Changing of Uric Acid Levels by Age and Sex in Patients with Diabetes Mellitus
Nilgün Başaran, Osman Evliyaoğlu, Veysel Sucu, Leyla Bulut, Okan Dikker, Fatma Tezcan, Müberra Vardar
J Clin Exp Invest 2016;7(1):1-6.
https://doi.org/10.5799/jcei.328707
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: We examined the association between uric acid and glycemic status by the aspects of age and sex.
Methods: The retrospective was performed study at Okmeydanı Educate and Research Hospital. All data were obtained from the patient records. Only one sample of HbA1c or glucose measurement within a year was included. To evaluate the pattern of glucose control, we categorized the patients according to HbA1c levels and grouped them according to a range of values. HbA1c was measured by high performance liquid chromatography, routine biochemistry parameters were determined by photometric method.
Results: Serum uric acid levels showed an increasing trend with the age in female group and this trend became significant after 30 years old (p<0.001). The significant effect of HbA1c and gender on uric acid levels were determined in the subjects having no renal failure. There was a significant increase of uric acid levels in prediabetics than normal group and decrease in unregulated diabetics. But in both sex groups the pattern of changing was different.
Conclusion: In conclusion, we found that age is an important factor examining the serum uric acid levels of female subjects. The peak values of serum uric acid were detected in prediabetic group in males but in females this peak point was diabetic group.
Keywords: Diabetes mellitus, uric acid, age, gender
Laparoscopic Uterine Nerve Ethanol Neurolysis (LUNEN) in Patients with Chronic Pelvic Pain
Seyhan Sönmez, Ümit Naykı, Paşa Uluğ, Cenk Naykı, Ferhan Sönmez, Şivekar Tınar, Yusuf Yıldırım
J Clin Exp Invest 2016;7(1):7-13.
https://doi.org/10.5799/jcei.328658
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: To investigate the efficacy of laparoscopic uterine nerve ethanol neurolysis (LUNEN) for pain management in patients with chronic pelvic pain (CPP).
Methods: LUNEN, as a chemical neurolysis procedure, was performed on 22 subjects, and these were compared with 20 controls that had a diagnostic laparoscopy alone. Pre-treatment and postoperative 6th month Visual Analogue Scale (VAS) scores were estimated and a subjective pain evaluation questioning patients’ satisfaction about pain relief in the 6th month after surgery was also performed.
Results: A total of 31 (73.8%) out of 42 CPP patients had a laparoscopic pelvic pathology. Preoperative VAS scores were similar in the groups; however, the mean postoperative VAS score was significantly lower in the LUNEN group than in the control group (3.18 ± 2.88 vs. 5.35 ± 3.09; p=0.02). In the LUNEN group, the number of patients who stated that their pain was relieved partially or completely was also significantly higher than in the control group (82% vs. 40%, p=0.019).
Conclusion: LUNEN is a feasible, safe and effective surgical alternative to traditional surgical methods in patients suffering from CPP.
Keywords: Chronic pelvic pain, uterine nerve neurolysis, laparoscopy, ethanol
A Single Center Experience on the Management of Placental Invasion Abnormalities
Alper Biler, Atalay Ekin, Cenk Gezer, Ulaş Solmaz, Nuri Peker, Aykut Özcan, Mehmet Özeren
J Clin Exp Invest 2016;7(1):14-18.
https://doi.org/10.5799/jcei.328659
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: The aim of this study is to investigate our management of placental invasion abnormalities.
Methods: A retrospective study was conducted on patients admitted to a tertiary referral center with a diagnosis of placental invasion abnormalities between 2011 and 2015. Risk factors and perinatal outcomes associated with placental invasion abnormalities were identified.
Results: The overall incidence of placental invasion abnormalities during the 5-year period was 8.3/10000 deliveries, which showed an increasing trend. Ultrasonography and magnetic resonance imaging correctly identified placental invasion abnormality in 36.7% and 68.7% cases, respectively. Majority of patients (55.1%) with adherent placenta were diagnosed at the time of delivery. Of these patients, 22.4% underwent hysterectomy, 83.8% required at least one of the additional surgical procedures and 55% were transfused at least four units of packed red blood cell.
