Hematologic parameters in geriatric patients with idiopathic sudden sensorineural hearing loss

Introduction: To assess the validity of complete blood count (CBC) parameters in the diagnosis and prognosis of idiopathic sudden sensorineural hearing loss (ISSNHL) in geriatric patients. Material and Method: Sixty-two patients (women, 36; men, 26; mean age of all patients, 51 +/- 19 years) with ISSNHL were included in our study, and 49 healthy volunteers (women, 33; men, 16; mean age of all volunteers 48.6 +/- 16.2 years) with no history of audiologic complaints or diseases formed the control group. Subjects in both the control and study groups were further divided into two groups according to their ages (= 65 years). CBC results were evaluated. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated. Results: NLR and PLR values in patients diagnosed with sudden hearing loss were much higher compared to those in the control group. However, in geriatric patients, there was no difference in NLR and PLR between the study and control groups. There was also no difference in mean platelet volume (MPV) levels between the control and study groups at all ages. Red cell distribution width (RDW) was higher in both geriatric and non-geriatric patients with ISSNHL compared with the control group. When NLR, LPR, MPV, and RDW of patients with ISSNHL were compared between those who responded and those who did not respond to the standard treatment, there was no significant difference between the groups. Conclusion: NLR, PLR, and RDW are increased in ISSNHL patients aged <65 years but only RDW is increased in geriatric patients with ISSNHL

Corticosteroid hypersensitivity in allergic rhinitis

Corticosteroid hypersensitivity in allergic rhinitis. Background: intranasal corticosteroid (IC) is the most effective treatment method in allergic rhinitis patients who are unresponsive to antihistamines. The literature reports an approximate 20% treatment failure for instances where IC is used for the treatment allergic rhinitis. Hypersensitivity reaction to corticosteroids may be one of the causes of this treatment failure. Objective: to discover the incidence and confounding factors of corticosteroid hypersensitivity in patients with allergic rhinitis. Methods: after 31 patients were excluded, 150 consecutive patients who were prospectively evaluated in our outpatient clinics with the diagnosis of allergic rhinitis and 50 age- and sex- matched healthy volunteers were included in this study. To diagnose allergic rhinitis, the symptoms of patients and a skin prick test were used. A skin patch test was used to determine corticosteroid hypersensitivity. Total IgE values and total eosinophil count were obtained for all patients. Total symptom scores were calculated for the severity of symptoms and to determine the response to therapy using intranasal corticosteroids. Results: the incidence of corticosteroid hypersensitivity determined via the skin patch test was 14.0% (21 out of 150 patients). A difference was observed for patch test positivity results between the study and control groups (14% vs. 0%, respectively). Serum IgE levels and total eosinophil count were higher among patients who had corticosteroid hypersensitivity (p:0.005 and p:0.004, respectively). Patients unresponsive to intranasal corticosteroids had a higher incidence of corticosteroid hypersensitivity (71.4% vs. 4.4%, p<0.001). Conclusion: our study is the largest to date investigating CH in patients with allergic rhinitis and patients with allergic rhinitis have been found to have a high incidence (14%) of corticosteroid hypersensitivity, which may affect the response of patients to intranasal corticosteroid treatment

Successful treatment of a case with cervical lymphatic malformation: Repeated bleomycin sclerotherapy

Lymphatic malformations (LM) are benign congenital malformations of the lymphatic system. They are frequently seen in the neck and sometimes can be life-threatening due to compression to the airway. Treatment modalities are widespread including surgical excision, radiotherapy, laser therapy, and application of intralesional sclerosing agents. We report the successful treatment of cervical LM in a 3-year-old boy who presented with a sudden onset of a large cystic mass in the posterior cervical triangle and was treated with repeated injections of intralesional bleomycin

How did the updated 2019 european society of cardiology/european atherosclerosis society risk categorization for patients with diabetes affect the risk perception and lipid goals, a simulated analysis of real-life data from EPHESUS study

