Surgical Anatomy of Mandibular Third Molar

                                           https://www.austinpublishinggroup.com/surgery/

Surgicalremoval of impacted third molar is one of the common surgical procedures carried out in the oral and maxillofacial surgery set up. Surgical management of impacted third molar is difficult because of its anatomical position, poor accessibility, and potential injuries to the surrounding vital structures, nerves, vessels, soft tissues, and adjacent teeth during surgeries. To overcome these hurdles of surrounding anatomical structures of third molar; we embarked on this review of literature to make the reader more aware of the surgical anatomy as well as possible complications associated with these structures. For a comprehensive review, we have categorised this anatomy into hard tissues and Soft tissues.

Whenthe mandible is viewed anteriorly, it is seen that the ramus tends to flare out buccal from the distal aspect of the third molar region. Mandibular third molar is situated at the distal end of the body of the mandible at the junction of mandibular body and the ramus. This junction constitutes a line of weakness and The lower third is embedded between a thick buccal cortical plate which is buttressed by the external oblique ridge and on the lingual side is present the comparatively narrower lingual cortical plate where is connection with relatively thin ramus.

Pediatric Stroke and Cell-Based Treatment – Pivotal Role of Brain Plasticity

                https://www.austinpublishinggroup.com/stemcell-research-transplantation/

Pediatricbrain damage of various etiologies, including stroke, and subsequent Cerebral Palsy (CP) are devastating and debilitating ailments with lifelong sequelae and high mortality. Unfortunately, there is no causative treatment beyond symptomatic and supportive care and the estimated lifetime costs per affected child amount to 800,000 Euro. The enormous number of 17 million people worldwide that live with cerebral palsy reflects the magnitude of unmet needs and the personal, medical, and global socioeconomic burden of this brain disorder.

Butthere is hope. Only recently the first successful cell-based treatment of arterial ischemic stroke in a child using autologous cord blood mononuclear cells (Jensen and Hamelmann, 2016 ) and of adult stroke using allogeneic cord blood mononuclear cells have been reported (Laskowitz et al., 2018 ). This renders a comprehensive review of the literature mandatory to explore safety and efficacy of cell-based treatment options for young and elderly patients alike.

Hypotheses Testing in Case-Control Spatial Point Processes

                                                  https://www.austinpublishinggroup.com/statistics/

Afundamental problem in spatial epidemiology is the understanding of the relationship between risks experienced by humans or animals. A widely used method to address such a problem is to consider a case-control study for a certain risk. In this research, we focus on problems of case-control studies for spatial point processes. In a case-control spatial point process model, data often consist of locations in a specific geographical region which can be classified into two categories: observations from the case process and observations from the control process.

Typically,each observation in the case process presents a positive result to a certain medical test while each observation in the control process presents a negative one. A common task in the analysis of the case-control spatial point patterns is to compare their spatial distributions. For instance, in our data example of Section 5, we are interested in the comparison between the spatial distributions of dead birds on whether or not they were infected by West Nile virus. The main interest is to discover whether the spatial distribution of the case process (i.e. positive incidences) and the spatial distribution of the control process (i.e. negative incidences) are the same. The results of the analysis can provide potentially useful information on how the behavior of birds is affected by the infection of the West Nile virus.

Physical Therapy and Migraines

                            https://www.austinpublishinggroup.com/sleep-disorders/

The study of effective techniques for migraines is justified by its high prevalence; a systematic review (Woldeamanuel and Cowan, 2017) concluded that it affects 1 out of 10 individuals worldwide, with preference in gender for females in comparison with males, in a ratio 2:1.

One of the reasons that promotes the use of physical therapy in the treatment of these patients is the concurrence of musculoskeletal dysfunctions in the neck in patients with migraines; a recent study concluded that 89% of the patients with migraines included in the study reported local or referred pain in the head during the realization of pressure on the high cervical segment. In a study about the prevalence of neck pain in patients with migraines observed it was of 76% during the year of the study.

