Mirizzi Syndrome Type 2: A Case Report

Mirizzi syndrome is an unusual complication of gallstone disease and occurs in approximately 1% of these pa-tients. Some cases can not be identified preoperatively; despite modern imaging techniques. Today; treatment of Mirizzi syndrome is surgical. If Mirizzi syndrome is pre-sent; the risk of bile duct injury increases; particularly during laparoscopic surgery. Therefore; preoperative or intraoperative diagnosis is important. Here; we pre-sented a 29 year-old woman with obstructive jaundice who diagnosed as cholelithiasis and choledocholithiasis. Preoperative endoscopic retrograde cholangiography re-lieved the common bile duct stone but cound not diag-nosed the Mirizzi syndrome preoperatively. During lapa-roscopy; the diagnosis of Mirizzi syndrome was sus-pected early and the procedure was converted to open cholecystectomy and T-tube to common bile duct. There was no bile duct injury and postoperative course was uneventful

Approximation by One and Two Variables of the Bernstein-Schurer-Type Operators and Associated GBS Operators on Symmetrical Mobile Interval

In this article, we purpose to study some approximation properties of the one and two variables of the Bernstein-Schurer-type operators and associated GBS (Generalized Boolean Sum) operators on a symmetrical mobile interval. Firstly, we define the univariate Bernstein-Schurer-type operators and obtain some preliminary results such as moments, central moments, in connection with a modulus of continuity, the degree of convergence, and Korovkin-type approximation theorem. Also, we derive the Voronovskaya-type asymptotic theorem. Further, we construct the bivariate of this newly defined operator, discuss the order of convergence with regard to Peetre’s K-functional, and obtain the Voronovskaya-type asymptotic theorem. In addition, we consider the associated GBS-type operators and estimate the order of approximation with the aid of mixed modulus of smoothness. Finally, with the help of the Maple software, we present the comparisons of the convergence of the bivariate Bernstein-Schurer-type and associated GBS operators to certain functions with some graphical illustrations and error estimation tables

Anorectal syphilis mimicking Crohn's disease

WOS: 000297210500021PubMed ID: 21437679Anorectal syphilis, one of the great masqueraders in medicine, can be difficult to diagnose not only because of its variable symptoms but also because it is hard to think of unless a detailed history about sexual preferences and practices, including homosexuality, has been gathered. With increasing acceptance of sexual activity in our culture, despite moral and religious issues, various forms of sex have led to many different clinical conditions of sexually transmitted diseases. In this report, we describe a rare case of primary anorectal syphilis with clinical, endoscopic and histologic features that was misdiagnosed as Crohn's disease

A patient with HIV infection presenting with diffuse membranous glomerulonephritis in a country with a low HIV prevalence—Remarkable remission with therapy

Summary: The most common manifestation of HIV in the kidney is HIV-associated nephropathy (HIVAN). In this report, we describe the first documented case of membranous glomerulonephritis in an HIV-positive individual in Turkey, the country with the lowest HIV prevalence in the region. The case occurred in an HIV-positive, hepatitis C (HCV)-negative, and hepatitis B (HBV)-negative Caucasian male, who presented with nephrotic-range proteinuria. The patient had a favorable response to HAART and an angiotensin-receptor blocker. Keywords: HIV, Nephropathy, Membranous glomerulonephriti

HCV-specific lymphocyte responses in individuals with positive anti-HCV but negative HCV-RNA

WOS: 000354124400016PubMed ID: 25959163Background: Hepatitis C virus (HCV) status cannot be reliably predicted in anti-HCV positive/HCV-RNA negative individuals who may either have recovered spontaneously or have a false-positive test due to antibody cross-reaction. Investigating T lymphocyte responses in individuals with different HCV status may help understand the cellular immune mechanisms underlying spontaneous recovery, treatment response, and chronicity. Objective: We aimed to determine whether anti-HCV positive, HCV-RNA negative individuals are truly spontaneous recoverers from acute HCV infection. Study design: We used enzyme-linked immunosorbent spot (ELISPOT) assay to compare HCV-specific lymphocyte response among anti-HCV positive/HCV-RNA negative individuals, patients with sustained virological response to interferon-gamma/ribavirin treatment, and patients with chronic HCV infection. Results: We found that 83% of anti-HCV positive/HCV-RNA negative individuals without a past medical history of acute icteric hepatitis had an HCV-specific T lymphocyte response in peripheral blood. Lymphocyte responses in these individuals were similar in magnitude to treatment responders unlike patients with chronic HCV whose virus-directed immunity was significantly suppressed. Conclusions: Detection of HCV-specific T lymphocyte responses using ELISPOT is a feasible method to ascertain past asymptomatic acute HCV infection.Office of Scientific Research Projects, Istanbul University [BYPS-1-26/31012007]This study is funded in part by the Office of Scientific Research Projects, Istanbul University (no: BYPS-1-26/31012007)

