Aflatoksikoza u rotvajlera nakon uzimanja pljesnive hrane: kliničkopatološki nalazi i učinkovita terapija tetrasulfatom.

The purpose of this study was to describe the clinical, hematologic, gross, histopathologic and toxicologic findings and to report effective therapy application for aflatoxicosis in dogs, ascribed to the ingestion of moldy wet bread contaminated with aflatoxin. A prospective case series of 10 client-owned dogs from the same household developed toxicological signs after eating moldy bread treated with water that had been stored for an undetermined period, fully covered with a grey-green mold. All dogs exhibited vomiting followed by excessive salivation and hyperaesthesia. Among the surviving dogs (n = 7), three of them presented with diarrhea, depression, abdominal pain and two others showed icterus. One of the dead dogs was found on the initial referral. Two others were dead following initial diagnosis and prior to therapy application. The most common gross findings in the dogs were generalized icterus, mucosal or submucosal edema and petechial, to ecchymotic hemorrhages in the organs. Histopathological findings included focal necrotic areas extending from the periacinar to centroacinar regions in the liver, biliary hyperplasia, cholestasis and multifocal hemorrhages in the kidneys and lungs. Due to the sudden onset of clinical signs, the lack of exposure to other toxins, and the confirmed evidence of ingestion of moldy bread, the results of analysis of liver samples and the histopathological signs, the definitive diagnosis was mycotoxicosis. Therapeutic applications included tetrasulphate (an antidote) given orally, and supportive treatment with balanced electrolyte solutions, antiemetics and H2 receptor antagonist. All treated dogs (7/7) made a full recovery over 18-24 hours. The results of the present study reported here describe the clinicopathological features of aflatoxicosis in Rottweilers, suggesting that the use of tetrasulphate solution as an inexpensive and available therapy may have helped the survival of the dogs and might reverse the adverse health effects of mycotoxins.Svrha je ovog rada iznijeti kliničke, hematološke, patoanatomske, patohistološke i toksikološke nalaze te izvijestiti o uspješnom liječenju pasa koji su jeli pljesnivu i vlažnu hranu što je sadržavala aflatoksin. U 10 pasa jednog vlasnika primijećeni su znakovi otrovanja nakon što su jeli pljesniv kruh namočen u vodu koji je prethodno bio čuvan neodređeno vrijeme, a u potpunosti je bio prekriven sivo-zelenom plijesni. Svi su psi povraćali uz obilno slinjenje i hiperesteziju. Od sedam preživjelih pasa, tri su imala proljev, bili su potišteni te su pokazivali bol u trbuhu, a dva su imala i žuticu. Jedan od uginulih pasa na početku je upućivao na toksikozu. Dva su uginula nakon postavljene dijagnoze, a prije početka liječenja. Patoanatomski je ustanovljena generalizirana žutica, edem sluznice ili submukoze te petehijalna do ekhimotična krvarenja po organima. Patohistološki su ustanovljena nekrotična žarišna područja pružajući se od periacinarnih do centroacinarnih područja u jetri, zatim bilijarna hiperplazija, kolestaza i multifokalna krvarenja po bubrezima i plućima. Na osnovi nagle pojave kliničkih znakova, nedostatka dokaza izloženosti drugim toksinima, potvrđenog dokaza uzimanja pljesnivog kruha, rezultata analize uzoraka jetre i patohistoloških nalaza postavljena je konačna dijagnoza mikotoksikoze. Za liječenje je peroralno bio primijenjen tetrasulfat(antidot) i uravnotežena otopina elektrolita, zatim antiemetici i antagonisti H 2 receptora. Svi liječeni psi (7/7) u potpunosti su se oporavili za 18 do 24 sata. Prikazani rezultati opisuju kliničke i patološke značajke aflatoksikoze u rotvajlera i upućuju na zaključak da se ona može liječiti otopinom tetrasulfata kao jeftinim i pristupačnim lijekom koji može pomoći u preživljavanju pasa te smanjiti štetne učinke mikotoksina na zdravlj

Ruptured Distal Anterior Cerebral Artery Aneurysms: Case series

OBJECTIVE: Aneurysms of the distal anterior cerebral artery are consist of small part of intracranial aneurysms. Their suırgical treatments present some difficulties because of location. We reported our experiences of cases with distal anterior cerebral arterey aneurysms focusing on clinically, radiologically, contribution of CSF drain through lumbar drain was evalueted and surgicical outcomes. MATERIAL and METHODS: We operated 5 distal anterior cerebral artery aneurysms between 2010-2016 and evaluated retrospectivily. Patients were evaluated regarding to preoperative Hunt-Hess grade, radyologically aneurysm locations, multiple aneurysms, aneurysms size, accompanying vascular anomally, aspect of hemorrhage and extended Glasgow Outcome scale and provided conveniences of lumbar drain during surgery. RESULTS: There were female dominance(f/m: 3/2), mean age was 46,2 years. Patients were suffered from frontal hematoma(n: 1), interhemispheric local hematom and intaventricular hemorrhage(n: l), interhemispheric local hematom(n: 2) and subarachnoid hemorrhage(n: 1). Aneurysms were identified on the A2(n: 1), A3(n3) and A3+anterior communicating artery by CT and digital subtraction cerebral angiography. All patient’s treatment was performed surgically by interhemispheric and/or pterional approach. CSF drain was performed by lumbar drainage during operation and postoperative period. We have no any morbidity and mortality. RESULTS: Although there are some surgical difficulties of the distal anterior cerebral artery aneurysms, these could be coped with lumbar drainage and application microsurgical technics

