Diagnosis,treatment and maxillofacial rehabilitation in rhinocerebral mucormycosis patient: A case report and review of the literature

Mucormycosis is an aggressive, rare and opportunistic infectious disease, with a high mortality rate. Etiologic agents are filamentous fungi, and infection among humans normally occurs through spore inhalation. A 61-year-old male individual, presenting left eye amaurosis, dark epistaxis, hyperalgesia and malodor underwent clinical examination, which detected ulcerative lesion and wide bone exposure in the hard palate and alveolar ridge. Direct microbiological examination, microbiological culture and lesion biopsy were performed. Non-septate smooth fungal hyphae forming right angles with each other were observed through the direct microbiological examination. Microbiological culture revealed fast-growing fungal colonies with cottony texture, identified as Rhizopus sp. Histopathological examination exhibited necrosis areas, intense mononuclear inflammatory infiltrate and bulky hyphae, thus concluding the mucormycosis diagnosis. Amphotericin B antifungal therapy and surgical intervention were adopted as treatment. The patient was then rehabilitated with maxillofacial prosthesis, subsequently to the healing of the surgical wound.     

Management of small renal masses: a review

Introduction  

Recently, small renal masses (SRMs) (≤4 cm) are found more frequently, especially in the elderly and co-morbid patients. Standard treatment for SRMs is nephron-sparing surgery (NSS). New techniques like energy ablation and surveillance have been introduced.     

Which is the best radiological imaging method for predicting actual prostate weight?

In this study, we compared the weight of the prostate specimen removed after robotic radical prostatectomy with the prostate weight measured pre-operatively by four different imaging modalities. Pre-operative prostate weight before robotic radical prostatectomy was measured by Transabdominal Ultrasonography (TAUS), Transrectal Ultrasonography (TRUS), Abdominal Tomography (CT) and MultiparametricProstate Magnetic Resonance imaging (mpMRI). Of the 170 patients enrolled in the study, the mean age was 65.2 ± 7.08 (46–84) years and mean prostate-specific antigen (PSA) 9.6 ± 7.7 (1.8–50). The mean post-operative actual prostate weight was 63.1 ± 30 gr. The mean pre-operative prostate volumes measured by TAUS, TRUS, CT and MPMRI were 64.5 ± 28.5, 49.1 ± 30.6, 54.5 ± 30.5 and 68.7 ± 31.7 ml, respectively (p < .001). Post-operative actual prostate weight correlated with prostate weight measured by TAUS, TRUS, CT and mpMRI (r coefficient 0.776, 0.802, 0.768 and 0.825 respectively). The best of these was mpMRI. Although prostate weight measured by different imaging methods has a high correlation to predict actual prostate weight, actual prostate weight is best predicted by measurements with mpMRI. However, errors and deviations that may occur with these imaging methods should be taken into consideration.     

The association between maternal hydronephrosis and acute flank pain during pregnancy: a prospective pilot-study

Purpose: Maternal hydronephrosis may cause flank pain during pregnancy. We aimed to investigate the association between maternal hydronephrosis and flank pain intensity.

Methods: From 2014 to 2015, all consecutive women with singleton pregnancies, who presented at our tertiary center due to acute flank pain, were prospectively evaluated by renal ultrasonography and pain questionnaires. A visual analogue scale was used to assess pain intensity. The study had 90% power to detect a significant correlation between hydronephrosis and flank pain (Spearman’s test).

Results: A total of 51 consecutive women with left-sided (13.7%), right-sided (64.7%) or bilateral (21.6%) pain were enrolled. The mean gestational age of these women, who presented due to their pain, was 27.5?±?6.8 weeks at the time of consultation. The mean VAS score was 7.6?±?2.2. In 43/51 (84.3%) women, hydronephrosis was found on renal sonograms. No correlation was found between the grade of hydronephrosis and pain intensity (p = 0.466; r=??0.28). Women delivered at a mean gestational age of 38.1?±?2.4 weeks and their infants had a mean birthweight of 3138?±?677?g.

Conclusions: Hydronephrosis is a common finding among pregnant women with acute flank pain. The grade of hydronephrosis does not affect pain intensity. This study suggests normal pregnancy outcomes in these women.     

Under-utilization of health care services for infectious diseases syndromes in rural Azerbaijan: A cross-sectional study

Background  

Infectious diseases present a potentially substantial yet undefined burden on the health of the adult Azerbaijani population. Efforts to quantify this burden in Azerbaijan are currently based almost exclusively on passive disease surveillance, and therefore hinge on the health utilization practices of the population. Understanding the prevalence of infectious syndromes and health utilization practices is paramount to disease surveillance, public health planning, and health care system reform.     

A novel framework for a remote patient monitoring (RPM) system with abnormality detection

ObjectiveThis research aims to build an effective and automated RPM system based on an information communication technology (ICT) framework that automatically triggers medical alerts, hospital visits, medications, and social support in a timely and precise manner, with specific attention to aging people. The goal of the proposed framework is to construct a safe, flexible, and manageable system containing multi-agent, auto-notice, sensor management, and secure transmission of data to allow an autonomous functioning of RPM.MethodsThe literature between 2002 and 2018 that introduces healthcare platforms with the technology of the Internet of things (IoT) is reviewed and compared in compliance with various technical and functional features. Eleven healthcare-based IoT platforms are compared. Eight of them utilize the Representational State Transfer Application Programming Interface (REST API), while ten of them have Message Queue Telemetry Transport (MQTT), seven of them have device management, and nine of them have security control. In addition, Kepware's KEPServerEX communication platform containing up to 250 communication protocols is included.ResultsThe results confirm that the proposed framework reliably operates within the complex healthcare processes, taking into account the equipment management, security management, messaging and diversification of communication protocols. This study uses the concept of IoT 3-tier through which a complete sensor management mechanism is structured. Moreover, secure data connection protects the patient's privacy. Each sensor provides a distinctive notification to construct flawless authority management.ConclusionsThe proposed framework can not only reach the machine-to-machine (M2M) realm, but also provide support in emergency cases.     

Rapid Multiple Immunoenzyme Assay of Mycotoxins

Mycotoxins are low molecular weight fungal metabolites that pose a threat as toxic contaminants of food products, thereby necessitating their effective monitoring and control. Microplate ELISA can be used for this purpose, but this method is characteristically time consuming, with a duration extending to several hours. This report proposes a variant of the ELISA method for the detection and quantification of three mycotoxins, ochratoxin A, aflatoxin B1 and zearalenone, in the kinetic regime. The main requirement for the proposed kinetic protocol was to provide a rapid method that combined sensitivity and accuracy. The use of biotin with an extended spacer together with a streptavidin–polyperoxidase conjugate provided high signal levels, despite these interactions occurring under non-equilibrium conditions. Duration of the individual mycotoxin assays was 20 min, whereas the analysis of all three mycotoxins in parallel reached a maximum duration of 25 min. Recovery of at least 95% mycotoxins in water-organic extracts was shown. The developed assays were successfully validated using poultry processing products and corn samples spiked with known quantities of mycotoxins. The detection limits for aflatoxin B1, ochratoxin A and zearalenone in these substances were 0.24, 1.2 and 3 ng/g, respectively.