Successful treatment of massive thrombosis in different locations with prolonged thrombolytic therapy: A life-saving intervention

Venous thrombosis is recognized as one of the most important complications of nephrotic syndrome (NS). In patients with NS, venous thrombosis may develop in the renal veins, the deep veins of the lower limb, and the inferior vena cava. Here, we describe a case report of an NS patient with multiple venous thrombosis in the right renal vein, the left iliac vein, the vena cava inferior, the right atrium, and the pulmonary arteries. Moreover, we describe the successful treatment of multiple venous thrombosis with prolonged thrombolytic treatment in spite of an increased risk of bleeding due to renal biopsy.     

A comparison of suprascapular nerve block and procedural sedation analgesia in shoulder dislocation reduction

Objectives

Dislocation of the shoulder joint is one of the most common dislocations. The reduction procedure is a painful procedure. In this study, 2 different treatment groups were compared for pain control during shoulder dislocation reduction. It was aimed to evaluate the differences between the groups in reduction, success, length of hospital stay, complications, side effects, patient-physician satisfaction, and ease of application.

Methods

The study was planned to be prospective and randomized. As procedural sedation analgesia (SA), titration of ketamine 1 to 2 mg/kg was administered intravenously to group 1. Suprascapular nerve block (SNB) was applied under ultrasound guidance (USG) to group 2. Conformity to normal distribution of variables was examined with the Kolmogorov-Smirnov test. The χ² test and Fisher test were used to evaluate differences between the groups in categorical variables and the Mann-Whitney U test, and a value of P < .05 was accepted as statistically significant.

Results

The study comprised a total of 41 patients; 20 in the group 1 and 21 in the group 2. No statistically significant difference was determined between the groups in terms of age (P = .916), sex (P = .972), reduction success (P = .540), and patient-physician satisfaction (P = .198). The time spent in the emergency department (ED) by patients in the SA group was signficantly longer compared with the SNB group. No side effects were observed in the SNB group.

Conclusions

Suprascapular nerve block, which can be easily applied under USG in the ED, can be evaluated as a good alternative to SA in the reduction of shoulder dislocations.     

维吾尔药薰衣草的生药学研究

目的：研究维吾尔药薰衣草的生药学鉴定特征,为其鉴别及应用提供科学依据。方法：采用观察、显微及薄层色谱鉴别方法对薰衣草的性状、显微和薄层色谱特征进行研究。结果：详细描述了维吾尔药薰衣草的生药学鉴定特征。结论：为薰衣草的鉴别、质量标准提高、开发利用及补充生药学资料提供参考依据。     

Laparoscopic vs open complete mesocolic excision with central vascular ligation for right-sided colon cancer

Complete mesocolic excision (CME) is being performed more frequently and has recently become an established oncologic surgical method for right hemicolectomy. Despite its advantages, such as its association with early mobilization, a short hospital stay, early bowel movement, mild postoperative pain, and good cosmesis, CME is technically demanding and carries the risk of severe complications. This study aims to compare the clinical, pathological, and oncological results of open and laparoscopic right hemicolectomy with CME.The data of 76 patients who underwent right hemicolectomy with CME and high vascular ligation were reviewed retrospectively. The patients were divided into 2 groups according to whether the open or laparoscopic technique was used.Thirty-two patients underwent open right hemicolectomy, and 44 patients underwent laparoscopic right hemicolectomy. The 2 groups were similar in age, sex, American Society of Anesthesiologists class, abdominal surgical history, tumor localization, and operation time. No significant differences were found regarding the specimen length, tumor size, harvested lymph nodes, number of metastatic lymph nodes, or tumor grade. According to the Clavien–Dindo classification system, the laparoscopic group had significantly fewer complications than did the open group (11.4% vs 31.2%; P = .04). The open group had a longer postoperative hospital stay than did the laparoscopic hemicolectomy group (9.9 ± 4.7 vs 7.2 ± 3.1 days; P = .002). In addition, the groups were similar with respect to disease-free survival (P = .14) and overall survival (P = .06).The data in this study demonstrated that no differences exist between the open and laparoscopic techniques concerning pathological and oncological results. However, significantly fewer complications and a shorter length of hospital stay were observed in the laparoscopic group than in the open group. Laparoscopic right hemicolectomy with CME and central vascular ligation is a safe and feasible surgical procedure and should be considered the standard technique for right-sided colon cancer.     

Attitudes of physiotherapists and physiotherapy students toward euthanasia: A comparative study

This interventional study was undertaken to assess the impact of physiotherapy education on the knowledge and attitudes of physiotherapists (PTs) and physiotherapy students (PSs) toward euthanasia. The study, which was conducted during the period between 2004 and 2005, included a total of 494 participants (311 PTs; 183 PSs) aged 18 to 52 y from the western and central portions of Turkey, who responded to a self-report questionnaire (response rate, 96.4%) that was based on data from the literature. Results indicated that PTs (48.9%) were more likely to approve of euthanasia than PSs (38.3%) (P<.05). The legalization of euthanasia was favored by 43.7% of PTs, compared with 29.5% of PSs (P<.05). On the other hand, PTs and PSs expressed similar views regarding euthanasia, including reasons for accepting or opposing euthanasia and acceptable conditions for its use (P> .05). Overall results showed that sex and age had no effect on whether euthanasia was accepted (P> .05); religiousness was found to have the greatest effect on attitudes toward euthanasia (P<.05). The findings of the current study suggest that (1) the attitudes of PTs are different from those of PSs, and (2) the Islamic point of view has a negative impact on the attitudes of PTs and PSs toward euthanasia.     

