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31.
BACKGROUND: Hydatid disease remains a serious health problem in Mediterranean areas. We reviewed the efficacy of a single-stage
operation in coexisting cysts of lung and liver in patients. METHODS: Forty-one patients operated for the cysts located on
the dome of the liver and right lung with one-stage surgical approach on between 1990 and 2010. There were 19 males (46%)
and 22 females (54%) patients. The age range was 10–82 years, with a median age of 34 years. RESULTS: All patients had simultaneous
operations for both organs via right thoracotomy and phrenotomy except one patient. Surgical techniques used in the lung were
cystotomy and capitonnage, with wedge resection of the destroyed lung parenchyma in three (7.3%) and additional decortication
in three (7.3%). Cystotomy was applied with membrane removal in the liver cysts. Postoperative complications were prolonged
biliary drainage, empyema, prolonged air leak, pleural effusion in one case (2.4%) each, respectively. All patients managed
successfully and discharged. No hospital mortality occurred. CONCLUSIONS: We propose that concomitant right pulmonary and
liver dome hydatid cysts can be treated effectively and safely in a one-stage operation through a right posterolateral thoracotomy
and phrenotomy. 相似文献
32.
Gul K Nas S Ozdemir D Gumus M Ersoy R Cakir B 《The American journal of the medical sciences》2011,341(1):28-32
IntroductionThe aim of this study is to compare CA 19-9 levels in patients with type 2 diabetes mellitus (DM) and healthy control group. The relation of CA 19-9 levels to metabolic control and microvascular complications in patients with diabetes was also investigated.MethodsThree hundred forty patients with type 2 DM and age-, sex- and body mass index-matched 214 healthy controls group were included in the study. HbA1c, duration of DM and microvascular complications of DM were reviewed. CA 19-9 levels (normal range, 0–35 U/mL) were measured in all participants.ResultsMedian CA 19-9 level was significantly higher in patients with diabetes compared with control group [19.5 U/mL (0–214.8 U/mL) versus 7.4 U/mL (0.4–47.0 U/mL)] (P < 0.001). Prevalence of high CA 19-9 levels in patients with diabetes was 31.2%, and CA 19-9 level was positively correlated with age, duration of diabetes, HbA1c and number of complications. Effects of duration of diabetes, HbA1c and diabetic nephropathy were still continuing in multiple linear regression analysis. Using regression coefficients of all variables in multiple regression analysis, this study tried to determine a new cutoff value for CA 19-9 level in patients with diabetes. The cutoff value at 97th percentile was 57.14 U/mL.ConclusionsHigh CA 19-9 value in patients with diabetes may indicate the need for a careful evaluation of blood glucose regulation and investigation of complications. Defining a new cutoff value in these patients would prevent unnecessary laboratory or imaging procedures. 相似文献
33.
Midgley JP El-Kares R Mathieu F Goodyer P 《Pediatric nephrology (Berlin, Germany)》2011,26(8):1335-1337
Cystinosis is a rare autosomal recessive disease caused by mutations of the CTNS gene in which cystine accumulates throughout
the body as a result of a defective efflux of cystine from lysosomes. Three phenotypic forms have been described according
to the age of onset and the severity of the clinical symptoms: infantile, intermediate, and ocular non-nephropathic cystinosis.
Here we report the natural history of cystinosis in a 55-year-old man with intermediate nephropathic cystinosis diagnosed
at 9 years of age. Although tubulopathy was unnoticed in the early years, he required transplantation at age 16. Sequencing
analysis of all the CTNS exons revealed that the proband is homozygous for a 21-bp in-frame deletion in exon 5 (c. 198_218del21),
resulting in an in-frame deletion of 7 amino acids from the N-terminal domain of the cystinosin protein. Our patient has had
relatively mild extra-renal disease despite lack of early cysteamine therapy. He has been able to attend university and pursue
a professional career into the 6th decade. 相似文献
34.
Abstract The objective was to determine the level of knowledge on diabetes in an adult population in Turkey. In this cross-sectional
study, 524 people aged over 30 were selected from the population of Narlıdere Health District, Izmir, Turkey. A questionnaire
was performed to determine sociodemographic characteristics and knowledge of diabetes. Each item on the questionnaire was
given a score with a possible final total of 100 points. Knowledge level was evaluated in the whole group, DM-positive and
-negative groups. “DM-positive” group refers to respondents who either have diabetes themselves or whose relatives have it.
