Approximation of protein quality (DIAAS) of vegetarian dishes served in restaurants

Protein quality (DIAAS) of the most popular vegetarian and meat dishes served by 93 restaurants was calculated using published data on the digestibility of individual amino acids. Protein qualities of the vegetarian dishes were found to be lower than the meat dishes. A considerable number of vegetarian dishes (16.1%) did not contain any proteinaceous ingredient and therefore received a DIAAS value of zero. Meat dishes did not contain any low quality protein and their DIAAS values were higher than 87%. Vegetarian dishes only comprised 15 to 30% of the total number of dishes in most restaurants (60.2%). Pasta (21.5%), vegetable dishes (such as boiled, grilled or sautéed vegetables) (20.4%) and salads (19.4%) were found to be the most-selling vegetarian dishes. Price of the dishes, whether they were vegetarian or not, did not relate to the protein quality of the dishes

Treatment experience with liposomal amphotericin B in pediatric patients with kala-azar

Amaç: Kala-azar retikuloendotelial sistemin multisistemik enfeksiyonudur. hepatosplenomegali ve hipergamaglobulinemi ile karakterizedir. pentavalan antimon bileşikleridir. Tedavide antimon içeren ilaçlara karşı direnç gelişmesi ve antimon bileşiklerinin yan etkileri nedeniyle lipozomal amfoterisin B kullanımı gündeme gelmiştir. Çalışmamızda kala-azarlı çocuk hastaların tedavisinde 6 aylık lipozomal amfoterisin B tedavisi deneyimlerimizi sunmayı amaçladık. Yöntem: Ocak 2014-Haziran 2014 tarihleri arasında Mustafa Kemal Üniversitesi Tıp Fakültesi Hastanesi'nde tanı alan 6 visseral leishmaniasisli olgu retrospektif olarak incelendi. Tüm hastalar lipozomal amfoterisin B (AmBisome®) ile tedavi edildi. Bulgular: Tüm hastalara kemik iliği aspirasyonu yapıldı ve tümünde Leishmania amastigotları görüldü. Olguların hepsinde ateş, hepatomegali ve splenomegali vardı. En sık hematolojik bulgu anemi (%100) ve nötropeni (%100) idi. Olguların beşinde hipergamaglobulinemi saptandı. Bir olguda Hemofagositik lenfohistiyositozis (HLH) saptandı. Uygun leishmaniasise.Objective: Kala-azar is a multisystem infection of the reticuloendothelial system. It is characterized by prolonged fever, hypergammaglobulinemia. The conventional treatment of kala-azar consists of pentavalent antimony compounds. Because of the resistance to drugs, including antimony and the side effects of antimony compounds, liposomal amphotericin B therapy is now being used. In our study, we aimed to present our 6 months of experience about treatment with liposomal amphotericin B of pediatric patients with kala-azar. Method: In this study, 6 consecutive cases of visceral leishmaniasis admitted to Mustafa Kemal University Medical Faculty Hospital between January 2014 and June 2014 were analyzed retrospectively. All patients with kalaazar were treated with liposomal amphotericin B (AmBisome®). Results: Bone marrow aspirate was obtained in all cases and Leishmania amastigotes were detected in all of them. Fever, hepatomegaly and splenomegaly were present in all cases. Anemia (100%) and neutropenia (100%) were the most Hypergammaglobulinemia was noted in 5 cases. Severe Hemophagocytic lymphohistiocytosis (HLH) secondary to visceral leishmaniasis revealed in 1 patient. Despite initiating appropriate antileishmanial and HLH 2004 protocol treatments, She died after 19 days of hospitalization due to acinetobacter septicemia. In 5 patients were finally cured. Conclusion: Kala-azar should be suspected in the differential diagnosis with prolonged fever, marked splenomegaly hepatomegaly, and cytopenia. Liposomal amphotericin B seems to be the effective therapy in the treatment of pediatric visceral leishmaniasis in Turkey

Intracranial Involvement Of Multiple Myeloma

OBJECTIVE: Multiple myeloma is usually restricted to the bone marrow. Central nervous system involvement is uncommon and can be observed in approximately 1% of the multiple myeloma patients. OBJECTIVES: We aimed to demonstrate brain magnetic resonance patterns in patients with multiple myeloma with neurologic symptoms and the literature is reviewed. METHODS: We retrospectively studied 39 patients with multiple myeloma with neurologic symptoms. All the patients underwent classic and contrast enhanced brain MR examination. RESULTS: Patients presented with the following symptoms: impaired consciousness (n=8, 20.5%), headache (n=6, 15.3%), hemiparesis (n=2, 5.1%), aphasia (n=6, 15.3%), scalp swelling (n=2, 5.1%), visual loss (n=1, 2.5%), seizure (n=2, 5.1%), vertigo (n=4, 10.2%), ophthalmoplegia (n=4, 10.2%), meningeal irritation findings (n=2, 5.1%), and orientation disorder (n=2, 5.1%). Among 39 patients with multiple myeloma, 14 (35.8%) had ischemic lesions, 14 (35.8%) had calvarial diploic metastases, 5 (12.8%) had dura mater mass, 4 (10.2%) had dura mater involvement, 2 (5.1%) had sinonasal mass, 1 had cavernous sinus and orbital apex mass, 1 (2.5%) had leptomeningeal involvement, 1 (2.5%) had intraorbital mass, 3 (7.6%) had clivus mass, 1 (2.5%) had optic neuritis, 1 (2.5%) had central pontine myelinolysis and 2 (5.1%) had meningitis. Examination of the cerebrospinal fluid was performed in 6 patients. Cerebrospinal fluid studies showed malignant plasma cells in 1 patient with leptomeningeal contrast enhancement. Despite serial cerebrospinal fluid examination, plasma cells in cerebrospinal fluid were not showed in 2 patients with dura mater involvement. Two patients had menengitis. CONCLUSION: Involvement of the central nervous system in multiple myeloma is very uncommon. The occurrence of neurological symptoms in a patient with myeloma requires an accurate evaluation with MR and lumbar puncture to detect a possible meningeal or cerebral involvement, when metabolic factors (hypercalcemia,drug toxicity, uremia), hyperviscosity, or medullary compression can be exclude