Assessment of platelet reactivity after the anthracyclinebased chemotherapy via mean platelet volume: Does it act on anthracycline-induced cardiotoxicity?
Gokmen Aktas 1, Tulay Kus 2, Emre Kuş 3, Murat Sucu 4, Handan Haydaroglu Sahin 5, Mustafa Pehlivan 5
1 Department of Internal Medicine, Division of Medical Oncology, Kahramanmaraş Sütçü İmam University, School of Medicine, Kahramanmaraş, 2 Department of Internal Medicine, Division of Medical Oncology, University of Gaziantep, Faculty of Medicine, Gaziantep Oncology Hospital, Gaziantep, 3 Department of Cardiology, Sehitkamil State Hospital, Gaziantep, 4 Department of Cardiology, University of Gaziantep, School of Medicine, Gaziantep, 5 Department of Hematology, University of Gaziantep, School of Medicine, Gaziantep, Turkey
DOI:10.4328/JCAM.5499 Received: 12.12.2017 Accepted: 23.01.2018 Published Online: 25.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 183-6
Corresponding Author: Gokmen Aktas, Department of Internal Medicine, Division of Medical Oncology, Kahramanmaraş Sütçü İmam University, School of Medicine, Kahramanmaraş, Turkey. GSM: +905076969249 E-Mail: email@example.com
Aim: Anthracycline-induced cardiotoxicity is the most frequent dose-limited toxicity. There has been numerous hypothesis about this matter. As an indicator of platelet size, mean platelet volume (MPV) is correlated with platelet reactivity, aggregation, and long-term atherosclerosis. We aimed to study whether the anthracycline triggers the elevation of MPV.
Material and Method: Patients who had breast carcinoma and received anthracycline-based chemotherapy for only adjuvant setting were included. Age, disease stage, history of diabetes mellitus (DM), hypertension (HT) and body mass index (BMI) were recorded. Patients with systemic inflammatory rheumatic disorders, the symptoms of infectious diseases, cytopenia after the chemotherapyand, BMI over 40 and metastatic disease were excluded. Blood samples were collected for initial MPV value and after four cycles of adjuvant anthracycline treatment. Statistical significance of the associations was analyzed using Pearson correlation, Student’s t, ANOVA tests and Wilcoxon signed-rank test.
Results: Three hundred operated breast cancer patients were recruited in this study. Mean age was 49.1 (20-77). There was no significant correlation between age and initial MPV (r=-1.111, p=0.056) or between BMI and initial MPV (r=0.023, p=0.697). Stage, DM, and HT did not affect initial MPV levels. Initial median MPV was 9.1 (6.2-12.8), and the last median MPV was 9.2 (6.1-12.9). According to Wilcoxon signed ranks test, positive ranks were found in 151 patients (p=0.003, Z=-3,002, based on positive ranks) after anthracycline therapy.
Discussion: Anthracycline causes elevation in MPV value which is a marker of thrombocyte reactivation and atherosclerosis. This might be responsible for the possible long-term cardiotoxicity of anthracyclines.
Keywords: Platelet Reactivation; Doxorubicin; Cardiotoxicity; Mean Platelet Volume
Neonatal septicemia in tertiary hospitals in Konya, Turkey
Nuriye Tarakcı 1, Murat Konak 2
1 Department of Neonatology, Dr. Faruk Sukan Women and Children’s Diseases Hospital, 2 Department of Neonatology, Selcuk University, Konya, Turkey
DOI: 10.4328/JCAM.5774 Received: 19.02.2018 Accepted: 04.03.2018 Published Online: 09.03.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 187-91
Corresponding Author: Nuriye Tarakcı, Department of Neonatology, Dr. Faruk SukanWomen andChildren’s Diseases Hospital, 42060 Konya, Turkey. T.: +90 3322380931 F.: +90 3322376025 E-Mail: firstname.lastname@example.org ORCID ID: 0000-0003-2444-4724
Aim: Neonatal sepsis is one of the leading causes of mortality and morbidity in the developing world. The present study aims to determine the incidence and risk factors of neonatal sepsis in a single center over a four-year period.
Material and Method: This is a retrospective study of all cases of culture-proven neonatal sepsis admitted in the neonatal intensive care unit of a single center between January 2013 and December 2016. Clinical features, risk factors, microbiological and biochemical results, and mortality rates were recorded. Associations between risk factors and mortality were investigated.
Results: The prevalence rate of neonatal sepsis was 2.7 per 1000 live births (94/30545) and 9.3 per 1000 neonatal admissions (94/10133). Low birth weight (≤ 2500g) was recorded in 79 (84%) neonates with sepsis. There was at least one risk factor in all cases. Gram-negative bacteria were more frequently isolated than gram-positive bacteria (63.8% (60/94) vs. 29.7% (28/94)). Klebsiella pneumonia was predominant in both early-onset sepsis and late-onset sepsis (53% (16/30), 29.7% (19/64) respectively). Late-onset sepsis episodes attributed to Klebsiella pneumonia were associated with the highest sepsis-related mortality (41.7%).
