Assessment of prolactin associated platelet activation in ischemic stroke
Ayşegül Akagündüz Ege, Şule Bilen, Fikri Ak
J Clin Exp Invest 2012;3(1):1-6.
https://doi.org/10.5799/ahinjs.01.2012.01.0101
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Objectives: We aimed to investigate whether there were any relations between prolactin levels, prolactin associated platelet activation and ischemic stroke, and whether they had role in etiology of ischemic stroke.
Materials and methods: Totally 57 patients with the diagnosis of acute ischemic stroke and 43 age and sex matched controls with no history of ischemic vascular diseases were included in the study. Prolactin levels, mean platelet volume (MPV) a marker of platelet activation, and platelet count, of the patients, after 12 hours of fasting, compared with the measurements of control group.
Results: Patients had significantly higher prolactin levels. A correlation between prolactin levels and early measurements of MPV was not detected. While there was no difference in terms of MPV, the platelet count was significantly higher in the patient group.
Conclusions: In the present study, the existence of an effect of prolactin on the mean platelet volume, or a relationship between early ischemic stroke and MPV could not be shown. However, in ischemic stroke patients, in early phase, presence of higher levels of prolactin and platelet count may be meaningful in etiology of ischemic events. Besides, presence of higher prolactin levels in early phase of ischemic stroke may lead to consider the potential role of prolactin elevation in ischemic stroke pathogenesis.
Keywords: Ischemic stroke, prolactin, mean platelet volume, platelet count
Clinical comparison of cross-pin and EndoButton for fixation of hamstring grafts
Mehmet Bulut, Murat Gürger
J Clin Exp Invest 2012;3(1):7-12.
https://doi.org/10.5799/ahinjs.01.2012.01.0102
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Objectives: A comparison of the clinical outcomes of EndoButton and cross-pin femoral fixation techniques in anterior cruciate ligament (ACL) reconstruction using hamstring tendons.
Materials and methods: In our clinic, between January 2006 and December 2009 patients who underwent surgery due to ACL rupture were retrospectively reviewed. Of the patients, 50 underwent arthroscopic anterior cruciate ligament reconstruction with an autogenous hamstring tendon graft using the cross-pin technique, and the remaining 50 patients underwent arthroscopic anterior cruciate ligament reconstruction with the EndoButton technique. Preoperative and postoperative clinical evaluation of the patients in both groups was performed according to the International Knee Documentation Committee (IKDC) and Lysholm II knee scoring systems.
Results: In the cross-pin group, 52% of the patients had IKDC scores of A, 40% B and 8% C in the last control. In the EndoButton group, 48% of the patients had IKDC scores of A, 42% B and 10% C. Postoperatively, 48% of the patients in the cross-pin group had excellent, 44% good and 8% fair Lysholm scores. Fifty percent of the patients in the EndoButton group had excellent, 44% good and 6% fair Lysholm scores. There was no difference between the groups in additional diseases, IKDC and Lysholm scores and complications. The mean operative time was shorter in the EndoButton group.
Conclusions: No statistically significant difference was found between the clinical outcomes of the femoral fixation techniques. The shorter operative time and easier learning curve are advantages of the EndoButton technique in ACL reconstruction.
Keywords: Anterior cruciate ligament, hamstring tendon graft, femoral fixation
Relation between epicardial fat tissue and atrial fibrillation
Mustafa Kurt, İbrahim Halil Tanboğa, Enbiya Aksakal, Süleyman Karakoyun
J Clin Exp Invest 2012;3(1):13-17.
https://doi.org/10.5799/ahinjs.01.2012.01.0103
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Objectives: The objective of the study was to evaluate the relationship of epicardial fat thickness (EFT) assessed by echocardiography with atrial fibrillation (AF) in a clinical setting.
Materials and methods: The study consisted of 58 AF patients who underwent echocardiography and a control group of 22 participants. The EFT thickness was measured on the free wall of the right ventricle from the parasternal long-axis view. The association between EFT and AF was studied by adjusting the risk factors for AF, including structural valvular diseases and multiple risk factors.
Results: EFT was significantly increased in patients with AF as compared to participants in the control group (6.5 ± 1.2 mm vs. 5.8 ± 1.0 mm, p=0.01). In subgroup analysis of different types of AF, EFT was significantly increased in permanent AF in relation to paroxysmal and persistent AF (6.8 ± 0.9 mm vs. 6,0 ± 1.2 mm and 5.8±1.2 respectively). In addition, EFT measurements were comparable between sinus rhythm, paroxysmal and persistent AF.
Conclusions: Epicardial fat thickness measured by echocardiography seems to be associated with the chronicity of AF.
Keywords: Epicardial fat, echocardiography, atrial fibrillation
Characteristics of bean aspiration in children
Mithat Günaydin, Burak Tander, Ünal Bıçakcı, Ahmet Güzel, Rıza Rızalar, Ender Aritürk, Ferit Bernay
J Clin Exp Invest 2012;3(1):18-21.
https://doi.org/10.5799/ahinjs.01.2012.01.0104
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Objectives: We aimed to evaluate the characteristics of the bean aspiration in children and its difficulties encountered during removing.
Materials and methods: Ten children with bean aspiration (4 female, 6 male, 9 months-5 years old, mean 34.5 months) were admitted between 2005 and 2011. The data recorded were reviewed according to age, gender, history about aspiration, complaints, reason for bronchoscopy, location of foreign body and problems encountered during bronchoscopy. For the beans removal, we used optical forceps adapted to telescope and extracted the foreign body under direct vision.
Results: The main findings were cough, decreased breath sound on physical examination and emphysematous appearance on plain films. Beans were found on right main bronchus in 5 patients and left main bronchus in 4 patients. The bean was not found in one patient despite the positive family history for bean aspiration. In early cases (n=7), bean could extracted more easily but in delayed cases (n=2), it took more time and challenging due to lung infection, intolerance to anesthesia, and need of more tracheal washing and aspiration. In one case, shell of bean adhered to bronhcial mucosa and coated with fibrin. It could have not been noticed until prompt washouts and aspiration.
