Posterior reversible encephalopathy syndrome caused by hypertensive encephalopathy and acute uremia

Introduction  

The posterior reversible encephalopathy syndrome (PRES) is a recently proposed cliniconeuroradiological entity. The most common causes of PRES are hypertensive encephalopathy, eclampsia, cyclosporin A neurotoxicity, and the uremic encephalopathy. On magnetic resonance imaging (MRI) studies, edema has been reported in a relatively symmetrical pattern, typically in the subcortical white matter and occasionally in the cortex of the posterior circulation area of the cerebrum.     

Removal of Fluoride from Contaminated Ground Water Using Raw and Modified Bauxite

Endemic fluorosis affects millions of people worldwide. Fluorosis arises from the consumption of fluorine (F) contaminated water and was observed also in some parts of Turkey with volcanic rocks and geothermal resources. In the present study the removal of F from drinking water by raw and modified bauxite at the laboratory scale was investigated using a batch mode. Modified bauxite was prepared by using Na and Mg incorporated (B–Na, B–Mg) bauxite and calcination of Mg incorporated bauxite at 500°C (B–Mg-500). The equilibration time for F between bauxite and water was identified to be 3 h. Adsorption of F increased with increasing adsorbent dose. Moreover, F adsorption isotherms fitted well with the Freundlich model. Low F adsorption was obtained onto the raw and incorporated bauxite. In contrast, maximum F adsorption was found for B–Mg-500, with K_f value of 0.247. This observation may be explained by the meaningfully stabilized and elevated number of positively charged sites in B–Mg-500.     

A comparative analysis of maxillary tooth movement produced by cervical headgear and pend-x appliance

The purpose of this study was to compare the effects of cervical headgear and pend-x on the maxillary first molar, second molar, first premolar, and upper incisors. Cephalometric radiographs were obtained at the start of treatment (T1) and after molar distalization was completed (T2) for 13 patients in a pend-x group and 13 patients in a cervical headgear group. The changes of the maxillary teeth were measured on maxillary superimpositions. Nonparametric Mann-Whitney U-test was used to compare the mean differences between the two groups. The mean amount of distalization for the headgear group was 3.15 +/- 1.94 mm and that for the pend-x group was 3.81 +/- 2.25 mm. The second molar teeth were also distalized to a mean amount of 2.27 +/- 1.33 mm in the headgear group and 2.04 +/- 2.15 mm in the pend-x group. The mean treatment time for distalization was 11.38 +/- 3.18 months for the headgear group and 7.31 +/- 4.09 months for the pend-x group. During distalization, the maxillary molars tipped distally in both groups, but intergroup differences were not significant. The anterior inclinations of the first premolar and upper incisor increased significantly in the pend-x group (P < .01). Maxillary molars showed no vertical movement in the pend-x group but extruded in the headgear group (P < .01). The anchorage loss of the pend-x appliance as well as the necessary patient compliance and greater treatment time with the cervical headgear should be taken into consideration.     

Satisfaction among women: Differences between current users of barrier (male condom) and non-barrier methods

Objectives To determine the differences in and factors related to satisfaction between barrier (male condom) and non-barrier method users.

Methods A semi-structured questionnaire was used for collecting data for this cross-sectional survey. The questionnaires were completed via one-on-one interviews by the researchers. The study group was selected using stratified random sampling. Exclusion criteria were, being unmarried, pregnant, in postmenopausal status and using traditional methods. A total of 434 currently married women using modern contraceptive methods participated in the study. Contraceptive users were dichotomized into two groups as non-barrier method users and barrier method users.

Results About half of the participants (n = 191, 44%) were barrier method users. Their mean age was 33.7 ± 7.3 years, 66.6% (n = 131) were well educated and reported significantly less pregnancies, given births, living children and abortions (reproductive history events) than non-barrier users. Barrier method users were significantly more likely to be satisfied with their contraceptive method of choice (OR: 2.4; 95% CI 1.2–5.2). Among barrier method users, deciding the type of the contraceptive method themselves had significant effect on satisfaction.

