Shear wave elastography evaluation of kidneys in children with familial mediterranean fever.

Background and Aim: Familial Mediterranean fever (FMF) is an autosomal recessive disorder. Typical clinical manifestations are self-limiting attacks of recurrent fever, abdominal pain, arthralgia, and chest pain due to aseptic polyserositis. Renal involvement is common in FMF patients. Shear wave elastography (SWE) is a noninvasive method that provides the measurement of tissue stiffness. In this study, we aimed to show that SWE can be used as an adjunctive method for evaluating renal involvement in children with FMF. Materials and Methods: Our study group consists of 79 pediatric FMF patients and 79 control individuals. The study was planned prospectively. The variables, such as age, height, weight, and body mass index (BMI) of the patient and control groups, were kept in a similar way in order not to be affected by the differences. The right and left kidney sizes, parenchymal thicknesses, and SWE values in both groups were compared. The parenchymal stiffness degrees of the kidneys were quantified by shear modulus values in kilopascals. Results: In our study, no statistically significant difference was found between the control and patient groups in terms of the right and left kidney longitudinal dimensions, transverse dimensions, and parenchymal thicknesses. When the kidneys were evaluated in terms of the right and left kidney stiffness values, the stiffness values in the patient group were significantly higher in both kidneys compared with those in the control group (P < 0.001). Conclusions: SWE can be a noninvasive quantitative imaging method that can be used to evaluate kidney involvement by detecting changes in kidney stiffness in children with FMF.

Frequency of thyroid pathologies in the central Black Sea Region: Ultrasound-based field study.

Background: Thyroid pathologies are very common diseases. The most common thyroid pathologies are goiter and thyroid nodules. Thyroid ultrasonography is the most widely used examination method in the evaluation of thyroid pathologies. The aim of this field study is to determine the frequency of thyroid pathologies in the province of Tokat and to evaluate its relationship with some factors such as gender and dietary habits. Materials and Methods: In this population-based prospective study, thyroid US examination was performed on a total of 822 patients. The examination procedure was carried out by one radiologist with at least 10 years of experience. During the examination, thyroid dimensions, parenchyma echo, presence of nodule, echo if any, number, size, and localization were evaluated. The relationships between thyroid pathologies and age, gender, body mass index (BMI), and chronic diseases in the participants were evaluated. Results: Up to 45.2% (n = 372) of the participants were male and 54.8% (n = 417) were female. The ages of the participants ranged from 20 to 87 years. The mean age of the participants was 47.2. Up to 9.8% of the participants had an increase in thyroid size, defined as goiter. Parenchyma was homogeneous in 72.1% of the participants and heterogeneous in 27.9%. Thyroid nodules were present in the thyroid gland in 40.8% of the participants. There was a statistically significant relationship between thyroid pathologies and female gender, age, and obesity. Conclusion: Thyroid diseases show regional differences. Older age, female gender, and obesity increase the frequency of thyroid pathologies.

Level of kisspeptin-10 in patients with multiple sclerosis and the association between third ventricle diameter size and vitamin D level.

OBJECTIVE: Multiple sclerosis (MS) is a chronic and progressive neurological disease affecting the central nervous system (CNS). Some studies report an association between MS pathogenesis and cytokines. Here, we aimed to determine and evaluate serum kisspeptin-10 level in MS patients and its related clinic parameters. MATERIALS AND METHODS: A total of 92 participants, 46 patients with relapsing-remitting MS (mean age, 38.92 ± 14.76; 22 men and 24 women) and 46 healthy controls (mean age, 37.04 ± 15.49; 22 men and 24 women) were enrolled in the study. All MS patients were neurologically examined, and magnetic resonance imaging (MRI) was performed. Clinical data (neuropathic pain, expanded disability status scale (EDSS) score, etc.) and the patients' demographic characteristics were recorded. The serum level of kisspeptin-10 was analyzed by enzyme-linked immunosorbent assay (ELISA) method. RESULTS: The level of kisspeptin-10 was measured as 2.305 ± 2.781 ng/mL in MS patients and 9.342 ± 9.483 ng/mL in controls. MS patients had significantly lower kisspeptin-10 levels than controls (P = 0.000). Kisspeptin-10 has the highest diagnostic value [Area under curve (AUC) = 0.881, 95% confidence interval (CI), 0.812-0.950] as cut-off value (2.470), sensitivity (80.40%) and specificity (72.87%) in the MS group. Furthermore, the kisspeptin-10 level was negatively correlated with third ventricle diameter (TVD) (P = 0.048) and vitamin D concentration (P = 0.004). No significant difference was determined between kisspeptin-10 and other clinical parameters. CONCLUSION: As a potential prognostic biomarker, serum kisspeptin-10 level was significantly lower in patients with MS than in those without. Moreover, we observed negative correlations between vitamin D, TVD size, and kisspeptin-10. We think comprehensive studies are needed to verify and elucidate this issue.

