PRESENTATION AT Research Articles

Synchronous Onset of Two Complications in Colon Cancer: A Case Report

As one of the most frequent malignancies in the world’s population, colorectal cancer is also associated with its complications (perforation, obstruction and bleeding). Their incidence is common (2.6-50%), but synchronous occurrence of two of them in a patient is a rare condition and it is reported in small series or as a case report in the literature. We present a case of the descending colon cancer in a female patient that presented with perforation on tumor site with consecutive retroperitoneal and lumbar abscess and simultaneous presentation of large bowel obstruction. The patient was admitted and operated the same day, the abscess was opened and drained and bowel resection was performed with colostomy creation. The postoperative recovery was uneventful and the patient was discharged on postoperative day 10. Due to the high morbidity/mortality in cases of colon cancer emergencies, Hartman’s procedure is often a reasonable option. Timely diagnosis of the colon cancer can reduce the complication rate of the disease worldwide. J Med Cases. 2021;12(6):248-250 doi: https://doi.org/10.14740/jmc3684

Cracked Tooth Syndrome: Assessment, Prognosis and Predictable Management Strategies.

Cracked tooth syndrome (CTS) is a common presentation in general practice. The diagnosis and management of teeth with CTS may be difficult due to the unknown extent of the crack. This article reviews the aetiology, diagnosis, management and prognosis of teeth with CTS. A thorough examination is required to effectively assess CTS. Intervention should aim to relieve symptoms and brace the remaining tooth structure effectively against further flexion. Restored teeth with CTS have a guarded prognosis due to the risk of further crack propagation, but the chances of survival at 5-years is acceptable (74.1-96.8%).

TÜRKİYE ALTERNATİF PERFORMANS ÖLÇÜTLERİ REHBERİ VE BİR UYGULAMA

Geleneksel performans ölçütleri; paydaş taleplerinin değişmesi, daha fazla bilgi talebi gibi muhtelif sebeplerden dolayı zamanla yetersiz kalmıştır. Bu boşluğu alternatif performans ölçütleri olarak ifade edilen ölçütler doldurmuştur. ESMA, IOSCO, IFAC ve SEC gibi kuruluşlar son yıllarda alternatif performans ölçütleri konusunda yasal düzenlemeler oluşturmuşlar ve işletmelerin kullanımına sunmuşlardır. Türkiye’de de işletmeler alternatif performans ölçütü ifadesi kullanmadan bu kapsamda yer alan performans ölçütlerini faaliyet raporları ve yatırımcı sunumları başta olmak üzere muhtelif yerlerde kullanmaktadırlar. Uluslararası kurumların alternatif performans ölçütleri konusunda getirdiği yasal düzenlemeler ile birlikte sağlanan doğrulanabilirlik, tarafsızlık, tutarlılık ve şeffaflık ise henüz Türkiye’deki işletmeler için geçerli değildir. Bunun nedeni ise ölçütler konusunda herhangi bir düzenlemenin ulusal düzeyde yer almamasıdır. Bu alandaki boşluğun UFRS’lerin Türkiye’deki uygulaması gibi alternatif performans ölçütlerinin de uluslararası düzenlemelere paralel ulusal bir düzenleme ile giderilebileceği düşünülmektedir. Bu çalışmada, ulusal düzeydeki bu açıktan hareket edilmiş ve Türkiye için alternatif performans ölçütleri için bir ulusal rehber önerisi ve bir uygulama örneği sunulmuştur. Türkiye Alternatif Performans Ölçütleri Rehberi’nin gelecekte Türkiye’de konu hakkında yapılacak olan çalışmalara temel teşkil etmesi amaçlanmaktadır. Rehberde yer alan ve işletme paydaşlarına asgari düzeyde güvence sağlayan alternatif performans ölçütlerine ilişkin denetim kontrol listesinin ise uluslararası literatüre katkı sunması beklenmektedir.

