A comparative ID migraine screener study in ophthalmology, ENT and neurology out-patient clinics

Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument.Pfizer-Türkiy

Malignant transformation of endometriosis on vaginal cuff after hysterectomy: a case report

Objective. Endometriotic tissue implants rarely transform to malignant tissue, especially in a patient with a hysterectomy and bilaterally salpingo-oophorectomy. However, several cases with cancer arising from endometriosis after hysterectomy were reported in the literature. Hormone replacement therapy only with estrogen is a crucial risk factor for malignant transformation of persistent endometriotic tissue. Case Report. The present case demonstrates an endometrioid adenocarcinoma arising from persistent endometriosis tissue in a patient who was performed hysterectomy with bilateral salpingectomy 3 years ago. The histopathologic specimens of the previous surgery did not include any malignant tissue. After 3 years, she applied to the hospital with abnormal vaginal bleeding, and her histopathologic examination result found an ulcerated mass at the upper one-third of the vagina that is compatible with endometrioid adenocarcinoma. Conclusion. It is crucial to keep in mind the endometriosis history of the patient, to be able to diagnose cancer arising from endometriosis while evaluating the patient with a hysterectomy

A Case Of Anaphylaxis to Measles Vaccination In an Infant with Cow's Milk Allergy

Background: Cow's milk is one of the most common of the foods that cause food allergies in children. Here, we present a 10-month-old male who was diagnosed with having an allergy to cow's milk and who developed an anaphylactic reaction after being recently vaccinated with a measles vaccine. Case: The patient had been diagnosed with atopic dermatitis and cow's milk allergy at 40 days old after a rash appeared on his face and arms while exclusively breastfeeding. At 9 months, on his routine welfare outpatient appointment, he developed a facial rash and swelling, wheezing, difficulty breathing, and cyanosis within 10 min of having his first measles vaccination (M-VAC (R); Serum Institute of India, Hadapsar, Pune, India). After an allergy evaluation and a physical examination that showed that he was otherwise healthy, he was diagnosed with an allergy to cow's milk, which was then eliminated from his diet. Laboratory evaluations were as follows: serum immunoglobulin E (IgE) to cow's milk: 36.2 kU/L, alpha-lactalbumin: 9.39 kU/L, beta-lactoglobulin: 8.74 kU/L, casein: 34.2 kU/L, latex-specific (sp)IgE: 0.10 kU/L, gelatin spIgE: <0.35 kU/L (normal levels <0.35 kU/L; Pharmacia, Uppsala, Sweden). Results revealed lactalbumin hydrolysate as one of the M-VAC ingredients according to the manufacturer's package insert. Conclusion: In most cases with a cow's milk allergy, vaccines are administered without any problems because the amount of milk proteins contained in the vaccines is not sufficient to represent a risk factor for anaphylaxis; however, the vaccine content should be examined for possible allergens, particularly for children with food allergies, before vaccinating. We should keep in mind when determining the agent responsible for an allergic reaction that the risk from a residual component of milk protein in vaccines can differ according to the nutritional habits of the population

6-12 Ay Arasındaki Çocuklara Uygulanan Beslenme Tutumlarının Çocukların Büyümesi Üzerine Etkisi:İzlem Çalışması

6-12 Ay Arasındaki Çocuklara Uygulanan Beslenme Tutumlarının Çocukların Büyümesi Üzerine Etkisi: İzlem ÇalışmasıGiriş: Tamamlayıcı beslenme; verilen besinlerin anne sütünün yerini alması değil, anne sütünün yanı sıra destekleyici olarak verilmesidir. Bu dönem sadece ideal büyüme ile değil erişkin dönem sağlığını belirlemek açısından da önemlidir. Duyarlı besleme anne, baba ya da çocuğa bakan kişi ile çocuğun karşılıklı oluşturduğu bir beslenme biçimi olarak tanımlanmıştır. UNICEF duyarlı beslemeyi tamamlayıcı besinlerin aktif olarak sunulması olarak tanımlamıştır. Duyarlı beslenme sağlıklı beslenme alışkanlıklarının gelişmesine, yemek saatlerinin daha kolay hale gelmesine, çocuğun kendini beslemesini öğrenmesine katkıda bulunur, çocuğun aşırı kilolu olmasını önler. Çalışmamızda duyarlı beslenme davranışının çocukların büyümesi üzerine etkisinin araştırılması amaçlanmıştır.Metod: Çalışma İstanbul Üniversitesi İstanbul Tıp Fakültesi Sosyal Pediatri Bilim Dalı, Çocuk Sağlığı ve İzlem polikliniğinde yürütüldü. Düzenli izlemleri yapılan ve duyarlı beslenip beslenmediğinin sorulduğu anket çalışmasına katılan 6-12 ay arasındaki bebeklerin 18. ve 24. ay boy, kilo, vücut kitle indeksi değerleri kaydedildi. Boy, kilo ve vücut kitle indeks (VKI) değerlerinin SDS değerleri hesaplandı. Bebeklerin 6-12 aylık döneminde uygulanan ankette yemeklerini oturarak mı yedikleri, beslenmesinde bebeğin dahil olup olmadığı, yemek sırasında dikkat dağıtıcı nesne kullanıp kullanılmadığı, yemek sırasında oyun oynanıp oynanmadığı, sadece anne sütü ve anne sütü alma süreleri soruldu.Bulgular: Çalışmaya dahil edilen 32 bebeğin 18’i (%56,3) erkek, 14’ü (%43,7) kız, anketin değerlendirildiği çalışmaya alınma yaş medyan (aralık) değeri 9 ay (6-12 ay) idi. Bebeklerin SAS beslenme süresi ile 18 ve 24. aylardaki VKI SDS’leri arasında pozitif yönde anlamlı ilişki saptandı (sırasıyla p=0,008 r= 0,477 ve p=0,027 r=0,391). Tamamlayıcı besin alırken bebeğin otur pozisyonda ya da yatar pozisyonda beslenmeleri karşılaştırıldığında 18. ay VKİ SDS’leri arasında fark bulunmazken, 24. ay VKİ SDS’leri değerlendirmesinde yatar pozisyonda beslenenlerin (VKI SDS=-0,53) VKI SDS değerleri oturarak beslenenlere (VKI SDS=-0,009) göre daha düşük saptandı(p=0,03)