Fournier Gangreni’ni Taklit Eden Massif Pelvik Sellülit: Olgu Sunumu ve Literatür Derlemesi

Introduction: Fournier’s gangrene (FG), a localized form of necrotizing fasciitis (NF), is a rapidly progressive infectious disease that particularly affects the genital area. Cellulitis, however, is a mild disease that affects the skin and extremities. Case Report: We report a case involving a 71-year-old woman with a rash, extending from her thigh to her breast, which had begun two days prior to her visit to the ER. She was referred to our clinic with an initial diagnosis of extensive pelvic cellulitis mimicking Fournier's gangrene. Following the first assessment (blood glucose >500 mg/dL, pyrexia of 38.3 °C), she was admitted to the intensive care unit, where she received antibiotics and dressings and was monitored. Showing a good recovery, she was discharged in two weeks. Discussion: In the diagnosis and treatment of Fournier's gangrene, significant advancements have been made since it was first described by Jean-Alfred Fournier in 1883. The disease’s morbidity and mortality, however, is still between 25% and 35%. Conclusion: In patients with FG, early diagnosis and aggressive treatment are highly recommended.Giriş: Fournier gangreni Nekrotizan fasiitin localize formu olup, genellikle genital bölgede görülen ve hızlı ilerleyen enfeksiyöz bir hastalıktır. Sellülit ise daha çok ekstremite ve deride görülen daha ılımlı bir hastalıktır. Olgu Sunumu: 71 yaşında bayan hasta, öyküsünde son 2 günde gelişen her iki uyluktan başlayıp memelere kadar uzanan Fournier gangrenini taklit eden geniş pelvik sellülit ile başvurdu. İlk değerlendirmeden sonra (Kan şekeri >500 mg/dl, ateş 38,3 oC) hasta yoğun bakıma alındı, hastaya antibiyotik tedavisi verildi ve sık aralıklarla pansumanlar yapıldı. Hasta iki hafta içerisinde şifa ile taburcu edildi. Tartışma: 1883 yılında Jean-Alfred Fournier tarafından tanımlanan Fournier gangreni tedavisinde, o zamandan beri önemli gelişmeler olmuştur. Ancak, morbidite ve mortalitesi hala yüksektir (%25–35). Sonuç: Fournier gangrenli veya bizim hastamızdaki gibi geniş pelvik sellülitli hastalarda, tanı erken konulmalı ve tedavi gecikmeden yapılmalıdır

13 yaşlı bir köpekte “old dog ensefalit” olgusu: Köpek distemper’ının ender formu

13 year-old male dog with complaints of fever, loss of appetite, stagnation as well as respiratory signs such as purulent nasal and eye discharge, cough and neurologic signs including apathy, ataxia, quadriplegia, muscular atrophy and myoclonus which admitted to the Animal Hospital of Faculty of Veterinary Medicine of Selcuk University. “Old dog encephalitis” was determined by clinical, laboratory examinations and rapid distemper test. Clinical findings revealed hyperthermia, tachypnea and tachycardia. Intravenous 0.9% NaCl and 5% dextrose solution, vitamin and amino acids, ceftriaxone, n-acetylcysteine for improving clinical appearance and for controlling myoclonus pregabalin were used. In conclusion canine distemper virus may affect mature dogs over six years old as “old dog encephalitis” and this condition may provide a valuable model for further study of demyelinating diseases including measles in humans.13 yaşlı erkek bir köpek ateş, iştahsızlık, durgunluk gibi genel; purulent burun ve gözyaşı akıntısı, öksürük gibi respiratorik; apati, ataksi, kuadripleji, kas atrofisi ve miyoklonus gibi nörolojik bulgular ile Selçuk Üniversitesi Veteriner Fakültesi Hayvan Hastanesine getirilmiştir. Klinik muayene, laboratuvar analizleri ve yapılan distemper hızlı kiti ile “old dog ensefalit” tespit edilmiştir. Klinik muayenede vücut ısısı, solunum sayısı ve kalp ritminde artış belirlenmiştir. Tedavi olarak intravenöz 0.9% NaCl ve 5% dekstroz solüsyonları, vitamin ve aminoasitler, seftriakson, N-asetil sistein, miyoklonusu kontrol altına almak için pregabalin uygulanmıştır. Sonuç olarak köpeklerin distemper virüsünün 6 yaşından büyük erişkin köpekleri “old dog ensefalit” olarak etkileyebileceği ve bu durumun insanlarda kızamık dahil demiyelinizasyon hastalıklarının daha ileri çalışmaları için değerli bir model olabileceği kanısına varılmıştır

Does Al2O3 airborne particle abrasion improve repair bond strength of universal adhesives to aged and non-aged nanocomposites?

