Evaluation of Tp-E interval and Tp-E/Qtc ratios in patients with overt hypothyroidism and subclinical hypothyroidism.

OBJECTIVE: Tp-e interval and Tp-e/QTc are among the new-generation indicators used for predicting cardiac arrhythmia and ventricular repolarization. In this study, we aimed to evaluate Tp-e and Tp-e/QTc ratios in patients with overt hypothyroidism and subclinical hypothyroid patients. PATIENTS AND METHODS: In this study, a total of 105 patients were included with 35 overt hypothyroidism, 35 subclinical hypothyroidism, and 35 healthy euthyroid patients. The anthropometric measurements, laboratory results, and electrocardiographic data of the patients were measured. The groups were compared in terms of Tp-e interval, Tp-e/QT and Tp-e QT/c ratios. RESULTS: When the Tp-e interval and Tp-e/QTc values of the patients were compared, a significant difference was found (p<0.001). A positive correlation was found between thyroid stimulating hormone (TSH) with Tp-e interval and Tp-e/QT ratio. CONCLUSIONS: Tp-e interval and Tp-e/QTc duration increased in overt hypothyroidism and subclinical hypothyroidism patients compared to euthyroid patients. We believe that regular use of levothyroxine therapy in overt hypothyroidism patients will decrease cardiac mortality. Cardiac risk factors should be considered to decide on levothyroxine therapy for subclinical hypothyroidism patients.

The novel predictor of metabolic risk in patients with polycystic ovary syndrome: could it be the visceral adiposity index?

OBJECTIVE: Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder in women of reproductive age, often accompanied by high androgen levels, irregular menstrual cycles and polycystic ovaries. In addition, patients with PCOS also present with an increase in abdominal adipose tissue and insulin resistance. Recently, the gender-specific mathematical formulation called visceral adiposity index (VAI) has been widely used in assessing cardiometabolic risk. This study aimed at comparing the VAI values of patients with PCOS, patients with idiopathic hirsutism (IH) and a control group. PATIENTS AND METHODS: We obtained demographic data, laboratory results and anthropometric measurements of patients from the hospital database. We retrospectively grouped all cases included in the study as PCOS (n = 52), IH (n = 57) and control (n = 58) according to the diagnoses. We also took venous samples for hormone and biochemical tests in the early follicular phase of the menstrual cycle, at least 8-10 hours after fasting in the early morning hours. Finally, we evaluated the variables using SPSS 22.0 software (IBM Corp., Armonk, NY, USA). RESULTS: We included 167 female individuals in the study. Of these, 57 (34.1%) were diagnosed with IH, while 52 (31.1%) were diagnosed with PCOS. The control group comprised 58 (34.8%) healthy female individuals. The median age of the study group was 25 years [interquartile range (IQR) = 8 years]. The age, height, weight, body mass index (BMI) and waist circumference values of the groups were similar. We found that the VAI values among the groups were significantly different (p = 0.028). Post-hoc analysis determined that this was due to the difference between the group with PCOS and the control group. In addition, we found significantly high HOMA-IR, fasting insulin and androgen levels in the group with PCOS (p < 0.001). CONCLUSIONS: After comparing data in groups with similar BMI levels, we found significantly high VAI values in patients with PCOS. The results reinforce the idea that VAI is a useful marker easily obtained in daily practice for assessing the cardiometabolic risk of patients with PCOS.

The evaluation of cerebral venous normal anatomy and variations by phase-contrast cranial magnetic resonance venography.

BACKGROUND: The aim of our study was to determine the ability of the phase-contrast-cranial magnetic resonance venography (PC-CMRV) technique to detect cranial anatomy, variations, thrombosis, to reveal the deficits of the technique and to discuss the reasons for these deficits on a physics basis. MATERIALS AND METHODS: Phase-contrast's detection rates of anatomic variations and physiological filling defects (FDs) were evaluated in 136 patients and compared with the time-of-flight technique magnetic resonance imaging (MRI) and cadaveric studies. RESULTS: The dominance correlation between the three evaluated sinuses (transverse sinus [TS], sigmoid sinus, jugular vein) which originated from different embryological buds was statistically significant and the right vessel chain was dominant. PC is inadequate to show some vessels like inferior sagittal sinus (anatomically, this vessel is approximately present in 100% of the cases, but it was only visualised in 41.2% of the patients in PC-MRI). Visualisation of major veins was sufficient. PC-MRI created physiological FDs in 27.2% (72.3% middle, 10.3% inner, 17% outer part) of the patients. The FDs were concentrated in the middle part and not observed in the dominant sinus. CONCLUSIONS: The defects of visualisation are present due to the PC's technique. It can be misdiagnosed as agenesis or thrombosis. PC creates a high incidence of physiologic FDs in TS. The results are not reliable, especially if FDs are in the middle part or non-dominant side.

Tear Film and Ocular Surface Evaluation in Gestational Diabetes Mellitus.