In the most recent study about this topic findings from the exploration of the cervical spine in patients with migraine and controls were compared and concluded that significant differences existed in the number of active trigger points, in the flexion-rotation test, joint mobility in the high cervical segment, in the crane cervical test and in the reproduction and resolution of symptoms during sustained pressure; also, 93% of the patients with migraine presented at least three cervical musculoskeletal dysfunctions .

Fibromyalgia: an Alternative View

                                https://www.austinpublishinggroup.com/austin-rheumatology/

Fibromyalgia is a complex neuroendocrine pain condition, but it is not incurable. Unfortunately, it cannot be cured simply by managing the symptoms with medication or picking one endocrine item to correct. It is important to discern how the patient came to develop fibromyalgia if you want the patient to actually recover.

As a group, Fibromyalgia patients seem all to have very similar neuroendocrine profiles when they reach the pain clinic. They have symptoms of low thyroid and high but normal TSH. Poor digestion and irritable bowel are common. Abnormal levels of gonadal hormones, low progesterone, testosterone, FSH and LH are characteristic.

As a group, Fibromyalgia patients have low levels of branch chain amino acids that interfere with proper serotonin and dopamine production and may contribute to abnormal thyroid hormone receptor structure. Pain is amplified in the thalamus instead of being suppressed there.

Need to Design a Tool that can Assess Preoperative Factors which may Affect Cardiac Complications after Non-Cardiac Surgeries among CKD Patients

                       https://www.austinpublishinggroup.com/austin-renal-disorders/

Each year, cardiac complications occur within 30 days after major non-cardiac surgery in more than 10 million people worldwide.Non Cardiac surgeries may improve the quality and patient’s life may get better or prolonged, however these surgeries may develop complications such as death from Cardiac causes, myocardial ischemia (MI), cardiac arrest or conjuctive heart failure. Unfortunately, a large proportion of ischemic episodes go undetected during surgery and in the postoperative period. Also, it is noticed that MI remains undiagnosed and physicians rarely administer therapy and plan secondary prevention in patients who have suffered from perioperative unstable angina or MI. The risk of subsequent cardiac events increases further due to lack of satisfactory management.

Knowing the clinical relevance of cardiac complications in the setting of non-cardiac surgery, preventive strategies for preoperative risk stratification have been proposed since 1977. Models were developed looking for associations between preoperative variables such as age, type of surgery, co-morbidities etc and the risk of cardiac complications in a cohort of patients undergoing non-cardiac surgeries called as “Derivation Cohort”. Variables that have independent predictive value using logistic regression analysis are incorporated into the risk index. The accuracy and validity of this risk index is then tested in a separate cohort called “validation cohort”.

Holistic Spatial Management of International Security

                             https://www.austinpublishinggroup.com/robotics-automation/

Internationalsecurity, also called global security, refers to the amalgamation of measures taken by states and international organizations to ensure mutual survival and safety. These measures may include military actions and diplomatic agreements such as treaties and conventions. Security policy is more than defence policy, more than military policy, more than a policy aimed at being prepared for war; security policy is also aimed at avoiding war. Security policy embraces domestic security, economic development policy, and policy for influencing the international system so as to create a peaceful environment, regionally as well as globally. The world is entering its most dangerous chapter in decades where the sharp uptick in war over recent years is outstripping the ability to cope with consequences. From global refugee crisis to the spread of terrorism, the collective failure to resolve conflict is giving birth to new threats and emergencies. Even in peaceful societies, the politics of fear is leading to dangerous polarization.

Conflictsare often spreading from local no nonlocal to international to global, covering large distributed spaces, and it is becoming more and more difficult to prevent, control, and stop them by traditional centralized agencies and resources, also existing measures and technologies. Something in a much broader and more powerful scale is needed for maintaining national, international and global security, which could operate holistically, globally, and spatially. And this is the aim and main contents of the current publication.

