Evidence of association of vitamin D receptor Apa I gene polymorphism with bone mineral density in postmenopausal women with osteoporosis

The vitamin D receptor (VDR) was the firstcandidate gene to be studied in relation to osteoporosis, andmost attention has focused on polymorphisms situated nearthe 3' flank of VDR. The aim of this study was toinvestigate the association about VDR gene Apa I polymorphismwith bone mineral density (BMD) in postmenopausalwomen with osteoporosis. We studied a total of 136postmenopausal women with a mean age of 56.36±10.29 years. Among them, a total of 75 had osteoporosis,37 had osteopenia, and 24 had normal BMD. Venous bloodsamples were obtained for evaluation of bone metabolismand genotyping. The VDR Apa I genotype was determinedby polymerase chain reaction-restriction fragment lengthpolymorphism. BMDs at the lumbar spine and hip weremeasured by dual-energy X-ray absorptiometry. Postmenopausalwomen with aa genotype had significantly lowerBMD values (grams per centimeter square) at lumbar spinescompared to persons with AA genotype. Also, postmenopausalwomen with AA genotype had significantly higherserum Ca level than the subjects with aa genotype. Inconclusion, our result may indicate that VDR Apa I genepolymorphism may be responsible for a important part ofthe heritable component of lumbar spine BMD in postmenopausalwomen, possibly related to impaired calciumabsorption from the bowel

Skin prick test results in patients from thrace region presenting with pulmonary symptoms

Amaç: Bu çalışmada Pulmoner semptomlarla başvuran hastalarda alerjen duyarlılığı profilinin belirlenmesi amaçlandı. Hastalar ve Yöntemler: Ekim 1999-Nisan 2005 tarihleri arasında pulmoner yakınmalarla başvuran 196 hastada (136 kadın, 60 erkek; ort. yaş 34.7±11.7) yapılan deri testi sonuçları, total IgE sonuçları ve alerji bilgi formları geriye dönük olarak incelendi. Bulgular: Çalışmaya alınan hastaların IgE medyan değeri (%25-75) 202 U/ml (118-530) idi. En sık görülen semptom %65.3 ile nefes darlığı iken ikinci sıklıkta başvuru nedeni %63.8 ile öksürüktü. Bu semptomlar %46.9 hastada toz alırken artmaktaydı. Hastaların %59.7'sinde en az bir alerjene duyarlık saptandı. Tek alerjen ile duyarlılık %18.9 iken çok alerjene duyarlılık %40.8 olarak tespit edildi. En sık %39.8 ile ev tozu akarlarına karşı alerji tespit edilirken ikinci sıklıkta %26 ile ağaç polenlerine karşı saptandı. D. Farinea'ya %33.7, D. Pteronyssinus'a %32.7 duyarlık saptandı. Sonuç: Trakya Bölgesi'nden alerjik semptomlarla başvuran hastalarda en sık ev tozu akarlarına karşı duyarlılık saptandı. Olguların %46.9'unda da semptomların evde, toz alırken artması bu bulguyu destekler nitelikteydi.Objectives: The aim of the study was to determine the profile of allergen sensitization in patients presenting with pulmonary symptoms. Patients and Methods: Skin test results of 196 patients (136 females, 60 males; mean age 34.7±11.7 years) presenting with pulmonary complaints between October 1999 and April 2005; total IgE results and allergy information forms were analyzed retrospectively. Results: Median value of IgE was (%25-75) 202 U/ml (118-530) in the patients enrolled. The most frequent symptom was shortness of breath (65.3%), and the second was cough (63.8%). These symptoms aggravated while patients were dusting. Sensitivity to at least one allergen was observed in 59.7% of the patients. Sensitivity to a single allergen was present in 18.9% and to multiple allergens in 40.8% of all patients. The most frequent allergy was determined to house dust mite (39.8%) and was followed by allergy to tree pollens (26%). Sensitivity rate to D. Farinea was 33.7% and 32.7% to D. Pteronyssinus. Conclusion: House dust mite were the primary causes of sensitization in patients presenting with allergic symptoms in the Thrace region. The fact that the symptoms aggravated in 46.9% of the patients while they were dusting at home, seemed to support this finding

