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

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

Transscleral fixation of a black diaphragm intraocular lens in severely traumatized eyes requiring vitreoretinal surgery

The records of 4 eyes of 4 patients who had transscleral fixation of black diaphragm intraocular lenses (IOLs) after vitreoretinal surgery due to complications of severe perforating trauma were retrospectively reviewed. The transscleral fixation was performed 4 to 13 months after the vitreoretinal surgery. All patients reported a subjective decrease in glare and photophobia, with improved visual acuity in 2 eyes during a mean follow-up of 3 years. Cystoid macular edema was noted in 1 eye and transitory intraocular pressure elevation due to intraocular silicone oil in 1 eye. Severe perforating eye injury is frequently associated with extensive iris defects and lenticular and vitreoretinal complications. Although visual acuity may not be the primary concern in these eyes, favorable visual rehabilitation can be achieved following proper management of the retinal complications and transscleral fixation of black diaphragm IOLs to overcome glare and photophobia