Unrecognized depression in community-dwelling elderly persons in Istanbul

OBJECTIVE: Depression, one of the most prevalent psychiatric disorders, causes disability and reduces quality of life. Rates of clinical depression in community samples of older adults range between 1-16%. Most studies of old age depression have been conducted in developed countries. The present study was conducted to determine the prevalence of depressive disorders among Turkish elderly in an urban community. METHOD: This study was carried out in the Kadik?y district of Istanbul. The sample for the cross-sectional part of the study was 1067 individuals age 70 or older, randomly selected from population registries. Geriatric Depression Scale (GDS), Mini-mental State Examination (MMSE) scores and demographic data were obtained by face-to-face home interviews. The data were analyzed using regression analysis for each variable. RESULTS: The study group consisted of 623 (61%) females and 395 (39%) males. The mean age was 74.8 years, with 63% of subjects aged 70-74, 29% between 75-84 years old and 8% aged 85 and above. Sixteen percent (n = 163) of the total group scored 14 or higher on the GDS. Only 9% of the depressed group were on antidepressant medication. Logistic regression analysis indicated that significant predictors for higher scores GDS scores were: illiteracy, aged 75-79 yrs, female sex and having 4 or more children. CONCLUSION: Depression is a common but unrecognized and thus untreated problem among the elderly population in Turkey. While gender and age are unmodifiable, education level and multiparity can be altered. Education of caregivers and medical staff about old age depression may increase its rate of detection and facilitate improved treatment.     

Primary Burkitt's lymphoma only involving the chest wall at relapse in a child

Burkitt's lymphoma primarily originating from the soft tissue is a very rare neoplasm. A five-year-old boy was admitted with a mass on the lateral side of the right breast. Radiological examination revealed a mass, which had originated from the soft tissue of the chest wall without any contiguous pleural and lung parenchyma disease. Histopathology showed this to be Burkitt's lymphoma. To our knowledge, this case is the first instance of Burkitt's lymphoma presenting as an isolated chest wall mass which originated from the soft tissue.     

Increasing vessel diameter with the open Y technique for diameter discrepancy

Free tissue transfers have increasingly become the mainstay of plastic surgery for the last two decades. Size discrepancy between the vessels in microsurgery is frequently encountered in clinical practice and may potentially be an important factor in the patency of the anastomosis. A rat model has been devised to improve the diameter discrepancy in microvascular anastomosis. Twenty Wistar rats have been used for this purpose. The external jugular vein was cut 1 mm distally from the bifurcation of the anterior and posterior facial veins. Both legs of the resultant Y-shaped vessel were united after inserting microscissors from one leg and exiting from the other. Performing an end-to-end anastomosis between the vein, which acquired an increased diameter as a result of this procedure, and the carotid artery prepared in the neck, helped to create an arteriovenous shunt. Patency was assessed in the operated rats 2 weeks later. In order to achieve a better understanding of the advantages of this technique, another study was carried out. In this subsequent study, specimens were collected from fresh sheep cadavers, including the brachiocephalic trunk, right common carotid, and right subclavian arteries. Different specimens were compared from each of the vessels and also from each of the subclavian and carotid arteries after they were joined together with the open Y technique and increased diameters of the vessels are obtained. As a result, the authors demonstrated that size discrepancy between the vessels was decreased, patency with a percentage of 94.1 was obtained, and when specimens from the fresh cadavers were evaluated, a reasonable gain was achieved. (p < 0.0001).     

Secondary osteoporosis in women. A retrospective analysis

Secondary osteoporosis comprises a minority of all osteoporosis cases. In this study we summarize the causes of secondary osteoporosis we encountered in patients currently on follow-up in our osteoporosis outpatient clinic. A total of 1015 female patients are involved in the study. Recorded data of the patients are evaluated retrospectively. Patients with spine bone mineral density (BMD) 2.5 standard deviation below a reference range established using our own data obtained from a Turkish population of normal healthy women using dual energy X-ray absorptiometry (T score less than –2.5) were accepted as having osteoporosis. We detected osteoporosis in 384 (38%) of the female patients. A secondary cause for osteoporosis has been found in 33 (8.6%) of the 384 osteoporotic patients. Thyrotoxicosis (n=10), parathyroid adenoma (n=10), and glucocorticoid administration (n=7) constituted 82% of the causes of osteoporosis. The data obtained in our study indicate that appropriate search for secondary causes of osteoporosis is essential because different modalities are needed for treatment. Received: 3 May 2001 / Accepted: 11 June 2001     

DIURNAL INTRAOCULAR PRESSURE VARIATION IN PSEUDOEXFOLIATION SYNDROME

Purpose: To describe and compare the diurnal intraocular pressure (IOP) variation in patients with pseudoexfoliation syndrome (PXS) and normal subjects. Methods: We prospectively investigated 20 PXS patients (11 bilateral and 9 unilateral) and age and sex matched 25 normal subjects. Both eyes of the bilat-     

Marine-Lenhart syndrome

Graves'' disease and toxic nodular goiter both cause thyrotoxicosis by different pathophysiological mechanisms. Cases with both etiologies have the diagnosis of Marine-Lenhart syndrome. Such a case is presented in this paper.     

A case of pneumocephalus and meningitis as a complication of silent otitis media

Silent otitis media is a progressive otogenic disease. Intracranial manifestations of this complication are limited; the most common is meningitis. We report a case of meningitis and pneumocephalus as a complication of silent otitis media. To the best of our knowledge, this is the first reported case of pneumocephalus as a complication of silent otitis media.     

Toxic epidermal necrolysis treated with intravenous immunoglobulin and granulocyte colony-stimulating factor

We report a case of toxic epidermal necrolysis who was successfully treated with intravenous immunoglobin and granulocyte colony-stimulating factor. He had poor prognostic factors such as extensive epidermal loss, neutropenia, acute respiratory distress syndrome and candida sepsis, but nonetheless made a complete recovery.