Risk of contamination of nasal sprays in otolaryngologic practice

BACKGROUND: Reusable nasal-spray devices are frequently used in otolaryngologic examinations, and there is an increasing concern about the risk of cross-contamination from these devices. The aim of our study was to determine, by means of microbiologic analysis, the safety of a positive-displacement or pump-type atomizer after multiple uses. METHODS: A reusable nasal spray bottle, pump, and tips were used in the nasal physical examination of 282 patients admitted to a tertiary otolaryngology clinic. The effectiveness of 2 different methods of prophylaxis against microbiologic contamination (the use of protective punched caps or rinsing the bottle tip with alcohol) was compared with that of a control procedure. RESULTS: Although there was no statistically significant difference in positive culture rates among the types of nasal spray bottles tested, methicillin-resistant coagulase-negative staphylococci were isolated in 4 of 198 cultures. CONCLUSION: Given these findings, we concluded that additional precautions (such as the use of an autoclave between sprays, disposable tips, or disposable devices) are warranted to avoid interpatient cross-contamination from a reusable nasal spray device

Reproductive Characteristics and Egg Development in Flounder (Pleuronectes flesus luscus) in the Southern Black Sea

Abstract Spawning time, total fecundity, egg size, fertilization and hatching rates, and egg development of the flounder, Pleuronectes flesus luscus, were investigated in six wild female broodstock (mean wt 394.4±226.8 g). Spawning lasted 33 days from December 29 to January 30. Mean total fecundity was 171.4±109 x 10 3 eggs per female. Newly ovulated eggs were spherical and buoyant, with a diameter of 1.075-1.213 mm (avg 1.156±0.025 mm), a colorless transparent chorion, a slightly yellowish unsegmented yolk, and a narrow perivitelline space, without an oil globule. Fertilization and hatching rates were 17.2±15.7% and 51.5±27.6%, respectively. Hatching occurred after 117 h of incubation at 9.8-11ºC. There were variations in egg size between batches, with the size tending to decrease during the spawning season (p<0.05)

Perfluorodecaline residue in the anterior chamber of a patient with an intact crystalline lens: a case report

Abstract Background Perfluorocarbon liquids are frequently used as intraoperative tools in vitreoretinal surgery and may occasionally be retained in the vitreous cavity. We report a patient who underwent pars plana vitrectomy for a giant tear after receiving blunt trauma to his right eye and sustained postoperative perfluorocarbon liquid residue in the anterior chamber in spite of an intact crystalline lens. Case presentation Perfluorodecaline was used as a temporary retinal tamponade. Three weeks after the surgery, a residue of heavy liquid was observed in the anterior chamber, even though the patient had an intact crystalline lens without any tilt or dislocation. The remnant of the heavy liquid was taken out of the anterior chamber immediately to avoid secondary complications. Conclusion Presence of heavy liquids in the anterior chamber may be associated with zonular defects even though the patient has an intact crystalline lens.</p

Professional development through technology-integrated problem solving: from InterMath to T-Math

The ability to integrate technology into instruction is among the characteristics of a competent mathematics teacher. Research indicates that the vast majority of teachers in Turkey believe the use of computers in education is important, but have limited knowledge and experience on how to use technology in their instruction. This paper describes the T-Math project (http://www.t-math.org), which adapted the InterMath (http://intermath.coe.uga.edu) knowledge base for mathematics teachers in the United States and developed relevant resources for professional development of Turkish mathematics teachers to guide them in constructing useful strategies for their students while developing as expert mathematics teachers. Examples of mathematical investigations adopted and developed in the T-Math project are presented as well as the anticipated challenges and subsequent strategies for integration

Congenital partial arhinia: a case report

Congenital arhinia is an extremely rare anomaly consisting of an absence of external nasal structures and nasal passages. Fewer than 30 cases have been reported. Patients with a familial absence of the nose have been reported, but the effects of genetic and maternal factors are unknown. Midface hypoplasia may accompany arhinia. Accompanying malformations are thought to be caused by an absent or rudimentary nose. A patient with partial congenital arhinia is presented and the embryology and literature review are discussed

Performance improvement potential of a PV/T integrated dual-source heat pump unit with a pressure booster ejector

Dual-source heat pump unit can utilize the evaporation of the refrigerant at two different pressures. By adopting an ejector, high-pressure refrigerant stream can be used to lift compressor inlet pressure which results in a higher coefficient of performance (COP). This study proposes a renewable energy sourced and high-efficiency heat pump system which can be easily building integrated to offer a renewable heating solution. The system is devised on the complementation of dual thermal sources; one is air and the other one is solar, to maximize the utilization of ambient energy for highly efficient operation of heat pump. Using the advantage of the relatively lower operating temperature in the solar collector line, the thermal efficiency of the collector would be sufficient in winter. Adaptation of photovoltaics in the collector as a PV/T unit, will benefit the system from the produced electricity for further reduction of the demand from the grid. Along with the use of PV/T collector, the system can be potentially carbon neutral for larger collector areas. In this study, the performance improvement potential of a dual-sourced heat pump unit with an ejector as a booster is investigated for different locations in Turkey which presents different solar and weather profiles. The optimum collector evaporation temperatures are determined, and COP improvement potentials are discussed for different conditions. For a heating supply of 5 kW, the COP of the system can be improved by 22.6% under 400 W/m2 and 10°C ambient using 15 m2 PV/T collector. Including the electricity generated from the PV, reduction of the electricity demand from the grid can reach to 75% for the same conditions

