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Kinetic Study on the OSL Technique Using Human Blood Sample
Get PDFIt is dear that humans are exposed to ionizing radiation both of internally or externally in radiotherapy. The determination of ionizing radiation dose in human blood has been previously performed by us using optically stimulated luminescence technique. OSL technique is based on measuring the luminescence intensity from a sample that has been exposed to ionizing radiation. In this study, the detrapping constants for human blood samples were investigated using Curve-Fitting, Active OSL-Approximation and Linear Modulation techniques. The Active OSL-Approximation was based on the radioactive decay law of successive disintegration. It allows obtaining the peak forms of luminescence signal. It has been observed that the decay rates for blood sample exposed to different radiation doses were changed with dose. AOSL- Approximation is appropriate for separating the peaks that correspond to decay rates
Factors affecting mortality in rectus sheath hematoma: A retrospective study
Get PDFAim: Rectus sheath hematoma is a rare clinical condition. Because it could mimic various intra-abdominal pathologies suspicious approach and attention is needed for proper diagnosis and management of rectus sheath hematoma. The aim of this study is a review of factors affecting mortality in patients with rectus sheath hematoma besides clinical features, diagnosis modalities, treatment periods and results of patients with rectus sheath hematoma. Material and Method: Twenty-three patients with rectus sheath hematoma from January 2012 to March 2017 in a tertiary care center were included in the study. Patients' files were reviewed retrospectively. Reviewed variables were demographic and clinical features, symptom and findings, co-morbidities, medications, laboratory findings, diagnostic modalities, APACHE II scores, treatment approaches, transfused blood products and length of hospital stay. Results: Fifteen (65.2%) of the patients were women, and 8 (34.8%) of the patients were men. The mean age was 61.9 +/- 13.5. Seventeen (74%) of the patients had abdominal pain. Twenty (87%) of the patients had anticoagulant and antiplatelet therapy. The mean hematoma diameter was 6.3 +/- 3.6 cm. The mean APACHE II score for the patients was 13.1 +/- 7.3. One patient had undergone surgery. There was mortality in 3 (13%) of the patients. The median length of stay in hospital was 5 (5) days. Discussion: The diagnosis of rectus sheath hematoma should be kept in mind while assessing old female patients and patients on anticoagulants with a complaint of abdominal pain. In our study, we identify risk factors such as higher APACHE - II scores, the presence of a transient ischemic attack, need for transfusion of more units of packed erythrocytes and more extended hospital stay as factors associated with mortality
A single-center experience of post-transplant lymphoproliferative disorder (PTLD) cases after pediatric liver transplantation: Incidence, outcomes, and association with food allergy
No full textBackground/Aims: We evaluated our 16-year single-center experience of pediatric post-transplant lymphoproliferative disorder (PTLD) cases who underwent liver transplantation between 2001 and 2017.
Materials and Methods: Of the 236 pediatric patients who underwent liver transplantation between 2001 and 2017, the clinical and laboratory data of eight patients diagnosed with PTLD were reviewed. The pre-transplant Epstein-Barr virus (EBV) status of 172 patients was also recorded.
Results: The total incidence of PTLD was 3.4%. The incidence of PTLD was 10% in pre-transplant EBV immunoglobulin G (IgG)-seronegative patients and 0.8% in pre-transplant EBV IgG-seropositive patients. The mean age of the patients at liver transplantation was 2.71 +/- 3.21 years, and four patients were aged below 1 year at the time of transplantation. PTLD was diagnosed at 21.81 +/- 18.1 months after transplantation. The primary site of involvement was variable among patients: peripheral and mediastinal lymph nodes, stomach and intestine, transplanted graft, bone marrow, and nasopharynx. The eosinophil count varied greatly among patients, with a mean value of 524.62 +/- 679/mm3. Three patients had a food allergy and were administered an elimination diet at the time of PTLD diagnosis. Six patients had PTLD of B-cell origin. One patient died due to neutropenic sepsis during chemotherapy, whereas seven patients were followed up in full remission for 7.75 +/- 4 years.
