Udar przysadki po operacji serca u chorego z podklinicznym gruczolakiem przysadki: opis przypadku i przegląd piśmiennictwa

Abstract Pituitary adenoma infarction associated with cardiac surgery occurs rarely but it is a serious, life-threatening acute clinical event. Several mechanisms have been proposed but no direct cause has been clearly identified. We report a case of pituitary apoplexy occurring in a 74-year-old patient 6 hours after cardiac surgery. The patient presented with confusion, unilateral ptosis and ophthalmoplegia. Neurological examination revealed right oculomotor nerve palsy and decreased level of consciousness. Magnetic resonance imaging showed a hemorrhagic and necrotic pituitary macroadenoma. After prompt endocrinological replacement therapy with hydrocortisone and levothyroxine, the confusion of the patient resolved. Removal of a non-functional macroadenoma with large necrotic areas resulted in full recovery. The physician should be aware of pituitary adenoma infarction after open cardiac surgery and should remember that it can be fatal or cause permanent neurological or endocrine damage without proper treatment. Surgical and endocrine treatment can be life-saving procedures.Streszczenie Zawał w obrębie gruczolaka przysadki związany z operacją serca występuje rzadko, ale jest stanem zagrożenia życia. Wskazywano na kilka mechanizmów wystąpienia tego powikłania, ale dotąd nie określono jednoznacznej przyczyny. Przedstawiono przypadek udaru przysadki, który wystąpił u 74-letniego mężczyzny po 6 godz. od operacji serca. U chorego zaobserwowano zmącenie, jednostronne opadnięcie powieki i zaburzenia gałkoruchowe. W badaniu neurologicznym stwierdzono porażenie prawego nerwu okoruchowego i zaburzenia przytomności. W badaniu za pomocą rezonansu magnetycznego uwidoczniono gruczolaka przysadki ze zmianami krwotocznymi i martwiczymi. Zaburzenia świadomości ustąpiły po niezwłocznym leczeniu hydrokortyzonem i lewotyroksyną. Usunięcie nieczynnego wydzielniczo gruczolaka z dużymi obszarami martwicy spowodowało powrót do zdrowia. Należy pamiętać o zawale w obrębie gruczolaka przysadki jako powikłaniu operacji na otwartym sercu. Nieleczona, choroba ta może doprowadzić do zgonu lub trwałych następstw neurologicznych bądx endokrynologicznych. Leczenie chirurgiczne i endokrynologiczne może być w tej sytuacji działaniem ratującym życie

Foliar-applied glyphosate substantially reduced uptake and transport of iron and manganese in sunflower (helianthus annuus L.) plants

Evidence clearly shows that cationic micronutrients in spray solutions reduce the herbicidal effectiveness of glyphosate for weed control due to the formation of metal-glyphosate complexes. The formation of these glyphosate-metal complexes in plant tissue may also impair micronutrient nutrition of nontarget plants when exposed to glyphosate drift or glyphosate residues in soil. In the present study, the effects of simulated glyphosate drift on plant growth and uptake, translocation, and accumulation (tissue concentration) of iron (Fe), manganese (Mn), zinc (Zn), and copper (Cu) were investigated in sunflower ( Helianthus annuusL.) plants grown in nutrient solution under controlled environmental conditions. Glyphosate was sprayed on plant shoots at different rates between 1.25 and 6.0% of the recommended dosage (i.e., 0.39 and 1.89 mM glyphosate isopropylamine salt). Glyphosate applications significantly decreased root and shoot dry matter production and chlorophyll concentrations of young leaves and shoot tips. The basal parts of the youngest leaves and shoot tips were severely chlorotic. These effects became apparent within 48 h after the glyphosate spray. Glyphosate also caused substantial decreases in leaf concentration of Fe and Mn while the concentration of Zn and Cu was less affected. In short-term uptake experiments with radiolabeled Fe (59Fe), Mn (54Mn), and Zn (65Zn), root uptake of 59Fe and 54Mn was significantly reduced in 12 and 24 h after application of 6% of the recommended dosage of glyphosate, respectively. Glyphosate resulted in almost complete inhibition of root-to-shoot translocation of 59Fe within 12 h and 54Mn within 24 h after application. These results suggest that glyphosate residues or drift may result in severe impairments in Fe and Mn nutrition of nontarget plants, possibly due to the formation of poorly soluble glyphosate-metal complexes in plant tissues and/or rhizosphere interactions

A Burkitt's Lymphoma Case Mimicking Crohn's Disease: A Case Report

Lymphomas are solid tumors that arise from lymphoid tissue and present themselves as Hodgkin's or non-Hodgkin's lymphoma. Particularly gastrointestinal lymphomas can be clinically confused with other gastrointestinal tumors as well as with diffuse and inflammatory bowel disease. Early diagnosis and treatment bear vital importance in the management of lymphomas due to their high proliferation rates. In this report, we are presenting a case which initially displayed clinical and radiological signs of Crohn's disease, but was eventually diagnosed as Burkitt's lymphoma by laparotomy, and also we aim to underscore the importance of differential diagnosis

Can Fear Of Movement, Depression And Functional Performance Be A Predictor Of Physical Activity Level In Patients With Knee Osteoarthritis?

