NEW PROPOSED FORMULA OF TI-RADS CLASSIFICATION BASED ON ULTRASOUND FINDINGS.

INTRODUCTION: The present study aimed to introduce a new formula for classification of nodules in TI-RADS and describe ultrasonography features of benign and malignant thyroid nodules. METHODS: This study was conducted on thyroid mass in 1033 patients. The incidence of malignancy for thyroid nodules was determined by selecting malignancy coefficients. Then the patients were first classified using conventional TI-RADS classification criteria and once again according to a new proposed formula. RESULTS: Among ultrasonography features of thyroid nodules, the irregular shape (46.7%), unclear margin (47.3%), extension to the capsule (irregular and infiltrative margin) (85%), the marked hypo-echoic nodules (63.8%), micro-calcification (49%), and to have vertical axis (74.0%) were associated with high incidence of malignancy. CONCLUSION: According to the proposed new formula for TI-RADS, there are four coefficients of 7, 3, 1 and 0 for incidence of malignancy of each one of ultrasound findings that help to standardization and unifying of TI-RADS classification. The incidence of malignancy in TI-RADS classification according to the new proposed formula was achieved as follows: group 2: 0.0%, group 3: 0.7%, groups 4a, 4b, 4c: 16.7%, 43.4%, 68.5%, and group 5: 95.2%, respectively.

Autotransplantation after primary bone repair of a recipient site with a large periradicular lesion: a case report.

AIM: To describe a case of autotransplantation nine weeks after the extraction of a hopeless tooth with a large periradicular lesion, which enabled the healing of the recipient site. SUMMARY: A 19-year-old male in generally good health was referred for evaluation of tooth 46. Clinically, there were class III mobility and sensitivity to percussion and palpation. There was a mesio-lingual swelling and a single narrow deep pocket of 15 mm at the disto-lingual aspect. CBCT imaging revealed a radiolucent area over 15 mm in diameter that extended from the mesial aspect of the mesial root of tooth 47 to the distal aspect of tooth 45. The radiolucent area was in proximity to the inferior alveolar canal and penetrated the buccal and the lingual cortical plates. The tooth was diagnosed with previously treated tooth, acute apical abscess and vertical root fracture. Tooth 46 was extracted, and a delicate curettage and drainage were performed. Nine weeks afterwards, a second surgery was performed: extraction of the impacted immature third molar (tooth 48). Immediately after the extraction, the tooth was replanted in the healing socket of tooth 46, and sufficient initial stability achieved. At a 1-year follow-up, the tooth had normal mobility, no sensitivity to palpation and percussion, and responded to thermal pulp testing. The soft tissue was normal, probing depths up to 3-mm, without swelling or sinus tract. Radiographically, periapical healing at the recipient site was observed. Compared to the post-operative periapical radiography immediately after the procedure, there was no change in the distal root dimensions. In the mesial root, development of the root length and a closed apex was demonstrated.

Surface modification of CoCr alloys by electrochemical reduction of diazonium salts.

Tailoring the surface chemistry of CoCr alloys is of tremendous interest in many biomedical applications. In this work, we show that CoCr can be modified by diazonium electrografting provided the surface is not homogeneously covered with an oxide layer. Cyclic voltammetry (CV) and X-ray photoelectron spectroscopy (XPS) show the electrografting of a poly(aminophenylene) (PAP) layer on CoCr when treated at a reductive potential (CoCr-0.5 V), whereas no PAP film was formed on CoCrOCP and CoCr1 V, treated at open circuit and anodic potentials respectively. Based on XPS results, we attributed the electrografting to the formation of carbide bonds between PAP and the inhomogeneous thin oxide layer of CoCr-0.5 V. We then show an example of application of PAP coatings on CoCr and prove that the presence of a PAP coating on CoCr-0.5 V results in a 5-fold increase of the adherence of poly methyl methacrylate (PMMA) to PAP-coated CoCr compared to uncoated samples; this is of prime significance to improving the long-term stability of dental prostheses. These findings support the importance of reducing the oxide layer for effective functionalization of metal oxides with aryl diazonium salts and suggest a promising surface modification approach for biomedical applications.