Conclusion: Since placental invasion abnormalities are associated with significant morbidity, delivery should be scheduled in a tertiary center with appropriate expertise and facilities.
Keywords: placenta accreta, placenta increta, placenta percreta, placental invasion abnormality
Crystallized Phenol Treatment in Postoperative Recurrent Pilonidal Disease
Zülfü Bayhan, Sezgin Zeren, Şükrü Aydın Düzgün
J Clin Exp Invest 2016;7(1):19-22.
https://doi.org/10.5799/jcei.328661
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: A variety of surgical and minimally invasive treatment options are available to treat pilonidal sinus disease. Recurrence after surgery is a major problem. In addition to the surgical treatment of post-surgical recurrences, minimally invasive treatment methods are also available. In our study, we aimed to investigate the results of crystallized phenol application on patients who were admitted to our clinic with post-surgical pilonidal sinus recurrence.
Methods: The data of 26 patients who were admitted to our clinic with postoperative pilonidal sinus recurrence and who were treated by crystallized phenol treatment were analyzed. Patients were evaluated in terms of age, gender, previous surgery, crystallized phenol application count, follow –up period and wound infection.
Results: Data of 26 patients were analyzed.3 patients (11.5%) were admitted with recurrence after Modified Limberg surgery. 11 patients (42.3%) were admitted with recurrence after Limberg flap surgery and12 patients (46.15%) were admitted with recurrence after primary repair. 19 patients (73.02%) were treated by one time crystallized phenol application. 5 (19. 23%) patients underwent a second time application and provided treatment after the second application. The cure was achieved in 24 (92.3%) patients after repeated applications.
Conclusion: Crystallized phenol application is a minimally invasive treatment method that can be applied easily under local anesthesia. The method has a high success rate after repeated applications in patients with recurrence after surgery and is a very good alternative to surgical therapy.
Keywords: Recurrent pilonidal disease, crystallized phenol treatment, minimally invasive treatment
Clinical Approach to Patients with Mastalgia in Breast Disease Outpatient Clinic
Sezgin Zeren, Zülfü Bayhan, Cengiz Koçak
J Clin Exp Invest 2016;7(1):23-28.
https://doi.org/10.5799/jcei.328663
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: The aim of this study was to report our approach and outcomes of patients applied to our breast disease policlinic with mastalgia.
Methods: The records of 877 patients presented with mastalgia to breast disease policlinic between April 2014 and January 2016 were examined retrospectively. Age, sex, body mass index (BMI), mammography breast imaging-reporting and data system score (BIRADS), ultrasonography evaluation, biopsy status, pathology results and operation procedures were investigated. Correlation between BIRADS score, age and BMI were analyzed.
Results: All of the patients were female and median age was 49,0 years. Ultrasound showed breast mass in 283 (32.3%) patients and 165 (18.8%) of these underwent fine needle aspiration or true cut biopsy. Only 14 (8.5%) patients were diagnosed as malignant. Eight of the malignant cases had breast conserving surgery. Ages of the patients showed significant positive correlation with BIRADS classification values of the patients (r = 0.069, p = 0.04). However, BMI values did not correlate with BIRADS classification values of the patients.
Conclusion: Mastalgia is a common symptom in women. In high risk patients for breast carcinoma, it should be investigated seriously. Both mammography and ultrasonography can be used at the same time for diagnoses. Especially in patients having dense breasts including young’s, mammography alone cannot be satisfying for the evaluation.
Keywords: Mastalgia, breast policlinic, cancer, mammography
Anticoagulant Therapy in Primary and Secondary Recurrent Pregnancy Losses with Hereditary Thrombophilia and Perinatal Outcomes
Hatice Işık, Hüsnü Alptekin, Refika Selimoğlu, Türkan Cengiz, Hasibe Uygun Kucukapan, Nazife Alptekin
J Clin Exp Invest 2016;7(1):29-34.
https://doi.org/10.5799/jcei.328667
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: To investigate the effect of anticoagulant treatment and perinatal outcomes in patients with primary or secondary recurrent pregnancy loss without cause other than inherited trombophilia.
