120 research outputs found
Association of myasthenia gravis and Behçet's disease: A case report
Myasthenia gravis is a disease of neuromuscular junction due to auto-immune destruction of the acetylcholine receptors. Behçet's disease, on the other hand, is a multisystemic vascular-inflammatory disease. Both conditions are not common in the general population although their association has not been reported in the literature. We wanted to present our patient who developed clinical course of myasthenia gravis following discontinuation of medications due to complications of corticosteroid for Behçet's disease. It was observed that clinical findings of myasthenia gravis recovered following restarting steroid treatment and he did not experience attacks of both conditions. Although Myasthenia gravis and Behçet's disease are distinct entities clinically as well as in terms of pathogenesis, they share common physiopathological features and their treatment is based on their common features
Endoscopic Retrograde Cholangiopancreatography in the Diagnosis and Management of Choledochal Cysts
Choledochal cysts are an uncommon anomaly of the biliary system manifested by cystic dilatation of the extra or intrahepatic biliary tree or both. It is most frequently found in Orientals and in females. Endoscopic retrograde cholangiopancreatography is a valuable imaging technique in the diagnosis of choledochal cysts in adults. Additionaly, in selected cases, a choledochocele may be effectively managed by endoscopic sphincterotomy. We present clinical and endoscopic findings of six adult patients with choledochal cysts. Clinical symptoms were characterized by abdominal pain, jaundice and cholangitis. Associated hepatobiliary pathologic findings included cholelithiasis, recurrent acute pancreatitis, gallbladder carcinoma, Cystolithiasis, choledocholithiasis, biliary stricture and hepatic abscess
Identifying Clinical Characteristics of Hypoparathyroidism in Turkey: HIPOPARATURK-NET Study
Hypoparathyroidism is an orphan disease with ill-defined epidemiology that is subject to geographic variability. We conducted this study to assess the demographics, etiologic distribution, treatment patterns and complication frequency of patients with chronic hypoparathyroidism in Turkey. This is a retrospective, cross-sectional database study, with collaboration of 30 endocrinology centers located in 20 cities across seven geographical regions of Turkey. A total of 830 adults (mean age 49.6 ± 13.5 years; female 81.2%) with hypoparathyroidism (mean duration 9.7 ± 9.0 years) were included in the final analysis. Hypoparathyroidism was predominantly surgery-induced (n = 686, 82.6%). The insulting surgeries was carried out mostly due to benign causes in postsurgical group (SG) (n = 504, 73.5%) while patients in nonsurgical group (NSG) was most frequently classified as idiopathic (n = 103, 71.5%). The treatment was highly dependent on calcium salts (n = 771, 92.9%), calcitriol (n = 786, 94.7%) and to a lower extent cholecalciferol use (n = 635, 76.5%) while the rate of parathyroid hormone (n = 2, 0.2%) use was low. Serum calcium levels were most frequently kept in the normal range (sCa 8.5–10.5 mg/dL, n = 383, 46.1%) which might be higher than desired for this patient group. NSG had a lower mean plasma PTH concentration (6.42 ± 5.53 vs. 9.09 ± 7.08 ng/l, p < 0.0001), higher daily intake of elementary calcium (2038 ± 1214 vs. 1846 ± 1355 mg/day, p = 0.0193) and calcitriol (0.78 ± 0.39 vs. 0.69 ± 0.38 mcg/day, p = 0.0057), a higher rate of chronic renal disease (9.7% vs. 3.6%, p = 0.0017), epilepsy (6.3% vs. 1.6%, p = 0.0009), intracranial calcifications (11.8% vs. 7.3%, p < 0.0001) and cataracts (22.2% vs. 13.7%, p = 0.0096) compared to SG. In conclusion, postsurgical hypoparathyroidism is the dominant etiology of hypoparathyroidism in Turkey while the nonsurgical patients have a higher disease burden with greater need for medications and increased risk of complications than the postsurgical patients. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature
The comparison of high and standard definition computed tomography techniques regarding coronary artery imaging
Objective: The aim was to compare coronary high-definition CT (HDCT)
with standard-definition CT (SDCT) angiography as to radiation dose,
image quality and accuracy. Material and Methods: 28 patients with
