J Formos Med Assoc
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In order to reduce the contamination in the ventilator, bacterial filters were placed on the expiratory limb of a ventilator circuit. Aerosolized mucolytic agents may increase the resistance of the ventilator. The goal of this study is to determine the impact of aerosolized mucolytic agents on the pressure change during mechanical ventilation. ⋯ This study demonstrated the aerosolized mucolytic agents could increase the pressure drop of the bacterial filters during mechanical ventilation. The pressure drop of the bacterial filters was higher with 10% acetylcysteine. It is critical to continuously monitor the expiration resistance, auto-positive end-expiratory pressure, and ventilator output waveform when aerosolized 10% acetylcysteine was used in mechanical ventilation patients.
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Case Reports
Intraosseous verrucous carcinoma arising from an infected dentigerous cyst-A case report.
Intraosseous verrucous carcinoma (IOVC) arising from an odontogenic cyst is extremely rare. We report a case of intraosseous verrucous carcinoma in a 74-year-old male who presented with a left mandibular swelling with recurrent pus discharge from gingiva of tooth #35. Panoramic radiography revealed an impacted tooth #34 and a large well-defined, radiolucent lesion surrounding the crown of tooth #34. ⋯ Histopathological examination showed proliferation of hyperparakeratotic stratified squamous cyst lining epithelium and down-growth of broad and bulbous epithelial ridges with pushing border invasion into the fibrous cystic wall. A verrucous carcinoma arising from an infected dentigerous cyst was diagnosed. There was no recurrence of the tumor 5 months after surgery.
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Rectus sheath hematoma (RSH) is a rare clinical entity. It can be mistaken for other intra-abdominal disorders, which can result in diagnostic and therapeutic difficulties. This study was undertaken to analyze the clinical presentation, diagnostic modalities, and management of patients affected with RSH. ⋯ RSH is a rare nonneoplastic entity that is usually associated with abdominal trauma and/or anticoagulant therapy. The gold standard for diagnosis is computed tomography, and ultrasonography can be used in follow-up. The treatment of choice is nonsurgical therapy because RSH is a self-limited condition. Surgical intervention should be reserved for cases with hemodynamic instability.
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Wastewater is a potential environmental source of Clostridium difficile, although a direct link with community-acquired C. difficile infection (CA-CDI) in humans has not yet been established. The present study was performed to determine the occurrence of C. difficile in two types of wastewater treatment plants (WWTPs) in Isfahan, Iran. A total of 95 samples were taken from a conventional activated sludge treatment plant and a waste stabilization ponds system, and analyzed for the presence of C. difficile. ⋯ C. difficile was also detected in 5% (2/40) of the samples from waste stabilization ponds. Polymerase chain reaction (PCR) analysis showed that all strains of C. difficile detected were toxigenic (tcdB gene positive). This study shows that C. difficile was present in WWTPs, which might constitute a potential source of community-acquired C. difficile infection.
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The CISD2 gene has been related to life span control and mitochondrial dysfunction in animals. In addition, inhibition of mitochondrial enzymes due to an accumulation of beta-amyloid peptide has been related to Alzheimer's disease (AD). This study aimed to explore the association between sequence variants of the CISD2 gene and risk for AD, which has not been explored previously. ⋯ Our findings suggested that CISD2 htSNPs are not associated with AD risk.