Plain X-ray, computed tomography and magnetic resonance imaging findings of telangiectatic osteosarcoma: a case report

An 18-year-old male patient presented with chronic nonspecific pain of three months located at his left proximal tibia. The patient was admitted to our department for plain X-ray, computed tomography and magnetic resonance imaging examination. Plain X-ray and computed tomography revealed a geographic lytic lesion at the medial aspect of the proximal tibia. Biopsy of the lesion showed telangiectatic osteosarcoma. Image findings of all modalities are presented

Ovarian vein thrombosis mimicking acute abdomen: a case report and literature review

<p>Abstract</p> <p>Background</p> <p>Ovarian vein thrombosis (OVT) is a rare, but serious condition that affects mostly postpartum women. A high index of suspicion is required in order to diagnose this unusual cause of abdominal pain.</p> <p>Case presentation</p> <p>A 19-year-old woman at three days postpartum was admitted to our hospital because of severe right lower quandrant abdominal pain and fever 38.5'C. Physical examination revealed an acutely ill patient and right lower quadrant tenderness with positive rebound and Giordano signs. The patient underwent appendectomy which proved to be negative for acute appendicitis. Postoperatively fever and pain persisted and abdominal CT-scan with intravenous contrast agent demonstrated a thrombosed right ovarian vein. The patient was initiated on low-molecular weight heparin (LMWH) and antibiotic treatment and a month later a new abdominal CT-scan showed a patent right ovarian vein.</p> <p>Discussion</p> <p>Pathophysiologically, OVT is explained by Virchow's triad, because pregnancy is associated with a hypercoagulable state, venous stasis due to compression of the inferior vena cava by the uterus and endothelial trauma during delivery or from local inflammation. Common symptoms and signs of OVT include lower abdomen or flank pain, fever and leukocytosis usually within the first ten days after delivery. The reported incidence of OVT ranges 0,05-0,18% of pregnancies and in most cases the right ovarian vein is the one affected. Anticoagulation and antibiotics is the mainstay of treatment of OVT. Complications of OVT include sepsis, extension of the thrombus to the inferior vena cava and renal veins, and pulmonary embolism. The incidence of pulmonary embolism is reported to be 13.2% and represents the main source of mortality due to OVT.</p> <p>Conclusions</p> <p>OVT is a rare condition, usually in the postpartum period. A high index of suspicion is required for the prompt diagnosis and management especially in cases that mimic acute abdomen.</p

The City of Collective Melancholy: Revisiting Pamuk’s Istanbul

This essay looks back upon Orhan Pamuk’s non-fiction book, Istanbul: Memories of a City (2003), and unpacks its multi-layered representation of the city as landscape. It is here that Pamuk pursues most overtly “the quest for the melancholic soul of his native city” which won him the 2006 Nobel Prize for Literature. Weaving personal memoir and historical essay into a unique narrative tapestry, Pamuk’s book explores a series of tensions that define the city’s image and identity; insider/outsider and East/West polarities, in particular, are tirelessly deconstructed. The essay examines Pamuk’s poetics and politics of memory in relation to works by other authors, notably Walter Benjamin. In conclusion, the new edition of Istanbul (2015) is discussed against the background of the social and spatial changes that have beset Turkey’s cultural capital in the interim

The role of natural science collections in the biomonitoring of environmental contaminants in apex predators in support of the EU's zero pollution ambition

