Assessment of cardiac autonomic activity in patients with chronic idiopathic urticaria by heart rate variability

Amaç: Kronik idiyopatik ürtikerli (KİÜ) hastalarda kalp hız değişkenliği kullanılarak kardiyak otonomik aktivitenin araştırılması amaçlandı. Metot: Çalışmaya 24 KİÜ’li hasta (18 kadın ve 6 erkek, yaş ortalaması 29±12 yıl) ve 18 sağlıklı birey (15 kadın ve 3 erkek, yaş ortalaması 28±10 yıl) dahil edildi. Her iki gruba 24 saat süreyle holter elektrokardiyografi uygulanarak zaman ve frekans bağımlı kalp hız değişkenliği parametreleri hesaplandı. Frekans bağımlı analiz parametrelerinden çok düşük frekans komponenti (VLF), düşük frekans komponenti (LF), yüksek frekans komponenti (HF) ve LF/HF, zaman bağımlı değişkenlerden 24 saat içindeki tüm normal sinus R-R intervallerinin standart deviasyonu (SDNN), 24 saatlik kayıt boyunca her 5 dakikalık segmentlerde normal sinus R-R intervallerinin ortalamasının standart deviasyonu (SDANN), normal sinus RR intervallerinde ardışık değişimlerin ortalama karekökü (RMS-SD) kullanıldı. Bulgular: KİÜ grubunda SDANN kontrole göre anlamlı düzeyde artmış olarak izlendi. Buna karşın HF, LF ve LF/HF, ve SDNN değerlerinde anlamlı değişim izlenmedi. Sonuç: Elde edilen sonuçlar KİÜ’li hastalarda dengelenmiş sempatik/parasempatik aktiviteye işaret etmektedir.Objective: The aim of the present study was to evaluate cardiac autonomic nervous system functions in chronic idiopathic urticaria (CIU) by using 24- hour Holter electrocardiogram. Method: The study group consisted of 24 patients with CIU (18 female and 6 male, 29±12 years) and the control group consisted 18 healthy participitants (15 female, and 3 male, 28±10 years). In these two groups, we assessed cardiac autonomic regulation by power spectral analysis and time dependent analysis of heart rate variability (HRV) using 24-hour Holter electrocardiogram. Frequency components of the power spectra consist of high frequency component (HF), low frequency component (LF), very low frequency component (VLF), and the ratio of low frequency component and high frequency component (LF/HF). Time dependent HRV consists the standard deviation of all normal sinus RR intervals over 24 h (SDNN), standard deviation of all averaged normal sinus intervals for each 5-min segment in the 24-h recording (SDANN) and the root mean square of successive differences between normal sinus RR intervals (RMS-SD). Results: SDANN increased significantly in the CIU group compared to controls. Contrary to this HF, LF, LF/HF and SDNN values were similar to controls. Conclusion: In the CIU group, power spectral analysis and time dependent variable reflecting balanced cardiac autonomic activity

Chemotherapy extravasation results in skin necrosis and cellulitis: a case report

WOS: 000379360300005Extravasation, the accidental leakage of an anticancer agent from a vessel into the surrounding tissues, can lead to irreversible local injuries and severe disability. Altough several oral chemotherapy agents have been developed, most chemotherapy agents are administered intravenously. The extravasation of cancer chemotherapeutic agents can easily occur and may cause severe and irreversible local injuries. The incidence of extravasation of chemotherapeutic agents has been reported to ocur in 0.01-6.9% of cases. Extravasated drugs are classified according to their potential for causing damage as vesicant, irritant and nonvesicant. In this report we represent a multipl myeloma patient who has skin necrosis and cellulitis after chemotherapy infusion

Dermatosurgical training model

Amaç: Çalışmamızla cerrahi işlemlerin uygulanacağı ve uygulayana deneyim kazandıracak bir model geliştirmeyi amaçladık.Materyal ve Metod: Deneysel işlem sonrası sakrifiye edilen ratların derileri çıkartıldı. Önceden hazırlanan çalışma tahtasına deri sabitlenerek üzerinde punch ve eksizyonel biyopsi, değişik dikiş yöntemleri, shave eksizyon ve flep uygulamaları çalışıldı.Bulgular: Modelimiz birçok cerrahi işlemde deneyim kazanmak için uygun bulundu.Tartışma: Ucuz ve oluşturması kolay olan bu modelin deneyim kazanmak isteyen kişiler için yararlı olacağını düşünmekteyiz.Aim: Our aim was to develope a training model on which dermatologic surgery procedures could be practiced.Material and Method: Skin were excised from sacrificed experimental rats. Rat skin was fixed on formerly prepared wood. Punch and excision biopsy, different suture techniques, shave excision and flap operations were practiced.Results: Our model was found to be useful for gaining practice for many surgical operations.Discussion: We consider that this cheap and easy to perform animal model could be useful for trainers of dermatosurgery

Guttate psoriasis-like lesions following BCG vaccination

A 7-year-old boy presented to our clinic with a 1-week history of guttate psoriasis-like lesions after BCG vaccination. Although the patient did not have any history of psoriasis, his father and uncle had a history of psoriasis vulgaris. He was treated successfully with topical corticosteroid. Complete healing was seen after 3 weeks and the patient was still in remission 4 months after the cessation of the therapy. We proposed that patients who have psoriasis or predisposition to psoriasis must be carefully followed after BCG vaccination. © Oxford University Press 2004; all rights reserved

A family with hereditary angioedema having been followed as familial Mediterranean Fever

