Consider Behcet's disease in young patients with deep vein thrombosis

AbstractBehcet's disease is a multi-systemic and chronic inflammatory vasculitis of unknown etiology characterized by recurrent oral and genital ulcers, uveitis, arthritis, arterial aneurysms, venous thrombosis, skin lesions and GIS lesions. Although pulmonary artery aneurysms are rare, it is a critical condition due to high risk of rupture. Venous involvement of Behcet's disease primarily occurs in the lower extremities. In the presence of deep vein thrombosis(DVT) and pulmonary embolism, the mainstay of treatment in Behcet's disease is immunosuppressant therapy. Anticoagulants can be used only after initiation of immunosuppressant therapy and suppression of the disease. Anticoagulant therapy alone may lead to fatal hemoptysis. We report the case of a 24 year-old patient who presented to the emergency service with complaints of shortness of breath, general condition disorder and hemoptyhis while using warfarin for DVT and whose thoracic CT angiography showed pulmonary embolism and pulmonary artery aneurysm and diagnosed with Behcet's disease

Generalized formulae for the periodic fixed and geometric-gradient series payment models in a skip payment loan with rhythmic skips

Nowadays, the periodic level payment model is the most widely used loan payment model by the banks. In addition, the periodic geometric and linear gradient payment models are available in the financial mathematics books. The arbitrary skip periodic level (or equal) loan payment model was firstly developed by Formato (1992). Formato’s model was extended to the geometric gradient loan payment model by Moon (1994) and the linear gradient model by Eroglu and Karaoz (2002). This loan payment models that have periodic level and geometric gradient series payment with rhythmic skips instead of arbitrary skips have beendiscussed. General formulae have been derived for these models. Numerical examples are solved to show the practical application of the developed payment models on home financing

Bioactive, functional and edible film-forming properties of isolated hazelnut (Corylus avellana L.) meal proteins

This study aimed characterization of bioactive, functional and edible film making properties of isolated proteins from untreated (HPI), hot extracted (HPI-H), acetone washed (HPI-AW), and acetone washed and hot extracted (HPC-AW-H) hazelnut meals. The most bioactive protein extract was HPC-AW-H, followed by HPI-AW, HPI-H and HPI, based on antioxidant activity (TEAC and ORAC: 158-461mmolTrolox/kg), iron chelation (60.7-126.7mmolEDTA/kg), angiotensin-converting enzyme inhibition (IC50: 0.57-1.0mg/mL) and antiproliferative activity on colon cancer cells (IC50: 3.0-4.6mg/ml). Protein contents of HPI, HPI-H and HPI-AW (93.3-94.5%) were higher than that of HPC-AW-H (86.0%), but HPC-AW-H showed the best pH-solubility profile. The extracts showed good oil absorption (7.4-9.4g/g) and foaming, but limited water holding and gelling capacities, and emulsion stability. The protein extracts gave transparent, yellowish to brownish and reddish colored and water soluble edible films. The HPI gave the lightest colored films with acceptable mechanical properties (elongation up to 144% and tensile strength up to 4.9MPa). 1-D and 2-D electrophoresis clearly showed the molecular and isoelectric profiles of hazelnut proteins. The overall results of this study showed that the bioactive, solubility and gelation properties of hazelnut proteins could be improved by simple processes like acetone washing and/or heat treatment. The hazelnut proteins are valuable as multipurpose food ingredients.Foundation of Izmir Institute of Technology (IZTECH

Heterojen Filolu Yeşil Araç Rotalama Probleminin Tavlama Benzetimi Yöntemi ile Çözümü

