Evaluation of Extrapulmonary Tuberculosis Cases Presenting with Different Clinical Findings

Introduction: Extrapulmonary tuberculosis cases may display different clinical symptoms and this causes a delay in diagnosis. Nutritional deficiencies, migrations, and wars facilitate the development and the spreading speed of the disease. The aim of this article is to examine extrapulmonary tuberculosis patients with different clinical presentations.Method: In this study, 15 extrapulmoner tuberculosis cases who were hospitalized and treated in our pediatrics clinic in the last two years, has been evaluated retrospectively.Results: The average age of our group was 11.7 ± 4.5 and six of the assessed patients were Syrian origin. The shared complaints of five patients diagnosed with peritoneal tuberculosis were abdominal pain and bloating. Abdominal ultrasonography findings of the patients in concordance with diffuse ascites. Two of these patients, Mycobacterium tuberculosis had peritoneal effusion. All of the five patients diagnosed with lymph node tuberculosis had swelling on the neck, and all had pulmonary involvement. However, only one patient's lymph node biopsy was concordant with tuberculosis. One patient bone tuberculosis patient applied to our clinic with hip and back pain symptom. Pott’s abscess was observed in the patient's thorax MRI and hip MRI was concordant with tuberculous arthritis. Our patient with renal tuberculosis was diagnosed during evaluation of sterile pyuria attacks and in her urine ARB (+) was detected and M. tuberculosis grew in urine culture. One patient with central nervous system involvement applied to our clinic with clouding of consciousness and headache. The cerebrospinal fluid (CSF) findings of the patient were concordant with tuberculosis and growth was observed in the CSF culture. One case with miliary tuberculosis had hypercalcemia and pulmonary involvement. The patient's M. tuberculosis DNA PCR test was positive in bronchoalveolar lavage fluid. Another patient with pericardial tuberculosis applied due to respiratory distress and had cardiomegaly and pericardial effusion. Nine of our patients also had a contact history, 12 had purified protein derivative of tuberculin (PPD) (+), and 11 had pulmonary involvement.Conclusion: Patients were admitted to our outpatient clinic with various clinical symptoms. After careful physical examinations were performed, detailed patient histories were taken and laboratory tests performed for differentials, patients were diagnosed with extrapulmonary tuberculosis. It was desired to emphasize that this disease may appear with different clinical presentations in endemic regions like our country

Are Mean Platelet Volume and Neutrophil-to-Lymphocyte Ratio Related with Hepatosteatosis in Obese Children?

Objective: Obesity is an important health problem, which affects children and adolescents and is highly prevalent throughout the world. Non-alcoholic fatty liver disease is fattening that occurs due to non-alcohol causes, and it is associated with obesity in most of the cases. We investigated the relation of mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR) to hepatosteatosis in obese children in our study.Material and Methods: 104 obese children aged between 4-16 years, who were determined to have a body mass index (BMI) of 95th percentile or higher according to age and gender, were examined retrospectively. The genders, ages, and examination findings of the patients were recorded. In obese children, leukocyte, hemoglobin, platelet, mean platelet volume, neutrophil and lymphocyte levels were assessed in the complete blood count performed during the first application. Neutrophil-to-lymphocyte ratio was calculated. Fasting blood glucose (FBG) and fasting insulin, serum aminotransferase values, ultrasonographic results of patients were recorded.Results: Hepatosteatosis was determined in 64 of 104 patients (61.53%) while it was not determined in 40 patients (38.47%). The BMI, fasting insulin, HOMA-IR, ALT levels were higher in obese children with hepatosteatosis than patients without hepatosteatosis. The average MPV of the group with hepatosteatosis was 7.78±1.57, and the average MPV of the group without hepatosteatosis was 7.42±1.43, no statistical difference was observed between the groups (p=0.236). The average NLR was 1.62±1.06 in the group with hepatosteatosis and 1.38±0.59 in the group without hepatosteatosis. There was no statistical difference between the NLR averages of both groups (p=0.200).Conclusion: No relation was determined between MPV and NLR and liver fattening in obese children