Methods: A total of 143 pregnant patients with recurrent pregnancy loss (≥2 abortus) and had no detected cause other than thrombophilia, were included in the study. Patients with no livebirth history were accepted as primary and patients with at least one livebirth were as secondary recurrent spontaneous aborters (PrimRSAs and SecRSAs). Inherited thrombophilia genetic results of the patients in both groups were compared. The effects of low-molecular weight heparin (LMWH) and low-dose aspirin (LDA) treatments alone or together, livebirth rates and pregnancy outcomes were investigated.
Results: Sixty-eight patients were in PrimRSAs and 75 were in SecRSAs. Ages, numbers of total, early and late pregnancy loss of both groups were similar. In PrimRSAs 49 (72.1%) and in SecRSAs 50 (66.6%) patients had three or more inherited thrombophilia genetic mutations. Of 113 patients who used LMWH+LDA during pregnancy 88 (77.6%) had livebirth; however, of 19 patients who used LMWH 6 (31.6%) and of 11 women who used LDA 8 (72.7%) had livebirth. Livebirth rate was significantly higher in patients who used LMWH+LDA together (p=0.001). Livebirth rates were higher in SecRSAs than PrimRSAs irrespective to the anticoagulant treatment (p=0.002).
Conclusion: LMWH and LDA treatment together may increase livebirth rates in patients with recurrent pregnancy loss and inherited thrombophilia. Having at least one livebirth of the patients is a good prognostic factor.
Keywords: Recurrent pregnancy loss, anticoagulant treatment, inherited thrombophilia
Are Pediatric Emergency Care Applied Research Network Rules (PECARN) Sufficient for Computed Cranial Tomography Decision in Pediatric Patients with Mild Head Trauma?
Hasan Mansur Durgun, Erkan Tektaş, Yılmaz Zengin, Recep Dursun, Mustafa İçer, Mehmet Üstündağ, Murat Orak, Cahfer Güloğlu
J Clin Exp Invest 2016;7(1):35-40.
https://doi.org/10.5799/jcei.328671
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: In this study we aimed to investigate the applicability of Pediatric Emergency Care Applied Research Network (PECARN) rules for decision to perform computed cranial tomography (CCT) in pediatric patients with minor head trauma (MHT).
Methods: 317 pediatric patients who underwent CCT for mild head trauma were evaluated retrospectively. The patients were classified in two groups according to PECARN rules: below 2 years old, above 2 years old and then, these patient groups were classified into two subgroups according to the compatibility with PECARN rules. The patients requiring CCT according to PECARN rules were classified as PECARN compatible (PECARN +), the patients who underwent CCT without the need of CCT according to PECARN were classified as PECARN incompatible (PECARN -).
Results: Approximately 20% patients in PECARN (+) group had abnormalities leading to prolonged hospitalization and only 3.8% patients of PECARN (-) group had abnormalities. However, none of PECARN (-) group patients required follow-up longer than 48 hours in the hospital. The most common symptoms necessitate CCT in PECARN (+) group were scalp swelling, scalp hematoma and vomiting. In PECARN (-) group the most common signs were cuts in the scalp and dermal abrasions. The incidence of fracture in CCT was significantly higher in PECARN (+) group.
Conclusion: Because CCT poses serious radiation exposure, neurological examination and clinical follow-up should be preferred in the evaluation of children with MHT. In conclusion, PECARN rules were sufficient for CCT decision in pediatric patients with MHT.
Keywords: Minor head trauma, pediatric trauma, computed cranial tomography
Assessment of Quality of Life, Psychological and Functional Status and Disease Activity in Patients with Ankylosing Spondylitis and Fibromyalgia
Mehmet Caglayan, Mehmet Gunes, Mehtap Bozkurt, Kemal Nas
J Clin Exp Invest 2016;7(1):41-46.
https://doi.org/10.5799/jcei.328679
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: Anxiety and depression are psychological disorders which frequently accompany and affect the course of rheumatic diseases. Quality of life is also affected by psychological status. In this study, we aimed to assess psychological status and quality of life in patients with ankylosing spondylitis (AS) and fibromyalgia (FM) and investigate their association with functional status, disease activity and physical limitation.
Method: Thirty-seven patients with AS and thirty-four patients with FM were included in this study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were used for assessment of disease activity and physical functions respectively. The Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire was used for disease-related quality of life in AS patients. Fibromyalgia Impact Questionnaire (FIQ) was used for assessment of functional status in FM patients. Nottingham Health Profile (NHP) and the Hospital Anxiety and Depression Scale (HADS) were, respectively, used for assessment of quality of life and psychological status in groups.