Conclusions: Success of removal of swollen foreign objects such as bean from bronchial airway depends on sufficient experience of anesthesia as well as pediatric surgeon. Using optic forceps bronchoscope rather than direct vision bronchoscope and extracting foreign subject via forceps that adapted to optical telescope increases rate of successful bronchoscopy.
Keywords: Bronchoscopy, foreign body aspiration, bean
Relationship between total antioxidant capacity and the severity of coronary artery disease
Murat Aydın, Yusuf Selcoki, Yunus Nazlı, Kadir Serkan Yalçın, Metin Canbal, Bora Demirçelik, Ramazan Yiğitoğlu, Beyhan Eryonucu
J Clin Exp Invest 2012;3(1):22-28.
https://doi.org/10.5799/ahinjs.01.2012.01.0105
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Objectives: It was known that oxidative/antioxidative balance shifted to oxidative side in patients with coronary artery disease. The aim of this study is to evaluate the relationship between coronary artery disease and total antioxidant status, oxidative stress index.
Materials and methods: The study group consisted of 87 consecutive patients who were hospitalized for coronary angiography. Plasma total oxidative status (TOS) and total antioxidative capacity (TAC) levels were measured and oxidative stress index (OSI) was calculated.
Results: The TAC values increased statistically significant in the four tertile compared with the first tertile (1.9 ± 0.2 vs 2.0 ± 0.2 mmol Trolox Eq/l) and the TOS values decreased non- significantly in the four tertile ( 5.2 ± 2.8 vs 7.2 ± 5.4 µmol H2O2 Eq/l) as compared to the patients in the first tertile. According to the number of diseased vessels, plasma oxidative characteristics did not differ between the three groups.
Conclusions: Plasma TAC levels increased in subjects with coronary atherosclerosis and severity of coronary atherosclerosis is related with TAC.
Keywords: Coronary artery disease; total antioxidant capacity; oxidative stress
Association between neutrophil/lymphocyte ratio and coronary collateral circulation
Habib Çil, Yahya İslamoğlu, Celal Yavuz, Zuhal Arıtürk Atılgan, Ahmet Çalışkan, Sinan Demirtaş, Mustafa Oylumlu
J Clin Exp Invest 2012;3(1):29-32.
https://doi.org/10.5799/ahinjs.01.2012.01.0106
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Objectives: To investigate relation between neutrophil/lymphocyte ratio and coronary collateral flow.
Material and methods: Eighty-two patients admitted Dicle University Medical Faculty Hospital Cardiology Department with diagnosis of coronary artery disease and detected significant stenosis or occlusion at least one of the coronary arteries, were included to study. Age, sex, presence of diabetes mellitus and hypertension, acute/stable coronary disease, body mass index, neutrophil/lymphocyte ratio, white blood count, Rentrop scores and number of diseased vessel were recorded.
Results: Well-developed coronary collateral circulation was found in 33 of the patients. Forty-nine patients had poor coronary collateral circulation. Mean age, sex, body mass index, presence of diabetes mellitus and hypertension were similar in two groups. Mean neutrophil/lymphocyte ratio was lower in well-developed coronary collateral circulation group than poor coronary collateral circulation group, but there was no significant differences (2.78 vs 2.89, p=0.12).
Conclusions: There was no association between neutron/hil lymphocyte ratio and coronary collateral circulation according to our data.
Keywords: Neutrophil/lymphocyte ratio, coronary collateral circulation
The comparison of effects of intrathecal two different levobupivacaine doses in appendectomy
Erdal Doğan, Gönül Ölmez Kavak, Feyzi Çelik, Adnan Tüfek, Zeynep B. Yıldırım, Orhan Tokgöz, Haktan Karaman, Enver Ay
J Clin Exp Invest 2012;3(1):33-37.
https://doi.org/10.5799/ahinjs.01.2012.01.0107
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Objectives: Spinal anesthesia, especially in the presence of coexisting diseases is preferred to reduce morbidity and mortality in many surgical practices. In this study, we aimed to compare the motor and sensory block characteristics, hemodynamic parameters, side effects and surgical and patient comfort, whom underwent appendectomy with spinal anesthesia in two different doses of levobupivacaine.
Material and methods: After Minister of Health ethical committee approval and written consent of the patients who underwent open appendectomy were obtained, fifhty patients between the ages of 18-40 with ASA I-II were enrolled in this study. The patients were randomly allocated to two groups; Group I received 15 mg levobupivacaine 0.5% (total 3 ml) and Group II received 20 mg levobupivacaine 0.5% (total 4 ml Hemodynamic data, surgical and patient comfort and side effects were also recorded.
Results: There were statistically significant differences between the two groups for two segment regression time of sensory block. Two-segment regression time was longer the Group II than Group I. In Group II motor block regression time (Group I 120 ± 40 min, Group II 158 ± 54 min) was significantly longer (p= p<0.05). There were statistically significant difference in numbers of side effects (hypotension, bradicardia) in Group II than Group I (p<0.05).
Conclusions: This study showed that 15 mg levobupivacaine dose provides safe and effective anesthesia for appendectomy surgery.
Keywords: Appendectomy, spinal anesthesia, levobupivacaine
Clinical and laboratory characteristics and associated risk factors of infants hospitalized in newborn unit for indirect hyperbilirubinemia
İlhan Tan, Özgül Salihoğlu, Yaşar Demirelli, Sami Hatipoğlu
J Clin Exp Invest 2012;3(1):38-43.
https://doi.org/10.5799/ahinjs.01.2012.01.0108
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Objectives: The aim of this study was to investigate characteristics of neonates hospitalized to Neonatal Unit due to indirect hyperbilirubinemia and to determine risk factors for indirect hyperbilirubinemia.
Materials and methods: Totally 222 newborns, aged ≥35 weeks of gestational age and hospitalized in neonatal unit with indirect hyperbilirubinemia, were investigated. Physical examination and laboratory studies of children were performed. Decision of phototherapy and exchange transfusion was done according to total serum bilirubin (TSB) level that notified in the Guidelines of American Academy of Pediatrics.
