Santral Venöz Port İmplantasyonunda Sefalik ‘cut-down' Yöntemi

Amaç: Bu çalışmada kliniğimzde sefalik ‘cut-down’ yöntemi kullanılarak yerleştirilen santral venöz port implantasyonunun cerrahi sonuçları değerlendirildi. Hastalar ve Yöntemler: Mart 2014 - Mart 2017 tarihleri arasında, Acıbadem Üniversitesi Tıp Fakültesi, Atakent Hastanesi, Göğüs Cerrahisi Servisi’nde sefalik ‘cut-down’ yöntemi ile venöz port implantasyonu uygulanan hastalar çalışmaya alındı. Altta yatan hastalıklar, ameliyat tekniği ve süresi ve perioperatif komplikasyonlar incelendi. Bulgular: Çalışmada toplam 263 hasta mevcuttu (erkek = 137, kadın = 126, ortalama yaş = 51 yıl, dağılım = 18-89 yıl). Bu hastaların 250’ine sefalik ‘cut-down’ yöntemi ile venöz port takıldı (başarı oranı: %95). Sefalik ven kalibrasyonun yetersiz veya tromboflebitik olmasından dolayı diğer 13 hastada (%5) işlem perkütan tamamlandı. 250 hastanın ortalama ameliyat süresi 33 dk (dağılım; 22-65 dk) idi. En sık altta yatan hastalık kolo-rektal kanserler idi. Sefalik ‘cut-down’ yöntemi ile venöz port takılan hastaların hiçbirinde ameliyat sırası komplikasyon izlenmedi. Perkütan yöntemle venöz port takılan bir hastada pnömotoraks gelişti. Tüp torakostomi gerekmedi. Postoperatif takipte 3 hastada (%1.4) port yerinde kanama nedeniyle revizyon yapıldı. Sonuç: Sefalik ‘cut-down’ yöntemi ile venöz port takılması kolay uygulanabilen, güvenilir ve komplikasyon oranı düşük bir işlemdir. Pnömotoraks, hemotoraks veya büyük damar yaralanması gibi yaşamı tehdit eden potansiyel komplikasyonların nadir olması en önemli avantajıdır. Bu nedenle, hem hasta hem de sağlık çalışanları açısından kullanım kolaylığı nedeniyle tercih edilen bir işlemdir

The prevalence of root dilacerations in a Turkish population

Objectives: The aim of this study was to determine the prevalence of root dilaceration in a Turkish dental patient population with respect to sexes and dental localization in relation between sex and this anomaly. Study Design: A retrospective study was performed using periapical radiography of 2,124 patients ranging in age from 15 to 65. All data (age, sex and systemic disease or syndrome) was obtained from the files. These patients were analyzed for root dilaceration. Descriptive characteristics of sexes, jaws, and dental localization were recorded. The Pearson chi-squared test was used. Results: Of 2,251 patients, 214 (9.5%) had root dilaceration. Root dilacerations were determined in 276 (4.3%) of 6386 teeth belong to 2251 patients. Anomalies were found in 9.8% of males compared with 9.3% of females. However, this difference was not statistically significant (p>0.05). Root dilacerations were similarly distributed between maxilla and mandible. The most frequently root dilacerated teeth were found to be mandibular third molars (12.8%), followed by maxillary third molars (7.4%), maxillary first molars (6.7%). Root dilaceration was not detected in maxillary central incisors, mandibular central incisors and mandibular lateral incisors. Conclusion: According to our results, root dilaceration is an uncommon developmental anomaly which mostly occurs in the posterior teeth that is not also possible to have trauma. The radiographic diagnosis of this anomaly is important before surgery and orthodontics treatment, but firstly endodontic treatment

A Vision for Cleaner Rivers: Harnessing Snapshot Hyperspectral Imaging to Detect Macro-Plastic Litter

