A cross-sectional study of female sexual function and dysfunction during pregnancy

IntroductionAlthough women may undergo changes in sexual function during pregnancy, there are limited studies correlating possible sexual function changes to androgen blood levels during the pregnancy.AimTo search for a possible correlation, we performed a cross-sectional observational study to assess sexual function scores and androgen blood levels of women during pregnancy.Materials and MethodsA total of 589 healthy pregnant women were recruited to the present cross-sectional study. Of these patients, 116 (19.6%), 220 (37.3%), and 253 (42.9%) were in their first, second, and third trimesters, respectively. They were evaluated with a detailed medical and sexual history, including IFSF questionnaire. In addition, maternal serum androgen levels (testosterone, dehydroepiandrosterone sulphate, free testosterone) were determined in each trimester during regular follow-ups.Main Outcome MeasuresAssessment of Index of Female Sexual Function (IFSF) domains and serum androgen levels in each trimester.ResultsThe mean age of the three groups were similar (P > 0.05). Overall, total IFSF scores of women in the first and second trimesters were 21.4 ± 10.1 and 22.3 ± 10, respectively, while it was 15.9 ± 12.3 during the third trimester (P < 0.05). The most common sexual dysfunction symptom was diminished clitoral sensation, observed in 94.2% of the patients, followed by lack of libido in 92.6% and orgasmic disorder in 81%. No correlation was detected between total IFSF score and serum androgen levels.ConclusionsIn this cross-sectional study, we noted lower sexual function scores in women in the third trimester of their pregnancies compared with those in their first two trimesters of pregnancy. These lower sexual function scores in the third trimester were not associated with lower androgen levels. We plan to perform a future prospective study to better assess both the change in sexual function and also its possible relation to androgen levels in pregnant women. Erol B, Sanli O, Korkmaz D, Seyhan A, Akman T, and Kadioglu A. A cross-sectional study of female sexual function and dysfunction during pregnancy.     

An unusual cause of gastric perforation in childhood: trichobezoar (Rapunzel syndrome). A case report

Trichobezoars are hair balls found in the stomach and formed following trichitillomania and trichopaghia. Rapunzel syndrome is a rare condition in which the presence of giant trichobezoars causes mechanical obstruction. To date, only two cases of stomach perforation caused by trichobezoars have been reported among pediatric patients. We report a 14-year-old female patient who experienced nausea, vomiting and severe abdominal pain for 1 month. Physical examination revealed diffuse abdominal distension. Palpation detected a mobile and sensitive mass, 15 × 15 cm , which filled the upper quadrant. Urgent surgery revealed that the stomach was perforated by the trichobezoar ball. This trichobezoar mass was totally excised by expanding the perforation area. Conclusion This is the reported third case of gastric perforation caused by trichobezoar in a pediatric patient. Among acute abdominal cases, gastric perforation should remain a possibility in differential diagnosis.     

Incidentally Diagnosed Unusual Ascending Aorta Mass

A 44‐year‐old female, with no medical history, was admitted to the cardiology department because of mild exertional dyspnea. Transthoracic and transesophageal echocardiography showed highly mobile, mass‐like lesion in the aortic root. The patient was operated in the same week and a 1 cm × 6 cm soft tissue was excised from the ascending aorta. Pathological examination revealed a fibrin clot surrounded by a fibrous cap. (Echocardiography 2011;28:E34‐E35)     

Minocycline affects cocaine sensitization in mice

Growing evidence has pointed to an interaction between the tetracycline antibiotic minocycline and drugs with abuse liability such as opioids and amphetamines. In this work, we tested the hypothesis that similar to its effects on methamphetamine-induced locomotor sensitization, minocycline may influence the behavioral effects of cocaine. Experiments were performed in male C57BL/6J mice using an automated system to measure locomotor activity. We found that 80 mg/kg minocycline significantly reduced locomotor activity when administered either alone or injected 30 min prior to cocaine, which increased locomotor activity. To investigate whether minocycline selectively affects the development of locomotor sensitization induced by four daily injections of 10 mg/kg cocaine, we sought a schedule of minocycline administration that does not per se affect locomotor activity. Thus, we selected 40 mg/kg minocycline administered 3 h prior to cocaine; minocycline did not affect cocaine-stimulated locomotor activity on the first day of administration but prevented the development of cocaine sensitization. We also tested whether minocycline would affect an already established cocaine sensitization. After establishing the sensitization effect by four daily injections, cocaine treatment was discontinued and mice were treated with minocycline daily (days 5–11) or on day 11 only. There was no effect of minocycline treatment on the response of cocaine-sensitized mice to the challenge dose of cocaine on day 11. The mechanisms by which minocycline interferes with the development of cocaine sensitization need to be characterized.     

