SAPHO syndrome with adrenal deficiency: a case report

Introduction: The SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteomyelitis) is a rare painful disorder, usually with a good long-term prognosis. Its etiology remains unclear, and various treatment regimens frequently fail to control the disease. Case presentation: A 46-year-old Caucasian female was referred for anterior chest wall and back pain. Physical examination was unremarkable except for skin lesions noted on soles of both feet, extremities and the face. A thoracic magnetic resonance imaging study demonstrated a lesion characterized with bone marrow edema and proliferation of soft tissue in the sternum. A brain MRI was requested secondary to the elevated prolactin level which was compatible with empty sella syndrome. Conclusion: The case presented here has the unique feature of adrenal deficiency presenting alongside the SAPHO syndrome and is presented as the first case reported. This syndrome could become complicated with different organ system involvement other than bone and skin. There is a need further studies that will explore the weak relationship between SAPHO syndrome and adrenal deficiency. © 2009 Eyigör et al.; licensee Cases Network Ltd

A Study on the Use of Massive Open Online Courses in Otorhinolaryngology After Graduation

Objective:The use of massive open online courses (MOOCs) in medical education and postgraduate education is becoming more and more widespread across the world. A survey study was carried out in Turkey to collect information and raise awareness about the use of MOOCs for educational and training purposes in the field of otorhinolaryngology after graduation.Method:The prepared survey questionnaire was published on the online communication platform of the Turkish Otorhinolaryngology-Head and Neck Surgery Association, and volunteers were asked to fill-out the questionnaire by clicking the given link.Results:A total of 210 volunteers participated in the survey study. Most of the volunteers (26.2%) were in the 36-40 age range. At the time of the study 53.8% of the volunteers were working as specialist doctors, 19.5% as residents, 10.5% as professors, 8.1% as associate professors, and 8.1% as assistant professors. Only 19 (9%) respondents ticked "yes" in response to the question "Are you familiar with the MOOC programs?" and only six (2.9%) of these respondents had attended a MOOC program. Evaluation of the correlation between academic title and awareness of MOOC programs showed that the instructors had a significantly higher level of MOOC awareness compared to the specialists and the residents (p=0.032).Conclusion:Results of the survey revealed that the use of MOOC programs in postgraduate otorhinolaryngology education was low and the volunteers were not well-informed about this practice

Otolaryngology Residents’ Attitudes, Experiences, and Barriers Regarding the Medical Research

Objective:It was aimed to investigate the attitudes, experiences, and barriers towards scientific research among otolaryngology residents in Turkey.Methods:Anonymous data were collected via an online survey. The demographic characteristics and experience in scientific research were investigated in the first section of the survey. The attitudes of participants towards scientific research and the barriers to the scientific research were examined in the second section of the survey using 17 items.Results:The present study involved 119 otolaryngology residents continuing their education. It was determined that 68.1% of participants think that “participating in scientific research” is a part of otolaryngology training. In the present study, it was shown that the residents having journal club hours in clinics on regular basis participated in various steps of scientific research projects (p<0.05). Residents stated that they participated in the “literature review” stage of the preparation of a scientific publication (mean value of 2.58±1.88) most and in “verbal presentation in a congress” least (mean value of 0.74±1.44). It was determined that 80.7% of participants have not attended in any training on scientific research. It was found that the residents receiving structured scientific research training participated more in steps of scientific research projects which was statistically significantly (p<0.05).Conclusion:In our country, otolaryngology residents are very enthusiastic about having research education and participating in researches. However, residency students frequently have time deficiency, lack of knowledge-skill, and lack of financial support. Dedicated time should be allocated for research training and practice in specialty programs. Journal club activities should be organized on regular basis and integrated with research education. On the other hand, the scholarly activities of residents should be supported by means of various countrywide educational activities on research training

Diz osteoartriti olan yaşlı hastaların ev egzersiz tedavisine uyumu

Objectives: This study aims to evaluate the compliance to home-based exercise regimen by elderly patients with osteoarthritis of the knee. Patients and methods: Between May 2012 and May 2013 year, a total of 72 patients (54 females, 18 males) over 65 years old with knee osteoarthritis admitted to the Physical Medicine and Rehabilitation outpatient clinic were included in the study. The patients were given a home-based exercise program. They were recommended to perform the exercises 10 times twice a day, for a month. We evaluated the patients’ demographic data, comorbid diseases, whether they exercised previously and compliance to exercise. Results: All patients’ home exercise program compliance was 62.5%. Males were more compliant than female patients and high education and comorbidity were also associated with poor compliance. Conclusion: The compliance of the geriatric patients to home-based exercise program is difficult and multiple variables affect the compliance