Higher serum lipids and oxidative stress in patients with normal tension glaucoma, but not pseudoexfoliative glaucoma

This study entailed a cross-examination of oxidant/antioxidant balance, high-density lipoprotein (HDL)-linked paraoxonase 1 (PON1) phenotypes, and levels of serum routine lipids among patients with normal tension glaucoma (NTG) or pseudoexfoliative glaucoma (PEXG) compared with healthy control groups. We aimed to investigate the links between oxidative stress (OS), HDL-related antioxidant enzyme activities and dyslipidemia in distinct subtypes of glaucoma. The study included 32 patients with NTG, 31 patients with PEXG, and 40 control subjects. Levels of PON1 and arylesterase enzymatic activity, total oxidant status (TOS), and total antioxidant status were measured by spectrophotometry and OS indexes (OSI) were calculated. The phenotype distribution of PON1 was determined using the dual substrate method. Blood serum levels of HDL, low-density lipoprotein, total cholesterol (TC), and triglyceride (TG) were measured. The TOS and OSI values in the NTG group were significantly higher compared with the other groups (both p < 0.01). The phenotype distribution found in the glaucoma and control groups were NTG: QQ, 59.4%; QR, 37.5%; RR, 3.1%; PEXG: QQ, 45.1%; QR, 48.4%; RR, 6.5%; and in the control group: QQ, 42.5%; QR, 50.0%; RR, 7.5%. Serum TC levels were significantly higher than the control in both NTG and PEXG groups, whereas TG was significantly higher in NTG only (p < 0.01 and p < 0.02, respectively). Hyperlipidemia, OS and variations in phenotype distribution of PON1 may play a role in the pathogenesis of different types of glaucoma

Synthesis, characterization, and electrokinetic properties of polyindene/colemanite conducting composite

The aim of the aqueous electrokinetic experiments in the present study was to assess the relative contribution of the conducting polyindene (PIn) and inorganic colemanite components to the zeta (ζ) potentials of the composite particles, thus providing further insight into their surface composition in the dispersed state and establishing colloidally stable conditions for potential rheological, industrial applications. For this, PIn and a PIn/colemanite composite (containing 5 wt.% colemanite) were synthesized by chemical oxidative polymerization using FeCl as an oxidizing agent. Colemanite, PIn, and PIn/colemanite composite samples were characterized by Fourier-transform infrared spectroscopy, elemental analysis, conductivity, dielectric constant, magnetic susceptibility, density, particle-size measurements, thermogravimetric analysis, differential scanning calorimetry, X-ray diffraction analysis, and scanning electron microscopy methods. The electrokinetic properties of colemanite and PIn/colemanite composite dispersions were determined by ζ-potential measurements in aqueous medium, taking into account the effects of time, pH, various electrolytes, surfactants, and temperature. The pH was observed to have a greater effect on the ζ potentials of colemanite in water but caused only slight changes in the presence of cationic (NaCl, BaCl, AlCl) and anionic (NaCl, NaSO) electrolytes. Increased pH values shifted the ζ potentials of PIn/colemanite composite dispersions to more negative values. The most effective surfactant acting on the ζ potentials of colemanite and PIn/colemanite composite dispersions was cetyltrimethylammonium bromide (CTAB), which shifted the z potentials to more positive regions. Elevated temperatures caused almost no change to the ζ potentials of either the colemanite or the PIn/colemanite composite dispersions

Protective effects of olive oil phenolics and gallic acid on hydrogen peroxide-induced apoptosis

Olive oil contains several phenolic compounds possessing antioxidant activity. The aim of this study was to investigate the protective effects of olive oil phenolic extract (OOPE) and one of its constituents, gallic acid (GA) against H2O2-induced oxidative stress and apoptotic cell death in HeLa cells, a model for human epithelial cells