Gallbladder Torsion Masking as Acalculus Cholecystitis: A Review of Two Cases Including Unsuccessful Management With Percutaneous Cholecystostomy

Gallbladder torsion is a rare cause of abdominal pain; however, it is important to diagnose pre-operatively. We report two cases of gallbladder torsion, both of which were not recognized until the time of surgery. Both patients were elderly thin females, presenting with right upper quadrant pain, and on examination had a positive Murphy’s sign, and pre-operative imaging was suggestive of acalculus cholecystitis. One patient was initially managed by percutaneous insertion of a cholecystostomy tube, with progression to a laparoscopic cholecystectomy after a failure of resolution of symptoms. The second patient was taken to theater shortly after presentation, with the gallbladder torsion recognized intra-operatively. In both cases, the gallbladder was distorted and a routine laparoscopic cholecystectomy was performed with good recovery following. These two cases highlight the need for gallbladder torsion to be considered as a diagnostic possibility in those presenting with right upper quadrant pain, particularly those groups at most risk, including elderly thin females. Whilst other causes of cholecystitis can be managed non-operatively, at least in the acute phase, gallbladder torsion requires urgent operative intervention. J Med Cases. 2021;12(6):223-225 doi: https://doi.org/10.14740/jmc3683

COVID-19 and Coronary Stent Thrombosis: A Systematic Review of Literature

Coronavirus Disease-19 (COVID-19) is a worldwide pandemic and it has created many difficulties in providing medical care due to the various multi-organ disease manifestations caused by the virus. In this paper we explore cases of stent thrombosis which occurred in patients who were infected with COVID-19 and discuss its role in potentiating this complication through the variety of mechanisms in which it creates a prothrombotic state. Stent thrombosis is described as the thrombotic occlusion of a coronary stent. The incidence of this complication has decreased considerably (from 16% to 0.7%) since the advent of antiplatelet therapy and drug eluting stents. In this systematic review, 8 papers were found which detailed 11 patients who were infected with COVID-19 and suffered a stent thrombosis. Data from these cases were tabulated and analyzed. The ages of the patient’s ranged from 49-81 years and quite interestingly the time between the time of stent placement and occurrence of stent thrombosis had great variation between patients, with some occurring within minutes of stent placement and others occurring in a stent that was placed many years ago. 91% of the patients had ST-segment elevation myocardial infarction (STEMI) for presentation of stent thrombosis and 9% had a non-ST segment myocardial infarction (NSTEMI) on presentation. Therapy mainly involved antiplatelet therapy and Percutaneous Coronary Angioplasty with new stent placement. Despite this mortality rate among the cases present was quite high at 45%, with some patients dying as a result of COVID-19 related complications. Through various literature reviews, we have found that COVID-19 contributes in creating a prothrombotic state through various inflammatory mediated mechanisms. This prothrombotic state is a major risk factor towards stent thrombosis and we recommend that physicians be aware of this potentially fatal complication in COVID-19 patients.

Microsurgical training for students: presentation of a model and preliminary results

Microsurgery is a form of surgery performed with the assistance of a magnifying device such as a microscope or loupe. It is not considered a distinct specialty but a competency required for different surgical specialties. The study presents an undergraduate training model designed in the authors’ institution and is directed towards medical students in their clinical years. It consists of 30 practical learning hours of how to conduct various microsurgical procedures. These took place during 15 three-hour classes (2 h under the microscope per lesson), held once a week. The simulation model used in this training was a chicken thigh and instrumentation consisted of surgical training microscopes and professional microinstruments. Effectiveness of the training was assessed through the observation of acquired skills and the so called “6-stiches test”. Other simulation models used in microsurgical training and other methods of evaluating the acquired proficiency were discussed. The results show that the proposed 30 h of undergraduate, facultative microsurgical training is effective in ensuring participating students acquire basic and advanced microsurgical skills, competence and confidence. The curriculum was designed to allow students to participate in training during the evening, away from other duties, so as not to burden them too much.