The antibiotic resýstance of staphylococci ısolated of clinical specimens

Amaç: Bu çalışmada çeşitli klinik örneklerden izole edilen stafilokokların antibiyotik direncinin saptanması amaçlanmıştır. Yöntem: Çalışmaya, klasik yöntemlerle tanımlanan 274 Staphylococcus. aureus (S. aureus) ve 172 koagülaz negatif stafilokok kökeni alınmıştır. Antibiyotik direnci, penisilin, metisilin, eritromisin, klindamisin, kotrimoksazol, siprofloksasin, vankomisin ve fusidik aside karşı Kirby-Bauer disk difüzyon yöntemi ile araştırılmış, metisilin direncinin saptanmasında oksasilin diski kullanılmıştır. Bulgular: Toplam 274 Staphylococcus aureus kökeninin % 92.3'ü penisiline, %10.9'u metisiline, % 21.5 'i eritromisine, % 14.8'i klindamisine %15.8'i ko-trimoksazole, % 7.3'ü siprofloksasine, % 5.7'si fusidik aside dirençli bulunurken, 172 koagülaz negatif stafilokok kökeninin%84.2'si penisiline, %38.8'i metisiline,%54.8'i eritromisine, % 44.4'ü klindamisine, %42.2'si ko-trimoksazole, % 25'i siprofloksasine, % 28.1'i fusidik aside dirençli bulunmuştur.Vankomisin direncine rastlanmamıştır. Sonuç: Koagülaz negatif stafilokok kökenlerinin S. aureusa göre antibiyotiklere daha yüksek oranda dirençli ve tüm stafilokok kökenlerinin vankomisine duyarlı olduğu saptanmıştır.Objective: The aim of this study was to detect the antibiotic resistance of staphylococci strains which were isolatedfromvarious clinical specimens. Methods: This study included 274 Staphylococcus aureus (S. aureus) and 172 coagulase negative staphylococci strains which were identified with classical methods. Antibiotic resistance of strains to penicilline, methicillin, erythromycin, clindamycin, co-trimoxazole, ciprofloxacin, vancomycin and fucidic acid were investigated by Kirby-Bauer disc diffusionmethod, while in the detectionofmethicilline resistance oxacilline discs were used. Results: Amongthe274 S. aureus strains, 92.3% werefoundresistantto penicilline, 10.9% to methicillin, 21.5% to erythromycin 14.8% to clindamycin, 15.8% to co-trimoxazole, 7.3% to ciprofloxacin, 5.7% to fucidic acid. Among 172 CNS strains 84.2% were found resistant to penicilline, 38.8% to methicillin, 54.8% to erythromycin, 44.4% to clindamycin, 42.2% to co-trimoxazole, 25% to ciprofloxacin and 28.1% to fucidic acid. Vancomycin resistance was not detected Conclusion: In this study we found that strains of coagulase negative staphylococci were much more resistant than S. aureus to antibiotics and all staphylococci were susceptible to vancomycin

A Rare Tumor of Palatine Tonsils: Chondrolipoma

Chondrolipomas are benign mesenchymal tumors that have two mature tissues simultaneously and emerge as a result of cartilaginous metaplasia in lipomas. They rarely occur in the head and neck area (1%-4%), and occur more frequently in the 60-70 years age group. Although there are cases of the nasopharynx, tongue, lip, and neck reported in the literature, we have been able to find only two cases on tonsils. The case of a 17-year-old male patient, who presented to our clinic complaining of dysphagia and was diagnosed with tonsillar chondrolipoma, is described here, along with the radiological, clinical, and immunohistochemical findings, as well as the review of the literatur

Malaria cases ın Aydın province

Amaç: Çalışmada Aydın ve çevresinde sıtma hastalığının durumunu değerlendirmek amaçlanmıştır. Yöntem: Sağlık Müdürlüğü Sıtma Birimi'nce 1997- 2000 yılları arasında toplam 119.458 kişiden alınan periferik kan örneklerinin kayıtları geriye dönük olarak araştırılmış, türleri saptanan olgular kökenlerine, yaşlarına, cinsiyetlerine göre sınıflandırılmıştır.Ayrıca yıllara göre sürveyans çalışmaları ve aylara göre sıtmalı olguların dağılımları değerlendirilmiştir. Bulgular: 189 erkek (%57.80), 138 kadın (%42.20) olan toplam 327 sıtmalı olguların yaşlara göre dağılımı incelendiğinde 10-20 yaş arasındaki olguların tüm olguların %33.64'ünü oluşturduğu görülmüştür. Sıtmalı olguların 70'inin (%21.40) sürekli olarak Aydın ilinde yaşadığı, 257 olgunun ise (%78.60) başta Güneydoğu ve DoğuAnadolu illeri olmak üzere başka illerden çeşitli nedenlerleAydın iline geldiği saptanmıştır. Aylara göre parazitli çıkanların yüzdeleri incelendiğinde ise; Ekim ayında 94 kişinin (%28.75) parazitli olduğu, bunu Eylül ve Kasım aylarının 65 (%19. 88) kişi ile takip ettiği saptanmıştır. Sonuç: İlimizde özellikle yerli sıtma olgularının son yıllarda giderek artması, sıtmanın yakın gelecekte ilimizde önemli sağlık sorunlarına neden olabileceğini düşündürtmektedir.Objectives: The aim of this study was to assess malaria incidence the province of Aydın. Method: Aretrospective analysis was conductedusing 119.458 blood sample records obtained by Aydın Malaria Control Unit between 1997-2000. Those withPlasmodium infestation have been classified with regards to region age and sex.. Annual surveillance and monthly distribution of malaria cases were also evaluated. Results: We found 189 males (57.80%) and 138 females (42.20%) withPlasmodium vivax infection.. 33.64% of all positive cases were between 10-20 years of age. 70 cases (21.40%) had been born and lived in Aydın, and the other 257 cases (78.60%) were immigrants, who came mainly from South-East and Eastern Anatolia regions. Monthly analysis of cases showed that 94 patients had been affected in October (28.75%), followedby 65 cases in September and November (19%). Conclusion: Increasing numbers of malaria cases in recent years indicate that, in the near future, malaria may cause significantproblems in Aydın Province