Results: Study group consisted of 131 (60%) male and 91 (30%) female newborns. No significant difference was found in TSB values between male and female neonates. There was 71.2% term and 19.8% late preterm newborn babies. Babies born with spontaneous vaginal delivery had borderline higher TSB values compared with cesarean section deliveries (p=0.051). ABO blood group incompatibility was found in 30.1% and Rh incompatibility in 6.7%. Insufficient nutrition and inadequate caloric intake were found in 49 (22.7%) of neonates, urinary tract infection in 19 (8.5%), hypernatremic dehydration in 9 (4.5%) and hypothyroidism in 4 (2.0%). Exchange transfusion was performed in 10 newborns and kernicterus occurred in two. A significant negative correlation was found between TSB values at hospitalization and baby’s birth (p<0.05) and a positive correlation between initial TSB value and percent of patient weight loss (p<0.05).
Conclusions: According to our results, the most frequent etiological causes of jaundice in newborns were ABO blood group incompatibility, insufficient nutrition and being late preterm.
Keywords: Indirect hyperbilirubinemia, etiological factors, kernicterus, late preterm
Urological laparoscopic surgery: Our experience of first 100 cases in Dicle University
Namık Kemal Hatipoğlu, Necmettin Penbegül, Haluk Söylemez, Murat Atar, Yaşar Bozkurt, Ahmet Ali Sancaktutar, Mehmet Nuri Bodakçi
J Clin Exp Invest 2012;3(1):44-48.
https://doi.org/10.5799/ahinjs.01.2012.01.0109
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Objectives: In this study the experience and results of first 100 laparoscopic surgery is presented.
Materials and methods: The laparoscopic surgical operations were reviewed between July 2010 and October 2011, retrospectively.
Results: During a year period we performed of 100 laparoscopic interventions. The ratio of male to female and the mean age was 57/43 and 48,65±8,94 years respectively. The kind of operation and total numbers were like this: simple nephrectomy 34, radical nephrektomy 22, renal cyst excision 21, orchiectomy 7, ureterolitotomy 4, adrenalectomy 4, orchiopexy 3, pyeloplasti 2, nefroureterectomy+cystectomy 1, nefroureterectomy+partial cystectomy 1 nefroureterectomy 1 patient.
Transperitoneal approach was used for 91 patients while retroperitoneal approach was used to 9 patients. The operation was completed by open surgical interventions for only 6 of 100 patients. The reason for open procedures during laparoscopy was not reaching to renal pedicles for three patients, adhesions to pararenal tissue and colon for 2 patients and splenic artery injury for 1 patient. Three patients needed blood transfusions. Except these patients there wasn’t any complications and mortalities. When performing right nephrectomy and adrenalectomy the fourth port was used to ecartate liver. Except these cases in all operations 3 ports was used. The mean hospitalization stay was 1,7(1-8) days. The operation times of mostly performed operations were like these minute (interval): simple nephrectomy 95 (70-135), radical nephrectomy 148 (125-190), renal cyst excision 45 (20-80), orchiectomy 41 (30-45), ureterolithotomy 104 (95-135), orchiopexy 85 (80-100), adrenalectomy 148 (110-180), pyeloplasty 170 (160-180) nefroureterectomy 150 minutes.
Conclusions: The results, success and complication rates of laparoscopic operations which are performed in our clinics were found as similar to literature. The laparoscopic surgery is alternative to open surgery that it can be used safely and effectively.
Keywords: Laparoscopic surgery, urology, experience
The relationship between gestation and iron deficiency anemia in women applied to obstetrics and gynecology outpatient clinic
Senem Yaman Tunç, Neval Yaman Görük, Bahadır Ceylan, Nurettin Tunç
J Clin Exp Invest 2012;3(1):49-52.
https://doi.org/10.5799/ahinjs.01.2012.01.0110
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Objectives: Iron deficiency anemia that is very fundamental for all stage of life can especially affect health of childbearing aged women and even can cause death of mothers and their babies. This study aimed to investigate the relationship between iron deficiency anemia and gestational condition (gravidity, parity, abortion, number of alive) of women applied to outpatient clinic of obstetric.
Materials and methods: Between November-December 2011, totally 61 patients who applied to Gynecology and Obstetrics Outpatient clinic were retrospectively investigated. The patients’ data including; age, gestational medical history (gravidity, parity, number of alive and abortion), hematocrit, hemoglobin, iron, serum iron binding capacity, and transferrin saturation values were evaluated.
Results: Anemia was found in only 12 of the patients (19.7%). The anemia frequency in patients whose gravidity ≤3 was 18.2%, whose gravidity >3 was 21.4%. Anemia ratio for patients having parity ≤2 was 16.6%, >2 was 21.6%. For patients having abortion ≤2 anemia frequency was 13.3% but it was 21.7% for patients having >2. We found that there was a negative correlation between the groups (gravidity, parity, abortion) and hemoglobin-transferrin saturation (p<0.05).
Conclusions: In our study, it was shown that the frequency of iron deficiency anemia increases with gravidity, parity, and number of alive. For this reason, gynecologic consulting and iron support should be provided to prevent anemia in childbearing aged women.
Keywords: gestational situation, iron deficiency anemia, parity
Comparison of the efficacy of dexmedetomidine and esmolol in the treatment of increased hemodynamic response during the recovery period
Hülya Günay, Elif Başağan Moğol, Fatma Nur Kaya, Gürkan Türker, Belgin Yavaşcaoğlu, Filiz Ahun, Ayşe Neslihan Bebek, Tuba Yeniaydoğmuş
J Clin Exp Invest 2012;3(1):53-60.
https://doi.org/10.5799/ahinjs.01.2012.01.0111
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Objectives: Our aim was to compare effectiveness of esmolol and dexmedetomidine in the treatment of increased hemodynamic response during anesthesia recovery period.
Materials and methods: 60 ASA I-II patients whom scheduled for elective surgery with endotracheal intubation were randomized before extubation according to their hemodynamic parameters that were increased 20% of their baseline values in order to receive 1mg/kg esmolol (Group Esmolol, n= 30) or 0.5 µg/kg dexmedetomidine (Group Dexmedetomidine, n= 30). Heart rate (HR), systolic and diastolic blood pressures (SBP,DBP), peripheral oxygen saturation (SpO2), end tidal carbon dioxide (ETCO2) values, extubation time, recovery time were recorded. The duration till having pain requiring analgesic was recorded and cognitive functions were evaluated with short memory orientation concentration test at 20th and 50th minutes.
