Rol de la laparoscopia en el manejo del síndrome OHVIRA: reporte de un caso y su relación con la endometriosis / Role of laparoscopy in the management of OHVIRA syndrome: a case report and its relation to endometriosis

El síndrome de hemivagina obstruida y anomalía renal ipsilateral (OHVIRA) es producido por una alteración en el desarrollo de los conductos de Müller y Wolff en la vida fetal. El síndrome es poco frecuente, se reporta una prevalencia de 1/2.000 a 1/28.000 casos. La endometriosis se presenta en un 19% de los casos complicando esta patología. El tratamiento del síndrome OHVIRA consiste en resecar el tabique vaginal drenando el hematocolpos. Hasta el momento no existe un consenso en recomendar la realización de una laparoscopia diagnóstica. El objetivo de este estudio es reportar la eventual importancia de la laparoscopia diagnóstica/terapéutica como parte del manejo del síndrome OHVIRA.

Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is caused by a defect in the development of Müllerian and Wolffian ducts at fetal life. The syndrome is uncommon, with a reported prevalence of 1/2,000 to 1/28,000 cases. Endometriosis is present in 19% of cases complicating this pathology. Treatment of OHVIRA syndrome consists in resecting the vaginal septum and draining the hematocolpos. Until now there isnt an agreement on recommending diagnostic laparoscopy as part of the treatment. The aim of this study is to report the importance of diagnostic/therapeutic laparoscopy in the management of OHVIRA syndrome.

How does radiotherapy affect the adhesion of universal adhesive to enamel and dentin? A qualitative and quantitative analysis? / Efecto de la radioterapia a la adhesión del adhesivo universal al esmalte y dentina? Un análisis cualitativo y cuantitativo?

Abstract This study investigated the shear bond strength (SBS) of a universal adhesive to enamel/dentin; 1) that had undergone radiotherapy (RT) and 2) that were readily restored and had undergone RT. Enamel and dentin surfaces were obtained from 90 intact human molars. They were randomly divided into six groups according to the presence and timing of irradiation (RT0:no radiotherapy/control, RT1:RT before restoration, RT2:RT after restoration groups) and adhesive application modes (etch&rinse/ER, self-etch/SE)(n=15). A universal adhesive and resin composites were applied. The radiotherapy protocol was conducted with 60 Gy. The SBS test was subjected (1mm/min) and failure type analysis was performed. The resin-enamel/dentin interfaces were examined. Data were statistically analyzed. For enamel and dentin, the presence and timing of irradiation did not significantly influence the SBS values (p>0.05). For enamel, significantly higher SBS values were obtained using etch&rinse mode than self-etch mode (p<0.05). The predominant failure was mixed type. Loss of enamel prisms and obliterated irregular dentinal tubules were found for the radiotherapy-treated specimens. Resin tags were clearer in the irradiated enamel treated with ER than SE. Irradiation with different timings did not influence the bond strength to enamel and dentin, negatively. Irrespective of radiotherapy, the etch&rinse mode caused higher bond strength to enamel than self-etch mode.

Resumen Este estudio investigó la fuerza de unión al cizallamiento (SBS) de un adhesivo universal al esmalte/dentina en piezas que se habían sometido a radioterapia (RT). Se obtuvieron superficies de esmalte y dentina de 90 molares humanos intactos. Se dividieron aleatoriamente en seis grupos según la presencia y el momento de la irradiación (RT0: sin radioterapia/control, RT1: RT antes de la restauración, RT2: RT después de la restauración considerando los modos de aplicación del adhesivo (n=15). Se aplicó un adhesivo universal y resinas compuestas. El protocolo de radioterapia se realizó con 60 Gy. Se sometió a la prueba adhesiva (1mm/min) y se realizó análisis del tipo de falla. Se examinaron las interfases resina-esmalte/dentina. Los datos fueron analizados estadísticamente. Para el esmalte y la dentina, la presencia y el momento de la irradiación no influyeron significativamente en los valores adhesivos (p>0,05). Para el esmalte, se obtuvieron valores adhesivos significativamente más altos utilizando el modo de grabado y enjuague que el modo de autograbado (p<0,05). La falla predominante fue de tipo mixto. Se encontró pérdida de prismas de esmalte y túbulos dentinarios irregulares obliterados en las muestras tratadas con radioterapia. La irradiación con diferentes tiempos no influyó negativamente en la fuerza de unión al esmalte ni a la dentina. Independientemente de la radioterapia, el modo de grabado ácido y enjuague provocó una mayor fuerza de adhesión al esmalte que el modo de autograbado.

