Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Assessing Changes in Oral Health-Related Quality of Life Following Dental Rehabilitation under General Anesthesia

WOS: 000337336200014PubMed: 25095323Objective: To determine whether dental treatment under general anesthesia (GA) improved oral health-related quality of life (OHRQoL) in pre-school children, to evaluate the sensitivity and responsiveness of the Turkish version of the Early Childhood Oral Health Impact Scale (ECOHIS) and to examine parental satisfaction with the care received Study design: The parents/caregivers of 120 pre-school children receiving dental treatment under GA, were asked to complete the ECOHIS before and after treatment. Participants were also asked a global transition judgement concerning change in their child's condition after treatment. Global transition judgement and distribution changes in ECOHIS scores were used to assess the sensitivity and responsiveness. Results: 98 children completed the follow-up survey Between pre- and post-treatment ECOHIS scores, significant reduction was observed (p<0.001). The effect sizes were moderate and large (0.36 to 1.63). Global transition rating groups were compatible with statistical differences between pre- and post-treatment scores, supporting the responsiveness of the ECOHIS. 91% of parents regarded the experience to be positive. Conclusions: Children's OHRQoL showed significant improvement after treatment. The majority of parents reported a high degree of satisfaction. Also, Turkish version of the ECOHIS was sensitive to dental treatment under GA for pre-school children and responsive to treatment-associated changes

Case report: intratesticular tetrathyridiosis in a cat

This report provides histological information on the incidental finding of tetrathyridium in the testicles of a three-year-old cross-bred cat. The cat was chemically castrated by intratesticular injection of calcium chloride (CaCl2). Bilateral orchiectomy was performed and no gross lesions were seen in the testicles. Histological evaluation of right testicle revealed tetrathyridium with convoluted borders and a thick eosinophilic cuticle. The stroma of the parasitic body was composed of a loose mesenchymal network with widely scattered parenchymal and muscle cells, and numerous clear vesicles (calcereous corpuscles). Thus, the case was evaluated as intratesticular tetrathyridiosis. To our knowledge, this is the first descriptive report of intratesticular tetrathyridiosis in a cat

Gastrocystoplasty in pigs and effect of selective antral vagotomy on acid secretion of the reconstructed bladder

Introduction: The aim of this study was to investigate the outcome of gastrocystoplasty and the effects of selective antral vagotomy (SAV) on the postprandial gastrin secretion from the antrum as well as on the acid secretion from the augmented bladder. Materials and Methods: In this study on 12 male pigs, we applied subtotal cystectomy plus gastric augmentation plus SAV to the study group and the same procedure without SAV to the control group. The animals were followed up for 3 months with respect to feeding, weight, and urine output. The urine pH levels and the gastrin levels of the pigs in the two groups were then followed up and compared. Results: The use of gastric segments in bladder reconstruction was found to be appropriate in terms of both gastric function and urinary system function. Nevertheless, regarding the effect of SAV, the differences between either the urinary pH levels or the gastrin levels of the pigs in the two groups were statistically significant. Conclusions: Although gastric segments in the bladder reconstruction were found to be appropriate in terms of both gastric function and urinary system function, SAV did not prevent postprandial gastrin secretion and the resulting increase of the urine acidity. Copyright (C) 2003 S. Karger AG, Basel

Geological and hydrogeochemical properties of geothermal systems in the southeastern region of Turkey

Yesilnacar, Mehmet Irfan/0000-0001-9724-8683; UZELLI, TAYGUN/0000-0003-0846-5921; BABA, ALPER/0000-0001-5307-3156WOS: 000458467900021The Anatolia region is one of the most seismically active regions in the world. It has a considerably high level of geothermal energy potential thanks to its geological and tectonic settings. The Southeastern Anatolia Region (GAP) is located in the south of Bitlis-Zagros Suture Zone (BZSZ) which is in the Arabian foreland. During the neotectonic period, the folded structures have been developed under the influence of tectonic compression from the Upper Miocene in the GAP Region where it is closely related to active tectonics. These tectonic activities produce more geothermal resources. Few studies have been carried out in this region for geothermal energy. Limited portions of the geothermal resources have been used both for thermal tourism and greenhouses in the GAP region. The aim of this study is to determine geological, tectonic and hydrogeochemical properties of a geothermal system in the GAP Region. The result indicates that the surface temperatures of geothermal fluids are from 20 to 84.5 degrees C A large number of abandoned oil wells, whose temperature reaches 140 degrees C, are found in the region. Also, hydrogeochemical results show that deep circulated geothermal fluids are enriched with Na-Cl and shallow geothermal system fluids have Na - HCO3 and Ca-SO4 characters because of cold water mixing and water-rock interaction. Cold waters are generally of Ca-Mg - HCO3 and Ca - HCO3 type. Cation geothermometers were used for determining reservoir temperature of the geothermal resources in the region. The results show that the reservoir temperature of these geothermal resources ranges from 50 degrees C to 200 degrees C. The isotope data (oxygen-18, deuterium and tritium) suggests that geothermal fluid is formed by local recharge and deep circulation

Slip partitioning in the Sea of Marmara Pull-Apart determined from GPS velocity vectors

Dislocation modelling is used to examine the GPS velocity vectors for the Marmara Sea region. First, the vectors due to the known Anatolia/Eurasia rotation are reproduced by introducing structures that approximate the large-scale tectonics. Observed features of the smaller scale fault system in the Marmara region are then progressively included with slip amplitudes and directions adjusted to fit an 80-vector subset of the GPS data. The motion in the Marmara Sea region is partitioned with the faults that bound the north of the basin carrying more strike-slip motion than predicted from the Anatolia-Eurasia plate motion and faults to the south having a greater perpendicular component. Taken together however, there is no net opening across the Marmara Sea perpendicular to the overall trend of the boundary and thus deformation in the Marmara region results only from the pull-apart geometry of the North Anatolian fault. No extension related to the Aegean system is needed to explain the observations. The GPS results are consistent with motion over the last 5 Myr that has been determined from geological reconstructions