Hysteroscopy in Patients with Normal Transvaginal Ultrasound Prior to IVF: A Randomized Controlled Trial

                                        Austin Journal of Reproductive Medicine & Infertility

InVitro Fertilization (IVF) treatment is used widely for women who have had difficulty conceiving. Nowadays more than 700000 treatment cycles were given in the USA and Europe alone and the number is expanding steadily worldwide. Despite numerous improvements in assisted reproductive techniques, only 30% of cycles of IVF lead to the birth of a child. IVF is an expensive treatment and implantation failure could be due to a variety of reasons, including embryo quality and uterine receptivity, but remains unexplained in many cases.

Accordingto several studies the most frequent cause of Implantation Failure (IF) is the presence of chromosomal abnormalities in the embryo. However, abnormalities of the uterine cavity such as myomas, polyps and adhesions are also related with impaired implantation and reduced chance of pregnancy. Approximately 25% of infertile patients have defects in uterine cavity and abnormal uterine findings are reported in about 50% of women with recurrent implantation failure. Hysteroscopy is considered the reference standard to detect these uterine disorders. It has been suggested that these abnormalities should be diagnosed and treated to optimize the condition of the uterine environment and the outcome of IVF treatment. Moreover, hysteroscopy could improve pregnancy rates through dilatation of the cervical canal to favour embryo transfer as well as through the induction of an inflammatory reaction of the endometrium with the procedure.

Realization of Students about Origin, Signs, Consequences and Remedy of Bacterial Disease Syphilis

                         https://www.austinpublishinggroup.com/radiation-oncology-cancer/

Syphilisis bacterial disease that is caused by the bacteria Treponema pallidum. It can be treated in early stages. Without treatment it can lead to fatal disorders like neurological disorders and death. It is highly contagious disease that is commonly spread by the sexual activity, including oral and anal sex. The disease primarily starts in the form of painless sore particularly on genital, rectum or mouth. Disease can be transferred to other person by close bodily contact. The pregnant woman will transfer this disease to new born. The bacteria can pass from mother to fetus. The disease cannot spread by using same objects like doorknobs and toilet seats. The disease is divided into different phases on the basis of symptoms, primary, secondary, latent, tertiary, neurosyphilis, congenital syphilis. The symptoms for primary syphilis appears about three weeks of exposure. The main symptom is formation of painless sores. These sores are called as chancres. Without cure the disease may lead to next phase. The secondary symptoms include muscle aches, fever, sore throat, patchy hair loss, swollen lymph nodes etc. The latent syphilis can last for long time sometimes for years. This phase occurs without particular symptoms.

Thelate or tertiary syphilis occur after 10 to 30 years of infection. This phase is very fatal because it includes organ damage like damage to heart, blood vessels, liver, bones and joints. Neurosyphilis is a phase in which bacteria spread to nervous system. This results in dementia, headache, abnormal gait, weakness. In congenital syphilis, infection can transfer from mother to offspring. The symptoms in child are fever, saddle nose, small blisters hands and feet. Penicillin is widely using for the treatment of syphilis. Only single, long term, intramuscular injection of Benzathine penicillin G can cure all types of syphilis.

Traumatically-Induced Pseudotumor of Rice Bodies (Corpora oryzoideoma) Around a Prosthetic Hip

                                          https://www.austinpublishinggroup.com/radiology/

Rice Bodies (RBs), named after their macroscopic likeness in color, shape, and size to polished grains of rice, are associated with chronic inflammatory processes, notably rheumatoid arthritis, seronegative inflammatory arthritis, and tuberculous joints. In this report, a massive aggregate of rice bodies around a prosthetic hip was clinically suspected to be a post-traumatic hematoma.

AlthoughRBs can normally be identified on T2-weighted MRI as hypointense fusiform-shaped nodules floating free in a fluid background, in the present case, the absence of a significant liquid milieu obscured RB detection. The rarity of massive RB aggregates, a history of trauma, and its unusual radiologic presentation due to an absence of significant joint fluid to separate the RBs, motivated investigation into the etiology of RB formation in the present case.

