Management of rectal foreign bodies

BACKGROUND: Entrapped anorectal foreign bodies are being encountered more frequently in clinical practice. Although entrapped foreign bodies are most often related to sexual behavior, they can also result from ingestion or sexual assault. METHODS: Between 1999 and 2009, 15 patients with foreign bodies in the rectum were diagnosed and treated, at Izmir Training and Research Hospital, in Izmir. Information regarding the foreign body, clinical presentation, treatment strategies, and outcomes were documented. We retrospectively reviewed the medical records of these unusual patients. RESULTS: All patients were males, and their mean age was 48 years (range, 33–68 years). The objects in the rectum of these 15 patients were an impulse body spray can (4 patients), a bottle (4 patients), a dildo (2 patient), an eggplant (1 patient), a brush (1 patient), a tea glass (1 patient), a ball point pen (1 patient) and a wishbone (1 patient, after oral ingestion). Twelve objects were removed transanally by anal dilatation under general anesthesia. Three patients required laparotomy. Routine rectosigmoidoscopic examination was performed after removal. One patient had perforation of the rectosigmoid and 4 had lacerations of the mucosa. None of the patients died. CONCLUSIONS: Foreign bodies in the rectum should be managed in a well-organized manner. The diagnosis is confirmed by plain abdominal radiographs and rectal examination. Manual extraction without anaesthesia is only possible for very low-lying objects. Patients with high- lying foreign bodies generally require general anaesthesia to achieve complete relaxation of the anal sphincters to facilitate extraction. Open surgery should be reserved only for patients with perforation, peritonitis, or impaction of the foreign body

Partial Nephrectomy of a Horseshoe Kidney With Renal-Cell Carcinoma and Cholecystectomy: a Case Report

DergiPark: 819253tmsjAims: Horseshoe kidneys are the most common type of renal fusion anomaly and it may be associated with other anomalies and complications. Our case aims to present the partial nephrectomy of a horseshoe kidney with renal-cell carcinoma and cholecystectomy. Case Report: A sixty-year-old male patient was admitted to our outpatient clinic with a 3 cm suspicious mass in the horseshoe kidney that was detected during an attack of acute cholecystitis. Computed tomography revealed a heteroge- neous hypodense lesion containing millimetric calcific foci of 35x31x33 mm in size at the ventral middle part of the right kid- ney. Partial nephrectomy was performed non-ischemically and then cholecystectomy was performed. Pathological examination revealed stage T1a clear cell renal carcinoma, WHO/ISUP Grade 2 with a negative surgical margin. During follow-up; urea, creatinine, and glomerular filtration rate were found to be normal. Conclusion: Horseshoe kidneys are fairly common among renal anomalies. Cholecystectomy following non-ischemic partial nephrectomy for a tumor in the horseshoe kidney is a rare case

A quantitative research on ideological and political polarization on social media