Background: The recent 2019 European Society of Cardiology/European Atherosclerosis Society practice guidelines introduced a new risk categorization for patients with diabetes. We aimed to compare the implications of the 2016 and 2019 European Society of Cardiology/European Atherosclerosis Society guidelines with regard to the lipid-lowering treatment use, low-density lipoprotein cholesterol goal attainment rates, and the estimated proportion of patients who would be at goal in an ideal setting. Methods: Patients with diabetes were classified into 4 risk categories according to 2019 European Society of Cardiology/European Atherosclerosis Society dyslipidemia guidelines from the database of EPHESUS (cross-sectional, observational, countrywide registry of cardiology outpatient clinics) study. The use of lipid-lowering treatment and low-density lipoprotein cholesterol goal attainment rates were then compared according to previous and new guidelines. Results: This analysis included a total of 873 diabetic adults. Half of the study population (53.8%) were on lipid-lowering treatment and almost one-fifth (19.1%) were on high-intensity statins. While low-density lipoprotein cholesterol goal was achieved in 19.5% and 7.5% of patients, 87.4% and 69.6% would be on target if their lipid-lowering treatment was intensified according to 2016 and 2019 European Society of Cardiology/European Atherosclerosis Society lipid guidelines, respectively. The new target <55 mg/dL could only be achieved in 2.2% and 8.1% of very high-risk primary prevention and secondary prevention patients, respectively. Conclusion: The control of dyslipidemia was extremely poor among patients with diabetes. The use of lipid-lowering treatment was not at the desired level, and high-intensity lipid-lowering treatment use was even lower. Our simulation model showed that the high-dose statin plus ezetimibe therapy would improve goal attainment; however, it would not be possible to get goals with this treatment in more than one-third of the patients

Successful Treatment of a Case with Cervical Lymphatic Malformation: Repeated Bleomycin Sclerotherapy

Lymphatic malformations (LM) are benign congenital malformations of the lymphatic system. They are frequently seen in the neck and sometimes can be life-threatening due to compression to the airway. Treatment modalities are widespread including surgical excision, radiotherapy, laser therapy, and application of intralesional sclerosing agents. We report the successful treatment of cervical LM in a 3-year-old boy who presented with a sudden onset of a large cystic mass in the posterior cervical triangle and was treated with repeated injections of intralesional bleomycin

(Trans)cribing History: The Oral Histories of Transgender Clergy in America

Popular American rhetoric around religion and LGBTQ issues puts the two at odds. The Bible has been the center of many debates over sexuality, gender identity, and faith. However, very few conversations have included or revolved around the authentic experiences of LGBTQ people of faith. Nine participants from various Protestant backgrounds shared their narratives with me and spoke on issues of gender and faith. This report is an in-depth summary of a short oral history project of transgender clergy (as well as candidates for ordination or exemplary church members)

HEMATOLOGIC PARAMETERS IN GERIATRIC PATIENTS WITH IDIOPATHIC SUDDEN SENSORINEURAL HEARING LOSS

Introduction: To assess the validity of complete blood count (CBC) parameters in the diagnosis and prognosis of idiopathic sudden sensorineural hearing loss (ISSNHL) in geriatric patients

Benign Paroksismal Pozisyonel Vertigo Tedavisinde Kanalit Repozisyon Manevralarının Kullanımı

