Social factors associated with pulmonary hydatid cyst in Aegean, Turkey.

BACKGROUND: Pulmonary hydatid cysts are caused by larval forms of the tapeworm Echinococcus granulosus. Hydatid disease, which is endemic in Turkey, is an important health problem in agricultural and stockbreeding areas where there are insufficient environmental health and preventive medicine services. Previous studies on this topic reported that hydatid disease was frequently associated with stockbreeding in rural areas. OBJECTIVES: In this retrospective clinical study, it is aimed to evaluate the social factors associated with pulmonary hydatid cyst in the Aegean region of Turkey. METHODS: Seventy-one pulmonary hydatid cyst cases reported between 1998 and 2010 in four hospitals in the Aegean region for which data were available on social and lifestyle factors were reviewed. RESULTS: In contrast to expectations, we found that pulmonary hydatid disease in the Aegean region was associated with city rather than rural life and with occupations other than stockbreeding. CONCLUSION: The findings are attributed to the presence of uncontrolled dogs in the city and urban environmental pollution. The offices of the public administration have a responsibility to inform citizens about the control of street animals, environmental health, and food hygiene.

Primer hydatid cyst of thymus: report of a case.

Cystic lesions in the mediastinum constitute one-fourth of all mediastinal masses and are usually identified incidentally. However, hydatid cysts very rarely present in the mediastinum. A 13-year-old male patient was admitted to our hospital because of chest pain and cough. A chest roentgenogram and computed tomography examination found a homogeneous cystic lesion with a size of 7.5 x 7 cm in the anterior mediastinum. Thymectomy was performed following a left thoracotomy in order to complete the pericystectomy. The histological diagnosis was hydatid cyst. No recurrence was observed during 1 year of follow-up.

Intrathoracic migration of ventriculoperitoneal shunt: a case report.

INTRODUCTION: Intrathoracic migration of ventriculoperitoneal shunt can be transdiaphragmatic or supradiaphragmatic. This complication causes important respiratory symptoms. CASE PRESENTATION: A 7 year-old Caucasian female, hospitalized with the prediagnosis of pneumonia, was determined to have ventriculoperitoneal shunt migration at left hemithorax. A left thoracotomy was performed and the shunt was successfully removed transdiaphragmatically. CONCLUSION: The patients with intrathoracic migration of ventriculoperitoneal shunt must be treated surgically as soon as possible. Transdiaphragmatic surgical approach would be more suitable from the point of surgical easiness.

Comparison of harmonic scalpel and high-frequency electrocautery in radial artery harvesting.

AIM: We evaluated the effects of the radial artery on the functional outcomes and endothelium when the harvest was made either by harmonic scalpel or by high-frequency electrocautery. METHODS: Between 2002 and 2007, 982 patients with coronary artery diseases were operated for coronary artery revascularization. The radial arteries were harvested for 101 of these patients and divided into two groups depending on the use of the harmonic scalpel (Group A; N=51) and the high-frequency electrocautery (Group B; N=50). Harvesting time, use of hemostatic clips, frequency of spasm, in situ free flow, and endothelial damage were compared between the two groups. RESULTS: Conventional high-frequency electrocautery technique used 8.7+/-3.9 hemostatic clips versus 1.5+/-1 clips (P<0.001). In situ free blood flow was 85+/-5.5 mL/min for Group B versus 114+/-21.7 mL/min for Group A (P<0.006). The endothelial damage of the radial arteries taken down with the harmonic scalpel was significantly less than when taken down with the high-frequency electrocautery (P<0.05). There was no statistically significant difference in terms of harvesting time and spasm between the two groups (P>0.05). CONCLUSION: Ultrasonic dissection with harmonic scalpel of the radial artery is associated with a decreased use of hemostatic clips. Moreover, the harmonic scalpel has a positive effect on endothelial preservation and it was associated with increased free blood flow of the radial artery.

Clinical experience with subxiphoid pericardiostomy in the management of pericardial effusions: a study of 240 cases.

We aimed to assess the effectiveness of subxiphoid pericardiostomy for treating patients with pericardial effusions (PE), and its contribution to defining the aetiology of these effusions. We undertook retrospective analysis of 240 PE patients who underwent subxiphoid pericardiostomy and tube drainage between 1990 and 2000. Echocardiography classified PE as severe in 132 patients, moderate in 99, and mild in nine. The main causes of PE were uraemic, idiopathic and undefined, tuberculous and non-tuberculous pericarditis, malignancy and trauma. Peri-operative myocardial injury requiring sternotomy, and recurrent effusion requiring further surgical intervention, occurred in three and 24 patients, respectively. Histopathological examination assisted the diagnosis in 94% of patients with malignancy, and 96% with tuberculous pericarditis. Overall 30-day mortality was 1.3% and pericardial constriction, requiring pericardiectomy, developed in seven cases. In conclusion, we believe that adults and children with PE can be safely, effectively and quickly managed with subxiphoid pericardiostomy, irrespective of its aetiology.