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Cyanide ingestion
No full textCyanide is one of the oldest poisons. It has recently been introduced into industrial use in the gold enrichment process in gold mines. A 36-year-old man engaged in silver polishing business was brought to our emergency department by his colleagues with impaired consciousness and foamy saliva expectoration after accidentally drinking a sip of water mixed cyanide used for silver polishing. His general status was poor, and he was unconscious upon admission. The patient was administered the antidote three hours after his admission and extubated 11 hours after admission. His vital signs gradually returned to normal. On follow-up his urine color turned red; therefore, a second consultation was made with the poison information center, which recommended administering a second dose of antidote. After doing so, the patient gradually recovered, and he was discharged with normal liver enzymes, normal consciousness, and good overall status on 4th day of admission
The Efficacy of Flow Diverter Stents in the Treatment of Wide-Necked Intracranial Aneurysms
No full textBackground: To present our findings obtained from the treatment of wide-necked intracranial neurysms with flow diverter stents.
Patients and Methods: Intracranial aneurysms were determined in 19 patients (14 females, 5 males; mean age, 56.6 years) between May 2011 and June 2014, and the patients were treated using flow diverter stents. A total of 28 flow diverter stents, including 9 Silk and 19 Pipeline stents were used. Occlusion rates evaluated with computed tomography at the end of month 6 and digital subtraction angiography after one year, intraoperative success, morbidity and mortality rates were determined.
Results: A total of 20 endovascular interventions, including two interventions in two different aneurysms in one patient were performed in 19 patients. Flow diverter stents were successfully implemented for wide-necked aneurysms at a success rate of 100%. Coil treatment had previously been performed in four patients. Aneurysm occlusion rates were 77.2% at month 6 and 90.9% at the end of month 12.
Conclusion: The use of flow diverter stents is a reliable and effective method in the treatment of wide-necked intracranial aneurysms with high aneurysm occlusion, and low morbidity and mortality rates
Heart-type fatty acid binding protein levels in elderly diabetics without known cardiovascular disease
No full textBackground: Cardiovascular disease (CVD) is reported to be higher in elderly diabetics. Serum heart-type fatty acid binding protein (H-FABP) is a serum marker of myocardial ischemia. We aimed to investigate the association between serum H-FABP level and conventional cardiovascular risk factors, inflammatory markers and subclinical atherosclerosis in elderly diabetics without overt CVD. Patients and methods: A total of 50 elderly diabetic patients without overt CVD and 30 age-, sex- and body mass index (BMI)-matched healthy controls were enrolled. Anthropometric and biochemical parameters, serum H-FABP, high-sensitivity C-reactive protein (hs-CRP), fibrinogen and carotid intima-media thickness (CIMT) were measured. Logistic regression analyses (adjustments for age, sex, hypertension, smoking, diabetes, BMI, blood pressure, lipid, blood glucose, hemoglobin A1c, hs-CRP and fibrinogen) were performed to evaluate the association between H-FABP and cardiovascular risk factors and atherosclerosis indices. Results: Serum fibrinogen (421.50±85.52 mg/dL vs 319.17±30.77 mg/dL, p=0.023), CIMT (0.70±0.12 mm vs 0.59±0.06 mm, p<0.001) and hs-CRP (5.72±4.50 mg/dL vs 1.60±0.72 mg/dL, p<0.001) were significantly higher in diabetic patients than controls. The mean serum H-FABP level did not differ between groups (1571.79±604.60 ng/mL vs 1500.25±463.35 ng/mL, p=0.905). H-FABP was positively correlated with fibrinogen (r2=0.473, p<0.001), hs-CRP (r2=0.323, p=0.003) and CIMT (r2=0.467, p<0.001). After full adjustments, the serum H-FABP level was independently associated with an increase in the fibrinogen level (odds ratio [OR] =4.21, 95% confidence level [CI] =1.49-11.90). Conclusion: Serum H-FABP was similar in the elderly diabetic patients without known CVD when compared with the nondiabetic control group. H-FABP does not possess a high diagnostic value as a cardiovascular marker when used alone; however, it may add supplementary information in patients with a high fibrinogen level. © 2017 Beysel et al
Extraction Orthodontic Treatment in an Autistic Patient
No full textAutism is a condition that restricts brain development. Early diagnostic criteria are as follows: less responsive to social stimuli, inability to develop natural speaking skills, lack of communication skills, and limited and repetitive behaviors. Orthodontic treatment is a challenging process for doctors in autistic patients. The clinical and cephalometric examination of a 17-year and 7-month-old autistic patient revealed class I malocclusion, increased vertical dimensions, proclined upper and lower incisors, and inconsistent lip closure. The treatment plan involved four premolar extractions from each quadrant. Upper and lower 1. premolar extraction with fixed treatment caused reduction in vertical dimensions and significant improvement in lip closure and incisor inclination. Due to the increased metabolic activity in these patients, treatment was completed in 13 months. As a result, autistic patients can be successfully treated. In this process, it is important to include communication as a major part of treatment
A Rare Diagnosis in the Neck During Childhood: Congenital Chondrolipoma
No full textChondrolipomas are mesenchymal tumors that found as mature cartilage tissue in a fat tissue. A 2-year-old boy was seen with a complaint of a mass of the neck. On physical examination of the child, there was a one-centimeter mass above the sternocleidomastoid muscle on the lateral neck. Pathological examination of this mass after excision was reported as chondrolipoma. Chondrolipomas are seen mostly in the breast and in the adult. They are rare tumors of the head and neck area and seen mostly the in oral cavity here. This is the first case of chondrolipoma with this age and localization combination in the literature. Chondrolipoma should therefore also be considered in the differential diagnosis of congenital masses located at lateral cervical area
The use of flexible laryngeal mask airway for Adenoidectomies: An experience of 814 Paediatric patients
No full textObjective: To assess flexible laryngeal mask airway (F-LMA) use during pediatric adenoidectomies in terms of patient safety, comfort, complication rates and surgeon satisfaction levels.