Results: After drug, HR reductions were significant at all periods in group Dexmedetomidine (Z2-Z10: p<0.001, Z11:p=0.001, Z12, p=0.006). In group Dexmedetomidine SBP value was high at 3rd min after drug (p<0.001), and SBP values were lower in all periods before and after extubation (Z6- Z10: p<0.001, Z11: p=0.02, Z12: p=0.04). In group Dexmedetomidine DBP value was higher at 1st min after drug (p=0.001), DBP values were lower at 10th min after drug and before extubation (p= 0.045, p=0.001). The duration of pain requiring analgesic and recovery period were longer in dexmedetomidine group (p<0.001, p<0.001).
Conclusions: Although esmolol and dexmedetotimidine attenuated hemodynamic response during recovery period, dexmedetotimidine was more effective in hemodynamic stabilization and the duration of pain requiring analgesic was longer. Esmolol provided faster recovery time.
Keywords: Dexmedetomidine, esmolol, extubation, hemodynamic response, cognitive function
Investigation of Toxoplasma gondii antibodies with ELISA among women of childbearing age in Şanlıurfa province: A three years evaluation
Ayşegül Çopur Çiçek, Fazilet Duygu, İbrahim Halil İnakçı, Nuray Boyar, İbrahim Hakan Boyar
J Clin Exp Invest 2012;3(1):61-65.
https://doi.org/10.5799/ahinjs.01.2012.01.0112
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Objectives: Toxoplasmosis is a parasitic disease, caused by Toxoplasma gondii, its prevalence varies depending on geographic location, age, nutrition and hygiene habits. In this study, it was aimed to investigate seroprevelance of antibodies occurring against Toxoplasma gondii, which can lead to congenital infections in risky group, women of reproductive age, referred to Şanlıurfa Women’s Health and Maternity Hospital in years between January 2007 and December 2009, and to compare its results with the previous studies.
Materials and methods: Sera obtained from women, their age range was 15 to 49, the mean age of 28.35 ± 7.48 were studied with chemiluminescense immunoassay and electrochemiluminescence methods and toxoplasma antibody results were investigated, retrospectively.
Results: In pregnant and non-pregnant women’s samples, anti-toxoplasma IgG antibodies seropositivity was found as 68.9% and 63.0%, respectively, whereas anti-toxoplasma IgM antibodies seropositivity was found as 2.8% and 3.0%, respectively. In both (pregnant and non-pregnant), the most frequent seropositivity rates for anti-toxoplasma IgG were detected in 35 to 45 years-old age group.
Conclusions: In conclusion, routine scanning for toxoplasma seropositivity may not be needed because of the high seropositivity ratios in this province. Education of all sensitive mothers about protection and control of toxoplasma infection and obstetrical follow-up can decrease the risk of congenital anomalies related to toxoplasmosis.
Keywords: Pregnancy, Toxoplasma gondii, seroprevalance, ELISA
Evaluation of the role of digital rectal examination and prostate specific antigen in diagnosis of prostate cancer
Bülent Altunoluk, Mustafa Remzi Bahar, Mustafa Eren, Remziye Eren, Harun Çıralık, Sefa Resim
J Clin Exp Invest 2012;3(1):66-70.
https://doi.org/10.5799/ahinjs.01.2012.01.0113
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Objectives: In this study, we examined the value of prostate specific antigen (PSA) and digital rectal examination (DRE) in prostate cancer detection among men.
Materials and methods: Between January 2006 and July 2011, transrectal prostate needle biopsy was performed in 349 patients with abnormal DRE and/or >4ng/ml serum total PSA level were involved in the study. According to the histopathological examination, the patients were divided into two groups as without and with prostate cancer and their data were compared.
Results: At the end of the histopathological examination, 121 (32.4%) cases had prostate cancer and 252 (67.6%) cases found without prostate cancer. Mean age and mean PSA values were higher and prostate volume was lower in the prostate cancer group than the other group. Prostate cancer was detected in 73 of the patients (66.4%) whose DRE was abnormal. In prostate cancer group, Gleason scores of 47 patients’ (38.8%) were “6”, Gleason scores of 42 patients’ (34.7%) were “ 7” and Gleason scores of 32 patients’ (26.5%) were between 8 and 10. Positive predictive values for high serum total PSA level (>4 ng/ml) and abnormal DRE were found as 39.7% and 66.4% respectively.
Conclusions: Only serum total PSA measurement or only DRE is inadequate differential methods for differentiation of benign and malign prostate diseases. When DRE was assessed with serum total PSA level, cancer detection rate and reliability increases.
Keywords: Prostate cancer, prostate biopsy, prostate specific antigen, digital rectal examination
Antibacterial susceptibility patterns of methicillin resistant staphylococcus spp. from a tertiary reference hospital
Canan Ağalar, Jülide Sedef Göçmen, Dilek Kılıç, Sedat Kaygusuz, Çiğdem Karabıçak
J Clin Exp Invest 2012;3(1):71-74.
https://doi.org/10.5799/ahinjs.01.2012.01.0114
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Objectives: Methicillin resistant Staphylococcus strains still remain as an important reason of hospital acquired infections. The aim of this study to see the antimicrobial sensitivity patterns of these strains for effective empirical therapy
Material and methods: Antibiotic susceptibility results of staphylococcus strains were investigated retrospectively from tertiary reference hospital. 276 methicillin resistant staphylococcus species, which were isolated from Kırıkkale University Faculty of Medicine Department of Infectious Disease and Clinical Microbiology laboratory between November 2009-2010 were enrolled in this study. Identification and antibiotic susceptibilities of the strains were evaluated by using Vitek automated systems (bioMerieux).
Results: Most of these strains were isolated from blood (49%) and wound (40 %) samples. There was no glycopeptide resistance established from 276 strains. Susceptibility percents of these strains to linezolid and erythromycin were 97% and 16% respectively.
