Evaluation of Extrapulmonary Tuberculosis Cases Presenting with Different Clinical Findings

Introduction: Extrapulmonary tuberculosis cases may display different clinical symptoms and this causes a delay in diagnosis. Nutritional deficiencies, migrations, and wars facilitate the development and the spreading speed of the disease. The aim of this article is to examine extrapulmonary tuberculosis patients with different clinical presentations.Method: In this study, 15 extrapulmoner tuberculosis cases who were hospitalized and treated in our pediatrics clinic in the last two years, has been evaluated retrospectively.Results: The average age of our group was 11.7 ± 4.5 and six of the assessed patients were Syrian origin. The shared complaints of five patients diagnosed with peritoneal tuberculosis were abdominal pain and bloating. Abdominal ultrasonography findings of the patients in concordance with diffuse ascites. Two of these patients, Mycobacterium tuberculosis had peritoneal effusion. All of the five patients diagnosed with lymph node tuberculosis had swelling on the neck, and all had pulmonary involvement. However, only one patient's lymph node biopsy was concordant with tuberculosis. One patient bone tuberculosis patient applied to our clinic with hip and back pain symptom. Pott’s abscess was observed in the patient's thorax MRI and hip MRI was concordant with tuberculous arthritis. Our patient with renal tuberculosis was diagnosed during evaluation of sterile pyuria attacks and in her urine ARB (+) was detected and M. tuberculosis grew in urine culture. One patient with central nervous system involvement applied to our clinic with clouding of consciousness and headache. The cerebrospinal fluid (CSF) findings of the patient were concordant with tuberculosis and growth was observed in the CSF culture. One case with miliary tuberculosis had hypercalcemia and pulmonary involvement. The patient's M. tuberculosis DNA PCR test was positive in bronchoalveolar lavage fluid. Another patient with pericardial tuberculosis applied due to respiratory distress and had cardiomegaly and pericardial effusion. Nine of our patients also had a contact history, 12 had purified protein derivative of tuberculin (PPD) (+), and 11 had pulmonary involvement.Conclusion: Patients were admitted to our outpatient clinic with various clinical symptoms. After careful physical examinations were performed, detailed patient histories were taken and laboratory tests performed for differentials, patients were diagnosed with extrapulmonary tuberculosis. It was desired to emphasize that this disease may appear with different clinical presentations in endemic regions like our country

Cytokine Profiles of Chronic Urticaria Patients and the Effects of Omalizumab Treatment

Introduction: Cytokines are key mediators in immunological and inflammatory conditions, including chronic spontaneous urticaria (CSU). Objectives: To investigate Th1, Th2, and Th17 cytokine profiles in CSU and to evaluate the possible effect of omalizumab treatment. Methods: Patients who were followed up for CSU, as well as healthy volunteers, were included in the study. To assess urticaria activity, the 7-day-Urticaria Activity Score (UAS-7), the Urticaria Control Test (UCT), and the Chronic Urticaria Quality of Life Questionnaire (CU-QoL) were filled. Serum levels of IL-6, IL-17, IL-31, eotaxin, RANTES, TNF-α, and TSLP were analyzed by ELISA and compared in CSU and control groups. The patients were analyzed in two groups as the omalizumab group and the non-omalizumab group based on their treatment status.   Results: Total IgE, ESR, CRP, RANTES, and TNF-a were significantly different in the overall comparison of the three groups: CSU-receiving omalizumab, CSU-not receiving omalizumab, and control groups (P <0.01, 0.015, <0.01, <0.01 and <0.01 respectively). Total IgE, CRP, RANTES, and TNF-α values were similar in those who received and did not receive omalizumab, yet these biomarkers were significantly higher in both groups than in the control group (P < 0.05). Statistical significance in ESR was observed only between the CSU-receiving omalizumab group and the control group (P = 0.01). Within the CSU patients, there was a slight but significant correlation between UCT and TNF-α (P = 0.008, r = 0.32) and IL-17 (P = 0.06, r = 0.33) levels. Conclusions: The investigated cytokine profile in CSU patients may differ from healthy controls, particularly with the higher levels of RANTES and TNF-α, and omalizumab treatment does not seem to affect that profile in CSU patients