İnternet kullanıcılara yer ve zamandan bağımsız olarak sınırsız veriye ve enformasyona kolayca erişebilecekleri bir ortam sağlamıştır. Ancak özellikle sosyal medya mecralarının yaygınlaşması ile algoritmik filtreleme faktörleri ve kullanıcıların kendine benzer özelliklerde olan kullanıcılarla etkileşimde bulunma durumu bir kullanıcının tükettiği içeriğin genişliğini daraltmıştır. Bu durum sosyal medyadaki kullanıcıların yalnızca kendi inanç ve görüşleriyle benzer özelliklerde olan içerikleri tükettiği kısır bir döngüye yol açmaktadır. Bu çalışma, sosyal medya mecralarını oluşturan algoritmaların filtreleme faktörlerinden bağımsız olarak kullanıcıların sosyal medya kullanma pratiklerinin ideolojik ve siyasi kutuplaşma üzerindeki etkilerini incelemektedir. Araştırmada basit tesadüfi örnekleme yöntemiyle 770 katılımcı belirlenmiş ve anket soruları katılımcılara çevrim içi araçlarla ulaştırılmıştır. Araştırma sonucu elde edilen bulgular katılımcıların büyük çoğunluğunun farklı ideolojik ve siyasi görüşe sahip diğer sıradan kullanıcıları takip etmediklerini ve bu kullanıcılarla etkileşimde bulunmadıklarını ortaya koymuştur. Benzer şekilde katılımcıların çoğunluğunun karşıt ideolojik görüşteki gazetecileri ve siyasi liderleri takip etmedikleri ve bu kişilerin sosyal medya paylaşımlarıyla etkileşimde bulunmadıkları bulgusuna ulaşılmıştır. Sonuç olarak filtre balonlarının etkisiyle kendi ideolojik ve siyasi düşüncesine benzer içerikler sunulan kullanıcılar, bilinçli olarak farklı görüşlerin önüne set çekmekte ve kendilerini gönüllü olarak yankı odalarına hapsetmektedir.The Internet has provided users with an environment where they can easily access unlimited data and information regardless of place and time. However, especially with the spread of social media channels, algorithmic filtering factors and the tendency of users to interact with other users with similar characteristics have narrowed the limit of the content consumed by a user. This leads to a vicious cycle in which users on social media only consume content that has similar characteristics to their own beliefs and opinions. This study examines the effects of users’ social media usage practices on ideological and political polarization in social media channels, regardless of the filtering factors of algorithms. In the study, 770 participants were determined by a simple random sampling method and the survey questions were delivered to the participants via online tools. According to the results of the research, it has been revealed that the majority of the participants do not follow users with different ideological and political views on social media and do not interact with these users. In addition, it was observed that the majority of the participants do not follow journalists and political leaders with opposing ideological and political views and do not interact with their posts. As a result, users, who are presented with content similar to their own ideological and political thoughts with the effect of filter bubbles, are also consciously blocking different opinions and voluntarily imprisoning themselves in echo chambers

Experimental laboratory modeling of choroidal vasculature: A study of the dynamics of intraoperative choroidal hemorrhage during pars plana vitrectomy

Amaç: Koroid kanamaları (KK), koroid damarlarının rüptürü ve kanın supra koroid boşluğuna ekstravazasyonu ile meydana gelir. Koroid damar sistemini daha iyi şekilde anlamak için, bu çalışmada amaca yönelik olarak ölçeklendirilmiş bir model kullanıldı. Bu model aracılığıyla, koroid damar sistemindeki stres düzeyleri farklı koşullar altında ölçüldü. Gereç ve Yöntem: Koroid damar yapısı modelinde, 1 cm genişliğinde ve 10 cm uzunluğunda lastik bir tüp kullanıldı. Modeldeki stres seviye ölçümü için ise özel iletken iplik kullanıldı. Modeldeki stres seviyeleri, farklı sistemik intravasküler kan basıncı seviyeleri (İVB), farklı göz içi basınç seviyeleri (GİB) ve farklı distorsiyon seviyeleri altında ölçüldü. Bulgular: Koroid damar modelindeki stres değerleri GİB ile negatif, İVB ve distorsiyon ile pozitif korelasyon gösterdi. Tüm korelasyonlar istatistiksel olarak anlamlı idi (p<0,05). Ancak, modelde ekspansil tamponad kullanıldığında bu korelasyon ekspansil olmayan tamponadlara göre daha kuvvetliydi. Distorsiyonun stres ile korelasyonu, İVB’nin korelasonuna göre daha güçlü idi. İVB’nin stres ile korelasyonu ise, GİB’nin korelasonuna göre daha güçlü idi. Distorsiyondan kaynaklanan damar yapısındaki stres, yüksek GİB etkisi ile karşılaştırıldığında gerileme gösterirken, yüksek İVB’den kaynaklanan damar yapısındaki stres tam tersine hafif bir artış sergiledi. Sonuç: Cerrahi işlemler sırasında göz küresinin aşırı distorsiyonu, nadiren görülen intraoperatif KK’lerin başlıca nedeni olabilir. Ekspansil olmayan oküler tamponat kullanımı, koroid kanamasına karşı vasküler yatak için daha iyi destek sağlar ve koroid kanaması saptanan hastalarda önerilen tampon çeşidi olmalıdır. GİB’nin aşırı artırılması, distorsiyondan kaynaklanan koroid damarlarındaki kanama riskinin önlenmesinde sınırlı etkiye sahiptir.Objectives: Choroidal hemorrhages (CH) result from rupture of choroidal vessels leading to extravasation of blood into the suprachoroidal space. In this study, we aimed to understand the hemodynamics of CH by developing a purpose-built scale model of the choroidal vasculature and calculating stress levels in the model under different conditions. Materials and Methods: We modeled the choroidal vasculature using a rubber tube 10 cm in length and 1 cm in diameter that was wrapped with conductive thread to enable the measurement of stress at the walls of the tube. Stress levels across the tube were continuously measured under different systemic intravascular blood pressure levels (IVP), intraocular pressure (IOP) levels, and distortion. Results: Stress values across the choroidal vessel model correlated negatively with IOP and positively with IVP and distortion. All correlations were statistically significant (p<0.05) and were stronger when the model was filled with expansile tamponade compared to non-expansile tamponades. Distortion showed the strongest correlation in terms of increasing stress across the model, while IVP showed stronger correlation compared to IOP. Raising IOP to counteract the stress in the model was effective when the stress in the model was secondary to increased IVP, but this approach was not effective when the stress in the model was caused by distortion. Conclusion: Excessive distortion of the globe during surgical maneuvers could be the primary reason for the rarely observed intraoperative CH. Non-expansile ocular tamponade provides better support for the vascular bed against CH and should be the recommended choice of tamponade in patients with existing CH. Increasing IOP excessively is of limited effect in preventing CH in vessels that are under stress as a result of distorting surgical maneuvers