The chemical industry is the leading sector in the EU in terms of added value. However, contaminants pose a major threat and significant costs to the environment and human health. While EU legislation and international conventions aim to reduce this threat, regulators struggle to assess and manage chemical risks, given the vast number of substances involved and the lack of data on exposure and hazards. The European Green Deal sets a 'zero pollution ambition for a toxic free environment' by 2050 and the EU Chemicals Strategy calls for increased monitoring of chemicals in the environment. Monitoring of contaminants in biota can, inter alia: provide regulators with early warning of bioaccumulation problems with chemicals of emerging concern; trigger risk assessment of persistent, bioaccumulative and toxic substances; enable risk assessment of chemical mixtures in biota; enable risk assessment of mixtures; and enable assessment of the effectiveness of risk management measures and of chemicals regulations overall. A number of these purposes are to be addressed under the recently launched European Partnership for Risk Assessment of Chemicals (PARC). Apex predators are of particular value to biomonitoring. Securing sufficient data at European scale implies large-scale, long-term monitoring and a steady supply of large numbers of fresh apex predator tissue samples from across Europe. Natural science collections are very well-placed to supply these. Pan-European monitoring requires effective coordination among field organisations, collections and analytical laboratories for the flow of required specimens, processing and storage of specimens and tissue samples, contaminant analyses delivering pan-European data sets, and provision of specimen and population contextual data. Collections are well-placed to coordinate this. The COST Action European Raptor Biomonitoring Facility provides a well-developed model showing how this can work, integrating a European Raptor Biomonitoring Scheme, Specimen Bank and Sampling Programme. Simultaneously, the EU-funded LIFE APEX has demonstrated a range of regulatory applications using cutting-edge analytical techniques. PARC plans to make best use of such sampling and biomonitoring programmes. Collections are poised to play a critical role in supporting PARC objectives and thereby contribute to delivery of the EU's zero-pollution ambition.Non peer reviewe

Color doppler sonohysterography in the evaluation of patients with ednometrial thickening