İdyopatik Hirşutizm Hastalarında QT Dispersiyonu

Amaç: Çalışmada idyopatik hirşutizm tanılı hastaların QT dispersiyonu açısından değerlendirilmesi amaçlanmıştır. Metod: 28 İH hastası ve kontrol grubu olarak 35 sağlıklı kadın çalışmaya dahil edildi. Hastaların hormonal incelemeleri ile birlikte elektrokardiyografi EKG analizleri yapılarak QT dispersiyonları QTd ile düzeltilmiş QT QTc değerleri kullanılarak düzeltilmiş QT dispersiyon QTcd değerleri elde edilmiştir. Bulgular: İH ve kontrol hastalarının minimum QT 336±30; 337±32 ms , maksimum QT 358±30; 358±34 ms , minimum QTc 391 ± 24; 399 ± 25 ms ; maksimum QTc 417 ± 24; 424 ± 26 ms , QTd 22±5; 21±7, P=0.6 ve QTcd 26 ± 6, 25 ± 9 ms, P= 0.7 değerleri arasındaki fark istatistiksel olarak anlamsızdı. Hirşutizm hastalarında açlık insülin, Homeostasis model assessment HOMA indeksi ve androjen düzeyleri anlamlı olarak yüksek saptandı. Sonuç: Hormonal ve metabolik bozukluklara rağmen İH hastalarında sağlıklı kadınlara göre anlamlı QT dispersiyonu saptanmamıştı

Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF

Restless Legs Syndrome with Current Diagnostic Criteria

Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a chronic movement disorder, characterized by an urge to move legs usually accompanied by uncomfortable sensations and sleep disorders. The prevalence of the syndrome ranges from 1% to 15% in the general population, and about 2% during childhood. RLS is the most common movement disorder in pregnancy. However RLS still remains underdiagnosed probably due to lack of accurate information about the disease. Family history is positive in 50-70% of the primary RLS patients. The secondary form of the syndrome is associated with iron deficiency, renal failure, pregnancy, diabetes mellitus and many rheumatologic disorders. Secondary forms generally manifest at older ages and have a rapid progression with a poorer prognosis. The pathophysiology of RLS is focused on the dopaminergic system, reduced central nervous system iron levels and genetic linkages. Diagnosis is based on clinical features and the diagnostic criteria suggested by International RLS Study Group. Secondary causes must be carefully investigated before the treatment. In mild forms of the disease non-pharmacologic therapies might be useful, while in moderate or severe forms of the disease generally pharmacologic therapies such as dopamine agonists, anticonvulsants, opioids and benzodiazepines are required. (Turkish Journal of Osteoporosis 2015;21: 87-95

Oligo-Amenorrheic Polycystic Ovary Syndrome Patients Have Higher Risk For Cardiovascular Disease Compared to Hirsute Patients and Healthy Control

OBJECTIVE: To evaluate the clinical, endocrine and cardiovascular disease risk profile differences in polycystic ovary syndrome (PCOS) patients who complain of hirsutism or oligo-amenorrhea. STUDY DESIGN: A total of 129 consecutive women underwent the screening investigation at Dr. Sami Ulus Women’s Health Teaching and Research Hospital between December 2009 and June 2010. There were 48 PCOS patients with hirsutism while 49 PCOS patients with oligo-amenorrhea and 32 healthy women included in the study. Body mass index (BMI), Waist/hip ratio (WHR) serum follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone, free testosterone, glucose, low density lipoprotein (LDL), total cholesterol, high density lipoprotein (HDL), triglceride (TG), high sensitive C reactive protein (hs-CRP), insulin, insulin sensitivity and carotid intima thickness (CIMT) were compared in PCOS patients who complain of hirsutism or oligo-amenorrhea and control group. RESULTS: Mean ages were similar among groups. There were significant differences among groups in terms of BMI, WHR, total cholesterol, LDL, TG, LH, fasting glucose, hsCRP, CIMT (p<0.05) (table 1). BMI, waist-hip ratio (WHR), total cholesterol, LDL, TG, LH, estrodiol, fasting glucose adjusted mean CIMT values were 0.40±0.01 mm, 0.49±0.012mm, 0.34±0.012mm (p<0.001) in hirsute, oligo-amenorrheic and control groups respectively. CONCLUSION: PCOS patients with oligo-amenorrhea without hirsutism have higher risk for cardiovascular disease (CVD) and abnormal lipid profile than patients with hirsutism without oligo-amenorrhea