Conclusions: we believe that, informing physicians about antibiotic susceptibility patterns of methicillin resistant staphylococcus species will be helpful for effective treatment and control the spread of these infections.
Keywords: Antibiotic susceptibility in staphylococci, methicillin resistance
The comparison of the effect of intrathecal levobupivacaine and bupivacaine for ano-rectal surgery
Hüseyin Göksu, Feyzi Çelik, Zeynep B. Yıldırım, Adnan Tüfek, Haktan Karaman, Gönül Ö. Kavak, Erdal Doğan
J Clin Exp Invest 2012;3(1):75-80.
https://doi.org/10.5799/ahinjs.01.2012.01.0115
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Objectives: Spinal anesthesia is widely used for ano-rectal surgery. We aimed to compare the anesthetic potencies and hemodynamic effects of levobupivacaine and bupivacaine with fentanil intrathecally administered in patients undergoing ano-rectal surgery.
Materials and methods: After Dicle University Medical Faculty Research Hospital ethical committee approval and written consent of the patients who underwent anorectal surgery were obtained, sixty patients between the ages of 18-65 with ASA I-II were enrolled in this study. The patients were randomly allocated to two groups; Group I recived 9 mg bupivacaine 0.5% and 20 mcg fentanil (total 2 ml), and Group II received 9 mg levobupivacaine 0.5% and 20 mcg fentanyl (total 2.6 ml). Spinal anesthesia was performed using a 26 G spinal needle via the L4-5 lumbar intervertebral space. Patients’ grade of sensory block was assessed with pin prick test, and the grade of motor block was assessed with bromage scale. Hemodynamic data were also recorded.
Results: Two segment regression time and of sensory block onset time are similar between the groups. Motor block onset time was longer in bupivacaine group than levobupivacaine group but motor block regression time was shorter in group levobupivacaine. Hemodynamic parameters were similar in both groups.
Conclusions: Our results shows that levobupivacaine which has similar features with bupivacaine in terms of sensory block may be a good alternative to bupivacaine in the operations in which development of the motor blocks is unwanted.
Keywords: Levobupivacaine; bupivacaine; spinal anesthesia; anorectal surgery
The comparison of audiological tests and VAS scores after use of trimetazidine hydrocloride in patients with tinnitus
Cengiz Çevik, Tekin Bağlam, Engin Şengül, Ercan Akbay, Elif Baysal, Erkan Karataş, Ali Kılıç
J Clin Exp Invest 2012;3(1):81-86.
https://doi.org/10.5799/ahinjs.01.2012.01.0116
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Objectives: Although the pathophysiology of tinnitus has not been understood well it is thought to be as a result of anatomical and/or functional change in hearing system. The aim of this study was to compare audiological test results and visual analog scala (VAS) scores after use of trimetazidine hydrocloride in patients with tinnitus.
Materials and methods: Forty patients (12 female, 28 male) who were admitted to our clinic with tinnitus complaint were included in this study. Demographical and medical records and tinnitus assessment data of the cases were recorded who received regular trimetazidine hydrochloride treatment for 3 months. Both pre- and post-treatment values of pure audiograms, frequency and intensity of tinnitus, minimal masking, residual inhibition, and the values in VAS questionnaire form were also evaluated from patient files.
Results: According to the statistical analysis, tinnitus intensity, frequency of tinnitus, discomfort value due to tinnitus and the concentration loss due to tinnitus values in VAS test were found to be decreased after medication (p=0.001). Among the audiological findings of patients, tinnitus frequency (p=0.250), tinnitus intensity (p=0.057), minimal masking level (p= 0.213), and residual inhibition values were found to have no statistically significant changes.
Conclusions: It was found that three-months treatment of trimetazidine treatment caused reduction in tinnitus complaints of patients and did not cause any significant change in audiological test results.
Keywords: Tinnitus, VAS, Audiological tests
Importance of nonspecific laboratory tests in Brucella diagnosis
Güliz Doğan Toklu, Arzu Etem Akağaç, Harun Ağca
J Clin Exp Invest 2012;3(1):87-90.
https://doi.org/10.5799/ahinjs.01.2012.01.0117
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Objectives: Brucella infection doesn’t have spesific clinical evidences, for this reason it can be confused with febrile diseases. In this study we aimed investigating the importance of diagnosis with nonspesific laboratory tests in brucellosis.
Materials and methods: We retrospectively screened clinically compatible with brucellosis, standard tube agglutination (STA) and STA tests with coombs of patients sera which came to Uşak State Hospital Central Laboratory between December 2010-May 2011. As control group, we determined random 62 patients attended to the laboratory between December 2010-May 2011 with STA test results are negative and not diagnosed brucellosis.
Results: C-reactive protein elevated in 54 patients (87.0%), ESR elevated in 44 patients (70.9%), AST elevated in 22 patients (35.4%), ALT elevated in 7 patients (11.2%), ferritin elevated in 19 patients (30.6%), 8 patients had anemia (12.9%) of patient group. In control group, 7 patients elevated CRP (11.2%), 10 patients elevated ESR (16.1%), 1 patient elevated AST (1.6%), 1 patient elevated ALT (1.6%), 6 patients had anemia (9.6%) and decrease in ferritin level wasn’t detected.
Conclusion: We concluded statistically significant high level of CRP, ESR, ALT, AST and ferritin support the test results too beside the spesific brucellosis tests.
Keywords: Brucellosis, C-Reactive protein, erythrocyte sedimentation rate, ferritin
Henoch-Schönlein purpura in childhood: Review of 214 patients
Aydın Ece, İlyas Yolbaş, Hasan Balık, Halil Kocamaz, Servet Yel, Ünal Uluca, İlhan Tan
J Clin Exp Invest 2012;3(1):91-95.
https://doi.org/10.5799/ahinjs.01.2012.01.0118
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Objectives: Due to involvement of various systems and clinical variety of in Henoch-Schönlein purpura (HSP), in this study, it was aimed to investigate clinical and laboratory features of children with HSP.
Materials and methods: Hospital records of 214 children with HSP followed up between 2000 and 2007 at Dicle University Hospital Pediatrics Clinics were retrospectively evaluated. Diagnosis was made based on the HSP criteria of American College of Rheumatology. Age, gender, clinical findings, laboratory variables, applied treatments, and outcome were recorded.