Effect of del nido cardioplegia use on kidney injury after coronary bypass operations

SUMMARY OBJECTIVE: After cardiac surgery, acute kidney injury is observed at a rate of 5-30%, and the second most common cause of acute kidney injury in intensive care units is cardiac surgery. In this study, we aimed to investigate the effect of del Nido cardioplegia solution use on postoperative acute kidney injury development in patients who underwent coronary artery bypass grafting operation with cardiopulmonary bypass. METHODS: Consecutive patients who underwent an elective coronary artery bypass grafting operation with cardiopulmonary bypass in our clinic between March 15, 2019, and March 15, 2020, were included in the study retrospectively. The patients were divided into two groups as those who received del Nido cardioplegia solution (Group 1) and blood cardioplegia (Group 2), and factors affecting the development of renal failure were examined. RESULTS: A total of 350 consecutive patients were included in the study. There were 156 patients in the del Nido cardioplegia group and 194 patients in the blood cardioplegia group. Among the patient group, 74 (21.1%) patients developed acute kidney injury. The total acute kidney injury development rate was significantly higher in Group 2 (p=0.018). In multivariate logistic regression analysis, advanced age (OR 1.128; 95%CI 1.044-1.217; p=0.042), increased blood product use (OR 1.318; 95%CI 1.154-1.998; p=0.019), preoperative creatinine elevation (OR 2.434; 95%CI 1.655-4.639; p=0.005), and increased cardioplegia volume (OR 1.254; 95%CI 1.109-2.980; p=0.009) were independent predictors of acute kidney injury. CONCLUSION: With this study, we showed that the use of del Nido cardioplegia solution can reduce the incidence of acute kidney injury.

First Report of Roseomonas aerofrigidensis Isolated from the Peritoneal Fluid of a Gastric Cancer Patient / 대한임상미생물학회지

Roseomonas aerofrigidensis is a gram-negative, strictly aerobic, non-motile bacterium, which was first isolated in 2017 in South Korea. We present the first report of the isolation of R.aerofrigidensis from the peritoneal fluid of a 38-year-old woman with a history of metastatic gastric cancer with peritoneal carcinomatosis. The isolate was resistant to cotrimoxazole. Further research on clinical and microbiological responses to several antibiotics are warranted.

Reattachment of Rhegmatogenous Retinal Detachment via Fibrin Tissue Adhesive

Purpose@#To manage reattachment of rhegmatogenous retinal detachment using tissue adhesive (fibrin glue) in five patients. @*Methods@#Five eyes of five patients with rhegmatogenous retinal detachment were treated with 23-gauge pars plana vitrectomy and the application of fibrin glue (Tisseel Lyo) into the break under air without laser photocoagulation or cryopexy. @*Results@#The median age of patients was 64 (range, 46–82) years, and the median duration of symptoms was 15 (range, 7–60) days. Three eyes had inferior and two had superior rhegmatogenous retinal detachments. Successful retinal reattachment was achieved in all cases and maintained during the followıng 10 to 24 months. The median best-corrected visual acuity improved from 2 / 100 preoperatively to a Snellen visual acuity of 20 / 50 by 6 months postoperatively. No postoperative complications were detected during the follow-up period. @*Conclusions@#Excellent adhesive effects of fibrin glue with respect to sealing retinal tears with no side effects were seen in our study. With further prospective studies, this technique could be an alternative method to conventional retinopexy.

