Mirizzi Syndrome Type 2: A Case Report

Mirizzi syndrome is an unusual complication of gallstone disease and occurs in approximately 1% of these pa-tients. Some cases can not be identified preoperatively; despite modern imaging techniques. Today; treatment of Mirizzi syndrome is surgical. If Mirizzi syndrome is pre-sent; the risk of bile duct injury increases; particularly during laparoscopic surgery. Therefore; preoperative or intraoperative diagnosis is important. Here; we pre-sented a 29 year-old woman with obstructive jaundice who diagnosed as cholelithiasis and choledocholithiasis. Preoperative endoscopic retrograde cholangiography re-lieved the common bile duct stone but cound not diag-nosed the Mirizzi syndrome preoperatively. During lapa-roscopy; the diagnosis of Mirizzi syndrome was sus-pected early and the procedure was converted to open cholecystectomy and T-tube to common bile duct. There was no bile duct injury and postoperative course was uneventful

Infectious and Noninfectious Causes of Epiglottitis in Adults, Review of 24 Patients

Objective:The present study reports the etiological differences, clinical features, management, and patient outcomes between infectious and noninfectious causes of epiglottitis in adult patients.Methods:The medical records of 24 patients with infectious and noninfectious epiglottitis were investigated. Diagnosis was made by anamnesis and endoscopic examination. On admission, respiratory distress of patients was classified according to Freidman’s classification.Results:Fifteen patients were male, and nine patients were female. Their ages ranged between 24 and 69 years of age (mean, 43.4±11.6). In total, 16 patients were diagnosed with infectious epiglottitis, and eight patients were diagnosed with noninfectious epiglottitis. Of patients with noninfectious epiglottitis, two had angioedema, two had experienced organophosphate ingestion, one had experienced hot water aspiration, one had experienced hot milk aspiration, one had experienced foreign body aspiration (fishbone), and one had epiglottitis due to Behçet’s disease. Sore throat was the most common symptoms of infectious and noninfectious epiglottitis in our patients. Odynophagia was the second most common symptom of infectious epiglottitis, and muffled voice was the second most common symptom in noninfectious patients.Conclusion:Epiglottit is an emergency situation; when a patient is diagnosed with epiglottitis, close follow-up should be performed, and airway support should properly be maintained according to the degree of respiratory distress. Tracheostomy should be performed without hesitation, as needed

Lumbar dynamic stabilization with 2-stage surgery: early results

Background: Screw loosening, which is a major problem in dynamic systems, can be easily overcome with 2-stage surgery. In this article, the clinical and radiological results of patients undergoing dynamic stabilization with a Dynesys device in 2 stages are discussed. Methods: A total of 10 male and 13 female adult patients were included in this single-center retrospective study conducted between 2018 and 2021. The mean age of the patients was 65.6 years. All of the patients had pain complaints that affected their daily lives. Bone density T scores were determined with the dual-energy x-ray absorptiometry method before patients were admitted for surgery. In the first surgery, Dynesys system pedicle screws were inserted. After 6 months of osteointegration, Dynesys system spacers and elastic bandages were placed. Preoperative, early postoperative, and late postoperative visual analog pain scale (VAS) scores and Oswestry Disability Index (ODI) scores were determined and statistically compared. Results: Patients were followed for an average of 30 months. Complications and recurrence were not observed. Neurological deficits were not observed after patients recovered from anesthesia. Significant improvement was observed in the ODI and VAS parameters in the preoperative (ODI: 66.2%, VAS: 7.8), early postoperative (ODI: 20.3%, VAS: 2.4), and late postoperative (ODI: 6.8% and VAS: 1.1) periods. Symptomatic improvement was seen in all patients. No screw breakage or loosening was detected by radiological evaluation in any of the patients during the 2-year follow-up period. Conclusions: In our experience, the insufficiency of the proximal and distal end screws is eliminated when 2 stages of dynamic system stabilizations are completed after osteointegration of the screws

The walls of gated communities in Brazil and Turkey: security, separation or status?

Gated communities are common types of housing estates found in many countries. They are based on strictly controlled access of people. Houses, and at times high-rise apartment blocks, are built behind a common wall, along private internal streets. Both in Brazil and in Turkey these types of residential neighborhoods can be found mainly on the outskirts of large urban areas. This paper investigates the reasons for the increase of such residential areas, in relation to the two countries urban problems. In Brazil the dominant reason for the proliferation of gated communities, found in the literature and in advertisement of such estates, is security, in view of the countries high crime rates. In Turkey the main reason for a family to choose to live in such residential areas is status and privacy. Although Brazil and Turkey have very different cultural backgrounds, in both countries gated communities are increasingly popular. The attraction of these so-called communities must therefore be analyzed. Are people more vulnerable in large mega-cities? Also, the impact on urban prospects as a whole must be discussed. Socio-cultural and psychological concepts such as territoriality, security, privacy, which can be represented by a pattern of behavior of an individual or group, as based on control of space, are thus touched on in the paper. Conclusions confirm that the reasons for preferences for gated communities are the feeling of belonging to a special place, fear of crime and a sense security and determine decision making of families in their homeownership choices

Effect of Modification of Lifestyle on Reproductive Potential Yașam Tarzı Değișikliğinin Üreme Potansiyeline Etkisi

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