Comparison of demographic, clinic and radiological features of patients with axial spondyloarthritis accompanying familial Mediterranean fever to patients with each condition alone.

OBJECTIVE: To compare the demographic, clinical, and radiological features of patients with axial spondyloarthritis (axSpA) accompanying familial Mediterranean fever (FMF) to patients with each condition alone. METHOD: Hacettepe University Hospital database was screened regarding ICD-10 codes for FMF (E85.0) and axSpA (M45). The diagnosis of FMF was confirmed by Tel-Hashomer criteria, and axSpA by the presence of sacroiliitis according to the modified New York criteria or active sacroiliitis on magnetic resonance imaging. As control groups, 136 gender-matched, consequent FMF patients without axSpA and 102 consequent axSpA patients without FMF previously treated with any biological agents were included in the analysis. RESULTS: In patients with FMF + axSpA compared to the axSpA group, age at axSpA symptom onset and age at diagnosis were lower [median with interquartile range (IQR): 21 (17-30) vs 27 (21-37), p < 0.001; 23 (21-38) vs 32 (24-43) years, p = 0.001], moderate to severe hip disease and total hip replacement were more prevalent (23.4% vs 4.7%, p < 0.001; 11.2% vs 2.8%, p = 0.016). In patients with FMF + axSpA compared to the FMF group, age at FMF symptom onset and age at diagnosis were higher [13 (6-30) vs 11 (5-18), p = 0.057; 23 (13-33) vs 18 (10-31) years, p = 0.033] and amyloidosis was more prevalent (6.6% vs 2.2%, p = 0.076). Although the M694V variant (in one or two alleles) was more prevalent in the FMF + axSpA group, the difference was not statistically significant. CONCLUSION: In patients with FMF + axSpA, the age of onset of axSpA was significantly earlier, moderate to severe hip involvement and amyloidosis were more common than in patients with each condition alone.

Colonic Wall Thickening Reported in Abdominal CT: Does It Always Imply Malignancy?

AIM/BACKGROUND: Early diagnosis of patients with colon cancer is one of the most important parameters affecting the survival of patients. In this study, we aimed to examine the effect of the age, hemoglobin (Hb), albumin, neutrophil lymphocyte ratio (NLR), thrombocyte lymphocyte ratio (PLR), and mean platelet values (MPV) on the separation of benign and malignant diseases in patients with suspected colon wall thickness (CWT) observed in abdominal computed tomography (CT) examination. METHOD: The study included 116 patients between the ages of 18 and 95 who had CT examination where the colon wall could be evaluated and who also had colonoscopy. Patients suspected for CWT in CT with difficulties in differential diagnosis were divided into two groups according to colonoscopic-histopathological evaluations. Normal or benign pathological causes were included in the first group, while malignant causes constituted the second group. Whether the two groups differed in terms of CWT, Hb, age, albumin, NLR, PLR, and MPV values was investigated with descriptive statistics. RESULTS: One hundred and sixteen patients (74 males, 42 females) with CT examinations and colonoscopic sampling were included in the study. After colonoscopic and histopathological evaluations, there were 64 cases in the first group and 52 in the second group. According to the results of the univariate analysis and multivariate logistic regression, CWT, Hb, NLR, and MPV were identified to be independent variables for determining colon cancer. CONCLUSION: A combined evaluation of Hb, NLR, and MPV values in patients with CWT in abdominal CT examination may contribute to the separation of benign and malignant pathologies.

Conservative Management of Large Rectosigmoid Perforation under Peritoneal Reflection: Case Report and Review of the Literature.

Colonoscopy is accepted as the best method in diagnosis, treatment, and follow-up of colorectal diseases. As the amount of the usage of diagnostic and therapeutic colonoscopy rises, iatrogenic complications are more likely to be seen. The most important complications are perforations and bleeding. Whereas perforation is a complication that is seen rarely, because of the high ratio of morbidity and mortality, it should be analyzed more carefully. There is not a common view on the optimal treatment of colonoscopic perforation. Most cases require urgent surgery, and in some cases the iatrogenic perforation of colon can be managed by conservative methods. In this report, we present a rectosigmoid perforation under peritoneal reflection and conservative management of this case.

Mature cystic teratomas: relationship between histopathological contents and clinical features.