Preemptive analgesic properties of ketamine on tonsillectomy surgery

Tonsillektomi/adenotonsillektomi operasyonlarında cerrahinin çesitli zamanlarında uygulanan ketaminin preemptif analjezik özelliklerini arastırmaktır. Tıp Fakültesi Etik Kurulu ve olguların/ailelerinin yazılı onamları sonrası, çalısma prospektif, randomize, çift kör olarak gerçeklestirildi.Yasları 5-15 arası, 90 çocuk 3 gruba ayrıldı. Preemptif grupta (Grup P, n=30) tosillektomi pozisyonununda, ketamin 0,5mg/kg intravenöz (IV) 2mL serum fizyolojik (%0.9 NaCl=SF) içinde uygulandı. Kanama kontrolüne kadar 6 g/kg/dak. ketamin infüzyonuna devam edildi ve kanama kontrolünde 2mLSF uygulandı. Ketamine grubunda (Grup K, n=30), tonsillektomi pozisyonu baslangıcında IV 2mLSF verildi. Sonrasında 10 mL/saat SF infüzyonuna devam edildi ve kanama kontrolünde 0,8 mg/kg ketamin 2 mL SF içinde IV verildi. Kontrol grubunda (Grup C, n=30) tonsillektomi pozisyonu, cerrahi boyunca ve kanama kontrolünde IV SF uygulandı. Postoperatif periyotta sözel agrı skoru (VPS)>3 oldugunda, ilk 6 saatte 1mg/kg IV tramadol, sonrasında 6 mg/kg oral parasetamol ile agrı sagaltımı yapıldı. Kardiorespiratuar sistem bulguları, anesteziden uyanma ve taburcu olma parametreleri tramadol ve parasetamole ihtiyaçı olan olgu sayısı, parasetamol doz sayısı ve komplikasyonlar kaydedildi. Bulgular: Anesteziden uyanma ve taburcu olma parametreleri ile kardiyorespiratuar sistem bulguları gruplar arasında benzerdi. Sözel agrı skoru preemptif grupta, erken postoperatif dönem ve 4. saatte diger iki gruptan daha düsükken, 6. saatte kontrol grubunda diger iki gruptan yüksekti (P<0,05). Parasetamol ve tramadol ihtiyacı olan olgu sayısı ve total parasetamol dozu preemptif grupta diger iki gruptan daha azdı. Cerrahi insizyon baslamadan önce kullanıldıgında, ketaminin tonsillektomi/ adenotonsillektomi operasyonu sonrası preemptif analjezik etkili oldugu ve postoperatif analjezik ihtiyacını azalttıgı kanısına varıldıThe aim was to evaluate the preemptive analgesic effects of ketamine was used in different stages of surgery. All of the patients/parents were informed and The Ethical Committee of the Medical Faculty approved the study. Ninety patients (ages, 5-15) divided into three groups. The pre-emptive group (Group P, n=30) received intravenous (IV) ketamine 0,5mg/kg in 2mL saline at tonsillectomy position, followed by a continuous infusion of ketamine 6 g/kg/min, and 2mLsaline was administered during homeostasis. In the ketamine group (Group K, n=30), 2 mL saline was given at tonsillectomy position, and saline infusion (10 mL/h) continued until homeostasis, and 0,8 mg/kg examine was given during homeostasis in 2mLsaline. In the control group (Group C, n=30) saline was given at all stages of study.WhenVPS is greater than 3; tramadol 1 mg/kg IV administered in the first 6 hours postoperatively, and after paracetamol orally, 40mg/kg was given. Cardiorespiratory system data, recovery from anaesthesia and discharging parameters tramadol and paracetamol requirement, total dose of paracetamol, and complications were recorded. Recovery from anesthesia and discharging parameters were similar between the groups. In the preemptive group, VPS scores were lower than the other two groups at the early postoperative period, and at 4 , hours. The VPS scores were higher in the control group than the other two groups at 6 hour (P< 0,05). Tramadol and paracetamol requirement, total dose of paracetamol were fewer than the other groups in the preemptive group.Total complication number was similar in all groups. Ketamine decreases postoperative analgesic requirement and has preemptive analgesic effect when used before surgery in tonsillectomy/adenotonsillectomy surger