Ortaokul Öğrencilerinin Bilimsel Süreç Becerilerinin Karşılaştırılması: Kuvvet ve Hareket Ünitesi Örneği

Fen öğretim programının vizyonu fen okuryazarı bireyler yetiştirilmesi olarak belirtilmiştir. Fen okuryazarı bireyler bilimsel bilgi ile birlikte bilimsel becerileri de kullanabilen kişilerdir. Öğrencilerin sahip olduğu bilimsel süreç becerilerinin geliştirilmesi bu açıdan önemlidir. Bu çalışma ile de ortaokul öğrencilerinin Kuvvet ve Hareket ünitesi için geliştirilen etkinliklerde bilimsel süreç becerilerini kullanma düzeylerinin karşılaştırılması amaçlanmıştır. Çalışma grubu olarak her bir sınıf düzeyinden 30’ar olmak üzere, ortaokul 5, 6, 7 ve 8. sınıf düzeyinden toplam 120 öğrenci belirlenmiştir. Araştırmacılar tarafından geliştirilen etkinlikler her sınıfta birer ders saati uygulanmış ve öğrencilerin bu etkinliklerde kullandıkları bilimsel süreç becerileri basamakları analiz edilmiştir. Araştırmanın sonucunda farklı sınıf düzeylerinde bilimsel süreç becerileri ile karşılaşılma sıklıklarının değişiklik gösterdiği belirlenmiştir. Gözlem yapma ve önceden kestirme becerilerinin bütün sınıflarda karşılaşılma oranı yüksek iken, verileri yorumlama ve karar verme becerileri ile karşılaşılma oranı daha azdır. Daha üst düzeydeki sınıflarda öğrenim gören öğrencilerde bile karşılaşılma oranı düşen beceriler mevcuttur. Verileri kullanma ve model oluşturma becerisi en fazla 5. sınıf öğrencilerinde karşılaşılmış ve üst düzeydeki sınıflarda karşılaşılma oranı azalmıştır. Bu sonuçlar ışığında araştırmada öğrencilerde karşılaşılma sıklığının az olduğu becerilerin geliştirilmesine yönelik uygulamalar yapılması önerilmektedir.Anahtar Kelimeler: Bilimsel süreç becerileri, ortaokul öğrencileri, kuvvet ve hareket ünites

The effect of smoking on atrial and ventricular functions in healthy subjects: A speckle tracking echocardiography study

Purpose Smoking is a well-known risk factor for coronary artery diseases. It is also associated with nicotine-induced myocardial dysfunction. The aim of this study was to evaluate the right and left atrial and ventricular functions in apparently healthy smokers. Methods We included consecutively 80 healthy smokers (56 males, mean age:35.5 +/- 8.4 years) and 70 healthy nonsmokers (44 males, mean age:33.9 +/- 9.5 years). None of the subjects had any additional cardiovascular risk factor other than smoking. The right and left atrial and ventricular functions were assessed by both conventional and speckle tracking echocardiography. Results Although there was no significant difference in left ventricular ejection fraction, the smokers had significantly lower ventricular global longitudinal strain than controls (-19.9 +/- 2.0% vs -21.2 +/- 1.9%,P < .001 and -18.4 +/- 2.1% vs -21.8 +/- 2.2%,P < .001, respectively, for the left and right ventricle). Smokers had also lower atrial reservoir and conduit strains: 35.9 +/- 11.1% vs 40.2 +/- 11.2%,P= .022 and 16.7 +/- 6.8% vs 19.4 +/- 6.8%,P= .016, respectively, for the left atrium, and 33.0 +/- 10.6% vs 37.6 +/- 11.2%,P= .011 and 15.2 +/- 5.6% vs 18.0 +/- 6.3%,P= .004, respectively, for the right atrium). Conclusion Even in apparently healthy people with no other cardiovascular risk factors, smoking is associated with impaired atrial and ventricular functions