Endoscopic Management of Dysphagia in Plummer–Vinson syndrome

Plummer‑Vinson syndrome (PVS), (also called Paterson‑Brown‑Kelly syndrome or sideropenic dysphagia) is an extremely rare syndrome which includes iron-deficiency anemia, dysphagia, and esophageal webs. If left untreated, progressive dysphagia can supervene and the patient is at risk of developing pharyngeal or esophageal squamous-cell carcinoma. Treatment consists of supplementation of iron and endoscopic dilations or surgery for the esophageal web. We describe the case of a 17-year-old women with Plummer- Vinson syndrome whose dysphagia was successfully treated with endoscopic dilation. She remains in good general condition 3 months after treatment

Comparison between 18F-FDG PET/CT and diffusion-weighted imaging in detection of invasive ductal breast carcinoma

Objective(s): Breast carcinoma is the most common type of cancer in females. This study aims to compare fluorine-18-fluorodeoxyglucose (18F-FDG) uptake pattern and apparent diffusion coefficient (ADC) value for the detection of the primary tumour and axillary metastases of invasive ductal breast carcinoma.Methods: This study included 40 breast carcinoma lesions taken from 39 patients. After staging by positron emission tomography-computed tomography (PET/CT) and diffusion-weighted magnetic resonance imaging (MRI), breast surgery with axillary lymph node dissection or sentinel lymph node biopsy was performed.Results: Primary lesion detection rate for PET/CT and diffusion-weighted MRI was high with 39 of 40 lesions (97.5%). The sensitivity and specificity for the detection of metastatic lymph nodes in axilla were 40.9%, 88.9%, with 18F-FDG PET/CT scans and 40.9%, 83.3%, for dw-MRI, respectively. No significant correlation was detected between ADC and SUVmax or SUVmax ratios. Estrogen receptor (p=0.007) and progesterone receptor (p=0.036) positive patients had lower ADC values. Tumour SUVmax was lower in T1 than T2 tumour size (p=0.027) and progesterone receptor-positive patients (p=0.029). Tumour/background SUVmax was lower in progesterone receptor-positive patients (p=0.004). Tumour/liver SUVmax was higher in grade III patients (p=0.035) and progesterone receptor negative status (p=0.043).Conclusions: This study confirmed the high detection rate of breast carcinoma in both modalities. They have same sensitivity for the detection of axillary lymph node metastases, whereas the PET/CT scan had higher specificity. Furthermore, ADC, SUVmax and SUVmax ratios showed some statistical significance among the patient groups according to different pathological parameters

Ultrasound Can Facilitate Percutaneous Endoscopic Gastrostomy Tube Insertion in the Non-Transilluminated Abdominal Wall

Percutaneous endoscopic gastrostomy (PEG), first described in the 1980s, is an enteral nutrition route used for long-term nutrition in patients who cannot be fed by mouth for various reasons but have no gastrointestinal disturbance. It is inserted percutaneously into the stomach with the aid of an endoscope. However, the light of the scope may not be seen in some patients due to certain reasons (obesity, prior operations). In this case, it is not safe to send the needle through the abdominal wall. Ultrasound can facilitate the procedure and also reduce adjacent organ injury

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A broker-based semantic agent for discovering Semantic Web services through process similarity matching and equivalence considering quality of service

WOS: 000314426900002The lack of semantic descriptions for "web service properties" makes it difficult to find suitable web services. Current solutions are mostly based on broker/mediator agent systems. However, these techniques are syntactical, rather than semantics oriented. This article presents a semantic matching approach for discovering Semantic Web services through a broker-based semantic agent (BSA). The BSA includes knowledge-bases and several processing steps. The BSA's knowledge-bases are concept, task, and process ontologies built to describe both functional and non-functional parameters of services. The BSA executes semantic-based matching algorithms to discover similar services through the semantic matching step, process equivalence task, and matching of quality of service parameters. Relevant services are ranked by client preferences utilizing the semantic descriptions of available services. Other matchmaker studies are reviewed and compared with the BSA. Performance of the BSA algorithm is compared with SAM using published data and an experimental setup. The results indicate that our approach is better and more effective in some respects.Eastern Mediterranean University (EMU), Turkey [BAP-A-07-20]This work was supported in full by Eastern Mediterranean University (EMU) Scientific Research Project (Grant No. BAP-A-07-20), Turkey. The second author was also employed at EMU

The Effect of Personality on Cyberbullying among University Students in Turkey

WOS: 000312228300007Problem Statement: Cyberbullying is associated with significant psychological issues among young people such as depression, emotional distress, low self-esteem, and poor academic achievement. It is also regarded as an increasingly emergent problem in educational settings, putting learners' psychological health, safety, and well-being at risk. Recent research has shown that a growing number of students are victims of cyberbullying and a wider realization and a thorough understanding of cyberbullying is needed. Purpose of the Study: This survey-based study set out to explore the relationship between personality traits and cyberbullying among university students receiving education through either face-to-face or distance education modes. Methods: A sectional research design and correlation survey method was adopted throughout the study. As a causal and comparative study, the dependent variable was set as cyberbullying (actively bullying others and/or being bullied) and the independent variable included five personality types. A path model was developed and tested in order to investigate the effects of learning modes and aforementioned personality types on two levels of cyberbullying. Findings and Results: The good fit indexes belonging to the model indicated acceptable conditions and capacity for explaining the relations among the variables. Emotional instability was observed as the leading predictor of being cyberbullied with a medium effect size. On the other hand, the weakest predictor of being bullied was found to be openness to experience with a minor level negative effect size. The developed model was observed to be valid for both face-to-face and distance education learning modes. In addition, a positive and medium level relationship between bullying and being exposed to bullying was observed. Ward's hierarchical cluster analysis conducted on the points obtained from the cyberbullying scale revealed that the majority of the group rarely bullies and is rarely exposed to cyberbullying. Conclusions and Recommendations: This study contributes to the extant literature on bullying in a few conceptual areas. For instance, few research studies have examined the bullying issue in the tertiary context and through learning modes. The current investigation was limited by using a single data set to conduct all analyses. Further research is recommended to involve various variables such as cross-cultural effects on cyberbullying

Isolated duodenal rupture due to blunt abdominal trauma

Duodenal rupture following blunt abdominal trauma is rare and it usually seen with other abdominal organ injuries. It represents approximately 2% to 20% of patients with blunt abdominal injury and often occurs after blows to the upper abdomen, or abdominal compression from high-riding seat belts. Two cases of blunt duodenal rupture successfully treated surgically, are presented with their preoperative diagnosis and final out comes