Conclusion: PTLD is a life-threatening complication of solid-organ transplantation with a heterogeneous clinical spectrum. Food allergy had a close association with PTLD. A close follow-up of patients with risk factors and an early diagnosis with appropriate treatment may lead to a better outcome
Recurrence of Primary Vascular Leiomyosarcoma Five Years after Initial Diagnosis in the Lower Extremity
No full textPrimary leiomyosarcomas of vascular origin are rare tumors. They frequently arise within the inferior vena cava; however, the peripheral vein was also affected. To date, only a few hundred cases have been reported in the world literature. Although it is an extremely aggressive tumor, the symptoms may be unspecific, especially in the lower extremities. In this report, we present a case of primary vascular leiomyosarcoma, arising from the short saphenous vein, with symptoms mimicking thrombus in the initial diagnosis. The diagnosis of leiomyosarcomas was confirmed by standard H&E staining and immunohistochemical staining. Recurrence of the tumor has been observed five years after surgical treatment. Due to its rarity, experience in the management of this type of tumor is limited. The mainstay of treatment for these tumors is complete surgical resection. The purpose of the presented case is to discuss the clinicopathological features and management options of this tumor, under the light of the most recent literatures
Tek taraflı periferik vestibüler bozukluğu olan hastalarda statokinesigram ve parametrelerinin video baş savurma testi ve otolitik reflekslerle olan korelasyonu
No full textPeriferik vestibüler bozukluklar, vestibüler labirent ya da vestibüler sinirlerdeki
patolojilerden kaynaklanır. Bu bozukluklarda, vertigo, postüral instablite ve denge kaybı gibi
semptomlar görülmektedir. Vestibüler sistemin değerlendirilmesinde, detaylı öykü ve fizik
muayenenin yanı sıra, sıklıkla kullanılan birkaç test bulunmaktadır. Literatürde bu testlerin
birbiriyle ilişkisini inceleyen herhangi bir çalışma bulunmaması bizde bu araştırmayı yapma
ihtiyacı doğurmuştur.
Bu çalışmanın amacı, tek taraflı periferik vestibüler bozukluğu olan hastalarda,
statokinesigramın ne ölçüde etkilendiğini incelemektir. Bu bağlamda, dinamik/ statik
postürografi ile tek taraflı vestibüler bozukluğu tanısına katkıda bulunan video baş savurma
testi (VHIT) ve vestibüler uyarılmış myojenik potansiyeller (VEMP) testlerinin ilişkisini
incelemektir.
Bu çalışma “tek taraflı periferik vestibüler bozukluk” tanısı almış, semptomları en az
üç aydır devam eden ve yaşları 40 ile 82 yaş arasında değişen 30 hastanın katılımı ile
gerçekleştirildi. Hastalara; statokinesigram (SKG), stabiliteninin limiti testi (limits of
stability), öne-arkaya postüral stabilite, sağa-sola postüral stabilite alt parametrelerini içeren
statik/dinamik sensoryal organizasyon testleri (dinamik postürografi); semisirküler kanalların
VOR kazanç ve ortalama hız parametrelerini içeren VHIT ve servikal- oküler VEMP testleri
uygulandı. Dinamik postürografi; farklı koşullardaki postüral stabiliteyi, VHIT; kanalların
VOR kazanç ve fonksiyonlarını; VEMP testleri ise, otolit fonksiyonunu ölçmekteydi.
Değişkenler arasındaki doğrusal ilişki pearson korelasyon analizi ile incelendi.
