Contact dermatitis due to ecg electrodes in critical care unit (a case report)

Elektrokardiyografi (EKG) monitörizasyonu sırasında kullanılan elektrotlara ait alerjik kontakt dermatit görülebilir. Bu olgu sunumunda EKG elektroduna baglı kontakt dermatit gelişen, atopik olmayan iki hasta bildirilmektedir.ECGelectrodes can cause allergic contact dermatitis.We report two unusual cases of allergic contact dermatitis to ECGelectrodes

Clinical outcomes and treatment patterns of primary central nervous system lymphoma: Multicenter retrospective analysis

Objectives: Primary central nervous system lymphoma (PCNSL) is a rare malignant disease with poor prognosis. Its low incidence leads to challenges in decision-making for treatment. As a matter of fact, there is still no consensus on the appropriate treatment modalities. In this context, the objective of this study is to investigate and comparatively assess the efficacies of several treatment modalities in the treatment of PCNSL. Methods: Thirty-four patients diagnosed with PCNSL at 5 different hematology centers between 2007 and 2021 were included in the study. Patients’ data from all five centers were collected retrospectively. Since ibrutinib is not approved for this indication in Turkey, consent for off-label use of ibrutinib is obtained from each patient. Ethics committee ap-proval was obtained on June 9, 2021 with decision number 2021/18-05. Results: The median age of the patients was 59 (min.: 22, max.: 78) years. The male-to-female ratio was 1.26/1. Nineteen (55.9%) patients had Eastern Cooperative Oncology Group (ECOG) performance score of ≥2. Fifteen (44.1%) patients had normal lactate dehydrogenase (LDH) levels and only 14.7% of the patients had B symptoms at the time of diagnosis. Magnetic resonance imaging (MRI) revealed a single mass lesion in 14 (41.2%) patients. As an induction therapy, meth-otrexate-based regimen was administered in 29 (85.3%) patients. Only 14 of the 34 patients received 4 or more cycles of high-dose methotrexate (MTX). About 32.4% of the patients received radiation therapy (RT) during follow-up as a part of induction therapy. Five patients received only RT due to poor performance status. Ibrutinib was administered in 5 patients for refractory disease. It was determined that four or more cycles of MTX treatment increased progression-free survival (PFS) (p=0.031) and overall survival (OS) (p=0.012). Moreover, RT improved PFS (p=0.023). Considering that the complete response achieved by induction therapy influences long-term survival, achievement of the best response to the treatment regimens administered in combination with new agents may prolong survival (PFS: p=0.01, OS: p=0.023). Conclusion: The findings of this study indicate that the initial response to treatment is crucial. Additionally, it was found that high-dose MTX treatment should be administered for 4 cycles or more in order to achieve the best results. Furthermore, it was determined that ibrutinib monotherapy was well-tolerated in our patients with relapsed/refractory disease, with excellent clinical benefits. In conclusion, a combination therapy consisting of high-dose MTX, ibrutinib, and rituximab appears to be a promising initial treatment approach in appropriate patients

Clinical Characteristics and Visual Outcomes of Pediatric Optic Neuritis: A Single Center Experience

INTRODUCTION: The aim of this study was to describe the clinical characteristics, visual outcomes of pediatric patients presenting with first-episode of optic neuritis. METHODS: We reviewed medical records of the patients newly diagnosed with optic neuritis younger than 18 years between January 2014 and December 2018 retrospectively. RESULTS: Twenty-eight patients were included to this study. The mean age at first onset of optic neuritis was 13.2+-3.1 years (range 6.2-17.3 years). The mean follow-up period was 4.2+-3.2 (range 0.6-13.08) years. 7 of 28 (25%) patients had recurrent optic neuritis. Optic neuritis involvement was unilateral in 17 of 28 (60%) patients. Forty percent of the patients had idiopathic optic neuritis. Of the six patients with demyelinating lesions in cranial magnetic resonance imaging (MRI) at the first admission, three were diagnosed with multiple sclerosis (MS) at the time of first optic neuritis attack, and three were diagnosed within 13.4+-4.8 months after the first episode. Eight of 21 optic neuritis patients (38%) had oligoclonal band positivity and the incidence of MS was significantly higher in these patients (p=0.014). The mean visual acuity at nadir was 0.48+-0.27 at admission. Whereas it was 0.74+-0.31 and 0.76+-0.33 at 1 and 6 months respectively. There was a strong correlation between first and sixth-month visual acuity (r=0.98, p=0.00). DISCUSSION AND CONCLUSION: Our study demonstrated that poor visual acuity (worse than 0.5) at 1 month can predict poor vision at 6 months. The patients with demyelinating lesions in cranial MRI at their first optic neuritis episode, are more likely to develop MS during the follow-up