Plastic waste entering the riverine harms local ecosystems leading to negative ecological and economic impacts. Large parcels of plastic waste are transported from inland to oceans leading to a global scale problem of floating debris fields. In this context, efficient and automatized monitoring of mismanaged plastic waste is paramount. To address this problem, we analyze the feasibility of macro-plastic litter detection using computational imaging approaches in river-like scenarios. We enable near-real-time tracking of partially submerged plastics by using snapshot Visible-Shortwave Infrared hyperspectral imaging. Our experiments indicate that imaging strategies associated with machine learning classification approaches can lead to high detection accuracy even in challenging scenarios, especially when leveraging hyperspectral data and nonlinear classifiers. All code, data, and models are available online: https://github.com/RIVeR-Lab/hyperspectral_macro_plastic_detection

Selective 5-HT7 receptor agonists LP 44 and LP 211 elicit an analgesic effect on formalin-induced orofacial pain in mice

The most recently identified serotonin (5-HT) receptor is the 5-HT7 receptor. The antinociceptive effects of a 5-HT7 receptor agonist have been shown in neuropathic and inflammatory animal models of pain. A recent study demonstrated the functional expression of 5-HT7 receptors in the substantia gelatinosa (SG) of the trigeminalsubnucleus caudalis, which receives and processes orofacial nociceptive inputs. Objective To investigate the antinociceptive effects of pharmacological activation of 5-HT7 receptors on orofacial pain in mice. Material and Methods Nociception was evaluated by using an orofacial formalin test in male Balb-C mice. Selective 5-HT7 receptor agonists, LP 44 and LP 211 (1, 5, and 10 mg/kg), were given intraperitoneally 30 min prior to a formalin injection. A bolus of 10 µl of 4% subcutaneous formalin was injected into the upper lip of mice and facial grooming behaviors were monitored. The behavioral responses consisted of two distinct periods, the early phase corresponding to acute pain (Phase I: 0–12 min) and the late phase (Phase II: 12–30 min). Results LP 44 and LP 211 (1, 5, and 10 mg/kg) produced an analgesic effect with reductions in face rubbing time in both Phase I and Phase II of the formalin test. Conclusion Our results suggest that 5-HT7 receptor agonists may be promising analgesic drugs in the treatment of orofacial pain

Selective 5-HT7 receptor agonists LP 44 and LP 211 elicit an analgesic effect on formalin-induced orofacial pain in mice

The most recently identified serotonin (5-HT) receptor is the 5-HT7 receptor. The antinociceptive effects of a 5-HT7 receptor agonist have been shown in neuropathic and inflammatory animal models of pain. A recent study demonstrated the functional expression of 5-HT7 receptors in the substantia gelatinosa (SG) of the trigeminal subnucleus caudalis, which receives and processes orofacial nociceptive inputs. Objective To investigate the antinociceptive effects of pharmacological activation of 5-HT7 receptors on orofacial pain in mice. Material and Methods Nociception was evaluated by using an orofacial formalin test in male Balb-C mice. Selective 5-HT7 receptor agonists, LP 44 and LP 211 (1, 5, and 10 mg/kg), were given intraperitoneally 30 min prior to a formalin injection. A bolus of 10 µl of 4% subcutaneous formalin was injected into the upper lip of mice and facial grooming behaviors were monitored. The behavioral responses consisted of two distinct periods, the early phase corresponding to acute pain (Phase I: 0–12 min) and the late phase (Phase II: 12–30 min). Results LP 44 and LP 211 (1, 5, and 10 mg/kg) produced an analgesic effect with reductions in face rubbing time in both Phase I and Phase II of the formalin test. Conclusion Our results suggest that 5-HT7 receptor agonists may be promising analgesic drugs in the treatment of orofacial pain

Minimally invasive repair of pectus excavatum (MIRPE) in adults: is it a proper choice?

