Effectiveness of oral zinc sulphate, oral methotrexate and their combination in the treatment of psoriasis
Jawad H. Ahmed, Saad Raheem Abd, Khalil I. Al-Hamdi
J Clin Exp Invest 2010;1(3):143-149.
https://doi.org/10.5799/ahinjs.01.2010.03.0031
Research Article
[Abstract]
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ABSTRACT
Objectives: To evaluate the effectiveness of oral zinc sulphate in treatment of psoriasis alone or in combination with methotrexate.
Materials and methods: A Total of 60 patients with psoriasis vulgaris were recruited for the study during the period October 2006 to October 2007. The patients were divided in to three groups according to their systemic treatments, as follows: Patients in Group1 (20 patients) were treated with oral zinc sulphate, Group 2 (20 patients) were treated with zinc sulphate plus oral methotrexate and patients in Group 3 (20 patients) were treated with oral methotrexate alone.
Results: There were 34 (56.7%) men and 26 (43.3%) women, with a male: female ratio 1.3:1.Their age ranged from 15-70 years with a mean of 32±11 years. Oral zinc sulphate produced a good response in about 60% of the cases; with a relapse rate amounts to 58% noticed 4 weeks after cessation of treatment. Combination of oral zinc sulphate and methotrexate induced a good response in 85% of the patients, with a relapse rate of 59 % that was noticed 4 weeks after treatment cessation. Methotrexate alone induced a good response in 70% of the patients with a relapse rate of 64%. Mild adverse effects were reported in 30% of the cases on zinc sulphate treatment.
Conclusion: Zinc sulphate is an effective treatment of psoriasis but the combination of zinc sulphate plus methotrexate could be more effective than zinc sulphate or methotrexate alone.
Keywords: Psoriasis, zinc sulphate, methotrexate, treatment, relapse
Approaching tobacco dependence in youngsters: impact of an interactive smoking cessation program in a population of Romanian adolescents
Antigona Trofor, Stefan Mihaicuta, Milena Adina Man, Ramona Miron, Valentina Esanu, Letitia Trofor
J Clin Exp Invest 2010;1(3):150-155.
https://doi.org/10.5799/ahinjs.01.2010.03.0032
Research Article
[Abstract]
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ABSTRACT
Objectives: The main objective of this study was to investigate the effectiveness of an interactive smoking cessation program when first implemented in a naïve population of Romanian adolescents. The secondary objective was to assess youngsters’ attitudes and beliefs towards tobacco dependence, their compliance to smoking cessation interventions and success rate of a standard smoking cessation pilot program.
Materials and methods: A total of 231 subjects 14-19 years old participated in the Adolescent Smoking Cessation (ASC) pilot program in Romania in 2005. Subjects were evaluated based on the ASC questionnaire, a validated set of questions about smoking and cessation profile, whether current smoker or not. Smoking status was validated by carbon monoxide determination in exhaled air. Participants were delivered 6 interactive ASC sessions about smoking hazards and methods to quit smoking. A final evaluation was done to assess overall program’s impact and to reward quitters and reducers by prizes.
Results: Study population was made of 52.4% every day smokers, 10.4% at least once/week but not every day smokers, 6% less than once/week smokers, 23.4% never smokers and 7.8% ex-smokers. Cessation rate was 12.3% in every day smokers and 16.6 % in at least once a week but not every day smokers. Also, 4.1% every day smokers and 30 % at least once/week not every day smokers reduced number of cigarettes smoked/day. The program registered a high attendance rate/sessions as 85.2 % of subjects were present in all sessions. Also, significant changes occurred in participant’s beliefs about smoking and cessation.
Conclusion: Pilot ASC was an efficient program with 12.3% of daily smokers to quit smoking and its positive impact on personal smoking and cessation beliefs in 90 % of participants.
Keywords: Smokers, smoking cessation, adolescents, peers, pilot project
The effects of iron deficiency anemia on the thyroid functions
Erdem Gökdeniz, Cengiz Demir, İmdat Dilek
J Clin Exp Invest 2010;1(3):156-160.
https://doi.org/10.5799/ahinjs.01.2010.03.0033
Research Article
[Abstract]
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ABSTRACT
Objectives: The aim of the present study was to investigate the effect of iron deficiency anemia and iron treatment on the thyroid functions.
