Successful Treatment of Herpes Esophagitis With Ganciclovir in a Liver Transplant Patient

The presence of Herpes Simplex Virüs-1 (HSV-1) esophagitis in patients with liver transplantation has been reported rarely. Among the reports that are accessible in the literature, none could have shown tissue positivity for Herpes virus-1 DNA via Polymerase Chain Reaction (PCR) in patients with liver transplantation. This case is presented as the patient was diagnosed with herpes esophagitis based on the histopathological findings and HSV-1 DNA positivity (detected by PCR) in the biopsy material and was treated with Ganciclovir. Due to the specific action of Ganciclovir against CMV infections, it is natural that the drug cannot use in the treatment of HSV infections. However it is reported that ganciclovir has been reduced the incidence of symptomatic HSV infections after liver transplantation. We report on a patient after liver transplantation with HSV-1 esophagitis, who was successfully treated with Ganciclovir. We assume that most transplant centers according to their protocols use ganciclovir for CMV prophylaxis, which may contribute to avoid HSV infection

Axillary mononeuropathy after herpes zoster infection misdiagnosed as neuropathic pain

PMID = 3078524

Prevalence of spondyloarthritis in Turkish patients with inflammatory bowel disease

Rheumatic manifestations are the most common extraintestinal findings of inflammatory bowel disease (IBD), although there are wide variations among different studies. The only previous Turkish study reported a rather high prevalence of spondyloarthritis (SpA) in patients with IBD. We aimed to determine the frequency of SpA and ankylosing spondylitis (AS) in patients with IBD attending a gastroenterology clinic from a referral centre. The study was conducted in 122 patients with established diagnosis of IBD [28 with Crohn's disease (CD) and 94 with ulcerative colitis (UC)]. A detailed medical history was obtained and a complete physical examination was performed in all the patients. Standard pelvic X-rays for examination of the sacroiliac joints were performed only when clinically indicated. The X-rays were read blindly by an experienced rheumatologist and reported according to the established grading system. The modified New York criteria were used to classify AS, and the European Spondyloarthropathy Study Group criteria for SpA. The prevalence of AS and SpA in patients with IBD was 8.2 and 28.7%, respectively. SpA was found to be significantly more common in the patients with CD compared to patients with UC, but the frequency of AS was not different between these two groups. There was no correlation between localisation or extent of the intestinal inflammation and presence of AS and SpA. A higher frequency of women was observed in patients diagnosed as SpA. Almost half of the patients with SpA (45.7%) had not been diagnosed before the study, although they had a history of IBP and/or peripheral arthritis. This study suggests that the prevalences of SpA and AS in Turkish patients with IBD are similar to those in many other populations. There may be a significant female predominance of SpA among patients with IBD

Irritable bowel syndrome in persons who acquired trichinellosis.

BACKGROUND AND AIM: The postinfectious irritable bowel syndrome (PI-IBS) frequently follows bacterial infections. Since people suffering from PI-IBS and Trichinella spiralis-infected mice develop similar findings, this animal model has been successfully used for PI-IBS studies; however, IBS has never been studied in humans after trichinellosis. The aim of this study was to evaluate the IBS symptoms in people who had acquired trichinellosis. PATIENTS AND METHODS: A large outbreak of trichinellosis caused by Trichinella britovi occurred in Izmir, Turkey, in 2003-2004. The diagnosis of trichinellosis was confirmed by serology and muscle biopsy. After clinical and laboratory evaluations, 72 patients (38 women, 34 men, mean age 33.2 +/- 10.4 yr) with trichinellosis without preexisting IBS were enrolled in the study. Noninfected people (N = 27) were used as control group. A questionnaire was developed to assess symptoms of IBS and alarm symptoms. The first interview was done face-to-face. After 2, 4, and 6 months of the first interview, the questionnaire was readministered to the patients without any information on the occurrence of a previous trichinellosis syndrome, while it was applied after a year only to the patients who had suffered IBS symptoms according to at least one of the previous interviews. RESULTS: According to Rome II criteria, PI-IBS developed in 10 of 72 (13.9%) people with confirmed trichinellosis, who had no preexisting IBS. The rate of PI-IBS was 13.9% and 13.9% at the 4th and 6th months, respectively. The symptoms of PI-IBS persisted in five of them up to 1 yr. People without trichinellosis did not develop any IBS symptoms. CONCLUSIONS: This is the first report of the development of PI-IBS after T. britovi. Consequently, IBS can be considered as a secondary syndrome induced by trichinellosis

Peri-ictal Prone Position Is Associated With Independent Risk Factors For Sudden Unexpected Death In Epilepsy: A Controlled Video-EEG Monitoring Unit Study

Introduction. Sudden unexpected death in epilepsy (SUDEP) is a major cause of death in patients with chronic drug-resistant epilepsy, and peri-ictal prone position has been elucidated as a risk factor for SUDEP. We aimed to investigate consecutive patients in peri-ictal prone positions in our video EEG monitoring (VEM) unit and compare patients with and without peri-ictal prone position to emphasize its relationship with other independent risk factors for SUDEP. Methods. We retrospectively screened all patients with peri-ictal prone position who underwent VEM for a 10-year period and these patients constituted the prone (+) group. All patients without peri-ictal prone position who underwent VEM in the past 2 years constituted the prone (-) control group. Sequences of peri-ictal positions and interventions were evaluated. Clinical and laboratory features and SUDEP-7 scores were compared between the groups. Results. A total of 21 seizures were identified with peri-ictal prone position from 16 patients. SUDEP-7 scores were significantly higher in the prone (+) group. Longer duration of epilepsy, early age at seizure onset, mental retardation, and frequency of seizures of any type (>50 seizures per month for the past year) were found significantly different between the prone (+) and prone (-) groups. Conclusion. Peri-ictal prone position in the VEM unit may relate with other independent risk factors of SUDEP, especially with mental retardation. Nocturnal supervision becomes important to reduce SUDEP risk, especially in patients with mental retardation

Status epilepticus in patients with juvenile myoclonic epilepsy: Frequency, precipitating factors and outcome

Status epilepticus (SE) is rarely described in patients with juvenile myoclonic epilepsy (JME), and little is known about its frequency, subtypes, and predictors and the prognosis of these patients. In this retrospective study, we aimed to analyze the incidence of SE in patients with JME and emphasize the risk factors and long-term outcome of SE in an epilepsy outpatient-based cohort