Retrospective Analysis of Follicular Lymphoma Patients in Trakya University School of Medicine: a Single Center Experience

DergiPark: 889334tmsjAims: To establish a dataset including demographic features, disease characteristics, and survival rate of follicular lymphoma patients in Trakya Universi- ty School of Medicine and contribute to the database of follicular lymphoma in Turkey. Methods: In this retrospective cross-sectional study, we analyzed data constituting of follicular lymphoma patients over 18 years of age followed during the years of 2015-2020 in Trakya University Division of Hematology. Results: Out of 43 patients, 22 (51.2%) were female and 21 (48.8%) were male. The mean age was 56.56 (standard deviation 13.24) years. There were 5 (11.6%) pa- tients with B symptoms, presence of bone marrow involvement was seen in 17 (39.5%) patients, lastly, there were 18 (41.9%) patients with splenomegaly. Twen- ty-one (48.8%) patients received rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone, making it the most common treatment protocol administered in our study. Conclusion: Follicular lymphoma patients usually end up getting diagnosed at an advanced stage of the disease, presenting with incidentally noticed painless lymphadenopathy. Additionally, based on evidence in the literature, a clear gap in the successful diagnosis of follic- ular lymphoma patients can be observed between developed and developing countries. To overcome this hurdle, enhanced cooperation with hematopathology may lead to an increased awareness enabling physicians to make a more accurate diagnosis. Nonetheless, further studies are still needed to fully apprehend the epidemiology of follicular lymphoma patients in Turkey

ADEA Claimant Can Retain Severance Payments and Sue Former Employer

Former employees can maintain claims under the Age Discrimination in Employment Act (ADEA) without first repaying the consideration received for an invalid release of claims. The Supreme Court\u27s pronouncement, Oubre v. Entergy Operations, Inc., 1988 U.S. Lexis 646 (Jan. 26, 1998), may change the way many employers negotiate and execute severance packages and settlements with terminated employees

The marine arthropods of Turkey

This recent checklist of marine arthropods found on the coasts of Turkey represents a total of 1531 species belonging to 7 classes: Malacostraca (766 species), Maxillopoda (437 species), Ostracoda (263 species), Pycnogonida (27 species), Arachnida (26 species), Branchiopoda (7 species), and Insecta (5 species). Seventy-fve species were classifed as alien species in the region. Tis paper also includes the frst record of the amphipod Melita valesi from the Levantine coast of Turkey (Kaş, Gulf of Antalya).This recent checklist of marine arthropods found on the coasts of Turkey represents a total of 1531 species belonging to 7 classes: Malacostraca (766 species), Maxillopoda (437 species), Ostracoda (263 species), Pycnogonida (27 species), Arachnida (26 species), Branchiopoda (7 species), and Insecta (5 species). Seventy-fve species were classifed as alien species in the region. Tis paper also includes the frst record of the amphipod Melita valesi from the Levantine coast of Turkey (Kaş, Gulf of Antalya)