Materials and methods: In this study, 42 patients and 38 healthy individuals were studied. Iron deficiency anemia was diagnosed by measurement of serum ferritin and complete blood counts. Free Triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine, total thyroxine, thyroid stimulating hormone (TSH) and cortisol levels were measured in blood samples before treatment and after two months of treatment with iron in patients group and after 12 hours of starvation in healthy controls.
Results: Before iron treatment, secondary hypothyroidism (35.7%) and subclinical hypothyroidism (16.6%) were found in patient group. Before the treatment TSH levels in the patient group were higher than the control group (p=0.001). FT3 values were not different between patient and the control groups (p>0.05). Before the treatment FT4 levels were significantly lower than the control group (p<0.001) and FT4 values significantly increased after treatment (p=0.001). Cortisol levels before treatment were significantly higher than the control group (p=0.001). Cortisol levels were significantly decreased after iron treatment in the patient group (p<0.001).
Conclusions: Secondary and subclinical hypothyroidism were found in iron deficiency anemia. Hormonal changes returned to normal values with iron supplementation.
Keywords: Iron deficiency, anemia, thyroid functions, secondary and subclinical hypothyroidism, iron supplementation
Direct versus indirect strategies for thyroid hormone reference intervals established in a middle-aged and elderly population on an immunoassay analyzer
Sedat Motor, Gönül Erden, Birsen Sahillioğlu, Serpil Erdoğan, Mustafa Metin Yıldırımkaya
J Clin Exp Invest 2010;1(3):161-167.
https://doi.org/10.5799/ahinjs.01.2010.03.0034
Research Article
[Abstract]
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ABSTRACT
Objectives: Establishment of reference values by direct strategy for selection of reference individuals is time-consuming and expensive for laboratories. The aim of this study was to establish reference intervals for thyrotrophin(TSH), free thyroxine (FT4), free triiodothyronine (FT3) in a middle-aged and elderly population (age range; 40-80 years) on an immunoassay analyzer using both direct and indirect strategies, and to compare the results of direct and indirect strategies.
Materials and methods: As for direct sampling strategy, healthy reference individuals were randomly selected (129 male, 131 female; age range: 40-80) by questionnaire. As for indirect sampling strategy, the results of TSH, FT3, FT4 measurements of all individuals (male, n=3060-3920; female, n=4090-4520; age range 40-80 years), were selected from laboratory information system. Reference intervals were calculated by nonparametric methods
Results: The following 95% reference intervals were determined: For direct sampling group: TSH 0.32-4.38 µIU/mL; FT4 0.75-1.32 ng/dL; FT3 1.98-3.65 pg/mL. For indirect sampling group: TSH 0.29-4.36 µIU/mL; FT4 0.71-1.37 ng/dL; FT3 1.69-3.32 pg/mL. Indirect sampling group showed a good concordance in the reference intervals for TSH and FT4 with direct sampling group.
Conclusion: Indirect sampling strategy and nonparametric method may be confidently used to evaluate the reference intervals of serum TSH and FT4 on an analyzer. We suggested the utilization of a very simple and practical way, indirect sampling strategy, for evaluating reference intervals for elderly population.
Keywords: Direct method, indirect method, reference intervals, thyrotrophin, free thyroxine, free triiodothyronine
Thrombophilic risk factors in women with recurrent abortion
Osman Yokuş, Özlem Şahin Balçık, Murat Albayrak, Funda Ceran, Mesude Yılmaz, Simten Dağdaş, Gülsüm Özet
J Clin Exp Invest 2010;1(3):168-172.
https://doi.org/10.5799/ahinjs.01.2010.03.0035
Research Article
[Abstract]
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ABSTRACT
Objectives: The aim of this study was to determine the thrombophilic risk factors and their frequency among women with history of recurrent abortion and a detected thrombophilic defect.
Materials and methods: In this study, 41 women with history of recurrent abortion, who have one or more detected thrombophilic defects including protein S, protein C, antithrombin deficiency, activated protein C resistance (APC-R), factor V Leiden (FVL), prothrombin G 20210A (PTG), methylenetetrahydrofolate reductase (MTHFR) C677 T gene mutation, antiphospholipid antibodies and elevated levels of factor VIII were retrospectively investigated.
Results: The most common detected thrombophilia defect (53.7%) was MTHFR gene mutation. While 22 of 41 patients (53.7%) had more than one concomitant defect, 20 of them had two concomitant defects and the remaining had three defects.