First Report of Roseomonas aerofrigidensis Isolated from the Peritoneal Fluid of a Gastric Cancer Patient / 대한임상미생물학회지

Roseomonas aerofrigidensis is a gram-negative, strictly aerobic, non-motile bacterium, which was first isolated in 2017 in South Korea. We present the first report of the isolation of R.aerofrigidensis from the peritoneal fluid of a 38-year-old woman with a history of metastatic gastric cancer with peritoneal carcinomatosis. The isolate was resistant to cotrimoxazole. Further research on clinical and microbiological responses to several antibiotics are warranted.

Reattachment of Rhegmatogenous Retinal Detachment via Fibrin Tissue Adhesive

Purpose@#To manage reattachment of rhegmatogenous retinal detachment using tissue adhesive (fibrin glue) in five patients. @*Methods@#Five eyes of five patients with rhegmatogenous retinal detachment were treated with 23-gauge pars plana vitrectomy and the application of fibrin glue (Tisseel Lyo) into the break under air without laser photocoagulation or cryopexy. @*Results@#The median age of patients was 64 (range, 46–82) years, and the median duration of symptoms was 15 (range, 7–60) days. Three eyes had inferior and two had superior rhegmatogenous retinal detachments. Successful retinal reattachment was achieved in all cases and maintained during the followıng 10 to 24 months. The median best-corrected visual acuity improved from 2 / 100 preoperatively to a Snellen visual acuity of 20 / 50 by 6 months postoperatively. No postoperative complications were detected during the follow-up period. @*Conclusions@#Excellent adhesive effects of fibrin glue with respect to sealing retinal tears with no side effects were seen in our study. With further prospective studies, this technique could be an alternative method to conventional retinopexy.

Comparative Evaluation of Completeness of Traditional Narrative versus Electronic Synoptic Operative Reports for Ovarian, Peritoneal and Fallopian Tube Cancer Surgery in a Tertiary Government Hospital

@#Objective. This study aimed to compare the completeness and ease of use of narrative reports (NR) submitted by residents compared to electronic synoptic reports (SR) by gynecologic oncology fellows for patients who underwent ovarian, fallopian, and peritoneal cancer surgery. Methods. We conducted a cross-sectional study in the Department of Obstetrics-Gynecology of the Philippine General Hospital from August to November 2019. We assessed the NRs and electronic SRs for completeness of data using quality indicators. Results. The average percentage of completeness of quality indicators is 77.1% (35.7/65). Eight indicators were absent in all NRs. Reporting of residual lesions was low (29.1%). The mean time to accomplish SRs (10.4 minutes) was significantly shorter than the mean time to accomplish NRs (21.9 minutes) (p value = 0.0001). SRs were assessed to be superior to NRs in several areas of surgery for quality, completeness and timeliness. Conclusion. This study showed that the NRs should be improved and periodic audit must be done to maintain quality assurance. The use of SR appears to be favorable and superior in terms of time required to accomplish.

Management of dermatologic adverse events from cancer therapies: recommendations of an expert panel

Abstract With the development of new cancer therapies, systemic toxicity profile and effects on survival achieved an important improvement. However, a constellation of toxicities has emerged, even more remarkably, cutaneous adverse events. This report, developed by a board of Brazilian experts in oncodermatology, aims to establish a guideline for the dermatological care of oncologic patients. When possible, evidence-based recommendations were made, but in many cases, when strong evidence was not available, a consensus was reached, based on some data supporting therapies combined with personal experiences.

Intention and Oral Health Behavior Perspective of Islamic Traditional Boarding School Students Based on Theory of Planned Behavior

Abstract Objective: To analyze the correlation of the students in an Islamic boarding school intention toward oral health behavior by means of the Theory of Planned Behavior (TPB) approach. Material and Methods: A cross-sectional analytic study was conducted on 153 students of an Islamic boarding school who fulfilled the criterion. Data were obtained by a questionnaire and clinical examination. Data were presented as mean and standard deviation. Results: The highest score of the variable that affects behavior recorded from both male and female respondents was Subjective Norm (57.288 ± 12.828), followed by Attitude (25.627 ± 4.144). Meanwhile, the lowest score that affects behavior was Oral Health Knowledge (3.179 ± 1.402). All study variables, according to the theory of planned behavior, such as knowledge, attitude, subjective norm, perceived behavior control, and intention had significant value to predict and assess behavior with p<0.05. Conclusion: Attitude, subjective norms, perceived behavioral control, and oral health knowledge in Private Boarding School's Santris influence the intention to improve oral hygiene behavior.