Simultaneous use of individual and joint regularization terms in compressive sensing: Joint reconstruction of multi‐channel multi‐contrast MRI acquisitions

Multi‐contrast images are commonly acquired together to maximize complementary diagnostic information, albeit at the expense of longer scan times. A time‐efficient strategy to acquire high‐quality multi‐contrast images is to accelerate individual sequences and then reconstruct undersampled data with joint regularization terms that leverage common information across contrasts. However, these terms can cause features that are unique to a subset of contrasts to leak into the other contrasts. Such leakage‐of‐features may appear as artificial tissues, thereby misleading diagnosis. The goal of this study is to develop a compressive sensing method for multi‐channel multi‐contrast magnetic resonance imaging (MRI) that optimally utilizes shared information while preventing feature leakage. Joint regularization terms group sparsity and colour total variation are used to exploit common features across images while individual sparsity and total variation are also used to prevent leakage of distinct features across contrasts. The multi‐channel multi‐contrast reconstruction problem is solved via a fast algorithm based on Alternating Direction Method of Multipliers. The proposed method is compared against using only individual and only joint regularization terms in reconstruction. Comparisons were performed on single‐channel simulated and multi‐channel in‐vivo datasets in terms of reconstruction quality and neuroradiologist reader scores. The proposed method demonstrates rapid convergence and improved image quality for both simulated and in‐vivo datasets. Furthermore, while reconstructions that solely use joint regularization terms are prone to leakage‐of‐features, the proposed method reliably avoids leakage via simultaneous use of joint and individual terms, thereby holding great promise for clinical use.     

Evaluation of river water genotoxicity using the piscine micronucleus test

The Berdan River, which empties into the Mediterranean Sea on the east coast of Turkey, receives discharges of industrial and municipal waste. In the present study, the in vivo piscine micronucleus (MN) test was used to evaluate the genotoxicity of water samples collected from different locations along the Berdan River. Nile tilapia (Oreochromis niloticus) were exposed in the laboratory for 2, 4, and 6 days, and micronuclei were evaluated in peripheral blood erythrocytes, gill cells, and caudal fin epithelial cells. A single dose of 5 mg/L cyclophosphamide was used as a positive control. In addition to micronuclei, nuclear abnormalities (NAs), such as binucleated cells and blebbed, notched, and lobed nuclei, were assessed in the erythrocytes, and chemical analyses were carried out to determine the amount of heavy metals in the water samples. MN and NA frequencies were significantly elevated (up to 2- to 3-fold) in fish exposed to river water samples taken downstream of potential discharges, and the elevated responses in gill and fin cells were related to the concentration of heavy metals in the water. MN frequencies (expressed as micronucleated cells/1,000 cells), in both treated and untreated fish, were greatest in gill cells (range: 0.80-3.70), and generally lower in erythrocytes (range: 0.50-2.80), and fin cells (range: 0.45-1.70). The results of this study indicate that the Berdan River is contaminated with genotoxic pollutants and that the genotoxicity is related to the discharge of wastes into the river water.     

A newborn with overlapping features of AEC and EEC syndromes

Ectrodactyly, ectodermal dysplasia, clefting (EEC) syndrome is the prototype of several p63 conditions, which include ankyloblepharon, ectodermal dysplasia, clefting (AEC) syndrome, limb-mammary syndrome (LMS), Rapp-Hodgkin syndrome (RHS), ADULT syndrome, and others. All these disorders include combinations of ectodermal dysplasia, orofacial clefting and limb malformations in variable severity. A newborn patient is presented with diffuse erythematous and desquamating skin lesions and anal atresia. She also had sparse and lightly colored thin hair, deeply set eyes, hypoplastic alae nasi, and a short philtrum. Cleft lip/palate and ankyloblepharon were not present. Complete cutaneous syndactyly was present on both hands in between the third and fourth fingers. Mild ectrodactyly was evident on all four extremities in between first and second digits. There was post-axial polydactyly on both feet. Anal atresia was present and defecation occurred through a rectovaginal fistula. The patient represented an interesting overlapping clinical condition between AEC and EEC syndromes. Diffuse skin lesions with excoriation and desquamation suggest AEC syndrome, despite the absence of ankyloblepharon, however; ectrodactyly and polydactyly strongly suggest the EEC syndrome. C308Y mutation in exon 8 of TP63 gene was detected, which was previously described to lead only to EEC syndrome and not to any of the other allelic conditions. These data emphasize the large degree of clinical variability that may be seen for specific TP63 mutations.     

