Leyla Yilmaz Aydin

Echocardiographic manifestations of pandemic 2009 (H1N1) influenza a virus infection

UNLABELLED SUMMARY AIM: The prevalence of myocardial involvement in influenza infection ranges from 0% to 12% depending on the diagnostic criteria used to define myocarditis. Whether such an association holds for the novel influenza A strain, pandemic-2009-H1N1, remains unknown. The aim of this present study is to evaluate the cardiovascular manifestations of pandemic (H1N1) 2009 influenza A (pH1N1) by using standard echocardiography and tissue Doppler imaging (TDI). METHODS Twenty-eight young patients who had been hospitalized for at least 24 h due to an influenza-like illness and tested positive for pH1N1 by real-time polymerase chain reaction were included in the study. All patients underwent echocardiographic studies during the first 72 h of admission. Echocardiographic studies of thirty gender and age matched control subjects were performed and the results were compared. RESULTS Heart rate was significantly higher in patients infected with pH1N1 virus. Other clinical variables were similar between the two groups (p > 0.05). Echocardiographic variables were also similar except left ventricular end-systolic dimension, which was significantly increased in the patient group (P = 0.042). Left ventricular tissue Doppler assessment at mitral annulus showed that mean systolic velocities of pH1N1 infected patients and control group were statistically similar. However, early diastolic velocity was decreased and late diastolic velocity was increased in the patient group. Therefore early diastolic/late diastolic velocity ratio was significantly decreased in pH1N1 infected patients. Also, isovolumetric contraction time and isovolumetric relaxation time were prolonged and ejection time was significantly shortened in pH1N1 infected patients. As a result, global myocardial performance index was significantly higher in pH1N1 infected patients (p < 0.001). Right ventricular tissue Doppler assessment at tricuspid annulus showed similar results with the left ventricular measurements. CONCLUSION The results of the study suggest an association between hospitalized pH1N1 and subclinical cardiac dysfunction as measured by tissue Doppler echocardiography.

Relationship among expression of basic-fibroblast growth factor, MTDH/Astrocyte elevated gene-1, adenomatous polyposis coli, matrix metalloproteinase 9,and COX-2 markers with prognostic factors in prostate carcinomas

BACKGROUND The etiopathogenesis of prostate cancer (PC) is still not clear, but hormonal, genetic, and environmental factors are thought to play a role in the tumor pathogenesis. Astrocyte elevated gene-1(AEG-1) as a novel transmembrane protein is predominantly located in the perinuclear region and endoplasmic reticulum. It has been found that AEG-1 upregulation increases the invasive ability of glioma and prostate cancer. Basic fibroblast growth factor (bFGF), matrix metalloproteinase-9 (MMP-9), cyclooxygenases-2 (COX-2), and adenomatous polyposis coli (APC) are very important in tumor progression as well. MATERIALS AND METHODS This study included 97 radical prostatectomy specimens. IHC stains for bFGF, MMP-9, COX-2, APC, and AEG-1 were performed on the tissue microarray using standard procedures. For each patient, the age, Gleason score, tumor volume, lymphovascular invasion, lymph node metastasis, surgical margin, and the invasion of vesiculoseminalis areas were assessed. Analyses were performed using the statistical PASW (ver. 18). RESULTS Statistically significant positive relationships were found MMP-9 and COX-2 (r = 0.242 and P = 0.017), between MMP-9 and APC (r = 0.207 and P = 0.043), and between bFGF and AEG-1 (r = 0.295 and P = 0.004). However, the relationships between age and staining results and tumor volume and staining results were not found to be significant. Although a positive correlation was found between the Gleason score and tumor volume and the Gleason score and age (r = 0.415 and P = 0.0001; r = 0.246 and P = 0.015, respectively), we did not find a statistically significant relationship between other stains and other prognostic parameters (lymphovascular invasion, lymph node metastasis, surgical margin, or vesiculoseminalis invasion). CONCLUSION The relationships we found between MMP-9 and COX-2, between MMP-9, and APC and between bFGF and AEG-1 as independent prognostic parameters could be helpful in the development of new therapeutic procedures.

An unusual presentation of bee sting: subarachnoid hemorrhagia.

A person consists of a variety of immune reactions as a result of bee stings, depending on his/her immunologic structure. A 49-year-old male patient was brought to the emergency department because of generalized tonic clonic seizure and loss of consciousness after an hour of wild bee bite from the anterior abdomen in a rural area. After cardiopulmonary resuscitation, he was admitted to intensive care unit. Although cranial computed tomography taken in the emergency department was normal, control cranial computed tomography at the 36th hour after admission was consisted with subarachnoid hemorrhagia (SAH). The patient was diagnosed as SAH due to exposure to bee stings. The patient was treated for a month in an intensive care unit and discharged in a vegetative state. We present and discuss the case that had epileptic seizures and SAH after a bee bite, with the review of the literature.

The benefit of expiratory-phase quantitative CT densitometry in the early diagnosis of chronic obstructive pulmonary disease.

PURPOSE We aimed to compare the inspiratory and expiratory quantitative computed tomography (CT) densitometric data of healthy volunteers, individuals with chronic obstructive pulmonary disease (COPD) risk, and COPD patients to aid in the early diagnosis of COPD. MATERIALS AND METHODS Of the study patients, 14 were healthy volunteers (Group I), 12 were patients at risk for COPD (Group II), and 13 were COPD patients (Group III). The high-resolution CT was performed at three levels (the upper, middle, and lower parts of the lungs). All images were evaluated with a specific program for the segmentation of pulmonary parenchyma. The mean lung density (MLD) was measured, and the emphysema index (EI) was calculated using this program. RESULTS Both MLD values and calculated EI ratios showed significant differences between Groups I and III, and Groups II and III in both expiratory and inspiratory phases (P < 0.05). However, in the comparison of healthy volunteers and patients at risk for COPD (Group I and II), only expiratory-phase MLD values showed statistically significant difference (P < 0.001). CONCLUSION In patients at risk for COPD, expiratory-phase MLD measurements can be used as an early diagnostic method.