Conclusion: MTHFR gene mutation, alone and/or with, concurrent thrombophilic defects was the most frequent factor for hereditary thrombophilia among our patients with a history of recurrent abortion.
Keywords: thrombophilia; clinical thrombophilia, recurrent abortion, factor V Leiden gene mutation, actived protein-C resistance, methylenetetrahydrofolate reductase gene mutation, prothrombin G20210A gene mutation, protein C deficiency, protein S deficiency; anticardiolipin antibody, lupus anticoagulant
A different insight into blood coagulation in vitro
Osman Evliyaoğlu, Selvi Kelekçi, M. Kemal Başaralı, Birgül Işık, Beri Hocaoğlu Bozarslan, Hanım Karahan
J Clin Exp Invest 2010;1(3):173-176.
https://doi.org/10.5799/ahinjs.01.2010.03.0036
Research Article
[Abstract]
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ABSTRACT
Objectives: The known model of blood coagulation involves a series of zymogen activation reaction sequences. At each stage, a zymogen is converted to an active protease by cleavage of one or more peptide bonds in the precursor molecule. The aim of this study was to investigate amino acid profiles during coagulation process in different conditions in vitro.
Methods: Samples of serum and plasma (treated by EDTA or citrate) were obtained from healthy donors and from patients with Phenylketonuria (PKU). Amino acid profiles analyzed with reverse phase HPLC column.
Results: There were no differences between two plasma amino acid levels which were obtained by EDTA and acid citrate (p>0.05). Serum aspartate (asp), glutamate (glu), serine (ser), histidine (his) and phenylalanine (phe) levels were significantly higher in serum than plasma (p<0.05). This significant difference was not observed in patients with PKU.
Conclusion: As a result the enzymatic reactions of coagulation process generate some aminoacids and these reactions take place in an appropriate chemical microenvironment. This microenvironment can be used to clarify the stages of coagulation cascades with further studies.
Keywords: Coagulation, amino acids, Phenylketonuria, in vitro
Effect of imaging time on post stress left ventricular ejection fraction and volume measures by gated myocardial perfusion single photon emission computed tomography
Zeki Dostbil, Mehmet Ali Elbey, Zuhal Arıtürk, Habib Çil, Ebru Tekbaş, Bekir Taşdemir
J Clin Exp Invest 2010;1(3):177-181.
https://doi.org/10.5799/ahinjs.01.2010.03.0037
Research Article
[Abstract]
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ABSTRACT
Objectives: Post-stress left ventricular ejection fraction (LVEF) and LV volumes have incremental value in predicting cardiac death (CD) in patients with coronary artery disease. In this study, we aimed to investigate the effect of imaging time after exercise on post-stress LVEF, end-diastolic volume (EDV) and end-systolic volume (ESV) calculated by cardiac quantification software program called Quantitative Gated SPECT (QGS-Cedars-Sinai).
Materials and methods: This study was consisted of 36 patient referred to Nuclear Medicine Department from Cardiology Clinics because of chest pain in ‘Elazig Research and Training Hospital’ in 2008-2009. In all patients, ECG Gated (8-bin frame mode) myocardial perfusion SPECT scintigraphy was performed 20 and 40 min later following 99mTc-Mibi injection during exercise. By means of the cardiac quantification software program called Quantitative Gated SPECT (QGS-Cedars-Sinai); LVEF, EDV and ESV were calculated. LVEF, EDV and ESV values obtained from initial and second acquisition were compared statistically.
Results: There was no statistically significant difference between post-stress LVEF, EDV and ESV measures of initial and second acquisition (p>0.05).
Conclusion: Left ventricular functional parameters after exercise are important for assess prognosis in patients with CAD. Post-stress LVEF, EDV and ESV measured on gated myocardial perfusion SPECT images within 20-40 min after completion of exercise give reproducible information.
Keywords: Cardiac gated SPECT, left ventricular function, imaging, QGS
Frequency of extended spectrum beta-lactamase and resistance to antibiotics in Escherichia coli strains isolated from urinary cultures
Özcan Deveci, Erkan Yula, Alicem Tekin
J Clin Exp Invest 2010;1(3):182-186.
https://doi.org/10.5799/ahinjs.01.2010.03.0038
Research Article
[Abstract]
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ABSTRACT
Objectives: Extended spectrum beta-lactamases (ESBL), are enzymes which can hydrolise cephalosporins and monobactams and usually responsible for resistance to beta-lactam antibiotics in Gram negative bacilli. The presence of ESBL in Escherichia coli strains isolated from urine samples in a State Hospital, was investigated and the sensitivity of these strains to some antibiotics was examined.