Herediter anjioödem fonksiyonel C1 esteraz inhibitör proteinin konjenital eksikliği sonucu oluşan, otozomal dominant kalıtılan nadir bir hastalıktır. Herediter anjioödemli hastalar klinik olarak yüz, gövde, solunum yolları, abdominal organları ve ekstremiteleri etkileyen tekrarlayan ödem epizodları ile karakterizedir. Ataklar ya spontan olarak ya da stres veya travmayı takiben oluşabilir. Hastalık sıklıkla karın ağrısı atakları ile seyreder. Öyle ki hastalar bu şikayet nedeniyle dermatoloji kliniğinden ziyade diğer kliniklere başvurabilir ve yanlış tanı konulup takip edilebilir. Bu nedenle karın ağrısından yakınan olgularda ayırıcı tanıda herediter anjioödem de düşünülmelidir. Bu yazıda uzun süredir Ailevi Akdeniz Ateşi olarak takip edilen herediter anjioödem tanılı bir aile sunmaktayız. Aile bireyleri çocukluk çağından beri vücudunun değişik bölgelerinde devamlı oluşup sonra kaybolan şişliklerden ve şiddetli karın ağrısından yakınmaktaydı. Hastalar yanlışlıkla Ailevi Akdeniz Ateşi tanısı ile yıllarca izlenmiş ve tedavi edilmeye çalışılmıştır. Olgulara kliniğimizde herediter anjioödem tanısı konuldu ve danazol tedavisinden fayda gördüler.Hereditary angioedema is a rare autosomal dominant disorder resulting from the congenital deficiency of functional C1 esterase inhibitor protein. Patients with hereditary angioedema are clinically characterized by recurrent episodes of swelling of the extremities, face, trunk, airways and abdominal viscera. Attacks may occur either spontaneously or following stress or trauma. The disease is usually associated with attacks of abdominal pain. So, patients may apply for this complaint to other clinics rather than dermatology, and may be misdiagnosed and followed for a long time. Therefore hereditary angioedema should be thought in differential diagnosis of patients suffering from abdominal pain. Here in this writing, we describe a family with hereditary angioedema who has been followed as Familial Mediterranean Fever for a long time. The family members complained from swellings which have been occuring in various regions of the body and disappearing spontaneously, and complained from severe abdominal pain, since childhood. These patients have been followed and tried to be treated with the misdiagnosis of Familial Mediterranean Fever for many years. These patients were diagnosed as hereditary angioedema in our clinic, and benefited from danazol treatment

Visual diagnosis: A child who has acute onset of unusual skin lesions and edema

WOS: 000242176800009PubMed: 1707950

A Family with Hereditary Angioedema Having Been Followed as Familial Mediterranean Fever

WOS: 000264332000007Hereditary angioedema is a rare autosomal dominant disorder resulting from the congenital deficiency of functional C1 esterase inhibitor protein. Patients with hereditary angioedema are clinically characterized by recurrent episodes of swelling of the extremities, face, trunk, airways and abdominal viscera. Attacks may occur either spontaneously or following stress or trauma. The disease is usually associated with attacks of abdominal pain, So, patients may apply for this complaint to other clinics rather than dermatology, and may be misdiagnosed and followed for a long time. Therefore hereditary angioedema should be thought in differential diagnosis of patients suffering from abdominal pain. Here in this writing, we describe a family with hereditary angioedema who has been followed as Familial Mediterranean Fever for a long time. The family members complained from swellings which have been occuring in various regions of the body and disappearing spontaneously, and complained from severe abdominal pain, since childhood. These patients have been followed and tried to be treated with the misdiagnosis of Familial Mediterranean Fever for many years. These patients were diagnosed as hereditary angioedema in our clinic, and benefited from danazol treatment. (Turkderm 2009; 43: 29-31

Importance of anesthesia in the intralesional interferon treatment of verruca plantaris

Verruka plantaris sık görülen, ağrı ve görünüm bozukluğuna sebep olabilen viral bir hastalıktır. Derin yerleşimli olması nedeniyle topikal tedavilerle genellikle yeterli sonuç alınamaz, intralezyonel interferon, tedavi seçeneklerinden birisidir. Fakat uygulama yaygın lezyonlarada ağrılı olabilmektedir. Bu yazıda interferon ile tedavi ettiğmiz bir verruka plantaris olgusu sunulmaktadır, intralezyonel interferon tedavisi planlanan olgumuza müdahale esnasında oluşabilecek şiddetli ağrı sebebiyle tedavi öncesi anestezi konsültasyonu istendi. Hastaya, intralezyonel enjeksiyonlar sırasında epidural anestezi uygulandı, işlem günaşırı olacak şekilde 5 kez tekrarlandı. Tedavi bitiminden 1 ay sonra hastanın tüm lezyonları düzeldi. Üçüncü ayın sonunda nüks yoktu.Verruca plantaris is a common viral disease that may be painful and cosmetically unacceptable. Because of their depth of penetration, topical treatment of the lesions is often unsuccessful. Intralesional interferon is one of the treatment choices. Unfortunately pain could be observed during this type of treatment. We present a case of verruca plantaris treated with intralesional interferon. The patient who was prepared to treat with intralesional interferon and consulted to the department of anesthesiology for pain that may occurduring treatment. Epidural anesthesia was applied to the patient during intralesional injections. Procedure was repeated for 5 times every other day. All lesions disappeared 1 month after the treatment and there was no recurrence at the end of 3 months of follow up