Evaluation of smoking habits among Turkish family physicians

Smoking is still a major public health problem in Turkey. It was aimed to investigate smoking prevalence and habits among Turkish family physicians. Cross-sectional study among physicians working in primary care settings was established. A self-administered study survey was applied. The surveys of 1233 family physicians were analyzed. The study included 704 (57.1%) male and 529 (42.9%) female physicians. Mean age (SD) was 38.94 (7.01) years. The proportions of the current, the former and never smokers among family physicians were 34.1%, 14.7% and 51.3%, respectively. Mean age (SD) of smoking initiation was 21.73 (5.04) years. Mean duration (SD) of smoking use was 14.61 (7.29) years. Proportion of current smoker in male physicians was quite higher than in female counterparts (36.9% vs. 30.4%; p < 0.001). Mean age (SD) of smoking initiation in female was 21.42 (4.59) years, but in male was 22.33 (4.98) years (p = 0.36). In female physicians, mean age (SD) for quitting cigarette smoking was found higher than in male (35.85 (6.35) years vs. 33.09 (6.45) years; p = 0.004). No significant difference between nicotine dependence (mean score (SD) of 3.76 (2.48) vs. 3.65 (2.82); p > 0.05) and mean (SD) unit of cigarette a day (18.34(6.03) vs. 17.17 ± 6.79; p > 0.05) between genders was observed. The number of male physicians who started smoking before faculty was higher than female counterparts (15.5% vs. 8.6%; p = 0.023). In conclusion, the smoking prevalence among Turkish family physicians is considerably high.

Enerji içecekleri hakkında neler biliyoruz

Energy drinks are popular among young individuals and marketed to college students, athletes, and active individuals between the ages of 21 and 35 years. In the beginning consumption of energy drinks can significantly improve physical and mental performance. Energy drinks contain a mixture of compounds, of which caffeine, guarana, and herbal supplements such as ginkgo and ginseng are major components. Unfortunately, the body of literature is limited and it is not known whether these improvements are due to the caffeine other herbal ingredients. Severe clinical manifestations may occur after use of energy drinks with alcohol The aim of this article is rising awareness about the ingredients of energy drinks and clinical manifestations that may occur after usage and update about knowledge. OZET

An unusual cause of recurrent spontaneous pneumothorax: the Mounier-Kuhn syndrome

We present a case of 63-year-old man who was referred to the emergency department with a right-sided pneumothorax. He had a history of spontaneous pneumothorax for 2 times. The chest computed tomographic scan showed tracheobronchomegaly with an increase in the diameter of the trachea and right and left main bronchus. Fiberoptic bronchoscopy revealed enlarged trachea and both main bronchus with diverticulas. These findings are consistent with a diagnosis of Mounier-Kuhn syndrome. Mounier-Kuhn syndrome is a rare clinical and radiologic condition. It is characterized by a tracheal and bronchial dilation. Diagnosis is made by computed tomography and bronchoscopy. Mounier-Kuhn syndrome should be kept in mind in the differential diagnosis of recurrent spontaneous pneumothorax.

Ani Kardiyak Arrestle Başvuran Konjenital Uzun QT Sendromu

Amac: Bu calismanin amaci high-grade displazi (HGD) ve invaziv kanser ( “ilerlemis patoloji (IP)” olarak tanimlanmistir) ile iliskili multipl hasta ve adenom karakterlerini degerlendirmektir. Materyal ve Metod: Toplam 6250 islem sonunda 894 hastada 1379 (% 22.06) polip mevcuttur. Biz patoloji sonuclarina ulasabildigimiz 914 polipi degerlendirmeye aldik. Bulgular: 914 polipte toplam 699 adenom tespit edildi. A total of 699 adenomas were detected from 914 polyps. Sag kolon yerlesimli poliplerde sola gore daha yuksek oranda IP ozellikleri bulundu (% 18.5 vs % 7.1 p: 0.002). Lojistik regresyon analizi sonucunda; erkek cinsiyet, 2 cm’e esit ya da buyuk boyut, villoz histoloji ve non-dimunitif gorunum adenomlardaki IP ozellikleri icin bagimsiz risk faktorleri olarak bulundu. Sonuc: Calismamizda, diger calismalara benzer olarak, erkek cinsiyet, 2 cm’e esit ya da buyuk boyut, villoz histoloji ve non-dimunitif gorunum adenomlardaki IP ozellikleri icin bagimsiz risk faktorleri olarak bulundu. Fakat diger bircok calismanin aksine biz sag kolon yerlesimli poliplerde sol taraf yerlesimli poliplere gore daha yuksek oranda IP ozellikleri bulduk.The long QT syndrome (LQTS) is characterized with arrhythmic attacks, repeating syncopes,seizures, and ventricular arrhythmias leading to sudden death. Arrhythmias with a potential ofmortal course develop due to elongation of ventricular repolarization, either acquired or inborn.Herein the present paper, a case of congenital LQTS, admitted after a sudden cardiac arrest andtotally recovered with implantable cardiac defibrillator (ICD), was focused on