Protracted Febrile Myalgia in a Child as the Presenting Sign of Familial Mediterranean Fever: Case Report and Review of the Literature

Protracted febrile myalgia (PFM) is a rare form of vasculitic disease which is an uncommon dramatic manifestation of familial Mediterranean fever (FMF), characterized by severe crippling myalgia and high fever. We describe a 14-year-old boy who presented with fever, abdominal pain and severe myalgia in all his muscles for 5 days. The diagnosis of PFM was considered based on the presence of fever, paralyzing myalgia with normal CPK, elevated CRP and ESR. Thus, we started prednisolone treatment and his symptoms disappeared and acute-phase reactants declined rapidly. Mutational analysis of the MEFV gene demonstrated homozygote M694V mutation. Thus, he was diagnosed as PFM and FMF. In this report, we present a child with PFM as the sole feature preceding the diagnosis of FMF, and draw attention to the PFM for the diagnosis of FMF even the patient does not fulfi ll the criteria for the clinical diagnosis. © Trakya University Faculty of Medicine

The relationship between temperament and character features, and social problem solving in psychiatric patients who attempted suicide with drugs: preliminary results

Objective: In order to gather information in a broader sample, the aims of this preliminary study were: 1) to identify psychiatric diagnoses and any history of suicidal thoughts and attempts in people who attempt suicide with drugs, 2) to evaluate the temperament and character features, social problem solving skills of these patients in relation to sociodemographic data and 3) to analyze the correlations between these factors. Methods: Sixty patients between 16 and 49 years old participated in this study. A Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), a Sociodemographic Data Form, the Beck Depression Inventory (BDI), Temperament and Character Inventory (TCI) and Social Problem Solving Inventory (SPSI) were administered to the participants. Results: According to the SCID-I, 23 (38.3%) of the participants had a major depressive disorder, and 39 (65%) of the participants had a history of previous suicide attempts before this admission. There was a significant relationship between self-esteem scores and the incidence of previous suicide attempts. There were significant (negative) correlations between the harm avoidance, reward dependence, self-directedness and cooperativeness dimensions of the TCI and the problem orientation and problem solving skills subscales of the SPSI. Conclusion: Psychiatric disorders are common in individuals who attempt suicide with drugs. These individuals may have a history of one or more suicide attempts before admission. In addition to differences in temperament and character features, this study found significant disorders of cognition and behavior in individuals that had attempted suicide. This result may indicate that dimensions of temperament and character can provide significant indications for cognitive and behavioral disorders. (Anatolian Journal of Psychiatry 2014; 15:31-38

Sıvı Kromatografisi Sıralı Kütle Spektroskopisi (LC-MS/MS) Tekniği İle Noskapin Ve İlgili Stres Bozunma Bileşiklerinin İncelenmesi Ve Tayini İçin Metot Optimizasyonu

Oral kullanım için uygun bitkisel kaynaklı bir öksürük baskılayıcı alkaloid olan noskapinin tübülin bağlanma anti-kanser aktivite özelliği son zamanlarda tespit edilmiştir. Noskapin kan, meme, akciğer, yumurtalık, beyin ve prostat orijinli insan ksenograftları taşıyan çıplak farelerde tümör büyümesinin gelişmesini engellemiştir,. Bu çalışmada bir alkaloit türevi ve ilaç etken maddesi olan Noskapinin, Beşeri İlaçların Ruhsatlandırma Teknik Gereksinimleri İçin Uluslararası Uyum Konseyinin (ICH) , belirlediği şartlar doğrultusunda, farklı zorlanmış koşullar altındaki davranışı-bozunma ürünleri, LC-MS/MS tekniği ile belirlenip bozunma mekanizması önerilmiştir. Noskapin asidik, bazik, oksidatif, fotolitik ve sıcaklık gibi farklı stres koşullarında işleme tabi tutulmuştur. Bozunma ürünlerinin belirlenmesinde ultra performanslı sıvı kromatografi sistemi 40 C0 de C18 kolon, mobil faz olarak %0,1 lik formik asit içeren Metanol: Su (50:50 v/v) karışımı, kolon akış hızı 1.2 mL/dk, dedeksiyon dalga boyu 310 nm ile optimize edilmiştir. Kütle spektrometresi ile pozitif iyon modda çalışılıp, Noskapinin kütle spekturumu 414.1 m/z olarak gözlemlenmiş ve diğer parçalanma ürünleride açık bir şekilde belirlenmiştir. Böylece UPLC ve MS birlikte optimize edilerek etken maddenin parçalanma ürünlerinin belirlenmesi için LC-MS/MS metodu geliştirilmiştir