The purpose of this study is to examine women with abnormal vaginal bleeding with Color Doppler Transvaginal Sonohysterography (TVS) and to distinguish between focal and diffuse endometrial abnormalities and to depict subendometrial disorders such as uterine fibromas to direct further work up. A special balloon-bearing catheter (H/S Catheter set, Ackard Laboratories) was placed through the cervical os. 10-20 ml of sterile saline were slowly injected during continuous real time Color Doppler transvaginal scanning. Multiplanar images of the uterus were then obtained. Over a 26 month period 43 patients with abnormal vaginal bleeding were examined with (TVS). Finally sonohysterography was performed at 35 patients (14 were premenopausal and 21 were postmenopausal). In the postmenopausal group 13 patients had endometrial cancer, histologically proven, 3 had endometrial polyps, 4 had endometrial hyperplasia due to Tamoxifen therapy for breast cancer and in 1 patient the istopathology revealed sarcoma. In the premenopausal group polyps were observed in 5 patients, endometrial cancer in 2 and normal secretory endometrium was found in 2 patients. Subendometrial disorders clearly depicted with TVS were found in 5 patients. Our study shows that Color Doppler (TVS) enables the physician to make an accurate diagnosis of polyps and endometrial cancer, except for the cases where endometrial cancer presents as smooth hyperplasia of the endometrium. TVS has become the standard test in the imaging evaluation of dysfunctional uterine bleeding and postmenopausal bleeding because it allows reliable differentiation between focal and diffuse endometrial lesions. Sonohysterography is a simple well- tolerated procedure that improves evaluation of the potentially abnormal endometrium. This technique has few contraindications (pelvic inflammatory disease) and leads to virtually no complications. It may be performed rapidly without significant patient discomfort and provides the referring physician with valuable information that will help determine the next step in case management in a cost-effective manner.Σκοπός της μελέτης μας είναι η μελέτη ασθενών με μητρορραγία ή μηνορραγία που παρουσιάζουν πάχυνση του ενδομήτριου με την τεχνική της ενδοκολπικής έγχρωμης Doppler υπερηχοϋστερογραφίας. Η τεχνική αυτή συμβάλει αφενός στο να γίνει διάκριση μεταξύ των εστιακών και διάχυτων παθήσεων του ενδομήτριου και αφετέρου στο να αναγνωριστούν υποβλεννογόνιες καταστάσεις (όπως ινομυώματα) οι οποίες μπορεί να εκδηλωθούν με αιμορραγία. Οι ασθενείς αρχικά υποβάλλονταν σε ενδοκολπικό υπερηχογράφημα και εν συνεχεία σε υπερηχοϋστερογραφία με την χρήση ειδικού καθετήρα ο οποίος φέρει μπαλόνι και έχει διάμετρο 5 Fr (Η/S Catheter set, Ackard Laboratories). Εισάγονται 10- 20 ml φυσιολογικού ορού και λαμβάνονται εικόνες σε διάφορα επίπεδα. Σε χρονικό διάστημα 26 μηνών εξετάσθηκαν 43 ασθενείς με αιμορραγία στις οποίες το απλό υπερηχογράφημα (υπερηβικό ή ενδοκολπικό ) ανέδειξε πάχυνση του ενδομήτριου. Από τις ασθενείς αυτές στην μελέτη μας περιελήφθησαν 35 οι οποίες υπεβλήθησαν σε ενδοκολπικής έγχρωμης Doppler υπερηχοϋστερογραφίας. Οι ασθενείς διακρίθηκαν στις προεμμηνοπαυσιακές (14 συνολικά) και στις μετεμμηνοπαυσιακές (21 συνολικά). Στην ομάδα των μετεμμηνοπαυσιακών ασθενών 13 έπασχαν από καρκίνο ενδομήτριου ιστολογικά αποδεδειγμένο, 3 είχαν ενδομητρικούς πολύποδες, 4 είχαν υπερπλασία ενδομήτριου συνεπεία λήψεως ταμοξιφαίνης για καρκίνο του μαστού και 1 έπασχε από σάρκωμα μήτρας. Στην ομάδα των προεμμηνοπαυσιακών ασθενών, 5 είχαν πολύποδες μήτρας, 2 εξ αυτών καρκίνο ενδομήτριου, σε 2 αποδείχθηκε ότι η πάχυνση του ενδομήτριου οφειλόταν σε φυσιολογικό εκκριτικό ενδομήτριο και τέλος σε 5 η αιμορραγία οφειλόταν σε υποβλεννογόνια αίτια όπως ινομυώματα (σε 3 ασθενείς), αδενομύωμα (σε 1 ασθενή) και λίπωμα μήτρας (σε 1 ασθενή). Τα ευρήματα της υπερηχοϋστερογραφίας συσχετίστηκαν με τα παθολογοανατομικά ευρήματα σε 31 ασθενείς. Στις υπόλοιπες λόγω της καλοήθους φύσεως των παθήσεων τους δεν υπήρξε ιστολογική επιβεβαίωση. Η υπερηχοϋστερογραφία είναι μία απλή και καλά ανεκτή μέθοδος από την ασθενή, η οποία βελτιώνει σημαντικά την εκτίμηση του δυνητικά παθολογικού ενδομήτριου. Ουσιαστικά δεν έχει καμία αντένδειξη, πλην της ενεργού πυελικής φλεγμονώδους νόσου και ουσιαστικά καμία σοβαρή επιπλοκή. Μπορεί να εκτελεστεί γρήγορα χωρίς προετοιμασία των ασθενών, έχει χαμηλό κόστος και το σημαντικότερο όλων είναι ότι δίνει στον παραπέμποντα ιατρό σημαντικές πληροφορίες οι οποίες θα συμβάλουν στο να σχεδιαστεί με ακρίβεια η περαιτέρω θεραπευτική αντιμετώπιση της ασθενούς

Increased Frequency of Rheumatoid Arthritis and Allergic Rhinitis among Pesticide Sprayers and Associations with Pesticide Use

Objective: The aim of this study was to identify diseases linked with the pesticide sprayer occupation and explore possible associations with exposure history data. Methods: Α cross sectional study was conducted among pesticide sprayers (n = 80) and the general population (n = 90) in Thessaly (Greece). Medical history, demographic characteristics and detailed exposure history were recorded by conducting personal interviews. Lifetime exposure indicators were calculated for several pesticide chemical subclasses. Moreover, organophosphate metabolite levels were quantified in urine samples of all participants by using gas chromatography -mass spectrometry (GC-MS). Multinomial analysis was used to determine associations between occupational pesticide exposure and diseases or disorders. Results: In the pesticide sprayers group, significantly higher frequencies for rheumatoid arthritis (RA) and allergic rhinitis were observed compared with the control group (p = 0.002 and p = 0.024 respectively). Within the pesticide sprayers group, high lifetime pesticide exposure was associated with increased risk for reporting RA (OR: 43.07 95% CI: 3.09–600.67) and allergic rhinitis (OR: 9.72 95% CI: 2.31–40.89), compared with low pesticide exposure. Exposure to organophsphate, guanidine and quinone pesticides were associated with RA while organophosphates, pyrethroids and paraquat were associated with allergic rhinitis. Despite the higher levels of certain pesticide metabolites observed among participants with rheumatoid arthritis, the differences were not statistically significant. One metabolite (diethylthiophosphate) was found to be significantly increased in allergic rhinitis cases (p = 0.037). Conclusions: The results from the current study suggest a possible association of occupational pesticide exposure with RA and allergic rhinitis that should be further investigated

