Prevalence of paranasal sinus pathology and its relationship with serum eosinophil and IgE levels in asthmatic patients

Amaç: Astım polikliniğinde izlediğimiz olgularda eşlik eden paranazal sinüs patolojisi sıklığını radyolojik olarak belirlemek ve sinüs mukoza inflamasyonu ile serum eozinofilisi ve IgE düzeyinin korelasyonunu araştırmaktır. Yöntem: Bu çalışmada astım tanısı ile izlenmekte olan ardışık 82 olguda öykü ve fizik bakı sonrası Water's grafisi çekildi, kuru spirometre ile solunum fonksiyon testleri yapıldı, serum eozinofil yüzdesi (hemocounter cihazı ile) ve serum total IgE düzeyi (nephelometrik teknikle) saptandı. ıstatiksel analiz ki-kare, t-test ve korelasyon testleri ile yapıldı. Bulgular: Olguların yaş ortalaması 42.82 13.28 idi ve %74'ü kadındı. Hastalık süresi ortalama 7.50 7.36 yıl idi. Başvuru sırasında %82'sinin astımla ilgili yakınmaları mevcuttu. Ortalama FEV1 1.98 0.69L ve FEV1/FVC %66 14 idi. Olgularda serum total IgE düzeyi 137.85 147.53 IU/ml, eozinofil %4.05 3.72 idi. Olgulardan 44'ünün (%53.6)Water's grafileri normal olarak değerlendirilirken, 38 olguda (%46.4) paranazal sinüs patolojisi bulgularından en az biri izlendi. Maksiller sinüste mukozal kalınlaşma %35.4, hava-sıvı seviyesi %14.6, polipkist %6.1 oranında bulundu. Paranazal sinüs patolojisi varlığı ile olguların astım hastalığı süresi (p=0.065) ve astımın ağırlığı (FEV1 düzeyi) (p=0.856) arasında ilişki saptanmadı. Maksiller sinüzitle uyumlu radyolojik bulguları olan ve olmayan olguların eozinofil düzeyleri karşılaştırıldığında belirgin fark bulunmadı (p=0.832). Serum IgE düzeyi ortalaması sinüziti olan astımlılarda sinüziti olmayanlardan daha yüksek olmakla birlikte istatiksel farklılık yoktu (p=0.968). Tartışma: Sinüzitin uygun tedavisi astmalı olgularda semptomları geriletecek ve ilaç gereksinimini azaltacaktır. Bu nedenle tüm astmalı olgular sinüzit yönünden araştırılmalıdır.Aim: To evaluate the prevalence of paranasal sinus pathology and investigate the relationship of sinusoidal mucosal inflammation with serum eosinophilia and IgE levels in asthmatic outpatients. Methods: Following the medical history and physical examination, we evaluated sinus x-rays (Water's graphy) in 82 asthmatic outpatients. Pulmonary function tests were performed with a dry spirometer. Serum eosinophil percentage was determined using a hemocounter and serum total IgE level by nephelometric technique. Statistical analyses were done by X-square, t-test and correlation tests. Results: The mean age of patients was 42.82+13.28 years and 74% were women. Duration of asthma was 7.50+7.36 years. 82% of patients were symptomatic for asthma during evaluation. MeanFEV1 was 1.98+0.69L and FEV1/FVC was 66+14%. Serum total IgE level was 137.8^5+147.53 IU/ml while eosinophil percentage was found to be 4.05+3.72. Water's graphy was normal in 44 of the patients (53.6%). At least one of radiological findings of sinusitis was detected in 38 of the cases (46.4%). There was maxillary sinus mucosal thickening in 35.4%, air-fluid level in 14.6% and polyp-cyst in 6.1%.There was no correlation between paranasal sinus pathology and duration of asthma (p=0.065) or severity of asthma (FEV1%) (p=0.856). There was no difference in eosinophil levels between asthmatic patients who had a paranasal sinus pathology and the ones who did not (p=0.832). Although mean serum IgE level was higher in patients with sinusitis, statistically significant difference was not detected (p=0.968). Discussion: Proper management of sinusitis may improve asthmatic symptoms and decrease need for medication. We suggest that asthmatic patients should be searched routinely for the presence of occult sinusitis

The Use of Human Epididymis 4 and Cancer Antigen 125 Tumor Markers in the Benign or Malignant Differential Diagnosis of Pelvic or Adnexal Masses