Objective: Patients with vertigo compose 2-3% of total admissions to emergency department. Dizziness affects especially the patients above60 years of age creating social life difficulties and causing, leads to dangerous and life-threatening situations. In this study, we tried to showthe effect of Epley maneuver on the symptoms of benign paroxysmal positional vertigo (BPPV) which is the most common type ofperipheric vertigo. Method: A total of 347 patients who attended to otolaryngology and emergency departments of Ufuk University andPrivate Medisun Hospital between 15.08.2018 and 15.02.2019 with peripheric vertigo complaints were included in the study. Each patientwas applied Epley maneuver and followed. Results were analyzed with SPSS program (Statistical Package for Social Sciences). Results: Ofall the patients, 201 (58%) were women, and 146 (42%) were men with a mean age of 51,2±3,1 years. Posterior semicircular canal pathologywas found in 54.5%; horizontal canal in 34.9%; anterior canal in 6.3%; multiple canal in 4.3%. Epley maneuver was applied to all patientsand succeeded in 94% of the patients. Conclusion: Vertigo is a common symptom that can cause serious effects on lifestyle. Searching theetiology can be challenging for both the physicians and the patients. The most common cause of peripheral vertigo is BPPV. Epley maneuveris a simple, safe, quick and effective method for treatment and the diagnosis of BPPV. In conclusion, using canalith reposition maneuversfirstly will decrease the recovery time and save patients from time loss.Amaç: Günümüzde acil servise başvuran hastaların toplam %2-3’ünü baş dönmesi şikayeti oluşturmaktadır. Özellikle, 60 yaş üzerinde sıklıkla görülen baş dönmesi kişinin sosyal hayatını ve yaşamı engellemekte; özellikle ileri yaşlı hastalarda düşmeye yol açarak hayati tehlikelere neden olabilmektedir. Çalışmamızda; en sık periferik baş dönmesi nedeni olan benign paroksismal pozisyonel vertigo (BPPV) tedavisinde kullanılan Epley manevrasının hastanın şikayetleri üzerine etkisini araştırdık. Yöntem: Araştırmaya 15.08.2018-15.02.2019 tarihleri arasında Ufuk Üniversitesi ve Özel Medisun Hastanesi acil servis ve kulak burun boğaz hastalıkları polikliniğine başvuran ve periferik kökenli olduğu tahmin edilen 347 baş dönmesi şikayeti olan hastalar katıldı. Hastalara Epley manevrası yapılmasının ardından iyileşmeleri takip edildi. Sonuçlar SPSS programı ile değerlendirildi. Bulgular: Araştırmamıza katılan 347 hastanın; 201’i (%58) kadın; 146’sı (%42) ise erkekti. Hastaların yaş ortalaması 51,2±3,1 yıl olarak bulundu. Hastaların %54,5’i posterior kanal; %34,9’u horizontal kanal; %6,3’ü anterior kanal; %4,3’ü çoklu kanal tutulumu gösterdi. Epley manevrası her hastaya yapıldı ve %94 oranında başarı sağlandı. Sonuç: Baş dönmesi sıklıkla görülen ve ciddi yaşamsal kısıtlamalara yol açabilen bir hastalıktır. Etyoloji araştırılmasında hem maddi hem manevi birçok yöntem denenmektedir. Periferik baş dönmesi nedenlerinden en sık görülen BPPV hastalığının hem tanı hem de tedavisinde Epley repozisyon manevrası, basit, güvenli, hızlı ve etkinliği yüksek bir yöntemdir. Bu nedenle baş dönmesi şikayeti ile başvuran hastalarda ilk olarak kanalit repozisyon manevralarının yapılmasının hem hastanın iyileşme sürecini hızlandıracağını hem de zaman kaybını önleyeceğini düşünmekteyiz

İlaçların Neden Olduğu Tat ve Koku Alma Bozuklukları

Odor and taste are important in vital functions. With taste-taking, human social life and dietary habits are affected all kinds. Besides, odor and taste have quite complex structures at the molecular level. It is claimed that most of the drugs used in the treatment of different diseases lead to disturbances in taste and smell as an undesirable effect. Changes in smell and taste sensations are not considered as medical necessity. This situation does not only cause the patient to live with taste or smell disorder, but also make person to be disaffected by the food and not to enjoy the social aspects of the person's life. the purpose of this review is to describe the effects of drugs on taste and smell sensations and to provide information about the drugs that can cause these effects.Koku ve tat almanın yaşamsal fonksiyonlarda önemi büyüktür. İnsanın sosyal yaşantısı ve diyet alışkanlıkları; tat alma ile etkilenmektedir. Ayrıca tat alma duyusu ile koku duyusu yakın bir ilişki içindedir. Bu durumun nedeni koku ve tat duyusunun moleküler düzeyde oldukça karmaşık yapılara sahip olmasıdır. Farklı hastalıkların tedavisinde kullanılan ilaçların çoğunun istenmeyen yan etki olarak tat ve koku duyusunda bozukluğa yol açtığı öne sürülmektedir. Koku ve tat duyularındaki değişiklikler tıbbi olarak gerektiği kadar dikkate alınmamaktadır. Bu durum, hem hastanın tat veya koku alma bozukluğu ile yaşamasına yol açmakta, hem de hastalar yemeklerden hoşnutsuz olmak, keyif alamamak gibi sosyal açılardan da olumsuz etkilenmektedir. Bu derlemenin amacı, ilaçların tat ve koku duyularında neden olduğu etkileri tanımlamak ve bu etkilere neden olabilecek ilaçlar hakkında bilgi sunmaktır

