Acute Upper Gastrointestinal Bleeding Due to Metastatic Lung Cancer: An Unusual Case

There have been several published reports on metastatic lesions in the stomach, but the number of cases have been limited due to the low frequency of the condition. Metastatic lesions in the stomach are usually asymptomatic. A 55-year-old man with known metastatic lung adenocancer exhibited epigastric pain, hematemesis, and melena. A bleeding, ulcerated gastric metastasis was found and treated with endoscopic therapy and omeprazole

Thyroid fine needle aspiration reporting rates and outcomes before and after Bethesda implementation: A single-center experience over 8 years

Aimː To evaluate data from our hospital system before and after the implementation of the Bethesda System for Reporting Thyroid Cytology (TBSRTC) and comparison of our data with the previously published studies. Methods: Seven hundred seventy-one patients with thyroid nodules who underwent fine needle aspiration biopsy (FNAB) and surgery at our institution were analyzed retrospectively. FNAB results were divided into two parts in terms of the period they related to: pre-TBSRTC (between 2005 and 2010) and TBSRTC (between 2011 and 2013). Results: 341 FNAB were applied in the period of TBSRTC. Of the 341 FNAB, 53(16%) were non diagnostic, 82(24%) were benign, 62(18%) were atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS), 28(8%) were follicular neoplasms and/or suspicion of follicular neoplasms (FN/SFN), 95(28%) were suspicion for malignancy (SuspM), and 21(6%) were malignant. Rates of malignancy reported on follow-up histopathological examination were non diagnostic in 11%, benign in 4.9%, AUS/FLUS in 23%, FN/SFN in 32%, SuspM in 44%, and malignant in 95.3%. Conclusions: In this study, the distribution of cases in TBSRTC categories and malignancy rates, differed from, recommended by TBSRTC and some studies. Implementation of TBSRTC did significantly affect our institution’s reporting rates

A Retrospective Study of Congenital Cardiac Abnormality Associated with Scoliosis

Study DesignRetrospective study.PurposeTo identify the incidence of congenital cardiac abnormalities in patients who had scoliosis and underwent surgical treatment for scoliosis.Overview of LiteratureCongenital and idiopathic scoliosis (IS) are associated with cardiac abnormalities. We sought to establish and compare the incidence of congenital cardiac abnormalities in patients with idiopathic and congenital scoliosis (CS) who underwent surgical treatment for scoliosis.MethodsNinety consecutive scoliosis patients, who underwent surgical correction of scoliosis, were classified as CS (55 patients, 28 female [51%]) and IS (35 patients, 21 female [60%]). The complete data of the patients, including medical records, plain radiograph and transthoracic echocardiography were retrospectively assessed.ResultsWe found that mitral valve prolapse was the most common cardiac abnormality in both patients with IS (nine patients, 26%) and CS (13 patients, 24%). Other congenital cardiac abnormalities were atrial septal aneurysm (23% of IS patients, 18% of CS patients), pulmonary insufficiency (20% of IS patients, 4% of CS patients), aortic insufficiency (17% of IS patients), atrial septal defect (11% of IS patients, 13% of CS patients), patent foramen ovale (15% of CS patients), dextrocardia (4% of CS patients), bicuspid aortic valve (3% of IS patients), aortic stenosis (2% of CS patients), ventricular septal defect (2% of CS patients), and cardiomyopathy (2% of CS patients).ConclusionsWe determined the increased incidence of congenital cardiac abnormalities among patients with congenital and IS. Mitral valve prolapse appeared to be the most prevalent congenital cardiac abnormality in both groups

Single-stage repair of adult aortic coarctation and concomitant cardiovascular pathologies: a new alternative surgical approach

BACKGROUND: Coarctation of the aorta in the adulthood is sometimes associated with additional cardiovascular pathologies that require intervention. Ideal approach in such patients is uncertain. Anatomic left-sided short aortic bypass from the arcus aorta to descending aorta via median sternotomy allows simultaneuos repair of both complex aortic coarctation and concomitant cardiac operation. MATERIALS: Four adult patients were underwent Anatomic left-sided short aortic bypass operation for complex aortic coarctation through median sternotomy using deep hypothermic circulatory arrest. Concomitant cardiac operations were Bentall procedure for annuloaortic ectasia in one patient, coronary artery bypass grafting for three vessel disease in two patient, and patch closure of ventricular septal defect in one patient. RESULTS: All patients survived the operation and were alive with patent bypass at a mean follow-up of 36 months. No graft-related complications occurred, and there were no instances of stroke or paraplegia. CONCLUSION: We conclude that single-stage repair of adult aortic coarctation with concomitant cardiovascular lesions can be performed safely using this newest technique

Citološka analiza endometrija kod krava s akutnim i kroničnim endometritisom.

