Right atrial myxoma presenting as post partum ascites and fever of unknown origin.

A case is reported of right atrial myxoma presenting clinically as ascites and fever of unknown origin. An extensive work-up, including laboratory investigations, X-ray imaging, laparoscopy and laparotomy, failed to explain the clinical picture which was manifested post partum. Echocardiography was diagnostic and led to the curative treatment of surgical resection.     

Preparation and characterization of co-processed starch/MCC/chitin hydrophilic polymers onto magnesium silicate

It was aimed to investigate the compressibility, compactibility, powder flow and tablet disintegration of a new excipient comprising magnesium (Mg) silicate co-processed (5%–85% w/w) onto chitin, microcrystalline cellulose (MCC) and starch as the hydrophilic polymers of interest. Initially, the mechanism of tablet disintegration was studied by measuring water infiltration rate, moisture sorption, swelling capacity and hydration ability. Moreover, the powders compression behavior was carried out by applying Kawakita model of compression analysis in addition to porosity and radial tensile strength measurements. In vitro drug release of compacts made of 400?mg ibuprofen and 300?mg of the hydrophilic polymers containing 30% w/w Mg silicate co-precipitate was investigated in phosphate buffer (pH 7.8). This work demonstrated that the incorporation of Mg silicate to the hydrophilic polymers lead to the improvement of powder flowability, compactibility, stability (with regard to storage conditions), compacts crushing strength, and disintegration time in addition to faster drug release. The overall findings are practically advantageous in the context of finding a low cost and multifunctional co-processed excipient of natural origins.     

Impact of cigarette smoking and vaping on the outcome of full-mouth ultrasonic scaling among patients with gingival inflammation: a prospective study

Objectives

There are no studies that have assessed the oral soft tissue response to full-mouth ultrasonic scaling (FMUS) among cigarette-smokers (CS) (group 1), individuals vaping electronic-cigarettes (E-cigs) (group 2), and never-smokers (NS) (group 3). The aim was to assess the impact of cigarette smoking and vaping on periodontal tissues following FMUS.

Materials and methods

In a clinical prospective study, 89 male individuals were divided into three groups: CS (group 1), E-cig users (group 2), and NS (group 3). A questionnaire was used to gather demographic data and information regarding duration and daily frequency of CS and vaping. Full-mouth plaque index (PI), bleeding on probing (BOP), clinical attachment loss (AL), and probing depth (PD) were measured at baseline and 3 and 6 months after FMUS (without root surface debridement). Numbers of missing teeth (MT) were also recorded.

Results

In groups 1, 2, and 3, 30, 28, and 31 individuals, respectively were included. In group 1, there was no statistically significant difference in mean PI and PD and numbers of sites with PD ≥ 4 mm at 6 months’ follow-up compared with baseline and 3 months’ follow-up. In groups 2 and 3, there was no significant difference in PI, BOP, and PD at 3 months’ (P > 0.05) and 6-months’ (P > 0.05) follow-up. There were no pockets with PD ≥ 4 mm at 3 and 6 months’ follow-up in groups 2 and 3. There was no difference in the numbers of MT and none of the individuals exhibited clinical AL in all groups.

Conclusion

Following FMUS, gingival inflammation is worse in CS compared with individuals vaping E-cigs and NS.

Clinical relevance

Periodontal inflammatory parameters are worse in cigarette-smokers than individuals vaping electronic cigarettes and never-smokers following FMUS. However, these findings should be interpreted with extreme caution as a number of factors may have influenced the present results.

     

苏丹患者200例行前单瓣外路泪囊鼻腔吻合术的研究(英文)

目的:介绍苏丹患者实施前单瓣外路泪囊鼻腔吻合术的手术效果。方法:我们对两百个接受了前单瓣外路泪囊鼻腔吻合术并有至少1a随访的连续病例的临床资料进行回顾性分析。手术是由同一名医生即第一作者施行的,患者在术后随访1a。1a后出现泪溢且探通冲洗无效视作手术失败。结果:本研究样本中患者的平均年龄为29.7a(范围:4~65a)。男女性别比例为1∶2。手术成功率是98%。有4例患者报告手术失败,其中两例是外伤性患者,有先前存在的眼眶畸形。结论:此研究进一步证实了前单瓣外路泪囊鼻腔吻合术的有效性。尽管这种手术技巧更加简易,其成功率与文献报道的传统手术方法的成功率具有可比性。     