Frontal mucocele with an accompanying orbital abscess mimicking a fronto-orbital mucocele: case report

BACKGROUND: Mucoceles are slowly expanding cystic lesions with respiratory epithelium containing mucus most commonly affecting the frontal and ethmoidal sinuses. They are caused by obstruction of sinus ostium. Mucoceles exert pressure on the bony boundaries and due to the proximity to the brain and orbit extension to these areas are common. CASE PRESENTATION: A case of a frontal mucocele with an accompanying orbital abscess mimicking a fronto-orbital mucocele is reported. A 77 year old female patient suffering from left sided proptosis and pain around the left eye was admitted to our department. She had a history of left frontal sinus mucocele one year ago that was offered an osteoplastic frontal sinus surgery that the patient refused. Patient had limitation of eye movements. Fundoscopic examination revealed a minimal papilledema. Coronal computerized tomography and orbital magnetic resonance imaging showed a frontal mucocele with suspicious erosion of the orbital roof and a superiorly localized extraconal mass displacing the orbit lateroinferiorly. Frontal and orbital masses had similar intensities. Thus surgery was planned for a fronto-orbital mucocele. During surgery no defect was found on the orbital roof. Frontal mucocele and orbital cystic mass was removed separately. Pathological examination showed a frontal mucocele and an orbital abscess wall. Postoperatively eye movements returned to normal and papilledema resolved. CONCLUSION: Fronto-orbital mucoceles are commonly encountered pathologies, but frontal mucocele with an orbital abscess is a rarely seen and should be kept in mind because their treatments differ

Benign paroxysmal positional vertigo after radiologic scanning: a case series

<p>Abstract</p> <p>Introduction</p> <p>Benign paroxysmal positional vertigo (BPPV) is the most common type of vertigo. It is frequently seen in elderly patients, and the course of the attack may easily mimic cerebrovascular disease. A BPPV attack after a radiologic examination has not been reported previously. We report the cases of two patients who had BPPV attacks after radiologic imaging.</p> <p>Case presentation</p> <p>The first patient with headache and tremor was admitted to the radiology department for cranial computed tomography (CT) imaging. During scanning, she was asked to lie in the supine position with no other head movements for approximately 10 minutes. After the cranial CT imaging, she stood up rapidly, and suddenly experienced a vertigo attack and nausea. The second patient was admitted to the radiology department for evaluation of his renal arteries. During the renal magnetic resonance angiography, he was in the supine position for 20 minutes and asked not to move. After the examination, he stood up rapidly with the help of the technician and suddenly experienced a vertigo attack with nausea and vomiting. The results of standard laboratory analyses and their neurologic examinations were within normal limits and Dix-Hallpike tests showed rotatory nystagmus in both cases. An Epley maneuver was performed to the patients. The results of a control Dix-Hallpike tests after 1 Epley maneuver were negative in both patients.</p> <p>Conclusion</p> <p>Radiologists and clinicians must keep in mind that after radiologic imaging in which the patient is still for some time in the supine position and then helped to stand up rapidly, a BPPV attack may occur.</p

Simultaneous Determination of Cyclosporine A, Tacrolimus, Sirolimus, and Everolimus in Whole-Blood Samples by LC-MS/MS

Objectives. Cyclosporine A (CyA), tacrolimus (TRL), sirolimus (SIR), and everolimus (RAD) are immunosuppressive drugs frequently used in organ transplantation. Our aim was to confirm a robust sensitive and selective liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for determination of CyA, TRL, SIR, and RAD in whole-blood samples. Materials and Methods. We used an integrated online solid-phase extraction-LC-MS/MS system and atmospheric pressure ionization tandem mass spectrometry (API-MS/MS) in the multiple reaction monitoring (MRM) detection mode. CyA, TRL, SIR, and RAD were simultaneously analyzed in whole blood treated with precipitation reagent taken from transplant patients. Results. System performance parameters were suitable for using this method as a high-throughput technique in clinical practice. The high concentration of one analyte in the sample did not affect the concentration of other analytes. Total analytical time was 2.5 min, and retention times of all analytes were shorter than 2 minutes. Conclusion. This LC-MS/MS method can be preferable for therapeutic drug monitoring of these immunosuppressive drugs (CyA, TRL, SRL, and RAD) in whole blood. Sample preparation was too short and simple in this method, and it permits robust, rapid, sensitive, selective, and simultaneous determination of these drugs