Autoimmune thyroiditis CRP association

Background: C-reactive protein (CRP) is an acute phase reactant and its serum levels may be risen during many diseases. Hypothyroidism is a clinical disease state accompanied by mild inflammation that is known to be significantly associated with atherosclerosis. In this study, we aim to determine and compare serum CRP levels in overt and subclinical hypothyroidism subgroups and research their association with autoimmune markers.Methods: Around 79 patients who are diagnosed with overt and subclinical hypothyroidism in our polyclinic were included in this study. Patients’ morning blood samples were collected after 8hours of fast and thyroid functions, CRP, sedimentation rate, anti TG and anti TPO antibody levels were studied. Thyroid ultrasonography was planned for each patient.Results: We found significant differences regarding age, sT3, sT4, TSH, anti-TPO, anti-TG and CRP levels between overt and subclinical groups. There was no significant difference between the groups in thyroxin use, nodularity and sedimentation rate. No significant difference was found between CRP levels and autoimmunity markers anti-TPO and anti-TG among the groups as well. A significant cut-off value was determined for CRP in overt hypothyroidism by using Roc analysis and this value was also considered for being a possible cardiovascular risk marker.Conclusions: In this study, we found out that CRP levels were high in both overt and subclinical subgroups, CRP levels were increased during progression of the disease from subclinical to overt and this increase may be related with higher inflammation and tendency to cardiovascular diseases.

The Effect of Hypermobility on Pain and Quality of Life in Young Adults

Objective:Hypermobility is the excessive range of motion of joints, and related to various musculoskeletal and extra-articular problems that may significantly impair quality of life (QoL) by causing pain. The aim of the study is to examine the prevalence of hypermobility in young adults, and its relationship with pain in various regions of body and QoL.Methods:Two hundred and twenty five volunteers, aged between 17 and 23, were classified as subjects-with-hypermobility or subjects-without-hypermobility according to the Beighton Criteria. Chronic pain was identified by using Nordic Pain Questionnaire, QoL was identified by Short Form-36 (SF-36) Questionnaire. Pain presence in 9 body regions and SF-36 scores were compared between groups using chi-square test and Independent Samples T-test, respectively.Results:Of the participants, 164 (64%) were female, 91 (36%) were male, 119 (46.7%) had hypermobility. Upper back was the body region with the highest pain prevalence where 79% of hypermobile and 74% of non-hypermobile subjects reported pain at least once in past 12 months. Pain prevalence in body regions did not differ between groups (p>0.05). In terms of QoL, physical and mental component scores of SF-36, as well as all subgroup scores except social function were significantly lower in hypermobile subjects (p<0.05).Conclusion:Pain prevalence in different body regions did not differ between subjects with and without hypermobility whereas the QoL was significantly impaired in hypermobile subjects. Hypermobility is a substantial anatomical finding in young adults that should not be disregarded. Education, emotional support and encouraging about strengthening and proprioception exercises may contribute to their quality of life

Treatment of nasolacrimal duct obstruction in adults with polyurethane stent

PURPOSE: To evaluate the efficacy of polyurethane nasolacrimal duct stents in the treatment of epiphora resulting from primary acquired nasolacrimal duct obstruction in adults. MATERIALS AND METHODS: In 25 patients (21 women and four men with mean age of 44 years, range 20 to 74 years) with nasolacrimal duct obstruction, 28 hollow polyurethane stents designed by Song and associates were placed under fluoroscopic guidance. The obstruction was complete in 20 lacrimal drainage systems and partial in eight. The lacrimal sac size was normal or large on dacryocystogram in all lacrimal drainage systems. A Ritleng probe was introduced through the upper punctum and advanced past the obstruction. A guide wire with a flexible tip was then introduced through the probe, over which the stent was advanced in retrograde fashion and placed into the lacrimal sac and nasolacrimal duct. Clinical success was defined by the demonstration of a completely patent lacrimal drainage pathway through saline irrigation and no or minimal complaint of epiphora. RESULTS: Stent placement was technically successful in 26 of 28 lacrimal drainage systems (93%). The mean time of fluoroscopy screening was 3.2 minutes (range, 1.4 to 5.8 minutes). The overall success rate was 82% (23 of 28 lacrimal drainage systems). Two stents were completely occluded. In one lacrimal drainage system with minimal epiphora, the stented drainage pathway was partially occluded. The patients were followed up from 4 to 22 months (mean, 7.2 months). CONCLUSIONS: Retrograde placement of a hollow polyurethane nasolacrimal duct stent is a technique that is simple and well tolerated by patients. This method achieves a high success rate and may be suggested as a nonsurgical procedure for adults with primary nasolacrimal duct obstruction and proper lacrimal sac size. The Ritleng probe facilitates the procedure