Pulmonary embolism versus pulmonary vasculitis in Hughes-Stovin syndrome: Characteristic computed tomography pulmonary angiographic findings and diagnostic and therapeutic implications. HSS International Study Group

Background and aim: Hughes-Stovin syndrome (HSS) is a rare systemic vasculitis with widespread venous/arterial thrombosis and pulmonary vasculitis. Distinguishing between pulmonary embolism (PE) and in-situ thrombosis in the early stages of HSS is challenging. The aim of the study is to compare clinical, laboratory, and computed tomography pulmonary angiography (CTPA) characteristics in patients diagnosed with PE versus those with HSS. Methods: This retrospective study included 40 HSS patients with complete CTPA studies available, previously published by the HSS study group, and 50 patients diagnosed with PE from a single center. Demographics, clinical and laboratory findings, vascular thrombotic events, were compared between both groups. The CTPA findings were reviewed, with emphasis on the distribution, adherence to the mural wall, pulmonary infarction, ground glass opacification, and intra-alveolar hemorrhage. Pulmonary artery aneurysms (PAAs) in HSS were assessed and classified. Results: The mean age of HSS patients was 35 ± 12.3 years, in PE 58.4 ± 17 (p &lt; 0.0001). Among PE 39(78 %) had co-morbidities, among HSS none. In contrast to PE, in HSS both major venous and arterial thrombotic events are seen. Various patterns of PAAs were observed in the HSS group, which were entirely absent in PE. Parenchymal hemorrhage was also more frequent in HSS compared to PE (P &lt; 0.001). Conclusion: Major vascular thrombosis with arterial aneurysms formation are characteristic of HSS. PE typically appear loosely-adherent and mobile whereas “in-situ thrombosis” seen in HSS is tightly-adherent to the mural wall. Mural wall enhancement and PAAs are distinctive pulmonary findings in HSS. The latter findings have significant therapeutic ramifications.</p

Treatment of multiple eccrine hidrocystoma with oral isotretinoin following erbium-yttrium aluminum garnet laser

WOS: 000457033100003PubMed: 29469597Eccrine hidrocystomes (EH) are benign cystic tumors of dermal eccrine ducts. There is still no gold standard treatment option for EH because of the large number of lesions, the risk of cicatrization and the different treatment options offered. We offer combined oral isotretinoin and following erbium-yttrium aluminum garnet laser treatment as an alternative treatment option in difficult patients with EH

Case study analysis with municipal enterprises

Belediyeler, hızlı şehirleşme nedeniyle artan görev ve sorumluluklarını yerine getirebilmesi için yeni organizasyonlara ihtiyaç duymuşlardır. Belediyeler, sağladıkları sermaye ile genellikle Anonim Şirket şeklinde belediye iktisadi teşebbüsleri (BİT) kurarak yeni organizasyonlarını oluşturdular. BİT'ler belediyelere kaynak tahsis etmek, kamu bürokrasisinden, idari vesayetten kurtulmak, yörenin sosyal ve ekonomik gelişmesine katkıda bulunmak ve bütçe prensiplerinden kaçınmak gibi amaçlarla kurulmuştur. Bu tez yerel hizmet üretmek amacıyla kurulan belediye iktisadi teşebbüslerini inceleme amacını taşımaktadır. Bu amaçla yapılan çalışma da Samsun Büyükşehir Belediyesi iktisadi teşebbüsleri incelenmiştir. Yöntem olarak konuyla ilgili kitaplar makaleler, internet ortamından elde edilen kaynaklar kullanılmış şirketlerin edinilen tablolar ve faaliyet raporlarından faydalanılmıştır. Şirketlerle beraber belediyelerin faaliyetlerinde bir artış olmuş ve belediyeler kendi görev alanlarıyla ilgili, ilgisiz birçok alanda faaliyet göstermeye başlamışlardır. Hizmet üretmek amacıyla kurulmuş olup sunumunu sadece belediyenin yaptığı hizmetlerde nispeten daha iyi olmakla beraber genelde verimli, etkin ve karlı olmadıkları görülmektedir.The municipalities have been in need of new organizations necessary to perform their increased responsibilities and duties due to rapid urbanization. They have established the Municipal Economic Enterprises (BIT), formed as corporation , using the capital they raised. The Municipal Economic Enterprises have been formed for the purposes of providing resources to the municipalities, slipping out bureaucracy and administrative guardianship contributing to the social and economic development of the related regions, and avoiding the principles of budget. The following thesis entitled aims to research the municipal economic enterprises established upon producing local services. In this paper written for this purpose, in the example of Samsun Metropolitan Municipality have been addressed. As method, books written in this area and especially articles and sources obtained from the internet have been used, while data obtained from company officials through the municipality and prepared as tables, activity reports and announcements of the results of tenders belonging to the Public Procurement Agency have been utilized. There has been observed an increase in the activities of the municipalities together with those of the companies and municipalities have started to display activity in many fields in and out of relation of their own field of business. It is evident that the tendency of incorporation, which seems to be relatively in a better condition within some services established to produce local services and whose host is only the municipality, is in general not productive, effective and economic except for this implementation