Background: Ovarian cancer is one of the highest mortality cancers in gynaecology. Discrimination of benign masses from malignant ones may sometimes become a challenge for the clinician since there is not a reliable tumour marker, thus some unnecessary, highly morbid operations can be performed. Aims: To explore the efficacy of human epididymis 4 (HE 4) and cancer antigen 125 (CA 125) markers in differentiating malignant and benign pelvic masses of ovarian origin and to identify the cut-off points for those markers. Study Design: Prospective study. Methods: Fifty-one patients who were diagnosed and planned to undergo surgery for ovarian mass between June 2008 and December 2008 were enrolled into this study. Preoperative venous blood samples were taken and frozen for marker investigation and final diagnoses were concluded by histopathological examination. After recruitment of all cases CA 125 and HE 4 levels were evaluated. Results: The statistical analysis did not indicate any statistically significant difference between the CA 125 levels of the patients with malignant and benign adnexal masses (p=0.105). The HE 4 levels of the patients with malignant adnexal masses were higher at a statistically significant level compared to the patients with benign adnexal masses (p=0.002). For HE 4 tumour marker and at the cut-off point of >25 pM, sensitivity was 1, specificity 0.40, positive cut-off value 0.19, negative cut-off value 1, accuracy 0.47 and positive likelihood ratio 1.65. Conclusion: Human epididymis 4 is a better diagnostic tool than CA 125 in benign-malignant discrimination of adnexal masses. The cut-off value of 25 pmol/L for human epididymis 4 will contribute to providing proper guidance to patients with adnexal masses and applying the proper treatment method

Anterior maksiller dişetinde yassı epitel hücreli karsinom olgusu: Vaka raporu

Ağız mukozasının malign tümörlerinin yaklaşık %90'ı yassı epitel hücreli karsinom niteliği taşır. Yassı epitel hücreli karsinomlar ağız mukozasının her yerinde görülebilir. Bu olguda anterior maksiller dişetinde görülen yassı epitel hücreli karsinomun klinik ve histopatolojik özellikleri sunulmaktadı

Duruoz Hand Index: Is it valid and reliable in children with unilateral cerebral palsy?

Purpose: To investigate the validity and reliability of the Duruoz Hand Index (DHI) in patients with unilateral cerebral palsy (CP). Methods: Assessments of patients (n = 23) were performed using the Modified Ashworth Scale (MAS), the Manual Ability Classification System (MACS), the grip and pinch strength tests, and DHI. Following the data collection, retest of DHI was administered telephonically within a 2-week period. Results: Test-retest reliability and internal consistency of DHI were found to be excellent with a Cronbach's alpha value of 0.93 and an intraclass correlation coefficient value of 0.94. The correlation between the DHI and MACS was detected significantly high (r = 0.840, p = < 0.010). The DHI also correlated with grip and pinch strength in the affected side (r = -0.459, p = r = -0.509, p = < 0.050). Conclusions: DHI is a valid and reliable questionnaire for patients with unilateral CP

Electrosprayed chitosan-coated alginate-pectin beads as potential system for colon-targeted delivery of ellagic acid

Background: Ellagic acid (EA), a potent dietary antioxidant, has limited bioavailability owing to its rapid absorption in the stomach and small intestine, and EA is transformed to more bioavailable compounds - urolithins - in the colon. An encapsulation system that sustains the release of EA in the gastrointestinal system and delivers more EA into the colon could improve the oral bioavailability of EA. Electrosprayed EA-loaded alginate-pectin beads were produced and coated with low- (LC) and high-molecular-weight chitosan (HC). The EA release from uncoated and coated beads under simulated gastrointestinal conditions was evaluated. The samples were characterized by particle size, gel strength, scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) analysis. Results: The encapsulation efficiency (EE%) of EA ranged from 49.53% to 69.85% for uncoated beads, which was elevated up to 86.50% by coating, and LC coating provided higher EE%. Pectin addition to alginate and chitosan coating reduced the gel strength and changed the size depending on the molecular weight of chitosan. SEM images of pectin-added beads showed fewer cracks but more wrinkles, and chitosan coating presented more aggregated surfaces. The ionic interaction of alginate-pectin-chitosan and the entrapment of EA were confirmed by FTIR. In the gastric medium, EA release was very low from uncoated beads (15.2-19.8%), and totally restricted by chitosan coating. In the intestinal stage, EA release from LC-coated alginate-pectin beads was only 18%, and it was between 55% and 65% for uncoated or HC-coated counterparts. Conclusion: The LC-coated alginate-pectin beads could be further explored as a potential system for colon-targeted delivery of EA. © 2021 Society of Chemical Industry

A retrospective review of the adnexal outcome after detorsion in premenarchal girls

Background: The aim of this study was to report our results on premenarchal girls with adnexal torsion who were treated with different approaches. Materials and Methods: Twenty-six adnexal torsions in children were analysed retrospectively. Group 1 included cases of oophorectomy for the twisted adnexa. Group 2 contained the patients with adnexal torsion who untwisted either with a laparoscopic or open approach. Postoperative restoration of ovarian function was evaluated by Doppler ultrasound at the 6 th month. All oophorectomy and biopsy specimens were also evaluated. Results: Group 1 consisted of eleven cases that underwent oophorectomy due to gangrenous change and haemorrhagic infarction. Histology was of a mature teratoma in two cases and haemorrhagic necrosis due to torsion in seven. Group 2 consisted of 15 patients. In 10 out of 15 patients, preoperative biopsy is performed in which their histology revealed haemorrhagic necrosis in eight cases, and simple cyst with a benign nature in two cases. In all of the 10 untwisted adnexas, postoperative radiological imaging showed complete recovery with normal follicular development. No malignancy or increased tumour markers were noted in both groups. Conclusion: Adnexas can be left in place regardless of the preoperative degree of necrosis. Biopsy can be added to the procedure to rule out malignancy