Discussion: Klebsiella pneumonia was found to be the most common agent in neonatal sepsis and responsible for sepsis-related mortality in this study. Prevalence of neonatal sepsis, its pathogens and risk factors differ in different parts of the world. Region-specific strategies to prevent new infections should be encouraged.
Keywords: Neonatal Sepsis; Neonatal Intensive Care Unit
A comparison of serum alpha-1-antitrypsin and vitamin B12 levels in patients with vitamin B12 deficiency
Yılmaz Sezgin 1, Mehtap Kartal 2, Azize Dilek Güldal 2
1 Department of Family Medicine, University of Health Science, İstanbul Educational Research Hospital, İstanbul, 2 Department of Family Medicine, Dokuz Eylül University, İzmir, Turkey
DOI: 10.4328/JCAM.5629 Received: 19.12.2017 Accepted: 05.01.2018 Published Online: 08.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 192-4
Corresponding Author: Yılmaz Sezgin, Department of Family Medicine, University of Health Science, İstanbul Educational Research Hospital, 34098 Fatih, İstanbul, Turkey. GSM: +905383425644 E-Mail: email@example.com
Aim: Alpha-1-antitrypsin (A1AT) loses its antiprotease activity as a result of oxidation of the methionine in its structure. Vitamin B12 plays an active role as a co-factor during methionine synthesis. Thus, we think that vitamin B12 deficiency may lead to decreased A1AT.
Material and Method: The research was planned as an observational study. One hundred eighty patients were enrolled. The levels of serum A1AT and vitamin B12 were compared based on demographic characteristics of the patients. Twenty-seven patients’ -who have accomplished therapeutic protocol and who have come to control visits- A1AT levels were controlled after treatment and compared with the before treatment levels.
Results: The levels of serum A1AT could not be found statistically significantly different according to the level of vitamin B12. However, in patients using any medication because of a chronic disease, the levels of serum A1AT were found higher in the group with high level of vitamin B12, than the group with the low level of vitamin B12. Serum A1AT levels were found significantly lower in obese than non-obese participants. Following treatment with vitamin B12, the levels of serum A1AT (pre-treatment 121.67±13.884, post-treatment 138.04±16.922, P=0.001) were found to be increased.
Discussion: This study’s results suggest that the level of vitamin B12 may have a significant role in the synthesis of A1AT.
Keywords: Vitamin B12; Alpha 1-Antitrypsin; Obesity
Publication rate of abstracts presented in national congress of Turkish society of anesthesiology
Kutlu Hakan Erkal, Yucel Yuce
Anaesthesiology and Reanimation Department, University of Health Sciences Kartal Dr. Lutfi Kirdar Education and Research Hospital, Kartal, Istanbul, Turkey
DOI: 10.4328/JCAM.5630 Received: 19.12.2017 Accepted: 19.01.2018 Published Online: 25.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 195-9
Corresponding Author: Yucel Yuce, Anaesthesiology and Reanimation Department, University of Health Sciences Kartal Dr. Lutfi Kirdar Education and Research Hospital, Kartal, Istanbul, Turkey. T.: +90 2164583000 F.: +90 21635200 E-Mail: firstname.lastname@example.org
Aim: This study aimed to determine the rate of conversion to scientific publication of abstracts presented at the annual congress of Turkish Society of Anesthesia and Reanimation (TARD) between the period of 2011-2013.
Material and Method: The abstracts presented at TARD Congresses in 2011, 2012, 2013 and published in various peer-reviewed medical journals were identified using PubMed and Google Scholar. In a retrospective study design, the abstracts were divided into either oral presentations(OP) or poster presentations(PP), type of the study; trial design, first author’s name and affiliated institution, mean publication time and journal name were analyzed.
Result: From a total of 2417 abstracts, 114(4.7%) were found to be published as a scientific full-text article. While the conversion rate of OP was; 24 of 187(12.8%), for PP it was 90 of 2230(4%), and the difference was statistically significant (p<0.001). Experimental studies had the highest publication rate compared to clinical studies and case reports. The publication rate of university-related anesthesia programs was higher than other hospitals. The mean time of publication after the abstract presentation was 14.4±11.4 months.
Discussion: This is the first study evaluating the publication rates of abstracts presented at TARD congress. Our study results show that conversion to publication rate of TARD congress presentations is 4.7% and this rate is relatively lower than those presented at national congress for other clinical specialties held in Turkey.
