Fatal panresistant Lomentospora prolificans fungemia in a patient with aplastic anemia: First report from Türkiye.

Lomentospora prolificans is an opportunistic pathogen that can cause invasive lomentosporiosis in immunocompromised patients. Patients with hematological malignancies and those who have undergone stem cell or solid organ transplantations are in the highest risk group. In addition to the limitations and delays in diagnostic possibilities, L. prolificans has a high mortality due to its resistance to all available antifungal drugs. In a patient diagnosed with aplastic anemia, we described the first case of L. prolificans in Türkiye. L. prolificans was identified in the blood culture, and despite the initiation of antifungal treatments, the fungemia resulted in mortality on the 7th day of intensive care hospitalization. This case highlights the importance of early recognition and prompt initiation of appropriate antifungal therapy to improve the outcome of patients with rare mold infections.

Low levels of serum vitamin D3 are associated with fibromyalgia syndrome in pre-menopausal women: A pilot study.

OBJECTIVES: This study aims to investigate the prevalence of fibromyalgia syndrome (FMS) among patients with low and adequate vitamin D levels in premenopausal women. PATIENTS AND METHODS: Between October 2012 and April 2013, a total of 80 premenopausal patients (mean age 38.1±7.1 years; range, 18 to 50 years) with non-specific musculoskeletal symptoms were included in the study. The determination of 25-hydroxyvitamin D3 (25(OH)D3) deficiency was based on a reference value of 25 ng/mL. Patients with deficient serum 25(OH)D3 levels (<25 ng/mL, n=40) comprised the patient group, while those with adequate serum 25(OH)D3 levels (≥25 ng/mL, n=40) comprised the control group. Data including demographic characteristics, laboratory parameters (i.e., calcium, phosphorus, alkaline phosphatase [ALP], and parathyroid hormone [PTH]), and clinical findings (i.e., proximal muscle weakness [PMW] and periarticular sensitivity [PAS]) were recorded and compared between the groups. Pain severity was evaluated using the visual analog scale (VAS), psychological status was evaluated using the Beck Depression Inventory (BDI), and quality of life (QoL) was evaluated using the Short Form 36 (SF-36). The diagnosis of FMS was made based on the 2010 criteria of the American College of Rheumatology. RESULTS: Although there were no statistically significant differences in the demographic characteristics between the groups, ALP and PTH levels were higher in the patient group (p<0.05). The VAS, frequency of FMS, PMW, and PAS were also significantly higher in the patient group (p<0.05). Depression and the mental and physical component scores of the SF-36 did not significantly differ between the two groups (p<0.05). CONCLUSION: Our study results suggest that patients with low 25(OH)D3 levels may more frequently experience FMS and pain than healthy individuals.

Comparison of the efficacy of dry needling and trigger point injections with exercise in temporomandibular myofascial pain treatment.

OBJECTIVES: We aimed to compare the efficacy of dry needling, trigger point injection, and protection methods through physical exercise on clinical symptoms and the pain threshold in patients with temporomandibular myofascial pain. PATIENTS AND METHODS: Between March 2013 and September 2013, in a random consecutive manner, a total of 63 consecutive patients (10 males, 53 females; median age 39.4±14.9 years; range, 18 to 65 years) were randomly divided into three groups: Group 1 (only exercise and protection training), Group 2 (dry needling + exercise + protection training), and Group 3 (trigger point injection + exercise + protection training). Dry needling or trigger point injection was performed for three times to the patients in Group 2 and Group 3 on a weekly basis. All patients were followed on Day 10 and at one month. RESULTS: A statistically significant improvement in the assessment and response variables was found for all groups, particularly for pain and functional limitation status (p<0.001). All groups were similar in terms of the improvement degree (p<0.001). Although not statistically significant, the highest improvement in the facial pain was seen in Group 3 on Day 10 (p=0.235); however, on Day 30, no significant difference was observed. CONCLUSION: Our study results showed that improvement in the subjective and objective symptoms in all treatment groups. Particularly, only exercise therapy was found to be beneficial as invasive methods. We suggest that all these methods should be applied together to achieve long-term efficacy.