history of coronary artery disease scanned by HDCT (Discovery CT750 HD)
and SDCT (Somatom Definition AS). The scan modes were both axial
prospective ECG-triggered. The vessel diameters and vessel attenuation
values of totally 280 measurements from 140 coronary arteries were
analyzed by two experienced radiologists. All data was analyzed by
intraclass correlation test. Image quality graded by motion and stair
step artifacts (grade 1, poor, to grade 4, excellent), accuracy of
vessel inner and outer diameters were compared between the two CT units
using the independent samples t-test and Mann-Whitney U test. Results:
The intraclass correlation coefficient (ICC) of measured vessel
attenuation values in SDCT between the two radiologists was exceedingly
good. The ICC was higher in HDCT. The radiation dose of HDCT was higher
than that of SDCT. The mean tube current was 180 (mA) in HDCT and
147(mA) in SDCT with the same tube voltage (kVp). There was no
significant difference between image quality. Conclusion: HDCT has a
higher radiation dose but has much more atenuation and the spatial
resolution which improve measurement accuracy for imaging coronary
arteries
Prevalence of sleep disorders in the Turkish adult population epidemiology of sleep study
Sleep disorders constitute an important public health problem. Prevalence of sleep disorders in Turkish adult population was investigated in a nationwide representative sample of 5021 Turkish adults (2598 women and 2423 men, response rate: 91%) by an interviewer‐administered questionnaire. Insomnia was defined by the DSM‐IV criteria, habitual snoring and risk for sleep‐related breathing disorders (SDB) by the Berlin questionnaire, excessive daytime sleepiness (EDS) by the Epworth sleepiness scale score, and restless legs syndrome (RLS) by the complaints according to the International Restless Legs Syndrome Study Group criteria. Mean age of the participants was 40.7 ± 15.1 (range 18 to 90) years. Prevalence rates (men/women) were insomnia 15.3% (10.5%/20.2%; P < 0.001), high probability of SDB 13.7% (11.1%/20.2%; P < 0.001), EDS 5.4% (5.0%/5.7%; P: 0.09), RLS 5.2% (3.0%/7.3%; P < 0.001). Aging and female gender were associated with higher prevalence of sleep disorders except for habitual snoring. Prevalence rates of the sleep disorders among Turkish adults based on the widely used questionnaires were close to the lower end of the previous estimates reported from different parts of the world. These findings would help for the assessment of the health burden of sleep disorders and addressing the risk groups for planning and implementation of health care
Quantitative trait loci conferring grain mineral nutrient concentrations in durum wheat 3 wild emmer wheat RIL population
Mineral nutrient malnutrition, and particularly
deficiency in zinc and iron, afflicts over 3 billion people
worldwide. Wild emmer wheat, Triticum turgidum ssp.
dicoccoides, genepool harbors a rich allelic repertoire for
mineral nutrients in the grain. The genetic and physiological
basis of grain protein, micronutrients (zinc, iron,
copper and manganese) and macronutrients (calcium,
magnesium, potassium, phosphorus and sulfur) concentration
was studied in tetraploid wheat population of 152
recombinant inbred lines (RILs), derived from a cross
between durum wheat (cv. Langdon) and wild emmer
(accession G18-16). Wide genetic variation was found
among the RILs for all grain minerals, with considerable
transgressive effect. A total of 82 QTLs were mapped for
10 minerals with LOD score range of 3.2–16.7. Most QTLs
were in favor of the wild allele (50 QTLs). Fourteen pairs
of QTLs for the same trait were mapped to seemingly
homoeologous positions, reflecting synteny between the A
and B genomes. Significant positive correlation was found
between grain protein concentration (GPC), Zn, Fe and Cu,
which was supported by significant overlap between the
respective QTLs, suggesting common physiological and/or
genetic factors controlling the concentrations of these
mineral nutrients. Few genomic regions (chromosomes 2A,
5A, 6B and 7A) were found to harbor clusters of QTLs for
GPC and other nutrients. These identified QTLs may
facilitate the use of wild alleles for improving grain
nutritional quality of elite wheat cultivars, especially in
terms of protein, Zn and Fe
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