Spinal musküler atrofili bir çocuk hastada kinezyoband uygulanması

Kinezyoband son 20 yıldır oldukça popüler olan ve çeşitli kas iskelet sistemi hastalıklarında kullanılan elastik bandajlama metodlarından biridir. Mekanizması tam açık değildir fakat bazı teoriler öne sürülmüştür. Bu olgu sunumunda progresif kas hastalıklarından olan spinal musküler atrofili bir hastada gelişen sırt ağrısına uygulanan kinezyoband sonuçlarını sunmayı amaçladık. Kinezyoband dört gün ara ile üç defa olmak üzere fasyal B tekniğiyle uygulandı. Uygulama sonrası ağrıda azalma sağlandı. Kinezyoband uygulaması progresif kas hastalığı olanlarda ağrı azaltılmasında faydalı olabilir.Kinesio taping is one of the elastic bandage methods which has been quite popular in the last 20 years and has been applied in various musculoskeletal conditions. Although the mechanism of action is not clear, many theories have been suggested so far. In this case report, we aimed to present the results of kinesiotape application for back pain of the patient with spinal muscular atrophy which is one of the progressive muscular disorders. It was performed for three times with four days interval. Fascial technique B (Space technique) was applied. Reduce of pain was also observed during the subsequent applications. The application of kinesio taping could be beneficial on reducing the pain in patients with progressive muscle diseases

Scleroderma After 5-Fluorouracil and Folinic Acid Therapy in a Patient with Colon Carcinoma

Skleroderma cilt altında ve iç organlarda artmış kollajen birikimi ile karakterize bir bağ dokusu hastalığıdır. Etiyolojisi tam aydınlatılamamakla birlikte bazı kimyasal ajanların ve çevresel faktörlerin etyopatogenezde rol oynadığı kabul edilmektedir. Progresif sistemik skleroderma olan olgularda gastrointestinal kanal karsinomlarının arttığına dair sınırlı veri bulunmaktadır. Kolon karsinomu tedavisinde kullanılan 5-florourasil ile skleroderma ilişkisine dair literatürde sadece iki olgu bildirilmiştir. 5-florourasil ve folinik asit tedavisi verilen timik karsinomlu bir olguda ise skleroderma benzeri klinik tablo ve otoantikor pozitifliği bildirilmiştir. Bu yazıda, 51 yaşında kolon karsinomu tanısıyla 3 kür 5-florourasil ve folinik asit tedavisi alan ve daha sonra scleroderma geliştiren bir olgu sunulmuşturSistemic sclerosis is a connective tissue disease which is characterized by the increase amount of collagene in subcutaneous tissue and internal organs. Several chemical agents and environmental factors are accused fort he etiopathogenesis however the etiology is not clear. There is limited data abput the increased frequency of colon carcinoma in the cases with sistemic sclerosis. There are 2 cases in the literature about the association between scleroderma and 5-fluorouracil which is used for the treatment of colon carcinoma. Similar clinical course and autoantibody positivity was also reported in a patient with tymic carcinoma who had been treated with 5-FU and folinic acid. In this article, a 51-year-old woman who developed scleroderma after 5-FU and folinic acid therapy which had been started for colon carcinoma has been reporte

Aromataz inhibitör terapisinin neden olduğu artraljinin değerlendirilmesi

Amaç: Meme kanseri hormon tedavisinde, aromataz inhibitörleri (AI) ve (Tamoksifen) Tmx sık olarak kullanılmaktadır. Bu çalışmada, meme kanserli kadınlarda görülen artralji yakınmalarının hormon tedavisinde kullanılan ajanlarla ilişkisi araştırılmıştır. Yöntem: Meme kanseri olan ve AI grubu ilaç alan 32 hasta ve Tmx alan 32 hasta çalışmaya dahil edildi. Hastaların eklem ağrılarının şiddetini belirlemek için Görsel Analog Skalası (VAS) kullanıldı. Yine tüm hastalara „mevcut eklem ağrılarınızın kaynağı hakkındaki nedenlerle ilgili düşünceniz nedir?? sorusuna cevap arayan beş seçenekli Likert ölçeği uygulandı. Laboratuar parametresi olarak, hastaların CBC, BUN, kreatinin, ALT, AST, alkalen fosfataz, kalsiyum, CRP, ESR, ANA, Anti-DNA, RF, östradiol seviyelerine bakıldı. Bulgular: AI kullanan hasta grubun yaş ortalaması 52,7±8,2 yıl, Tmx kullanan grubun yaş ortalaması 47,4±6,5 yıl idi (p0,05). Sonuç: Çalışmamızda AI alan hastalarda Tmx alan hastalara göre daha sık ve daha şiddetli artralji olduğu saptanmıştır. AI kullanan hastalardaki artralji nedenlerinden biri de, düşük östradiol düzeyi olabilir.Purpose: In breast cancer treatment, aromatase inhibitors (AI) and tamoxifen (Tmx) are frequently used. In this study, the relationship between the hormonal therapy and arthralgia in women with breast cancer was studied. Methods: Sixty-four patients of whom 32 taking AI and 32 taking Tmx were included in the study. VAS was used to determine the intensity of pain. Also five options Likert scale was applied to all patients to answer the question “what are your thoughts about the sources of your current pain?”. As laboratory parameters, CBC, BUN creatinine, ALT, AST, alkaline phosphatase, calcium, CRP, ESR, ANA, RF, and estradiol levels of the patients were analyzed. Results: The mean age of the AI group was 52.7 ± 8.2 years old and in the Tmx group, it was 47.4 ± 6.5 years old (0.05, for each). Conclusion: In our study, more frequent and severe arthralgia has been observed in patients under AI treatment when compared to tamoxifen. One of the causes that leads to arthralgia in patients using AI may be low levels of estradiol