Analizler sonucunda, arkaya stabilite limiti ile posterior kanal hız ölçümleri arasında
negatif yönlü, orta derecede (r=-0,555; p=0,032); sola stabilite limiti ile anterior ve lateral
kanal hızları arasında pozitif yönlü orta derecede (r=0,528; p=0,043 / r=0,549; p=0,034);
anterior kanal kazancı ile servikal VEMP dalga latansları arasında negatif yönlü kuvvetli
derecede (r=-0,807; p=0,015 / r=-767; p=0,026); gözler açık SKG alanı ile servikal VEMP N1
dalga amplitudu arasında pozitif yönlü, çok yüksek derecede (r=0,826; p=0,011); gözler açık
ön-arka postüral stabilite ile posterior kanal hızı arasında negatif yönlü, yüksek derecede (r=-
0,643; p=0,010); gözler kapalı ön-arka postüral stabilite ile anterior kanal kazancı arasında,
negatif yönlü, orta derecede (r=-0,580; p=0,024); gözler kapalı ön-arka postüral stabilite ile
posterior kanal hızı arasında, negatif yönlü, yüksek derecede (r=-0,661;p=0,007); örümcek
ön-arka postüral stabilite ile posterior kanal hızı arasında negatif yönlü, yüksek derecede (r=- 0,614; p=0,015); servikal VEMP P1 dalga amplitudu ile örümcek sağ-sol postüral stabilite ve
laterak kanal hızları arasında negatif yönlü yüksek derecede (r=-0,772; p=0,025 / r=-0,843;
p=0,009); stabilite limiti total alanı ile anterior kanal hızı arasında pozitif yönlü, orta derecede
(r=0,574; p=0,025); lateral kanal kazancı ile servikal VEMP dalga latansları arasında negatif
yönlü yüksek derecede (r=-0,780; p=0,022; r=-0,722; p=0,043); gözler açık SKG alanı ile
lateral ve anterior kanal hızları arasında pozitif yönlü orta derecede (r=0,534; p=0,040;
r=0,602;p=0,018); gözler kapalı ön-arka postüral stabilite ile lateral kanal hızı arasında pozitif
yönlü orta derecede (r=0,520; p=0,047); gözler kapalı sağ-sol postüral stabilite ile servikal
VEMP P1 latansı arasında negatif yönlü, çok yüksek derecede (r=-0,835; p=0,010); örümcek
SKG alanı ile anterior kanal hızı arasında pozitif yönlü, orta derecede doğrusal ilişki
bulunmuştur (r=0,614; p=0,015).
Çalışmanın bulguları dikkate alındığında, tek taraflı periferik vestibüler bozukluğu
olan hastalarda, dinamik postürografi alt parametrelerinden sitatokinesigramın, farklı
ölçülerde etkilendiği ve VHIT ile VEMP testleri ile farklı kuvvetlerde ilişkili olduğu
bulunmuştur. Bu sonuçların, vestibüler rehabilitasyon programlarının planlanması aşamasında
dikkate alınmasını önermekteyiz.
Peripheral vestibular disorders are resulted from vestibular labyrinth or vestibular
nerve pathologies. In these disorders, it is also possible to observe symptoms such as vertigo,
postural instability and poor balance. Some other tests exist for evaluating vestibular system
as well as detailed medical history and physical examination. Not finding any studies
investigating the relation between these tests in literature created a need to conduct this study.
The aim of this study are to examine the level of effect that statokinesigram (SKG) has
exposed on patients having Unilateral Peripheral Vestibular Disorder (UPVD), in this context,
to investigate the relation between Video Head Impulse Test (VHIT) and Vestibular Evoked
Myogenic Potential (VEMP) Test, which contributes diagnosis of UPVD and Static /
Dynamic Posturography.
This study has been conducted with 30 patients whose ages differ between 40-82 years
and diagnosed UPVD, and their symptoms lasting at least 3 months. Static/ Dynamic Sensory
Organization Test (SOT) including sub-parameters of SKG, Limits of Stability (LOS) Test,
antero-posterior postural stability, medio-lateral postural stability, VHIT including VOR gains
and head velocity and cervical-ocular VEMP tests were all administered to patients. Dynamic
Posturography assesses postural stability in different conditions, VHIT assesses VOR gains
and functions of canals, VEMP assesses otoliths functions. Linear correlation between
variations was examined with Pearson Correlation Analysis.