Thirty-sixmonths prior to presentation, the 66-year-old male patient underwent uncomplicated total left hip replacement for advanced osteoarthritis. Seventy days following left hip replacement, the patient resumed horseback riding 3-5 times a week for a total of 40 hours per month. Sixteen months post-op for left hip arthroplasty he developed moderate, intermittent, idiopathic lateral hip pain with associated tenderness isolated in the trochanteric region and symptoms of trochanteric bursitis. At twenty-eight months post-op, his horse bolted out from under him as he tried to mount and the fall onto his left side led to significant pain and marked swelling about the left knee. The knee improved over the next few days but a newly appreciated area of swelling and marked tenderness appearing over the left greater trochanter.

Pleithropic Effects of Erythropoietin and Its Potential use in Plastic Surgery

                               https://www.austinpublishinggroup.com/plastic-surgery/

Erythropoietin (EPO) is known to be a body-own hormone which is produced depending on the oxygen partial pressure in the blood by fibroblasts of the kidney parenchyma and controls the differentiation of the erythrocytes in the bone marrow.

The need for the existence of such a hormone had been postulated more than a century ago. But only a good half-century ago (1953) the glycoprotein could be isolated and its erythropoietic effect proved. After more than a quarter of a century genetic modification of hamster cells succeeded in producing recombinant human EPO. Thus, there was nothing in the way of a large-scale industrial, pharmaceutical production. Now, for almost three decades, EPO has become an indispensable part of the clinical routine, for example, in the case of anemias of terminal renal failure, tumor-induced anaemias and pre-blood donation. In this respect, it is important to note that the erythropoietic effects are generally observed only after a certain dosis and secondly in repeated applications of systemically administered EPO.

The first work on the non-erythropoietic effects of EPO was published around the turn of the Millennium. Since then, our understanding of EPO has been changing. In the meantime, a number of works have already demonstrated that EPO plays a role in responding to acute and chronic tissue damage. It was shown in several rodent models that EPO is synthesized in a variety of tissues in the acute phase after trauma. There, it inhibits the initial inflammatory reaction and thereby facilitates the healing and thus the “Restitutio ad Integrity”.

Infant and Child Immunization: Consequences of Federal Legislation 2017

                              https://www.austinpublishinggroup.com/pregnancy-child-birth/

It is difficult to predict the final federal health care legislation at this time; however, it may have life and death ramifications as well as public health consequences. Medicaid is now the largest source of health care insurance in the United States, covering 34 million children and 40% of the 4 million live births in the US each year. These programs comprise about 20% of the $545 billion spent for Medicaid in 2015. The Children’s Health Insurance Program (CHIP) covers an additional 9 million near-poor and middle-income children at a cost of almost $15 billion. Together with Medicaid, these two programs cover nearly one-third of all US children.

Thirty-one states have opted into the Medicaid expansion set up by the Affordable Care Act (ACA) also known as “Obama care”. This legislation expanded the ability for more children and others to qualify for coverage. Among other provisions, this groundbreaking legislation mandated coverage by commercial health insurance companies for essential health benefits including preventive care (such as immunizations) and for pre-existing medical conditions. The ACA currently mandates “first dollar” coverage for ACIP recommended immunizations as well as the attendant physician visits, without any co-pays or other expenses for the patient or their family. The unfortunate Republican efforts to “repeal and replace” the ACA would terminate many of the most important provisions including Medicaid expansion and would cap federal contributions to states for all Medicaid programs. These and other callous efforts would lead to a 25% reduction in federal Medicaid spending and up to 22 million individuals loosing their health insurance coverage.