The use of Canalith Reposition Maneuvers in Treatment of Benign Paroxysmal Positional Vertigo

Objective: Patients with vertigo compose 2-3% of total admissions to emergency department. Dizziness affects especially the patients above60 years of age creating social life difficulties and causing, leads to dangerous and life-threatening situations. In this study, we tried to showthe effect of Epley maneuver on the symptoms of benign paroxysmal positional vertigo (BPPV) which is the most common type ofperipheric vertigo. Method: A total of 347 patients who attended to otolaryngology and emergency departments of Ufuk University andPrivate Medisun Hospital between 15.08.2018 and 15.02.2019 with peripheric vertigo complaints were included in the study. Each patientwas applied Epley maneuver and followed. Results were analyzed with SPSS program (Statistical Package for Social Sciences). Results: Ofall the patients, 201 (58%) were women, and 146 (42%) were men with a mean age of 51,2±3,1 years. Posterior semicircular canal pathologywas found in 54.5%; horizontal canal in 34.9%; anterior canal in 6.3%; multiple canal in 4.3%. Epley maneuver was applied to all patientsand succeeded in 94% of the patients. Conclusion: Vertigo is a common symptom that can cause serious effects on lifestyle. Searching theetiology can be challenging for both the physicians and the patients. The most common cause of peripheral vertigo is BPPV. Epley maneuveris a simple, safe, quick and effective method for treatment and the diagnosis of BPPV. In conclusion, using canalith reposition maneuversfirstly will decrease the recovery time and save patients from time loss.Amaç: Günümüzde acil servise başvuran hastaların toplam %2-3’ünü baş dönmesi şikayeti oluşturmaktadır. Özellikle, 60 yaş üzerinde sıklıkla görülen baş dönmesi kişinin sosyal hayatını ve yaşamı engellemekte; özellikle ileri yaşlı hastalarda düşmeye yol açarak hayati tehlikelere neden olabilmektedir. Çalışmamızda; en sık periferik baş dönmesi nedeni olan benign paroksismal pozisyonel vertigo (BPPV) tedavisinde kullanılan Epley manevrasının hastanın şikayetleri üzerine etkisini araştırdık. Yöntem: Araştırmaya 15.08.2018-15.02.2019 tarihleri arasında Ufuk Üniversitesi ve Özel Medisun Hastanesi acil servis ve kulak burun boğaz hastalıkları polikliniğine başvuran ve periferik kökenli olduğu tahmin edilen 347 baş dönmesi şikayeti olan hastalar katıldı. Hastalara Epley manevrası yapılmasının ardından iyileşmeleri takip edildi. Sonuçlar SPSS programı ile değerlendirildi. Bulgular: Araştırmamıza katılan 347 hastanın; 201’i (%58) kadın; 146’sı (%42) ise erkekti. Hastaların yaş ortalaması 51,2±3,1 yıl olarak bulundu. Hastaların %54,5’i posterior kanal; %34,9’u horizontal kanal; %6,3’ü anterior kanal; %4,3’ü çoklu kanal tutulumu gösterdi. Epley manevrası her hastaya yapıldı ve %94 oranında başarı sağlandı. Sonuç: Baş dönmesi sıklıkla görülen ve ciddi yaşamsal kısıtlamalara yol açabilen bir hastalıktır. Etyoloji araştırılmasında hem maddi hem manevi birçok yöntem denenmektedir. Periferik baş dönmesi nedenlerinden en sık görülen BPPV hastalığının hem tanı hem de tedavisinde Epley repozisyon manevrası, basit, güvenli, hızlı ve etkinliği yüksek bir yöntemdir. Bu nedenle baş dönmesi şikayeti ile başvuran hastalarda ilk olarak kanalit repozisyon manevralarının yapılmasının hem hastanın iyileşme sürecini hızlandıracağını hem de zaman kaybını önleyeceğini düşünmekteyiz