This study investigated the effect of universal adhesives on the resin composite–composite adhesion for immediate and aged repair with and without air-borne particle abrasion. Composite resin specimens were fabricated by placing multiple increments of resin composite (Clearfil Majesty Posterior) into cylindrical cavities (diameter: 4 mm, height: 2 mm) and photo-polymerized. Specimens (N = 720) were randomly assigned to 4 groups (fresh dry specimens, 24 h and 6 months water storage and thermocycled). These four main groups (n = 180) were further assigned to 2 groups (n = 90) according to the surface conditioning procedures; (a) Al2O3 air-abrasion and (b) No air-abrasion. Then, all subgroups were divided into six subgroups due to the adhesive procedures (a) All Bond Universal: AB (Bisco Inc.), (b) Monobond Plus: MP (Ivoclar Vivadent), (c) G-Premio Bond: GP (GC), Gluma Bond Universal: GB (Heraus Kulzer), Clearfil Universal Bond: CU (Kuraray), Clearfil Universal Bond Quick: SK (Kuraray). All bonding systems were applied according to the manufacturer’s instructions and new composite blocks were bonded to the specimens for shear bond strength testing at the Universal Testing Machine (0.5 mm/min). Al2O3 air-abraded groups showed significantly higher bond strength values compared to non-treated groups (p < 0.0001). CU and SK groups showed higher bond strength values and the worst values were observed for the groups of MP. Conditioning with Al2O3 air-abrasion and silane in universal adhesives improves the bond strength of universal adhesives in composite repair

To rechallenge or not to rechallenge, that is the question? An unsuccessful attempt of hypomethylating agent plus venetoclax in an elderly FLT3-positive relapsed acute myeloid leukemia patient after a yearlong period of remission

Dear Editor, Acute myeloid leukemia is the most common sub-type of acute leukemia in adulthood [1]. It has a detrimental prognosis with conventional combination chemotherapy, mainly with anthracyclines and cytarabine. Allogeneic stem cell transplantation has signifcantly prolonged the overall survival in a particular “eligible” patient population, but as AML is a disorder of the elderly, not all patients are able to proceed with allogeneic stem cell transplantation

Predicting Strict Trifecta Outcomes after Robot-Assisted Partial Nephrectomy: Comparison of RENAL, PADUA, and C-Index Scores

Nephrometry scores are designed to characterize tumors and stratify the surgical complexity. It remains unclear as to which nephrometry score can accurately predict the surgical outcomes. We aimed to assess the utility of radius, exophytic/endophytic, nearness, anterior/posterior, location (RENAL), preoperative aspects and dimensions used for anatomic classifications (PADUA), and centrality index (C-index) nephrometry scores for predicting the strict Trifecta achievement from a single institution series robotic-assisted partial nephrectomy (RAPN). We retrospectively identified the prospectively maintained robotic surgery database records of 91 patients who underwent RAPN between June 2015 and September 2020 in Antalya Training and Research Hospital. The main outcome of the study was the achievement of strict Trifecta (negative surgical margin, no major urologic complications, warm ischemia time ≤25 min, and ≥85% preservation of estimated glomerular filtration rate). A multivariable analysis was performed to identify the factors of strict Trifecta success. The mean patient age was 55.82 ± 13.37 years with a median clinical tumor size of 3.5 cm (IQR 2.5–4.9). The median RENAL, PADUA, and C-index score were 7(IQR 6–8), 8(IQR 7–10), and 2.01(IQR 1.64–2.72), respectively. A strict Trifecta could be achieved in 54 patients (59.3%). Clinical tumor size (P = 0.011), RENAL risk groups (low:reference; intermediate; P = 0.040; high; P = 0.009), PADUA risk groups (low:reference; intermediate; P = 0.044; high; P = 0.001) and C-index risk groups (low:reference; high; P = 0.015) were the independent predictors of strict Trifecta attainment in the multivariate analysis. None of the nephrometry scores were a superior predictor compared to other nephrometry scores in comparative analysis. RENAL, PADUA, and C-index scores were all independent predictors of a strict Trifecta achievement. Our comprehensive comparison of the three scores identified that none of the nephrometry scores proved to be inferior to others nephrometry scores

Massive Pelvic Cellulitis Mimicking Fournier's Gangrene: A Case Report and Review of The Literature

Introduction:Fournier’s gangrene (FG), a localized form of necrotizing fasciitis (NF), is a rapidly progressive infectious disease that particularly affects the genital area. Cellulitis, however, is a mild disease that affects the skin and extremities.Case Report:We report a case involving a 71-year-old woman with a rash, extending from her thigh to her breast, which had begun two days prior to her visit to the ER. She was referred to our clinic with an initial diagnosis of extensive pelvic cellulitis mimicking Fournier's gangrene. Following the first assessment (blood glucose >500 mg/dL, pyrexia of 38.3 °C), she was admitted to the intensive care unit, where she received antibiotics and dressings and was monitored. Showing a good recovery, she was discharged in two weeks.Discussion:In the diagnosis and treatment of Fournier's gangrene, significant advancements have been made since it was first described by Jean-Alfred Fournier in 1883. The disease’s morbidity and mortality, however, is still between 25% and 35%.Conclusion:In patients with FG, early diagnosis and aggressive treatment are highly recommended

Hemoglobin is inversely related to flow-mediated dilatation in chronic kidney disease

The microcirculation is regulated by oxygen gradients and by endothelial release of nitric oxide, which can react with hemoglobin to form S-nitroso derivatives. Here we induced flow-mediated dilatation of the brachial artery in response to ischemia in 141 non-diabetic patients with stage 3–4 chronic kidney disease who had no history of smoking, cardiovascular events or use of erythropoietin-based agents. Patients with hemoglobin concentrations above the cohort median of 11.6 g/dl were found to have significant reductions in flow-mediated dilatation compared to those below the median. This inverse relationship remained significant after adjustment for potential confounders, including insulin sensitivity, glomerular filtration rate, proteinuria, body mass index, serum urate, etiology of underlying renal disease, treatment with anti-hypertensive drugs, and traditional Framingham risk factors. Given that hemoglobin can act as an important nitric oxide carrier and buffer, our studies suggest that the mechanism by which hemoglobin influences the endothelium-dependent microcirculation requires its nitrosylation; however, more direct studies need to be performed