Headache in children and dynamic thiol/disulfide balance evaluation with a new method

Headache is one of the most common causes of presentation to the physician in children. We aimed to evaluate the dynamic thiol/disulfide homeostasis with a new method in children with headache and also to investigate the relationship between the headache type, pain severity and duration in our study. We included 40 patients diagnosed with migraine, 40 patients diagnosed with tension-type headache (TTH) and 40 healthy children in the study. No significant difference was found between the total thiol, native thiol, and disulfide levels of the patient and control groups. However, the disulfide/native thiol and disulfide/total thiol ratios were higher in the migraine group than in the TTH and control groups. No correlation was found between the Pediatric Migraine Disability Assessment (PedMIDAS) score and the headache duration and any of the thiol/disulfide parameters. A negative correlation was found between the total thiol and native thiol levels and the PedMIDAS score in the TTH group. Migraine and TTH patients have different effect to thiol/disulfide homeostasis.     

Evaluation from various viewpoints of the Lippes Loop, Multiload Cu 250 and Nova T

In the present study, our experience at the family planning unit Ankara Military Hospital with intrauterine devices Lippes Loop, multiload Cu 250 and Nova T are presented. 595 women were included in the study between march 31, 1984 with a follow up of 12 months. Out of 595 women 547 (92%) reported no complaints at all. From the remaining 48 women 8 wished to have the device removed, 8 had spontaneous expulsions and in 31 IUD was removed for medical purposes.     

L-carnitine in experimental retinal ischemia-reperfusion injury

The effect of L-carnitine on retinal ischemia-reperfusion injury was evaluated in guinea pigs. 90 min of pressure-induced retinal ischemia followed by 24 h of reperfusion was established in both eyes of 2 groups of animals receiving either L-carnitine (100 mg/kg repeated in 5 doses) or saline intraperitoneally. After enucleation of all the eyes, including those of a control group, malonyldialdehyde (MDA) levels and the thickness of the retinal tissue were measured in 3 groups. The mean MDA value and the tissue thickness of the L-carnitine-treated group were statistically insignificant versus the control group (p > 0.05 and p > 0.05, respectively). However, these values were significantly different in the group receiving saline versus the control group and that receiving L-carnitine (p < 0.001, p < 0.001 and p < 0.001, p < 0.001 respectively). L-Carnitine might be an alternative drug for ischemia-reperfusion injury of the retina.     

Determination of theophylline and ephedrine HCL in tablets by ratio-spectra derivative spectrophotometry and LC

Two methods are described for the determination of theophylline (THP) and ephedrine hydrochloride (EPH) in combined pharmaceutical tablet forms. The first method depends on the use of the first derivative of the ratio-spectra obtained by dividing the absorption spectrum of binary mixtures by a standard spectrum of one of the compounds. The first derivative amplitudes at 231.8 and 250.3 nm were selected for the assay of THP and EPH, respectively. Calibration graphs were established for 20-180 microg ml(-1) for THP and 10-50 microg ml(-1) for EPH. The second method is based on high-performance liquid chromatography on a reversed-phase column using a mobile phase of methanol-water (40+60,v/v) (pH 3) with detection at 217 nm. Linearity was obtained in the concentration range of 5-150 microg ml(-1) for THP and 15-75 microg ml(-1) for EPH. The detection limits for THP and EPH were 0.73 and 0.92 microg ml(-1) by ratio-spectra derivative spectrophotometry and 0.59 and 0.86 microg ml(-1) by HPLC, respectively. The proposed methods were successfully applied to the determination of these drugs in laboratory-prepared mixtures and in tablets. The relative standard deviations were found to be less than 1.5%, indicating reasonable repeatibility of both methods.     

Brucellosis: a retrospective evaluation

One hundred and sixty-six presumed brucellosis patients were included in the study. These patients were classified as primary (91), relapse (18) and suspected (57) cases according to their clinical presentations, and serologic and microbiologic test results. Primary and relapse cases were evaluated retrospectively according to age, sex, residence, routes of transmission, clinical and laboratory findings, treatment regimens, duration of treatment, and relapse rates. Of the 109 primary and relapse patients, 57 were male and 52 female. The ages of the patients ranged between 16-75 (mean age 40.2). The percentages of the urban and rural residence of the patients were 41.3% and 58.7%, respectively. The most common mode of transmission was consumption of unpasteurized milk and milk products (67.9%). Malaise, fever and sweating were the most frequently observed symptoms (96.3%, 95.4%, 91.7%, respectively). The most common signs were fever (97.2%), splenomegaly (59.6%), and hepatomegaly (37.6%). The liver was the most frequently involved organ (21.1%). Almost all (99.1%) patients were serologically positive. However, the positivity rate of culture was low (15.6%). The most frequently preferred antimicrobial regimen was rifampin and doxycycline combination. The relapse rate was 8.3%. Brucellosis is still prevalent in Turkey as in many other countries in the Mediterranean basin. The clinical presentation of the disease may show regional variations. Patients with a history of occupational or nutritional contact with the bacterium and with a compatible clinical picture should be examined using appropriate diagnostic techniques before any attempt to prescribe an antimicrobial.     

Antidepressant medication management and Health Plan Employer Data Information Set (HEDIS) criteria: reasons for nonadherence

BACKGROUND: While nationwide data have found that many patients do not meet the National Committee for Quality Assurance uniform standards for successful antidepressant treatment, reasons for this failure are not well understood. We examined the reasons for this failure through a systematic chart review. METHOD: A chart review was conducted on a random sample of 249 health maintenance organization patients who failed 1 or more of the 3 Health Plan Employer Data Information Set criteria (i.e., 3 follow-up visits or adequate duration of acute or continuation phase treatment). RESULTS: The most common reason for visits failure (N = 192) was that the patient restarted a previously prescribed successful antidepressant (N = 30, 16%). In 23 patients (12%), the patient had a visit with the prescribing provider, but mental health was not coded or documented in the case notes. Twenty-one percent (N = 40) were misclassified as not having 3 visits. The most common reasons for misclassification were mental health was discussed but not coded (N = 16, 8%) and wrong start dates due to use of medication samples (N = 10, 5%). Patient nonadherence was the most common reason for failure to meet adequate acute (N = 109) and continuation (N = 99) phase duration of treatment (13% and 24%, respectively); only 9% stopped taking medication in the acute phase due to side effects. Twenty-five percent of patients had told their doctor they were taking their medication while the pharmacy database found they were not. CONCLUSION: A large discrepancy between patients' actual and reported compliance was found and may in part account for physicians' inability to detect and thus address this issue. Patients' restarting a previous medication is common and warrants discussion regarding differential need for visit frequency.     

Primary renal lymphoma and xanthogranulomatous pyelonephritis in childhood

Primary renal non-Hodgkin's lymphoma is very rare in childhood. A six-year-old boy presented with bilateral non-obstructive multinodular nephromegaly and renal failure. Percutaneous needle biopsy showed large-cell lymphoma. The patient was started on chemotherapy. A right nephrectomy was done when systemic hypertension developed in the presence of a non-functional right kidney. Histopathologic examination revealed focal lymphomatous infiltration and xanthogranulomatous pyelonephritis which is an atypical form of chronic renal infection. The case is discussed in relation to previons reports.