A needle in the breast: a case report

Abstract Introduction A needle in the breast tissue is very rarely encountered in clinical practice. Case presentation A 21-year-old woman presented with a needle in her right breast. She was operated on under fluoroscopic guidance. The needle was removed successfully. Conclusion Because of the risk of migration of the needle into the thoracic cavity and adjacent vital organs, patients with a needle in their breast tissue must be treated surgically.</p

Anesthetic Management of a Pediatric Patient With Wilsons Disease

Wilsons disease, characterized by cirrhosis, extrapyramidal symptoms and Kayser-Fleischer corneal rings, is a rare hereditary disease of human copper metabolism. Clinical findings in Wilsons disease are complex and neurological symptoms such as tremor, dysarthria, rigid dystonia, seizures, psychiatric disorders, acute liver failure, chronic hepatitis or cirrhosis may develop. A 4-year-old male patient was operated for traumatic depressed skull fracture and intracerebral hematoma. He was diagnosed with Wilsons disease at the age of 2.5 years and treated with zinc sulphate and D-penicillamine. General anesthesia was induced with propofol, fentanyl, atracurium, and maintained with isoflurane, and oxygen. No complications were encountered during the operation or in the postoperative period. We concluded that general anesthesia can successfully be given to Wilsons disease patients using an anesthetic agent, the metabolism of which is least affected by the liver disease, one that induces least hepatic toxicity. By close follow-up of patients clinically and biochemically, it is possible to reduce the complication rates to a minimum

EFFECT OF CORE TRAINING PROGRAM ON RESPIRATORY FUNCTION AND INSPIRATORY MUSCLE STRENGTH IN SWIMMERS

The aim of this study is to examine the effect of core training program on respiratory functions and inspiratory muscle strength in swimmers. 22 male swimmers between the ages of 18 and 22, who do regular swimming training, participated in the study voluntarily. The subjects were divided into experimental (n: 11) and control (n: 11) groups. A core training program was applied to the experimental group 3 days a week for 8 weeks. Both groups continued their normal swimming training. Before and after core training, the subjects' maximal inspiratory muscle strength (MIP), vital capacity (VC), forced vital capacity (FVC), forced expiratory volume (FEV1) and forced expiration rate (FEV1 / FVC) were measured. The respiratory functions of the subjects were determined by using a Spirometer and the respiratory muscle strengths were determined by using the MicroRPM pressure gauge device. The obtained data were analyzed by the SPSS 22.0 program. The paired Samples T tests were used for within-group comparison and Independent Samples T tests were used for the group comparison. As a result of the statistical analysis, a statistically significant difference was found in the respiratory parameters and inspiratory muscle strength values of the experimental group (

SAPHO syndrome with adrenal deficiency: a case report

Introduction: The SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteomyelitis) is a rare painful disorder, usually with a good long-term prognosis. Its etiology remains unclear, and various treatment regimens frequently fail to control the disease. Case presentation: A 46-year-old Caucasian female was referred for anterior chest wall and back pain. Physical examination was unremarkable except for skin lesions noted on soles of both feet, extremities and the face. A thoracic magnetic resonance imaging study demonstrated a lesion characterized with bone marrow edema and proliferation of soft tissue in the sternum. A brain MRI was requested secondary to the elevated prolactin level which was compatible with empty sella syndrome. Conclusion: The case presented here has the unique feature of adrenal deficiency presenting alongside the SAPHO syndrome and is presented as the first case reported. This syndrome could become complicated with different organ system involvement other than bone and skin. There is a need further studies that will explore the weak relationship between SAPHO syndrome and adrenal deficiency. © 2009 Eyigör et al.; licensee Cases Network Ltd

The evaluation of Pat-Pat related injuries in the western black sea region of Turkey