Comparison of standard 4-row versus 6-row 3-D linear cutter stapler in creation of gastrointestinal system anastomoses: a prospective randomized trial

OBJECTIVE:

This prospective study was conducted to compare the clinical outcomes of a 6-row 3-D linear cutter with the standard 4-row linear cutter in patients who underwent elective gastrointestinal surgery anastomosis.

METHOD:

Patients who underwent elective open gastrointestinal surgery that included stapled anastomosis using a linear cutter (Proximate®, Ethicon Endo-Surgery, Cincinnati, OH) between January 2011 and May 2011 were included in the study. The patients were randomly assigned to two groups according to the linear cutter that was used in the surgery: the standard 4-row cutter (the S group) or the new 6-row cutter (the N group). The groups were compared based on the patient demographic data, the laboratory parameters, the preoperative diagnosis, the surgery performed, the operation time, intra- or postoperative complications, the time to oral tolerance and the length of the hospital stay.

RESULTS:

The S group included 11 male and nine female patients with a mean age of 65±12 (35-84) years, while the N group included 13 male and eight female patients with a mean age of 62±11 (46-79) years (p = 0.448, p = 0.443, respectively). Anastomotic line bleeding was observed in eight (40%) patients in the S group and in one (4.7%) patient in the N group (p = 0.006). Dehiscence of the anastomosis line was observed in two (10%) patients in the S group and none in the N group (p = 0.131). Anastomotic leakage developed in three (15%) patients in the S group and in one (4.7%) patient in the N group (p = 0.269). The mean hospital stay was 12.65±6.1 days in the S group and 9.52±2.9 days in the N group (p = 0.043).

CONCLUSION:

The 6-row 3-D linear cutter is a safe and easily applied instrument that can be used to create anastomoses in gastrointestinal surgery. The new stapler provides some usage benefits and is also superior to the standard linear cutter with regard to anastomotic line bleeding.     

Comparison of topical treatment methods used in recurrent anterior epistaxis: a randomized clinical trial

IntroductionRecurrent epistaxis is a common medical problem faced by ENT specialists, emergency physicians, and pediatricians. The facts that many treatment modalities are being searched and no single treatment method is universally accepted yet support this information.ObjectiveWe aimed to compare the clinical efficacy of topical antiseptic ointment, topical decongestant ointment and chemical cauterization treatments, which are frequently used in recurrent anterior epistaxis, both singly and in combination.Material-methodsBetween August 2017 and February 2018, 137 patients who were diagnosed with recurrent anterior epistaxis were randomly divided into 5 groups. group I received topical antiseptic ointment, group II received topical decongestant ointment, group III received chemical cauterization, group IV received topical antiseptic ointment + chemical cauterization and group V received topical decongestant ointment + chemical cauterization treatment. All patients were phoned 2 weeks and 1 month after the treatment and questioned about the presence (failure) or absence (success) of at least 1 episode of epistaxis. Patients with comorbid diseases were excluded. Treatment success was statistically analysed.ResultsThere was no significant difference (p > 0.05) between the groups in the success rate at 15th day after treatment. Group IV and group V had higher success rates at 30th day after treatment compared with group I and group II (p < 0.05). In group III 30th day treatment success was not different from the other 4 groups (p > 0.05).ConclusionAlthough the number of patients who improved with chemical cauterization (group III) was higher in our study, no significant difference was observed in single treatment modalities (group I?III) at 14th day and 30th day after treatment. Although no statistically significant difference was observed between combined treatments (group IVV) and single treatments (group I?III) in the 2nd week after treatment, combined treatments were significantly more effective in the 1st month.