A late preterm infant with progressive respiratory distress

A 2300 g female baby was born at 36+4 gestational age via caesarean section. Prenatal history was unremarkable. At 2 hours of age the baby was transferred to neonatal intensive care unit due to progressive respiratory distress and received poractant alfa as intubation-surfactant-extubation therapy after which FiO2 requirement decreased from 0.50 to 0.25. At 34 hours of age, while she was still on nasal continuous positive airway pressure (CPAP), she had sudden deterioration with retractions, desaturation and bradycardia. The infant was immediately intubated and put on high frequency oscillatory ventilation (HFOV) after which her oxygen saturations and heart rate stabilized.

What does washing the dishes look like?

A case of polymyalgia rheumatica and ankylosing spondylitis coexistence

Ankylosing spondylitis is a chronic inflammatory disease that affects the spine and peripheral joints. Polymyalgia rheumatica is an inflammatory disease characterized by aching and prolonged morning stiffness mainly in the shoulder and pelvic girdles. Many other diseases may mimic polymyalgia rheumatica, and thus differential diagnosis is predominantly required. A wide variety of diseases, including spondyloarthropathies, may present polymyalgia-like symptoms, and two diseases rarely coexist. We present a case of a 54-year-old man who had been followed-up for ankylosing spondylitis and presented with pain in the shoulder and pelvic girdles, restricted movement, and morning stiffness for 2 months. Physical examination revealed that the pain was located mostly in the shoulder and pelvic girdles. In addition, increased erythrocyte sedimentation rate revealed the coexistence of the two diseases. Corticosteroid treatment dramatically improved the patient's symptoms and supported the diagnosis. This case demonstrated that ankylosing spondylitis may present polymyalgia-like symptoms, and the two diseases may rarely coexist in the elderly. The coexistence of these two diseases has been rarely reported in literature. Accurate diagnosis of the two diseases is essential for improving the patient's symptoms and quality of life.

Reproducibility of Diagnosis of ASC-US, Reflection of Diagnostic Criteria to Cervical Histopathological Results and Investigation of p16 Antibodies in Cervical Biopsies

We aimed to investigate reproducibility of diagnosis, presence of Bethesda criteria and their reflection to histopathology in Papanicolau (PAP) smears with atypical squamous cells of undetermined significance (ASC-US). We also searched for p16 antibody positivity in cervical biopsy specimens of the patients with diagnosis of ASC-US. Methods: 33 patients who had undergone cervicopathologic evaluation were chosen from patients given ASCUS diagnosis in our department between 2006 and 2013 for this study. All the Pap smear specimens were reevaluated simultaneously by two pathologists. The specimens were evaluated for positivity of each Bethesda ASC-US diagnostic criteria separately. The biopsy specimens were stained with p16 antibody. Results: The reproducibility rate of cytology reports for Pap smear specimens diagnosed as ASC-US was found 88%. Neither of the Bethesda diagnostic criteria showed significant precedence over each other for frequency of

To What Extent Peritonitis Carcinomatosa Can Foreseeable in Digestive System Tumors?

Peritoneal dissemination may develop in many digestive system and gynecological cancers. Despite advances in imaging technologies, it is difficult to diagnose PC induced by digestive system tumors before surgery. Methods: In this study, staging tests used in patients with PC that unidentified preoperatively were reviewed retrospectively. Eighty-two patients were evaluated in between January 2012 and November 2015. Results Forty-five (54.8%) patients had been operated with stomach cancer, 24 patients (29.2%) with colorectal, and 13 patients (15.8%), pancreas and biliary tract cancers. Computerized Tomography (CT) was taken to all patients for staging, 26 patients were also evaluated with abdominal ultrasonography (USG) and 4 patients with magnetic resonance imaging (MRI). Positron Emission Tomography (PET-CT) was applied to eight patients. While 40 (48.7%) patients underwent surgical bypass and other palliative procedures, no additional surgical procedures were performed in 42 patients. In our series of patients who all have undergone laparotomy, all patients were evaluated with preoperative CT and suspicious findings identified in 10 patients were interpreted as not being specific to quit laparotomy. The most suspicious findings were reported in PC patients with gastric cancer (8/45). In our study, the PET/CT findings of 4 out of 8 patients evaluated were interpreted as suspicious, but they were not strong enough to exclude PC. Conclusion: It is still difficult to diagnose PC before surgery with conventional radiological imaging techniques. Combined use of different imaging modalities together can increase the success rate. It should be known that the probability of PC is especially high in patients with tumor marker elevation and locally advanced and borderline resectable disease findings. If palliative interventions are not planned in these patients, staging laparoscopy emerges as a suitable alternative.