Regarding the analysis in this study shows that a negative correlation-moderate degree
(r=-0.555; p=0.032) has been found between LOS posterior and posterior SSC peak head
velocity, and a positive correlation-moderate degree (r=0.528; p=0.043 / r=0.549; p=0.034)
between LOS left and Anterior/ Lateral SSC peak head velocity. In addition to this, a negative
correlation-high degree (r=-0.807; p=0.015 / r=-767; p=0.026) between Anterior SSC VOR
gain and cervical VEMP Latans, and a positive correlation-high degree (r=0.826; p=0.011)
between eyes open SKG area and cervical VEMP N1 Amplitude, and a negative correlationhigh
degree (r=-0.643; p=0.010) between eyes open antero-posterior postural stability and
posterior SSC peak head velocity have been observed. In addition correlations were
following; a negative correlation-moderate degree (r=-0.580; p=0.024) between eyes closed
antero-posterior postural stability and Anterior SSC VOR gain, and a negaive correlation-high
degree (r=-0.661;p=0.007) between eyes closed antero-posterior postural stability and
posterior SSC peak head velocity, and a negative correlation-high degree (r=-0.614; p=0.015) between cobweb antero-posterior postural stability and posterior SSC peak head velocity, and
a negative correlation-high degree (r=-0.772; p=0.025 / r=-0.843; p=0.009) cervical VEMP P1
amplitude and cobweb right-left postural stability / lateral SSC peak head velocity have been
found. Additionally, a positive correlation-moderate degree (r=0.574; p=0.025) between LOS
total area and anterior SSC peak head velocity, and a negative correlation-high degree (r=-
0.780; p=0.022; r=-0.722; p=0.043) between lateral SSC VOR gain and cervical VEMP
latans, and a positive correlation-moderate degree (r=0.534; p=0.040; r=0.602; p=0.018)
between eyes open SKG area and lateral/anterior SSC peak head velocity have been come by.
Finally, this study has come up with a positive correlation-moderate degree (r=0.520;
p=0.047) between eyes closed antero-posterior postural stability and lateak SSC peak head
velocity, and a negative correlation-high degree (r=-0.835; p=0.010) between eyes closed
medio-lateral postural stability and cervical VEMP P1 latans, and a positive correlationmoderate
degree (r=0.614; p=0.015) between cobweb SKG area and anterior SSC peak head
velocity.
In line with these findings, this study presents that SKG being sub-parameters of
Dynamic Posturography has been affected in various degrees in patients experiencing UPVD,
and SKG has a correlation with VHIT and VEMP in various degrees. We strongly suggest
these findings to be taken into consideration in planning of vestibular rehabilitation programs
Evaluation of Treatment Response by Using a Handheld Dermoscope in Patients with Alopecia Areata
No full textObjective: Treatment response is variable in patients with alopecia areata, and may not be understood until significant hair growth is obtained. The aim of this study is to determine the potential benefit of handheld dermoscope in evaluating of treatment success in alopecia areata.
Methods: Forty-nine patients who were diagnosed with alopecia areata were included in the study. Diagnosis was established clinically, and scalp biopsy was performed in doubtful cases. Dermoscopic examinations were performed by a polarized light and handheld dermoscope with 10-fold magnification. The images were taken by a digital camera with threefold optical zoom. Among 49 patients, 30 of them were followed-up during six months and concluded the study.
Results: Of the 30 patients, 12 had a complete response to treatment (group 1), whereas 18 patients did not respond well to treatment or were remained completely responseless (group 2). When the trichoscopic findings were examined pretreatment, only thinning hairs were significantly more frequent in group 1 than group 2. The pre- and posttreatment findings of group 1 was shown that yellow dots, black dots, thinning hairs and broken hairs decreased or disappeared after the treatment, and this difference was statistically significant. In all of the patients in the first group, short terminal hairs were appeared at the end of treatment.
