A new method of tracheoesophageal fistula treatment: Using an atrial septal defect occluder device for closure—The first Turkish experience

Objective

One of the techniques used in the treatment of tracheoesophageal fistula is applying the umbrella catheter, designed for closure of atrial septal defects, in this region. In the literature, we have encountered only 9 case reports in this regard. We shared a successfully closed tracheoesophageal fistula case with this technique.

Case

A tracheoesophageal fistula in a 47-year-old male patient was successfully closed with an atrial septal defect occluder device. The patient died on the 42nd day after the procedure with no atrial septal defect occluder device-related problems.

Conclusion

Using of atrial septal defect occluder device may be an appropriate option for tracheoesophageal fistula treatment. It can be said that the procedure is successful when the device is completely covered. Even so, there is a need for multi-centered, randomized, controlled studies of large series about the subject.

     

Differentiation of old and new world leishmania species at complex and species levels by PCR

The variable and conserved sequence boxes of kinetoplast DNA (kDNA) of 11 standard strains of 6 complexes of New and Old World Leishmania were amplified using PCR. Four strains from 2 complexes of Old World Leishmania - L. major (MRHO/IR/64/Nadim-1), with 2 bands at 850 and 620 bp, L. major (MHOM/SU/73/5-ASKH), with a band at 620 bp, L. donovani, with a band at 800 bp and L. infantum, with a band at 650 bp - could be differentiated from each other and from the New World strains, with the exception of L. infantum. Seven Leishmania strains from 4 complexes of New World Leishmania - L. mexicana and L. pifanoi, with a band at 730 bp, L. guyanensis, with 2 bands at 730 and 650 bp, L. peruviana, with a band at 710 bp and L. amazonensis, L. garnhami and L. braziliensis, each with a band at 650 bp - were identified. Of these strains, L. guyanensis and L. peruviana could be differentiated from each other and from the Old World strains. These results show that using PCR amplification of kDNA we could differentiate between New and Old World Leishmania at both complex and strain levels. The amplified kDNA PCR products, together with other techniques, could be useful as a diagnostic tool for the identification of Leishmania species.     

Oxidative Stress Responses to Nigella sativa Oil Concurrent with a Low‐Calorie Diet in Obese Women: A Randomized,Double‐Blind Controlled Clinical Trial

The aim of the present study was to determine the effects of Nigella sativa (NS) oil concurrent with a low‐calorie diet on lipid peroxidation and oxidative status in obese women. In this double‐blind placebo‐controlled randomized clinical trial, 50 volunteer obese (body mass index = 30–35 kg/m²) women aged 25–50 years old were recruited. Participants were randomly divided into intervention (n = 25) and placebo (n = 25) groups. They received a low‐calorie diet with 3 g/day NS oil or low‐calorie diet with 3 g/day placebo for 8 weeks. Forty‐nine women (intervention group = 25; placebo group = 24) completed the trial. NS oil concurrent with a low‐calorie diet decreased weight in the NS group compared to the placebo group (?4.80 ± 1.50 vs. ?1.40 ± 1.90 kg; p < 0.01). Comparison of red blood cell superoxidase dismutase (SOD) indicated significant changes in the NS group compared to the placebo group at the end of the study (88.98 ± 87.46 vs. ?3.30 ± 109.80 U/gHb; p < 0.01). But no significant changes in lipid peroxidation, glutathione peroxidase, and total antioxidant capacity concentrations were observed. NS oil concurrent with a low‐calorie diet decreased weight and increased SOD levels in obese women. However, more studies are suggested to confirm the positive effects of NS in obesity and its complications. Copyright © 2015 John Wiley & Sons, Ltd.     

Predictors of non-alcoholic fatty liver in a group of non-obese and non-diabetic Iranian adults

Non-alcoholic fatty liver disease (NAFLD) is not uncommon in non-obese people. We examined the independent predictors of NAFLD in a group of non-obese and non-diabetic men and women in Rasht, Iran. Sixty-one adults aged 38.4 ± 8.4 years (32 men and 29 women) with body mass index (BMI) <30 kg/m² and non-diabetic with clinical features of NAFLD who visited our center between 2007 and 2009 were compared to 147 non-obese, non-diabetic and normal liver subjects (40 men and 107 women) aged 40.8 ± 9.1. Data on blood lipids, anthropometry, fasting blood glucose, exercise, and educational levels were gathered using a questionnaire. Logistic regression analysis revealed that weight gain during adulthood [OR = 1.90 (95% CI = 1.03–1.84), P < 0.04] and high serum triglyceride levels [OR = 1.19 (95% CI = 1.09–1.28), P < 0.0001] were independent predictors of NAFLD in this group of non-obese subjects. BMI, educational levels, gender, and habitual physical activity were not independently related to NAFLD in this study. These data suggest that weight gain after 20 years of age rather than BMI and high levels of triglyceride may serve as screening tool for NAFLD in clinical practice in this population. In nutritional management of these apparently normal weight subjects with NAFLD modest weight loss is necessary.     

Sudden Unilateral Vision Loss Arising from Calcified Amorphous Tumor of the Left Ventricle

Calcified amorphous tumor of the heart is a very rare non-neoplastic intracavitary mass. The clinical presentation is similar to that of other cardiac masses. The precise cause and best approach to treatment remain unclear. We describe a case of cardiac calcified amorphous tumor presenting with refractory unilateral vision loss that was successfully treated by surgical excision. To our knowledge, this is only the 2nd reported case of retinal arterial embolism due to cardiac calcified amorphous tumor in the English-language literature.Key words: Blindness/etiology, calcinosis/complications/radiography/surgery, diagnosis, differential, tumor, cardiac calcified amorphous, vision loss, suddenCalcified amorphous tumor (CAT) of the heart is a very rare non-neoplastic cardiac intracavitary mass. It was first described as a distinct pathologic entity by Reynolds and colleagues in 1997.¹ Since then, very few cases of cardiac CAT have been reported in the English-language medical literature^2–19 (12 TABLE I. Clinicopathologic Findings of Published Cases of Cardiac Calcified Amorphous Tumor Open in a separate window TABLE I, continued. Clinicopathologic Findings of Published Cases of Cardiac Calcified Amorphous Tumor Open in a separate window In the present report, we describe a case in which cardiac CAT presented with refractory unilateral vision loss, which was successfully treated by surgical excision.     

Desferoxamine and Urinary Zinc Excretion in β-Thalassemia Major

This study has been undertaken to find out whether urinary zinc excretion, which is already increased in patients with thalassemia, is further increased by usual and high doses of desferrioxamine (DF). A total of 11 β-thalassemia major patients were included. DF infusions have been performed with doses, either 50 mg/kg or 150 mg/kg. Nine age and sex matched normal children were taken as the control group. The mean basal-Zn excretion of the patients was significantly higher than the mean Zn excretion observed in controls. No significant difference is observed between the mean Zn excretion obtained on different doses of DF. However, they are both significantly higher than the mean basal-Zn levels of the controls.