Enhancing in vitro biocompatibility and corrosion protection of organic-inorganic hybrid sol-gel films with nanocrystalline hydroxyapatite.

Application of novel organic-inorganic hybrid sol-gel coatings containing dispersed hydroxyapatite (HAp) particles improves the biocompatibility, normal human osteoblast (NHOst) response in terms of osteoblast viability and adhesion of a Ti6Al4V alloy routinely used in medical implants. The incorporation of HAp particles additionally results in more effective barrier proprieties and improved corrosion protection of the Ti6Al4V alloy through higher degree of cross-linking in the organopolysiloxane matrix and enhanced film thickness.

Triethylphosphite as a network forming agent enhances in vitro biocompatibility and corrosion protection of hybrid organic-inorganic sol-gel coatings for Ti6Al4V alloys.

The biocompatibility and life of metallic implants can be enhanced through improving the biocompatibility and corrosion protection characteristics of the coatings used with these materials. In this study, triethylphosphite (TEP) was used to introduce phosphorus into organic-inorganic hybrid silica based sol-gel coatings prepared using γ-methacryloxypropyltrimethoxysilane and tetramethylorthosilicate. Addition of TEP dramatically increased the rate of intermolecular condensation and resulted in materials showing greater cross-linking. Protein (fibrinogen) uptake, osteoblast in vitro biocompatibility and corrosion resistance was enhanced in coatings containing TEP. Although higher concentrations of phosphorus supported the greatest improvement in biocompatibility, a compromise in the phosphorus concentration used would be required if corrosion resistance was most desirable parameter for optimisation. Films prepared by dip coating on Ti6Al4V alloys from these sols offer a promising alternative to wholly metallic prostheses.

Operative and non-operative management of endoscopic retrograde cholangiopancreatography-associated duodenal injuries.

INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) is indispensable in everyday surgical practice. Despite this, as an invasive procedure, it has its own mortality and morbidity, the most feared of which is periduodenal perforations. Our experience with ERCP related periduodenal perforations and its treatment strategies are presented. Additionally, a rarely encountered subtype is highlighted. METHODS: Patients who underwent ERCP and sustained a periduodenal perforation between August 2008 and October 2011 were reviewed. RESULTS: During the period from August 2008 to October 2011, 597 ERCP procedures were performed in our hospital. Ten of these patients (3 male, 7 female) had a perforation. The mean patient age was 56.6 years. During the procedure, injury was suspected in four patients; it passed unnoticed in the remaining six. The decision to operate or follow a conservative policy was based on a combination of clinical and radiological findings. Operative intervention was required in three patients, with one mortality, while conservative treatment was followed in the remaining seven. A laparotomy was performed early in two patients whereas it was performed after an initial period of conservative treatment in one. The presence of periduodenal fluid collection, contrast extravasation or free intraperitoneal air were decisive factors for performing laparotomy. CONCLUSIONS: ERCP-related periduodenal perforations include different categories. Certain types require operative repair while others should be treated conservatively. The choice of the management approach should be individualised, depending on the clinical picture and radiological findings. Although rare, these are potentially serious complications that may end fatally. Early recognition and appropriate intervention is the only way to avert a fatal outcome.

Strategy of surgical treatment of giant presacral tumor - a case report.

Presacral tumors are uncommon lesions that can be difficult to diagnose because of their nonspecific presenting signs and symptoms. Surgery is the mainstay of treatment as it establishes the diagnosis and prevents the adverse consequences associated with malignant degeneration and secondary bacterial infection. Large, highly vascularised pelvic tumors may pose intraoperative difficulties as bleeding and intraoperative tumor perforation. Cross-sectional imaging is essential in evaluating these lesions to determine the optimal surgical approach and the extent of resection. We emphasize a multidisciplinary expert individualized approach. We report a case of a presacral giant gastrointestinal tumor initially considered as unresectable but further on successfully managed by preoperative vascular embolization followed by resection via abdomino-perineal approach.

Electronic properties of Fibonacci and random Si-Ge chains.