Results: There was no significant difference between the groups in HADS-total, HADS-depression and HADS-anxiety scores (p>0.05). However, patients with FM had significantly higher NHP-total and NHP-pain scores compared to patients with AS (p<0.05).
Conclusion: There was no significant difference between the two groups in psychological distress. Higher NHP-pain scores in patients with FM might have been caused by lower pain threshold in these patients. The generalizability of our findings is also limited because of the relatively small sample size.
Keywords: Psychological status, functional status, quality of life, ankylosing spondylitis, fibromyalgia
The Effect of Elevated Homocysteine Levels on Atherosclerosis in Patients with Peritoneal Dialysis
Fatih Şahpaz
J Clin Exp Invest 2016;7(1):47-51.
https://doi.org/10.5799/jcei.328680
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: Cardiovascular disease is an important cause of morbidity and mortality in patients with renal failure. Patients with chronic renal failure are significantly susceptible to atherosclerosis. In the present study, we aimed to investigate the effect of elevated homocysteine on atherosclerosis and inflammation in continuos ambulatory peritoneal dialysis (CAPD) patients.
Methods: 56 patients undergoing CAPD and 27 healthy subjects was enrolled in the study. All patients total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, hs-CRP, homocysteine, intima-media thickness, arterial stiffness values were measured and statistically analyzed.
Results: It is determined that the levels of total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, homocysteine, intima-media thickness, arterial stiffness and hs-CRP was higher in patients compared to the control group (in order; p=0.03, p=0.0006, p=0.02).
Conclusion: Carotid intima-media thickness being increased because of increased levels of homocysteine and inflammation in CAPD patients. Therefore, in case of atherosclerosis, hyperlipidemia and inflammation more aggressive treatment protocol should be considered. Patients with elevated plasma homocysteine concentrations should be treated.
Keywords: Inflammation, peritoneal dialysis, intima-media thickness, arterial stiffness
The Effect of Therapeutic Touch Performed During Cataract Surgery on Anxiety and Patient Satisfaction
Emel Yılmaz, Zeliha Birer, Hakan Baydur
J Clin Exp Invest 2016;7(1):52-62.
https://doi.org/10.5799/jcei.328682
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: The aim of the study was to determine the effect of therapeutic touch (TT) on anxiety and patient satisfaction when performed during a cataract surgery.
Methods: A randomized controlled trial sample consisted of 114 individuals, 57 in the intervention group and 57 controls, who were hospitalized for cataract surgery and who conformed to the study criteria. Prior to the study approval was obtained from the ethics committee and informed consent was given by the patients. Data was collected using a personal information form, a visual analogue scale (VAS) to measure anxiety, the Spielberg State/Trait Anxiety Inventory (STAI) and the Newcastle Satisfaction with Nursing Care Scale (NSNCS). During the surgery, patients in the intervention group received a 15-minute session of TT.
Results: In the intervention group, patients’ mean VAS anxiety score after TT was 3.56±1.85, while that of the control group in the 15th minute of the operation was 8,88±1,50. It was found that anxiety levels were reduced in the intervention group after TT compared with the control group, and that vital signs were affected positively. NSNCS scores of patients in the intervention group were higher than those in the control group.
Conclusion: It was observed that TT applied during surgery reduced anxiety, affected vital signs positively and increased patent satisfaction. The application of TT during surgery is recommended.
Keywords: Cataract surgery, therapeutic touch, anxiety, patient satisfaction
Evaluation of Hearing Functions with Audiological Tests in Patients with Rheumatoid Arthritis
Selma Evran Uzun, Adem Yıldırım, Gülseren Dost Sürücü, Sedat Doğan, Mehmet Karabiber, Yasin Sarıkay
J Clin Exp Invest 2016;7(1):63-68.
https://doi.org/10.5799/jcei.328683
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: Aim of this study was to show the effects of rheumatoid arthritis (RA) on auditory system using pure tone audiometer and tympanometric assessments and to compare these values with healthy controls.