Materials and methods: E. coli strains isolated from urinary cultures were identified by conventional methods. Antimicrobial susceptibility tests have been studied by using “Kirby-Bauer disk diffusion method”. Extended Spectrum β-Lactamase producing E. coli strains have been detected by using “double disk synergy test”.
Results: In this study, the prevalence of ESBL producing isolates among E. coli was found to be 13%. The antimicrobial resistance rates of ESBL positive strains to many antibiotics which were not substrate for these enzymes were found higher than those of ESBL negative strains (p<0.05).
Conclusion: Since resistant strains isolated from urinary tract infections frequently show multiple resistances, selection of antibiotic should be made by considering results of antibiotic susceptibility tests in treatment. Determination of ESBL production and reporting antimicrobial susceptibility testing will be important for enhancing the success of treatment.
Keywords: Extended spectrum beta-lactamase, Escherichia coli, antimicrobials, resistance
The effects of iron deficiency anemia and its treatment on P wave durations and parameters of diastolic function
Hakkı Şimşek, Hasan Ali Gümrükçüoğlu, Yüksel Kaya, Musa Şahin, Mustafa Tuncer, Cengiz Demir, Yılmaz Güneş
J Clin Exp Invest 2010;1(3):187-194.
https://doi.org/10.5799/ahinjs.01.2010.03.0039
Research Article
[Abstract]
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ABSTRACT
Objectives: We aimed to compare P wave variables and LV diastolic function between patient with iron deficiency anemia (IDA) and healthy control group and to investigate the effects of anemia treatment on these parameters.
Materials and methods: The study included 56 patients having IDA without cardiovascular dissease and 50 healthy subjects. The cases were evaluated with clinical examination, ECG and transthoracic echocardiography (TTE) before and after treatment of IDA. Tissue Doppler imaging was assessed in addition to conventional TTE. The difference between maximum (Pmax) and minimum P wave duration on the 12-leads ECG was defined as PWD.
Results: Compared to control group left atrium (LA) diameter (p=0.02), left ventricular enddiastolic diameter (LVED) (p=0.001), frequency of LV diastolic dysfunction (LVDD) (p=0.02), Pmax (p=0.002) and PWD (p=0.001) were significantly increased in patients with IDA. Correlations analysis revealed that PWD (r=0.367, p=0.001) and frequency of LVDD(r=0.231, p=0.02) were significantly correlated with severity of anemia. Compared to pre treatment period; LA diameter (p=0.001), LVED (p=0.001), frequency of LVDD (p=0.001), Pmax (p=0.001), Pmin (p=0.001) and PWD (p=0.001) were significantly decreased after treatment.
Conclusion: IDA may be associated with increased PWD, left heart dimensions and frequency of LVDD in paralel with severity of anemia. These parameters may improve with treatment of anemia.
Keywords: Iron deficiency anemia, diastolic dysfunction, P wave dispersion
Is Anesthesiologist’s experience important while inflating the endotracheal tube cuff with the right pressure?
Alkin Çolak, Cavidan Arar, Sevtap Hekimoğlu Şahin, Ali Söker, Işıl Günday, Nesrin Turan
J Clin Exp Invest 2010;1(3):195-198.
https://doi.org/10.5799/ahinjs.01.2010.03.0040
Research Article
[Abstract]
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ABSTRACT
Objectives: Cuff pressure in endotracheal tubes should be in the range of 26–30 cm H2O. In this study we aimed to examine whether anesthesiologist’s experience is important while inflating the endotracheal tube correctly after the intubation.
Materials and methods: The patients who were included to the study were intubated after the induction of general anesthesia. The patients were divided into 4 groups according to the training year of the anesthesia research assistant resident inflating the endotracheal tube (ET) cuff. Group I (n=64) the cuff pressure which were inflated by the first year residents; Group II (n=92) the cuff pressure which were inflated by the 2nd year residents; Group III (n=144) the cuff pressure which were inflated by the 3rd year residents; Group IV (n=93) the cuff pressure which were inflated by the 4th year residents were measured by manometer.