A rare cause of acute abdominal pain in adolescence: hydrosalpinx leading to isolated torsion of fallopian tube

Torsion of the fallopian tube accompanying hydrosalpinx is a rare occurrence in the pediatric population. This report describes a 13 year old sexually inactive girl with isolated tubal torsion due to hydrosalpinx. The girl had lower left abdominal pain for two days. The physical examination revealed left lower quadrant tenderness with a firm round anterior mass on rectal examination. Abdominal ultrasound showed left tubal enlargement with free pelvic peritoneal fluid. Magnetic Resonance Imaging (MRI) showed engorgement and dilatation of the left fallopian tube without contrast enhancement suspicious of tubal torsion. At operation, torsion of the left tube on its longitudinal axis was observed, and a salpingectomy was performed. Although rare, the diagnosis of torsion of the fallopian tube should be considered when evaluating acute abdominal pain. The earlier tubal torsion is diagnosed, the greater the likelihood of salvaging the fallopian tube. (C) 2012 Elsevier Inc. All rights reserved

The importance of costoclavicular space on possible compression of the subclavian artery in the thoracic outlet region: a radio-anatomical study

OBJECTIVES: The purposes of this study were to identify possible compression points along the transit route of the subclavian artery and to provide a detailed anatomical analysis of areas that are involved in the surgical management of the thoracic outlet syndrome (TOS). The results of the current study are based on measurements from cadavers, computed tomography (CT) scans and dry adult first ribs. METHODS: The width and length of the interscalene space and the width of the costoclavicular passage were measured on 18 cervical dissections in 9 cadavers, on 50 dry first ribs and on CT angiography sections from 15 patients whose conditions were not related to TOS. RESULTS: The average width and length of the interscalene space in cadavers were 15.28 ± 1.94mm and 15.98 ± 2.13 mm, respectively. The widths of the costoclavicular passage (12.42 ± 1.43mm) were significantly narrower than the widths and lengths of the interscalene space in cadavers (P < 0.05). The average width and length of the interscalene space (groove for the subclavian artery) in 50 dry ribs were 15.53 ± 2.12mm and 16.12 ± 1.95mm, respectively. In CT images, the widths of the costoclavicular passage were also significantly narrower than those of the interscalene space (P 0.05). CONCLUSIONS: Our results showed that the costoclavicular width was the narrowest space along the passage route of the subclavian artery. When considering the surgical decompression of the subclavian artery for TOS, this narrowest area should always be kept in mind. Since measurements from CT images and cadavers were significantly similar, CT measurements may be used to evaluate the thoracic outlet region in patients with TOS

In vitro antifungal activities of 26 plant extracts on mycelial growth of Phytophthora infestans (Mont.) de Bary

Antifungal activities of 26 plant extracts were tested against Phytophthora infestans using radial growth technique. While all tested plant extracts produced some antifungal activities Xanthium strumarium, Lauris nobilis, Salvia officinalis and Styrax officinalis were the most active plants that showed potent antifungal activity. They totally inhibited the mycelial growth of P. infestans. The other tested plant extracts exhibited moderate activity and average daily radial growth of fungus varied from 0.8 to 5.0 mm/day which were significantly lower than the control. The lowest antifungal activity was observed on Cynodon dactylon extract. The minimum inhibitory concentration (MIC) of the extracts ranged between 2 and 8% (w/v). X. strumarium extract produced the lowest MIC value of 2% which was lower than the standard fungicide Ridomil Gold mz 68 WP. Further studies on isolation and characterization of the active (antifungal) compound is needed before the possible use of the tested extracts in control strategies of this fungus.Keywords: Plant extracts, Phytophthora infestans, antifungal, minimum inhibitory concentration (MIC

The effects of tourism students’ attitudes toward sector on their desire to career: A study on ınterned students