Results: Totally 214 HSP patients (121 male, 93 female) with the mean age of 9.0 ± 3.2 years (range, 2-16) were included. There was a history of upper respiratory tract infection in 136 children (63.6%). There was abdominal pain in 62.1% of patients, vomiting in 22.1%, and occult blood in stool or melena in 25.4%. Three patients underwent operation due to intusception. Joint involvement was seen in 117 (54.7%) and angioedema in 73 (34.3%) of patients. Renal involvement as hematuria was seen in 63 (29.4%) children, proteinuria in 57 (26.6%), leukocyturia (9.8%), and nephritic/nephritic proteinuria in five patients. Increased IgA and C3 levels were found in 35 (16.0%) and 41 (19.3%), respectively; and decreased C3 in 23 (10.7%). Benzathine penicillin and penicillin V were used in 114 (53.5%) of children, non-steroidal anti-inflammatory drugs in 128 (59.8%) and parenteral/oral corticosteroids in 86 (40.2%). Immonusuppressives were given to 5 patients with nephrotic proteinuria following renal biopsy.
Conclusions: Gastrointestinal and renal involvement in children with HSP, rarely lead to major complications.
Keywords: Henoch-Schönlein purpura, child, clinical findings, laboratory results
Ovarian malignant melanoma presenting with hypercalcemia and bone marrow infiltration: a case report and review of the literature
Muhammet Ali Kaplan, Mehmet Küçüköner, Ali İnal, Abdurrahman Işıkdoğan, Zuhat Urakçı
J Clin Exp Invest 2012;3(1):96-98.
https://doi.org/10.5799/ahinjs.01.2012.01.0119
Case Report
[Abstract]
[PDF]
ABSTRACT
Malignant melanoma originating from the ovary is a very rare condition. Bone marrow involvement and hypercalcemia is observed at a very low rate in malignant melanoma cases (5-7 and 1.1-11.9%, respectively). In this paper, we present very rare condition as a 67-year-old female patient with malignant melanoma of ovary origin accompanied by bone marrow infiltration and hypercalcemia.
Keywords: Ovarian malign melanoma, bone marrow infiltration, hypercalcemia
Bilateral branchial cleft anomaly type two and type three seen together
Cüneyt Kucur, Vefa Kınış, Yusuf Eren, Ali Okan Gürsel
J Clin Exp Invest 2012;3(1):99-101.
https://doi.org/10.5799/ahinjs.01.2012.01.0120
Case Report
[Abstract]
[PDF]
ABSTRACT
Branchial apparatus begins to develop at about second week of gestation and each complex will transform into different structures in the head and neck. Branchial cleft anomalies develop due to defect in the closure of these structures by time. Branchial cleft anomalies may be diagnosed at any age but most of them are seen in pediatric population. Although, branchial cleft anomalies are frequently seen, bilateral cases, which have been reported are very rare. We present a 14 years old boy who was diagnosed and operated due to bilateral branchial cleft anomaly.
Keywords: Branchial cleft anomaly, bilateral, type 2, type 3
Acute arthritis as initial presentation of sarcoidosis: Significance of chest X-ray
Ayten Türcan, Sacide Ünel, Mustafa Akif Sarıyıldız, Muhammed Emin Akkoyunlu
J Clin Exp Invest 2012;3(1):102-104.
https://doi.org/10.5799/ahinjs.01.2012.01.0121
Case Report
[Abstract]
[PDF]
ABSTRACT
Sarcoidosis is a multisystem granulomatous disease that predominantly affects the lungs. It usually presents with fatigue and respiratory findings. The rate of arthritis in sarcoidosis is 15-25%. Arthritis as initial manifestation of sarcoidosis has been reported rarely in the literature. In present paper we highlighted the importance of sarcoidosis and conventional chest X-ray in differential diagnosis of acute arthritis.
Keywords: Acute arthritis, sarcoidosis, conventional chest X-ray
Treatment of cornual viable pregnancy with single dose methotrexate: Case report
Neval Yaman Görük, Ahmet Göçmen, Mustafa Gazi Uçar, Senem Yaman Tunç, Özlem Tosun
J Clin Exp Invest 2012;3(1):105-107.
https://doi.org/10.5799/ahinjs.01.2012.01.0122
Case Report
[Abstract]
[PDF]
ABSTRACT
We herein report a case of cornual viable pregnancy that was successfully treated with a single dose methotrexate without the need for surgical intervention. A 37 year-old woman was diagnosed cornual pregnancy based on transvaginal ultrasound findings and hormonal assays. A single dose systemic methotrexate (50 mg/m2) was administered. No side effects were experienced. Early diagnosis of interstitial pregnancy can lead to conservative treatment options. Although the most effective methotrexate protocol for conservative treatment is uncertain we concluded that in the hemodynamically stable patient a single dose systemic methotrexate treatment is a useful and should be considered as the first line treatment. This is safe and highly effective management even though viable fetus or high level of human chorionic gonadotropin (B-hCG) was assigned. Hemodynamic stability is the most important criteria and that is directly correlated with the early diagnosis. Surgery can be avoided; however, with conservative management a longer and close follow-up is required.
Keywords: Cornual pregnancy, methotrexate, treatment, viable
Essential tremor responsive to levetiracetam
Aysel Milanlıoğlu, Ömer Faruk Odabaş, Abdullah Yılgör
J Clin Exp Invest 2012;3(1):108-110.
https://doi.org/10.5799/ahinjs.01.2012.01.0123
Case Report
[Abstract]
[PDF]
ABSTRACT
Essential tremor is one of the most common movement disorders with a prevalence of 0.4% to 3.9% in the general population and increases with age. The medical treatment available for patients with essential tremor is often inadequate. Propranolol and primidone are the first-line treatment options, improving in up to two thirds of cases. This article reports a satisfying response to levetiracetam with disabling essential tremor in a 58-year-old man whom propranolol as well as primidone had to be discontinued due to unresponsiveness and severe side effects. One of the antiepileptic drugs, levetiracetam, may be more useful in the treatment of essential tremor.
