Esophageal stents for less invasive treatment of mediastinitis.

INTRODUCTION: In spite of the progress in diagnosis and therapeutic options, esophageal perforation resulting in mediastinitis is a very serious condition with a high morbidity. AIM: To evaluate the use of esophageal stents for the treatment of patients suffering from mediastinitis. MATERIAL AND METHODS: Retrospective (2008-2012) analysis of a group of patients requiring surgical treatment. The evaluation was focused on the cause of perforation, stent type and its parameters, the surgical method used, duration of stenting and total length of treatment. RESULTS: In total, 16 patients were treated by stenting. All patients were treated with the stent being placed across the defect in the esophagus. Mediastinitis was accessed and drained with the aid of a thoracotomy or thoracolaparotomy (8 cases), or using a combination of a laparotomy/laparostomy and pleural drainage (5 cases). The most basic interventions were either pleural or external cervical drainage (3 and 1 cases, respectively). One patient, in whom a stricture had developed at the healed perforation, was subjected to esophageal resection. Four patients died. The average period that the stent was left in situ was 53.7 days. The average period of hospitalization of those patients who survived was 53.4 days. CONCLUSIONS: Using stents in therapy neither increased survival (mortality of 25%), nor decreased the length of therapy of patients once mediastinitis had developed. The main advantage of stenting is the preservation of the native esophagus and the reduced extent of surgical mediastinal drainage.

Phlegmasia cerulea dolens as a complication of a severe form of acute hemorrhagic-necrotizing pancreatitis.

Phlegmasia cerulea dolens is an extreme form of deep venous thrombosis with a proximal localization of the blockage, most frequently in the ileofemoral area. Symptoms are graded as follows: swelling of the entire extremity, pain, and cyanosis. This form of the disease is rare, occurring most frequently in the terminal stage of malignancies. Diagnosis of phlegmasia usually causes no problems because the proper diagnosis is usually revealed during clinical examination and confirmed by imaging techniques. The authors present a case report of phlegmasia cerulean dolens and discuss the options for treatment.

Solid phase microextraction and gas chromatography with ion trap detector (GC-ITD) analysis of amitraz residues in beeswax after hydrolysis to 2,4-dimethylaniline.

An analytical method for the determination of amitraz residues in beeswax after hydrolysis to 2,4-dimethylaniline is reported. It consists of wax extraction with an acid buffer solution, head space solid phase microextraction and GC-ITD analysis. The limit of determination is 1 ng g(-1). Wax samples from beekepers and commercial foundations were analysed, content of residues varied from <1 to 20.5 ng g(-1).

Decreased level of novelty seeking in blood donors infected with Toxoplasma.

OBJECTIVES: Toxoplasma gondii, a parasitic protozoan, infects about 30 - 60% of people worldwide. Toxoplasma is known to induce behavioral changes and an increase of dopamine in mice. The presence of anti-Toxoplasma antibodies (latent toxoplasmosis) is also a risk factor for schizophrenia. Latent toxoplasmosis in men (male soldiers) is associated with lower novelty seeking. As the novelty seeking is supposed to negatively correlate with level of dopamine, the observed effect was interpreted as indirect evidence of increased dopamine levels in subjects with toxoplasmosis. However, it is also possible that the observed effect was caused by association of both novelty seeking and Toxoplasma infection with a third factor, e.g. size of place of residence. METHODS: Personality profile of 290 blood donors (205 men and 85 women) were measured by Cloninger's TCI (Temperament and Character Inventory) and their blood samples were assayed for the presence of anti-Toxoplasma antibodies. Difference between Toxoplasma-infected and Toxoplasma-free subjects was tested with ANCOVA method with gender, size of place of residence, and age as covariates. RESULTS: The present analysis revealed that lower novelty seeking was associated with latent toxoplasmosis both in men and women. The effect of infection on novelty seeking remained significant even after adjustment for size of place of residence (p<0.01). CONCLUSION: Decreased novelty seeking in Toxoplasma-infected subjects have been already confirmed in three independent populations (male soldiers and male and female blood donors). These findings suggest that the local inflammation-induced increase in dopamine in the brain of infected subjects can represent a missing link between toxoplasmosis and schizophrenia.