Bilateral perineal ectopic testes

Perineal testicular ectopia is seen very rarely, bilaterality is even more scarce and three cases have been reported in the literature. Here we present the fourth case with bilateral perineal ectopic testes.     

Neuroleptic malignant syndrome induced by ziprasidone on the second day of treatment.

Neuroleptic malignant syndrome (NMS) is the rarest and most serious of the neuroleptic-induced movement disorders. We describe a case of neuroleptic malignant syndrome (NMS) associated with the use of ziprasidone. Although conventional neuroleptics are more frequently associated with NMS, atypical antipsychotic drugs like ziprasidone may also be a cause. The patient is a 24-year-old male with a history of schizophrenia who developed signs and symptoms of NMS after 2 days of treatment with an 80-mg/day dose of orally administrated ziprasidone. This case is the earliest (second day of treatment) NMS due to ziprasidone reported in the literature.     

Influence of immediate and delayed post space preparation on sealing ability of resilon.

OBJECTIVE: The purpose of this study was to evaluate the effect of immediate and delayed post space preparation on the sealing ability of a new root canal filling material. STUDY DESIGN: Seventy-two extracted teeth were prepared and obturated with gutta-percha/AH-Plus and Resilon/Epiphany sealer by the lateral compaction technique. The teeth were divided randomly into 4 groups, and the post space was prepared either immediately after filling or after the obturated teeth had been stored in saline at 37 degrees C for a week. Leakage was determined by a fluid-transport device. RESULTS: The results showed that immediate post space preparation of the Resilon/Epiphany-filled group had a mean leakage value of 0.81 microL/h, whereas the delayed preparation had a mean leakage value of 0.75 microL/h. No difference (P > .05) in microleakage was found between gutta-percha/AH-Plus and Resilon/Epiphany-filled groups after immediate preparation. There was significant difference between gutta-percha/AH-Plus and Resilon/Epiphany groups in the delayed post space preparation (P < .05). CONCLUSION: Epiphany/Resilon obturation achieved better sealing than gutta-percha/AH-Plus at the apical end, especially in delayed post space preparation when mechanical techniques were used.     

Dosimetric evaluation of the effect of dental implants in head and neck radiotherapy.

OBJECTIVE: The aim of the study was to examine the dose enhancement from scattered radiation at bone-dental implant interfaces during simulated head and neck radiotherapy. STUDY DESIGN: Four cylindrical titanium dental implants with 3 different sizes and lengths were implanted into a human mandible in 4 different positions. Ionization measurements for 6 MV X, 25 MV X, and Co-60 gamma rays were done. Thermoluminescent dosimeter (TLD 100 ) chips were used to measure radiation dose enhancement due to the scattered electrons from titanium and electronic disequilibrium at the tissue-metal interface. RESULTS: The results showed that for Co-60, there is a 21% maximum increase in dose to alveolar mandibular bone at the close proximity to the titanium. For 6-MV x-rays the dose enhancement increase was almost the same or slightly lower than for Co-60, while for 25-MV high-energy x-rays, dose enhancement was lower than that of others. This increase in dose enhancement fell off rapidly and became insignificant at 2 mm from the interface. CONCLUSION: Total dose that may lead to osteoradionecrosis risk of the mandible is slightly but not significantly affected by the scattered dose of the dental implants of lower jaw in the radiation field exposed to 3 different radiation beams.     

When is the right time to take an emergency surgery decision in Mechanical Intestinal Obstruction?

Background/Objective: Ischemia is a leading cause of morbidity in Mechanical Intestinal Obstruction (MIO) in which the timing of decisions of whether to proceed to surgical or conservative treatment is critical in emergency departments (ED). While advanced technological options are available, patients may be negatively affected by the application of contrast agents or radiation. The use of ultrasound is limited because of the air in the intestines does not allow a good field of vision. While biomarkers can be considered as a good alternative option at this point. In the present study we examine the effect of hemogram and blood gas parameters on early surgical decision-making in MIO patients.MethodInvolved in this observational prospective study were 264 patients diagnosed with MIO who presented to the Department of Emergency Medicine, Ataturk Research and Training Hospital, Katip Celebi University between February 2018 and February 2019. Contrast-enhanced tomography (CECT) and laboratory results of the patients were recorded. Pathology reports of the patients who underwent surgery were collected. Laboratory data were analyzed by comparing CECT and pathology reports.ResultsIn a ROC analysis of the laboratory values of the patients who were diagnosed with ileus, the sensitivity was calculated as 80% and the specificity was 57.7 in values above WBC>10.75 (10⁹/L), 96.6%, and the specificity was 31.1% in N/L > 2.9. For intestinal ischemia, the cut-off values were WBC> 12.6 and N/L > 3.2, Lactate >2.8 mmol/L and B.E < -3.6 mmol/L.ConclusionDiagnoses of ileus are based on the results examinations and imaging methods. More data are needed to support decisions on the timing of surgery in ED. WBC, N/L, Lactate and Base Excess indicate an ischemic segment. When the parameters are evaluated together, they strongly support early surgical decision-making regarding the treatment of intestinal ischemia.