The aim of the present study was to evaluate the findings of endometrial cytology in cows with acute and chronic endometritis. For this purpose samples were collected from 217 Brown Swiss and Holstein cows, housed on the Atatürk University Dairy Research Farm between the years 2010 and 2012, and they were stained with Giemsa for cytological examination. In the evaluation, overall 100 cells were counted in the microscopic area and the cells were classified as polymorph nuclear leukocyte, macrophage, lymphocyte and epithelial cells. The cytopathological classification was done according to the percentages of inflammatory cells. Briefly, 126 (58.06 %) samples had extensive inflammatory cells, and of the uterine samples 91 (41.94 %) had normal exfoliation. According to the cellular density results, acute, and chronic and subacute endometritis were described in 68 (31.33 %), 23 (10.60 %) and 35 (16.13 %) cases, respectively. In conclusion, endometrial cytology was found to be an applicable and reliable diagnostic method in diagnosis and diffentiation of acute and chronic endometritis.Cilj istraživanja bio je procijeniti citološke nalaze u endometriju krava s akutnim i kroničnim endometritisom. U tu su svrhu između 2010. i 2012. godine bili prikupljeni uzorci od 217 krava smeđe i holštajnske pasmine, uzgajanih na pokusnoj mliječnoj farmi na Sveučilištu Atatürk. Uzorci su bili obojeni Giemsinim bojenjem. Pri procjeni je u vidnom polju mikroskopa bilo izbrojeno ukupno 100 stanica kojesu razvrstane u polimorfononuklearne leukocite, makrofage, limfocite i epitelne stanice. Citopatološko razvrstavanje bilo je provedeno na osnovi postotka upalnih stanica. Ukratko, upalne stanice bile su ustanovljene u 126 (58,06 %) uzoraka, dok je u 91 (41,94 %) uzorku maternice ustanovljeno normalno ljuštenje stanica. Na osnovi stanične gustoće, akutni endometritis bio je dokazan u 68 (31,33 %) uzoraka, kronični u 23 (10,60 %), a subakutni u 35 (16,13 %) uzoraka. Zaključno, citologija endometrija pokazala se primjenjljivom i pouzdanom metodom u dijagnostici odnosno razlikovanju akutnog od kroničnog endometritisa

Growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula in infants with cow’s milk protein allergy

ObjectiveTo evaluate growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula (eHCF) in infants with cow’s milk protein allergy (CMPA).MethodsA total of 226 infants (mean ± SD age: 106.5 ± 39.5 days, 52.7% were girls) with CMPA who received eHCF comprising at least half of the daily dietary intake were included. Data on anthropometrics [weight for age (WFA), length for age (LFA) and weight for length (WFL) z-scores] were recorded at baseline (visit 1), while data on infant feeding and stool records, anthropometrics and Infant Feeding and Stool Patterns and Formula Satisfaction Questionnaires were recorded at visit 2 (on Days 15 ± 5) and visit 3 (on Days 30 ± 5).ResultsFrom baseline to visit 2 and visit 3, WFA z-scores (from −0.60 ± 1.13 to −0.54 ± 1.09 at visit 2, and to −0.44 ± 1.05 at visit 3, p < 0.001) and WFL z-scores (from −0.80 ± 1.30 to −0.71 ± 1.22 at visit 2, and to −0.64 ± 1.13 at visit 3, p = 0.002) were significantly increased. At least half of infants never experienced irritability or feeding refusal (55.7%) and spit-up after feeding (50.2%). The majority of mothers were satisfied with the study formula (93.2%), and wished to continue using it (92.2%).ConclusionsIn conclusion, eHCF was well-accepted and tolerated by an intended use population of infants  ≤ 6 months of age with CMPA and enabled adequate volume consumption and improved growth indices within 30 days of utilization alongside a favorable gastrointestinal tolerance and a high level of parental satisfaction

Replacement of a Lost Removable Partial Dental Prosthesis Using Ball-Attachment Analogs: A Clinical Report

WOS: 000293912100010PubMed: 21843230Attachment-retained removable partial dental prostheses (RPDPs) may be lost. Although in such situations, the RPDP should be remade, no method has yet been described for replacing lost attachment-retained RPDPs. This report describes a method for fabrication of a replacement for a lost maxillary RPDP using ball-attachment analogs