Synovial chondromatosis of the subtalar joint: a case report and review of the literature

Synovial chondromatosis is an uncommon disorder characterized by the formation of multiple cartilaginous nodules within the synovium and most commonly affects large joints, such as the knee and hip. Diagnosis in synovial chondromatosis is generally confirmed by histology after clinical and radiologic examination. Diagnosis may sometimes be difficult because synovial chondromatosis resembles a soft-tissue mass and may give no radiologic findings. We describe a case of synovial chondromatosis stemming from the subtalar joint, in which diagnosis was difficult clinically and radiologically. The patient presented with pain in the ankle and with a soft-tissue mass. This case is presented with a review of the literature on subtalar joint involvement of synovial chondromatosis.     

Rethinking the usefulness of bone marrow biopsy on treatment decision in CLL patients at diagnosis

We aimed to investigate the role of bone marrow infiltration pattern (BMIP) and bone marrow reticulin fibrosis (BMRF) in determining treatment demand in patients with diagnosis of chronic lymphocytic leukemia (CLL). We retrospectively evaluated the data of 65 patients, who were followed with the diagnosis of CLL at Istanbul Training and Research Hospital, Department of Hematology, between July 2007 and June 2016. The median age of the patients was 64 years (range, 32–83). Twenty-three (35.4%) patients were female, and 42 (64.6%) were male. Early/mild grade BMRF was observed in 46 (70.8%) patients and advanced grade BMRF in 19 (29.2%) patients. Eleven (23.9%) of 46 patients with early/mild grade BMRF and 10 (52.9%) of 19 patients with advanced grade BMRF required treatment during follow-up (p = 0.04). According to the BMIP, 14 (21.5%) patients had diffuse and 51 (78.5%) patients had non-diffuse BMIP. Eleven (78.6%) of 14 patients with diffuse BMIP and 10 (19.6%) of 51 patients with non-diffuse BMIP required treatment during follow-up (p < 0.001). In univariate analysis, both advanced grade BMRF and diffuse BMIP had an impact on occurrence of treatment demand (p = 0.028, HR = 3.535 vs. p < 0.01 HR = 15.033). Multivariate analysis also revealed diffuse BMIP to be effective (p < 0.001, HR 13.089), while advanced grade BMRF failed to significantly influence treatment demand (p = 0.140, HR 2.664). In conclusion, in the light of our findings, it is reasonable to consider that bone marrow biopsy at the time of diagnosis might provide a preliminary information about treatment demand in patients with CLL.     

Influence of medical education on students' attitudes towards the elderly

As life expectancy increases, the elderly population grows accordingly. Today, physicians interface with elderly patients more frequently and, therefore, geriatric education should be a part of medical training. Examining medical students' knowledge and attitudes about elderly will provide valuable information in planning the geriatric education in medical school. The aim of this study is to determine and compare the attitudes and knowledge of class-1, -4 and -6 Turkish medical students about the elderly. A questionnaire that included statements about physical and social situations of the elderly, developed by Reuben et al., was used. Five-hundred-thirty-five students educating in Hacettepe University Medical Faculty took part in the study. Age, gender and the number of people aged >65 living with the students were also asked. Gender and number of old people living with the students had no significant effect on the answers. Social statements were answered positively, and there were no significant changes among the classes. Statements about physical situations and illnesses were significantly associated with the students' years of education. Geriatric education in developing countries needs more attention because the students' attitudes towards elderly and caregiver preference are mostly affected by the students' own experiences and knowledge.     

Sleep disturbance among women with chronic pelvic pain

Objective

To investigate the effect of chronic pelvic pain (CPP), a debilitating condition, on sleep quality.

Methods

The present case–control study enrolled women older than 18 years attending the Gynecology Clinic of Çanakkale Onsekiz Mart University Hospital, Çanakkale, Turkey, with CPP between August 2011 and August 2012. The control group was selected from women attending the clinic for another complaint. Sleep quality was evaluated via the Pittsburgh Sleep Quality Index, and differences between the groups were compared by t and χ² tests.

Results

During the study period, 157 women were enrolled. Seventy-two had CPP symptoms, and 85 attended the clinic for other complaints. Poor sleep quality was found in 80% (n = 58) of the women with CPP, and 55% (n = 47) of the control group (P < 0.05).

Conclusion

Women with CPP were found to have poor sleep quality. Sleep education should be recommended in psychiatry and neurology clinics to increase the awareness of sleeping problems among these women.