AIMS: The aim of this study was to evaluate the relationship between pathological findings and clinical features in patients with ovarian mature cystic teratomas (MCTs). MATERIALS AND METHODS: We reviewed and compared the demographic and clinical features of 32 patients confirmed pathologically as having MCT at a university hospital from 2009 to 2014, with MCT contents such as skin, hair, sebum, and cartilage. RESULTS: The mean age of the patients was 33.7 ± 13.4 years. The mean tumor diameter was 7.1 ± 3.3 cm (range: 2-15 cm). The mean serum CA-19.9 level was 37.5 ± 79.5 IU/ml and the mean serum CA-125 level was 29.1 ± 33.0 IU/ml. The postmenopausal and pregnancy status rates of participants were 18.8, and 15.6%, respectively. The mean age, postmenopausal and pregnancy status, tumor size, symptoms related to MCT and laterality of the tumor did not differ among the patients according to the MCT contents. CONCLUSIONS: Our findings suggest no relationship between the clinical features and histopathological contents of MCTs.

A case of bilateral carpal tunnel syndrome with palmaris longus and FDS anomalies.

We report a case of bilateral carpal tunnel syndrome due to two distinct muscular anomalies coexisting with trigger finger deformity. Many muscular anomalies in association with carpal tunnel syndrome have been described so far. But such a unique case of bilateral carpal tunnel syndrome with two different muscular anomalies, flexor digitorum superficialis anomaly on one side and palmaris longus anomaly on the other side has not been described. Even rare, muscular anomalies should be considered in the aetiology of carpal tunnel syndrome.

A comparison of the effects of Veau-Wardill-Kilner palatoplasty and furlow double-opposing Z-plasty operations on eustachian tube function.

OBJECTIVE: The purpose of this study was to compare the effects of Veau-Wardill-Kilner (VWK) two-flap palatoplasty and Furlow double-opposing Z-plasty operations on eustachian tube (ET) opening in patients with cleft palate (CP). DESIGN: Twenty-six patients underwent CP repair between 1993 and 1997. VWK and Furlow operations were used in 13 patients each. All patients were examined by the otorhinolaryngologist before and after the operations; mean follow-up time was 27.3 months. Secretory otitis media (SOM), as identified by tympanograms, was the comparison criterion used. RESULTS: The prevalence of SOM was 69% (n = 18) in all CP patients preoperatively. Among those with preoperative SOM, we did not find any statistically significant difference in the frequency of postoperative SOM between the two techniques. CONCLUSION: This study suggests that there is no difference in postoperative ET function between patients undergoing either VWK or Furlow operations, in spite of the differences in muscle positioning in these operations. We discuss the implications of this finding in relation to surgical anatomy and histology of the soft palate muscles.

[Reconstruction of the distal lower extremity defects with distal pedicled fasciocutaneous flaps]. / Die Wiederherstellung der distalen Unterschenkeldefekte mit distal gestielten fasziokutanen Lappen.

Soft-tissue coverage of defects in the distal lower extremity has its limitations because of minimal blood supply to the skin and the thin muscle layer. Split-thickness skin grafting is impossible in cases of defects of tendons or bones. Local flaps are applicable only for smaller defects. With the cross-leg flaps, it is necessary to immobilize the patient for a long time. Special microsurgical technique and knowledge are needed for the free flaps. Fasciocutaneous flaps of the lower extremity after Donski and Fodgestam are simpler and safer than the other methods. From 1987 to 1992, this method was successfully used on 15 patients in the Department of Plastic Surgery of Sisli Etfal Hospital in Istanbul. In the two-thirds of those patients, accidents were the cause of the defects. The advantages of this methods are: simpler technique, larger flap-surface, earlier mobilisation of patients, better adaptation of the flap to its neighbourhood regarding colour and thickness.

[Results of silastic prosthesis for the semilunar bone in semilunar malacia]. / Ergebnisse mit der Mondbeinsilastikprothese bei lunatummalazie.

In the hospital of Plastic surgery and Hand surgery in Eschweiler has been treated in the period from January 1980 to June 1983 23 patients with lunatomalacia. They were treated operatively by an interposition of a silastic prothesis by Swanson. A follow-up study was made on 21 out of 23 patients after a period of 6 to 46 months. The clinical and radiological examination has shown that 20 out of 21 patients were satisfied by the result.