Türkiye, sahip olduğu doğal, kültürel ve tarihi zenginlikler sayesinde diğer birçok turizm ülkesi ile rekabet halinde olan önemli bir turizm destinasyonudur. Bu kapsamda ekonomiye önemli ölçüde girdi ve bu doğrultuda gelir etkisi yaratan turizm sektörünün sürekliliği ve gelişimi için üst ve alt yapı olanaklarına ilave olarak bu sektöre kalifiye işgücü yetiştirecek yeterli düzeyde eğitim kurumlarının olması bir zorunluluktur. Bu eğitim kurumlarında, ufku açık, bilgili, geniş düşünen ve turizm sektörünü benimseyerek kendini sürekli geliştiren kalifiye işgücü yetiştirme çabaları sektörün gelişmesine katkı sağlayan/sağlayacak gelişmelerden olacaktır. Turizm eğitimi alan öğrencilerin sektörde çalışarak kariyer elde edebilecekleri gibi, farklı kamu kurumlarında ve üniversitelerde de istihdam edilebilmektedir. Buradan hareketle araştırmanın amacını, lisans düzeyinde turizm eğitimi alan ve staj yapan öğrencilerin turizm sektörüne yönelik tutumlarının belirlenerek kariyer yapma istekleri üzerindeki etkisini ortaya koymak oluşturmaktadır. Araştırmada veri toplama aracı olarak anket tekniğinden yararlanılmış ve araştırma Afyon Kocatepe Üniversitesi Turizm Fakültesinde eğitim gören toplam 401 öğrenciye uygulanmıştır. Araştırmadan elde edilen bulgular, araştırmanın amacına uygun olarak, yüzde, frekans, aritmetik ortalama, standart sapma, korelasyon ve regresyon analizleri kullanılarak çözümlenmiştir. Korelâsyon ve regresyon analizi sonucuna göre değişkenler (sektöre yönelik tutum ve kariyer yapma isteği) arasında anlamlı ilişkiler olduğu tespit edilmiştir.Turkey is an important tourist destination in competition with many other tourism countries with its' wealth of natural, cultural and historical heritages. In this context, for sustainability and development of tourism sector which ensures significant inputs and income effects for economy, the existence of educational institutions are required which trains skilled labors for tourism sector in addition to the substructures and superstructures. The efforts of training the skilled labor that on horizon, broad-minded and self-improvement by adopting tourism sector in these educational institutions, will be the one of improvements which contribute/will contribute to the development of the tourism sector. The students who study in tourism, as they can have a career by working in tourism sector, they can be also employed in different public institutions and universities. Hence, the aim of this study is to determine the interned students' attitudes towards the tourism sector and to prove its' effects on their desire to career. The survey technique was used for the data collection and applied to 401 students studying at the Faculty of Tourism in University of Afyon Kocatepe. The findings obtained from the study were analyzed by using analysis of percentage, frequency, mean, standard deviation, correlation and regression according to the aim of study. According to the results of correlation and regression analysis, the significant relationships were found between the variables (attitudes toward sector and desire to career in sector)

An observational, multicenter, registry-based cohort study of Turkish Neonatal Society in neonates with Hypoxic ischemic encephalopathy

BACKGROUND: Hypoxic ischemic encephalopathy (HIE) is a significant cause of mortality and short- and long-term morbidities. Therapeutic hypothermia (TH) has been shown to be the standard care for HIE of infants ≥36 weeks gestational age (GA), as it has been demonstrated to reduce the rates of mortality, and adverse neurodevelopmental outcomes. This study aims to determine the incidence of HIE in our country, to assess the TH management in infants with HIE, and present short-term outcomes of these infants. METHODS: The Turkish Hypoxic Ischemic Encephalopathy Online Registry database was established for this multicenter, prospective, observational, nationally-based cohort study to evaluate the data of infants born at ≥34 weeks GA who displayed evidence of neonatal encephalopathy (NE) between March, 2020 and April 2022. RESULTS: The incidence of HIE among infants born at ≥36 weeks GA (n = 965) was 2.13 per 1000 live births (517:242440), and accounting for 1.55% (965:62062) of all neonatal intensive care unit admissions. The rates of mild, moderate and severe HİE were 25.5% (n = 246), 58.9% (n = 568), and 15.6% (n = 151), respectively. Infants with severe HIE had higher rates of abnormal magnetic resonance imaging (MRI) findings, and mortality (p0.05). TH was administered to 85 (34.5%) infants with mild HIE, and of those born of 34-35 weeks of GA, 67.4% (n = 31) received TH. A total of 58 (6%) deaths were reported with a higher mortality rate in infants born at 34-35 weeks of GA (OR 3.941, 95% Cl 1.446-10.7422, p = 0.007). CONCLUSION: The incidence of HIE remained similar over time with a reduction in mortality rate. The timing of TH initiation, whether [removed

Clinical Features and Surgical Results in Harada-Ito Surgery Patients

Symptomatic excyclotorsion is an important clinical problem, especially in acquired superior oblique muscle palsy. Excyclotorsion can disrupt the fusion and cause torsional diplopia. Harada-Ito surgery (HI) is a widely used method for treating excyclotorsions. This method relieves the torsional diplopia by increasing the effect of the incyclotorsion. In this study, we aimed to report the clinical features of patients with torsional diplopia due to acquired trochlear nerve palsy and the results of HI surgery in these patients