The effectiveness of extracorporeal shockwave treatment in subacromial impingement syndrome and its relation with acromion morphology.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of the extracorporeal shock wave therapy in the subacromial impingement syndrome and its relationship with the acromion morphology. METHODS: Thirty patients (24 women, 6 men) with subacromial impingement were evaluated. The average age of patients was 53.6 ± 9.8 years (range 39-80). Patients were divided into 3 groups according to the acromion morphology. ESWT 1500 at 0.12 am mL/mm2 violence was applied once a week for 3 weeks. Shoulder pain and disability index (SPADI) was used to assess function and pain scores of the patients. The evaluations were made prior to and 12 weeks after the ESWT. RESULTS: Thirteen shoulders had type 1 acromion, 11 shoulders type 2 acromion and 6 shoulders type 3 acromion. After ESWT, the SPADI pain score decreased from 16.1 ± 5.1 (7-25) to 10.4 ± 4.9 (1-20); SPADI functional score decreased from 37.3 ± 19.8 (5-70) to 26.7 ± 17.5 (1-60); SPADI total score decreased from 53.4 ± 24.5 (14-95) to 37.1 ± 21.6 (2-74) (p < 0.05; paired t test). In each group better functional outcomes were achieved after ESWT (p < 0.05; paired t test). There were no differences between the groups according to functional outcome both before and after the ESWT treatment (p > 0.05, one way ANOVA test). CONCLUSION: ESWT was found to be effective in the treatment of impingement syndrome both for pain and functional outcome in the early period regardless of acromion morphology. LEVEL OF EVIDENCE: Level IV, Therapeutic study.

Ultrasonographic Evaluation of Lower Extremity Entheseal Sites in Diabetic Patients Using Glasgow Ultrasound Enthesitis Scoring System Score.

OBJECTIVE: The prevalence of musculoskeletal complications in diabetes mellitus (DM) increases with the duration of disease and with poor glycemic control. Our aim was to evaluate lower extremity musculoskeletal complications in patients with DM using the Glasgow Ultrasound Enthesitis Scoring System, and to reveal the relationship between clinical and sono-graphic findings. MATERIALS AND METHODS: A total of 67 patients (25 men, 42 women) with DM were included in the study. All the diabetic patients were selected if they did not have any symptom of muscu-loskeletal system in the lower extremities. They were divided into four groups. Ultrasonographic assessment was performed according to the Glasgow Ultrasound Enthesitis Scoring System with an Esaote MyLab 5 device equipped with a 5-13 MHz linear transducer. Correlation between diabetes duration and lower extremity enthesopathy scores were evaluated. RESULTS: There was a significant correlation between duration of DM and total Glasgow Ultrasound Enthesitis Scoring System scores (p < 0.001). In addition, duration of DM was significantly correlated with enthesophyte scores and erosion scores (both p < 0.001). There was a significant difference among Groups 1 -4 for the mean enthesophyte score and mean erosion score (both, p < 0.001). CONCLUSION: Musculoskeletal ultrasonography is an effective, inexpensive, and useful tool without radiation for evaluating diabetic patients for the early diagnosis of musculoskeletal complications.

Effects of various sulphuring methods and storage temperatures on the physical and chemical quality of dried apricots.

The effects of different sulphuring methods, i.e. sulphuring by "burning the elemental sulphites (BES)," "SO2 gas from liquified SO2 tank (SG)" and "dipping into sodium metabisulphite solution (DSM)" on the colour (brown colour formation and carotenoid degradation) and the loss of SO2 in apricots from Hacihaliloglu and Kabaasi varieties stored at 5, 20 and 30 °C for a year were investigated. There were significant effects of variety, sulphuring method and especially storage at 30 °C on the brown colour formation and loss of SO2 (P<0.05). As storage temperature-time increased, ß-carotene content decreased. Sulphuring methods and variety did not show significant effect on ß-carotene content (P>0.05). The changes in L(*), b(*) and C(*) values were directly associated with ß-carotene content and browning values. The most suitable method for all samples, except for Hacihaliloglu variety stored at 30 °C (BES), is SG, because the samples retained their attractive golden yellow colour during storage.