“DM-negative” group refers to respondents who do not have diabetes themselves and whose relatives do not. In total, 479 people
were included in the study (response rate=87.6%). The mean age of the study group was 50.2±12.8 and 61% of them were women.
Mean diabetes knowledge scores were 62.9±17.9 for the study group, 68.3±16.1 for the “DM-positive” group and 60.6±18.2 for
the “DM-negative” group. The “DM-negative” group had a significantly lower mean score than the other two groups. Overall,
diabetes knowledge was higher in participants with diabetes or who had a relative with diabetes, who were educated for more
than 5 years and who had health insurance. The diabetes knowledge of the study group was not satisfactory. Diabetics and people
who have relatives with diabetes had a higher knowledge level than the population without diabetes. Detailed information regarding
diabetes should be provided to not only diabetics, but also the population as a whole. 相似文献
35.
Hemophilia is a coagulation disorder characterized by acute hemorrhages into the musculoskeletal system, leading eventually to arthropathy and disability. We investigated the functional loss, namely disability, in hemophiliacs. The clinical and radiological characteristics of joint involvement were also evaluated. There were 31 patients between the ages of 3 and 18 years and 65 involved joints. The knees were the most commonly affected joints followed by the elbows and ankles. There was a positive correlation between the radiological and clinical evaluation scores; however, the clinical evaluation score did not correlate with age. The radiological score increased in conjunction with increasing age of the patients. We observed a significant relationship between the disability score and the clinical evaluation and radiological scores. These observations suggest that hemophilia is a life-long condition, with a high potential for functional disability if not promptly and adequately controlled. The main principle in the treatment of hemophilic arthropathy is the restoration of the patient’s lifestyle and mobility with a comprehensive multidisciplinary approach. 相似文献
36.
ABSTRACT The purpose of this study is to determine if a significant relationship exists between the sociodemographics, substance use characteristics, criminal history, and completion of substance abuse treatment. In this study, 115 individuals being monitored for substance abuse treatment on probation at the Probation and Help Center under the Republic of Turkey's Ministry of Justice's Chief Public Prosecutor's Office of Istanbul were included successively between the dates of April 2008 and April 2009. During a 24-week follow-up, individuals whose urine analyses were clean 6 times consecutively were considered to have completed the treatment successfully. To determine the effect of sociodemographic factors and substance use characteristics on treatment completion, a semistructured sociodemographic data survey was used. Also, the participants’ criminal records were examined. A total of 115 people participated in the study. One hundred ten (95.7%) of them were male. Sixty-eight (59.1%) of the participants had completed treatment. Age group, education level, age of onset for substance use, number of substances used, employment status, and criminal records showed a significant difference between treatment completers and noncompleters. When a logistic regression analysis was done, only number of substances used and criminal record (other than drug possession) were significantly different for the 2 groups. The current treatment program for polysubstance users and individuals with a criminal record is insufficient. It is necessary that treatment systems be developed so they can be beneficial for these types of patients. 相似文献
37.
Nurgül ?rnek Teoman Apan Reyhan O?urel Kemal ?rnek 《Indian journal of ophthalmology》2014,62(4):388-391
Purpose:
To conduct an in vitro experimental study comparing the effectiveness of conventional silicone oil and heavy silicone oil against endophthalmitis-causing agents.Materials and Methods:
The antimicrobial activity of conventional silicone oil (RS OIL 5000) and heavy silicone oil (heavySil 1500) was tested. The antimicrobial effects of both silicone oils were determined by the growing capability of the microorganism.Results:
The number of Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans decreased to zero levels at the second day of inoculation in heavy silicone oil. In conventional silicone oil, the microorganisms survived longer than in heavy silicone oil.Conclusion:
Heavy silicone oil seems to be more effective than conventional silicone oil against endophthalmitis-causing agents. 相似文献38.