Introduction : The Nuss procedure is suitable for prepubertal and early pubertal patients but can also be used in adult patients. Aim : To determine whether the minimally invasive technique (MIRPE) can also be performed successfully in adults. Material and methods : Between July 2006 and January 2016, 836 patients (744 male, 92 female) underwent correction of pectus excavatum with the MIRPE technique at our institution. The mean age was 16.8 years (2–45 years). There were 236 adult patients (28.2%) (> 18 years) – 20 female, 216 male. The mean age among the adult patients was 23.2 years (18–45 years). The recorded data included length of hospital stay, postoperative complications, number of bars used, duration of the surgical procedure and signs of pneumothorax on the postoperative chest X-ray. Results: MIRPE was performed in 236 adult patients. The average operative time was 44.4 min (25–90 min). The median postoperative stay was 4.92 ±2.81 days (3–21 days) in adults and 4.64 ±1.58 (2–13) in younger patients. The difference was not statistically significant (p = 0.637). Two or more bars were used in 36 (15.8%) adult patients and in 44 (7.5%) younger patients. The difference was not statistically significant either (p = 0.068). Regarding the overall complications, complication rates among the adult patients and younger patients were 26.2% and 11.8% respectively. The difference was statistically significant (p = 0.007). Conclusions : MIRPE is a feasible procedure that produces good long-term results in the treatment of pectus excavatum in adults

Classification criteria for autoinflammatory recurrent fevers.

BACKGROUND: Different diagnostic and classification criteria are available for hereditary recurrent fevers (HRF)-familial Mediterranean fever (FMF), tumour necrosis factor receptor-associated periodic fever syndrome (TRAPS), mevalonate kinase deficiency (MKD) and cryopyrin-associated periodic syndromes (CAPS)-and for the non-hereditary, periodic fever, aphthosis, pharyngitis and adenitis (PFAPA). We aimed to develop and validate new evidence-based classification criteria for HRF/PFAPA. METHODS: Step 1: selection of clinical, laboratory and genetic candidate variables; step 2: classification of 360 random patients from the Eurofever Registry by a panel of 25 clinicians and 8 geneticists blinded to patients\u27 diagnosis (consensus ≥80%); step 3: statistical analysis for the selection of the best candidate classification criteria; step 4: nominal group technique consensus conference with 33 panellists for the discussion and selection of the final classification criteria; step 5: cross-sectional validation of the novel criteria. RESULTS: The panellists achieved consensus to classify 281 of 360 (78%) patients (32 CAPS, 36 FMF, 56 MKD, 37 PFAPA, 39 TRAPS, 81 undefined recurrent fever). Consensus was reached for two sets of criteria for each HRF, one including genetic and clinical variables, the other with clinical variables only, plus new criteria for PFAPA. The four HRF criteria demonstrated sensitivity of 0.94-1 and specificity of 0.95-1; for PFAPA, criteria sensitivity and specificity were 0.97 and 0.93, respectively. Validation of these criteria in an independent data set of 1018 patients shows a high accuracy (from 0.81 to 0.98). CONCLUSION: Eurofever proposes a novel set of validated classification criteria for HRF and PFAPA with high sensitivity and specificity

Lung Cancer Surgery Part D: Lobectomies

The aim of surgical treatment of NSLC is complete resection. Lobectomy remains the definitive resections because it is an anatomic resection that assures the regional lymph nodes that course along the lobar bronchus and thus provides the best staging information and local control. The risk of pulmonary resection depends on both patient characteristics (i.e. FEV1, DLCO etc.), and type of resection (i.e. pneumonectomy, lobectomy, segmentectomy; open thoracotomy vs. VATS). The posterolateral position is used for lobectomy because it gives the surgeon the greatest maneuverability. Key points in the performance of lobectomy are mobilization of the lobe, fissure dissection and management of the vessels and bronchus

Lung Cancer Surgery Part C: Segmentectomy and Wedge Resection in the Surgical Treatment of NSCLC

The standard treatment for stage I NSCLC is lobectomy with mediastinal lymph node sampling or dissection. The role of limited resection for stage IA lesions, especially those <= 2 cm in diameter is controversial despite many proponents. Patients with physiologic limitation prohibiting lobectomy should be evaluated for sublobar resection, as it seems to offer increasingly similar overall and cancer-free survival rates. Limited resection should be done with systematic or complete lymph node sampling