Early mammographic screening after breast conserving surgery and radiotherapy: Is it necessary?

The aim of this study is to reveal the impact of first mammographic screening timing after Breast Conserving Surgery (BCS) and Radiotherapy (RT) on further radiological evaluations, biopsies and recurrent tumor detection. METHODS: Two hundred and seventy eight patients treated with BCS and RT with at least one bilateral mammography (MG) obtained within two years of postoperative period were evaluated. Patients screened with MG within 6 months of RT completion constituted Group-1 and the rest (6 months to 2 years) were grouped as

Radioguided Occult Lesion Localization in Patients With Locally Recurrent Papillary Thyroid Carcinoma: How We Do It?

Papillary thyroid carcinoma (PTC) is the most-frequent type of thyroid cancer. Following primary treatment, regional metastasis in the cervical region can be seen in more than 50 percent of cases and in the central region in more than 25 percent of cases. Our aim is to present our experiences with patients operated on for the recurrence of papillary thyroid cancer with the combined use of pre-operative ultrasonographic mapping and radio-guided occult lesion localisation. Methods: Eight patients who had already undergone total thyroidectomy and central/lateral neck dissection for papillary thyroid carcinoma were re-operated on due to locoregional metastasis. High-resolution ultrasonography, fine needle aspiration cytology and blood Tg levels were used to search for recurrences. The patients with proven recurrences and high Tg wash-out levels in cytopathologic aspirates were operated on. For each patient, age, gender, size of the primary tumor, type of previous surgery, adjuvant treatments, time to recurrence, site and duration of surgery, numbers of marked and non-marked lesions, and the metastatic and total numbers of marked/non-marked and non-mentioned lesions in the maps were recorded. Results: Sixteen lesions of 20 lesions removed after localisation were found to be malignant. In addition to the marked lesions during mapping, 36 additional lesions had been defined as suspicious. Thirty-four of these lesions were found at exact anatomic sites and localisations described and removed. Two lesions could not be found at areas described during mapping. Of 34 lesions, 27 were found to be metastatic. During the postoperative follow-up, chylous leak with spontaneous regression in 7 days and seroma occurred in one patient. Conclusion: Radio-guided occult lesion localisation and pre-operative mapping contribute to the safety and comfort of patients in planned re-operations on lateral and central neck regions.

An Assessment Method For The Stress Of Newborn Infants: Salivary Cortisol Level

Stres , fi ziksel, kimyasal veya duygusal faktörlere bağlı olarak ortaya çıkan bedensel ve ruhsal gerginlik durumu ve hastalığa yatkınlığı arttıran bir faktör olarak tanımlanmaktadır. Yenidoğan yoğun bakım ortamı ve yenidoğana uygulanan girişimler güçlü birer s tres ve travma kaynağıdır. Stres yenidoğan beyin gelişiminde olumsuz sonuçlara yol açabi len bir durumdur. Stres in aza ltılması en önemli hemşirelik girişimlerinden biridi r. Stres in aza l tılmas ı i çin öncel ikle değerlendirilmesi gerekmektedir. Yenidoğanın s tresi davranışsal ölçekler i le değerlendirilebil i r, ayrıca s tresin değerlendirilmesinde biyokimyasal ölçümler de kullanılmaktadır. En yaygın olarak kul lanılan biyokimyasal ölçüm non-invaziv olarak elde edi len tükürük kortizol düzeyinin incelenmesidir. Derlemede yenidoğanlarda s tres in değerlendiri lmes inde tükürük kortizol düzeyi ölçümü, tükürük a lınma zamanları, tükürük a lma materya l leri ve yenidoğanlarda tükürük kortizol düzeyinin değerlendirildiği çalışmalar güncel literatür ışığında sunulmuştur. .

Bilateral infraclavicular block with ultrasonography in pediatric patient

Anesthesia management in a patient with Carney Syndrome: Case report

Carney Syndrome is a complex of symptoms which can demonstrate autosomal dominant or sporadic transition that are followed by cardiac and cutaneous myxomas and endocrine abnormal activity. Myxomas demonstrate familial transition due to autosomal dominant inheritance at a rate approximately of 5%. 80% of non-familial sporadic myxoma has normal DNA structure, whereas 20% has abnormal chromosomal structure. Familial myxomas, unlike sporadic myxomas are encountered in younger patients as equally in both sexes (1).