When Pain Persists, Disability in Elders Can Begin

                                         https://www.austinpublishinggroup.com/austin-pain-relief/

Humanaging is a gradual and adaptive process characterized by the loss of physical and cognitive capacities without any evidence of a defined disease. Pain is by far one of the most common symptoms presented in daily clinical practice. When pain persists for longer than three months, it is defined as Chronic Pain (CP), and it can transform from a symptom to an independent medical condition. In geriatric patients, the management of CP becomes increasingly complicated because of age-related homeostatic imbalances, especially in systems related to pain perception, pain inhibition and pain interpretation. The assessment of CP in elders becomes a challenge for many reasons, including cognitive impairments, lack of family support and/or abuse, the existence of comorbidities and polypharmacy; such factors can cause CP to be underestimated in this population. In addition to the implications of unidentified or incorrectly treated CP for life quality and mood equilibrium, its recent association with frailty in elders makes it a potential risk factor for an established and irreversible functional limitation state.

WhenCP is established, regardless of its cause, general alterations in the organism are triggered, as many authors have noted. Nevertheless, when considering elder patients from an integrated geriatric point of view, there are main factors and systems involved that could play a key role in the predisposition to develop frailty. Two main aspects need to be addressed: the perception of pain and the pathophysiological adaptation to CP.

Nutritional Status and Consumption of Omega-3 Fatty Acids by Substance Abusers in Recovery

                       https://www.austinpublishinggroup.com/psychiatry-mental-disorders/

Psychoactivesubstance abuse is the third most prevalent Brazilian psychiatric disorder affecting men and women of all ages, ages and races. This includes newborn infants who inherit diseases and/or dependence from their mothers. According to the Minnesota Department of Human Services individuals who are no longer able to control the frequency with which they use psychoactive chemicals are considered to be chemically dependent, in spite of the harmful consequences, since these substances can alter the body, behavior and mind. Furthermore, according to Williams and McElhiney this condition is the result of adaptations of specific neurons to continuous exposure to one or more drugs of abuse. Thus, psychoactive substances may induce various disorders, including intoxication, withdrawal syndromes, delusions, psychoactive disorders, mood and sleep disorders, dementia, anxiety disorders, memory loss and sexual dysfunction.

Inaddition to the changes caused by frequent drug use, there is a change in eating habits and nutritional status of the user, since the use of psychoactive substances can affect appetite and food intake or can act directly on the metabolism of some nutrients. In addition to inadequate dietary intake, nutrient absorption may be altered, causing nutritional deficiencies. According to Benton, Fordy and Haller these deficiencies can disturb brain waves and brain function.

Posttraumatic Stress Disorder and Major Depression Disorder: A Case Report of Yemeni Woman

                                        https://www.austinpublishinggroup.com/austin-psychiatry/

A Yemeni woman was in 30 presented to our emergency unity via the general physician in the residence hall where she is living. She settled in Morocco about one year ago to continue her studies to achieve the equivalence of her diploma of neuro-physiologist which she obtained in Yemen. After a long struggling with managing dementia in her mother the three last years, she was alone in front of that, her father went and married again, her brother traveled to Malaysia and lost his novella. She had in the same time conflicts with her husband because she discovered he is homosexual which impacted her a lot. The health of her mother became critical and the situation became more delicate with the war ambiance. Our patient had material difficulties to cover the hospitalization needed to her mother, and she was jobless too, she was victim of moral harassment in university where she was teaching neurophysiology. Her mother dead because of bed rest complications. After death of mother, she vended all what she had as goods to start her life in Morocco.

In-depthinterview was used to gain qualitative data and insight into her personal experiences as a Yemeni woman refugee after death of her mother. The case reported here was manifested by nightmares and periods of unreality associated to problems in concentration and social isolation. Suffering professional harassment while civilian war in Yemen. Therefore, she opened up to us about her experience after her divorce when she discovered the reality that her husband is homosexual. We found Major Depression Disorder’s (MDD) criteria associated to Post Traumatic Stress Disorder’s criteria.

Importance of Oral Care Before, During and After Chemotherapy

                                 https://www.austinpublishinggroup.com/pediatric-oncology/

Within the most current concepts of health, it is of fundamental importance to consider the patient in a holistic manner. A multidisciplinary team should form the oncology group, especially in the hospital setting. The role of a dentist on this team is to diagnose, prevent and minimize the immediate effects of chemotherapy and/or radiotherapy as well as identify the effects of treatment to improve the quality of life of patients.