Results: When we compared the cases in which the cuff pressure were between 26-30cm H2O we found that the best results were in Group II and respectively in Group III and IV and the worst results were in Group I. The difference between Group II and Group I were statistically significant (p<0.05).
Conclusion: We believe that manometer should be used ET for cuff pressure setting and monitoring.
Keywords: General anesthesia, ntubation, cuff pressure, residents
The opinions of nurses regarding the orientation training
Gül Pınar, Aysun Doğan, Yeter Kırlangıç, Çiğdem Özdemir
J Clin Exp Invest 2010;1(3):199-205.
https://doi.org/10.5799/ahinjs.01.2010.03.0041
Research Article
[Abstract]
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ABSTRACT
Objectives: The aim of this study was to investigate the opinions of nurses regarding the orientation training.
Materials and methods: This research is a descriptive type of study. Since it is planned that all the nurses (N=250) in Baskent University Ankara Hospital will be in the scope of the research, sampling was not performed. The number of nurses who are reached and agreed to join the research is 203. Hence, 80% of them are reached. The researchers prepared a questionnaire containing 30 questions after examining the literature. The questionnaire was carried out between April 15 and May 15 2008 to participants.
Results: The mean age is 23±5.29 years and 97% of the nurses are female, 50.2% of them are male from Health College. Of all, 55.2% of them have worked less than 3 years. A total of 91.1% of the nurses stated that orientation training must be carried out and 80.3% of them who attended to orientation training think that the training is adequate.
Conclusion: The nurses stated that the materials were adequate and organized while evaluating the orientation training which they attended, moreover they emphasized that the training should be given periodically rather than by classical method.
Keywords: Training, orientation, clinical orientation, nurse
Evaluation of phalangeal osteoid osteoma in hand with respect to late diagnosis
İsmail Ağır, Cihangir Tetik, Bülent Erol, Hakan Başar
J Clin Exp Invest 2010;1(3):206-210.
https://doi.org/10.5799/ahinjs.01.2010.03.0042
Research Article
[Abstract]
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ABSTRACT
Objectives: Osteoid osteoma in the hand, especially in the phalanges is presented with nonspesific clinical and radiologic findings and are seen infrequently in that localization. Therefore, the diagnosis of osteoid osteomas in these localization is difficult. In present study, we evaluated seven phalangeal osteoid osteomas in hand with respect to late diagnosis.
Patients and methods: Seven patients (5 females, 2 males; mean age 21 years; range 17 to 23 years) who underwent surgery for hand phalangeal osteoid osteoma were investigated. Lesions were seen at four cases in right hand and at three cases in left hand. Twelve months was the longest diagnosis time while the earliest diagnosis time is 4 months among seven cases (mean 9 months).
Results: In all cases lesions were seen in proximal falanges. The affected fingers were the second finger in four patients, third finger in one patient and fourth finger in two patients. All patients had been treated with nonsteroidal anti enflamatuar drugs before the diagnosis. Symptoms were relieved but did not disappear completely. The diagnosis was done by scintigraphy with increase activity and the nidus localization in some patients by computed tomography but by conventional radiograpy diagnosis was done in none of patients. Histopathological examinations of the peroperative biopsies confirmed diagnosis of osteoid osteoma in all cases. In two cases, lesions were treated by high speed burr, at the rest five patients were curettaged.
Conclusion: Osteoid osteoma should be kept in mind in situations such as, painless swelling in hand fingers without trauma, prolonged pain and swelling after minimal trauma, single finger clubbing deformity, and bone scintigraphy and multisliced CT should be performed beside conventional radiography.
Keywords: Bone tumors, hand , phalanx, osteoid osteoma, delayed diagnosis
Celiac disease presenting with extraintestinal manifestations
Şule Bilen, Memet Aslanyavrusu, Aylin Bolat, Fikri Ak
J Clin Exp Invest 2010;1(3):211-213.
https://doi.org/10.5799/ahinjs.01.2010.03.0043
Case Report
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ABSTRACT
Celiac disease (CD) is a multiorgan involved systemic disease that most commonly affects the gut but also affects other organs. Up to 10% of patients with CD and gastrointestinal symptoms have otherwise unexplained neurological presentations. In this paper we report a case with the final diagnosis of celiac disease while being investigated for the underlying etiology of iron deficient anemia, peripheral neuropathy, and gait and speech disturbances.