Methods: This study included 107 subjects: 57 RA patients who were being followed at our clinic with a RA diagnosis and 50 healthy controls who had similar age and gender properties. Besides clinical and laboratory findings audiometric, and tympanometric tests and stapes reflex measurements were compared for all patients.
Results: Results of this study showed statistically significant differences in air conduction thresholds at 0.5, 1, 2, 4, and 6 kHz frequencies between RA patients and controls. In RA patients, bone conduction was affected only at 4 kHz and more in left ear. Additionally, air-bone conduction differences were significant except at 2 kHz. Although air-bone conduction difference was higher in the study group than the control group, this was not statistically significant. Similarly no significant difference was detected in stapes reflex and tympanometric measurements between RA patients and healthy controls statistically.
Conclusion: This study showed that conduction type hearing loss is seen more frequently in RA patients and bone conduction is affected at high frequencies in particular. Moreover, No significant differences were seen in stapes reflex, compliance and pressure measures between groups.
Keywords: Rheumatoid arthritis, pure tone audiometer, hearing loss
Investigation of Hepatitis E Virus IgG Seroprevalence in Women with Reproductive Age
Erdal Özbek, Hakan Temiz, Ayşe Batgi Azarkan, Mehmet Obut, Şeyhmus Mete
J Clin Exp Invest 2016;7(1):69-72.
https://doi.org/10.5799/jcei.328684
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: Hepatitis E virus (HEV) infection can cause fatal hepatitis particularly in pregnant women. In this study, it was aimed to investigate the rate of anti HEV IgG seroprevalence in women of childbearing age and whether there are differences in seroprevalence among people living in urban and rural areas or not.
Methods: A total of 158 women volunteers aged 15-49 years living in rural or urban areas were included in this study. Anti-HEV IgG antibodies were performed with enzyme immunoassay method. The obtained data were presented as numbers and percentages and statistically analyzed.
Results: Anti-HAV IgG was detected positive in 41 of the 158 volunteers (25.9%). Anti-HEV IgG was found positive in 25 of the 92 volunteers living in urban areas (27.2%) and in 16 of the 66 volunteers in rural areas (24.2%).
Conclusion: In our city, HEV seroprevalence is above the average in Turkey. We think that epidemiological factors should be investigated and that screening HEV serology can be useful in pregnancy monitoring.
Keywords: HEV, seroprevalence, woman
Mean Platelet Volume in Patients with Chronic Venous Insufficiency
Mehmet Akif Sarıca, Betül Kızıldağ, Mustafa Yavuz Selçuk, Ayşe Şahin Tutak, Ali Haydar Baykan, Hacı Taner Bulut, İbrahim Halil Türkbeyler
J Clin Exp Invest 2016;7(1):73-77.
https://doi.org/10.5799/jcei.328685
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: the mean platelet volume (MPV) is a good indicator of platelet activity; it is reported to increase in diseases associated with inflammatory processes and in vascular diseases. This study investigated the importance of mean platelet volume in patients with chronic venous insufficiency (CVI) and whether the MPV was likely to be a predictor of the CVI.
Methods: 117 patients who were diagnosed as CVI by colored Doppler Ultrasound (CDU) method and 49 healthy volunteers (forming the control group) were enrolled to this study, which was planned retrospectively. The patients’ blood count values taken within one month before and after the CDU evaluation were recorded by the hospital information system. The complete blood count, routine biochemical tests and thyroid function tests of the patients diagnosed with CVI were compared to the control group.
Results: Significant differences were not detected between the patients and the control group in terms of the levels of creatinine, aspartate aminotransferase, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, erythrocyte, sedimentation speed, leukocyte, haemoglobin and thrombocyte (p>0.05). The thyroid stimulating hormone and the MPV levels were significantly lower in the control group (p<0.05).
Conclusion: MPV levels as an easy, cheap and practical data extracted from complete blood count, were found higher in patients diagnosed with CVI compared to the control group. This may be originated from endothelium changes as an answer to venous hypertension and dilatation in CVI. MPV can be used as a follow-up marker in CVI patients.
Keywords: Mean, platelet, volume, vein, insufficiency
The Effects of Gender, Age, and Refractive Error on Corneal and Conjunctival Epithelial and Overall Thicknesses
İsmail Erşan, Selcuk Kara, Sedat Arıkan, Baran Gencer, Hasan Ali Tufan
J Clin Exp Invest 2016;7(1):78-82.
https://doi.org/10.5799/jcei.328687
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: To evaluate the corneal, conjunctival epithelial and overall thicknesses measured by anterior segment optical coherence tomography (OCT) in healthy population.