Tulin Cagatay Zeki Kilicaslan Penbe Cagatay Munevver Mertsoylu Ziya Gulbaran Reyhan Yildiz Leyla Pur Sevil Kamali Ahmet Gul 《Rheumatology international》2011,31(9):1147-1151
Tumour necrosis factor-alpha (TNF-α) antagonist drugs have been associated with increased risk of tuberculosis (TB). Tuberculin
skin test (TST) is the most frequently used tool for identification of latent TB infection. We herein aimed to analyse the
effect of TNF-α antagonists on the TST responses in a prospective study. The study group consisted of 182 patients (99 female,
83 male) who received TNF-α antagonists for various rheumatic disorders. All patients were evaluated with TST along with other
parameters on the day of referral and on the 12th month visit. For those patients with a response of <5 mm induration at the
initial evaluation, the TST was repeated to observe the booster effect. Out of 182 patients, 87 patients (48%) had a negative
(0–4 mm) and 95 (52%) had a positive (≥5 mm) TST response at initial evaluation. The TST responses were converted from negative
at initial visit to positive at 1-year repeat in 26 (30%) patients. A significant increase was observed in the diameters of
TST that were repeated on the first year of TNF-α antagonist treatment (9.15 ± 0.55) compared to their initial diameters (6.60 ± 0.51)
(P < 0.001). Increased TST responses in patients receiving TNF-α antagonists may be associated with the restoration of suppressed
immune reactivity against TB antigens with the decreased disease activity. The meaning of TST conversion in the definition
of latent TB infection and the need for chemoprophylaxis in these patients remains to be answered by further studies. 相似文献
39.
Nikhil Yegya-Raman Meral Reyhan Sinae Kim Matthew P. Deek Ning Yue Wei Zou Jyoti Malhotra Joseph Aisner Salma K. Jabbour 《Practical radiation oncology》2019,9(1):e74-e82
Purpose
This study aimed to investigate the association between target volume margins and clinical outcomes for patients with inoperable non-small cell lung cancer (NSCLC) treated with concurrent chemoradiation therapy.Methods and materials
We reviewed the records of 82 patients with inoperable NSCLC treated between 2009 and 2016 with concurrent chemoradiation. All patients received positron emission tomography–based treatment planning, 4-dimensional computed tomography simulation to define an internal target volume, and daily cone beam computed tomography. We quantified variations in target volume margins with a margin deviation index (MDI), calculated as the percentage change in equivalent uniform dose between the original planning target volume (PTV) and a standard reference PTV 10 mm beyond the original gross tumor volume, consistent with the minimum margins mandated by recent NSCLC trials. Greater MDIs equated to smaller effective target volume margins. We dichotomized patients by the upper tercile MDI value (5.8%). Endpoints included time to locoregional progression and time to grade ≥ 3 radiation esophagitis (RE3) or radiation pneumonitis (RP3), modelled with the Fine-Gray method.Results
Median follow-up was 37.8 months (range, 5.9-58.1 months). Larger MDIs correlated with smaller clinical target volume (CTV) + PTV margins, larger gross tumor volumes, later treatment year, and intensity modulated radiation therapy use. The risk of locoregional progression did not differ for MDI ≥5.8% versus <5.8% (adjusted hazard ratio: 0.88; P = .76), but the risk of RE3 or RP3 was decreased for MDI ≥5.8% (adjusted hazard ratio: 0.27; P = .027). Patients with MDI ≥5.8% were treated with smaller CTV + PTV margins (median, 5.6 vs 8 mm; P < .0001) and a marginally lower volume of esophagus receiving ≥50 Gy (median, 31.1% vs 35.3%; P = .069).Conclusions
Smaller margins were used for larger tumors but were not associated with an increase in locoregional failures. Additional studies could clarify whether smaller margins, when used alongside modern radiation therapy techniques, decrease treatment-related toxicity for inoperable NSCLC. 相似文献40.
Demirci FY Küçükkaya R Akarçay K Kir N Atamer T Demirci H Ongör E 《International ophthalmology》1998,22(6):323-329
The purpose of this study is to evaluate the ocular findings in patients with the primary antiphospholipid syndrome (APS).
Patients and methods: Twenty-two patients (44 eyes) with primary APS (17 women, 5 men) were examined. All patients were younger than 50 years (median
age; 37.5 years). In 18 patients, fundus flourescein angiography was performed in addition to the ophthalmologic examination.
Results: Sixteen patients (72.7%) described visual symptoms. Anterior segment was normal in 19 patients (86.4%). Posterior segment
abnormalities were observed in 15 patients (68.2%). Venous dilatation and tortuosity were the most common ocular findings.
Retinal vascular occlusive disease was detected in 5 patients (22.7%). Flourescein angiography abnormalities were noted in
14 of the 18 patients (77.8%). The most common angiographic finding was pigment epithelial window defects. Conclusions: Our results
indicate that posterior eye segment involvement is relatively common in the primary APS. It also seems that the screening
for APS is important in young patients with retinal vascular occlusion, especially in those without conventional risk factors.
This revised version was published online in July 2006 with corrections to the Cover Date. 相似文献