In this paper we address a theoretical calculation of the electronic spectra of an Si-Ge atomic chain that is arranged in a Fibonacci quasi-periodic sequence, by using a semi-empirical quantum method based on the Hückel extended model. We apply the Fibonacci substitutional sequences in the atomic building blocks A(Si) and B(Ge) through the inflation rule or a recursion relation. In our ab initio calculations we use only a single point, which is sufficient for considering all the orbitals and charge distribution across the entire system. Although the calculations presented here are more complete than the models adopted in the literature which take into account the electronic interaction only up to the second and third neighbors, an interesting property remains in their electronic spectra: the fractality (which is the main signature of this kind of system). We discuss this fractality of the spectra and we compare them with the random arrangement of the Si-Ge atomic chain, and with previous results based on the tight-binding approximation of the Schrödinger equation considering up to the nearest neighbor.

Erradicación de la infección por helicobacter pylori en la práctica clínica / Helicobacter pylori eradication in clinical practice

El descubrimiento del helicobacter pylori...El objetivo de este estudio fue evaluar en la práctica clínica cotidiana la eficacia e incidencia de efectos adversos de un esquema cuádruple de tratamiento que combina Pantoprazol, Subcitrato de Bismuto Coloidal, Metronidazol y Tetraciclina para la erradicación de la infección por helicobacter pylori....La terapia cuádruple erradicó la infección en cerca del 90 por ciento de los pacientes. Los efectos adversos fueron leves, y no interfirieron con la eficacia del tratamiento ni motivaron abandonos de la medicación. Esta terapia puede ser recomendada, incluso como primera línea de tratamiento

Erradicación de la infección por helicobacter pylori en la práctica clínica / Helicobacter pylori eradication in clinical practice

El descubrimiento del helicobacter pylori...El objetivo de este estudio fue evaluar en la práctica clínica cotidiana la eficacia e incidencia de efectos adversos de un esquema cuádruple de tratamiento que combina Pantoprazol, Subcitrato de Bismuto Coloidal, Metronidazol y Tetraciclina para la erradicación de la infección por helicobacter pylori....La terapia cuádruple erradicó la infección en cerca del 90 por ciento de los pacientes. Los efectos adversos fueron leves, y no interfirieron con la eficacia del tratamiento ni motivaron abandonos de la medicación. Esta terapia puede ser recomendada, incluso como primera línea de tratamiento

[Some hemorheological factors in patients with cerebrovascular ischemia]. / Algunos factores hemorreológicos en pacientes con enfermedad cerebrovascular isquémica.

INTRODUCTION AND OBJECTIVE: To study hemorheological factors in patients with ischemic cerebrovascular disease (not secondary to embolic cardiopathy). PATIENTS AND METHODS: We assessed 40 patients with an average age of 64.5 years; 26 had cerebral infarcts due to alterations in major blood vessels and 14 had lacunar infarcts. Forty persons with no cerebrovascular disease acted as controls. The hematological studies were done between three weeks and six months after the initial ictus. RESULTS: Blood viscosity and plasma fibrinogen concentrations were significantly higher in the patients than in the controls. However, hematocrit values were similar in all three groups studied. With regard to the hematocrit, fibrinogen levels and blood viscosity, no differences were seen between the group with damage to the great vessels and those with lacunar infarcts.

Hypertension as a presentation of bilateral intrarenal arateriovenous malformation.

Congenital arteriovenous malformations are rare lesions of the kidneys. The first case of bilateral renal arteriovenous malformations was described in 1987. A case of extensive bilateral intrarenal arterivenous malformations presented to us as a case of hypertension. Renal angiography confirmed the diagnosis. Magnetic resonance angiography ruled out these malformations in cerebral circulation, and enhanced abdominal CT scan was normal. The blood pressure of the patient was controlled by medical therapy only.

Factors associated with domestic violence in low-income Lebanese families.