Conclusion: According to our study, polarized light handheld dermoscope provides benefit for the evaluation of treatment success in patients with alopecia areata
Legionnaires' disease
No full textLegionnaires disease is a severe from of pneumonia caused by Legionella species which arc ubiquitious in both natural and man-made environments. It has high morbidity and case fetality rates. The disease is acquired by aspiration of water or inhalation of aerosols containing the bactena from environmental sources. Early diagnosis and appropriate treatment are important factors in determining prognosis. Clinical and laboratory predictors will not reliably identify cases of legionnaires disease, therefore the diagnosis of Legionnaires' disease requires specific diagnostic tests. The diagnosis of Legionnaires' disease is made by culture, Legionella urinary antigenaria, polymeras ion, or serologic analyses. Isolation of Legionella from clinical samples is the gold standart for diagnosing Legioimaire's disease. Legionella urinary antigen tests are easy and useful for early diagnosis of Legionnaires' disease. Flouroquinolones, macrolides and doxycicline are drugs of choice. Legionnaires' disease is considered a preventable illness since it is possible to control and remove the bacteria in reserviors. In Turkey, travel-associated Legionnaires' disease has a specific surveillance programe since 1996. After the year of 2015, it became mandatory to take environmental cultures for Legionella from the hospital water systems. The aim of this review is to raise awereness for legionollosis and to summarize the current literature
Rationale and design of the EACVI AFib Echo Europe Registry for assessing relationships of echocardiographic parameters with clinical thrombo-embolic and bleeding risk profile in non-valvular atrial fibrillation
No full textThe European Society of Cardiology (ESC) guidelines for management of atrial fibrillation (AF) recommend the use of CHA(2)DS(2)VASc risk score for assessment of thromboembolic (TE) risk, whereas the stratification of bleeding risk should be obtained by HAS-Bleed to balance the most appropriate anticoagulation (OAC) therapy. However, men with CHA(2)DS(2)VASc score=1 and women with CHA(2)DS(2)VASc=2, who are at intermediate TE risk, represent a grey zone where guidelines do not provide a definite OAC indication. Accordingly, implementation of risk stratification with echocardiography could be extremely useful. Both prospective and cross-sectional studies on transthoracic echocardiography (TTE) prediction of TE events and studies utilizing transoesophageal echocardiographic parameters as surrogate markers of TE events makes sustainable the hypothesis that echocardiography could improve TE prediction in non-valvular AF. Moreover, considering the close association of AF and stroke, all echo-Doppler parameters that have shown to predict AF onset and recurrence could be useful also to predict TE events in this clinical setting. Accordingly, EACVI AFib Echo Europe Registry has been designed as an observational, cross-sectional study, with the aim of evaluating: (i) left atrial (LA) size and function together with left ventricular geometry, systolic and diastolic functions in paroxysmal, persistent, and permanent AF; (ii) relationships of structural/ functional parameters with clinical TE and bleeding risk profile. By the AFib Echo Europe Registry, we expect to collect data on echocardiographic phenotype of patients with AF. The large data set accumulated will be useful to test the level of agreement of different echocardiographic measurements with the available risk scores
Assessment of Endotracheal Tube Position After Oral Intubation in Neonates
No full textAim: Endotracheal intubation is a common procedure in the delivery room and neonatal intensive care unit. We aimed to determine the accuracy of this method of endotracheal tube (ETT) placement in our neonatal cohort.
Materials and Methods: Data on infants requiring oral intubation were reviewed retrospectively. The initial ETT depth of insertion had been calculated using the Tochen 7-8-9 rule. The initial depth was compared to the mid-tracheal region. The differences between the initial and ideal depth was calculated and divided by the mid-tracheal distance. Infants were grouped according to their weights as = 3001g.
Results: We evaluated ETT placement in 160 neonates. The mean gestational age was 32.2 +/- 4.4 weeks (23 to 41 weeks) and the mean weight was 1989 +/- 829 g (560 to 3800 g). The mean range of the difference between the initial depth and ideal depth divided by mid-tracheal distance was 0.39 +/- 0.04, 0.35 +/- 0.04, 0.46 +/- 0.05, and 0.23 +/- 0.04 in infants weighing = 3001 g respectively (p=0.025). The differences between the 2001-3000 g group and the 1001-2000, also the 2001-3000 g group and the >= 3001 g group were statistically significant (p<0.05).
Conclusion: The 7-8-9 rule should be used to assess ETT length in neonates, especially in those weighing more than 3 kg. As this rule has low accuracy for extremely low birth weight neonates, its reliability may not be high for neonates weighing less than 3 kg in weight
Broncholithiasis presenting with lithoptysis
No full textBroncholithiasis is defined as calcified or ossified material in the bronchial lumen. The most frequently seen symptoms are a non-productive cough and hemoptysis. Occasionally, broncholytic expectoration can be seen, which is known as lithoptysis. As this is not a common finding, a case diagnosed with lithoptysis is presented here