Giardiosis tanısında duodenal sıvı muayenesinin değeri

We were unable to detect any parasites in the microscopic examination of multiple faecal specimens from 40 patients who had gastrointestinal symptoms similar to those of giardiasis, For this reason, in order to detect the G. intestianalis trophozoites in duodenal fluid, duodenal aspiration was performed in all cases. in the direct microscopic examination, the trophozoites of G. intestianalis were found in the duodenal fluid of 6 (15%) of the patients.Giardiosis ile uyumlu gastrointestinal sistem yakınmaları plan 40 olgunun, üstüste yinelenen dışkı bakılarında plumlu bir sonuç alınamamıştır. Bu nedenle, duodenal sıvıda Giardia intestinalis trofozpitlerini araştırmak için duodenal tubaj uygulanmıştır. Elde edilen duodenal sıvı örneklerinin direkt mikroskopik bakısında 6 (%15) hastada G. intestinalis trofozoitleri saptanmıştır

Bowel Cleansing with Oral Sodium Phosphate is a Risk Factor for Nephropathy in Acromegaly

Because of increased risk of colorectal carcinoma, screening by colonoscopy is recommended in patients with acromegaly. Cleansing should be vigorous in these patients due to increased bowel length and delayed colonic transit time. Recently, cases of phosphate nephropathy associated with a widely preferred purgative oral sodium phosphate (OSP) have been reported. Although main risk factors for phosphate nephropathy have been described, acromegaly has not been included as a risk factor. The present case is a 63-year old male patient, who developed transient renal failure after using three doses of OSP, which increased the serum phosphate level by 8.1 mg/dL. An acromegalic patient may have many risk factors for phosphate nephropathy after OSP administration, including having high basal serum phosphate levels, increased bowel transit time, need for high purgative dosages, increased tubular phosphate reabsorption, advanced age, and concurrent administration of angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and nonsteroidal anti-inflammatory drugs (NSAIDs). Physicians should be warned against the risks of using OSP in acromegalic patients, and intensive follow-up is necessary in the hospital setting soon after OSP administration. Therefore, we suggest that acromegaly should be included as a risk factor for nephropathy due to OSP in the current guidelines

Parathyroid changes after high dose radioactive iodine in patients with thyroid cancer

The study aimed to investigate the effect of high dose radioactive iodine (RAI) on parathyroid function in patients with differentiated thyroid cancer

Effects of vitamin D replacement therapy on serum FGF23 concentrations in vitamin D-deficient women in short term

Objective: Fibroblast growth factor 23 (FGF23), a phosphatonin, inhibits renal phosphate reabsorption and suppresses 1-alpha hydroxylase activity. Calcitriol stimulates FGF23 synthesis in bone. We aimed to determine the effect of vitamin D replacement therapy on serum FGF23 concentrations in vitamin D-deficient women and to compare the FGF23 concentrations of vitamin D-deficient patients with healthy subjects and patients with genetically determined hypophosphatemic rachitis

İlk başvuruda primer odağı bilinmeyen metastatik karaciğer tümörlü 43 olgunun irdelenmesi

Background/aim: Although patients with liver metastases and unknown primary focus have poor prognosis, some have a relatively good prognosis, such as cases of liver metastases of neuroendocrine tumors. Thus, the histopathological property of these metastatic tumors is valuable in treatment and follow-up of these patients. The aim of this study was to evaluate the histopathological and cytological properties of our patients with liver metastases retrospectively. Materials and methods: The medical reports of 43 patients who were hospitalized at the Gastroenterology Department between January 2000-May 2003 and diagnosed to have biopsy-proven liver metastases were reviewed retrospectively. Patients who were diagnosed to have primary hepatic tumor, cholangiocarcinoma, or lymphoma and those with insufficient medical records were excluded. Age, sex, histopathological and cytological diagnoses and, if found, primary focus of malignancy of the patients were evaluated. Results: The mean age of the 43 patients (23 males, 20 females) was 59 years (range: 19-88). Histopathological spectrum included adenocarcinoma in 26, neuroendocrine tumor in 8, anaplastic carcinoma in 4, and other in 5. Malignant cytology in 37 (86%), benign cytology in 5 (11%) and suspected cytology in 1 (3%) were reported. Sensitivity of the cytology was found to be 86%. Primary focus of malignancy was found in 17 (40%) patients and 26 (60%) patients were diagnosed to have a malignancy of unknown primary focus with liver metastases. Conclusion: Both the percentage of neuroendocrine tumors presenting with liver metastases and the percentage of patients whose primary focus of malignancy unknown were found to be higher than the percentage reported in literature. We suggest that liver biopsy should be performed in metastatic liver tumors.Giriş ve amaç: Primeri bilinmeyen metastatik karaciğer tümörlü hastaların prognozu kötü seyretmekle birlikte, nöroendokrin tümörler gibi bazı tümör metastazlarında göreceli olarak daha iyi prognoz beklenir. Bu durumdan dolayı bu hastalarda, tümörün histopatolojik özelliği tedavi ve takipte önem kazanmaktadır. Bu çalışmanın amacı metastatik karaciğer tümörlü olgularımızın histopatolojik ve sitolojik olarak retrospektif değerlendirilmesidir. Gereç ve yöntem: Gastroenteroloji Kliniğinde Ocak 2000-Mayıs 2003 tarihleri arasında yatan ve biyopsi yapılarak metastatik karaciğer tümörü tanısı alan 43 olgunun dosyaları retrospektif olarak değerlendirilmiştir. Primer karaciğer tümörleri, kolanjiyoselüler karsinom ve lenfoma tanısı alan olgular ile kayıtları yetersiz olan olgular çalışmadan dışlanmışlardır. Olgular yaş, cinsiyet, histopatolojik ve sitolojik tanıları ve eğer saptanmışsa primer odakları açısından değerlendirilmiştir. Bulgular: 23'ü erkek, 20'si kadın olan 43 olgunun ortalama yaşı 59 (19-88) dur. Metastatik tümörlerin histopatolojik değerlendirilmesinde; 26'sında (%60) adenokarsinom, 8'inde (%18) nöroendokrin tümör, 4'ünde (%9) anaplastik karsinom ve 5'inde diğer tümör metastazı saptanmıştır. 37 (%86) olgunun sitolojik incelemesi malign, 5'inin (%11) benign ve 1 (%3) olgunun da kuşkulu olarak rapor edilmiştir. Sitolojik incelemenin duyarlılığı %86 bulunmuştur. 17'sinde (%40) primer odak bulunmuş, 26 (%60) olgu primeri bilinmeyen metastatik karaciğer tümörü tanısı almıştır. Sonuç: Metastatik karaciğer tümörü ile başvuran nöroendokrin tümör sıklığımız ve primeri saptanan hasta sıklığımız literatürde belirtilenden daha yüksektir. Metastatik karaciğer tümörlü olgularda biyopsi yapılmalıdır