BACKGROUND: Accidents caused by motorized vehicle in the agricultural sector are frequently observed. In Turkey; accidents arising from motorized vehicles, named Pat-Pat, which are used by farmers in the Western Black Sea region is not unusual. METHODS: One hundred five patients who were brought into the Emergency Department of Duzce University, Medical Faculty Hospital between September 2009 and August 2010 due to Pat-Pat related accidents were evaluated. RESULTS: The cases consisted of 73 (69.5%) males and 32 (30.5%) females, ranging from 2 to 73 years of age. In the 10-39 age group, a total of 63 (60.0%) cases were determined. The months when the greatest rate of cases applied to the hospital consisted of July, August, September and the season is summer. The cases were exposed to trauma in roads in 54 (51.4%), and 51 (48.6%) occurred in agricultural area without roads. Eighty seven (82.9%) cases were injured due to the overturning of vehicle. The patients were brought to the hospital using a private vehicle in 54 (51.4%) of the cases and in 51 (48.6%) cases, 112 ambulance system was used. The cases were determined to apply to the hospital most frequently between 6 pm-12 am. The injuries frequently consisted of head-neck and spine traumas, thorax traumas and upper extremity traumas. In 55 (52.4%) cases, open wound-laceration was determined. Seventy five (71.4%) cases were treated in the Emergency Department, and 28 (26.7%) were hospitalized. Three (2.9%) cases were deceased. CONCLUSIONS: Serious injuries can occur in Pat-Pat related accidents, and careful systematic physical examination should be conducted. In order to prevent these accidents, education of farm operators and engineering studies on the mechanics and safety of these vehicles should be taken and legal regulations should be created

Use of external valvular stenting on isolated saphenofemoral junction incompetence: report of 3 cases

Izole safenofemoral bileske yetmezligi özellikle genç olgularda sık olarak karsılasılan ve ilgili alt ekstremitelerde basta agrı ve ödem olmak üzere rahatsız edici semptomlara neden olabilen klinik bir antitedir. Bu bölgedeki terminal kapakçık üzerine implante edilen silikon ile kuvvetlendirilmis dacrondan olusan valvüler stentlerin uygulanması ile semptomlar azaltılabilir ve nüks önlenebilir. Yirmili yaslardaki semptomatik üç olguda venöz doppler ultrasonografi ile safenofemoral bileske seviyesinde anlamlı reflü tespit edilmis, venöz sınıflama sistemleri kullanılarak degerlendirilmis ve olguların safenofemoral bileskelerine eksternal valvüler stent implantasyonu yapılmıstır. Olguların tümünde erken postoperatif dönemde asikâr klinik iyilesme olusmus ve semptomlar kaybolmustur. Altıncı ay kontrolünde olgular asemptomatik olarak degerlendirilmis ve yapılan venöz doppler ultrasonografilerinde patolojiye rastlanmamıstır. Bu dönemde aynı venöz sınıflama sistemleri ile tekrar degerlendirilmis ve tüm olguların evre ve skorlarında gerileme tespit edilmistir. Sonuç olarak, safenofemoral bileske bölgesindeki izole kapak yetmezligi ve reflü mevcudiyetinde diger metotlara nazaran daha az invaziv olan eksternal valvüler stent implantasyonu ile etkili rekonstrüksiyon saglanabilmektedir.Isolated saphenofemoral junction incompetence is a clinical entity encountered most often in young cases and led to irritating symptoms mainly such as pain and swelling in related extremities. The symptoms can be reduced and the recurrence can be avoided by implanting valvular stents made of dacron reinforced silicon on the terminal valve in this region. Significant reflux in saphenofemoral junction was observed in three symptomatic cases in their twenties through venous doppler ultrasonography. They were staged by using venous classification systems, and external valvular stents were implanted to the saphenofemoral junctions of the cases. In all of the cases, an obvious clinical recovery was realized in the early postoperative period and the symptoms disappeared. During the control visit in 6 month, the cases were evaluated as asymptomatic, and there was no pathology in the venous doppler ultrasonography. Then, all of the cases were reevaluated by using same venous classification systems and downstaging was observed. As a result, external valvular stent implantation which is less invasive compared to other methods may provide an effective reconstruction in the existence of isolated valvular incompetence and reflux in saphenofemoral junctio