Wernicke Encephalopathy after Gastrointestinal Surgery

We herein describe a child operated for acute abdomen who developed Wernicke's encephalopathy (WE) secondary to prolonged total parenteral nutrition (TPN) that lacked vitamin B1 supplementation. The author concluded that surgeons, child neurologists, pediatricians and radiologists need to be aware of the predisposing factors and symptoms of WE. Clinicians need to keep in mind that ophthalmoplegia, ataxia or altered mental status could be findings of WE

A systematic literature review of physiotherapy and rehabilitation approaches to lower-limb amputation

WOS: 000445710200001PubMed: 29351504Background: Successful use of prostheses after lower-limb amputation (LLA) depends on undergoing physiotherapy and rehabilitation both physically and psychologically. The aim of this systematic literature review is to systematically review the scientific evidence regarding prosthetic rehabilitation and physiotherapy after LLA. Methods: A systematic literature search was conducted using PubMed, Web of Science, Cochrane, CINAHL, EMBASE, SCOPUS, and EMB Reviews databases on December 31, 2015. Studies with the search keywords were identified and independently assessed by reviewers. The search yielded 403 potentially relevant articles after the removal of duplicates. Of these, only nine articles met the inclusion criteria. All studies were original articles, one of which was a randomized controlled study. Different measurement methods were used and positive results in terms of functional status, weight-lifting capacity with prosthesis, walking and balance ability, and acute care process were gained with a physiotherapy program. Conventional methods still possess high importance; however, it is safe to say that virtual reality and software-based programs for rehabilitation are increasingly being developed and getting more and more support. Discussion: LLA rehabilitation is a topic that requires the focus of current and future studies; evidence-based studies are required on the approaches to rehabilitation for specific LLA groups

The comparison of pandemic H1N1 IgG levels between H1N1 influenza-vaccinated healthcare workers and unvaccinated healthcare workers

KISA, Ucler/0000-0002-8131-6810WOS: 000344155900020PubMed: 25552159Background/aim: To compare pandemic H1N1 (pH1N1) IgG antibody levels between healthcare workers who were vaccinated with the pH1N1 influenza vaccine and the unvaccinated healthcare workers who were selected as the control group. Materials and methods: A total of 68 healthcare workers were included in this study. Of those, 53 were adults vaccinated with the H1N1 influenza vaccine and 15 were unvaccinated. Serum samples were parsed and stored at -40 degrees C until they were examined. Results: Of the total 53 vaccinated healthcare workers, 16 (30.1%) were positive for IgG antibodies (titer > 11), 17 (32.0%) were negative for IgG antibodies (titer < 9), and 20 (37.7%) were borderline (titer: 9-11). Of the 15 unvaccinated healthcare workers, 1 (6.6%) was positive for IgG antibodies, 11 (73.3%) were negative for IgG antibodies, and the remaining 3 (20.0%) had borderline values (P = 0.014, P < 0.05). In both groups, there was no statistically significant difference between IgG-negative, IgG-positive, and borderline subjects in terms of age or sex. Conclusion: The IgG antibody level was higher in the vaccinated healthcare workers than among the unvaccinated healthcare workers

Respiratory Distress in Infants and Congenital Lobar Emphysema

Congenital lobar emphysema (CLE) is a rare congenital lung abnormality. Intrinsic or extrinsic obstruction of the lobar bronchus causes air trapping and hyperinflation Clinical presentation may vary from asymptomatic to acute neonatal respiratory failure, recurrent infectious episodes and tachypnea episodes. Lobectomy has been recognized as the most effective method of treatment in patients with severe symptoms. With the widespread use of antenatal ultrasound and radiological imaging in recent years, now it is possible to diagnose CLE in asymptomatic infants or infants with mild symptoms. In this paper, we present the case of a early diagnosed CLE in an infant who was followed up conservatively