Hashimoto tiroiditi ve polimiyozitle birlikte olan bir skleroderma olgusu

Sistemik skleroz etkilenen organlarda fibrozis ve mikrovasküler hasarla karakterize bir hastalıktır. Herne kadar SSc tek başına görülebilse de SLE, RA, inflamataur kas ' hastalığı, kronik tiroidit ve Sjögren sendromu ile birlikte over-lap yapabilmektedir. Bu makalede Hashimoto tiroiditi ve polimiyozitle birlite olan bir skleroderma vakası literatür ışığında gözden geçirildi.Systemic sclerosis (SSc) is a generalized disorder that is characterized by fibrosis and microvascular injury in affected organs. Although SSc may show a single presentation without any other disease, one may see any of the aforementioned man-ifestations of SSc with features ofSLE, RA, inflammatory mus-cle disease , chronic thyroiditis or Sjögren 's syndrome.In this article a case -with scleroderma with coexisting Hashimoto's thyroiditis, polymyositis is presented and literature is reviewed

Esansiyel hipertansiyon ve insülin direnci

Esansiyel hipertansiyonlu olgularda insülin rezistansı sıklığını ve sonuçta insülin rezistansının esansiyel hipertansiyonun oluşumunda rol oynayıp oynamadığını araştırmak istediğimiz çalışmamıza, yaş ortalaması 46.73^6.11 yıl olan 7'si erkek (E), 23'ü kadın (K) 30 hipertansif olgudan oluşan hasta grubu ve yaş ortalaması 44.8±7.06yıl olan 12'si E, 181K, 30 olgudan oluşan kontrol grubu alındı.. Hasatalık ve kontrol gruplarında her olguya Oral Glukoz Tolerans Testi (OGTT) uygulandı. Hipertansif olgularımızın 12 'sinde (%40) OGTT bozuktu. 18'inde (%60) OGTT bozukluğu saptanmadı. Kontrol grubunda 24 (%80) olguda OGTT bozukluğu yoktu. Hastalık ve kontrol grubları arasında OGTT bozukluğu sıklığı istatistiksel olarak anlamlı fark göstermedi (p>0.05). Hipertansif olgularda 1 saatlik plazma insülin düzeyi kontrol grubuna göre anlamlı olarak yüksekti (p<0.001). Bu sonuç hipertansif olgularda insülin rezistansının varlığını ve esansiyel hipertansiyon etyolojisinde insülin rezistansının rol oynayabileceğini göstermektedir.In this study, we aimed to search the frequency rate of insulin resistance in the patients with essential hypertension and to reveal either insulin resistance was important or not in the development of hypertension. The enrolled patients were classified into two groups. Group 1, consisted of 30patients with hypertension, mean age 46.73&plusmn;6.11 years (7 male, 23 female). Group 2, consisted of 30 subjects without hypertension, as a control group, mean age 44.00&plusmn;7.06 years (12 male, 18 female). After preparation period, in both groups, standard oral glucose tolerance test (OGTT) was performed by each subject and plasma insulin levels were measured at the beginning (fasting) and at the first hour of the test. 12 of hypertensive patients (40%) had impaired OGTT and 18 of hypertensive patients (60%) gave normal responses to OGTT. On the other hand, in the control group, normal OGTT values were found in the 24 subjects (80%). Impaired OGTT rates did not reveal statistical significance between the patient group and the control group.(p&gt;0.05) In the studies, it is found that groups revealed significant statistical difference.(p&lt;0.001) Between the hypertensive patients with and without impaired OGTT, there were no statistical significance according to the fasting and the first hour plasma insulin levels.(p&gt;0.05).In the hypertensive patients, the first hour plasma insulin levels were significantly higher than those of control group, as these results reveal; hypertensive patients have insulin resistance and insulin resistance may be important in the etiology of hypertension

Treatment Results of Patients With Lupus Nephritis: A Single Center’s Experience

Objective: Lupus nephritis (LN) is a type of organ involvement of systemic lupus erythematosus (SLE) that leads to disease-related morbidity and mortality. Lack of good treatments for LN continues to be problematic. Many different treatment protocols are applied in treatment centers. Not every treatment protocol is successful. Moreover, patients who reached remission may present with exacerbations. In this study, we aimed to evaluate the treatment results of our patients and investigate their remission rates as well as factors that affect remissions.Materials and Methods: We retrospectively investigated the results of 41 patients who were diagnosed with lupus nephritis after kidney biopsy in the Nephrology and Immunology-Rheumatology departments of Atatürk University Medical Faculty Training Hospital between January 2000 and December 2008. Demographic information, clinical history and laboratory results were collected from each patient’s records. The relationships among clinical, laboratory, demographic parameters and remissions were investigated. The patients were grouped in terms of urine protein levels; patients with urine protein 0.05). We compared class 3 LN patients at the 6th and 12th months according to treatment protocols. Azathioprin or mycophenolate mophetil were significantly better at placing urine protein levels in remission as compared to cyclophosphamide (p<0.05).Conclusion: According to our study, no relationship was found between basal clinical and laboratory parameters and patient remission. Response rates of our LN patients were similar to those in the literature. However, complete remission is still a problem in LN. The results of the protocols used in the treatment of LN show similarities. Although there are some data suggesting that MMF used in recent years is effective, it should be supported by prospective multicenter studies. It is important to note that it is difficult to achieve complete remission in LN patients