The relationship of recurrent aphthous stomatitis and Helicobacter pylori, cytokine gene polymorphism and cobalamin

Background/Aims: The aim of the present study was to investigate whether Helicobacter pylori causes or triggers recurrent aphthous stomatitis (RAS) through cytokine gene polymorphism and/or cobalamin deficiency.Materials and Methods: Thirty-six patients with RAS and 130 patients without RAS were genotyped for IL-1? (?511C/T) and IL-6 (?174G/C) and evaluated for H. pylori infection and serum cobalamin level.Results: The patient groups according to RAS had similar rates of H. pylori gastritis and interleukin genotypes/alleles, and there was a non-significant difference between serum cobalamin levels (p>0.05). RAS patients with H. pylori gastritis showed a higher frequency (51.9%) of GC IL-6 genotype than RAS patients without H. pylori gastritis (11.1%) (p=0.036). Non-GG genotype and C allele were increased in patients without RAS and with H. pylori gastritis (p0.05). RAS patients with H. pylori gastritis showed a higher frequency (51.9%) of GC IL-6 genotype than RAS patients without H. pylori gastritis (11.1%) (p=0.036). Non-GG genotype and C allele were increased in patients without RAS and with H. pylori gastritis (p<0.05). Patients with H. pylori gastritis showed a lower value of serum cobalamin without statistical significance, although this difference was more prominent in RAS patients (p=0.07).Conclusion: The carriage of the C allele of IL-6 may lead a susceptibility to chronic gastric inflammation after contamination with H. pylori. If H. pylori infection is justified as a predisposing factor for RAS and its severity by further studies, we can speculate that subjects with genetic susceptibility to this infection may benefit from H. pylori eradication treatment with respect to RA

Erythema elevatum diutinum coexisting with ankylosing spondylitis

A 43-year-old woman presented to our hospital with the complaint of a reddish-purple rash on the extensor sides of her forearms. She had been diagnosed with ankylosing spondylitis 7 years ago. On physical examination, reddish-purple nodules were detected on the pretibial areas of both legs and extensor sides of both hands and forearms. Neutrophil, eosinophil, lymphocyte, and mixed-type leukocyte infiltration and erythrocyte extravasation were observed in skin biopsy. Erythema elevatum diutinum (EED) was diagnosed. For treatment, sulphasalazine, colchicine, and diclofenac were started. After 3 months of treatment, the lesions were healed. To the best of our knowledge, this is the first report of EED coexisting with ankylosing spondylitisA 43-year-old woman presented to our hospital with the complaint of a reddish-purple rash on the extensor sides of her forearms. She had been diagnosed with ankylosing spondylitis 7 years ago. On physical examination, reddish-purple nodules were detected on the pretibial areas of both legs and extensor sides of both hands and forearms. Neutrophil, eosinophil, lymphocyte, and mixed-type leukocyte infiltration and erythrocyte extravasation were observed in skin biopsy. Erythema elevatum diutinum (EED) was diagnosed. For treatment, sulphasalazine, colchicine, and diclofenac were started. After 3 months of treatment, the lesions were healed. To the best of our knowledge, this is the first report of EED coexisting with ankylosing spondyliti

Erythema elevatum diutinum coexisting with ankylosing spondylitis

A 43-year-old woman presented to our hospital with the complaint of a reddish-purple rash on the extensor sides of her forearms. She had been diagnosed with ankylosing spondylitis 7 years ago. On physical examination, reddish-purple nodules were detected on the pretibial areas of both legs and extensor sides of both hands and forearms. Neutrophil, eosinophil, lymphocyte, and mixed-type leukocyte infiltration and erythrocyte extravasation were observed in skin biopsy. Erythema elevatum diutinum (EED) was diagnosed. For treatment, sulphasalazine, colchicine, and diclofenac were started. After 3 months of treatment, the lesions were healed. To the best of our knowledge, this is the first report of EED coexisting with ankylosing spondylitis