COINCIDENCE THEOREMS VIA CONTRACTIVE MAPPINGS IN ORDERED NON-ARCHIMEDEAN FUZZY METRIC SPACES

In this article, we prove coincidence point theorems for comparable ψ-contractive mappings in ordered non-Archimedean fuzzy metric spaces utilizing the recently established concept of T-comparability and relatively weaker order theoretic variants. With a view to show the usefulness and applicability of this work, we solve the system of ordered Fredholm integral equations as an application. In the process, this presentation generalize and improve some prominent recent results obtained in Mihet [Fuzzy Sets Syst., 159 (6), 739-744, (2008)], Altun and Mihet [ Fixed Point Theory Appl. 2010, 782680, (2010)], Alam and Imdad [Fixed Point Theory, 18(2), 415-432, (2017)] and several others in the settings of partially ordered non-Archimedean fuzzy metric spaces.

Presentation

Presentación del número especial de RED “Transición de la educación convencional a la educación y al aprendizaje en línea, como consecuencia del COVID19” Presentation of the special issue Transition from conventional education to online education and learning, as a consequence of COVID19.

Presentation

Presentation

The Role of a Medical Intermediate Care Unit in the Management of Budd-Chiari Syndrome: Case Series

Budd-Chiari syndrome (BCS) has a wide spectrum of presentations, from an asymptomatic status to acute liver failure (ALF). The therapeutic approach depends on disease severity and related etiology with patients with severe forms of presentation classically managed in intensive care units (ICUs). Here, we report a series of five BCS patients managed in a medical intermediate care unit (IntCU), with three of them presenting with acute liver injury. Progression to ALF was seen in three patients, two of whom died, with one being successfully submitted to liver transplantation. IntCUs allow a 24-h patient surveillance and a prompt management of BCS, with less economic impact when compared to ICUs. Mortality was related to the presence of associated comorbidities that limited therapeutic approach. J Med Cases. 2021;12(5):190-194 doi: https://doi.org/10.14740/jmc3659

‘Do not dare speak of Scientology in France!’

In this article I contrast the ease with which I have always been able to study Scientology with the near impossibility to speak about my research in France unless it is to attack the Church, considered as the epitome of the dangerous tentacular cult. Any factual presentation of its origins and workings will be interpreted as a biased promotion of this dangerous ‘secte.’ I narrate a year-long attack by anti-cultists against my work and against CESNUR.

Disseminated Nocardiosis: The Complexity of the Diagnosis

Nocardiosis is a rare infection in immunocompetent patients. Nocardia spp. is an uncommon cause of prostate abscesses and is responsible for only 1-2% of brain abscess. Hematogenous dissemination can occur, and presentation of abscesses in more than two locations is required to determine a disseminated nocardiosis. The microbiological diagnosis of this agent is still a challenge due to the complexity of its identification in regular laboratories. An early diagnosis and adequate treatment with effective antibiotics are critical for treating this entity. We report a case of a patient who presented with brain abscess with a previous medical history of prostate abscess to Nocardia spp. which evolved to disseminated nocardiosis. J Med Cases. 2021;12(5):205-208 doi: https://doi.org/10.14740/jmc3673

Discussion: Toddbrook reservoir reports and presentations

Discussion: Toddbrook reservoir reports and presentations

Fury Road: Medical Physics Education Using Film

As part of a public education outreach effort, an introduction to the health effects of ionizing radiation and the field of medical physics was developed by a clinical medical physicist. The presentation was delivered to a broad public audience in 2019 (prior to COVID-19 safety concerns) through a community outreach science literacy program that pairs popular films with educational material. The program is a collaboration between a local science center and a community movie theater, and includes content developed by a keynote guest scientist and the screening of a popular film. The film chosen for the medical physics curriculum was “Mad Max: Fury Road” (Warner Bros. Pictures, Burbank, CA), which takes place in a fictional post-apocalyptic environment with widespread radiation contamination. The lecture introduced the audience to concepts of ionizing radiation, DNA damage from radiation, risk models, historical significance, ionizing radiation in the film, and ionizing radiation in our world (including therapeutic medical applications). A panel of clinical medical physicists answered audience questions following the film screening. Event attendance was high, with ticketed and lecturer seats occupying 98% of the theater’s seating capacity. Informal feedback from audience members indicated attendees had an increased interest of the field of medical physics following the program. The described education and outreach format may be used by educators interested in similar opportunities in their own communities, and also may be adapted as an entertaining and accessible installment of a physics club, seminar, or colloquium event in more formal educational settings. The electronic lecture slides are available for download as supplementary materials.