A neurobrucellosis case associated with bilateral optic neuritis, vitritis and chorioretinal involvement Nörobruselloz Olgusuna Eşlik eden bilateral optik nörit, vitritis ve koryoretinal tutulum

Brucellosis is an endemic zoonosis seen in some regions of Turkey. A wide spectrum of clinical findings can be seen in brucellosis while ocular involvement may also be present. All ocular structures may be affected in ocular brucellosis but the most common clinical presentation is uveitis. Therefore, the diagnosis and treatment of ocular and systemic brucellosis may be very difficult. In this case study, we report a neurobrucellosis case associated with bilateral optic neuritis, vitritis, and chorioretinitis. In addition, the management of ocular brucellosis and its treatment options are discussed

Long-Term Follow-Up of the Postoperative Macular Fold following the Vitreoretinal Surgery with Air Tamponade

A 64-year-old male who had a macula-on superior bullous retinal detachment in OD underwent scleral buckling, 20-gauge-pars plana vitrectomy, internal drainage of subretinal fluid with perfluorocarbon fluid, 360° endolaser and perflourocarbon-fluid-air exchange surgery. Patient sat upright immediately after the surgery for the night. At the first postoperative morning although the retina was attached, there was a macular fold extending toward the temporal retinal periphery. Patient denied further surgery. During the follow-up, retinal fold gradually became less visible and it could be noticeable only by fundus autoflorescence imaging at the sixth postoperative year with a subtle epiretinal membrane formation on the optical coherence tomographic section

The long-term effect of intravitreal ranibizumab on retinal nerve fiber layer thickness in exudative age-related macular degeneration

The aim of this study was to evaluate the long-term effect of intravitreal ranibizumab on the retinal nerve fiber layer (RNFL) in exudative age-related macular degeneration (AMD). Patients with treatment naive neovascular AMD in one eye were enrolled into the study. Following 3 monthly intravitreal ranibizumab injections, the patients were evaluated according to disease activity and re-injections were performed according to "treat and extend" protocol. During the follow-up, peripapillary nerve fiber layer thickness measurements were compared with normal fellow eyes. Forty-four eyes of 11 women and 11 men with the mean age of 66.3 +/- A 8.8 years (50-80) were enrolled into the study. All patients had completed at least 12 months of follow-up time. Patients received an average of 4.7 (3-11 injections) intravitreal injections. At baseline, no significant difference was observed between two groups for RNFL thickness, which was assessed as quadrants (p = 0.250-0.944) and globally (p = 0.814). In each group, there was a significant RNFL thinning (p = 0.009 and 0.022) after the third month, whereas no significant difference was observed between treated and untreated eyes. Patients were also classified according to the number of injections, and RNFL thickness showed no difference between eyes treated with less or more than five intravitreal injections (p = 0.757-0.973). Although there was no statistically significant difference in RNFL thickness between study and control eyes during 12 months of follow-up, a significant thinning was recorded in both groups compared with baseline values. Cross-sectional images with higher resolutions and precise segmentation opportunities are needed to investigate the hypothesis "VEGF neutralization and inhibition of cell maintenance" in detail

Peripapillary whitening in high myopia: only a staphyloma posticum?

This article reports the case of a 55-year-old female patient who presented with visual deterioration and previously known myopia. Funduscopy revealed a tilted optic disc along with a peripapillary staphyloma and a yellowish lesion on the inferior border of the optic disc. Optical coherence tomography showed an intrachoroidal cavitation. Multimodal imaging characteristics of this clinical entity are provided in this case report

Spontaneous closure of the retinal pigment epithelial microrupture caused by a retained retrobulbar pellet

We describe a 48-year-old woman with a retained retrobulbar pellet and associated retinal pigment epithelial detachment. Spectral optical coherence tomography disclosed a focal microrupture of the retinal pigment epithelium. After two weeks of oral prednisolone treatment, the retinal pigment epithelial detachment was flattened and the microrupture was sealed. Optical coherence tomography is an important tool to elucidate the pathogenesis of blunt trauma-related posterior pole changes

Bilateral cytomegalovirus retinitis in a HIV positive patient HIV pozitif bir olguda bilateral sitomegalovirus retiniti

AIDS (Acquired Immune Deficiency Syndrome) is a worldwide disease affecting more than 40 million people. Despite the common use of HAART (Highly Active Antiretroviral Treatment), ocular involvement still occurs in %50-75 of AIDS patients. CMV retinitis is the most common opportunistic ocular infection in patients with AIDS. Since 15% of CMV retinitis patients may be asymptomatic, fundoscopic examination is recommended in patients with less than 50 cells/μl CD4+ lymphocytes for routine screening every 3 months. The aim of this study is to present a HIV positive patient complicated with CMV retinitis and discuss the clinical approach