Methods: This retrospective study included 134 eyes of 134 healthy individuals who were undergone a Cirrus HD-OCT examination using the Anterior Segment 5 Line Raster protocol. Corneal, conjunctival epithelial and overall thicknesses were measured on OCT images. The average values of four OCT parameters were compared between sexes and among the six subgroups with respect to age.
Results: The average corneal epithelial and overall thicknesses were 51.30±4.60 μm and 532.47±37.30 μm, respectively. The average conjunctival epithelial and overall thicknesses were 47.20±8.03 μm and 237.07±40.62 μm, respectively. All of the measurements were thicker in males compared to females, however the significant difference was found for only corneal epithelium (p=0.043). Using the Spearman correlation coefficient, central corneal and conjunctival epithelial thicknesses showed significant negative correlations with age (p=0.006, p=0.005, respectively) and refraction (p=0.040, p=0.033, respectively).
Conclusion: Ocular surface parameters measured by anterior segment OCT were gender, age, and refraction-related. Thus, further studies conducted to evaluate the corneal and conjunctival thicknesses should involve gender, age, and refraction-matched control groups.
Keywords: Anterior segment optical coherence tomography, epithelial thickness, spherical equivalent
Punch Biopsy Results of Nasopharynx Pathologies
İsa Özbay, Cüneyt Kucur, Sinan Aksoy, Fatih Oğhan, Semra Külekçi, Nadir Yıldırım
J Clin Exp Invest 2016;7(1):83-86.
https://doi.org/10.5799/jcei.328689
Research Article
[Abstract]
[PDF]
ABSTRACT
Objective: Although nasopharynx (NF) has an anatomically distant sites to view, biopsy can be taken easily from NF by the help of an endoscope in order to reach a definitive diagnosis. In this study, NF pathology results in the patient group were analyzed retrospectively.
Methods: NF biopsy results of 80 patients who were admitted to Ear, Nose and Throat (ENT) clinic of Dumlupınar University Evliya Celebi Education and Research Hospital between September 2012-February 2016 were included in the study, retrospectively. NF has been viewed to rule out NF cancer under general or local anesthesia by rigid or flexible endoscopes and punch biopsies were taken.
Results: NF patients who underwent biopsy were composed of 25 (31.2%) females and 55 (68.8%) males and the average age was 35.33. Histopathological results in 3 patients (3.7%) were malignant. The pathology (96.3%) were identified as chronic lymphoid hyperplasia and lymphoid processes in the remaining 77 patients. 4 patients underwent repeat biopsy follow-on clinical suspicion of malignancy, but ultimately malignancy was not observed.
Conclusion: NF biopsy is a method which is easily applied in the examination of the cancer and other masses of NF. In this study, age, sex, clinical and histopathologic analysis of the patients who underwent NF biopsies were discussed in the light of the literature.
Keywords: Nasopharynx, biopsy, malignancy
A Rare Cause of Abdominal Mass: Rapunzel Syndrome
Feyzullah Uçmak, Remzi Beştaş, Haydar Adanır, Nazım Ekin, Ali Tardu
J Clin Exp Invest 2016;7(1):87-90.
https://doi.org/10.5799/jcei.328692
Case Report
[Abstract]
[PDF]
ABSTRACT
Bezoar is a condition in which foods or fibers that are not absorbed in the gastrointestinal system usually accumulate in the stomach. It usually develops in persons with gastrointestinal motility disorders, anatomic changes or psychiatric disorders. Trichobezoar is the accumulation of hair in the gastric chamber among people with psychiatric disorders such as trichotillomania and trichophagia. Rapunzel syndrome, however, is a rare form of trichobezoar extending from the stomach to the small intestine. In this paper, we present a rare case of 15-year old girl diagnosed with Rapunzel syndrome on admission due to abdominal pain and abdominal mass
Keywords: Rapunzel syndrome, trichobezoar, abdomen mass
Three Cases of Adenomyoepithelioma: An Unusual Breast Neoplasm
Murat Özgür Kılıç, Meral Şen, Cenap Dener, Dilek Kösehan, Sibel Yenidünya
J Clin Exp Invest 2016;7(1):91-93.