Hughes-Stovin Syndrome as an Outcome of Behçet Disease or as a Different Entity

Hughes-Stovin syndrome is a rare disorder of unknown etiology. Although the association between multiple pulmonary artery aneurysms and venous thrombosis of the lower limbs was reported by Beattie and Hall in 1911, it was not until 1962 that the eponym “Hughes-Stovin syndrome” was formally introduced in the medical literature. We describe 2 patients with Hughes-Stovin syndrome who presented with pulmonary artery aneurysm, thrombophlebitis, hemoptysis, and oral ulcers, review the manifestations of the disease, and compare its similarities with and differences from Behçet disease

Varfarin tedavisinde nadiren gözlenen yan etki: Deri nekrozu

Warfarin is commonly used in the treatment and prevention of thromboembolic events. However, it is known to undesirably cause hypercoagulable conditions, including warfarin-induced skin necrosis (WISN). This report describes a 70-year-old man presented with an extensive WISN while an inpatient for treatment of a left deep femoral vein thrombosis. He had a background of colon adenocarcinoma and multiple metastatic foci in the liver.Varfarin yaygın olarak tromboembolik hastalıkların önlenmesinde ve tedavisinde kullanılmaktadır. Bununla birlikte varfarin kullanımının, istenmeyen şekilde, varfarin kaynaklı cilt nekrozunun (WISN) da dahil olduğu aşırı-pıhtılaşma koşullarına neden olduğu bilinmektedir. Bu olgu sunumunda, sol kalp yetmezliği sonucu gelişen femoral ven trombozunun tedavisi sebebiyle hastanede yatan ve WISN gözlenen 70 yaşındaki bir erkek hasta tanımlamaktadır. Hastanın öyküsünde ayrıca kolon adenokarsinomu ve karaciğerde çoklu metastatik odaklar bildirilmiştir

Rationale for the autologous serum skin test in acute versus chronic urticaria

WOS: 000506827300010PubMed: 31997998Introduction: Autologous serum skin test (ASST) is a rapid, in-vivo clinical test to detect functional autoantibodies in patients with chronic spontaneous urticaria (CSU), but the rationale for its use in acute urticaria (AU) is unknown. Aim: To evaluate the efficacy of ASST among patients with AU or CSU. Material and methods: Treatment-naIve adult (age >= 18 years) patients with a diagnosis of AU ( 100 IU/ml) in AU (85.2%) and CSU (65.2%) groups was similar (p = 0.06), but significantly higher than in the control group (10.7%) (p < 0.001 and p < 0.001). The CSU group had significantly higher abnormal thyroid test results (45.7%) than AU (14.8%) and control groups (3.6%) (p = 0.01 and p < 0.001), whereas patients with clinically diagnosed thyroiditis were only in the CSU group (6.5%). In logistic regression analysis, there was no relation found among the possible risk factors for ASST, even if analysed separately as AU, CSU and control groups. Conclusions: Even though thyroid function test levels were found to be related with CSU, and total IgE was associated with urticaria, ASST was found to be of importance. This study confirms that ASST was insufficient to demonstrate autoimmunity and acute-chronic urticaria nature. Further tests indicating auto-antibodies in AU and CSU are needed