Keywords: Celiac disease, gluten sensitivity, speech disturbance, peripheral neuropathy, gait disturbance
Spinal anesthesia with small dose bupivakain in the highly elderly patient
Feyzi Çelik, Adnan Tüfek, Zeynep Baysal Yıldırım, Haktan Karaman, Halit Baykan, Gönül Ölmez Kavak, Vildan Temel
J Clin Exp Invest 2010;1(3):214-215.
https://doi.org/10.5799/ahinjs.01.2010.03.0044
Case Report
[Abstract]
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ABSTRACT
The most patients that are applied hip and lower-extremity surgery are in the elderly group. The presence of cardiac, endocrine, renal, cerebral and respiratory diseases in this age group increases the risk of peroperative, postoperative morbidity and mortality.
In this case, it is presented the managing of anesthesia of a 106 year-old man whom the operation of right hip prosthesis is made.
Keywords: Bupivacaine, spinal anesthesia, hip fractures, elderly patient
Is end-stage renal disease always symptomatic?
Rabia Alkan, Ebru Uz, Özlem Şahin Balçık, Burak Uz, Yeter Bayram
J Clin Exp Invest 2010;1(3):216-218.
https://doi.org/10.5799/ahinjs.01.2010.03.0045
Case Report
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ABSTRACT
Chronic kidney disease presenting acutely is not uncommon, often avoidable and associated with adverse outcomes. In the early stages of chronic kidney disease, there may be no symptoms. However, when kidney function is less than one-tenth of normal, the symptoms may arise. The patients in end-stage renal disease may also present with nonspecific symptoms. A 46 year old man admitted to our hospital with knee pain. He had no other complaints. His blood urea and creatinin levels were 232 mg/dl and 19.5 mg/dl respectively. He was anemic and venous blood gas revealed pH: 7.10, HCO3-: 10 mEq/L. But his physical examination was normal. The glomerular filtration rate was greatly reduced, altough his blood pressure was within normal limits. Hemodialysis had been initiated immediately and within 24 hours blood urea nitrogen had decreased to 145 mg/dl. The clinicians must be aware of non-spesific symptoms such as arthralgia, which should masquerade the underlying chronic kidney disease. The identification, follow-up and appropriate referral of patients with raised serum creatinine is likely to reduce its incidence.
Keywords: chronic kidney disease, glomerular filtration rate, hemodialysis, kidney function tests, acidosis
A general evaluation on pulmonary nocardiosis due to three patients presenting with a mass like radiographic appearance on chest X-ray
İrfan Uçgun, Füsun Alataş, Bengü Doğan
J Clin Exp Invest 2010;1(3):219-225.
https://doi.org/10.5799/ahinjs.01.2010.03.0046
Case Report
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ABSTRACT
Pulmonary nocardiosis is an important cause of opportunistic infection in immune-compromised patients. Pulmonary nocardiosis manifests as an acute, subacute or chronic infection. Although, there is specific treatment, there are usually difficulties in its diagnosis and, therefore nocardiosis already has a high rate of mortality.
All of the nocardia infections of our study were pulmonary nocardiosis. The first case of our study was receiving immunosuppressive drugs after renal transplantation; second patient was receiving high dose corticosteroid and methotrexate due to the systemic lupus erithematosus; and third patient was newly diagnosed acute renal failure. All the diagnosis of pulmonary nocardiosis was done by isolation of the organism from bronchial lavage fluids. All patients were healed and discharged. The duration of therapy was 12 months in the first patients, 2 months in the second and 3 months in the third patient.
According to results of our cases we concluded that nocardia tends to affect patients with cellular immune-compromised, physicians should notify the laboratory staff when Nocardia is suspected and the duration of therapy depends on the severity and the host’s immune status.
Keywords: Nocardiosis, pneumonia, immune-compromised patient, opportunistic infection
Up to which limit can one survive with iron deficiency anemia?