The objective of the protocol is to establish a standard for the care of patients with cancer. Emphasize the importance of oral health, in support for outcomes associated with oral care health, the knowledge of oral health for effectiveness in continuing the therapeutic treatment of cancer and awareness of effects acute and late in the mouth from cancer therapy: prevention of local and systemic infections, control pain, maintain oral functions, reduce side effects and improve the quality of life of patients.

Hematopoietic Stem Cell Transplantation (HSCT) is a procedure that requires conditioning to high doses of chemotherapy and/or radiotherapy. Dental treatment prior of HSCT is important. The oral mucosa and teeth should be examined using panoramic radiography to document oral status prior to HSCT. Moreover, such patients need to develop a specific oral hygiene regimen, the instructions for which should be clear and concise. Motivation and understanding with regard to oral care can have a considerable impact during HSCT. Bacterial plaque should also be evaluated, as this is a key factor to the development of gingival and periodontal disease and can contribute to acute infection as well as systemic disorders.

Interdisciplinary Protocols for Timely Assessment and Management of Delirium Symptoms

                               https://www.austinpublishinggroup.com/palliative-care/

Deliriumis an epidemic among hospitalized adult patients, with an incidence of up to 64% in high risk populations such as patients in intensive care who are ventilated and patients receiving anesthetics and sedation. It is one of the most common neuro-psychiatric complications experienced by palliative care patients. Patients predisposed to delirium tend to be ill, frail and/or elderly. Delirium is generally the result of multiple contributory factors which are easily recognized and potentially modifiable. Yet, symptoms are under recognized and delirium is under-diagnosed, with up to 84% of physicians and 30% of nurses missing the diagnosis in hospitalized patients. Variable symptom presentation contributes to the challenge of detecting delirium and it is frequently misdiagnosed as “sedation”, “confusion” or “anxiety”.

Deliriumincreases per patient cost by approximately $24,000 and results in up to 8 additional hospital days. Total United States health care costs for delirium are estimated to be as high as $152 billion dollars which is equal to the combined annual cost of both nonfatal falls and diabetes. This fiscal cost does not consider the suffering endured by afflicted patients and families. Up to 80% of those who remember their delirious episode report it to be the worst nightmare of their lives. Some patients experience a post delirium cognitive decline that may be permanent or progressive, especially in the case of preexisting dementia. The distress that occurs in delirium is multidimensional for all involved. Severe distress has been reported by 76% of family members and 73% of nurses caring for patients with delirium. There may be worry on the part of patients’ families that their loved one is “going crazy” and that the change will be permanent. Delirium may also result in the loss of patient dignity and complicates discharge planning. Family members often feel a sense of helplessness, frustration and guilt. For the health professional, delirium symptoms are difficult to assess and manage.

MDT Spasticity Assessment

                           https://www.austinpublishinggroup.com/pediatrics-child-health-care/

We do inject our patients with Botulinum Toxin for their spa limbs following their neurological illness. To improve the multidisciplinary team and to improve the functional Ou management, now we developed a multidisciplinary approach includes them being seen in the ward round by the multidisc them for their spasticity together and make a management their goals in mind. We designed a Performa for each patient management to be filled via MDT approach and be reviewed.

We developed a multidisciplinary approach for these patient being seen in the ward round by the multidisciplinary team spasticity together and make a management plan according mind. We designed a Performa for each patient who needs filled via MDT approach and be reviewed accordingly. The timescale for this project was from October 2015 to Ja audit to make sure we achieved the goals and made the se implemented accordingly.

