Does the use of Surgicel affect postsurgical radiological follow-up of kidney tumors?

Remaining Surgicel in the body can be mistaken for complications such as hematoma, abscess, or tumor recurrence in paraclinical examinations after surgery. We have presented the case of kidney cancer who underwent radical nephrectomy. In radiological follow-ups, hematoma was reported in the surgery site. The typical appearance of Surgicel on a postoperative CT scan is characterized by air trapped bubbles. Surgicel exhibits a short relaxation time on T2-weighted images. It is important to differentiate the remaining Surgicel from cases such as hematoma, abscess and tumor recurrence. T2MRI images will be most accurate in the correct diagnosis of Surgicel.

Cognitive functioning in adults with autism spectrum disorder.

INTRODUCTION: Neuropsychological deficits in areas of Executive Functioning (EF), theory of mind, and central coherence have been well-documented among children and adolescents with autism spectrum disorder (ASD); however, there remains a significant gap in knowledge with regards to neuropsychological profile in adults with ASD. This study aims to investigate the intellectual functioning and neuropsychological profiles of a clinical population of adults with ASD. METHODS: This cross-sectional study included 40 available autistic individuals referred to an adult developmental disorders clinic at a hospital between 2021 and 2022. All participants were assessed using the Stanford-Binet Intelligence Scale (SBIS), Autism Spectrum Quotient (AQ), Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), and Social Responsiveness Scale (SRS). RESULTS: Individuals with ASD exhibited lower IQ scores across all domains of the Stanford-Binet Intelligence Scale, compared to the general population, although the mean IQ scores remained within the normal range. Significant differences were observed in Full Scale IQ, Verbal IQ, Non-Verbal IQ, Fluid Reasoning, Knowledge, Quantitative Reasoning, Visual-Spatial Processing, and Working Memory compared to the general population. Additionally, autistic individuals' performance on verbal knowledge was higher compared to non-verbal knowledge. No significant correlations were found between the total and subscale scores of verbal and nonverbal IQ and AQ, RAADS-R, and SRS scores. CONCLUSION: Considering the significant impacts of cognitive and executive function on the social and occupational aspects of autistic adults, further investigations in this area are warranted.

Absconding from a Psychiatric Hospital in a Developing Country, Related Factors, and the Consequences.

Background: This study aimed to investigate the factors related to absconding and consequences of absconding in a psychiatric hospital in a developing country within 3 years. Methods: This was a retrograde descriptive cross-sectional study from a psychiatry hospital in a developing country, Iran. The registered data of absconding between March 2018 and February 2021 were extracted. Furthermore, a retrograde follow-up by telephone on what happened after the absconding and the remembered motives was done. The obtained data were analyzed using SPSS statistical software for Windows Version 23 by descriptive statistics. The chi-square test, Fisher exact test, Student t test, or Mann-Whitney U tests were used for data analysis. P ˂ .05 was considered statistically significant. Results: Out of 7069 admitted patients during a 36-month period, 51 (39 men and 12 women) had absconded. The total absconding rate was 0.72%. The mean ± (SD) age of the patients was 29.7 ± (10.46) years, with a range of 10 to 54 years. No statistical difference between men and women emerged in terms of age (P = 0.89). Most of the absconders were men (76%), young (mean age, 29.7 years), single (70.6%), and involuntarily hospitalized (78.4%) in an urban area (90.2%), and absconded in the evening shift (58.8%) via the route of the main gate (58.8%) in the early days of admission (5 days). In terms of psychiatric diagnosis, the highest rank belonged to bipolar disorder (33.33%) and substance-related disorders (33.33%). About one-third of absconders had a current substance-related problem and most of them had experienced withdrawal symptoms or cravings days before absconding (75%). Absconders mentioned that "no need for admission" (45.1%), "economic problems" (23.5%), and "substance craving" (13.7%) were the most common reasons for leaving the hospital. Most of the absconders were hospitalized later (70.5%). The risk for self-harm (21%) or harm to others (2%) after absconding was low. Conclusion: The general profile of absconders was concordant with previous studies. It was highlighted that economic problems in recent years had an evident impact on patients and it could be postulated that consideration of substance withdrawal may decrease absconding. It is advised to adhere to the policies that support community-based psychiatry and place an emphasis on early discharge and continuity of outpatient care.

Intravesical Gemcitabine versus Intravesical Bacillus Calmette-Guerin for the Treatment of Intermediate-Risk Non-Muscle Invasive Bladder Cancer: A Randomized Controlled Trial.