Ovarian vein thrombosis mimicking acute abdomen: a case report and literature review

Background: Ovarian vein thrombosis (OVT) is a rare, but serious condition that affects mostly postpartum women. A high index of suspicion is required in order to diagnose this unusual cause of abdominal pain. Case presentation: A 19-year-old woman at three days postpartum was admitted to our hospital because of severe right lower quandrant abdominal pain and fever 38.5’C. Physical examination revealed an acutely ill patient and right lower quadrant tenderness with positive rebound and Giordano signs. The patient underwent appendectomy which proved to be negative for acute appendicitis. Postoperatively fever and pain persisted and abdominal CT-scan with intravenous contrast agent demonstrated a thrombosed right ovarian vein. The patient was initiated on low-molecular weight heparin (LMWH) and antibiotic treatment and a month later a new abdominal CT-scan showed a patent right ovarian vein. Discussion: Pathophysiologically, OVT is explained by Virchow’s triad, because pregnancy is associated with a hypercoagulable state, venous stasis due to compression of the inferior vena cava by the uterus and endothelial trauma during delivery or from local inflammation. Common symptoms and signs of OVT include lower abdomen or flank pain, fever and leukocytosis usually within the first ten days after delivery. The reported incidence of OVT ranges 0,05-0,18% of pregnancies and in most cases the right ovarian vein is the one affected. Anticoagulation and antibiotics is the mainstay of treatment of OVT. Complications of OVT include sepsis, extension of the thrombus to the inferior vena cava and renal veins, and pulmonary embolism. The incidence of pulmonary embolism is reported to be 13.2% and represents the main source of mortality due to OVT. Conclusions: OVT is a rare condition, usually in the postpartum period. A high index of suspicion is required for the prompt diagnosis and management especially in cases that mimic acute abdomen

Target Analysis of Volatile Organic Compounds in Exhaled Breath for Lung Cancer Discrimination from Other Pulmonary Diseases and Healthy Persons

The aim of the present study was to investigate the ability of breath analysis to distinguish lung cancer (LC) patients from patients with other respiratory diseases and healthy people. The population sample consisted of 51 patients with confirmed LC, 38 patients with pathological computed tomography (CT) findings not diagnosed with LC, and 53 healthy controls. The concentrations of 19 volatile organic compounds (VOCs) were quantified in the exhaled breath of study participants by solid phase microextraction (SPME) of the VOCs and subsequent gas chromatography-mass spectrometry (GC-MS) analysis. Kruskal&ndash;Wallis and Mann&ndash;Whitney tests were used to identify significant differences between subgroups. Machine learning methods were used to determine the discriminant power of the method. Several compounds were found to differ significantly between LC patients and healthy controls. Strong associations were identified for 2-propanol, 1-propanol, toluene, ethylbenzene, and styrene (p-values &lt; 0.001&ndash;0.006). These associations remained significant when ambient air concentrations were subtracted from breath concentrations. VOC levels were found to be affected by ambient air concentrations and a few by smoking status. The random forest machine learning algorithm achieved a correct classification of patients of 88.5% (area under the curve&mdash;AUC 0.94). However, none of the methods used achieved adequate discrimination between LC patients and patients with abnormal computed tomography (CT) findings. Biomarker sets, consisting mainly of the exogenous monoaromatic compounds and 1- and 2- propanol, adequately discriminated LC patients from healthy controls. The breath concentrations of these compounds may reflect the alterations in patient&rsquo;s physiological and biochemical status and perhaps can be used as probes for the investigation of these statuses or normalization of patient-related factors in breath analysis