Keywords: Congress; Anesthesia; Publication; Abstract; Full-Text Article; Pubmed; Google Scholar
Evaluation of reasons for rejecting candidates for living donor liver transplantation
Ali Ozer 1, Hikmet Aktaş 2, Meltem Güner 3, Ercument Gurluler 1, Remzi Emiroglu 1
1 Organ Transplantation Department, Acibadem Atakent University Hospital, Istanbul, 2 Organ Transplantation Department, Acibadem Bursa Hospital, Bursa, 3 Anesthesiology Department, Acibadem Atakent University Hospital, Istanbul, Turkey
DOI: 10.4328/JCAM.5635 Received: 22.12.2017 Accepted: 05.01.2018 Published Online: 09.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 200-2
Corresponding Author: Ali Özer, Acibadem Atakent University Hospital, Turgut Ozal Bulvarı, Halkalı, Küçükçekmece, Istanbul,Turkey. GSM: +905332122324
Aim: The shortage of cadaveric donors has sparked an interest in living donor transplantation in Eastern countries. Obtaining an optimal graft for a recipient and avoiding jeopardizing the health of a donor is the main concern in this procedure.
Material and Method: A three-step assessment protocol was used to select the appropriate donor. The reasons for rejected candidates were analyzed to refine donor selection and minimise complications.
Results: Between January 2016 and October 2017, 290 volunteers were evaluated for living liver donation, and 88 were rejected. At each step of donor evaluation, the individuals were excluded based on laboratory, imaging or liver biopsy results. Volumetric measurement results were the most detected reason (40.9%) to reject a candidate.
Discussion: Ensuring donor safety in living donor liver transplantation is fundamental for transplant teams. Therefore, using systematic evaluation is the principal concern in this procedure.
Keywords: Donor Selection, Living Donor, Liver Transplantation
Can eight weeks of stabilization exercise change the amount of knee flexion and anterior shear force?
Faraj Fatahi 1, Gholamali Ghasemi 1, Mohamadtaghi Karimi 2, Ramin Beyranvand 3
1 Department of Sports Injuries and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, 2 Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, 3 Department of Sports Injuries and Corrective Exercises, Faculty of Sport Sciences, Shahid Bahonar University of Kerman, Kerman, Iran
DOI: 10.4328/JCAM.5638 Received: 24.12.2017 Accepted: 05.01.2018 Published Online: 09.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 203-8
Corresponding Author: Faraj Fatahi, Darvazeh Shiraz Square, University of Isfahan, Isfahan, Iran. T.: +989163188344 E-Mail: email@example.com; firstname.lastname@example.org
Aim: This study aimed to evaluate the effect of eight-week stabilization training on knee flexion and anterior shear force during a single leg drop landing to prevent ACL injury.
Material and Method: Thirty basketball athletes were randomly assigned to a training group (n = 15) and a control group (n = 15). Training group performed the Core stability training for 8 weeks, but control group did not perform these exercises. Lower extremity kinetics and kinematics variables during single-leg drop landing were collected by motion analysis and force plate in pre and post-test. Data were analyzed by using mixed ANOVA repeated measure test with significance level of P≤0.05.
Results: The results showed that the amount of knee flexion significantly increased after conducting the 8 weeks of core stability training (P< 0.05), while there was no significant decrease in anterior shear forces (P> 0.05).
Discussion: Based on the results, the core stability training by increasing the core stability can improve the core muscles recruitment during landing. Therefore, it can be concluded that core stability training can reduce the ACL injury risks during the dynamic movements.
Keywords: Stabilization Training; Kinetics; Kinematics; Single Leg Drop Landing; Acl Injury
Cochlear implantation surgery experience of a tertiary clinic
Ahmet Mutlu 1, Mete Iseri 2, Merve Durgut 3, Murat Topdag 4, Selvet Erdogan 3, Murat Ozturk 3
1 Department of Otolaryngology, Uskudar State Hospital, Istanbul, 2 Private Practice, Kocaeli, 3 Department of Otolaryngology, Kocaeli University Faculty of Medicine, Kocaeli, 4 Department of Otolaryngology, Acibadem University Faculty of Medicine, Istanbul, Turkey
DOI: 10.4328/JCAM.5639 Received: 24.12.2017 Accepted: 05.01.2018 Published Online: 10.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 209-12
Corresponding Author: Ahmet Mutlu, Barbaros Mahallesi, Veysi Pasa Sokak No:14, 34672, Uskudar, Istanbul, Turkey. GSM: +905355003650 F.: +902164747912 E-Mail: email@example.com
Aim: Cochlear implantation (CI) is a commonly performed procedure for severe to profound deafness in patients. It has been widely used for this purpose, and it becomes more complicated than expected for new institutes. In this report, we aimed to discuss the patient features, surgery indications, results of the CI surgeries in the experience of a single center.
Material and Method: We retrospectively analyzed 65 patients who were underwent CI in a tertiary hospital. Hearing loss etiologies, hearing results and postoperative complications were assessed.
Results: Sixty-five patients were evaluated within in two groups as 0-6 years-old and over 7 years-old. Twenty-nine patients were placed in 0-6 years-old group, and 36 patients were placed in over 7-years-old group. In 0-6-years-old group; 27 patients hearing loss remained idiopathic, but 1 patient had Cogan syndrome, and 1 patient had a cochlear malformation. Hearing gain of the entire group was found statistically significant (p<0.000). In over 7-years-old group; 1 patient underwent CI for each of indications: traumatic hearing loss, iatrogenic cochlear damage, Meniere’s disease, chronic otitis media, electrode renewing. The etiology of the 31 patients were not revealed in the over 7-years-old group. The hearing gain of the group was found statistically significant (p<0.000). One patient had a dural injury, and 1 patient had a round window gusher. Six patients had postoperative vertigo. Post-implantation facial nerve stimulation was revealed in 1 patient.