PURPOSE: The most common adjuvant therapy known for non-invasive muscle bladder cancer (NMIBC) is intravesical Bacillus Calmette-Guerin (BCG). Intravesical chemotherapy drugs like gemcitabine can also be used post-TURBT, which is considered as a good alternative for BCG, or can be used as a second-line treatment. Due to the common side effects of BCG, the use of chemotherapy drugs as intravesical treatments is currently increasing. MATERIALS AND METHODS: 117 intermediate-risk NMIBC cases were included in this study. All the patients underwent TURBT surgery and received 1 gr intravesical gemcitabine immediately after performing the surgery. The patients were then divided into two groups, either receiving intravesical gemcitabine or intravesical BCG weekly for 6 weeks. The patients were followed up with cystoscopy. RESULTS: Most patients were men who had smoking risk factors. The youngest patient was 36 years old and the oldest one was 88 years old. The rate of side effects in the group receiving gemcitabine (13.6%) was much lower than the group receiving BCG (44.8%). (P-value = 0.016). The recurrence rate during a one year period was lower in the group consisting of patients receiving gemcitabine compared to the group receiving BCG (19 patients vs. 23 patients) (p-value = 0.401) Conclusion: The efficacy of intravesical gemcitabine and intravesical BCG was almost equal in the treatment of intermediate-risk NMIBCs. The adverse effects of gemcitabine were found to be significantly lower than BCG. Due to causing fewer complications, gemcitabine can be known as a good alternative, especially among elderly patients with comorbidities.

Calicovesicostomy surgery in the patient with ureteral rupture.

Transurethral lithotripsy (TUL) surgery, which is used to crush ureteral stones, can have complications, including bleeding, infection, ureteral stenosis, ureteral rupture, and ureteral avulsion. In this study, we present a 45-year-old woman who was referred, due to a right ureteral rupture during transurethral lithotripsy surgery. At first, the patient underwent ureteroneocystostomy surgery by a combination of boari flap and psoas hitch techniques. Due to the obstruction and necrosis at the anastomosis site, the patient underwent calicovesicostomy surgery.

A Large Primary Retroperitoneal Synovial Sarcoma: A Case Report of a Huge Malignant Tumor.

Synovial Sarcoma (SS) is a rare soft-tissue malignancy. Only about 15% of SS originates from the retroperitoneum. Retroperitoneal SS (RSS) is usually diagnosed incidentally due to the anatomy of the retroperitoneum. The most common complaints of patients are abdominal and low back pain. Other common symptoms of RSS are palpable abdominal mass, weight loss, and anemia. In this study, we will describe a 29-year-old white Asian man with a diagnosis of RSS after radical nephrectomy. He was admitted to the Urology Department of Shohada-e Tajrish hospital, Tehran, Iran in March 2019. The distinguishing feature of this case is the size of the mass, which has never been reported so much for retroperitoneal synovial sarcoma. Radiologic imaging showed a huge retroperitoneal mass originating from the kidney. Based on the pathologic features and immunohistochemistry (IHC) study, the diagnosis was consistent with synovial sarcoma. Accurate diagnosis of RSS is usually based on the pathological findings. Therefore, in case of doubt, a biopsy can be employed. Surgical resection of the tumor and lymph nodes dissection is the main and most important part of the treatment. Aggressive resection with free margin is recommended. The role of adjuvant and neoadjuvant chemotherapy in RSS is not certain to date, but it is recommended according to the patient's condition.

Gelfoam embolization of high-flow priapism due to coitus: A case report.

Priapism is a condition in which a person has an erection without sexual arousal and lasts for at least 4 hours. High flow priapism (HFP) usually follows blunt trauma to the penis or perineum, causing arterial-lacunar fistula. HFPs are rare after sexual intercourse, and early treatment by embolization can prevent erectile dysfunction (ED). The use of gel foam has good results and has shown the least side effects.

Inguinoscrotal herniation of bladder and ureter: A case report.

Simultaneous herniation of the bladder and ureter into the scrotum is a rare condition. In this study, we present a 60-year-old man who has been suffering from pain and swelling in the right hemi-scrotum. The patient needed to squeeze his scrotum for urination and he had difficulty in emptying his bladder. Ultrasound and Computed Tomography(CT) was performed for the patient, which confirmed the diagnosis. The patient underwent herniorrhaphy and partial cystectomy. His urinary problems were completely eliminated with surgery.

Head and Neck Squamous Cell Carcinoma in Iran: Clinico-Pathological and Treatment-Related Factors Influencing Survival.

BACKGROUND: Evidences about survival of the patients with head and neck squamous cell carsinoma (HNSCC) have been scant in our region. OBJECTIVES: The aim of current study was to determine clinico-pathological and treatment-related factors, influencing outcome of these patients. PATIENTS AND METHODS: We have reviewed all patients with a new diagnosis of HNSCC admitted between 2008 and 2014 in "Jorjani Cancer Center", Tehran, Iran. Overall survival (OS) and event free survival (EFS) of the patients, and their relation with demographic and clinico-pathological factors have been analyzed. RESULTS: Among 119 included patients, 90 were male and 29 were female with mean age of 58 years. Larynx was the most common primary tumor site (55% of all patients). With a median follow-up period of 28 months, OS and EFS of the study patients was 61.2% and 52.4%, respectively. Tumor stage was the only parameter has significantly influenced the patients' OS. Patients with normal BMIs had significantly higher mean EFS compared with patients with bellow or above normal BMIs. Surgical treatment modalities have resulted in the same prognosis as non-surgical approaches. CONCLUSIONS: Our study seems to be the first that investigated outcome of Iranian patients with head and neck cancer and its influencing factors.