Familial primary carpal tunnel syndrome with possible skipped generation

Carpal tunnel syndrome, an entrapment neuropathy of the median nerve, is rarely seen in childhood. Familial carpal tunnel syndrome, an even more exceptional entity, is frequently associated with inherited systemic disorders. Rarely it can be presented as a primary familial form with Mendelian autosomal dominant inheritance. We report the occurrence of carpal tunnel syndrome in two generations of a family in which the index case was a 6-year-old boy with bilateral hand pain and paresthesias. Our report demonstrates an interesting inheritance pattern of carpal tunnel syndrome in a family transmitted by an autosomal dominant gene with variable expressivity and reduced penetrance. To our knowledge, it is the first report of familial bilateral carpal tunnel syndrome in a family with possible skipped generation.     

Effects on mortality of changing trends in the management of burned children in Turkey: eight years' experience

This retrospective review of data from a single burn centre revealed a sharp decrease in the mortality associated with childhood burn. Between January 1998 and January 2006, 1035 children were admitted to our burn unit in Ankara. The overall mortality was 5.8%, falling from 23% between 1998 and 2000 to 5.6% between 2001 and 2005. Scalds were commonest among the younger and flame and electrical burns among the older children. Flame burns were associated with the largest burned body surface areas and highest mortality rates. Electrical burns remained a major health problem with significant amputation rates and lengths of hospital stay. Candidaemia was a mortal consequence of burn. Renovation of the unit with changes in the management of burn victims from conservative treatment to more up-to-date approaches were associated with improved outcomes.     

The effects of tramadol and fentanyl on gastrointestinal motility in septic rats

In this study, we investigated the effects of tramadol and fentanyl on gastrointestinal transit (GIT) during acute systemic inflammation in an experimental model of cecal ligation and perforation (CLP). One-hundred-twenty male Swiss-Albino rats were divided randomly into 6 groups: Group I = sham-operated + saline; Group II = sham-operated + fentanyl; Group III = sham-operated + tramadol; Group IV = CLP + saline; Group V = CLP + fentanyl; Group VI = CLP + tramadol. Suspension of charcoal was administered as an intragastric meal to measure the GIT. GIT% (mean +/- sd) were 46.1% +/- 9.8%, 43.2% +/- 9.8%, 45.9% +/- 10.2%, 33.2% +/- 9.2%, 24.9% +/- 4.1%, and 31.8% +/- 8.4% in Groups I, II, III, IV, V, and VI, respectively. GIT% was significantly less in Group V than in Groups I, II, III, and IV (P < 0.05). The Group VI mean value was significantly lower than those of Groups I, II, and III (P < 0.05) but not different from those of Groups IV and V (P > 0.05). The antitransit effect of fentanyl was shown to have increased in the experimental sepsis model, but no decrease in GIT was obtained with tramadol. This was thought to be the result of an associated endogenic opioid system activation and receptor upregulation in sepsis.     

Robot-assisted laparoscopic pectouteropexy: an alternative uterus-sparing technique for pelvic organ prolapse surgery

The aim of this video is to demonstrate the alternative technique of robot-assisted laparoscopic pectouteropexy for uterus preservation in obese patients with pelvic organ prolapse. We present the case report of a 44-year-old patient with apical pelvic organ prolapse. A pelvic examination was performed during a Valsalva maneuver in the dorsal lithotomy position and in the standing position, and the patient was diagnosed with stage III apical prolapse in accordance with the Pelvic Organ Prolapse Quantification system of the International Continence Society (POP-Q: Аа ?1, Ва 0, Вр 0, С +2). We performed the procedure, which was developed as an alternative to sacrocolpopexy or sacrouteropexy, as described by Banerjee and Noé (Arch Gynecol Obstet 284:24–28, 2011). Pectouteropexy is a new method for prolapse surgery that uses the lateral parts of the iliopectineal ligament for bilateral mesh fixation of the descended structures and provides strong apical support. We believe that robot-assisted laparoscopic pectouteropexy is a valuable alternative approach for uterus-preserving pelvic organ prolapse surgery owing to its better robot maneuverability, reduced operating time, and better visualization in obese patients.     

Uterine activity during sleep

REM-related increases in uterine activity were found in 10 healthy young adult volunteer subjects. Contraction baseline pressures were elevated compared with NREM sleep, stage 2 sleep, stages 3 and 4 slow wave sleep (SWS), and stage 0. Contraction amplitudes during REM sleep were greater than those during SWS and stage 0, while contraction rates differed only between REM sleep and SWS. The results strongly indicated a cycle of genital activity in women that parallels the penile erection cycle in men. The implications of this finding and suggestions for future research are discussed.     