Mehmet Vural, Hakan Büyükhatipoğlu
J Clin Exp Invest 2010;1(3):226-227.
https://doi.org/10.5799/ahinjs.01.2010.03.0047
Case Report
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ABSTRACT
Iron deficiency anemia is an important public health problem worldwide. In this case report we presented an unusual case of iron deficiency anemia manifesting with extremely low hemoglobin (Hb) level of 1.7 g/dl. This case was challenging because, the cause of anemia in this patient was insufficient intake, which is an unusual cause of iron deficiency anemia. Secondly, the degree of Hb level that the patient had might not be compatible with life. On the other hand, by means of this case we wanted to present the adaptive capability of human body to chronic long-standing anemia. Therefore, the question of when and how much transfusion will be given should be queried.
Keywords: Iron deficiency anemia, lower limit, hemoglobin, survival
Descending necrotising mediastinitis: Case report
Şevval Eren, Alper Avcı, Abidin Şehitoğulları, Canan Eren
J Clin Exp Invest 2010;1(3):228-231.
https://doi.org/10.5799/ahinjs.01.2010.03.0048
Case Report
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ABSTRACT
Descending necrotising mediastinitis is a rare but usually fatal infection. It commonly results of oropharyngeal and odontogenic infections. Complete recovery may be achieved by early diagnosis, prompt medical and surgical approach. We are reporting our desending necrotizing mediastinitis case secondary to tooth abscess, and it’s successfull surgical treatment.
A-48-year-old man admitted with fever, exhaustion neck distendion for a week. He had a tooth abscess one week ago. Chest tomography showed neck and mediastinal air and fluid collections. Antibiothreapy was started and urgent surgical management applied. Neck drainage was performed via transcervical approach. Mediastinal drainage was performed via right thoracotomy. Continue mediastinal washing feasibility was done by drainage tubes. Drainage was ended after nonextra drainage and cultural growthless. Vital signs became stable and control tomography showed complete recovery. He was healthfull at the 6th month’s follow-up.
Broad antibiothreapy, surgical management are the main approaches for descending necrotising mediastinitis. The most common surgical procedure is the combination of transcervical approach and thoracotomy. We suggest early and agressive surgical management for the complete recovery.
Keywords: Descending necrotising mediastinitis, tooth abscess, surgery
Accelerated atherosclerosis in autoimmune rheumatic diseases
Manole Cojocaru, Inimioara Mihaela Cojocaru, Isabela Silosi, Camelia Doina Vrabie
J Clin Exp Invest 2010;1(3):232-234.
https://doi.org/10.5799/ahinjs.01.2010.03.0200
Review
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ABSTRACT
Atherosclerosis is increasingly considered an immune system-mediated process of the vascular system. Autoantibodies, autoantigens, pro-inflammatory cytokines and infectious agents play a role in that process. Autoimmunity-related cardiovascular disease and atherosclerosis are important clinical problems. The reason for accelerated atherosclerosis in patients with autoimmune rheumatic diseases remains unclear. Some cases of autoimmunity-related cardiovascular disease may be more related to thrombosis than atherosclerosis. Although, mechanisms causing the increased risk are not precisely clarified, a combination of traditional and nontraditional risk factors, including inflammation appears to be of importance. Further studies are needed to determine whether these autoimmune rheumatic diseases are also associated with accelerated atherosclerosis and its manifestations.
Keywords: Atherosclerosis, autoimmune rheumatic diseases, mechanisms
Current approach to sexual disfunctions in women
Hikmet Yaşar, Levend Özkan, Abdulkadir Tepeler
J Clin Exp Invest 2010;1(3):235-240.
https://doi.org/10.5799/ahinjs.01.2010.03.0201
Review
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ABSTRACT
Even though sexual problems and sexual dysfunction are commonly observed in the society, a significant majority of the problems are not reported to the doctors, and due to this fact, remain unaddressed. In our country, the studies about sexual dysfunction are limited in number but in recent years there has been an increase in these studies. The ratio of sexual dysfunction is higher in women than the ratio in men (43%; 31%). However, there are few treatment modality about women sexual dysfunction. Most commonly observed sexual dysfunctions in women are loss of sexual interest/desire, sexual arousal dysfunctions, orgasm dysfunctions, dyspareunia, vaginismus and sexual anxiety. In DSM-IV-TR, sexual dysfunction is treated by taking stress and interfamily relation problems into consideration. According to WHO’s definition, sexual health refers the combination of physical, emotional, intellectual and social sexual existense with the techniques that would increase personality communication and love. Sexual problems damage this combination, and cause pyschological and social problems.
Keywords: Sexual dysfunciton, woman, treatment