Complicación infrecuente de un quiste hidatídico de pulmón: neumomediastino, hidroneumotórax y enfisema masivo de tejidos blandos / Unusual complication of a lung hydatid cyst: Pneumomediastinum, hydropneumothorax, and massive soft tissue emphysema

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The clinical and radiological importance of extraarticular contrast material leakage into adjacent synovial compartments on ankle MR arthrography in patients with OCD and anterolateral impingement.

PURPOSE: To evaluate the tibiotalar joint capacity and the localisation, frequency and amount of extravasation in patients with extraarticular contrast material leakage into adjacent synovial compartments on ankle magnetic resonance (MR) arthrography. MATERIALS AND METHODS: Sites of extravasation were determined in the ankle MR arthrograms of 69 patients. Thirty-four patients without extraarticular contrast material leakage into locations unrelated to the injection path were included as a control group. Volumetric measurements of extraarticular contrast material leakage and the tibiotalar joint capacity were performed on a three dimensional (3D) volume measurement workstation. RESULTS: Extravasation of contrast material occurred through the anterior, posterior, and anterolateral recesses of the tibiotalar joint. The most common site of extravasation was along the flexor hallucis longus tendon synovium (24.6%). The amount of extravasation was significantly higher in patients with ankle osteochondritis dissecans (OCD) than in patients with a different diagnosis (p=0.039). Loose bodies were detected in all OCD's patients with insufficient tibiotalar joint distention. CONCLUSIONS: Connections between the ankle joint and neighboring synovial compartments can decrease the diagnostic value of ankle MR arthrography examinations due to inadequate joint distention. Large injection volumes should be used for ankle MR arthrography of patients with OCD (especially OCD's patients with loose body) and impingement syndrome.

Gastroenterology cases of cutaneous leukocytoclastic vasculitis.

Rarely, leukocytoclastic vasculitis can result from ischemic colitis, inflammatory bowel disease, and cryoglobulinemia. There is no established standard for the treatment of leukocytoclastic vasculitis associated with gastroenterologic diseases. This paper presents three cases of leukoytoclastic vasculitis, each of which is associated with a different gastroenterologic condition: ischemic colitis, Crohn's disease, and chronic hepatitis C. Each condition went into remission by treatment of leukocytoclastic vasculitis, regardless of the underlying disease.

Ogilvie's syndrome in an elderly patient with multi-system atrophy.

Multi-system atrophy (MSA) is characterized by symptoms of autonomic failure, such as orthostatic hypotension and constipation. When intensive bowel motility problems are seen in elderly patients with MSA, Ogilvie Syndrome is kept in mind the management, before surgery.

Vitamin B12 and folic acid levels are not related to length of stay in elderly inpatients.

OBJECTIVE: We designed this study, to evaluate the interaction (relation) between vitamin B12 and folic acid levels and length of hospital stay in elderly inpatients. METHODS: In this cross-sectional study, the Mini Nutritional Assessment-Short Form (MNA-SF) test was used to evaluate nutritional status of 615 (239 men, 376 female; mean age 72.89 ± 8.93 y) inpatients of a university hospital. Length of stay and blood samples in elderly inpatients were evaluated. RESULTS: Only 33.8% of the patients were classified as having an adequate nutritional status; 44.3% had a risk of malnutrition, and 21.8% were classified as malnourished. Low MNA-SF score was related to length of stay, but vitamin B12 and folic acid were not related to risk of malnutrition and length of stay. CONCLUSION: MNA-SF score is associated with length of stay; however, vitamin B12 level, per se, is not associated with length of hospital stay in elderly inpatients.

[A sudden rise in INR due to combination of Tribulus terrestris, Avena sativa, and Panax ginseng (Clavis Panax)]. / Tribulus terrestris, Avena sativa ve Panax ginseng kombinasyonu (Clavis Panax) kullanimina bagli ani INR yükselmesi.

Warfarin sodium is an antithrombin agent used in patients with prosthetic valve and atrial fibrillation. However, there are many factors that can change the effectiveness of the drug. Today, herbal mixtures promoted through targeted print and visual media can lead to sudden activity changes in patients using warfarin. In this case report we will present two cases with a sudden rise in INR due to using combination of Tribulus terrestris, Avena sativa and Panax ginseng (Panax Clavis). Two patients who used warfarin due to a history of aortic valve replacement (case 1) and atrial fibrillation (case 2) were admitted to the hospital due very high levels of INR detected during routine follow-up. Both patients had used an herbal medicine called ''Panax'' during the last month. The patients gave no indication regarding a change in diet or the use of another agent that might interact with warfarin. In cases where active bleeding could not be determinated, we terminated the use of the drug and re-evaluated dosage of warfarin before finally discharging the patient.