Clinical evaluation of simultaneous integrated boost in brain metastasis patients with helical intensity modulated radiotherapy

Background: this study was performed to assess patient survival and treatment toxicity after helical tomotherapy [HT] with simultaneous integrated boost [SIB] radiotherapy [RT] for cancer patients with one to eight brain metastases [BM] who have been treated with or without surgery

Materials and Methods: a total of 48 brain metastasis [BM] patients were included in this retrospective study between April 2015 and December 2016,. The patients were treated with image-guided intensity modulated radiation therapy [IMRT] on the helical tomotherapy [HT] machine. Whole brain HT as 25 Gy and SIB to metastasis sites as 35 Gy was delivered in 10 fractions. The patient were aged between 50 to 80 years old, volume of the BM was between 6 to 75 cc and the number of brain metastasis was between 1 to 8, Karnofsky Performance Score [KPS] ranged between 50-90 and RPA I-III. Surgery was performed to two patients before RT. The maximum patient follow -up _me was 20 months

Results: the primary neurotoxicity observed in patients was grade I- II brain edema related headache and lethargy. In patients who had survived 3- 12 months, KPS improved median score of 20 points and RPA was grade I after six months. Twelve patients had passed away at the end of a 20- month follow-up

Conclusion: HT utilizing SIB treatment for 1- 8 BM was achieved successfully with no significant toxicity. An improvement of performance status indicators of patients following RT was observed

Peri-operative radiotherapy for the prevention of post-operative fibrosis on rats

Background: post-operative fibrosis related pains and functional anomalies can be serious problems for patients. Radiotherapy [RT] could inhibit fibrosis which may occurs post- operation especially following laminectomy. Therefore, this study was designed to investigate the effect of peri-operative RT on the prevention of post-operative fibrosis and scar formation on rats

Materials and Methods: twenty three male Wistar albino rats, were divided into three experimental groups. Laminectomy was performed to L3 and L4 lomber vertebral regions of group L and L+R rats. The rats in L+R group in addition to this procedure also received peri-operative RT on the laminectomy area. A total dose of 700 cGy of RT was applied as a single fraction using electrons. Control rats received no treatment. A rotarod test was performed at 20, 30 and 40 rpm/min speed rates to determine the physical performances of the rats

Results: the results have indicated statistically significant [P<0.05] differences for the 30 rpm/min rotarod test between the L and L+R groups. Histopatologically, significant differences were observed in epidural fibrosis, fibroblast cell density and arachnoid adhesion between the L and L+R groups

Conclusion: it was concluded that peri-operative RT may provide a significant advantage for prevention post-laminectomic of scar tissue formation

Atrial conduction times and left atrial mechanical functions and their relation with diastolic function in prediabetic patients

