Solitary cecal diverticulitis, a rare cause of right lower quadrant pain: Four cases

Solitary cecal diverticulitis is a rare clinical condition. Like diverticulitis in other segments of the colon, it requires immediate surgical intervention if it is causing complications. Solitary cecal diverticulitis may be misdiagnosed as acute appendicitis, since it causes right lower quadrant pain, or as a cecal tumor or inflammatory bowel disease, due to an intraoperative appearance resembling an inflammatory mass. Four patients with solitary cecum diverticulitis presenting with acute right lower quadrant pain are discussed in this report. Three patients underwent surgery with a preliminary diagnosis of acute appendicitis or cecal tumor, and 1 patient was diagnosed with cecal diverticulitis and treated medically. The treatment approach may change depending on a preoperative or intraoperative diagnosis of cecal diverticulitis. Therefore, in areas where this disease is uncommon, cecum diverticulitis should not be forgotten in the differential diagnosis of acute right lower quadrant pain or inflammatory bowel mass

Serum macrophage migration inhibitory factor levels in Hashimoto's thyroiditis; a case control study

Objective: The cell-mediated immune process by CD4+ and CD8+ lymphocyte subsets of T-cells has a major role in the pathogenesis of Hashimoto's thyroiditis (HT). However, the exact mechanisms of initiation and progression of thyroid autoimmunity have not been completely clarified yet. Macrophage migration inhibitory factor (MIF) is commonly recognized as playing vital roles in various autoimmune diseases. Ee aimed to investigate serum MIF levels in subjects with HT and correlate them with the level of thyroid hormones and autoantibodies. Materials and methods: This study included 93 patients with untreated Hashimoto's thyroiditis and 53 healthy controls. We measured serum levels of TSH, free T4 (FT4), free T3 (FT3), anti-Thyroglobulin autoantibody (TGAb) and anti-Thyroid peroxidase autoantibody (TPOAb) in all patients and thyroid ultrasonography was performed. The concentration of MIF was measured using enzyme-linked immunosorbent assay (ELISA) method. Results: We enrolled 93 patients with HT (mean age; 31.3 ± 11.1 years), and 53 healthy control group (mean age; 29.3 ± 8.5 years) in the current study. The patient group consisted of 52 with euthyroid autoimmune thyroiditis, 31 with subclinical hypothyroidism and 10 with overt hypothyroidism. Serum levels of MIF were higher in patients with overt hypothyroidism (6300.9 ± 2504.3 pg/ml) than the euthyroid patients (3955.2 ± 3013.6 pg/ml) (p = 0.036). Conclusion: MIF increases in overt hypothyroidism due to the Hashimoto's thyroiditis. Further investigations are needed to explore the role of MIF in pathogenesis of Hashimoto's thyroiditis. © 2014 Ayaz et al

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Age- and region-specific hepatitis B prevalence in Turkey estimated using generalized linear mixed models: a systematic review

Toy M, Önder FO, Wörmann T, et al. Age- and region-specific hepatitis B prevalence in Turkey estimated using generalized linear mixed models: a systematic review. BMC infectious diseases. 2011;11(1): 337.BACKGROUND: To provide a clear picture of the current hepatitis B situation, the authors performed a systematic review to estimate the age- and region-specific prevalence of chronic hepatitis B (CHB) in Turkey. METHODS: A total of 339 studies with original data on the prevalence of hepatitis B surface antigen (HBsAg) in Turkey and published between 1999 and 2009 were identified through a search of electronic databases, by reviewing citations, and by writing to authors. After a critical assessment, the authors included 129 studies, divided into categories: 'age-specific'; 'region-specific'; and 'specific population group'. To account for the differences among the studies, a generalized linear mixed model was used to estimate the overall prevalence across all age groups and regions. For specific population groups, the authors calculated the weighted mean prevalence. RESULTS: The estimated overall population prevalence was 4.57, 95% confidence interval (CI): 3.58, 5.76, and the estimated total number of CHB cases was about 3.3 million. The outcomes of the age-specific groups varied from 2.84, (95% CI: 2.60, 3.10) for the 0-14-year olds to 6.36 (95% CI: 5.83, 6.90) in the 25-34-year-old group. CONCLUSION: There are large age-group and regional differences in CHB prevalence in Turkey, where CHB remains a serious health problem

