Life-Threatening Massive Thromboembolism After Laparoscopic Splenectomy in an Idiopathic Thrombocytopenic Patient

A life-threatening massive thromboembolism is reported that developed after laparoscopic splenectomy in a 57-year-old female with idiopathic thrombocytopenic purpura (ITP). Although asymptomatic, she underwent splenectomy because of poor response to steroids and intravenous (IV) gamma globulin. Thirteen days after splenectomy, she suffered portal and mesenteric emboli, followed by pulmoner emboli and left popliteal thrombophlebitis. Extensive workup for hypercoagulable states was negative. Low molecular weight heparin (LMWH) was initiated at a suboptimal dose because of thrombocytopenia. During follow-up, her platelet count increased gradually. Whenever the platelet count had remained stable at > 50 x 109/L, she received full dose of LMWH treatment. Over the next 38 days, her pain resolved, she tolerated a full diet, and sent home. Follow-up imaging studies demonstrated a recanalized portal vein and totally resolved pulmonary arteries. We thought that, consumption of platelets in the massive thromboembolism sites including portal, mesenteric and pulmoner vascular beds had resulted in deep thrombocytopenia, which improved gradually with anticoagulant therapy

Sarcopenia assessment project in the nursing homes in Turkey

WOS: 000336884600008PubMed ID: 24569540BACKGROUND/OBJECTIVES: Sarcopenia and sarcopenic obesity (SO) are geriatric syndromes leading to physical disability, poor quality of life and death. The aim of this study was to investigate the prevalence of sarcopenia and SO in nursing homes in Turkey and to define local disparities for diagnosing sarcopenia and SO. SUBJECTS/METHODS: This cross-sectional multicenter study was performed in 711 patients in 14 nursing homes. Comprehensive geriatric assessment tests, handgrip strength and calf circumference (CC) measurements were carried out. Sarcopenia was both defined by handgrip strength and CC criteria. RESULTS: According to handgrip strength measurement, 483 (68%) of patients were sarcopenic (male: 72%, female: 63.8%), 228 were non-sarcopenic. The prevalence of SO was 22% (13.7% in men, 30.2% in women). Patients (82.5%) who were diagnosed as sarcopenic by the handgrip strength test were not sarcopenic according to CC sarcopenia criteria. Therefore, we tried to determine the optimal CC value fOr diagnosing sarcopenia in our population. CONCLUSIONS: Both sarcopenia and SO were prevalent among Turkish nursing home elderly residents. Most of the patients with sarcopenia were obese or overweight. We showed that di'agnosing sarcopenia with CC measurement underestimated the sarcopenia prevalence assessed by handgrip strength. So we concluded that, although different assessment methods are recommended for the diagnosis of sarcopenia local disparities should be considered

Investigating Late Neolithic ceramics in the northern Levant: the view from Shir

This paper presents a review of the ceramic investigations at the Late Neolithic site of Shir. Situated in Western Syria the site occupies a central position in the so-called ‘Levantine corridor’, which linked the southern Levant, Central Anatolia, and Upper Mesopotamia in the Neolithic. The ceramic sequence covers a period of several centuries between c. 7000 and 6450 cal BC. The pottery analysis combined bulk processing in the field and archaeometric work in the laboratory to construct a viable ceramic categorization. This paper discusses long-term ceramic trends that follow the first appearance of pottery in the northern Levant, including the development of pottery containers for storage.Archaeology of the Near Eas