Attitudes of adult asthma patients towards influenze vaccination

Giriş: Astımlı hastalarda viral infeksiyonların atakları tetiklediği bilinmektedir. Fakat influenza aşısının alevlenmeyi önlemesine yönelik çelişkili sonuçlar olmasının yanı sıra, influenza aşısı konusunda astım hastalarının tutumunu da değerlendiren bir araştırmaya rastlanmamıştır. Bu çalışmada, astımlı hastaların influenza aşısına bakışlarını ve etki eden faktörleri değerlendirmeyi amaçladık.Materyal ve Metod: Astım tanısıyla kliniğimizde takip edilen hastalar ile, astım tanısı olmayan hastalara demografik özelliklerini, ko-morbiditelerini, gribal infeksiyon geçirme sıklıklarını, influenza aşısı yaptırıp yaptırmadıklarını ve aşı konusundaki görüşlerini sorgulayan bir anket uygulandı. Sonuçlar her iki grupta ayrı ayrı değerlendirildi ve birbiriyle karşılaştırıldı.Bulgular: Çalışmaya 108 (91 kadın,17 erkek) astım ve 110 (64 kadın, 46 erkek) kontrol olmak üzere toplam 218 hasta alındı. Astım hastalarında bu yıl aşılanma oranı kontrol grubuna göre belirgin olarak daha yüksekti (sırasıyla; %40.7, %8.2) ve bu hastaların yarısı her yıl düzenli olarak aşı yaptırmaktaydı. Aşı yaptırmayan hastalar incelendiğinde ise; kontrol grubundakilerin yarısının aşı yaptırmaya gerek duymadığı, %26.2'sinin ise aşının koruyucu etkisine inanmadığı görüldü. Astımlı hasta grubunda ise, kontrol grubuna yakın bir oranda (%20.3) hastanın aşının koruyucu etkisine inanmadığı görüldü. Astımlı hasta grubunda; daha önce aşı yapıldığında şikayeti olanların %66.7'si bu yıl aşı yaptırmamıştı (p= 0.02). Aşı olmayanların %53.1 oranında bu yıl gribal infeksiyon geçirdiği, aşı yapılanlarda ise bu oranın anlamlı ölçüde düştüğü ve aşının koruyucu olduğu görüldü (p= 0.00). Sonuç: Astım hastalarının influenza aşısı ve grip konusundaki bilgilerinin yetersiz olduğu ve aşının koruyuculuğuna inançlarının beklenenin aksine düşük olduğu izlendi. Hastaların çeşitli etkinliklerle bilgilendirilmesinin koruyucu hekimlik açısından çok önemli olduğu düşüncesindeyiz.Introduction: It is known that viral infections trigger exacerbations in asthma patients.There are conflicting reports on whether influenza vaccine is preventive or not. In this study, we aimed to evaluate asthmatic patient's attitude towards influenza vaccine and to determine which factors affect this attitude.Materials and Methods: A questionnaire involving data about demographic information, co-morbidities, frequency of viral upper respiratory tract infections, subject's influenza vaccination status and attitude towards vaccination had been filled for our outpatient clinic asthma patients and also for healthy controls. Results were evaluated separately for the two groups and then compared to each other.Results: For the study; 108 asthma patients (91 female, 17 male) and 110 non-asthmatic controls (64 female, 46 male) were enrolled. In asthma group, vaccination rates were significantly higher in the previous year (40.7%) and nearly half of them stated that they do regularly have influenza shots every year. Contrast to this find; half of the patients in the control group stated that they do not need to vaccinate themselves and 26.2% said that they don't believe influenza vaccine has any preventive effect. Also in the asthma group, this ratio was similar to the control group (20.3%). In asthma group, 66.7% of the patients who had side effects at their previous shots did not want to vaccinate themselves this year (p= 0.02). More than a half of the patients (53.1%) whom did not have shots had an episode of viral upper respiratory tract infection this year and this rate was significantly lower in the vaccinated group (p= 0.00). This result highlights the preventive effect of vaccination. Conclusion: We found that asthma patients' knowledge on influenza infection and vaccine were insufficient and also their belief towards the preventive features of the vaccination was low. Informing and encouraging patients about preventive medicine through various activities and meetings would be crucial