Yatak istirahatı ve yarı oturur pozisyon hakkında doktor ve hemşirelerin görüşlerinin değerlendirilmesi

Objectives: We investigated healthcare personnel knowledge of commonly illnesses in which bed rest is often preferred, and their opinion about early mobilization, bed-rest duration and putting patients in the semi- recumbent position. Material and Method: 556 persons who agreed to participate were included in the questionnaire. They were 55 family physicians, 62 nonsurgical and 47 surgical specialists, 75 family practice nurses, 159 nonsurgical and 158 surgical clinic nurses. The questions were asked about the bed-rest duration of uncomplicated acute myocardial infarction, acute lower back pain, and cardiac catheterization and after liver biopsy, start mobilization after a total knee replacement and stroke. In the second group questions were asked about their acknowledge- ment of semi-recumbent positioning. Results: The majority of healthcare personnel suggested the short-term bed rest in acute low back pain and after a total knee replacement, whereas the approximately more than 50% of healthcare personnel supported the long-term bed-rest in myocard infarction, after cardiac catheterization and liver biopsy. Although specialists encouraged early mobilization in stroke, the most of the other healthcare staff proposed long period bed rest in this event. Conclusion: Healthcare providers did not agree with early mobilization, and tended to lean towards the practice of a long period of bed rest

Bone mineral density in geriatric patients with toxic nodular goiter

WOS: 000351531100014PubMed: 25161096Background We aimed to assess bone mineral density (BMD) in geriatric patients with hyperthyroidism caused by TNG. Materials and Methods Bone mineral density was measured at the lumbar spine and proximal femur, using dual-X-ray absorptiometry (DXA) in 90 patients with TNG (mean age; 69.2 +/- 4.4 years) and compared with those in 42 age-matched healthy subjects (mean age; 68.40 +/- 4.3 years). Serum levels of TSH, fT3, fT4, 25-OH vitamin D and PTH were measured. Results BMD was significantly lower at total spine (0.904 +/- A 0.1 vs. 1.114 +/- A 0.1 g/cm(2)) and total hip (0.850 +/- A 0.1 vs. 1.079 +/- A 0.1 g/cm(2)) in male patients with TNG in comparison to the healthy men (p = 0.001, p 0.005). Conclusion Geriatric patients with hyperthyroidism secondary to TNG had reduced BMD at the total spine and hip. Thus, we suggest to investigate bone mineral density in geriatric patients with TNG

Cumhuriyetin 10. yılında Türkiye

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2016.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by Demirakın, Nahide Işık

Two cases of primary intramuscular hydatid cyst in the same family

A 39 years old woman was admitted to the hospital due to swelling and pain on her left lumbar region. In family history we learned that; her 19 years old daughter was operated due to primary muscular hydatid cyst located on gastrocnemius muscle one year ago. A painful painful mass with a size of 6x5 cm was palpated on patients’ left lumbar region during physical examination. Her indirect hemaglutination (IHA) for Echinococcus granulosus was positive. The lesion was reported as muscular hydatid cyst during ultrasound and computed tomography examinations. Hydatid disease was not in the previous history of the patient. Partial cystectomy and drainage was performed under spinal anesthesia on prone position. Excised material was confirmed as a hydatid cyst in histopathological examination. Albendazol (15 mg/kg/day) was given to patient for three months following the operation. There were no postoperative complications. After 6 month follow up, the patient showed no evidence of recurrent hydatid disease. A hydatid cyst should be considered in the differential diagnosis of muscular cystic lesions in regions where hydatid cysts are endemic. Positive family history may help us in suspicion to this disease. If total excision is impossible, partial cystectomy and drainage can be the choice as surgical treatment for a muscular hydatid cys

Question LXXXVIII, Pharmacie et littérature

Rocchietta Sergio. Question LXXXVIII, Pharmacie et littérature. In: Revue d'histoire de la pharmacie, 67ᵉ année, n°242, 1979. p. 232