Keywords: Essential tremor, anticonvulsant drug, levetiracetam
A rare case of intraosseous ganglion of the triquetrum
Boris Matev, Georgi P. Georgiev, Luben Stokov
J Clin Exp Invest 2012;3(1):111-112.
https://doi.org/10.5799/ahinjs.01.2012.01.0124
Case Report
[Abstract]
[PDF]
ABSTRACT
Carpal intraosseous ganglia are one of the rarely seen pathologic conditions in the hand. In this report we present a rare case of an intraosseous ganglion cyst in a 16-year-old girl located in the triquetrum bone as an uncommon cause of wrist pain. Radiographic and magnetic resonance imaging demonstrated the cystic lesion into the triquetrum. The patient was successfully treated by excision of the ganglion cyst and curettage of the bone. Clinical aspects, radiological findings and treatment modalities of this condition were briefly reviewed.
Keywords: Intraosseous ganglion, triquetrum, wrist
Successful radiofrequency ablation of multiple accessory pathways in a patient with tachycardiomyopathy
Yahya İslamoğlu, Mehmet Kemal Aktaş, Mehmet Ali Elbey, Ebru Tekbaş, Abdurrahman Akyüz
J Clin Exp Invest 2012;3(1):113-116.
https://doi.org/10.5799/ahinjs.01.2012.01.0125
Case Report
[Abstract]
[PDF]
ABSTRACT
Tachycardiomyopathy secondary tachycardia is a subgroup of cardiomyopathy. Multiple accessory pathways in tachycardia arrhythmias are very rare and usually additional pathology is associated with it. In our case, 58 years old female patient who does not have any additional dısease, have shown multiple accessory pathways and multiple accessory pathway successfully ablated. As a result, patient\'s tachycardiomyopathy were healed.
Keywords: Tachycardiomyopathy, multiple accessory pathway, ablation
Brucellar epididymoorchitis: A case report
Ramazan Topaktaş, Cevper Ersöz, Emre Can Polat, Mehmet Remzi Erdem, Abdulkadir Tepeler, Abdullah Armağan, Şinasi Yavuz Önol
J Clin Exp Invest 2012;3(1):117-120.
https://doi.org/10.5799/ahinjs.01.2012.01.0126
Case Report
[Abstract]
[PDF]
ABSTRACT
Epididymoorchitis caused by Brucella species is a rare infection. Although the most common genitourinary involvement of brucellosis is epididymoorchitis, other findings may also occur. Clinical and serological data are sufficient for the diagnosis. We present a-34-year-old male admitted to our outpatient clinic with right testicular swelling and pain, high fewer, malaise, arthralgia, myalgia for ten days and hospitalized with prediagnosis epididymoorchitis. Testicle ultrasonography showed hipoechoic right testicular mass. Tumor markers were measured and found within the normal limits. Doxycycline and rifampicin were administered for six weeks and recovered uneventfully. Brucella epididymoorchitis should be kept in mind for the etiology of epididymoorchitis resistant to standard therapeutic approach especially in our country where Brucellosis is endemic.
Keywords: Epididymoorchitis, brucellosis, Testicular mass
A case with Stenotrophomonas maltophilia keratitis related to contact lens use
Tuba Dal, Mehmet Sinan Dal
J Clin Exp Invest 2012;3(1):121-122.
https://doi.org/10.5799/ahinjs.01.2012.01.0127
Case Report
[Abstract]
[PDF]
ABSTRACT
We examined a 30 years old female patient, which had a paracentral corneal abcess due to contact lens use. We took samples from corneal abcess and fluid in the contact lens and sent for microbiological examination. After taken samples, gatifloxacin was started for antibiotherapy. Stenotrophomonas maltophilia was grew in both samples during microbiological examination. Gatifloxacin antibiotherapy was continued and corneal abcess formation was regressed and treated in the course of therapy.
Keywords: Stenotrophomonas maltophilia, keratitis, contact lenses, gatifloxacin
A rare case of coagulation disorder presenting with unexpected bleeding non-responding to fresh frozen plasma replacement: Factor XIII deficiency
Murat Albayrak, Harika Çelebi, Birgül Öneç, Başak Ünver Koluman, Serra Özbal
J Clin Exp Invest 2012;3(1):123-126.
https://doi.org/10.5799/ahinjs.01.2012.01.0128
Case Report
[Abstract]
[PDF]
ABSTRACT
Factor XIII deficiency is a quite rare bleeding disorder in which detecting tests for coagulation are found in normal ranges. This disorder usually does not cause spontaneous bleeding but other than excessive bleeding after invasive procedures, impaired wound healing, abnormal scar formation, recurrent spontaneous miscarriages in women, oligospermia and infertility in men could be seen.
Case Report: A thirty three years old male patient with previously diagnosed as factor XIII deficiency referred to emergency with serious stomachache which began after he fell down at his home. After recognition of a retroperitoneal hematoma and splenic rupture, laparotomic splenectomy with fresh frozen plasma (FFP) replacement was performed. Meanwhile factor XIII levels were detected <1%. Although FFP (15-20 ml/kg) and cryopresipitate was given postoperatively, bleeding from the incision and surgical drains continued. Until postoperative 15th day approximately 20 units of red blood cells were transfused. Because the bleeding couldn’t be stopped, plasma concentrate of factor XIII is brought from abroad and administered at a dose of 20 IU/kg (1500 U/day) weekly, for three weeks (totally three doses). After the administration of the first dose the amount of bleeding decreased progressively and eventually stopped.
We reported this case because, besides factor XIII deficiency is a rare form of bleeding disorder; this patient had more severe and prolonged bleeding than expected and did not responded FFP or cryopresipitate therapy. So unexpected bleeding could not be stopped until plasma concentrate of factor XIII was administered, though to be worth for attention.