Objectives: This study aims to explore whether fear of movement, depression and functional performance are predictors of physical activity levels in patients with knee osteoarthritis (OA). Patients and methods: A total of 200 patients (80 males, 120 females; mean age 53.23 +/- 5.99 years; range, 40 to 65 years) with knee OA participated in this cross-sectional, correlational-design study. Oxford Knee Score (OKS) was used to evaluate physical function and pain through patient perspective. Six-Minute Walk Test (6-MWT) was used to evaluate functional performance. International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to assess subjective physical activity level. A 17-item of the self-reported Tampa Scale for Kinesiophobia (TSK) questionnaire was used to determine the fear of movement level. Beck Depression Inventory (BDI) was used as a self-reported measure for depression level. Spearman correlation analysis and the linear regression model with R-square (R-2) were used to correlate and explain the total variance. Results: International Physical Activity Questionnaire-Short Form was significantly correlated to OKS (r=-0.550), 6-MWT (r=-0.561), TSK (r=-0.693) and BDI (r=-0.429) in patients with OA (p<0.001). Linear regression analysis revealed that OKS, 6-MWT test, TSK and BDI were independently associated with IPAQ-SF in predicting physical activity level in patients with knee OA (p <= 0.001; R-2 =0.621). Conclusion: This study increases the understanding of the predictors of physical activity level related to fear of movement, depression and functional performance in patients with knee OA. Improving physical activity levels in OA population is necessary to implement early treatment strategies before the disease progresses and more costly solutions are needed.WoSScopu

Three different techniques for administering analgesia during transrectal ultrasound-guided prostate biopsy: a comparative study

PURPOSE: The efficacy of three different analgesic techniques during transrectal ultrasound (TRUS) guided prostate biopsy, including (i) periprostatic blockage (PPB), (ii) intrarectal gel instillation, and (iii) sedoanalgesia were compared. MATERIAL AND METHODS: During a period of five months, 100 consecutive men were enrolled in this study. A 10-point linear visual analogue scale (VAS) was used to assess the pain scores during (VAS 1), immediately after (VAS 2) and one hour after (VAS 3) the needle biopsy procedure. The relationship between the level of pain, prostate volume, age and PSA was determined. RESULTS: There were no statistically significant differences between the four groups in terms of mean age and PSA values. The pain scores were significantly lower in sedoanalgesia and PPB groups (p = 0.0001). There was no statistically significant difference between the groups in terms of complications. CONCLUSIONS: In this study, it was shown that patient comfort is better and it is possible to get decreased pain scores with PPB or sedoanalgesia. However, PPB is a preferable method in TRUS-guided prostate biopsy since it is much more practical in outpatient clinics

Fluid Rim Sign: A New Ultrasonographic Sign Of Soft Tissue Aspergillosis

The air crescent sign is a well-known important diagnostic finding in invasive pulmonary aspergillosis. Herein we report a distinctive but rare ultrasonographic appearance in a patient with myositis secondary to Aspergillus flavus infection, which can be considered as the soft tissue counterpart of the air crescent sign.WoSScopu

Effects of the Glutamine on the Neuronal Cell Death in rat Ischemia-reperfusion Model

ATILLA, PERGIN/0000-0001-5132-0002WOS: 000347120800005Background: The aim of this study was to explore the effects of glutamine in brain ischemia/reperfusion model in rat. Methods: Right common carotid arteries of 24 Wistar albino rats were clamped for a duration of 30 minutes. Two hours later, except CONTROL group, glutamine was infused into left femoral vein of rats in GLIV group; and glutamine and normal saline was administered into cisterna magna of rats in GLIS and SFIS groups, respectively. After 7 days, all animals were decapitated and each brain was divided into two hemispheres for histopathological and biochemical evaluation. The right hemisphere was called "Hypoxia/Reperfusion side (HRS)" and the left hemisphere was called " Toxicity side (TS)". Results: In TS and HRS, degenerated neuron counts of GLIV groups were significantly higher than other groups' values. Degenerated neuron count values of TS were significantly lower than HRS values for GLIS, and SFIS groups, but the results of GLIV group in TS did not different from the GLIV group in HRS. LPO levels of TS and HRS of the groups was not statistically significant. Conclusion: This study results showed that glutamine had no beneficial effect to the hypoxia/reperfusion injury in rat model