An Usual Painful Bipartite Patella

Most bipartite patellae are asymptomatic and observed only as an incidental finding when the knee is radiographed for other reasons. Although bipartite patella is usually asymptomatic, it can become painful in subjects following overuse or injury. Most of the patients with painful bipartite patella respond relatively well to nonsurgical treatment. When the pain is persistent and resistant to those conservative treatments, a certain type of surgical procedures can be applied. In this report, we present a case of symptomatic bipartite patella in a patient with no underlying disease

Çocuklar İçin Bilgisayar Oyun Bağımlılığı Ölçeği

Araştırmanın amacı, çocukların bilgisayar oyun bağımlılığını ölçebilmek amacıyla geçerli ve güvenilir bir ölçek geliştirmektir. Araştırmanın örneklemini Trabzon ilinde farklı sosyo ekonomik düzeylerdeki ilköğretim okullarına devam eden 460 öğrenci oluşturmaktadır. Ölçeğin geçerlik çalışmalarında yüz görünüm geçerliliği ve kapsam geçerliliği için uzman görüşüne başvurulmuştur. Yapı geçerliliği için açımlayıcı faktör analizi yapılmıştır. Yapılan faktör analizi sonucunda 21 maddeden oluşan dört faktörlü bir yapı, toplam varyansın %45’ini açıklamaktadır. Ölçeğin güvenirliği için Cronbach Alfa iç tutarlık katsayıları hesaplanmıştır. Ölçeğin iç tutarlık kat sayısı .85 olarak bulunmuştur. Bulunan bu değerler ölçeğin psikometrik niteliklerinin kabul edilebilir sınırlar içinde olduğunu göstermektedir

Rehabilitation of a case with acute motor and sensory axonal neuropathy syndrome

Guillain-Barre Sendromu (GBS) demiyelinizasyon ile seyreden muhtemelen otoimmün mekanizmalarla oluşan akut bir polinöropatidir. GBS tanısı klinik, beyin omurilik sıvısı (BOS) bulguları ve elektronöromyografi (ENMG) ile konmaktadır. Akut Motor ve Sensorial Aksonal Nöropati sendromu GBS alt tiplerinden bir tanesidir ve prognozu diğer alt tiplere göre daha kötüdür. Akson hasarından dolayı sinir rejenerasyonu daha çok vakit almaktadır. Yavaş ve yetersiz iyileşme daha yoğun ve uzun süreli rehabilitasyon sürecini gerektirmektedir.Guillain-Barre Syndrome (GBS) is an acute idiopathic polyneuropathy with demyelinization. The diagnosis of GBS is made with clinical presentation, cerebro spinal fluid (CSF) findings and electroneuromyography (ENMG). Acute Motor and Sensorial Neuropathy Syndrome is one of the subtypes of GBS and its prognosis is worse than the other subtypes. Nerve regeneration takes much more time due to axonal damage. Because of the slow and insufficient recovery, more intensive and long term rehabilitation period is required

Acute Calcium Pyrophosphate Arthritis after Parathyroidectomy

Hypocalcemia after parathyroidectomy is a well-known metabolic sequela, but rare conditions such as acute calcium pyrophosphate (CPP) arthritis can be observed. In this study, we presented a case of acute CPP arthritis in both knees after parathyroidectomy. A 48-year-old man presented with pain and swelling in his right knee that started 1 day ago. There was no feature in his background and family history other than parathyroidectomy surgery performed for parathyroid adenomy a week ago. The diagnosis of acute CPP arthritis was made on the basis of blood, imaging and synovial fluid analysis. Evaluation was made after 3 days and acute arthritis in left knee was detected. Similar findings were also observed in the synovial fluid examination. After cold application and colchicine 1 mg/day started, improvement in arthritis and acute phase markers was detected. Acute CPP arthritis after parathyroidectomy is a rare condition and there are various theories in this regard. According to the most widely accepted theory; as a result of the decrease in the calcium level, the solubility of the CPP crystals decreases, and the CPP crystals previously deposited in the articular cartilage are poured into the synovial fluid. As a result; CPP arthritis should also be considered in differential diagnosis in patients with arthritis after parathyroidectomy and synovial fluid analysis should be performed