Comparison of magnesium versus titanium screw fixation for biplane chevron medial malleolar osteotomy in the treatment of osteochondral lesions of the talus

European Journal of Orthopaedic Surgery & Traumatology - This retrospective study aimed to compare the clinical and radiological outcomes of patients who underwent biplane chevron medial...     

Moyamoya syndrome associated with sickle cell trait in a child

Moyamoya syndrome is a chronic, progressive occlussion of cerebrovascular arteries that leads to the development of characteristic collateral vessels. It is usually accompanied with sickle cell disease and other hemoglobinopathies. We report a 7-year-old boy, who admitted to our clinic with headache, diagnosed as moyamoya syndrome associated with sickle cell trait. To date, two such cases have been reported in the literature. As far as we know, this patient is the first child reported.     

Pharmacological profile of survivors of acute myocardial infarction at Turkish academic hospitals

AIM: The purpose of this study was to document treatment profiles in 850 patients surviving acute myocardial infarction at 17 academic hospitals in Turkey. METHODS AND RESULTS: Pharmacological management data of acute myocardial infarction survivors were collected and divided into three categories: drugs which patients received before hospitalization, during the hospitalization, and at hospital discharge. Data regarding medical history, complications during hospitalization, MI extent (Q wave or non-Q wave), infarct location and diagnostic and revascularization procedures were also recorded. This study is based on the 850 patients who met the diagnostic criteria for initial acute MI in the period examined. Among 850 patients with myocardial infarction enrolled 408 (48%) received thrombolytic therapy. The median time interval from symptom onset to initiation of thrombolytic therapy was 196 min. The most commonly used thrombolytic agent was streptokinase (93%). Thrombolytic recipients were younger, and presented sooner after onset of symptoms. Among patients receiving thrombolytic therapy, concomitant pharmacotherapy included aspirin (95%), intravenous heparin (93%), intravenous nitroglycerin (91%), oral beta-blockers (44%), calcium channel antagonists (13%), and angiotensin converting enzyme inhibitors (41%). The lipid lowering therapy was only used in 4% of all patients, and was given to 18% of patients with hyperlipidemia. CONCLUSION: Current usage rates of thrombolytic therapy in Turkey are lower than expected, but when compared with previous reports it increased. Although adjunctive treatment with intravenous heparin and intravenous nitroglycerin is usually used, beta-blockers appear to be underused and calcium channel blockers appear to be overused. The lipid reducing therapies were infrequently prescribed.     

Treatment in patients with low traumatic pneumothorax ratio

Thoracostomy tube placement (TT) is currently one of the most important treatment modalities used in traumatic pneumothorax patients. In patients with low pneumothorax ratio (percentage), both follow-up without surgery and employing intervention when indicated may be appropriate choice. We presented the outcome of patients with low traumatic pneumothorax ratio treated by follow up without surgical intervention in our clinic. During the period from January 2000 until January 2002, 108 patients who were treated and followed with low percentage traumatic pneumothorax in Ankara Numune Hospital Thoracic Surgery Clinic were allocated into three groups due to blunt trauma of the thorax, penetrating-cutting instrument injury and gunshot injury. All patients were admitted to the clinic with the purpose of observation without surgical intervention and chest roentgenograms were taken at the sixth and twelfth hours and daily thereafter. TT was performed for 46 (43%) patients whose pneumothorax ratio increased during the observation period. TT was more frequent in patients with 20% percentage pneumothorax (69%) as well as with two or more fractured ribs (69%). Follow-up without surgical intervention may one of the appropriate modes of treatment in patients who have minimal traumatic pneumothorax.     

Malnutrition,associated clinical factors,and depression in systemic sclerosis: a cross-sectional study

Clinical Rheumatology - The aim of this study was to evaluate the associations between malnutrition and the clinical features of the disease and depression in patients with systemic sclerosis...     

Ovarian torsion in puerperium: A case report and review of the literature

INTRODUCTION

Ovarian torsion (OT) is a rare cause of acute abdominal pain that requires prompt recognition and treatment during puerperium. Diagnosis of OT can be challenging due to nonspecific clinical features and uncommon objective findings. The management of OT is often delayed because of diagnostic uncertainty. Early and timely recognition and prompt intervention are crucial to preserve ovarian function and to minimize morbidity.

PRESENTATION OF CASE

We report a 29-year-old postpartum woman who presented to the emergency department (ED) with severe right flank pain, nausea and anorexia initially considered as renal colic. After further investigation, OT caused by large mucinous cyst was diagnosed. Right-sided salpingo-oophorectomy was performed due to hemorrhagic ovary and huge cystic mass causing ischemic OT.

DISCUSSION

OT is often diagnosed based on the clinical presentation, including severe, sharp, sudden onset of unilateral lower abdominal pain and tenderness with a palpable laterouterine pelvic mass and nausea/vomiting. Emergency surgical intervention should be performed if OT is suspected to confirm the diagnosis and uncoil the twist to prevent ovarian damage.

CONCLUSION

In conclusion, emergency physicians should be aware of the possibility of OT in postpartum women. Therefore, early and timely surgical intervention should be undertaken.