https://doi.org/10.5799/jcei.328693
Case Report
[Abstract]
[PDF]
ABSTRACT
Adenomyoepithelioma of the breast is an unusual tumor characterized by biphasic proliferation of both epithelial and myoepithelial cells. Although most of these tumors have a benign course, a small number of malignant lesions have been reported in the literature. Adenomyoepithelioma is also characterized by propensity for local recurrence. Therefore, the sufficiency of initial surgery plays very important role in the management of these tumors. Due to the potential to malignant transformation and high risk of local recurrence, totally excision with wide margins should be performed in surgical treatment of these tumors. In this paper, three cases of adenomyoepithelioma of the breast with different clinical presentations and radiological findings were reported.
Keywords: Adenomyoepithelioma, breast, diagnosis, treatment
Bietti Crystalline Retinal Dystrophy: A Case Report
Muhammed Şahin, Adnan Yıldırım, Fatih Mehmet Türkcü, Harun Yüksel, Alparslan Şahin
J Clin Exp Invest 2016;7(1):94-97.
https://doi.org/10.5799/jcei.328695
Case Report
[Abstract]
[PDF]
ABSTRACT
Bietti’ crystalline retinal dystrophy (BCD) is a rare, autosomal, recessively inherited disorder, characterized by the deposition of yellow crystals in the corneal limbus and retina. In this paper we aimed to present a pediatric case with BCD, with clinical, electrophysiological and spectral domain optical coherence tomography (SD-OCT) findings and discuss BCD with the light of the literature.
Keywords: Bietti’ crystalline dystrophy, cornea, crystalline deposits, retina
Pulmonary Nodulosis Associated with Leflunomide Therapy in Rheumatoid Arthritis: Report of Four Cases and Review of the Literature
Ayse Balkarli, Veli Cobankara
J Clin Exp Invest 2016;7(1):98-102.
https://doi.org/10.5799/jcei.328697
Case Report
[Abstract]
[PDF]
ABSTRACT
Rheumatoid arthritis (RA) is a multisystem inflammatory disease characterized by destructive synovitis and systemic extra-articular involvement. Leflunomide is a disease-modifying anti-rheumatic drug with anti-inflammatory and anti-proliferative features. Leflunomide is an isoxazole immunomodulatory agent, which inhibits dihydroorotate dehydrogenase enzyme involved in de novo pyrimidine synthesis. It was shown that leflunomide can reduce signs and symptoms of rheumatoid arthritis (RA) with regression in structural damage. Pulmonary involvement is one of the extra-articular manifestations of rheumatoid arthritis and it can occur due to either disease itself or medications used in the treatment. We presented 4 cases with rheumatoid arthritis which developed pulmonary nodules with leflunomide therapy and reviewed literature.
Keywords: Rheumatoid arthritis, leflunomide, pulmonary nodule
Early Development of Slipped Capital Femoral Epiphysis in a Patient with Infantile Tibia Vara
Hristo Georgiev, Georgi Petrov Georgiev, Milka Dikova
J Clin Exp Invest 2016;7(1):103-106.
https://doi.org/10.5799/jcei.328700
Case Report
[Abstract]
[PDF]
ABSTRACT
Herein, we present a unique case of an early development slipped capital femoral epiphysis with bilateral infantile tibia vara in a girl of 7 years 5 months of age. There are only few such case reports previously published in the literature. We make a brief review of these pathological conditions involving the physis and compare them to our case.
Keywords: Slipped capital femoral epiphysis, infantile tibia vara, child
Benign Endometrial Polyp and Primary Endometrial Small Cell Neuroendocrine Carcinoma Confined to the Polyp: A Rare Association
Pembe Oltulu, Ceyhan Uğurluoğlu, Ayşenur Uğur, Sıdıka Fındık, Lema Tavlı
J Clin Exp Invest 2016;7(1):107-110.
