Delay in the diagnosis of SLE: the importance of arthritis/arthralgia as the initial symptom.

Despite the current diagnostic and serologic testing for SLE, the interval between the onset of symptoms and the diagnosis is still long. In this study, we aimed to show the interval between the initial symptoms and the diagnosis of SLE and to investigate the presence of any relationship between the interval and the initial symptoms. One hundred and thirty-six patients were diagnosed with SLE using the 1982 ARA criteria. The mean age of the patients at diagnosis was 29.9 +/- 10.5 years. The mean interval between the onset of symptoms and the diagnosis of SLE was 21.82 +/- 30.32 months. The subjects were evaluated twice, at intervals of &#60; or = 3 and &#60; or = 12 months after the onset of symptoms. Although arthritis and/or arthralgia were the most common initial symptoms (60.3%), only 26.8% of the patients with these symptoms were diagnosed earlier than 3 months after the onset. If the first initial symptoms were butterfly rash or pericarditis, pleuritis, spontaneous abortion or cognitive dysfunction, they led to early diagnosis. In conclusion, since arthritis and/or arthralgia are the most common initial symptoms of the disease, every young woman with these symptoms should be carefully evaluated for SLE.</p

Paraesthesia Caused by the Separated Endodontic Instrument: Case Report

Abstract In endodontics, separated endodontic instruments located in the mandibular canal may cause an injury of the inferior alveolar nerve (IAN) resulting in disabling sensory disturbances such as pain, paraesthesia, and dysaesthesia of the lower lip and chin area. In clinically paraesthesia usually manifests as numbness, tingling or any deviation from normal sensation. The suggested therapeutic sequence for endodontic related paraesthesia is the control of pain and inflammation and, whenever possible, the surgical elimination of the cause. A healthy 33-yearold woman was referred to the Department of Endodontics, Oral and Dental Healthy Hospital, Eskişehir suffering from pain and paraesthesia in the left lower lip and chin. Radiographic examination revealed the presence of a separated endodontic instrument beyond the apex of the mandibular left second molar and this instrument was inside the left mandibular canal. Damage to the IAN secondary to extrusion of a separated endodontic instrument was diagnosed. Extraction of the tooth was decided and after prednisone and pregabalin treatments both pain and paraesthesia on the left side of the lower lip and chin were gone

Cutaneous Metastasis from Squamous Cell Carcinoma of The Bladder: A Case

Objective: To report a case with cutaneous metastasis of bladder squamous cell carcinoma. Very few cases of skin metastases from the urinary bladder are reported in the literature.Case report: Cutaneous metastasis of bladder squamous cell carcinoma is an extremely rare clinic entity associated with poor prognosis. Cutaneous metastasis is accepted as a late manifestation of systemic spread. A 58-year-old man had undergone radical cystoprostatectomy with pelvic lymph node dissection in November 2013. The pathology report showed a moderately differentiated squamous cell bladder carcinoma with a staging of T3N0M0. Then, a large regional cutaneous lesion measuring 4x3.5 cm with an ulcerated and necrotic appearance located in the suprapubic area was detected in February 2014, and the lesion was removed with a 2 cm safety margin. The pathologic examination revealed squamous cell carcinoma. This report describes an interesting and rare case of cutaneous metastasis of bladder squamous cell carcinoma as the primary presentation of metastatic disease with a generally dismal prognosis.Conclusion: The skin metastasis of bladder squamous cell carcinoma is a rare clinical entity with a poor prognosis. Clinicians should be aware of this rare entity

Trends in distance education research: A content analysis of journals 2009-2013

This study intends to explore the current trends in the field of distance education research during the period of 2009-2013. The trends were identified by an extensive review of seven peer reviewed scholarly journals: The American Journal of Distance Education (AJDE), Distance Education (DE), The European Journal of Open, Distance and e-Learning (EURODL), The Journal of Distance Education (JDE), The Journal of Online Learning and Technology (JOLT), Open Learning: The Journal of Open, Distance and e-Learning (OL) and The International Review of Research in Open and Distributed Learning (IRRODL). A total of 861 research articles was reviewed. Mainly content analysis was employed to be able to analyze the current research. Also, a social network analysis (SNA) was used to interpret the interrelationship between keywords indicated in these articles. Themes were developed and the content of the articles in the selected journals were coded according to categories derived from earlier studies. The results were interpreted using descriptive analysis (frequencies) and social network analysis. The reporting of the results were organized into the following categories: research areas, theoretical and conceptual frameworks, variables, methods, models, strategies, data collection and analysis methods, and the participants. The study also identified the most commonly used keywords, and the most frequently cited authors and studies in distance education. The findings obtained in this study may be useful in the exploration of potential research areas and identification of neglected areas in the field of distance education

The Incidence of Anemia in Rheumatoid Arthritis

WOS: 000440319800071

A new freshwater amphipod species, Gammarus topkarai sp nov., from Turkey (Amphipoda: Gammaridae), with a key for Turkish freshwater Gammarus species

WOS: 000265188800004A new species of freshwater Amphipod, Gammarus topkarai sp. nov., collected from Ivriz Creek, Tarsus Province, South Anatolia, is described and illustrated. The new species belongs to Gammarus pulex-group and shows similar characteristic features with Gammarus agrarius G. S. Karaman, 1973. Absence of well developed dorsal elevations on the urosome segments, smaller body length and relatively lower endopod/exopod ratio of third uropod are the most obvious features differ from G. agrarius. A detailed morphological description and illustrations of new species are given and differences from related species are discussed. An updated identification key of Gammarus taxa reported from Turkey, up to date, was also presented