Left ventricular pseudoaneurysm causing coronary angiography images resembling myocardial bridging

Acquired pseudoaneurysm of the left ventricle is a rare disorder that usually ofvccurs after transmural myocardial infarction or after cardiac surgery. Pseudoaneurysms are usually detected because of symptoms; less often incidentally. Here we present a case of pseudoaneurysm as a result of unknown etiology causing myocardial bridging like image at angiography.     

Psychiatric comorbidity in medication overuse headache patients with pre-existing headache type of episodic tension-type headache.

BACKGROUND: Medication overuse headache (MOH) mostly evolves from migraine and episodic tension-type headache (ETTH). Chronic tension-type headache (CTTH) is another headache type that evolves over time from ETTH. It is well known that psychiatric comorbidity is high in MOH patients. AIM: To investigate the frequency of psychiatric comorbidity, and the intensity of depression and anxiety in MOH patients evolving from ETTH and to compare results with CTTH patients and MOH patients evolving from migraine. METHODS: Twenty-eight CTTH (Group C) and 89 MOH patients were included into the study. MOH patients were divided into two groups according to their pre-existing headache types: MOH patients with pre-existing ETTH (Group E, n = 31), and with pre-existing migraine (Group M, n = 58). All patients were interviewed with a psychiatrist and SCID-CV and SCID-II were applied. Beck Anxiety Inventory and Beck Depression Inventory scales were also performed. RESULTS: Eleven patients (39.3%) in Group C, 21 patients (67.7%) in Group E, and 31 patients (53.7%) in Group M were diagnosed to have comorbid psychiatric disorders. The psychiatric comorbidity was found significantly higher in Group E than Group C. In Group E, mood disorders were found significantly higher, but the difference between the two groups with regard to anxiety disorders was insignificant. Mean depression scores were significantly higher in Group E than Group C. The mostly diagnosed type was obsessive-compulsive personality disorder in all the three groups, and was statistically significant in Group M than Group C. CONCLUSION: Psychiatric comorbidity in MOH patients with pre-existing ETTH is common as in those with pre-existing migraine headache and MOH with regard to developing psychiatric disorders should be interpreted as a risk factor in chronic daily headache patients.     

Effects of Carvacrol on Survival,Mesenteric Blood Flow,Aortic Function and Multiple Organ Injury in a Murine Model of Polymicrobial Sepsis

Carvacrol (CRV) has strong cytoprotective, antioxidant, and anti-inflammatory properties. We aimed to demonstrate the possible protective effects of CRV on survival, mesenteric artery blood flow (MBF), vascular reactivity, and oxidative and inflammatory injuries in a murine model of polymicrobial sepsis induced by cecal ligation and puncture (CLP). Wistar rats were allocated into the following four groups: Sham, CLP, Sham + CRV, and CLP + CRV. The animals were orally administered with CRV (80 mg/kg/day) or vehicle (corn oil; 1 mL/kg/day) for 7 days. At the eighth day, Sham or CLP procedure was applied. Twenty hours after the operations, MBF and contractile responses of isolated aortic preparations to phenylephrine were measured. Tissue samples were obtained for biochemical and histopathological assessments. Additionally, survival rates were recorded throughout 96 h. CRV administration improved the mesenteric perfusion, contractile function of aorta, and survival after CLP. CRV substantially prevented the elevations in the levels of LDH, BUN, Cr, and inflammatory cytokines (tumor necrosis factor-alpha, interleukin-1 beta and interleukin-6) but could not prevent the elevations of AST and ALT after CLP. The decreased liver, kidney, and spleen glutathione levels and increased liver, kidney, lung, and spleen malondialdehyde levels induced by CLP were substantially restored by CRV. Also, histopathological protective effects of CRV on multiple organ damage due to CLP were observed. CRV possesses strong ameliorative effects on sepsis due to its protective effects on mesenteric perfusion and aortic function and its antioxidative and anti-inflammatory effects.     

Can femoroacetabular impingement and hip dysplasia be distinguished by clinical presentation and patient history?

Purpose  

Hip dysplasia and femoroacetabular impingement may both lead to disability and hip osteoarthritis. The purpose of the current study was to compare the two entities in order to define differences in their clinical presentation.     

Treatment of Ingrown Toenail With Proximolateral Matrix Partial Excision and Matrix Phenolization

PURPOSE

Ingrown toenail is one of the most common nail conditions. Although many surgical treatments are described for complicated cases, recurrence of pain and postoperative disability are common. We evaluated the long-term efficacy of proximolateral matrix partial excision followed by chemical matricectomy with phenol.

METHODS

We performed 348 proximolateral partial matricectomies and phenol ablations in 225 patients with stage 2 or 3 ingrown toenail. Patients were examined weekly until full wound healing was achieved and were observed for 24 months to assess the long-term efficacy of the treatment.

RESULTS

Short-term results were good. We observed only 1 recurrence during the 24-month follow-up period, at 8 months. The success rate was therefore 99.7%. No severe complications occurred. Cosmetic results were remarkably good.

CONCLUSIONS

Proximolateral partial matricectomy with phenol ablation is an excellent surgical method for the treatment of ingrown toenails, having low morbidity and a high success rate, even in the long term.Key words: ingrown toenail, onychocryptosis, unguis incarnatus, surgery, phenol, matricectomy     

Management of thoracic empyema in childhood

A total of 160 cases of thoracic empyema admitted to our clinic between September 1988 and March 1994 have been analyzed retrospectively. There were 83 males and 77 females whose ages ranged from 25 days to 13 years. Cough (82%), fever (81%), and dyspnea (70%) were the most common presenting symptoms followed by chest pain, abdominal pain, and cyanosis. The preadmission history was often long (average 14 days). Following admission antibiotic therapy was initiated by parenteral administration of sulbactam-ampicillin, amikacin or netilmicin, and ornidazole or clindamycin and modified with vancomycin or piperracillin on the basis of culture and sensitivity reports. Fifty-four of 156 aerobic and 2 of 28 anaerobic cultures were positive.Staphylococcus aureus was the most common (57%) micro-organism isolated followed byPseudomonas aeroginosa andStreptococcus pneumoniae. In addition, 5 of 11Haemophilus influenzae latex-agglutination tests were positive. Two patients with pneumatocele formation received antibiotics as the only therapy. In the remaining patients, in addition to antibiotics treatment modalities included tube drainage (n = 111), decortication (n = 39), decortication with lobectomy or segmentectomy (n = 6), and pneumonectomy (n = 2). The overall mortality was 5%. Our results show that appropriate antibiotics and tube drainage provided effective control of childhood thoracic empyema, although in patients with serious respiratory distress and poor response to tube drainage, operative intervention is required.