Methods: Patients who had undergone an elective adenoidectomy after receiving general anesthesia using F-LMA from June 2012 to November 2015 were included. Patients' demographics and the incidence of perioperative complications were investigated. The surgeon's satisfaction level was also evaluated by questionnaire.
Results: Eight hundred fourteen patient were included in the study. Conversion from F-LMA to an endotracheal tube was carried out in two patients (0.2%). Airway complications were identified in two patients. The mean duration of stay in the postoperative anesthesia care unit was 17 minutes. All patients were discharged the same day. According to the otolaryngologists F-LMA applications provide a significant reduction in the processing time (100%), postoperative patient comfort is better than when using endotracheal intubation (83.3%) and the consensus was that there should be a complete continuation of the use of the F-LMA (100%) in subsequent adenoidectomies.
Conclusion: Our data show that the use of F-LMA for pediatric adenoidectomies has well tolerability profile and resulted in a lower incidence of complications. We think that the use of F-LMA for pediatric adenoidectomy is safer, simpler and speeder method
Usage of Analgesics among Young Girls and Dysmenorrhea
No full textObjective: This study aimed to determine dysmenorrhea prevalence and menstruation characteristics among young girls and whether dysmenorrhea affects the use of analgesics.
Methods: This cross-sectional study was conducted in female university students who applied to Baskent University's Medicosocial Center.
Results: There were 190 participants in the dysmenorrhea group and 80 participants in the control group. The prevalence of dysmenorrhea was 70%. Reading of the drug prospectus in the dysmenorrhea group was higher than in the control group (69.9% vs. 46.8%, p < 0.05). Recommending her own drug to someone else (67.8% versus 53.3%, p < 0.05) and not paying attention to the recommended drug use period (72.5% vs. 59.7%; p < 0.05) was higher in the dysmenorrhea group than in the control group. In the dysmenorrhea group, the reasons to take the last pain relievers were headache or abdominal pain in the same order as the control group and the rate of abdominal pain was higher in the study group (30.0% versus 11.5%, p < 0.05). The inability to remember the name of the last used pain reliever was higher in the study group (24.2% versus 17.5%, p < 0.05). The rate of knowing the name of any three different pain relievers was higher in the study group (81.6% versus 80.4%, p < 0.05).
Conclusion: University students who are in need of medication due to diseases more frequently encounter drugs. Developing behaviors on rational drug use in these students may provide productive results. It may be effective to organize contact meetings for students on the use of non-prescription drugs
The role of predicted spermidine family transporters in stress response and cell cycle in Schizosaccharomyces pombe
No full textFission yeast Schizosaccharomyces pombe has a variety of stress-signaling proteins that protect cells against environmental or intracellular stress. These proteins help the cells to respond to stress conditions and regulate intracellular functions such as cell division or gene expression. Polyamines (spermidine, spermine, and putrescine) are known to be important in the regulation of stress response and cell division. In this study, we tried to experimentally characterize novel S. pombe genes that are involved in the polyamine pathway and understand their potential roles. Sequence analysis revealed four genes that code for (predicted) spermidine family transporters in S. pombe. In an attempt to characterize these (predicted) spermidine family transmembrane transporters and their possible roles, deletion mutants of these candidate genes were created. These mutants were exposed to different stress conditions, such as DNA-damaging agents and osmotic stress, to understand their significance in the stress response. Next, the mutants were analyzed in terms of cell size, growth rate, and spore formation to understand their contribution to cell cycle control. The results revealed that individual deletion of two of these genes, SPBC36.01c and SPBC36.02c, resulted in sensitivity to DNA-damaging agents, indicating their role in DNA damage response
Ultrasound Elastography and Magnetic Resonance Imaging Findings of Breast Angiosarcoma Mimicking a Benign Lesion by Elastography: A Case Report
No full textIntroduction: Primary and secondary angiosarcomas of the breast are rare neoplasms. Radiologically, magnetic resonance imaging, mammography, and ultrasound (US) findings of angiosarcomas have been reported previously. However, ultrasound (US) elastography findings of angiosarcoma have not been reported yet. Currently, US elastography should be used commonly to decide biopsy or short-term follow-up of breast lesions.
Case Presentation: A 39-year-old female from Adana, Turkey, was admitted to Dr.Turgut Noyan Adana Teaching and Medical Research Center at the breast center of Baskent University, with a palpable right breast mass, which had been enlarging for one year in 2015. Our breast center is a tertiary referral center. B-mode US and US elastography findings suggested that the lesion was benign; however, magnetic resonance imaging showed a mass enhancing intensely at early phases with rapid wash out. The final diagnosis of the mastectomy specimen confirmed low-grade angiosarcoma. If the recommendation would have been based on the elastography findings, it would have been catastrophic because angiosarcomas tend to rapidly increase in size.
Conclusions: B-mode US and elastography findings of breast angiosarcoma may mimic benign lesions
Benign Paroxysmal Positional Vertigo in Pregnancy
No full textBenign paroxysmal positional vertigo (BPPV) is a clinical entity characterized by acute, brief paroxysmal attacks of rotational vertigo induced by head position changes. It is the most common peripheral vestibular pathology and is seen more frequently in women. However, to our knowledge, there is very limited data on the association between BPPV and pregnancy in both English and Turkish literature. We present four pregnant women diagnosed with BPPV for the first time during gestation and revise the etiological factors of BPPV and the role of pregnancy-related changes in BPPV