Keywords: Factor XIII deficiency, fresh frozen plasma, cryopresipitate
A case report of renal Ewing sarcoma
Alaaddin Akay, Gökmen Akarer, Zafer Akar, Gül Türkçü, Taner Çiftci
J Clin Exp Invest 2012;3(1):127-129.
https://doi.org/10.5799/ahinjs.01.2012.01.0129
Case Report
[Abstract]
[PDF]
ABSTRACT
Primitive neuro-ectodermal tumors (PNETs) are seen mostly at central nervous system. Peripheral localizations are rare. PNETs are belong to Ewing sarcoma family. Ewing sarcoma has two subtypes as originated from bones or from another organ. Renal PNET is a very rare tumor. Peripherally localized PNETs originated from kidney, usually found at young men, and have poor prognosis with aggressive behavior. A 28-year-old man referred to our clinic with left flank pain and gross hematuria. Radiological investigations yielded gross renal mass compatible with malignancy. Radical nephrectomy was performed. Histopathological diagnosis was PNET/Ewing sarcoma with findings of large and hyperchromatous nuclei, narrow cytoplasms, spindle shaped cells- but mostly rosette formation- and strong straining with CD99. Chemotherapy was given to the patient. At the end of the chemotherapy, there no recurrence was detected by radiological investigations.
Keywords: Ewing sarcoma, renal tumor, case
An uncommon cause of acute abdomen: Isolated small bowel obstruction due to gastrointestinal stromal tumor
Murat Okudan, Fatih Taşkesen, Tufan Egeli, Zülfü Arıkanoğlu, Abdullah Böyük, Akın Önder
J Clin Exp Invest 2012;3(1):130-132.
https://doi.org/10.5799/ahinjs.01.2012.01.0130
Case Report
[Abstract]
[PDF]
ABSTRACT
Gastrointestinal stromal tumors (GIST) are mesenchymal tumors with original histologic features which located primarily in the gastrointestinal tract and abdomen. Most common place for GIST is stomach (50%) and then the small intestine (25%) but GIST can be anywhere in the gastrointestinal system. Most of the patients shall be operated with other diagnoses or symptoms of obstruction. Here, clinical appearance of a case of localized jejunal stromal tumor is reviewed according to view of the literature.
Keywords: Acute abdomen, gastrointestinal stromal tumors, small bowel obstruction
Cleidocranial dysplasia: Etiology, clinicoradiological presentation and management
İsmet Rezani Toptancı, Hakan Çolak, Serhat Köseoğlu
J Clin Exp Invest 2012;3(1):133-136.
https://doi.org/10.5799/ahinjs.01.2012.01.0131
Review
[Abstract]
[PDF]
ABSTRACT
Cleidocranial dysplasia (CCD) is an autosomal dominant skeletal dysplasia characterised by abnormal clavicles, patent sutures and fontanelles, supernumerary teeth, short stature, and a variety of other skeletal change. Cleidocranial dysplasia is caused by mutation in the gene on 6p21 encoding transcription factor CBFA1, i.e. runt-related transcription factor 2 (RUNX2). Individuals with CCD should be followed by either a team of specialist or by individual specialist familiar with the problems that can be associated with this condition.
Keywords: Cledio-cranial dysplasia, supernumerary teeth, diagnosis
Current treatment methods in osteoarthritis
Demet Uçar, Mehtap Bozkurt
J Clin Exp Invest 2012;3(1):137-140.
https://doi.org/10.5799/ahinjs.01.2012.01.0132
Review
[Abstract]
[PDF]
ABSTRACT
Osteoarthritis, the most common chronic disease in the joints, resulting destruction. It is the most common cause of pain and loss of function in society. The primary goal of treatment, to educate patients about the course and results of the disease, to prevent the progression of joint damage and alleviate pain, and provide functionality in activities of daily living. To date, several options are defined on the treatment of osteoarthritis. In this review, current non-surgical methods of treatment will be discussed in osteoarthritis.
Keywords: Osteoarthritis, medical treatment, outcome
An industrial risk: Beryllium
Emrah Çaylak, Metin Aytekin
J Clin Exp Invest 2012;3(1):141-148.
https://doi.org/10.5799/ahinjs.01.2012.01.0133
Review
[Abstract]
[PDF]
ABSTRACT
Beryllium is a vocational disease factor and beryllium exposure can potentially lead to Chronic Beryllium Disease (CBD) in 2-6 % of workers. While acute lymphocytic pneumonia occurred in individuals who were exposed to high doses of beryllium, low dose exposure to beryllium followed by a long subclinical period can cause CBD characterized with chronic granulomatosis. It has been observed that varying amounts of beryllium exposure are necessary to produce symptoms of CBD or beryllium sensitization (BeS). Genetic differences between patients may be the underlying cause of these dose-effects and further study of the differences in patients exposed to beryllium may lead to earlier diagnosis and the identification of biomarkers of CBD. In this review, it is summarized the general properties of beryllium exposure, the immunopathogenesis and genetic differences of beryllium-induced diseases, genotoxicity and the carcinogenic effects of beryllium.
Keywords: Beryllium, diagnosis, lung diseases, beryllium sensitization, chronic beryllium disease
Early and late endocrinologic complications of the hematopoetic stem cell transplantation performed for hematologic malignancies
Osman Yokuş, Murat Albayrak
J Clin Exp Invest 2012;3(1):149-150.
https://doi.org/10.5799/ahinjs.01.2012.01.0134
Review
[Abstract]
[PDF]
ABSTRACT
Hematopoietic stem cell transplantation (HSCT) is used for various hematologic malignancies seen in children and adults. There may be several complications before, during, and after the HSCT. Just one of them is endocrinologiccomplications, since endocrine system (particularly the pituitary gland, thyroid gland, adrenal glands, and gonads) is highly sensitive against various stress. Chemotherapy and/or total body irradiation used as preparative regimens and immunosuppressive agents (especially corticosteroids) used for the graft-versus-host disease can cause hormonal disorders. Time elapsed after the HSCT, transplantation type (autologous or allogeneic), preparative regimen choice, age, and gender determines the complications. A multidisciplinary management containing a specialist of endocrinology for these patients is preferred. In this report, we reviewed the endocrinologiccomplications that observed after the HSCT in children and adults referring to the recent literatures.
Keywords: Hematopoietic stem cell transplantation, pituitary hormones, follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid gland, cortisol, osteoporosis, metabolic syndrome