BACKGROUND/AIMS: The aim of this study was to investigate atrial conduction times and left atrial mechanical functions, the noninvasive predictors of atrial fibrillation, in prediabetic patients with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). METHODS: Study included 59 patients (23 males, 36 females; mean age 52.5 ± 10.6 years) diagnosed with IFG or IGT by the American Diabetes Association criteria, and 43 healthy adults (22 males, 21 females; mean age 48.5 ± 12.1 years). Conventional and tissue Doppler echocardiography were performed. The electromechanical delay parameters were measured from the onset of the P wave on the surface electrocardiogram to the onset of the atrial systolic wave on tissue Doppler imaging from septum, lateral, and right ventricular annuli. The left atrial volumes were calculated by the disk method. Left atrial mechanical functions were calculated. RESULTS: The mitral E/A and E′/A′ ratios measured from the lateral and septal annuli were significantly lower in the prediabetics compared to the controls. The interatrial and left atrial electromechanical delay were significantly longer in prediabetic group compared to the controls. Left atrial active emptying volume (LAAEV) and fraction (LAAEF) were significantly higher in the prediabetics than the controls. LAAEV and LAAEF were significantly correlated with E/A, lateral and septal E′/A′. CONCLUSIONS: In the prediabetic patients, the atrial conduction times and P wave dispersion on surface electrocardiographic were longer before the development of overt diabetes. In addition, the left atrial mechanical functions were impaired secondary to a deterioration in the diastolic functions in the prediabetic patients.

Evaluation of Two ELISA and Two Indirect Hemagglutination Tests for Serodiagnosis of Pulmonary Hydatid Disease

To establish a definite diagnosis for pulmonary hydatid disease, combination of radiology and serology is useful. In this study, 19 preoperative sera from patients with surgically confirmed pulmonary hydatidosis, 40 sera from patients with other parasitosis and pulmonary diseases, and 20 sera from healthy donors were evaluated using 4 different serological tests, i.e., the commercial ELISA (ELISA-kit) test, the ELISA (ELISA-lab) test prepared in our laboratory, the commercial indirect hemagglutination assay kit (IHA-kit) test, and the IHA test using sensitized sheep red blood cells with tannic acid (IHA-TA). The ELISA-kit was the most sensitive (84.2%) and the most specific test (100.0%). The ELISA-kit also demonstrated the highest positive (100.0%) and negative (95.2%) predictive values. The sensitivity of the ELISA-lab test, that we prepared, was found to be 73.6%, whereas the IHA-kit test and the IHA-TA test were found to be 73.6% and 68.4%, respectively. The specificity of these tests was 96.6%, 98.3%, and 83.3%, respectively. When all 4 tests were assessed together, it was found that the sensitivity had risen to 94.7%. When the ELISA-kit was assessed with the IHA-kit and IHA-TA together, it was found that the sensitivity was 89.5% and 84.2%, respectively. Likewise, the combination of the ELISA-lab and IHA-kit or IHA-TA allowed us to achieve a sensitivity of 84.2% in cases of pulmonary echinococcosis. In conclusion, the diagnosis would be imminent if least 2 tests were applied together.

Posttransplant diabetes mellitus in kidney allograft recipients at Shaheed Hasheminejad Hospital

Our aim was to evaluate the frequency and risk factors of posttransplant diabetes mellitus [PTDM] at our kidney transplant center, and to compare graft and patient outcomes between the kidney recipients with and without PTDM. We studied 203 kidney transplant recipients with a negative history of diabetes mellitus before transplantation. We examined them for PTDM and made diagnosis on the basis of the American Diabetes Association criteria. Measurements of plasma glucose were carried out from 3 months to 24 months after transplantation. All data including recipient and donor demographics, cause of end-stage renal disease, cytomegalovirus and hepatitis C virus antibody tests, and patient and graft outcomes were assessed in relation to PTDM. High fasting plasma glucose was seen in 24 [11.8%], 19 [9.4%], 16 [7.9%], and 13 [6.4%] patients at 3, 6, 12, and 24 posttransplant months, respectively. Moreover, impaired glucose tolerance was seen in 17 [8.4%], 16 [7.9%], 17 [8.4%], and 19 [9.4%] patients at the corresponding times, respectively. Accordingly, 39 patients [19.2%] were diagnosed to have PTDM. The mean age of the kidney recipients with PTDM was 46.5 +/- 12.3 years as compared to 38.6 +/- 13.4 years in nondiabetic kidney recipients [P = .02]. The 5-year patient and graft survival rates were not significantly different between the kidney recipients with and without PTDM. This study showed that PTDM is a common metabolic disorder in our kidney transplant patients. We recommend a less diabetogenic immunosuppressive protocol, especially for our older recipients

