Assessment of sublingual microcirculation in critically ill patients: consensus and debate

The main concern in shock and resuscitation is whether the microcirculation can carry adequate oxygen to the tissues and remove waste. Identification of an intact coherence between macro- and microcirculation during states of shock and resuscitation shows a functioning regulatory mechanism. However, loss of hemodynamic coherence between the macro and microcirculation can be encountered frequently in sepsis, cardiogenic shock, or any hemodynamically compromised patient. This loss of hemodynamic coherence results in an improvement in macrohemodynamic parameters following resuscitation without a parallel improvement in microcirculation resulting in tissue hypoxia and tissue compromise. Hand-held vital microscopes (HVMs) can visualize the microcirculation and help to diagnose the nature of microcirculatory shock. Although treatment with the sole aim of recruiting the microcirculation is as yet not realized, interventions can be tailored to the needs of the patient while monitoring sublingual microcirculation. With the help of the newly introduced software, called MicroTools, we believe sublingual microcirculation monitoring and diagnosis will be an essential point-of-care tool in managing shock patients

Comparative morphology and fruit anatomy of Ferula szowitsiana DC. and Ferula caspica M.Bieb.

Ferula caspica and Ferula szowitsiana grow in the same area of Central Anatolia. According to Flora of Turkey, they can be easily confused for one another during the flowering time. In this study, morphological and anatomical features of these two species were examined in order to reveal their differences. Leaves, flowers and fruits of these two species were examined and necessary measurements were made. The proliferation in the inflorescence of F. caspica, was not observed in the species F. szowitziana. There were distinct morphological differences in the fruits, also, the numbers of the secretory channels were different in the anatomical sections of mericarps. Morphological differences were observed in leaf lobes of these two species. As a result, the data that can be used to distinguish between these species are shown

Multidisciplinary Management of Limited Interocclusal Space: A Clinical Report

Prosthetic management of partial edentulism can be challenging with the presence of limited interocclusal space. The extrusion of opposing teeth combined with the alveolar extrusion of the edentulous areas reduces the space needed for fabricating a removable or fixed prosthesis when edentulous areas are present in the maxilla. This clinical report describes the treatment provided to a patient who presented with a limited interocclusal space on the posterior right quadrant. Before prosthetic rehabilitation, mandibular right posterior teeth were intruded, and the maxillary right posterior alveolar crest was reduced by alveoloplasty. After gaining adequate space, prosthetic rehabilitation was completed with a maxillary removable partial denture. During the 2-year follow-up period, the patient's chewing functions and physical appearance improved, and no complications occurred

Prevalence of Coronary Artery Anomalies in 12,457 Adult Patients Who Underwent Coronary Angiography

Background: Coronary artery anomalies are found in 0.2% to1.3% of patients undergoing coronary angiography and 0.3% of an autopsy series. We aimed to estimate the frequency of coronary artery anomalies in our patient population

The endocrine spectrum of intracranial cysts in childhood and review of the literature

Intracranial cysts (ICC) may cause a wide spectrum of endocrinological disorders. We evaluated 27 patients who were diagnosed with ICC during investigation for neuroendocrine dysfunctions and reviewed the relevant literature. The types of ICC in the patients were arachnoid cysts (n = 13); Rathke cleft cysts (n = 7); pineal cysts (n = 5); an ependymal cyst (n = 1) and a cavum septum pellucidum cyst (n = 1). The neuroendocrine dysfunctions of the patients were obesity (n = 7), isolated growth hormone deficiency ( n = 6), central precocious puberty (n = 6), multiple pituitary hormone deficiency (n = 3), central diabetes insipidus (n = 1), growth hormone deficiency and central precocious puberty (n = 1), obesity and galactorrhea (n = 1), obesity and hypogonadotropic hypogonadism (n = 1) and growth hormone neurosecretory dysfunction (n = 1). Only three patients, who had arachnoid cysts, showed neurologic symptomatology. Although three patients underwent surgery, no improvements in endocrinological dysfunctions were observed. ICC should be considered when evaluating patients with endocrinological problems and patients with coincidental ICC should be recommended for follow-up