Araç rotalama problemi, müşterilere siparişlerini ulaştırmak için minimum maliyetli rota kümesinin belirlendiği optimizasyon problemidir. Son yıllarda çevresel duyarlılıktaki artışla beraber, uygulayıcılar ve araştırmacılar fosil yakıtların çevreye olan etkilerini azaltmak için taşıma faaliyetlerinin çevre ile ilgili özelliklerine odaklanmaya başlamıştır. Araç rotalama probleminin bu duyarlılığı dikkate alan türü ise yeşil araç rotalama problemi olarak adlandırılmaktadır. Yeşil araç rotalama problemi son yıllarda üzerinde oldukça yoğun çalışılan bir konudur. Çalışmanın ana motivasyonu, güncel hayatta doğal olarak karşılaşılan heterojen araç filoları için yük toplama/dağıtma rotalarının işlemesi sonucu ortaya çıkan emisyon gazlarının minimize edilmesi amacıyla bir yaklaşım geliştirmektir. Çalışmada, bölge distribütörü olarak faaliyet gösteren bir firmanın dağıtım faaliyetleri heterojen filolu yeşil araç rotalama problemi olarak ele alınmış ve tavlama benzetimi yöntemiyle daha düşük emisyon değerleri sağlayan çevreci çözümler elde edilmeye çalışılmıştır. Çözüm yaklaşımında heterojen bir filo için emisyon değerleri araçların taşıdığı yük miktarı ve yüklerin taşındığı mesafe üzerinden hesaplanmıştır. Yeşil Araç Rotalama çözümleri, standart araç rotalama problemi olarak elde edilen çözümler üzerinden hesaplanan emisyon değerleri ile kıyaslanmıştır. Sonuç olarak, yük miktarı, taşıma mesafesi ve emisyon salınımı ilişkileri nedeniyle önerilen yaklaşım bazı veri setlerinde daha yüksek dolaşım mesafesine karşın daha düşük emisyon miktarı içeren çözümler sağlamıştır. Bütün çözümlerin toplam değeri göz önüne alındığında, seyahat mesafesi bakımından %38,5 ve emisyon değeri bakımından ise %86,7 oranında daha iyi çözümler elde edilmiştir

Evaluation of central and peripheral neuropathy in patients with chronic obstructive pulmonary disease

Conclusion: Central and peripheral nervous system involvement could develop in patients with moderate-severe COPD, and these patients should be monitored for neuropathic changes in combination with neurological examination

May Biochemical Variables and Pleural Fluid Cell Count Be Used in the Benign-Malign Differentiation of Pleural Effusions Associated with Lung Cancer?

Conclusion: In our study, we found that the values of albumin, HCT, RBC and protein in pleural fluid were higher in malignant pleural effusion

Diaphragmatic thickness in chronic obstructive lung disease and relationship with clinical severity parameters

Conclusion: Diaphragmatic dysfunction in COPD is related to mobility restriction rather than muscle thickness

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

The role of multiplex PCR test in identification of bacterial pathogens in lower respiratory tract infections

Objectives: Lower respiratory tract infection is one of the most important causes of morbidity and mortality. However establishing a microbial diagnosis for patients with lower respiratory tract infection is still challenging and is often achieved in only half of cases by conventional methods. This study was designed to compare the fast responsive PCR method with the culture method in lower respiratory tract infections and to evaluate the reliability of multiplex PCR method. Methods: One hundred ninety seven patients with the symptoms of acute lower respiratory tract infection, and diagnosed with community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease and exacerbations of bronchiectasis were included in the study. Both culture and PCR methods was performed for the isolation of most commonly seen bacteria, from sputum, nasopharyngeal swabs and bronchoalveolar lavage fluid samples. Results: While at least one bacterial isolation was determined in 62 (31.5%) of all patients with culture method, this number increased to 125 (63.5%) with multiplex PCR. The bacteria most commonly identified by PCR were S. pneunnoniae (32%) and H. influenzae (31%). There was a significant difference between PCR and culture in terms of multi-factor detection rates (p < 0.005). Multiple bacteria were detected in only two cases in cultures; however, multiple pathogens were detected in 47 cases with PCR. Conclusions: Conventional methods, such as culture and serology are not always adequate to detect the pathogens in lower respiratory tract. Real-time PCR assays proved highly sensitive and rapid. The prevalence of bacteria and multiple agent detected by real-time PCR compared with culture was substantially higher. Widespread use of PCR methods, by providing the immediate and appropriate "agent specific antibiotic treatment" of LRTI, will help reduce failure and contributes to a reduction in antibiotic resistance