Discussion: CI is a very revolutionary technic for the hearing-impaired patients. The implant success is strongly related to the patient management and appropriate surgical technics
Keywords: Cochlear Implantation; Hearing Loss; Complication; Indication
The effect of high volume adrenalin solution infiltration on blood loss in reduction mammaplasty
Department of Plastic Surgery, Namik Kemal University, Tekirdağ, Turkey
DOI: 10.4328/JCAM.5641 Received: 25.12.2017 Accepted: 16.01.2018 Published Online: 17.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 213-7
Corresponding Author: Erkan Orhan, Reşat Nuri Sok. No: 71/31 Y.Ayrancı, Çankaya, Ankara, 06510, Turkey. GSM: +905325004192 F.: +90 2822509900 E-Mail: firstname.lastname@example.org
Aim: One of the important complications during and after the reduction mammoplasty operation is blood loss. The most implemented method to decrease the amount of bleeding is adrenaline infiltration, but adrenalin is mostly infiltrated with the fluid in the volume less than 250cc in the clinic. It is expected that adrenaline will accumulate more in the tissue and thus, exhibit more bleeding-reducing effect by increasing the fluid volume used in the infiltration. In this study, it is aimed to indicate the effect of the infiltration of adrenaline with the high volume fluid, on the amount of blood loss occurring due to the reduction mammoplasty operation.
Material and Method: Patients who had undergone bilateral reduction mammoplasty between July 2013 and August 2017 were retrospectively examined. Patients not subjected to infiltration were described as Group 1, patients infiltrated with adrenalin 100cc were described as Group 2, and patients infiltrated with adrenalin 500cc were described as Group 3.
Results: The average decrease in the hemoglobin level (bleeding) after the operation was calculated to be 3.4±0.97 in Group 1, 2.8±0.83 in Group 2, 1.0±0.46 in Group 3 and the average amount of bleeding in Group 2 and Group 3 in comparison with Group 1 and the average amount of bleeding in Group 3 in comparison with Group 2 were statistically significantly lower (p<0.001).
Discussion: The infiltration of adrenaline in the same concentration with a fluid of a higher volume decreases blood loss after the reduction mammoplasty operation.
Keywords: Reduction Mammoplasty; Blood Loss; İnfiltration
Risk of sharp injuries and mucocutaneous exposures in healthcare workers: ongoing problem despite prevention programs
Zeliha Haytoglu 1, Ozlem Ozgur Gundeslioglu 2
1 Department of Pediatrics, 2 Department of Pediatrics, Division of Pediatric Infectious Disease, Cukurova University, Faculty of Medicine, Adana, Turkey
DOI: 10.4328/JCAM.5648 Received: 03.01.2018 Accepted: 10.01.2018 Published Online: 11.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 218-21
Corresponding Author: Zeliha Haytoglu, Department of Pediatrics, Cukurova University, Faculty of Medicine, 01130, Adana, Turkey. GSM: +905052540485 E-Mail:email@example.com
Aim: The fact that documented cases of sharp injuries and mucocutaneous exposures are still occurring is a reminder of the importance of preventing injuries and of providing services for the prompt and appropriate management of such incidents. Our study provides an overview of the risks associated with needlestick and sharps injuries and lids a light in prevention strategies to protect the healthcare professionals.
Material and Method: Between January 2015 and September 2017 the reports of the occupational injuries in our high-technology hospital that is located in the metropolitan area with 1200 beds and 3300 healthcare workers were examined.
Results: One hundred eighty-five occupational exposures were reported. Percutaneous injuries were the most common exposure (87.5%) (161/185). Mucocutaneous exposures decreased from 16%(9/56) in 2015 to 9.4%(5/53) in 2017. Of all injuries, injuries observed in nursing professions was 49.1%. Twenty-two Hepatitis B surface antigen (HBsAg) positive, 12 Hepatitis C (HCV) and 3 human immunodeficiency virus (HIV) positive source exposures were reported. Seroconversion was not observed in workers exposed to the Hepatitis B (HBV), HCV and HIV. Of 185 workers 75 workers (40.5%) reported that they had sustained injuries without a report. The use of self-protective equipment was poor. When the exposure occurred 22% and 90% of the workers were not using gloves and goggles respectively.
