Symptomatic renal metastasis 5 years after the management of a squamous cell carcinoma of the lung

A case of solitary renal metastasis five years after the management of a primary squamous cell carcinoma of the lung is presented.     

Is childhood asthma still underdiagnosed and undertreated in Istanbul?

BACKGROUND: Childhood asthma is reported to be underdiagnosed and undertreated worldwide. The purpose of the present study was to investigate the rate of underdiagnosis and undertreatment among children diagnosed with asthma in a tertiary reference center in Turkey. METHODS: A questionnaire survey was carried out among the parents of 1134 patients diagnosed with asthma in a tertiary reference outpatient clinic. RESULTS: Mean age of the patients was 4.9 years (range 1-17 years). Of these children 45.5% had recurrent asthma attacks (average 4.8 attacks per year) and 24.7% had only the symptom of vigorous fits of coughing. Although they had been symptomatic for 29.6 months, only 41.1% were diagnosed as having asthma before admission to the clinic. In this study group 61.3% had received some form of asthma treatment, but only 21.1% of all patients were treated according to the guidelines. The rate of treatment according to guidelines was lower in the children under 6 years of age than older children (18.8 vs 24.2%, respectively, P = 0.02). CONCLUSIONS: Underdiagnosis and undertreatment of childhood asthma still seem to be a major problem in the management of childhood asthma, especially in preschool children, even after the recommendations of guidelines.     

Reversible Myoglobinuric Renal Failure Following Rhabdomyolysis as a Rare Complication of Cardioversion

CAVUSOGLU, Y., et al .: Reversible Myoglobinuric Renal Failure Following Rhabdomyolysis as a Rare Complication of Cardioversion. Reversible myoglobinuric renal failure following rhabdomyolysis that was related to repeated countershocks delivered for the treatment of refractory recurrent VT and VF attacks during acute myocardial infarction is presented in this case report, in which scan with technetium-99m pyrophosphate has been used for in the diagnosis of extensive skeletal muscle damage. (PACE 2003; 26[Pt. I]:645–646)     

Unusual Vascular Complications Associated with Transradial Coronary Procedures Among 10,324 Patients: Case Based Experience and Treatment Options

Objectives

We aimed to present our experience regarding the unusual vascular complications and specific treatment strategies in patients who underwent transradial coronary procedure (TRC).

Background

Transradial access provides lower vascular access site complication rates compared with transfemoral access. However, there is lack of data obtained from large study populations concerning the incidence and treatment strategies of hemorrhagic and vascular complications following a TRC in the literature.

Methods

10,324 patients (2,652 patients with percutaneous coronary intervention and 7,672 patients with a diagnostic transradial coronary angiography) who underwent a TRC from February 2010 to December 2014 were reviewed to identify cases of large hematoma, perforation, arteriovenous fistula, and pseudoaneurysm.

Results

The observed incidence was 0.44% (45 patients) for all unusual vascular and hemorrhagic complications. Of these 45 patients; 32 patients (0.31%) presented with large hematoma (≥6 cm), 8 patients (0.08%) presented with perforation, 4 patients (0.04%) presented with arteriovenous fistula (AVF), and only 1 case (0.009%) presented with radial artery pseudoaneurysm. Forty‐one of forty‐five patients were managed with mechanical compression. Surgery was performed in only 3 cases; a patient with a brachial artery perforation leading to compartment syndrome, a patient with AVF resulting in limb ischemia, and a patient with radial artery pseudoaneurysm. A right internal mammarian artery perforation resulting in huge breast hematoma was treated via endovascular graft stent implantation.

Conclusions

Hemorrhagic and vascular complications are rarely seen during TRC. However, majority of these complications could be managed conservatively without a requirement for surgical reconstruction. (J Interven Cardiol 2015;28:305–312)

     

Urethral polyps in children: A review of the literature and report of two cases

A solitary polyp of the urethra is a rare benign fibroepithelial growth and has often been described in boys. Its occurrence in girls is exceptional. In the present paper, two children with solitary polyps of the urethra are presented and discussed. The first case was an 18-month-old boy with a posterior urethral polyp arising from the posterior urethra and extending to the bladder. It was excised by cystostomy because of an unsuccessful endoscopic removal attempt. The second case was a 2-year-old girl with an interlabial mass arising from the posterior wall of urethra and protruding from the external urethral meatus. It was excised transurethrally.     

Medico-legal child deaths in Istanbul: data from the Morgue Department

BACKGROUND: Before determining health policies, finding solutions to problems and taking precautions, one should define the problems and their regional and national dimensions. Data about causes of death vary from country to country and, therefore, it is clear that precautions should be based on regional data and needs, which will be more effective. METHOD: The authors reviewed deaths among children aged 1 month to 18 years, whose autopsies were performed in the Morgue Department, State Institute of Forensic Medicine, Istanbul, Turkey, between 2000 and 2002. RESULTS: The authors evaluated autopsy reports about 736 child deaths. The mean age of the children was 8.77 +/- 6.25 years and 62.8% of the children were male. As to causes of death, the most frequent was asphyxia. Almost half of them were caused by mechanical asphyxia due to drowning. A total of 48.5% of the deaths were accidental. There was a significant difference in causes of death between children aged 11 years or younger and those aged over 11 years. Death due to nontraumatic conditions and poisoning was predominant among children aged 11 years and younger, while death due to gunshot wounds and stab wounds was predominant among children aged more than 11 years. There was a significant difference in causes of death between females and males. CONCLUSION: Asphyxia, poisoning and blunt traumatic injuries were found to be the leading causes of death, which can be prevented or decreased by certain precautions. As a result, new regulations should be enacted to protect children against accidents, injuries and hazards and a child protection program is needed in Turkey.     

Effect of hypothyroidism on the nitrergic relaxant responses of corpus cavernosal smooth muscle in rabbits

BACKGROUND: The incidence of hormonal dysfunction as a cause of impotence remains controversial. However, several recent studies have reported evidence of hormonal abnormalities in 25-35% of impotent men. Hypothyroidism has been reported to occur in 6% of impotent men. METHODS: In the present study, we examined nitrergic responses in hypothyroidism in rabbit corpus cavernosum and compared them with controls. RESULTS: Carbachol-induced relaxation responses and electrical field stimulation (EFS)-induced frequency-dependent relaxations decreased significantly in hypothyroid rabbits. Papaverine and sodium nitroprusside (SNP)-induced relaxation responses did not change significantly in hypothyroid rabbits. The contraction responses of phenylephrine and EFS-induced frequency-dependent contractions were significantly decreased in the hypothyroid group. CONCLUSIONS: We can speculate that the reduction of relaxant responses to EFS and carbachol in hypothyroid rabbits can depend on a decreased release of nitric oxide (NO) from nitrergic nerves and endothelium or a reduction of muscarinic receptor density. Also, decreases in contraction responses may depend on diminished adrenoceptor density.