Presentation and implementation multi-objective mathematical models to balance the assembly line

The use of assembly lines is one of the important approaches in mass production of industrial products. Imbalance of assembly lines increases cycle time and idle times, resulting in reduced production rates, line efficiency, and increased system costs, which ultimately lead to low productivity. A hybrid model assembly line is a type of production line on which various models of products are assembled. These assembly lines are increasingly accepted in the industry in order to overcome the diversity of customer demand. The hybrid model assembly line is able to respond quickly to sudden changes in demand for different models of a product without maintaining a large inventory.The purpose of this paper is to present a multi-objective integer linear mathematical programming model for balancing assembly lines, which is solved using the general criteria method. The three objective functions considered in this model are: (1) Minimizing cycle time (2) Minimize the idle time of each station and (3) increase the efficiency of the assembly line. In order to investigate the model, Iran-Shargh Neishabour Company has been considered as a case study. After implementing the proposed model of the paper, the results show the optimal performance of the proposed model and the studied parameters in line balancing have been significantly improved.

The Influence of Gift card Presentation Format on Consumer’s Mental Accounting

The Influence of Gift card Presentation Format on Consumer’s Mental Accounting

Simulation of Lueders bands using regularized large strain elasto-plasticity

This paper deals with the numerical simulation of an instability phenomenon called Lueders bands with two regularized material models: viscoplasticity and gradient-enhanced plasticity. The models are based on large strain kinematics and temperature-dependence is incorporated. The Huber–Mises–Hencky yield condition and multi-branch hardening are employed. After a brief presentation of the constitutive description, test computations are performed using AceGen and AceFEM symbolic packages for Wolfram Mathematica. The first benchmark is a rectangular tensile plate in plane strain isothermal conditions. For the viscoplastic model, simulation results for different values of viscosity, loading duration and enforced displacement are compared. For the gradient model different internal lengths are used. Mesh sensitivity of the results and the influence of boundary conditions are also examined. Next to the Lueders-type response to a softening-hardening yield strength function, an additional softening stage leading to failure is also considered. The second example concerns a bone-shape sample under tension, for which, next to mesh sensitivity and the effect of regularization, the influence of heat conduction on simulation results is evaluated.

Isolated Vestibulopathy: A Potentially Unrecognized Presentation of COVID-19

Isolated Vestibulopathy: A Potentially Unrecognized Presentation of COVID-19

The 2021 Gastrointestinal Cancers Symposium

The all-virtual 2021 Gastrointestinal Cancers Symposium (January 15–17, 2021) included presentations on promising new agents, reports of outcomes with

Quality assessment of global lung cancer screening guidelines and consensus

Objective: To understand the research progress and quality of lung cancer screening guidelines and consensus in China and abroad, and to provide reference for the formulation of high-quality lung cancer screening guidelines in China. Methods: Databases including PubMed, Medline, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, SinoMed, VIP and Wanfang Data were searched, websites and important references were also searched by hand retrieval. The Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ) and Reporting Items for Practice Guidelines in Healthcare (RIGHT) were used to assess the quality of newly published or updated guidelines and consensus. Results: A total of 9 guidelines and consensus published between 2015 and 2020 were included in this study, with countries including the United States, China, Canada, Saudi Arabia and South Africa. The field of scope and purpose and clarity of presentation scored relatively high but the rigor of development and applicability scored low. Five guidelines were judged to be A-level, all of which were published abroad, and the remaining four were B-level, including three guidelines and consensus issued by China and 1 guideline issued by South Africa. The report rate of RIGHT were higher in basic information and background, lower in review and quality assurance, funding and declaration and management of interests. There were 5 guidelines with a good level and 4 guidelines and consensus with a moderate level. The best overall quality guidelines were those published by the American College of Chest Physicians in 2018 and by the Canadian Task Force on Preventive Health Care in 2016. Conclusions: The number of countries and institutions that issue lung cancer screening guidelines and consensus had been increasing gradually, but the quality in China remained low. It is necessary to develop high-quality lung cancer screening guidelines suitable for China's national conditions in combination with evidence-based methods to guide practice.