Comparison of antibiotic susceotibility tests, plasmid profiles and restriction enzyme analysis of plasmid DNA of methicillin susceptible and resistant-staphylococcus aureus strains isolated from intensive care units

To differentiate methicillin-resistant Staphylococcus aureus [S. aureus] [MRSA] and methicillin-sensitive S. aureus [MSSA] strains and detect the source of epidemic strains and prevent their access to patients. All the procedures were carried out in the Department of Microbiology, Medical Faculty Hospital, Dokuz Eylul University, Izmir, Turkey from 1996-1998, and antibiotic susceptibility tests continued in the laboratory of King Fahad Hospital, Al-Baha, Kingdom of Saudi Arabia [KSA], from 2001-2004. A total of 81 S. aureus strains [71 MRSA, 10 MSSA] from Turkey were isolated from different sites of patients in Intensive Care Unit's [ICU's], evaluated by plasmid profile, Restriction Endonuclease Analysis of Plasmids [REAP], and antibiotic sensitivity tests. A total of 117 S. aureus strains [24 MRSA, 93 MSSA] from KSA were isolated from different sites of patients in ICU's, evaluated by antibiotic sensitivity tests as recommended by National Committee for Clinical Laboratory Standards [NCCLS]. Seventy-one MRSA from Turkey were divided into 13 groups by antibiotic sensitivity tests and into 4 groups by plasmid profiles, in which 3rd and 4th groups subdivided into 2 subgroups, and into 5 groups by REAP. The 1st, 2nd, 3rd and 5th groups were subdivided into 2 subgroups. Ten MSSA were divided into 4 groups by antibiotic sensitivity tests, 3 in plasmid profiles and 2 in REAP tests. Twenty-four MRSA strains from KSA were divided into 9 groups by antibiotic sensitivity tests while 93 MSSA strains were divided into 7 groups. In respect to epidemiological survey, plasmids profiles and REAP seems to discriminate more respect to antibiotic sensitivity tests but at the same time neither of them were 100% accurately differential. According to the plasmid profile of the 3rd MSSA [Turkey] group, a multi-drug resistance by antibiotic susceptibility tests were noticed and showed the same plasmid profile in MRSA first subgroup of the 3rd group, but the same groups were different in REAP tests. In order to distinguish the discriminatory power of the strains, where REAP is better than plasmid profile and antibiotic sensitivity tests, we may formulate the statement into the following; REAP > plasmid profile > antibiotic sensitivity tests. For typing and gathering of epidemiological data, it is suggested that all 3 methods should be employed in clinical laboratories as they are cheap, practical and easily interpreted

Single dose povidone-iodine on thyroid functions and urinary iodine excretion.

The effect of single dose povidone-iodine on serum thyrotropin and thyroxine levels and urinary iodine excretion in 30 preterm, 40 full-term newborns and 50 infants at Dr. Sami Ulus Children's Hospital was studied. There was no significant change of thyroid function in any of the groups (p>0.05). Urinary iodine excretion in preterm and full-term groups elevated significantly (p<0.05). The authors conclude that patients who receive single dose povidone-iodine for skin disinfection are not at risk for thyroid disorders.

Educaçäo em saúde: técnicas educativas em saúde pública / Health education: educational techniques in public health

Manual elaborado por educadores de saúde pública, membros do Núcleo de Apoio à Cultura e Extensäo para a Promoçäo e Educaçäo em Saúde Escolar - NACE-NUPESE/USP, resultante da intervençäo educativa junto à Associaçäo de Apoio à Criança com Câncer - AACC, com o intuito de promover a saúde e melhorar a qualidade de vida das crianças portadoras de câncer, acompanhadas dos respectivos pais ou responsáveis, durante o período em que permaneceram hospedadas para o tratamento médico exigido

Formaçäo em saúde escolar: a criança em idade escolar; [conferência] / Graduate in school health: child in school age; [conference]

Histórico sobre saúde escolar até a reforma sanitária, e a funçäo da escola na comunicadade (MC)