Anxiety and depression in patients with rheumatoid arthritis

Rheumatoid arthritis (RA) mostly follows a painful, progressively disabling course, and individuals with RA experience more psychological distress than healthy individuals. The objective of the present study is to examine the prevalences of accompanying anxiety and depression in RA cases. The study included 82 RA cases and 41 age- and sex-matched healthy volunteers as the control group. Psychiatric examinations of all cases of the patient and control groups were performed according to DSM-IV criteria. Hamilton Anxiety Scale or Hamilton Depression Scale was applied to those who were found to have anxiety or depression. Total prevalence of anxiety, depression, and mixed anxiety-depressive disorder was found to be 70.8% (n=58) in the patient group and 7.3% (n=3) in the control group, and the difference was significant (p<0.001). Of the RA patients, 41.5% (n=34) was found to have depression, 13.4% (n=11) anxiety, and 15.9% (n=13) mixed anxiety-depressive disorder. The disease duration in patients with anxiety was shorter than the RA patient with depression (p<0.05). The disease duration was positively correlated with the degree of depression and negatively correlated with the degree of anxiety (r=0.341, p<0.05; r=−0.642, p<0.05, respectively). The results of our study suggest that prevalences of anxiety and mainly depression, increase in RA cases. When the clinical picture in RA cases becomes complicated with anxiety or depression, some problems at patients’ adaptation and response to treatment may be possible. RA cases should be monitored for accompanying anxiety or depression during follow-up.     

The thickness and the lengths of the anterior wall of adult maxilla of the West Anatolian Turkish people

The maxilla is the key structure on facial formation and stability. The knowledge about maxillary thickness and dimensions is crucial during facial reconstruction including this bone. In this study, anthropometric measurements of anterior wall of the maxilla on the dry human skulls were aimed. Sixty maxillae of 30 adult dry skulls of West Anatolian people were evaluated. Four vertical lines were drawn between the piriform aperture and lateral border of the bone and six horizontal lines between the infra-orbital margin and the inferior border of the piriform aperture. After establishing the lines, maxillary thicknesses on the intersection points of the vertical and horizontal lines and the lengths of the vertical lines from the infra-orbital margin to alveolar arch were measured by using a fine caliper. It was found that the thickest point of the anterior wall of the maxillae is on the lateral of the infra-orbital margin (5.17 ± 2.27 mm), and thinnest one is on the inferior of the infra-orbital foramen (0.92 ± 1.06 mm). The length of the vertical line tangent to piriform aperture (47.66 ± 3.61 mm) is the longest. The corresponding data of the left and right maxillae were compared by Student’s t test. There was no significant difference between both sides. After collecting the data, a thickness map of anterior wall of the maxilla was drawn. This data may be helpful in clinic during osteotomies, bone reconstructions, screw, or other reconstruction apparatus applications on the maxilla.     

Serum lipid levels in psoriasis

A predisposition to occlusive vascular diseases has been reported in patients with psoriasis and it has been suggested that some of these patients have some disorders of lipid metabolism. In this study, serum lipid levels were investigated in psoriatic patients to explore to the knowledge of this relationship. One hundred psoriatic patients and 100 non- psoriatic controls were included in the study. Total cholesterol, triglyceride, high-density lipoprotein-cholesterol (HDL-cholesterol), low-density lipoprotein-cholesterol (LDL-cholesterol), and very low-density lipoprotein-cholesterol (VLDL-cholesterol) levels were measured. In patients with psoriasis, total cholesterol and LDL-cholesterol levels were found to be significantly higher than those of controls. No significant differences were found in the other parameters. We concluded that psoriatic patients should be evaluated and followed up for the risk of hyperlipidemia and obstructive vascular diseases.     

Location and incidence of the zygomaticofacial foramen: An anatomic study

The location and incidence of the zygomaticofacial foramen (ZFF) was studied in 80 dry skulls (160 sides) of unsexed adult skulls of West Anatolian people. The average distances from the ZFF to the frontozygomatic suture, to the zygomaticomaxillary suture, and to the inferior orbital rim were found to be 26.2 ± 3.2 mm, 18.6 ± 3.14 mm, and 5.94 ± 1.43 mm, respectively. The zygomas were evaluated for the number of foramina on their facial aspects. There was none in 25 (15.6%), one in 71 (44.4%), two in 45 (28.1%), three in 10 (6.3%), four in seven (4.4%), and five in two (1.3%) sides. The ZFF was also studied for its distribution around the zygoma by dividing the surface into four anatomical areas. There was no statistical difference between the morphometrical results on both sides. Data regarding the location and variation in the number of the ZFF is important in avoiding zygomatic nerve and vessel injury during surgery, but by virtue of the great variability found, ZFF is an unreliable landmark for maxillofacial surgery. Clin. Anat. 22:559–562, 2009. © 2009 Wiley‐Liss, Inc.     

DNA ploidy,proliferative activity,and concanavalin A reactivity in breast cancer

Paraffin-embedded primary tumor specimens from 48 patients with breast cancer were examined for DNA ploidy, S-phase fraction (SPF), and concanavalin A (Con A) reactivity. The results were correlated with clinicopathological prognostic factors, including patients' age and menopausal status, stage of disease, nuclear grade, and size of the primary tumor. There were no associations among ploidy, SPF, Con A reactivity, and menopausal status, stage of disease, or size of the primary tumor. However, among patients who were 50 years or older, 81 % had diploid tumors and 73% had good reactivity (3+ or better staining score) with Con A. In contrast, among patients who were younger than 50 years, 45% had diploid tumors (P < 0.05) and 21% had good Con A reactivity (P < 0.05). Seven of 19 (37%) poorly differentiated tumors and 7 of 9 (78%) moderately differentiated tumors had good reactivity with Con A (P < 0.05). Reactivity of tumor cells with Con A in primary breast cancer tissues deserves further evaluation as a potential biomarker of prognosis. © 1994 Wiley-Liss, Inc.