Severe Respiratory Failure in the Coexistence of Polymyositis and Hypothyroidism

Polimyozit sistemik inflamatuar bir kas hastalığıdır. Solunum kas tutulumuna bağlı solunum yetmezliği görülebilen bir klinik tablodur. Burada 41 yaşında hastanemize ani başlayan nefes darlığı ve göğüs ağrısı şikayetleriyle başvuran bir hasta sunulmuştur. Muayenesinde proksimal kas güçsüzlüğü saptandı. Kreatin fosfokinaz yüksekliği, ANA pozitifliği ve elektromyografik incelemesinde myopatik değişiklikler bulundu. Deltoid kas biyopsisi sonucu polimyozit ile uyumlu bulundu. Hastaya 5 gün 1 gram iv pulse metil prednizolon tedavisi uygulandı. Aynı zamanda 25 mg/hafta parenteral metotreksat tedavisi uygulandı. Laboratuar testinde hipotiroidi de tespit edilmesi üzerine levotiroksin replasmanı tedaviye eklendi. Takipte klinik bulgular ile birlikte kas enzimleri ve tiroid stimülan hormon düzeyleri düzelen hasta gece NIMV kullanımı önerisi ile taburcu edildi. Polimyozite hipotiroidinin eşlik ettiği tabloda klinik semptomlar daha ciddi izlenmektedir.Polymyositis is a systemic, inflammatory muscle disease. Respiratory insufficiency as a result of respiratory muscle involvement could also be observed. Here we report a fortyone-year-old man who attended to the hospital with the complaints of shortness of breath and chest pain that have suddenly started. Physical examination has revealed proximal muscle weakness. Serum creatinine phosphokinase level has increased, ANA was positive and the electromyographic examination has revealed myopathic changes. Deltoid muscle biopsy was in accordance with polymyositis. Methyl-prednisolone 1 gram iv pulse therapy was given during the first 5 days. He was started with 25 mg/week parenteral methotrexate. Laboratory tests suggested hypothyroidism and levothyroxine replacement therapy was started. The clinical findings have improved concomitant with the reduction in the muscle enzymes and thyroid stimulant hormone levels into the normal ranges. He was discharged with the recommendation of the NIMV device application during night-time. The clinical symptoms are more severe in the presence of alveolar hypoventilation due to polymyositis and coincidantal hypothyroidism

FAMILIAL COLLAGEN TISSUE DISEASE AND SERUM LEVELS OF ANTINUCLEAR ANTIBODIES IN PANDAS OCD PATIENTS

Amaç: Bu çalışmanın amacı Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) ilişkili çocukluk çağı Obsesif Kompulsif Bozukluğu (OKB) olgularında Anti nükleer Antikor (ANA) pozitifl iğinin ve ailesel Kollajen Doku Hastalıkları (KDH) öyküsü sıklığının araştı- rılmasıdır. Yöntem: OKB tanısı ile izlenen hastalara Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi - Şimdi ve Yaşam Boyu Şekli – Türkçe (ÇDŞG-ŞY-T). Hastaların serum Anti Streptolysin O (ASO), C Reactive Protein (CRP) ve Anti nükleer Antikor (ANA) düzeyleri ölçüldü. Sonuçlar: Bu çalışmada 52 (%57.1) PANDAS, 19 (%20.9) non-PANDAS ve 20 (%22) PANDAS-varyant olmak üzere toplam 91 OKB olgusu yer almıştır. Ailesel KDH öyküsü 34 (%37.4) idi. Bunların 18’i (%52.9) birinci derece, 16’sı (%47.1) ikinci derece yakınları idi. 7 olgu ile Romatoid Artrit (RA) (%20.5) en sık bildirilen KDH idi. Hastalık alt grupları karşılaştırıldığında PANDAS olanlarda 15 (%28,8) ile ANA pozitifl iği anlamlı düzeyde fazlaydı (p=.90) Tartışma: Bu çalışma PANDAS ve ailesel KDH arasındaki ilişkiyi araştıran az sayıda çalışmalardan biri olması nedeniyle önemlidir. PANDAS OKB’ nin Kollajen Doku Hastalığı ile ilişkisini araştıran genetik çalışmalara ihtiyaç bulunmaktadır.Objective: The aim of this study was to investigate the frequency of familial history of collagen tissue disease and antinuclear antibody (ANA) positivity in cases with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) related to childhood Obsessive Compulsive Disorder. Method: To determine psychiatric diagnoses, Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime Turkish Version (KSADS-PL) was administered to the patients followed up with the diagnosis OCD. Serum levels of Anti Streptolysin O (ASO), C Reactive Protein (CRP) and Anti nuclear Antibody (ANA) were screened. Results: There were 91 OCD patients. Among these, 52 patients (57,1%) were diagnosed with PANDAS, 19 (20.9%) were diagnosed with nonPANDAS and 20 (22%) were diagnosed with PANDAS-variant. History of familial CTD was found in 34 (37.4%) of the cases. Among these,18 (52,9%) were fi rst degree relatives while 16 (47,1%) were second degree relatives. The most commonly reported CTD was Rheumatoid Arthritis as present in 7 patients (20,5%). When each subgroup was compared, ANA positivity was most common in the PANDAS group, present in 15 patients (28,8%) indicating a statistical signifi cance at p=.90. Discussion: This study is important for being one of the limited number of studies that searched for an association between familial CTD and PANDAS. There is a need for genetic studies to explore the association between PANDAS OCD and familial collagen tissue disease