Epidemiology of Acinetobacter baumannii Infection in a University Hospital

                                https://www.austinpublishinggroup.com/pathology-microbiology/

AcinetobacterBaumannii is a gram-negative coccobacillus. it is an opportunistic pathogen in immunocompromised patients, that attracted considerable attention for the last 40 years as the most important emerging bacterial pathogen. this is explained by its ability to colonize the biotic and abiotic surfaces with high resistance to disinfectants but also to desiccation by formation of biofilms. baumannii currently occupies an important place in hospital pathology globally, with an important role in potentially epidemic nosocomial infection. indeed, infections due to a. baumannii are frequent and severe with high morbidity and mortality. a. baumannii is also characterized by its ability to over-regulate its innate resistance mechanisms, but above all to acquire new resistance mechanisms whose diversity is impressive with various genetic supports. therefore, the therapeutic options for this bacteria are very limited. knowledge of local epidemiology is essential to monitor trends in antibiotic resistance, in order to determine the magnitude of this phenomenon, to adapt the protocols of probabilistic antibiotic therapy and to evaluate actions to fight this bacterium. the aim of this study is to determine, through a 6 year descriptive study (from 2010 to 2015), the evolution of the epidemiological profile of a. baumannii isolated at the university hospital mohammed vi in marrakech (morocco) and evaluate levels of resistance to different antibiotics.

Mercury Emission Abatement Strategies of China’s Coal-Fired Power Plants

                               https://www.austinpublishinggroup.com/austin-public-health/

Mercuryand its compounds are highly toxic to humans, especially to the developing nervous system. They are also harmful to ecosystems and wildlife populations. Microbial metabolism of deposited mercury can create methylmercury, which has the capacity to collect in organisms (bioaccumulate) and to concentrate up food chains (biomagnify), especially in the aquatic food chain. Methylmercury is a well-documented neurotoxicant, which may in particular cause adverse effects on the developing brain. It readily passes both the placental barrier and the blood-brain barrier; therefore, exposures during pregnancy are of highest concern. It may also cause adverse effects on the cardiovascular system, thereby leading to increased mortality. Methylmercury compounds are considered possible carcinogenic to humans according to the International Agency for Research on Cancer. Furthermore, inhalation of elemental mercury vapour causes symptoms such as tremors, insomnia, memory loss, neuromuscular changes, and headaches. Kidney and thyroid may be affected.

Mercuryin the atmosphere is divided into three inorganic forms   i.e. the elemental mercury reactive gaseous mercury and particulate mercury. Hg0 is the main chemical speciation of atmospheric mercury, which constitutes the majority of the mercury in the atmosphere over 95%. As Hg0 has very low solubility in water and its chemical reaction rate is very slow with other components in the atmosphere such as the strong oxidant O3, H2O2, OH and NO3 radicals Hg0 has a long atmospheric lifetime  and can be transported through the atmosphere over thousands of kilometers.

Mucinous Adenocarcinoma of Bladder; a Primitive not to Disregard

                                       https://www.austinpublishinggroup.com/austin-pathology/

Bladdercancer is the second most common tumor in genitourinary tract. Adenocarcinoma represent less than 2% of all bladder cancers, mucinous variant is even more rare. They are characterized by a very aggressive behaviour and are not very sensitive to radio and chemotherapy. They exhibit histological features similar to those from other sites and adenocarcinoma of urachus, making diagnosis difficult, hence the primary role of immunohistochemistry in determining primitive site. Because of its rarity and these difficulties, diagnosis is always delayed. We report the case of an 80-year-old woman with no pathological history who consulted for total hematuria. The physical examination revealed a slight hypogastric sensibility.

Ultrasoundshowed a thickening of the bladder wall with a heterogeneous content from which the indication of a computerized tomography scan that showed presence of a bladder tumor process without repercussion on the upper urinary tract. A transurethral resection of the tumor is performed. Pathological study suggested the initial diagnosis of a mucinous adenocarcinoma infiltrating bladder muscle. An immunohistochemical study was performed, having objectified the positivity of tumor cells to cytokeratin 20 but cytokeratin 7 was negative. Cytoplasmic staining of the tumor cells with loss of nuclear expression of beta Cathenin confirmed the primitive character. Patient was readmitted after 6 months for radical treatment. She had a pelvic anterior flap with an lymph node iliac dissection and a urinary diversion with cutaneous ureterostomy.