Discussion: The low number of reported exposures suggests that hospital staff are not yet fully informed about possible consequences of their injuries and true number of seroconversion attributable to occupation exposures to HCV and HIV may be potentially underestimated
Keywords: Mucocutaneous Exposures; Needlestick Injuries; Seroconversion
Cecal diverticulitis mimicking acute appendicitis: Management and short-term results of surgery
Volkan Oter 1, Serdar Oter 2, Mehmet Tolga Kafadar 3
1 Department of Gastroenterological Surgery, Health Sciences University, Mehmet Akif İnan Training and Research Hospital Şanlıurfa, 2 Department of Gastroenterological Surgery, School of Medicine, Mersin Unıversity, Mersin, 3 Department of General Surgery, Health Sciences University, Mehmet Akif İnan Training and Research Hospital Şanlıurfa, Turkey
DOI: 10.4328/JCAM.5650 Received: 30.12.2017 Accepted: 10.01.2018 Published Online: 14.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 222-5
Corresponding Author: Volkan Oter, Department of Gastroenterological Surgery, School of Medicine, Sakarya Unıversity, Serdivan, Sakarya, Türkiye. GSM: +905053366333 F.: +90 2642955032 E-Mail: firstname.lastname@example.org
Aim: Cecal diverticulum is an infrequent cause of acute abdomen, and cecal diverticulitis usually presents in a behavior similar to acute appendicitis. This study aims to review our experience with surgical or nonsurgical management of cecal diverticulitis mimicking acute appendicitis in our department.
Material and Method: From January 2012 to April 2017, fourteen patients were treated for cecal diverticulitis at our clinic. We retrospectively reviewed the patients’ records, imaging modalities, and operative findings.
Results: Nine men and five women with a mean age 43.93 ± 8.95 (range 32 to 65) years were evaluated. Total of nine (64.2%) patients were managed operatively. All patients were urgently operated. The mean hospital stay was 6.11 ± 1.61 days. In the postoperative period, two patients had wound infection, and postoperative mortality was not observed. Nonoperative management was used for the treatment in five (35.7%) patients who were preoperatively diagnosed with cecal diverticulitis, Hinchey stage I or II.
Conclusion: Inflammation of the diverticulum of the cecum is an uncommon disease, but should be kept in mind in the differential diagnosis of pain in the right lower quadrant. Diagnostic laparoscopy can be used in patients and especially in women with atypical presentations of acute appendicitis. Preoperative diagnosis of cecal diverticulitis is very important in order to decide how to manage this condition.
Keywords: Cecum Diverticulitis; Management; Mimicking Acute Appendicitis
Monoblock and twinblock mandibular advancement devices in the treatment of obstructive sleep apnea
Ignazio La Mantia 1, Calogero Grillo 1, Simone Narelli 2, Claudio Andaloro 3
1 Department of Medical Sciences, Surgical and Advanced Technologies, University of Catania, Catania, 2 Dental Unit, ASP Ragusa, Ragusa, 3 Ear Nose and Throat Unit, Santa Marta e Santa Venera Hospital, Acireale, Catania, Italy
DOI: 10.4328/JCAM.5659 Received: 02.01.2018 Accepted: 08.01.2018 Published Online: 10.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 226-30
Corresponding Author: Claudio Andaloro, Ear Nose and Throat Unit, Santa Marta e Santa Venera Hospital, Via Caronia, 95024, Acireale, Catania, Italy. T.: +3909532610274 E-Mail: email@example.com
Aim: Mandibular advancement devices (MADs) are an alternative to continuous positive airway pressure (CPAP) for patients with obstructive sleep apnea syndrome (OSAS). There is conflicting evidence of how different MAD designs may affect OSAS outcomes in certain patients. This study aimed to assess and compare the effectiveness of two different MADs in treating OSAS, based on subjective and objective measurements.
Material and Method: A randomised crossover design trial was carried out on 38 patients with OSAS. A monoblock and a twinblock MAD were tested in each patient. Changes in objective outcomes (apnea-hypopnea index (AHI), total sleep time (TST), oxygen desaturation index >4% (ODI4%), total duration of oxygen saturation with less than 90% (SpO2<90%), total arousal index (TAI) and sleep efficiency) were assessed by polysomnography, changes in subjective outcomes by the Sleep Apnea Quality of Life Index (SAQLI) and Epworth Sleepiness Scale (ESS).
Results: Both MADs proved to be effective in improving several objective parameters from baseline, but when compared there was a significant difference in favor of the monoblock in terms of improving AHI, ODI 4% and total duration with SpO2<90% (p=0.032; 0.046 and 0.043, respectively). Both MADs were efficacious in improving patients’ SAQLI score and ESS score (all p<0.05), but no significant difference was observed between the two MADs.
Discussion: Use of the monoblock MAD should be considered when patients with OSAS choose MAD treatment, as it was more efficient in improving objective OSAS parameters compared to twinblock MAD.
