Cerebral sinus thrombosis in scleroderma: a case report

Scleroderma or systemic sclerosis is a multisystem disease due to excessive collagen deposition in different organs and autoimmunity by production of autoantibodies.According to previous reports, brain is rarely affected in scleroderma, however recent studies show central nervous system can be affect not only as a complication of systemic involvement (hypertension, renal failure) but also as a primary manifestation. In scleroderma, thrombus formation in central nervous system and peripheral systems is uncommon may be due to endothelial cells damage which causes to release antithrombotic factors. We discuss a scleroderma patient with high titter of anticardiolipin antibody who developed to cerebral sinus thrombosis and cerebellum infarction. Then we review literature for both primary brain involvement and thrombotic event in systemic sclerosis.     

Is it necessary to place a double j catheter after laparoscopic ureterolithotomy? A four-year experience

Abstract Purpose: To assess the necessity of placing a ureteral stent after transperitoneal laparoscopic ureterolithotomy (TPLU). Patients and Methods: In the period from May 2006 to November 2010, 46 patients underwent TPLU. There were 13 females and 33 males. All patients had an impacted stone larger than 1.5?cm in the upper and middle parts of the ureter. TPLU was performed as either a primary therapy or as a salvage therapy in patients in whom another treatment had failed. The exclusion criteria were pregnancy, a body mass index more than 35, and patients with abnormal results on coagulative tests. In all cases, after removing the stone, the ureter was sutured. In the first 23 patients, no ureteral catheter was placed, but in the second 23 patients, a Double J catheter was inserted through the ureter. Results: In one case, the stone was pushed back. The stone-free rate was 97.8%. There were four cases of prolonged urinary leakage after the surgery. All of them were in the group in whose members the Double J catheter had not been placed. The problem was resolved in one patient spontaneously after 4 days, but for the other three patients, a Double J catheter was placed and the leakage was stopped in 24 hours. There was no case of urinary leakage in the second group of patients with a placed Double J catheter. Conclusion: Placing a Double J catheter during surgery does not increase the time of operation and may play a role in prevention of urinary extravasation after laparoscopic ureterolithotomy.     

Asymptomatic cryptosporidiosis in nomadic shepherds and their sheep

The formed stool samples of 276 asymptomatic members of 36 households of a group of nomadic shepherds and 215 non-diarrhoeal faecal samples from their sheep were examined for cryptosporidial infection by a modified Ziehl-Nielsen technique. Thirty-six (13%) human samples and 37 (17.2%) samples from sheep were positive. A strong possibility of asymptomatic zoonotic transmission of cryptosporidiosis due to prolonged and constant association of shepherds and their sheep was an important finding.     

Biofeedback treatment of narcotic addiction: A double-blind study

This is a report on the double-blind study on EMG biofeedback for 37 narcotic addicts in an outpatient methadone clinic. Patients were randomly assigned to either the experimental group (N = 24) receiving a contingent EMG biofeedback or a control group (N = 13) receiving non-contingent preaped “pseudo-biofeedback”. All patients were stabilized on a study dose of methadone and the mean daily amount did not differ between groups. All were experiencing a significant degree of anxiety at the time of evaluation. The evaluation consisted of the patient's self-report, which comprised the Beck Depression Inventory, anxiety checklist, withdrawal sickness rating, drug references, and the psychiatrist's rating of depression, namely the Hamilton Depression Scale, Hamilton Anxiety Scale, and BPRS. In addition, an evaluation of progress was obtained from the patient and his counselor which included the current job or school status and brief ratings of drug use, psychiatric symptoms, social adjustment, and illegal activity. All patients had at least one urine sample analyzed weekly for illicit drug use. Evaluation was done at the beginning, and at the end of the treatment and at a follow-up one month later.Termination status was assessed only for subjects who completed the course of 15 biofeedback sessions (N = 19). Patients attended five sessions per week for thirty minutes just prior to receiving the methadone. Fifteen sessions were scheduled over a three-week period. The results indicated that the two study groups did not differ and there was a significant improvement (p < 0.05) on several variables for the total patient sample. All the psychiatric ratings of anxiety, depression, psychopathology were significantly reduced. In addition, self-rated craving for narcotics and self-rated anxiety were lower and there were fewer drug avoidance responses on the sentence completion test. But there were no meaningful differences in the two groups in improvement as reflected in the psychometric instruments.     

Tubeless percutaneous nephrolithotomy: 5 years of experience in 201 patients

BACKGROUND AND PURPOSE: Our aim was to evaluate the safety, effectiveness, and feasibility of tubeless percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: From June 2000 to September 2005, 201 patients with renal stones >2 cm underwent tubeless PCNL by a single surgeon. We report details of the outcomes. RESULTS: The complete stone clearance rate was 91.04% (183 patients). After surgery, 18 patients (8.96%) had stones (mean size = 7 mm) detected on a plain abdominal radiograph or ultrasonographic examination and were referred for shockwave lithotripsy. The mean stone size was 30 mm (range 20-40 mm). The mean operative time was 35 minutes (range 30-60 min), and the mean hospital stay was 3.5 days (range 2-5 days). Postoperative ultrasonography did not reveal considerable fluid collection. There were no visceral injuries. Twenty-two (10.9%) patients received a transfusion, and 16 (7.9%) patients had urinary tract infection. CONCLUSION: In our experience, tubeless PCNL is safe, effective, and feasible without any discomfort for patients.     

The effects of intramuscular and intraperitoneal injections of benzo[a]pyrene on selected biomarkers in Clarias gariepinus

This study investigated the dose-dependent and time-course effects of intramuscular (i.m.) and intraperitoneal (i.p.) injection of benzo[a]pyrene (BaP) on the biomarkers EROD activity, GST activity, concentrations of BaP metabolites in bile, and visceral fat deposits (Lipid Somatic Index, LSI) in African catfish (Clarias gariepinus). Intraperitoneal injection resulted in 4.5 times higher accumulation of total selected biliary FACs than i.m. injection. Hepatic GST activities were inhibited by BaP via both injection methods. Dose-response relationships between BaP injection and both biliary FAC concentrations and hepatic GST activities were linear in the i.p. injected group but nonlinear in the i.m. injected fish. Hepatic EROD activity and LSI were not significantly affected by BaP exposure by either injection route. We conclude that i.p. is a more effective route of exposure than i.m. for future ecotoxicological studies of PAH exposure in C. gariepinus.