The spectrum of diseases causing fever of unknown origin in Turkey: a multicenter study.

OBJECTIVE: The purpose of this trial was to determine the spectrum of diseases with fever of unknown origin (FUO) in Turkey. METHODS: A prospective multicenter study of 154 patients with FUO in twelve Turkish tertiary-care hospitals was conducted. RESULTS: The mean age of the patients was 42+/-17 years (range 17-75). Fifty-three (34.4%) had infectious diseases (ID), 47 (30.5%) had non-infectious inflammatory diseases (NIID), 22 (14.3%) had malignant diseases (MD), and eight (5.2%) had miscellaneous diseases (Mi). In 24 (15.6%) of the cases, the reason for high fever could not be determined despite intensive efforts. The most common ID etiologies were tuberculosis (13.6%) and cytomegalovirus (CMV) infection (3.2%). Adult Still's disease was the most common NIID (13.6%) and hematological malignancy was the most common MD (7.8%). In patients with NIID, the mean duration of reaching a definite diagnosis (37+/-23 days) was significantly longer compared to the patients with ID (25+/-12 days) (p=0.007). In patients with MD, the mean duration of fever (51+/-35 days) was longer compared to patients with ID (37+/-38 days) (p=0.052). CONCLUSIONS: Although infection remains the most common cause of FUO, with the highest percentage for tuberculosis, non-infectious etiologies seem to have increased when compared with previous studies.     

Are postoperative drains necessary with the limberg flap for treatment of pilonidal sinus?

PURPOSE: Different methods for managing pilonidal sinus have been described in the literature. Our purpose was to evaluate the influence of postoperative drainage in Limberg flaps. METHODS: Forty patients with pilonidal sinus undergoing radical excision and reconstruction with Limberg flap between 1994 and 1996 were evaluated prospectively. After patients were assigned randomly to the two groups, the effects of drains were studied statistically in terms of wound complications, hospital stay, and recurrence rate. RESULTS: Except for two minor transient wound dehiscences, in all cases primary healing was achieved. Early wound complication rate was 7.5 percent and recurrence rate was 2.5 percent for both groups. There was no significant difference between the groups in early wound complications (P>0.05). The length of hospital stay was significantly longer in the drainage group (P<0.001). CONCLUSION: We conclude that Limberg flaps with no drains in place will result in shorter hospital stays without deleteriously affecting the surgical results of wide excision and primary closure with well-vascularized tissue.     

Adolescents’ somatic complaints in eight countries: what influence do parental rearing styles have?

Medically unexplained physical symptoms are frequently named by adolescents in both clinical and normative samples. This study analyzed the associations between parental rearing styles and adolescents’ body complaints in diverse cultural contexts. In a cross-cultural study of 2415 adolescents from eight countries (Argentina, France, Germany, Greece, Pakistan, Peru, Poland, and Turkey), the associations of maternal and paternal support, psychological control, and an anxious parental monitoring style with youth body complaints were tested. Girls reported more somatic complaints than boys, the level of complaints differed between countries, and gender differences varied significantly between countries. Hierarchic multilevel models revealed that the expression of distress via body complaints, after controlling for country, gender, and sociodemographic status, was significantly associated with parental rearing styles. The negative impact of mothers’ psychological control on body complaints generalize across countries. In addition, mothers’ anxious monitoring had a negative impact on the offspring’s health, whereas higher levels of paternal support and lower levels of paternal psychological control contributed to lower levels of somatic complaints. Sociodemographic variables such as family structure, standard of living, and employment status of the parents, did not turn out as significant in the final model. The findings point to the different roles of fathers and mothers play in adolescents’ health and their complex interplay.

     

Prognostic significance of 68Ga-Pentixafor PET/CT in multiple myeloma recurrence: a comparison to 18F-FDG PET/CT and laboratory results

Annals of Nuclear Medicine - This study investigates the prognostic value of 68Ga-Pentixafor PET/CT using PET-derived quantitative in multiple myeloma (MM) patients with suspected recurrence in...     

Evaluation of Estrogen,Progesterone, and GCDFP-15 Expression in Uterine Leiomyomas

Approximately, one fourth of women have leiomyomas. Leiomyomas are benign tumors that originated from smooth muscle cells. Estrogen is claimed to relate as a cause but exact mechanism has not fully understood. In this study, 95 leiomyoma cases that have been diagnosed by our department in years between 2010 and 2012 were examined. Age ranges of patients, sizes, locations, and numbers of leiomyomas were identified. Immunohistochemically ER (estrogen), PR (progesterone), and Gross cystic disease fluid protein-15 stains were performed to the paraffin blocks and their percentages of staining were noted. Statistically, submucosal and intramural locations were significantly related to ER and PR (p < 0,001). There were significant relationship between ER and PR in 30–50 years age group (p < 0,001). There were significant relationship between ER, PR and locations (p < 0,001), numbers (p < 0,001), sizes of leiomyomas (below 5 cm; p < 0,001), (between 5 and 10 cm; p = 0,037), larger than 10 cm; p = 0,002). Consequently, relationship between leiomyoma and ER, PR were revealed in this study. Also, relationship between leiomyoma locations and patient ages were identified statistically. There was no immunoreactivity with GCDFP-15 in leiomyomas.     

Cytomegalovirus colitis in a patient with Behcet’s disease receiving tumor necrosis factor alpha inhibitory treatment

Anti-tumor necrosis factor alpha （TNF-α） inhibitors are effective in the treatment of various inflammatory rheumatic conditions. Increased risks of serious infections are the major issues concerning the long-term safety of these agents. We present a case of a young male Behcet’s patient whose disease was complicated by cytomegalovirus （CMV） colitis. Colitis started 10 d after the third Infliximab dose and responded to the cessation of TNF blocking treatment and administration of ganciclovir. Tumor necrosis factor alpha and interferon gamma act at several levels in combating viral infections.CMV infections should be kept in mind and included in the differential diagnosis of severe gastrointestinal symptoms in patients receiving anti-TNF agents.