BACKGROUND: Dry eye syndrome is one of the complaints of diabetic patients. The aim of the present study was to evaluate the tear functions in pregnant women with gestational diabetes mellitus (GDM) using tests: Schirmer, tear break-up time (TBUT), and tear film osmolarity (TFO) tests and the Ocular Surface Disease Index score (OSDI). METHODS: Pregnant women with GDM (Group 1, n=46) and healthy pregnant women (Group 2, n=36) were enrolled. Initially, all participants were asked to answer the OSDI and then they underwent a detailed ophthalmic examination including Schirmer, TBUT, and TFO tests. The individuals with ocular or systemic disorders that might affect the tear function tests and who were using topical medications were excluded. RESULTS: The results of Schirmer, TBUT, TFO tests and OSDI scores were 11.20±4.93 mm, 5.59±2.16 sec, 309.65±14.80 mOsm/L, and 9.59 ± 9.69 in Group 1, respectively, and 12.33±5.33 mm, 5.67±2.68 sec, 308.36±16.00 mOsm/L, and 10.62±8.66 in Group 2, respectively. There was no significant difference in any of the tear function tests and OSDI scores between the study groups (p>0.05). CONCLUSION: GDM seems to have no negative effects on tear function tests. This may be due to a lack of duration of hyperglycemia long enough to affect the tear function tests of pregnant women.

Capillary telangiectasia of the brain: imaging with various magnetic resonance techniques.

Brain capillary telangiectasia is an incidental vascular malformation found usually in pons and sometimes in extra- pontine sites. Typical MRI features are enhancement on post contrast T1 weighted images and signal loss on gradient echo images. We evaluated 10 patients with various MR techniques. Susceptibility weighted imaging was superior to GRE T2 in showing decreased signal due to susceptibility effects. Diffusion weighted imaging and diffusion tensor imaging proved not useful in the diagnosis.

A novel missense mutation (N78D) in a family with von Hippel-Lindau disease with central nervous system haemangioblastomas, pancreatic and renal cysts.

von Hippel-Lindau (VHL) disease is a hereditary tumor syndrome caused by mutations in the VHL tumor suppressor gene. In a family with VHL, we identified a novel missense mutation (N78D), which affects a fully conserved residue in the VHL protein. Interestingly, several other missense mutations reported at same codon in the VHL protein that might be associated with a low risk of renal cell carcinoma (RCC) but not pheochromocytoma appear to be associated with a VHL type 1 phenotype. At the moment, RCC is present in none of the affected mutation carriers in the family described here. In contrast to other missense changes at codon 78, the change in our VHL family is predicted to have a mild effect on VHL function, which apparently is insufficient to cause predisposition to RCC. Our findings suggest that the risk of RCC in VHL is attributable to the severity of the amino acid substitution at this particular codon in the VHL protein.

Desmoplastic fibroma in humerus.

Desmoplastic fibroma of the bone is a very rare benign tumour, which may be locally aggressive. We report X-ray radiographic and MRI findings of a case of desmoplastic fibroma of the humerus in a 33-year-old man who presented with a slowly enlarging arm mass over years. Desmoid fibroma should be taken into consideration in case of a low T2 signal in a non-sclerotic fibroosseous lesion.

Pyo-pneumothorax in patients with active pulmonary tuberculosis: an analysis of 17 cases without intrapleural fibrinolytic treatment.

OBJECTIVE: To review the medical records of patients with active pulmonary tuberculosis (TB) and pyo-pneumothorax (PPT). SUBJECTS AND METHODS: Medical records of 17 patients (14 male, 3 female, mean age 23.8 years, range 20-52) with PPT and active pulmonary tuberculosis at Gulhane Military Medical Academia Haydarpasa Training Hospital, Istanbul, Turkey, were reviewed from January 1998 to December 2002. The patients were treated with chest tube drainage and chemotherapy. Intrapleural fibrinolytic agents or irrigation was not performed. RESULTS: Pleural fluid samples were available in 14 patients and the mean levels of LDH, protein and glucose in the pleural fluid were 1,767 +/- 944 U/l, 5.2 +/- 1.4 g/dl and 31.7 +/- 22.6 mg/dl, respectively. Mycobacterium tuberculosis was detected in the pleural effusion of 3 patients. The duration of chest tube drainage was longer in cases who underwent open drainage (p = 0.014). At the end of the treatment period 10 patients developed pleural thickening, 4 of them underwent decortication and pneumonectomy was also done in 1 patient. The development of pleural thickening was related to the level of pleural fluid glucose (p = 0.04). CONCLUSION: This study shows that while taking care of patients with pulmonary TB the physician must be aware of the complication of PPT and that adequate chemotherapy and drainage must be duly performed.

Isolated interrupted inferior vena cava with azygos continuation mimicking paraesophageal lymph node enlargement.

We report a case of interrupted inferior vena cava with azygos continuation diagnosed as a isolated finding in a patient with lung carcinoma. Findings of the unopacified CT scan initially simulated a paraesophageal lymphadenopathy. The contrast-enhanced spiral CT scan showed a dilated azygos vein in the absence of definable inferior vena cava.

van der Knaap's leukoencephalopathy: report of five new cases with emphasis on diffusion-weighted MRI findings.

We present five new cases of van der Knaap's leukoencephalopathy, which is a rare abnormality characterized by infantile-onset white matter disease with swelling and mild clinical course. Based on the very rare histopathological data, this disease is considered a vacuolating myelinopathy with peripherally located intralamellar vacuoli. Although approximately 70 cases have so far been published, there are very limited data in the literature regarding diffusion-weighted imaging (DWI) findings of this recently discovered entity. In this paper, in addition to MRI, MRS and DWI findings in three patients are shown, apparent diffusion coefficient (ADC) maps are calculated, and ADC measurements made from various regions of interest are documented. MRI showed diffuse swelling and areas of T2 high signal in supratentorial white matter, sparing the cortex and central gray matter structures. MRS findings indicated some degree of neuronal loss. DWI and ADC maps showed increased diffusion rates, suggesting a different type of tissue damage than that would be expected in vacuolating myelinopathies. We believe that DWI and ADC mapping would be of help in providing a baseline for monitoring the progression of the disease.