Plevra sıvısı PGE2 düzeyinin akciğer kanserli hastalarda tanısal değeri ve transüda-eksuda ayırımındaki yeri

Bu çalışmaya 2001-2002 yılları arasında, Selçuk Üniversitesi Meram Tıp Fakültesi Göğüs Hastalıkları ve Tüberküloz Kliniğinde yatırılarak tetkik edilen 100 plörezi olgusu ve kontrol grubu olarak seçilen 22 sağlıklı birey dahil edildi. Plevra sıvıları, tanılarına göre transüda-eksuda, malign-benign ve spesifik tanı grupları olmak üzere 3 gruba ayrıldı ve olgular bu üç grupta incelendi. Olguların plevra sıvısı ve plazma PGE2 düzeyleri eş zamanlı olarak EIA yöntemi ile belirlendi. Transüda-eksuda grupları arasında plevra sıvısı PGE2 seviyeleri açısından istatistiki olarak anlamlı fark bulundu (p=0.005). Eksudatif sıvıların ayırt edilmesinde sınır değer 112.7 pg/ml olarak alındığında, plevra sıvısı PGE2 düzeyinin tanısal değeri, sensitivitesi % 63.5, spesifitesi % 80 olarak belirlendi. Benign-malign grup arasında plevra sıvısı PGE2 seviyeleri açısından fark bulunamadı. Akciğer kanseri grubu ile tüberküloz grubu hariç, diğer tüm gruplar arasında plevra sıvısı PGE2 seviyeleri açısından anlamlı fark bulundu. Akciğer kanseri tanısında plevra sıvısı PGE2 düzeyinin tanısal değeri, sınır değer 210 pg/ml olarak alındığında sensitivitesi % 70.8, spesifitesi % 76.3 olarak saptandı. Plazma PGE2 konsantrasyonları karşılaştırıldığında transüda-eksuda ve benign-malign gruplar arasında fark bulunamadı. Sonuç olarak plevra sıvısında PGE2 düzeyinin transüda-eksuda ayırımında ve malign-benign ayırımında kullanılmasının uygun olmadığı, akciğer kanseri tanısında ise şüphede kalman durumlarda yararlı olabileceği kanaatine varıldı.The study included 100 patients with the pleural effusions, who were examined in The Chest Diseases and Tuberculosis department of Meram Medical School of Medicine in Selçuk University between 2001 and 2002 years and 22 healthy individuals as a control group. The patients were assessed in 3 groups, which were transudates-exudates according to the diagnosis, malignant-benign effusions and specific diagnosis group (lung cancer, mesothelioma, metastatic lung cancer, tuberculosis, parapneumonic effusion and transudates) The pleural fluid and synchronous plasma PGE2 levels were determined by EIA method. A statistically significant difference was found between transudates and exudates in terms of pleural fluid PGE2 level (p=0.005). In the differentiation of exudative fluids, the sensitivity of the pleural fluid PGE2 level was 63.5 % and the specificity was 80 % with a cut-off value of 1 12.7 pg/ml. The pleural fluid PGE2 level was not significantly different in malignant and benign effusions. The pleural fluid PGE2 levels in the patients with lung cancer differed significantly from the other causes of pleural fluid except the tuberculous fluid. The sensitivity and the specificity of the pleural fluid PGE2 level in the diagnosis of lung cancer was 70.8 % and 76.3 %, respectively with a cut-off value of 210 pg/ml. The plazma PGE2 level was not significantly different in malignant-benign and transudates-exudates groups. As a conclusion, we have considered that the determination of PGE2 level in the pleural fluids is not suitable in the separation of transudative and exudative effusions and also malignant and benign effusions due to the low diagnostic efficiency, and it may be helpful in the discrimination of pleural effusions associated with lung cancer in suspicious conditions