Keywords: Obstructive Sleep Apnea; Mandibular Advancement; Quality of Life
Investigation of thiol/disulfide homeostasis in familial mediterranean fever patients
Gokhan Cakirca 1, Muhammet Murat Celik 2, Huseyin Erdal 3, Salim Neselioglu 4, Ozcan Erel 4, Mustafa Kemal Basarali 5, Tuba Damar Cakirca 6
1Department of Biochemistry, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, 2 Department of Internal Medicine, Mustafa Kemal University, Faculty of Medicine, Hatay, 3 Department of Molecular Biochemistry and Genetics, Mustafa Kemal University, Faculty of Medicine, Hatay, 4 Department of Biochemistry, Yildirim Beyazit University, Faculty of Medicine, Ankara, 5 Department of Biochemistry, Ankara Public Health Institution, Ankara, 6 Department of Infectious Diseases and Clinical Microbiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
DOI: 10.4328/JCAM.5789 Received: 26.02.2018 Accepted: 11.03.2018 Published Online: 13.03.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 231-4
Corresponding Author: Gokhan Cakirca, Biochemistry Department, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey. T.: +90 4143186000 F.: +90 4143186707 E-Mail: firstname.lastname@example.org ORCID ID: 0000-0003-1526-5899
Aim: To determine the thiol/disulfide homeostasis in patients with familial Mediterranean fever (FMF) and its correlation with the levels of inflammatory markers consisting of white blood cell count, erythrocyte sedimentation rate, C-reactive protein and fibrinogen.
Material and Method: This study was performed in the internal Medicine department of Mustafa Kemal University Hospital in Turkey. A total of 27 FMF patients in the attack period (AP), 33 FMF patients in the attack-free period (AFP), and 36 healthy controls participated in this study. Thiol/disulfide profile parameters were detected using the novel method of Erel and Neselioglu.
Results: Total and native thiol levels of the FMF-AP group were markedly lower than those of healthy controls, while the difference in disulfide level was not statistically significant. Thiol/disulfide levels in the FMF-AFP group were similar to the levels in both the FMF-AP group and healthy controls. Correlation analysis showed a negative correlation between fibrinogen levels and total and native thiol levels, while there was a positive correlation between white blood cell count and disulfide levels in the FMF-AP group.
Discussion: The findings suggest that decreased concentrations of total and native thiol in patients with FMF-AP are likely to be an outcome of inflammation-induced oxidative stress.
Keywords: Familial Mediterranean Fever; Thiol; Disulfide; Oxidative Stress; Inflammation
A case of brainstem encephalitis treated with plasmapheresis
Nagehan Aslan 1, Didar Arslan 1, Dinçer Yıldızdaş 1, Emine Kocabaş 2, Özden Özgür Horoz 1, Özlem Hergüner 3, Derya Alabaz 2, Özlem Özgür Gündeşlioğlu 2
1 Çocuk Yoğun Bakım Bilim Dalı, 2 Çocuk Enfeksiyon Bilim Dalı, 3 Çocuk Nöroloji Bilim Dalı, Çukurova Üniversitesi Tıp Fakültesi, Adana, Türkiye
DOI: 10.4328/JCAM.5390 Received: 26.09.2017 Accepted: 27.11.2017 Publihed Online: 27.11.2017 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 235-8
Corresponding Author: Nagehan Aslan, Çocuk Yoğun Bakım Bilim Dalı, Çukurova Üniversitesi Tıp Fakültesi, Sarıçam, Adana, Türkiye. GSM: +905055499986 E-Mail: email@example.com
Brain stem encephalitis is a rare disease, which can be triggered by infection, with an unclear etiology, in which infectious and autoimmune mechanisms are thought to play a role in the pathogenesis . Major clinical symptoms are ataxia, muscle weakness and ocular and bulbar dysfunction . Its etiology can vary from infection to autoimmune reasons. Listeria, enterovirus type 71 and Herpes simplex virus are the most common infectious causes. It may also be caused by neurobehcets, Bickerstaff’s encephalitis, autoimmune diseases such as multiple sclerosis and paraneoplastic reasons [3-5]. With those in mind, the underlying etiology is unclear in most cases . Treatment is based on etiology. Immunosuppressive treatment can be tried in brain stem encephalitis patients whose etiology can not be made clear . In this case report, we present a case of brainstem encephalitis which did not respond to the present treatment and was treated with plasmapheresis.
Keywords: Brain Stem Encephalitis; Plasmapheresis
Bilateral cortical blindness after recurrent ischemic stroke
Murat Uysal 1, Serhat Karaman 2
1 Department of Anatomy, 2 Department of Emergency Medicine, Gaziosmanpasa University, Faculty of Medicine, Tokat, Turkey
DOI: 10.4328/JCAM.5516 Received: 18.12.2017 Accepted: 08.01.2018 Publihed Online: 10.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 239-41
Corresponding Author: Serhat Karaman, Department of Emergency Medicine, Gaziosmanpasa University, Tokat, Turkey. T.: +90 3562149444 F.: +90 3562133179 E-Mail: firstname.lastname@example.org
Cerebrovascular diseases, which are the third most common cause of death after cardiovascular diseases and cancer, represents an enormous public health burden. Visual loss caused by geniculocalcarine visual pathways are named cortical blindness. The causes of cortical blindness include head trauma, episodes of hypoglycemia or hypotension, cardiac arrest, stroke, tumor and occipital lobe epilepsy. We present a case of right occipital cortex with encephalomalacic change after a previous ischemic stroke and total cortical blindness with a newly developing ischemic stroke in the left occipital cortex.
