Research Hospital, Istanbul, Turkiye
DOI: 10.4328/ECAM.10127 Received: 2025-07-08 Accepted: 2025-08-08 Published Online: 2025-08-30 Printed: 2025-09-01
Abstract
Aim: Septic arthritis is a time-sensitive surgical emergency with high morbidity and mortality if not promptly managed. As patients increasingly turn to online platforms such as YouTube for health information, the quality and reliability of such content warrant investigation, and this study assessed the educational quality of YouTube videos on septic arthritis using the DISCERN instrument, Global Quality Score (GQS), Journal of the American Medical Association (JAMA) Benchmark Criteria, and Video Power Index (VPI).
Materials and Methods: A YouTube search was conducted in July 2025 using the keyword “septic arthritis.” Fifty English-language videos longer than 60 seconds were evaluated. Two independent reviewers—a board-certified orthopedic surgeon and an infectious disease/microbiology specialist—assessed each video using the tools above. Statistical analyses included Kruskal-Wallis, Mann-Whitney U, and Spearman correlation tests.
Results: The videos garnered 3,362,470 total views (mean per video: 67,249). Only 1 out of 50 videos (2%) achieved an excellent DISCERN score, while 35 out of 50 videos (70%) were rated very poor. GQS analysis showed 86% of videos as poor or very poor, with none rated excellent. Physician-uploaded videos had significantly higher DISCERN (median 46.8), GQS (median 4.2), and JAMA scores (median 3.1) compared to commercial and patient-uploaded content (p<0.001). VPI scores did not differ significantly between uploader types. Interobserver agreement was strong, with Krippendorff’s alpha values ranging from 0.78 to 0.86 across the scoring tools.
Discussion: Most YouTube videos on septic arthritis provide suboptimal educational value, particularly those from non-professional sources. Greater involvement by healthcare professionals in digital content creation is critical to combat misinformation.
Keywords: septic arthritis, YouTube, DISCERN, JAMA benchmark, patient education
Corresponding Author: Muhammed Enes Karataş, Department of Orthopaedics and Traumatology, Istanbul Medeniyet University, Istanbul, Turkiye. • E-Mail: menskrts@hotmail.com • P: +90 543 842 19 92 • Corresponding Author ORCID ID: https://orcid.org/0000-0003-0995-0953
Other Authors ORCID ID: Betül Yıldız Karatas, https://orcid.org/0009-0002-1756-7022
How to cite this article: Muhammed Enes Karatas, Betül Yıldız Karatas. Evaluation of the accuracy and quality of YouTube videos as an information source on septic arthritis. Eu Clin Anal Med 2025;13(3):66-69
Efficacy and safety of different doses of remifentanil for monitored anesthetic care during transurethral resection
Remifentanil treatment in transurethral resection
Aziz Yarbil 1, Rauf Gul 2, Vahap Saricicek 3, Levent Sahin 4, Metin Kilinc 5, Ergun Mendes 6, Huseyin Gocergil 1, Muharrem Baturu 7
1 Department of Anesthesiology and Reanimation, Ministry of Health Kilis State Hospital, Kilis, Turkey, 2 Department of Anesthesiology and Reanimation, Faculty of Medicine, Gaziantep University, Sahinbey Research and Application Hospital, Gaziantep, Turkey, 3 Department of Anesthesiology and Reanimation, Gaziantep Private Medical Point Hospital, Gaziantep, Turkey, 4 Department of Anesthesiology and Pain Medicine, University of Washington, Harborview Medical Center, Seattle WA, USA, 5 Department of Anesthesiology and Reanimation, Ministry of Health Mardin Training and Research Hospital, Mardin, Turkey, 6 Department of Anesthesiology and Reanimation, Basaksehir Çam Sakura Training and Research Hospital, Istanbul, Turkey, 7 Department of Urology, Faculty of Medicine, Gaziantep University, Sahinbey Research and Application Hospital, Gaziantep, Turkey
DOI: 10.4328/ECAM.10130 Received: 2025-08-13 Accepted: 2025-08-31 Published Online: 2025-08-31 Printed: 2025-09-01
Abstract
Aim: We aimed to investigate the efficacy and safety of transurethral resection (TUR) under monitored anesthetic care (MAC) and the effective dose of remifentanil.
Material and Methods: In this prospective, randomized, controlled trial, 50 patients were randomized to undergo TUR under monitored anesthetic care MAC. Vital signs were recorded at baseline and at 1, 5, 10, 15, 20, 30, 40, 50, and 60 minutes after induction. During induction, all patients received propofol at 1 mg/kg/h and remifentanil at 0.25 µg/kg/h. Following induction, Group 1 received a remifentanil infusion at 3 µg/kg/h, and Group 2 received 6 µg/kg/h. The depth of anesthesia was monitored using bispectral index (BIS) monitoring. Intraoperative and postoperative side effects, surgeon satisfaction, propofol consumption (PC), and recovery time were also recorded.
Results: In our study, effective sedation and analgesia were achieved in both groups. However, intraoperative depth of anesthesia (p = 0.03), postoperative recovery time (p = 0.017), and surgeon satisfaction (p = 0.019) were better in Group 2. Hemodynamic and side effects were similar between the groups (p > 0.05). No adverse events were observed in any patient that would negatively affect the surgical procedure. SpO₂ values were transiently lower in Group 1 at 1, 5, and 15 minutes, but these differences were not statistically significant. BIS scores in group 2 were statistically lower than group 1 at all measurement times (p = 0.02). Group 2 demonstrated significantly shorter awakening and recovery times.
Discussion: We think that TUR procedures using both remifentanil doses can be preferred under MAC. Both regimens were safe and effective; however, Group 2 demonstrated better hemodynamic stability, deeper sedation, higher surgeon satisfaction, and faster recovery.
Keywords: bispectral index, monitored anesthetic care, propofol, remifentanil, transurethral resection
Corresponding Author: Rauf Gul, Department of Anesthesiology and Reanimation, Faculty of Medicine, Gaziantep University, Sahinbey Research and Application Hospital, Gaziantep, Turkey. • E-Mail: drraufgul@gmail.com • P: +90 532 5958 465 • Corresponding Author ORCID ID: https://orcid.org/0000-0001-7739-902X
Other Authors ORCID ID: Aziz Yarbil, https://orcid.org/0000-0001-7303-156X . Vahap Saricicek, https://orcid.org/0000-0001-9403-1024 . Levent Sahin, https://orcid.org/0000-0003-4729-3931 . Metin Kilinc, https://orcid.org/0000-0002-1813-1274 . Ergun Mendes, https://orcid.org/0000-0003-4350-6055 . Huseyin Gocergil, https://orcid.org/0000-0001-5265-6405 . Muharrem Baturu, https://orcid.org/0000-0003-0618-8393
This study was approved by the Ethics Committee of Gaziantep University (Date: 2013-09-17, No: 17.09.2013/323)
How to cite this article: Aziz Yarbil, Rauf Gul, Vahap Saricicek, Levent Sahin, Metin Kilinc, Ergun Mendes, Huseyin Gocergil, Muharrem Baturu. Efficacy and safety of different doses of remifentanil for monitored anesthetic care during transurethral resection. Eu Clin Anal Med 2025;13(3):70-74