Tinea cruris in routine urology practice

INTRODUCTION: Tinea cruris is almost exclusively a male dermatophytosis. This infection is also sexually transmitted, and may cause epidemics in public areas such as common bathing facilities, dormitories and among military recruits. It has been aimed to investigate the prevalence and the causative agents of tinea cruris and tinea pedis in patients who were admitted to the Department of Urology with various pathologies. MATERIALS AND METHODS: Direct microscopy and cultures of the epithelial scrapings were performed to identify the causative agent in patients who were admitted to the Department of Urology. RESULTS: Out of a total of 155 cases examined, 39 (25.1%) were mycologically proven cases of dermatomycosis. In 11 (28.2%) of the patients tinea pedis, in 3 (7.7%) tinea cruris and in 10 (25.6%) Candida intertrigo were detected. In the remaining 15 (38.5%) cases, only direct microscopic examinations were found positive. The most common causative agent was Candida albicans (33.4%) followed by Trichophyton rubrum (29.1%), Trichophyton mentagrophytes var. interdigitale (29.1%), Candida glabrata (4.2%) and Candida tropicalis (4.2%). CONCLUSION: The investigation of genital dermatomycosis should be a part of routine urological examination and the clinical diagnosis should be confirmed by mycological methods.     

The sociodemographic findings, beliefs and behaviours of the patients admitted to Kocaeli University, Faculty of Medicine, Epilepsy Section.

Using a standard questionnaire, 121 consequent epileptic patients have been evaluated sociodemographically and according to their beliefs and behaviours about their illness. Monthly income per person was between 26 and 62.5 U.S. dollars (USD) for 3/4 of the patients. About half of the patients were concealing their illness. About one third of the patients' education was hindered because of their illness. When the patients who concealed their illness were compared with the ones who did not, it became clear that the education of the ones who did not conceal the illness was far more hindered. "Carrying an amulet" ratio was greater among the patients who had no social security when compared to the patients with social security. We concluded that prejudice against epileptic patients and superstitions in Turkish population are still valid. Physician should consider the expense of antiepileptics for both patients and the country when prescribing them. All parts of the society should be informed about epilepsy but this again depends on the country's budget.     

The influence of green coffee bean extract supplementation on blood glucose levels: A systematic review and dose–response meta‐analysis of randomized controlled trials

Studies regarding the influence of green coffee extract (GCE) on blood glucose levels are conflicting. Thus, we sought to conduct a meta‐analysis and systematic review of all available randomized controlled trials (RCTs) to quantify the effects of GCE and CGA intervention on blood glucose and insulin levels. We performed systematic online searches in Scopus, Web of science, and PubMed databases, from inception to July 2019. Data were combined analyzed using a random effects model (Der Simonian‐Laird method) and reported as weighted mean differences (WMD). Ten trials reported the influences of GCE on FBS and insulin and were subsequently entered into the meta‐analysis. Combined results highlighted that FBS was significantly altered after GCE consumption (WMD: ?1.791 mg/dl, 95% CI ?3.404, ?0.177), with no significant heterogeneity among the studies (I² = 35.0%, p = .128). However, overall results demonstrated that GCE administration did not result in any significant alteration in insulin levels (WMD: ?0.925 μU/ml, 95% CI:?1.915, 0.064), with significant heterogeneity found across studies (I² = 87.9%). In sub‐group analysis, insulin levels were significantly reduced when GCE was supplemented in dosages of ≥400 mg/day (WMD:?1.942 mg/dl, 95% CI:?1.184, ?0.975; I² = 0.0%). The results of present study support the use of GCE for the enhancement of blood glucose, while subgroup analysis highlighted significant improvements in insulin levels when GCE is supplemented in doses ≥400 mg/day.     

Haemolytic and co‐haemolytic (CAMP‐like) activity in dermatophytes

Dermatophytes are some of the most common fungal pathogens in both humans and animals. These fungi release enzymes (e.g., keratinases) that play roles in their pathogenesis. Little is known about their haemolytic and co‐haemolytic (CAMP‐like) activities; however, in bacteria, these components play significant roles in pathogenesis. This study characterised these two factors in 45 dermatophyte strains (representing the genera Arthroderma, Epidermophyton, Microsporum and Trichophyton) using Columbia agar (CA) supplemented with 5% bovine, ovine and equine erythrocytes. Haemolysis was best observed on CA supplemented with ovine erythrocytes followed by equine and bovine erythrocytes, while CAMP‐like reactions occurred using bovine and ovine but not equine erythrocytes. Haemolytic and CAMP‐like activities were best observed using ovine and bovine erythrocytes in CA in 44 and 38 strains at 7 and 3 days respectively. Most dermatophytes recovered from both symptomatic and asymptomatic lesions had haemolytic and CAMP‐like activities. We suggest that the haemolytic and CAMP‐like activities are not correlated with ecological characteristics, isolation sites or clinical manifestations of dermatophytic fungi. We also believe that this study has the potential to contribute to the existing literature on dermatophytes and dermatophyte pathogenesis.     

Ursodeoxycholic acid and atorvastatin in the treatment of nonalcoholic steatohepatitis.

BACKGROUND/AIMS: Nonalcoholic steatohepatitis (NASH) is a serious disorder with the potential to gradually progress to cirrhosis. It is generally associated with obesity, diabetes and hyperlipidemia. Currently, there is no established therapy for NASH. The aim of the present study was to evaluate the effectiveness of atorvastatin and ursodeoxycholic acid (UDCA) in the treatment of NASH. METHODS: This prospective study included 44 adult patients (24 men, 20 women) with a mean age of 48.90+/-7.69 years and mean body mass index (BMI) of 29.40+/-3.82. Ten patients had a history of diabetes. Serological markers for viral hepatitis were negative in all patients and there was no history of alcohol or drug abuse. Patients who had autoimmune hepatitis were excluded from the study. Liver biopsy was performed before therapy to confirm the diagnosis. Among NASH patients, 17 normolipidemic cases received UDCA 13 to 15 mg/kg/day (group 1), while hyperlipidemic cases (n=27) received atorvastatin 10 mg/day (group 2) for six months. The BMI, serum lipids, liver function tests and liver density, assessed by computerized tomography, were evaluated before and after the treatment period. The BMI, serum aminotransferase levels, histological parameters (steatosis, inflammation, fibrosis scores) and liver densities were not statistically different between the groups at the beginning of therapy. RESULTS: The BMI, serum glucose, and triglyceride levels did not change in either group after the treatment period. In group 1, serum alanine aminotransferase (ALT) and gamma-glutamyl-transferase (GGT) levels reduced significantly, and in group 2, serum cholesterol, aspartate aminotransferase, ALT, alkaline phosphatase and GGT levels reduced significantly. Liver densities increased only in group 2, probably as a result of diminishing fat content of liver. The normalization of transaminases was also more prevalent in group 2. Liver steatosis was closely correlated with liver density, but inflammation and fibrosis were not. CONCLUSIONS: The use of atorvastatin in NASH patients with hyperlipidemia was found to be both effective and safe. The benefit of statin and UDCA therapy in normolipidemic patients with NASH requires confirmation with further placebo-controlled trials.     

The relationship between fragmented QRS complexes and syntax II scores in patients with ST-segment elevation myocardial infarction

Background

Even though the relationship between syntax score (SS) and fragmented QRS (fQRS) has been studied, the relation between syntax score II (SS II) and fQRS in patients with ST elevation myocardial infarction (STEMI) is undefined. We aimed to define the relationship between fQRS and SS II for the evaluation of extension and complexity of coronary artery disease.