Keywords: Cerebrovascular Disease; Bilateral Cortical Blindness; Stroke
Successful treatment with home care in a second-half twin pregnancy complicated with a too short cervix: a case report
Tahereh Zahedifard 1, Mohammad Zarei 2, Reza Nori 3
1 Department of Midwifery, Quchan Branch, Islamic Azad University, Quchan, 2 Nursing Department, Shirvan Center of Higher Health Education, North Khorasan University of Medical Sciences, Bojnurd, 3 Department of Nursing, Bojnurd Branch, Islamic Azad University, Bojnurd, Iran
DOI: 10.4328/JCAM.5634 Received: 22.12.2017 Accepted: 05.01.2018 Publihed Online: 07.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 242-4
Corresponding Author: Mohammad Zarei, Nursing Department, Shirvan Center of Higher Health Education, North Khorasan University of Medical Sciences, Bojnurd, Iran. GSM: +989151811304 T./F.: +985836248988 E-Mail: email@example.com
A 34-year-old primiparous female patient with twin pregnancy presented in the 26th week of pregnancy with a cervical length of 11 mm, with prolapse of membranes. The patient received a special kind of bed rest and supportive proceedings and the pregnancy completed successfully at 36 weeks and 5 days. In the second half of pregnancy, due to the risk of emergency cerclage, expectant management seems an appropriate and safe approach.
Keywords: Pregnancy; Cervix Disorders; Homecare
A rare cause in the differential diagnosis of abdominal pain: stercoral colitis
Cihan Bedel 1, Ural Koç 2
1 Emergency Medicine Department, Antalya Training And Research Hospital, Antalya, 2 Radiology Department, Erzincan Mengücek Gazi Training and Research Hospital, Erzincan, Turkey
DOI: 10.4328/JCAM.5637 Received: 23.12.2017 Accepted: 10.01.2018 Publihed Online: 11.01.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 245-7
Corresponding Author: Cihan Bedel, Antalya Training and Research Hospital, 07100, Muratpaşa, Antalya,Turkey. GSM: +905075641254 E-Mail: firstname.lastname@example.org
Stercoral colitis is a rare and often fatal complication of constipation. Diagnosis of stercoral colitis is made in only 10% of patients before surgery. A 45-year-old female presented to the emergency department with abdominal pain and constipation. Computerized abdominal tomography was suitable with the diagnosis of stercoral colitis. Stercoral colitis complications are related to high mortality and morbidity. Early diagnosis and treatment should be started. We have presented a rare case of “stercoral colitis” and have observed the diagnosis and treatment methods in the light of literature information.
Keywords: Stercoral Colitis; Constipation; Abdominal Pain
A very rare case of sphenoid lymphoma presenting as cavernous sinus syndrome
Taylan Gun 1, Aslan Guzel 2
1 ENT Department, Faculty of Medicine, Bahçeşehir University, Ankara Medical Park Hospital, Ankara, 2 Neurosurgery Department, Bahçeşehir University, Faculty of Medicine, Gaziantep Medical Park Hospital, Gaziantep, Turkey
DOI: 10.4328/JCAM.5669 Received: 23.01.2018 Accepted: 20.02.2018 Publihed Online: 22.02.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 248-50
Corresponding Author: Taylan Gun, Ankara Medical Park Hospital Kentkoop Mah. 1868 Sok. No:15, Batıkent, Ankara, Turkey. Tel: +90 3126668000 GSM: +905323435019 F.: +90 3126668666 E-Mail: email@example.com
A 4-year-old boy admitted to our clinic with unilateral ophthalmoplegia, ptosis, and proptosis. He has been suffering the symptoms of a headache, nausea, dyspnea, fatigue, weakness, and loss of appetite for about three months. Complete blood count showed an increased white blood cell count with 77% blast cells, anemia, and thrombocytopenia. Magnetic resonance imaging (MRI) examination revealed the mass was obliterating the sphenoid and cavernous sinuses also causing osseous changes of the sinus walls. We performed endoscopic surgical decompression to relieve the symptoms of cavernous sinus syndrome also to obtain enough tissue samples for pathologic diagnosis. Pathologic examination revealed that the mass was diffuse B cell non-Hodgkin lymphoma and the patient was referred to pediatric oncology department for further treatment.