Tracheobroncopathia osteochondroplastica: Three case reports with literature review.

Tracheobroncopathia osteochondroplastica (TO) is a benign disease of the large airways seen very rarely. It is characterized by 1-3 mm sized ossified nodular lesions in submucosa. Its etiology is unclear, but it is stated that malignancy, chronic inflammation, amyloidosis, and genetic factors might have an effect on it. It was first described by Wilks in a 38-year-old man diagnosed with tuberculosis in 1857. Generally, patients are asymptomatic and TO is diagnosed incidentally. But symptoms become significant with infections and obstruction in tracheabronchial tree. Generally chest radiography is normal, so thorax computed tomography can be remarkable in diagnosis of TO. Besides, final diagnosis can be established by viewing ossified nodules in trachea and bronchus through the fiberoptic bronchoscopy. Amyloidosis, tuberculosis, sarcoidosis, bronchial carcinoma, and tracheobronchial calcinosis must be remembered in differential diagnosis. Also ossifications in submucosa and proof of bone marrow in histopathological examinations are important in diagnosis of TO. Mostly palliative treatment is performed to the symptoms . We want the clinicians to keep in mind for this very rarely seen tracheal disease with three case reports.

Prevention of measles spread on a paediatric ward.

Since measles is a highly contagious respiratory infection with significant airborne transmission risk in hospitals, effective prevention measures are crucial. After a mother accompanying her child on a paediatric ward lacking a negative pressure room was diagnosed with measles, exposed persons without evidence of immunity (documentary evidence of receiving two doses of measles-mumps-rubella vaccine) were treated with vaccination or intravenous immunoglobulin (IVIG). The interruption of transmission with these treatments was evaluated. There were 44 children and 101 adults exposed to the index patient. Twenty-five children and 88 adults were considered immune, providing evidence of immunity. Nineteen children and 13 adults were either given vaccination or IVIG for post-exposure prophylaxis (PEP). There were no additional cases of measles after 3 weeks follow-up. We conclude that measles is highly preventable by adequate PEP with vaccination or IVIG in a healthcare setting that lacks the benefit of a negative pressure room.

Age and duration of disease as factors affecting clinical findings and sacroiliitis in brucellosis.

OBJECTIVE: Brucellosis may be seen in any age group, but it still involves young and middle aged adults more frequently. Our aim was to investigate the relationship between age and the duration of disease on clinical findings of brucellosis in adults in this study. PATIENTS AND METHOD: One hundred and sixty-three patients with brucellosis, treated in our hospital, between 1997 and 2003, were evaluated retrospectively. RESULTS: Fever was found in 60.7% of the patients, and it was significantly higher when the duration of disease was less than one month (p = 0.03). Fever was significantly lower in the > or = 65 age group (p = 0.01). Sacroiliitis was detected in 44.1% of patients. Sacroiliitis was significantly higher in the 15-35 age group (p = 0.03). There were no differences between age groups and other clinical and laboratory findings. CONCLUSIONS: Sacroiliac involvement was noted particularly in young adults who manifested lumbar pain and fever, but this might not be a major symptom of brucellosis in the elderly, or in patients showing symptoms for more than a month.

The influence of BCG immunisation on tuberculin reactivity and booster effect in adults in a country with a high prevalence of tuberculosis.