https://doi.org/10.5799/jcei.328701
Case Report
[Abstract]
[PDF]
ABSTRACT
Neuroendocrine tumors (NETs) are a heterogeneous group of tumoral lesions originating from diffuse endocrine system cells. They occur mostly in the gastrointestinal system and the lung. Primary NETs of the female reproductive tract are rare. In a widely used classification, primary small cell neuroendocrine carcinomas (SCNECs) and large cell neuroendocrine carcinomas (LCNECs) of the endometrium were included in a subgroup of poorly differentiated neuroendocrine carcinomas. SCNECs of the endometrium are very rare and they are often combined with other epithelial neoplasms. Their myometrial and extrauterine invasions are common during the initial diagnosis due to their aggressive behaviors. In this article, we present a rare case of primary endometrial SCNEC detected within the benign endometrial polyp and without invasion of myometrium and extrauterine tissues in a 70-year-old female patient presenting with postmenopausal bleeding. Histopathologically, the tumor cells showed positive staining with Synaptophysin, the Ki-67 labeling index was 80-90%, the mitotic index was 15/10 per HPF and there was no necrosis and lymphovascular invasion.
Keywords: Small cell carcinoma, endometrial polyp, neuroendocrine tumor, endometrium
In the Context of Bioethics and Biopolitics with Keeping Track of the Helsinki Declaration
Ümit Yaşar Öztoprak, Mesut Ersoy, Onur Naci Karahancı, Nüket Örnek Büken
J Clin Exp Invest 2016;7(1):111-119.
https://doi.org/10.5799/jcei.328703
Review
[Abstract]
[PDF]
ABSTRACT
Bioethics and biopolitics derive from ethics, which constitutes their denominator but their choice and the application of the moral principles ranges from being simply different to being outright contradictory. In order to understand the interaction between bioethics and biopolitics, which has been repeatedly mentioned, we believe that it is important to examine the Declaration of Helsinki. When the revisions of the declaration are analyzed thoroughly, especially when the differences between the 2008 and 2013 revisions are examined, it is possible to see how bioethics and politics contradict and/or overlap each other in the world of clinical research.
In 1952 ethics commission was established under WMA (World Medical Association), in 1961 an outline of text about use of human subjects and researches on human being was created to be a guideline for physicians. This text has been declared at the 18th General Assembly of the WMA (Helsinki 1964).
In our study, in the light of this document, we will evaluate with a critical perspective, the revision in 2013 and the WMA’s biopolitics concerns relating to reserch on human subject. We will scent out the traces of the capitalism on the health and health care era.
Keywords: Helsinki declaration, biomedical research, bioethics, biopolitics
Thyroid Diseases and Treatment in Pregnancy
Aynur Aktaş, Zafer Pekkolay
J Clin Exp Invest 2016;7(1):120-124.
https://doi.org/10.5799/jcei.328705
Review
[Abstract]
[PDF]
ABSTRACT
Assessment of thyroid disease in pregnancy is important for gestational maternal health, obstetric outcome and, subsequent development of child. Pregnancy has profound effects on the regulation of thyroid function, and on thyroidal functional disorders, that need to be recognized, carefully evaluated and correctly managed. In women with normal thyroid function there is an increase in thyroxine (T4) and triiodothyronine (T3) production and inhibition of thyroid-stimulating hormone (TSH) in the first trimester of pregnancy,. In the pregnant woman, elevated thyroxine-binding globulin (TGB) and concomitant increases in total T4 and T3 levels plateau at 12-14 weeks of pregnancy, and free T4 measurements slowly decrease. The most frequent thyroid disorder in pregnancy is maternal hypothyroidism. It is associated with fetal loss, placental abruptions, preeclampsia, preterm delivery and reduced intellectual function in the offspring. Hyperthyroidism during pregnancy is relatively uncommon, with a prevalence estimated to range between 0.1% and 1%. The most common cause of hyperthyroidism is Graves disease, as this etiology accounts for 85% of clinical hyperthyroidism in pregnancy. Another cause of hyperthyroidism is hyperemesis gravidarum. This is common and requires differentiation from Graves disease. There has been much discussion and many publications on the optimal management of pregnant women who are hyperthyroid or hypothyroid. Despite the lack of consensus organizations, which are based on analyses, support screening in all pregnant women in the first trimester for thyroid disease. In this article, we provide information about the current approaches of thyroid dysfunction in pregnancy.
Keywords: Pregnancy, thyroid function, complications, treatment