Keywords: Non-Hodgkin Lymphoma; Cavernous Sinus Syndrome; Ophthalmoplegia
A case of Fahr’s disease presenting with seizures
Cihan Bedel 1, Göker Coşkun 2
1 Emergency Medicine Department, Antalya Training And Research Hospital, Antalya, 2 Medicine Department, Süleyman Demirel University Faculty of Medicine Emergency, Isparta, Turkey
DOI: 10.4328/JCAM.5687 Received: 14.01.2018 Accepted: 14.02.2018 Publihed Online: 16.02.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 251-3
Corresponding Author: Cihan Bedel, Acil Tıp ABD, Antalya Eğitim ve Araştırma Hastanesi, Antalya, Turkey. GSM: +905075641254 E-Mail: firstname.lastname@example.org
Fahr’s disease is a rare idiopathic bilateral and symmetrical calcification of the basal ganglia, thalami, subcortical hemispheric white matter and deep cerebellar nuclei. We report an unusual case of Fahr’s disease in a 53-year-old man who presented with generalized seizure in our emergency department. Based on clinical, radiological and endocrinological appearance, the patient was diagnosed with Fahr’s disease associated with hypoparathyroidism. Parenteral calcium and calcitriol supplementation were given in the emergency department. The clinical outcome was favorable after the treatment. Our case illustrates that Fahr’s disease, though rarely seen, has to be considered in a patient with convulsive state associated with calcifications of the basal ganglia.
Keywords: Fahr’s Disease; Hypoparathyroidism; Seizure
Lneonatal meningitis due to streptoccocus dysgalactiae subspecies equisimilis: a case report and literature review
Nuriye Tarakci 1, Fatma Hilal Yılmaz 1, Nazlı Dilay Gültekin 1, Hüseyin Altunhan 1, Rahmi Örs 2
1 Department of Neonatology, Meram Medical Faculty, Necmettin Erbakan University, 2 Medova Hospital, Konya, Turkey
DOI: 10.4328/JCAM.5697 Received: 17.01.2018 Accepted: 14.02.2018 Publihed Online: 16.02.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 254-6
Corresponding Author: Nuriye Tarakci, Department of Neonatology, Meram Medical Faculty, Necmettin Erbakan University, Konya 42080, Turkey. T.: +90 3322236000 F.: +90 3322236585 E-Mail: email@example.com
Streptococcus dysgalactiae subsp. equisimilis (SDSE) was firstly reported as a toxon among human streptococcal pathogens in the year 1996. Diseases caused by SDSE may vary from milder skin involvements including wound infection, erysipelas, and cellulitis to life-threatening clinical pictures as streptococcal toxic shock syndrome and necrotizing fasciitis. We describe a case of SDSE sepsis and meningitis in a 2-day-old newborn. He was referred to our intensive care unit (ICU) with fever, respiratory distress, seizures, peripheral cyanosis, and somnolence. SDSE grew out of the CSF and blood cultures obtained on admission to the ICU. SDSE cases reported in the literature are frequently older patients with an underlying disease. Also, SDSE may cause serious neonatal infections.
Keywords: Streptococcus Dysgalactiae Subspecies Equisimilis; Neonate; Meningitis
If no suspection, then no diagnosis: A case report
Emin Kürşat Bulut 1, Ömer Faruk Ateş 2, Galip Beltir 1
1 Department of Orthopedics, Ankara Oncology Training and Research Hospital, 2 Department of Radiology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
DOI: 10.4328/JCAM.5713 Received: 19.01.2018 Accepted: 20.02.2018 Publihed Online: 22.02.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 257-9
Corresponding Author: Galip Beltir, Ankara Oncology, Hospital, Ankara, Turkey. GSM: +905424045370 E-Mail: firstname.lastname@example.org
In this study, we examined the history and examination outcomes with differential diagnosis and further investigations of a 17-year old female patient with left wrist pain for about 3 years. It was reported the difficulty in diagnosis of a disease which can be presented in the wrist with atypical findings and that it must be considered in the differential diagnosis.
Keywords: Diagnosis; Wrist; Pain; Tumor
A hidden etiology in a case of recurrent carpal tunnel syndrome: Giant cell tumor of the tendon sheath
Galip Beltir 1, Şefik Murat Arıkan 1, Ömer Faruk Ateş 2, Füsun Ardıç Yükrük 3, Sadettin Dolar 4
1 From Department of Orthopaedics and Traumatology, Ankara Oncology Training and Research Hospital, Ankara, 2 From Department of Radiology, Ankara Atatürk Training and Research Hospital, Ankara, 3 From Department of Pathology, Ankara Oncology Training and Research Hospital, Ankara, 4 From Department of Internal Medicine, İzmir Ege Üniversity Hospital, İzmir, Turkey
DOI: 10.4328/JCAM.5721 Received: 24.01.2018 Accepted:23.02.2018 Published Online: 25.02.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 260-3
Corresponding Author: Galip Beltir, Ankara Oncology Hospital, Ankara, Turkey. GSM: +905424045370 E-Mail: email@example.com ORCID ID: 0000-0003-0452-4541
Giant cell tumors of the tendon sheath are the second most common neoplasms of hand and one of the rare reasons of carpal tunnel syndrome. Usually, the findings include swelling, tingling, pain, and loss of sense associated with the mass. A 54-year-old female patient with recurrent carpal tunnel syndrome had a massive lesion that was not detected on physical examination, but carpal tunnel compressed by the giant cell of the tendon sheath was detected through advanced investigations. Symptoms were resolved after surgical excision.
Keywords: Carpal Tunnel Syndrome; Hand; Wrist; Giant Cell Tumor