The relationship of age and previous BCG vaccination with tuberculin skin test (TST) reactivity was investigated to assess the interpretation of TST results in the adult population of Turkey, where there is a high prevalence of tuberculosis and a routine BCG vaccination programme. The influences of age and BCG vaccine status on booster reaction were also evaluated. TST was applied (5 tuberculin units of purified protein derivative intradermally) to two healthy adult groups, namely 98 medical students and 187 elderly people in a retirement home. The TST was considered positive if an induration > or = 10 mm in diameter was produced. Subjects (41 elderly people and 39 students) with a reaction < 10 mm in diameter were retested 1 week later. There was no significant difference between the students (59.1%) and elderly subjects (58.8%) with respect to positive TST response. No influence of BCG scars on TST reactivity was observed in either group. The booster effect was seen more commonly in the elderly, but the presence of a BCG scar did not influence the booster effect in either group. It was concluded that a positive TST response and booster reaction in adults in high-prevalence countries may be caused by latent tuberculosis rather than previous vaccination.

[A comparison of the frequency of hepatitis B surface antigen and antibody in hospital and nonhospital personnel]. / Hastane personeli ve hastane disindan kisilerde hepatit B Yüzey antijeni ve antikoru sikliginin karsilastirilmasi.

HBsAg and Anti-HBs positivity was determined in hospital personnel and volunteer blood donors (controls) by using Enzyme Immuno Assay (EIA) method. The combined prevalence of antigen-antibody positivity among hospital personnel was 40.52% (HBsAg 5.57%, Anti-HBs 34.94%) while it was present 37% (HBsAg 6% Anti-HBs 31%) in controls. The frequency of the antigen and antibody in hospital personnel and controls did not differ significantly.

[An outbreak of influenza in hospital personnel]. / Hastane personelinde bir influenza epidemisi.

During the last week of December 1989, an outbreak of respiratory system infection involved 32 hospital personnel and 2 patients was detected in Gazi University Medical Faculty Hospital. White blood cells count of the patients were either normal or there were a slight leucopenia. Throat cultures of the most patients were normal. Serum ASO, CRP, bilirubin, AST and ALT were usually within normal limits. According to symptoms, signs and laboratory data we considered a viral disease, especially influenza. All patients recovered without any sequelae. Of 34 in-patients, 8 paired sera, 2 acute phase sera, and 10 convalescent phase sera were tested for the presence of Hemagglutination Inhibition (HI) antibody to three influenza virus strains recommended by WHO in the 1989-1990 season: Influenza A/Taiwan/1/86 (H1 N1), Influenza A/Shanghai/11/87 (H3 N2), Influenza B/Victoria/2/87. All of the sera were negative for Influenza B/Victoria/2/87. There were no significant rises in HT antibody titer for Influenza A/Taiwan/1/86 (H1 N1). The sera for 4 of 8 patients examined both acute and convalescent phase sera had fourfold or greater rise in HI antibody for Influenza A/Shanghai/11/87 (H3 N2). Four patients examined only convalescent sera had 1/40 or greater rises in HI antibody for this influenza subtype. It was considered that this influenza outbreak was probably caused by Influenza A/Shanghai/11/87 (H3 N2).

[Postoperative wound infections]. / Postoperatif yara infeksiyonlari.

Between July 1987 and October 1988, 400 postoperative wound infection material sent to Microbiology Laboratory from various surgery clinics were examined bacteriologically. Staphylococcus aureus was the predominant organism. E. coli and coagulase negative Staphylococci were second and third in frequency respectively.

[Monoclonal antibodies]. / Monoklonal antikorlar.

Monoclonal antibodies have the capability to bind specifically to the antigens to which they are targeted, and hybridoma technology makes the production of these antibodies possible. Now, it is used in diagnosis and treatment of various diseases.

[Penicillinase activity of staphylococci and their sensitivity to penicillin G and oxacillin (author's transl)]. / Stafilokoklarin penicillinase aktivitesi ve penicillin G ile oxacillin'e duyarliligi.

The penicillinase activities of 169 strains of staphylococci isolated from outpatients were detected by a simple technique that gives the result in 10 minutes on benzylpenicillin and bromocresol purple absorbed Whatman No 1 filter papers. Seventy three out of 100 S. aureus strain and 4 out of 69 S. albus were found to have the enzyme. The ratio of penicillin G resistance among S. aureus and S. albus were found to be 89% and 41% respectively. Six strains (6%) of S. aureus and 5 (7%) S. albus were resistant to both antibiotics. When the findings were compared with those previously reported in Turkey, it was seen that the proportion of the penicillinase + strains and the incidence of resistance in staphylococci to both kinds of penicillins was increased.