Latex allergy in Bozyaka Social Security Hospital workers, Turkey

Latex glove used in healthcare settings has risen dramatically since around 1987. The increased threat of contracting HIV, hepatitis B, and other infectious agents during the course of delivering health care to patients has created the need for barrier protection. 1 Studies have estimated that the prevalence of latex allergy in healthcare workers ranged from 2.9% up to 17%.2     

Graves' disease in a renal transplant

The occurrence of hyperthyroidism and/or Graves' disease (GD) in transplant recipients receiving immunosuppressive therapy is extremely rare. A 47-year-old man developed GD after renal transplantation while he was under adequate immunosuppressive therapy. To our knowledge, the case presented here is the second case report of GD developed in a renal transplant recipient under adequate immunosuppressive therapy. The patient had undergone a renal transplantation 2 years before, and since then, he had been receiving continuous immunosuppressive therapy with cyclosporine A and prednisone. He presented with 3 months' history of palpitation, excessive sweating, weakness, heat intolerance and weight loss. Thyroid ultrasonography and scan revealed diffusely enlarged thyroid gland without nodules. The finding of elevated serum levels of thyroid hormones and suppressed TSH level subsequently confirmed hyperthyroidism. A diagnosis of GD was made after the demonstration of elevated thyroid autoantibodies. Although the mechanisms involved in transplant rejection and human autoimmunity are thought to be similar, the development of GD in a patient receiving therapeutic immunosupression suggests that different immunologic processes may be involved in GD. Further studies seem to be needed since the pathogenetic mechanisms suggested in the literature so far are not satisfactory to explain the development of GD in transplant patients under adequate immunosuppressive therapy.     

Sex workers and the issues surrounding registration in Turkey

Awareness of the activities of commercial sex workers can be an important step toward understanding the transmission of sexually transmitted infections (STIs) in developing countries. This study discusses how sex workers are viewed in Turkey and the process of mandatory registration. To support the information provided and the conclusions drawn, a sample of 150 sex workers who made regular visits to a STI hospital was interviewed. Information on socio-demographic characteristics, family and support information and certain risk behaviors were solicited. Recommendations for increasing preventive education are made, with considerations for increased attention and support for this group of individuals.     

Consequences of iodine deficiency and preventive measures

Iodine Deficiency Disorders (IDD) can be prevented by an adequate intake of iodine in the population. Monitoring and evaluation are the most important phases of an IDD control program. The consequences of iodine deficiency are goiter and subclinical/clinical hypothyroidism in pregnancy. The deficiency is an important risk factor for brain damage and motor-mental development in the fetus, the neonate and in the child. In order to assess IDD, control programs should be developed, followed up and evaluated. The recommended methods of assessing status are; assessment of the goiter rate, measurement of urinary iodine concentration, determination of thyroid hormone levels and of thyroglobulin. Although adequate technology exists, elimination programs for IDD have not been successful until recent years. The most important issue at present is the long-term sustainability of salt iodization programmes. Alternative strategies are also needed for iodization in areas where iodized salt will not be available in the foreseeable future.     

A new technique for superior hypogastric plexus block: the posteromedian transdiscal approach

Superior hypogastric plexus block has been advocated for the treatment of cancer related pelvic pain. Neurolysis is usually established using the classical posterolateral approach in the prone position, in which correct placement of the needle is sometimes difficult due to vertebral anatomy and the patient's inability to lie prone. We describe an alternative posteromedian transdiscal approach under fluoroscopic guidance for the treatment of intractable pelvic pain in three patients, in whom the classical approach was not possible. The L5-S1 interdiscal space was identified with fluoroscopy. The needle was then introduced through the disc and advanced under lateral fluoroscopic control. After verifying correct needle placement, neurolysis was performed with 8 ml of 10% phenol solution. All patients had significant pain relief immediately after the block, lasting from 6 to 12 months, and their pain severity scores and opioid consumption were reduced by more than 50%. There were no complications such as discitis, disc rupture or nerve injury. Since this new posteromedian transdiscal approach provides easy access to the superior hypogastric plexus with a single puncture and with any patient position, it may be an alternative to the classical approach.     

Miliary osteoma cutis of the face: treatment with the needle microincision-extirpation method

Multiple miliary osteoma cutis of the face represents primary extra-skeletal bone formation that arises within the skin of the face. Multiple miliary osteoma cutis of the face is a rare complication of chronic inflammatory acne vulgaris and has invasive and non-invasive treatment alternatives different from acne vulgaris. Invasive techniques should be simple, easy, and inexpensive, with minimal risk of scarring and pigmentation. We used a needle microincision-extirpation technique in a patient with multiple miliary osteoma cutis unresponsive to non-invasive treatment modalities. Skin overlying the papules was incised with a needle and then the calcificated papules were extirpated by using a small curettage device. Lesions were left to secondary healing. Results were quite good and cosmetically acceptable.