Gluteal compartment syndrome is a rare reason of rhabdomyolysis resulting from atraumatic origin, and leading to renal failure. Beside to other atraumatic causes like drug abuse, alcohol intoxication, and antihyperlipidemic medications prolonged operation duration in a fi xed position is an important cause of this syndrome. Male sex, diabetes mellitus, hypertension and obesity are risk factors for gluteal compartment syndrome associated kidney failure. We report a 56 year old obese patient with a medical history of diabetes mellitus, and hypertension who undergo a nephrectomy operation resulting with gluteal compartment syndrome, and chronic kidney disease. We also highlight the importance of preventive cares and early recognition of gluteal compartment syndrome to avoid further morbidity.
came with complaints of chest pain that starting with exertion and ending with rest. Physical examination revealed a 1/6 systolic murmur. The electrocardiogram showed no signs of ischemia. The transthoracic echocardiogram at admission revealed no significant finding except that minimal mitral valve regurgitation. Treadmill showed significant horizontal ST-segment depression in D11-D111-aVF and V4–V5-V6 with accompanied by chest pain. Cardiac catheterization showed a fistuluzation from circumflex coronary artery to pulmonary artery (Figure 1, 2). Origin of the circumflex artery from the pulmonary artery has been proved by multislice computed tomography (Figure 3). Myocardial perfusion scintigraphy were performed to evaluate myocardial ischemia and ischemia was identified at the perfusion area of the circumflex coronary artery. As a result of this, the patient was advised surgery
Aim: Malnutrition is a serious and frequently encountered condition affecting more than 900 million individuals worldwide. Its relationship with negative clinical outcome, bad prognosis and susceptibility to diseases has been demonstrated in numerous studies alongside with the importance of early nutritional intervention. The aim of this study was to define the beneficial influence of a hypercaloric enteral supplement on body mass index (BMI) z-score as well as ferritin, vitamin B12 and vitamin D micronutrients. Methods: This study is a retrospective observational study. Records of patients who were diagnosed with malnutrition via a physician by having height and weight scores below -2 standard deviation were collected from Gaziosmanpaşa Training and Resource Hospital, Istanbul, Turkey. A comparative statistical analysis was performed on 205 pediatric malnutrition patients (ages 1 to 16) by gathering their BMI, ferritin, b12 and vitamin D at baseline with their measurements at 2 follow-up visits after the administration of hypercaloric (1.5kcal/mL) enteral supplement over 6 months. Results: There was a significant inverse correlation between BMI z-scores and the duration of enteral supplement administration, reflected by a 33.2% reduction of the mean BMI z-scores from -2.11 to -0.7 over 6 months (Z=-12.4, P<0.001). Additionally, there was a reduction in the number of patients with excessive or insufficient amounts of ferritin, b12 and vitamin D concentrations with 80%, 41.7% and 39.3% respectively over six months. Conclusions: Hypercaloric enteral supplementation is a short-acting and highly beneficial nutritional intervention in pediatric patients diagnosed with malnutrition, which provides a robust improvement in the BMI z-scores as well as a 2-tailed improvement of aforementioned micronutrients after six months of supplementation.
We aim to test the changes of coagulation parameters after the TBI by thromboelastography. Eleven patients who underwent TBI between march 2005 and march 2006 in our department were included in this study. Blood samples were taken from all patients immediately before the delivery of TBI and 12 hours after the completion of TBI. Com- plete blood counts, partial thromboplastin time (aPTT), prothrombin time (PT), and the fibrinogen levels were mea- sured. FIB-EXTEM, extrinsic (TEG-EXTEM), intrinsic (TEG-INTEM) clotting pathways, and platelet functions were measured by rotational thromboelastogram (ROTEM). All measured parameters were compared by using wilcoxon- paired test. There was no difference in the PT, aPTT, thrombin and thrombocyte counts before and after TBI. However, maximum clot firmness was decreased after TBI in FIBTEM measurement (18.6 vs 15.5, p<0.05). The clot formation time was also significantly prolonged (115.8 vs 121.7 seconds, p<0.05 ) and maximum clot firmness was decreased in EXTEM measurements. The fibrinogen levels were significantly decreased after TBI. Our results demonstrated that the clot formation was significatly decreased in the early period after TBI. Prolongation of clot formation time and decrease in maximum clot firmness in extrinsic pathway after TBI indicates disturbance in platelet functions.
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