Apolipoprotein-E Genotype and the Risk of Developing Cholelithiasis following Bariatric Surgery: a Clue to Prevention of Routine Prophylactic Cholecystectomy

Background: Obesity and especially rapid weight loss following bariatric surgery are known risk factors for cholelithiasis. Since the risk may be high, prophylactic cholecystectomy has been advocated. Apolipoprotein (Apo) E, an important carrier protein in cholesterol metabolism and trafficking, is believed to play a role in gallstone pathogenesis. In particular, the Apo E4 allele has been suggested to be associated with cholesterol cholelithiasis. The aim of this study was to assess the incidence of postoperative cholelithiasis in our patient population and to determine a possible correlation with the Apo-E genotype. Methods: 134 morbidly obese patients undergoing gastric restrictive surgery [laparoscopic assisted gastric banding (LAGB) or silastic ring vertical gastroplasty (SRVG)] had abdominal ultrasound before and 6 to 12 months after operation, to determine the presence of gallstones. None of the patients enrolled in the study had gallstones before surgery.They did not have a prophylactic cholecystectomy or receive bile salt treatment. Apo-E genotypes were determined by Polymerase Chain Reaction restriction enzyme analysis. Results: 10 patients (7.5%) developed postoperative cholelithiasis. The incidence of cholelithiasis in each ApoE genotype was: E2/E3 - 1/20 (5%), E3/E3 - 3/91 (3%), E3/E4 - 6/21 (29%), and E4/E4 - 0/2. ApoE allele frequencies in the study population were identical to those of a healthy control population. The mean BMI dropped from 43.6 to 29.4 kg/m². Conclusions: The occurrence of postoperative gallstones was low in our population. However, in subjects with the Apo-E3/E4 genotype, the incidence is of practical significance. These data suggest that Apo-E genotyping may be useful in selecting patients for gallstone prevention (surgical or medical) when undergoing bariatric surgery.Further testing in larger patient populations may be able to give more definite guidelines in the future.     

The Influence of Surgically-Induced Weight Loss on the Knee Joint

Background: The causal relationship between obesity and osteoarthritis (OA) of the knee is generally accepted. Weight loss has been shown to reduce the development of OA and improve the radiological parameters of existing disease. However, inducing weight reduction is difficult, and thus the number of patients studied has been small. We wished to determine the effects of surgically-induced weight loss on objective, radiological evidence of OA in the knee joint. Methods: 64 consecutive patients that were referred to the Bariatric Surgical Unit were enrolled in the study. The only exclusion criterion was the prior diagnosis of OA. Knee pain alone did not exclude patients from the study. The study was performed in a prospective manner as a before-after trial. Radiographic data was evaluated by an independent radiologist not involved in the patient care or follow-up. Upright film of the knee was taken prior to surgery and 3 months following surgery. Minimal medial joint space width (JSW) was measured by a digital image computer. In addition, patients were clinically assessed using the American Knee Society Score (AKSS) at these times. Results: 59 of 64 patients were available for followup. BMI decreased from 43.4 to 36.9 (P<0.01). The medial joint space increased from 4.6 mm to 5.25 mm (P<0.001). The AKSS improved from 78.5 points (perfect function = 100 points) to 90.69 points (P<0.01). Conclusion: Surgically-induced weight loss is an effective, rapid and dependable means of reversing the radiological signs of early changes associated with OA.     

Laparoscopic adjustable gastric banding surgery for morbid obesity: imaging of normal anatomic features and postoperative gastrointestinal complications

OBJECTIVE: The purpose of this essay is to describe the normal anatomic findings after laparoscopic adjustable gastric banding surgery and the imaging findings of postoperative gastrointestinal complications. CONCLUSION: With the increasing prevalence of morbid obesity, laparoscopic adjustable gastric banding surgery has evolved to be a leading surgical technique. Radiologists need to be familiar with the normal anatomic findings after laparoscopic adjustable gastric banding surgery and with the imaging findings of postoperative complications.