The effect of preoperative radiotherapy on local control and prognosis in high-grade non-metastatic intramedullary osteosarcoma of the extremities

Introduction This study aimed to analyse the effect of preoperative radiotherapy on survival, recurrence and necrosis rates in osteosarcoma patients treated with neoadjuvant chemotherapy and limb-salvage surgery. Materials and methods Osteosarcoma patients who referred to our clinic from 1998 to 2015 were investigated retrospectively. 141 patients with non-metastatic osteosarcoma of the limb who received neoadjuvant chemotherapy and underwent limb-sparing surgery with or without preoperative radiotherapy were included in the study. 73 patients had neoadjuvant chemotherapy only (CT group), while 68 patients had additional preoperative radiotherapy (CT + RT group). 5-year survival, disease-free survival, limb survival, local recurrence, metastasis, complication and necrosis rates were compared between the two groups. Results Overall 5-year survival, 5-year disease-free survival, 5-year limb survival rates were 68.5, 64.3, 65.7 for CT group and 72.1, 67.6, 64.7 for CT + RT group, respectively. Preoperative radiotherapy gave similar survival and disease-free survival rates. Limb survival, recurrence and metastasis rates were similar between the groups. The necrosis rate of the lesions was significantly higher in the CT + RT group compared to the CT group. Conclusion Preoperative radiotherapy can provide a higher necrosis rate and may allow the resection of unresectable lesions in the treatment of osteosarcoma. CT + RT provided similar 5-year survival despite the larger tumour size compared to CT group. Due to the higher wound complication rate (8.2% in CT, 23.5% in CT + RT group, p = 0.01), CT + RT should be restricted to the lesions with large size or close proximity to neurovascular structures

The Comparison of Pullout Strengths of Various Pedicle Screw Designs on Synthetic Foams and Ovine Vertebrae

AIM: One of the most common problems with transpedicular screws is screw pullout. This study was conducted to measure the pullout strengths of newly designed transpedicular screws. MATERIAL and METHODS: The design of the three group screws were conical cored standard pedicle screw (Type A), dual threaded pedicle screw (Type B), dual core and dual threaded pedicle screw (Type C), respectively. Polyurethane (PU) blocks in 25 mm and 50 mm thickness were used to investigate the effect of just the pedicle on pullout strength and both distal (vertebral body) and proximal (pedicle) parts of the screw. The screws were also tested in ovine lumbar vertebrae. RESULTS: Type C screw exhibited 5.9% and 12.9% higher pullout strength than Type A and Type B, and 15.4% and 8.6% higher pullout strength than Type A and Type B, respectively on 25 mm and 50 mm thick PU foam block.Type C also exhibited 74.5% and 22.5% higher pullout strength than Type A and Type B, respectively on the ovine vertebrae. CONCLUSION: Transpedicular screws redesigned with modified helical angles exhibit higher pullout strength compared to the classical transpedicular screws and can be inserted more rapidly with the same number of screwing rounds result with doubled insertion depth.This work was supported by the Research Fund of TUBITAK, Project # 111M583, Project # 113S101, and Osimplant medical devices. Special thanks to Nevzat Ucler for the recommendations on design and Akif Kaya Aybek for the manufacturing of the designed screws

Trasplante de riñón de donante vivo: por qué los donantes y receptores potenciales no lo logran. Algoritmo de Malatya

Introduction: In some countries, organ donation is not widespread enough due to medical, cultural, ethical and socioeconomic factors. Living-donor kidney transplant constitutes the main source of kidney donation. Aim: To evaluate the causes of cancellation of living-donor kidney transplant and improve the effectiveness of transplant programs. Methods: Medical records of possible donors and recipients who were evaluated for living-donor kidney transplant at a tertiary medical center between November 2010 and September 2019 were reviewed retrospectively. Results: Evaluations were performed on 364 potential donors and 338 living-donor kidney transplant recipients; 207 of the latter (61.24%) underwent living-donor kidney transplant. Immune disorders represented the majority of cancellations (38.84%). Fifty-six donors (15.38%) were rejected mainly due to renal disorders (39%). Conclusion: Timely referral of patients to transplant centers must be guaranteed in order to overcome immune problems. Transplant centers should invest in programs adequate both for their resources and for their patients: paired kidney exchange, desensitization protocols, future research, etc.Introducción: En algunos países la donación de órganos no es suficiente debido a factores médicos, culturales, éticos y socioeconómicos. El donante de riñón vivo constituye la principal fuente de donación de riñones. Objetivo: Evaluar las causas de cancelación de los donantes vivos de riñón y mejorar la eficacia de los programas de trasplante. Material y métodos: Registros médicos de posibles donantes y receptores, que fueron evaluados para trasplante de riñón de donante vivo en un centro terciario, entre noviembre de 2010 y septiembre de 2019, fueron revisados ​​retrospectivamente. Resultados: Se evaluaron 364 donantes potenciales y 338 receptores de trasplante de riñón de donante vivo, 207 destinatarios (61,24%) se sometieron a trasplante de riñón de donante vivo. Problemas inmunológicos representaron la mayoría de las cancelaciones (38,84%). A cincuenta y seis donantes (15,38%) se les negó la donación, principalmente debido a problemas renales (39%). Conclusión: La derivación oportuna de los pacientes a los centros de trasplante debe garantizarse para superar las barreras inmunológicas. Los centros de trasplante deberían invertir en programas adecuados, tanto por sus recursos como por los pacientes: riñón emparejado intercambio, protocolo de desensibilización, investigación futura, etc