PURPOSE: To analyze the cultural context of domestic violence in low-income Moslem and Christian-Armenian families living in Lebanon. Analysis also included an identification of family stressors, conflict management strategies, and Moslem and Christian-Armenian cultural differences. The study was part of a larger project designed to identify patterns of wife and child abuse in low-income Middle Eastern families living in Lebanon and Egypt. DESIGN: Qualitative content analysis of descriptive narratives by 60 low-income women who self-reported spouse abuse in two urban Lebanese clinics during a 2-month period in 1992. METHODS: Narratives describing exemplary incidents were obtained during a semi-structured interview and recorded in the participant's native language then translated to English for coding and content analysis. FINDINGS: Contextual factors for violence included unmet gender role expectations, conflict with husband's relatives, and alcohol abuse. Family stressors were: emotional, financial, and work. Women used three types of conflict management: negotiation, taking initiative, and passive resignation. CONCLUSION: From a cultural perspective, the analysis revealed both strengths and vulnerabilities of Lebanese women who experienced domestic violence. The study raised several questions, including whether it is appropriate to apply Western-generated domestic violence theories to a Middle Eastern population. Culturally-specific nursing interventions should be directed toward bolstering strong family and social resources to cope with family stressors and to modify patterns of maladaptive communication.

Radionuclide contamination of foods imported into Iraq following the Chernobyl nuclear reactor accident.

Since early 1986, a monitoring program for radionuclides in imported foods has been carried out by the Iraqi Atomic Energy Commission. After the Chernobyl nuclear reactor accident in the Soviet Union, the program was expanded; our laboratory was officially designated by the Iraqi Government to measure radionuclide activity concentrations in foodstuff imported from countries known to be severely contaminated by Chernobyl radioactive fallout. Gamma-spectrometric analysis was used. Food items such as powdered milk, lamb meat, poultry, cereals and grains imported into Iraq before the Chernobyl accident did not contain any detectable fission products. However, all lamb meat, 81% of the lentil, 44% of the powdered milk and chick-pea, and 17% of the roast beef samples were contaminated with 137Cs or 134Cs and 137Cs. The highest 137Cs contamination levels found were 82, 147, 420, 6 and 4 Bq kg-1, respectively. Contamination by 134Cs was approximately 50% of the values given above.

Patient satisfaction with nursing care in Alexandria, Egypt.

The study assessed the satisfaction of medical and surgical patients in a university hospital in Egypt using the La Monica/Oberst Patient Satisfaction Scale. In spite of the nursing shortage in that hospital, the results indicated that patient satisfaction was high. The implications for nursing care are discussed in terms of the validity of the scale and the objectivity of clients when responding to the questionnaire.

A seroepidemiological survey of viral hepatitis in the Yemen Arab Republic.

During February 1988 a seroepidemiological survey of hepatitis A, B and D was performed in the Yemen Arab Republic. 879 sera were collected from 4 different areas; Sanaa, Hajja, Hodeidah and Taiz. The prevalence of hepatitis B surface antigen (HBsAg) was 12.7% (112/879) and some marker of hepatitis B infection was found in 45.5% (399/879) of study subjects. Only 2 (1.8%) of the 112 HBsAg positives were positive for antibody to delta hepatitis, and 9.7% (9/93) were positive for hepatitis B e antigen (HBeAg). Univariate analysis showed age, sex, qat chewing, blood transfusion, surgery and a past history of jaundice to be associated with hepatitis B infection. Using multivariate logistic regression analysis only, age (odds ratios 1.37 for HBsAg carriers and 1.51 for seropositives), a past history of jaundice (odds ratio 1.42), and combined history of blood transfusion and surgery (odds ratio 2.76) were independent predictors of infection. Hepatitis B appears to be a major health concern in the Yemen Arab Republic.

Osteoartropatia neumica hipertrofiante y su desaparicion despues de exeresis del tumor. / Hypertrophic pneumic osteoarthropathy and its disappearance after tumor exeresis

Se presenta una enfermera que ingresa en el hospital docente "General Calixto Garcia" con un sindrome osteoartricular y que se demuestra posteriormente se trataba de una manifestacion paraneoplasica de un tumor maligno del pulmon. Despues de la intervencion quirurgica regresaron todas estas manifestaciones. Se hace una breve revision de la osteoartropatia neumica hipertrofiante de Pierre Mari-Remberger; esta atiende fundamentalmente a las teorias que invocan en su patogenia