Conclusion In our study, satisfaction was mostly affected by heavy side effects and health risks of the methods resulting in less satisfaction with the contraceptive method among non-barrier method users. Other factors which may influence satisfaction deserve further investigation.     

The results of three different treatment modalities in patients with locally advanced nasopharyngeal carcinoma

The aim of the study was to evaluate the toxicity and efficacy of 62 patients with locally advanced nasopharyngeal carcinoma (NPC) (stage III, IVA, IVB) treated by three different modalities. Cisplatin was given weekly 35 mg/m²/day or every 3 weeks 100 mg/m²/day during radiotherapy (RT) in all patients. Patients were classified into following three groups: The patients in the group 1 (n = 23) were treated only with concurrent chemoradiotherapy (CCRT). In the group 2 (n = 15), before the CCRT, neoadjuvant chemotherapy, consisting of intravenous cisplatin and docetaxel on day 1, every 3 weeks treatment cycles was administered. In the group 3 (n = 24), adjuvant chemotherapy, consisting of cisplatin on day 1 and 5-flourouracil on day 1 to 5 every 3 weeks was used after CCRT. Three arms were treated with the same RT technique and dose. There was no difference for age, sex, and stage among the groups. Radiotherapy was administered in planned dose for all patients. A total of 82% patients completed planned chemotherapy concurrent with RT. The treatment related adverse effects were mild or moderate in intensity. There was no statistical difference between the groups regarding the treatment responses. Complete response rate of RT was 73.9%, 86.7%, and 87.5%, respectively. Median progression free survival (PFS) and overall survival (OS) were 13, 12, 9 months and 22, 20, 15 months for groups 1, 2, 3, respectively. No difference was observed in median OS and PFS among three groups. In our study, the efficacy and toxicity of neoadjuvant and/or adjuvant chemotherapy with CCRT and CCRT alone were found similar.     

Schwannoma originating from the infraorbital nerve: a case report

A 16-year-old female admitted to otolaryngology outpatient clinic with the complaints of pain and replacement of her left eyeball upwards. Radiological imaging demonstrated a solid mass inferior to the left globe. The anterior wall of the maxilla was thinned and the mass pushed the orbital floor inferiorly. Following subciliary incision, the bone over the mass was removed from the orbital rim and the mass was exposed. The mass originated from the infraorbital nerve. The mass was excised and the orbital rim, malar region and the orbital floor were reconstructed by a titanium mesh. The histopathological report was "schwannoma". Seven cases of schwannomas arising from the infraorbital nerve reported in English literature. In this paper we report a case of infraorbital schwannoma and review the literature.     

Sinopulmonary aspergillosis in children with hematological malignancy

Invasive pulmonary aspergillosis is a serious infectious complication in immunocompromised especially neutropenic patients. Despite improvements in early diagnosis and effective treatment, invasive pulmonary aspergillosis is still a devastating opportunistic infection. These infections also interfere with the anticancer treatment. We report our experience in the diagnosis and therapeutic management of sinopulmonary aspergillosis in 4 children with hematologic malignancy. All patients except the first were neutropenic when sinopulmonary aspergillosis was diagnosed. Clinical signs included fever, cough, respiratory distress, swallowing difficulty, headache, facial pain-edema and hard palate necrosis. Radiodiagnostic methods showed bilateral multiple nodular infiltrations, soft tissue densities filling all the paranasal sinuses, and bronchiectasis. Diagnosis of aspergillosis was established by bronchoalveolar lavage in one case, tissue biopsy, positive sputum and positive cytology, respectively, in the other 3 cases. One patient was treated with liposomal amphotericin B and other 3 cases were treated with liposomal amphotericin B + itraconozole. Outcome was favorable in all cases except the one who died due to respiratory failure. Early diagnosis, appropriate treatment and primary disease status are important factors on prognosis of Aspergillus infections in children with hematological malignancy.