Bullous pemphigoid associated with prostate adenocarcinoma

Bullous pemphigoid is a common autoimmune skin disease characterized by the presence of subepidermal blisters. It has been associated with underlying neoplasia in isolated reports. A 78-year-old man with generalized blisters was diagnosed as bullous pemphigoid on clinical, histopathological and direct immunofluorescence grounds. His free and total prostate specific antigen (PSA) levels were high and histopathological examination of a prostate specimen revealed prostate adenocarcinoma. We present this rare case to discuss the possible association between bullous pemphigoid and prostate adenocarcinoma

Ecstasy Intake Related Coagulopathy

3,4-methylenedioxymethamphetamine (MDMA), substance known as "Ecstasy" among the people and used due to entertainment, euphoric and energy booster effect, is one of the famous synthetic stimulants.  22-year-old man was found as unconscious in the early morning. According to the expressions of his family and friends, it was learned that he drank alcohol until late in the previous evening and took ecstasy besides this before he died. It was reported that he was taken to intensive care unit with temperature of 41oC and death occurred 12 hours later. At autopsy in external examination, petechial and purpuric hemorrhages in purple and red color were detected on body. In internal examination, petechial hemorrhages on the surface of the heart and lungs, subendocardial hemorrhage in the heart, hemorrhage on the mucosal surface of the stomach were seen. In the toxicological analyses of the blood, Paracetamol (4870 ng/ml), MDMA (847 ng/ml), MDA (94,2 ng/ml), Lidocaine (23 ng/ml), Pantoprazole (10,5 ng/ml), Midazolam (1,83 ng/ml) were detected. The death occurred due to coagulopathy related MDMA intoxication. Here, we present a case of autopsy, clinical findings and histopathologic findings, laboratory results in medicolegal literature

Forensic age estimation in living individuals by 1.5T magnetic resonance imaging of the knee: a retrospective MRI study

Our aim is to analyse proximal tibial epiphysis and distal femoral epiphysis patterns according to the Dedouit staging method using 1.5 T magnetic resonance imaging (MRI) with fast spin echo (FSE) for proton density images. In addition, we discuss the results in relation to the literature for forensic age estimation. In this study, images belonging to 195 female and 277 male patients ranging in age from 10 to 30 years who had a knee MRI for any reason in our Radiology Clinic between January 2014 and December 2016 were retrospectively evaluated. According to the Dedouit et al. five-stage method, they were evaluated by two radiologists. The kappa value was calculated for intra-observer and inter-observer compliance. The evaluation of knee epiphysis patterns from MRI is an alternative, efficient, radiation-free and non-invasive method that is helpful in forensic age estimation. In particular, stage 5 in distal femoral epiphysis can determine the 21st year of life in both sexes, and proximal tibial epiphysis could present evidence of age 18 in males. It should be used for evaluation in addition to other methods for determining skeletal system maturity.WOS:0005448927000082-s2.0-8505761476

Bloodless Aortic and Coronary Artery Dissection: A Case Report: Bloodless Aortic and Coronary Artery Dissection

Aortic dissection is the most common catastrophic event affecting the aorta, which is characterized by complex clinical manifestations, and high missed and delayed diagnosis rate. Acute aortic dissection has the importance of medical emergency and is associated with a high mortality. The presented case was, 55 year-old-man who was found as dead in the shed. At autopsy on internal inspection; heart examination revealed dissection 1 cm above aortic valve surrounding full thickness and intact adventitia, also hematoma making pressure on the descending branch of left coronary artery after 1 cm from proximal resulting from dissection and full- thickness dissection in the origin of the right coronary artery and intact adventitia were observed. We aimed to discuss this interesting aortic dissection case in the aspects of medico legal literature

Clinical Study External Rotator Sparing with Posterior Acetabular Fracture Surgery: Does It Change Outcome?

This study analyses the results of the treatment with external rotator sparing approach in acetabular fractures to determine whether muscle sparing has a positive impact on functional outcome. 20 patients with a mean age of 45.9 years (range: 26-64) that had been treated for displaced acetabular fractures were included in this series. Short Musculoskeletal Function Assessment (SMFA) questionnaire and hip muscle strength measurement were done at the 24-month of follow-up period. The radiographic results at the final followup were excellent in 9 hips (45%), good in 6 hips (30%), fair in 4 hips (20%), and poor in one hip (5%) according to the criteria developed by Matta. The average SMFA score for all of the patients was 18.3 (range: 0-55.4). The mean dysfunctional and bother indexes were 17.2 and 20.6, respectively. The overall muscle strength deficit was 11.8%. The greatest loss of strength was in internal rotation. In patients with better postoperative reduction quality of acetabular fracture, peak torque, and maximum work of hip flexion, extension and also internal rotation maximum work deficit were significantly lower ( < 0.05). Accurate initial reduction and longer postoperative muscle strengthening exercise programs seem critical to decrease postoperative hip muscle weakness after acetabular fractures

External Rotator Sparing with Posterior Acetabular Fracture Surgery: Does It Change Outcome?

This study analyses the results of the treatment with external rotator sparing approach in acetabular fractures to determine whether muscle sparing has a positive impact on functional outcome. 20 patients with a mean age of 45.9 years (range: 26–64) that had been treated for displaced acetabular fractures were included in this series. Short Musculoskeletal Function Assessment (SMFA) questionnaire and hip muscle strength measurement were done at the 24-month of follow-up period. The radiographic results at the final followup were excellent in 9 hips (45%), good in 6 hips (30%), fair in 4 hips (20%), and poor in one hip (5%) according to the criteria developed by Matta. The average SMFA score for all of the patients was 18.3 (range: 0–55.4). The mean dysfunctional and bother indexes were 17.2 and 20.6, respectively. The overall muscle strength deficit was 11.8%. The greatest loss of strength was in internal rotation. In patients with better postoperative reduction quality of acetabular fracture, peak torque, and maximum work of hip flexion, extension and also internal rotation maximum work deficit were significantly lower (P<0.05). Accurate initial reduction and longer postoperative muscle strengthening exercise programs seem critical to decrease postoperative hip muscle weakness after acetabular fractures

Bullous pemphigoid associated with prostate adenocarcinoma

Bullous pemphigoid is a common autoimmune skin disease characterized by the presence of subepidermal blisters. It has been associated with underlying neoplasia in isolated reports. A 78-year-old man with generalized blisters was diagnosed as bullous pemphigoid on clinical, histopathological and direct immunofluorescence grounds. His free and total prostate specific antigen (PSA) levels were high and histopathological examination of a prostate specimen revealed prostate adenocarcinoma. We present this rare case to discuss the possible association between bullous pemphigoid and prostate adenocarcinoma