Serum S100B levels in children with simple febrile seizures

PurposeRecent studies have found that S100B is a useful marker for astroglial activation seen in various neurologic disorders. The purpose of this study was to evaluate whether simple febrile seizures (SFS) was associated with an elevation in serum S100B levels.MethodsIn this study the samples consisted of 39 patients with SFS ranging from 6 to 36 months of age, and age-matched and sex-matched controls including 30 patients with fever and 30 healthy subjects. Two serum samples were obtained for S100B from the study group at 0–1 h and 6–24 h following seizure. Serum samples were drawn once in the control group. The serum samples were then analyzed using ELISA.ResultsIn the study group, the mean values of the serum S100B concentrations at 0–1 h and 6–24 h were 32.6 ± 7.8 pg/ml and 32.1 ± 5.8 pg/ml, respectively, while the concentrations were 32.1 ± 8.8 pg/ml and 29.5 ± 7.8 pg/ml in the control groups. No significant differences were detected in serum S100B levels at 0–1 h or 6–24 h in the study when compared to the control groups.ConclusionsThese results suggest that SFS do not raise serum S100B concentration above the normal range.     

Nursing diagnoses in elderly residents of a nursing home: a case in Turkey

There are limited studies on nursing diagnoses of the elderly living in nursing homes worldwide. This study aimed to define the most frequent nursing diagnoses in the elderly residents of a nursing home elder care and rehabilitation center. Seventy-four elderly individuals were included in the study. Data were collected using the “Elderly Individual’s Introduction Form” between April 2007 to August 2007. The content of the form was based on a guide to gerontologic assessment, and Gordon’s Functional Health Patterns. The nursing diagnoses (NANDA-I Taxonomy II) were identified by the 2 researchers separately according to the defining characteristics and the risk factors. The consistency between the nursing diagnoses defined by the 2 researchers was evaluated using Cohen’s kappa (κ). There was an 84.7% agreement about nursing diagnoses defined by the 2 researchers separately. The weighted kappa consistency analyses showed there was an adequate level of consistency (κ = 0.710), and the findings were significant (p < 0.0001). The most frequent diagnoses were ineffective role performance (86.5%), ineffective health maintenance (81.2%), risk for falls (77%), and impaired physical mobility (73%). The diagnosis of ineffective role performance was more frequent in patients with dementia (x² =10.993, df = 1, p = 0.001). There was a very significant relationship between dementia and the diagnosis of impaired verbal communication (x² = 32.718, df = 1, p = 0.0001). The relationship between mobility disorder and self-care deficit was also significant (x² = 19.411, df = 1, p = 0.0001). To improve quality in patient care, nurses should use nursing diagnoses with a systematic assessment and should help the elderly in health promotion or use of the maximum current potential.     

Upper and lower gastrointestinal endoscopical investigation in elderly patients with iron deficiency anaemia

Iron deficiency anaemia is frequently observed in male adults and postmenopausal women due to chronic occult bleeding, usually from the gastrointestinal tract. Practically, as endoscopical investigation of the gastrointestinal system is an invasive procedure, iron replacement treatment was generally started without investigation of the underlying aetiology even in first-line health institutions. This study evaluates the role of endoscopy in the investigation of the aetiology of anaemia in 95 patients (51 males, 44 females), aged 64.9+/-12.5 years (range 50-90 years). All patients having iron deficiency anaemia were investigated by upper gastrointestinal endoscopy and colonoscopy. Upper and lower gastrointestinal pathologies were seen in 10 (10.6%) and 55 (57.8%) patients, respectively. However, no gastrointestinal lesion was found in 30 (31.6%) patients with iron deficiency anaemia. Out of the 95 patients, 16 (16.9%) had erosive gastritis, 15 (15.8%) duodenal ulcer, 8 (8.4%) gastric ulcer, 7 (7.3%) gastric tumours, 7 (7.3%) oesophagitis. 5 (5.4%) colon tumours, 3 (3.2%) haemorrhoids, 2 (2.1%) non-tropical sprue, 1 (1%) colonic polyp, and 1 (1%) colitis. In the majority of elderly patients with iron deficiency anaemia, upper gastrointestinal system disease was found. In 12 (12.7%) patients in the study group, malignancies were detected. In elderly patients with iron deficiency anaemia, the aetiology should be highlighted before giving iron supplementation.