Hydatid disease of the liver with portal vein invasion mimicking portal vein thrombosis

Hydatid cyst disease is a zoonosis caused by the parasite Echinococcus. It may infest any organ of the body, but it most frequently involves the liver, lungs, and nervous system. Portal vein involvement by hydatid cyst disease is extremely rare with only five cases published in the English literature to our knowledge. We present the ultrasonography (US) and computed tomography (CT) findings of a 77-year-old male with hydatid disease of the liver with portal vein invasion mimicking portal vein thrombosis. Colour Doppler US confirmed the lack of blood flow within the portal vein and stigmata of cavernomatosis. CT clearly demonstrated a communication between the multiloculated lesion and the portal vein and the multiple daughter vesicles obstructing the portal vein. The consideration of this complication will make it possible to distinguish this entity from portal vein thrombosis and, thus, the management of the patients with hydatid cyst disease particulary in endemic regions.     

Rho-kinase (ROCK-1 and ROCK-2) upregulation in oleic acid-induced lung injury and its restoration by Y-27632

The possible contribution of Rho/Rho-kinase signalling in oleic acid (100 mg kg-1, i.v., for 4 h)-induced lung injury was investigated in rats. Furthermore, the possible protective effect of the administration of a Rho-kinase inhibitor, (+)-(R)-trans-4-(1-aminoethyl)-N-(4-pyridyl) cyclohexanecarboxamide dihydrochloride monohydrate (Y-27632, 0.5-5 mg kg-1, i.v., 15 min before the administration of oleic acid), was also examined. Western blot analysis as well as histopathological examination revealed that Rho-kinase (ROCK-1 and ROCK-2) was upregulated in lungs obtained from oleic acid-administrated rats. In addition, the markers of oxidative and nitrosative stress, i.e., malondialdehyde, myeloperoxidase, 3-nitro-L-tyrosine and nitrite/nitrate, in serum and lung tissue were also increased in the injury group. Treatment of rats with 5 mg kg-1 Y-27632 reversed the oleic acid-induced lung damage, which was demonstrated by histopathological assessment and confirmed in Western blot experiments: ROCK-blots were more intense in the oleic acid group than in control and Y-27632 treatment reversed ROCK upregulation. In addition, malondialdehyde, myeloperoxidase, 3-nitro-L-tyrosine and nitrite/nitrate were also normalized after the administration of Y-27632 (0.5 mg kg-1 and 5 mg kg-1). These findings suggest that ROCK-1 and ROCK-2 are involved in oleic acid-induced lung damage in rats, and that inhibition of this enzyme by Y-27632 may have a protective effect against such damage. Consequently, Rho kinase inhibitors may be potential therapeutic agents in the treatment of acute respiratory distress syndrome (ARDS).     

Validity and reliability of the Philadelphia Geriatric Center Morale Scale among Turkish elderly people

Purpose  

We translated the original 17-item Philadelphia Geriatric Morale Scale (PGCMS) into Turkish and examined its validity and reliability to determine whether it may used as a tool to measure quality of life (QOL) in a Turkish elderly sample people.     

Effects of crossed leg on blood pressure

It is known that many factors influence an individual's blood pressure measurement. However, guidelines for accurately measuring blood pressure inconsistently specify that the patient should keep feet flat on the floor. The purpose of this study was to examine the effects of a crossed leg position on blood pressure in a Turkish sample. A prospective study of 238 subjects with an unmedicated high-normal blood pressure, stage 1 or stage 2 hypertension was conducted. After obtaining informed consent, subjects positioned their feet flat on the floor while their blood pressure was being measured. After 3 min, the blood pressure was measured again with the subject's leg crossed at the knee. Mean values of blood pressure were compared by t-test between two measurements. Statistical significance for all analysis was taken at the 5% level. The results indicated that both systolic and diastolic blood pressure increased significantly with the crossed leg position. Crossing the leg at the knee results in a significant increase in blood pressure. When blood pressure is measured, subjects should be instructed to have feet flat on the floor to eliminate a potential source of error.     

The Effect of Sterilization Methods of Endoscopic Instruments on the Body: A Study on Rat Model

Purpose: Laparoscopy is widely used in many surgical areas for diagnosis and treatment. The need for sterilization of reusable instruments is an important issue. Ensuring patient safety, preventing infection, and protecting the functionality of the instruments are the most important points to be considered. We aimed to investigate two sterilization methods and their effects generated by their distribution into intra-abdominal tissues during insufflation. Materials and Methods: 21 rats were used in the study. The Control Group (Group 1) received anesthesia for 1 hour; Group 2 (Glutaraldehyde (GA)-Pneumoperitoneum Group) received anesthesia for 1 hour; Group 3 (Ethylene Oxide (EO)-Pneumoperitoneum Group) received anesthesia for 1 hour. After 24 hours, the animals were sacrificed, and the kidneys and omentum of the animals were analyzed in a histopathological manner. Blood samples were analyzed at preoperative 24th hour and at postoperative 24th hour. Results: There was a statistically significant difference in omentum, endothelium, and glomerular scores between the groups (p < 0.001 for all groups). Endothelial and glomerular scores were different at a statistically significant level in the EO and GA groups compared to the Control Group. The total score was higher at a statistically significant level in the EO and GA groups compared to the Control Group (p < 0.001 for both groups). Conclusion: It was determined in our study that sterilization methods such as EO and GA cause damage in intra-abdominal tissues. In the light of these results, we consider that the most ideal laparoscopic surgery set is the single-use laparoscopy set. However, this does not seem possible especially in developing countries in practice.     

A retrospective assessment and comparison of the effectiveness of benzoyl peroxide; the combination of topical niacinamide,gallic acid,and lauric acid; and the combination of benzoyl peroxide and erythromycin in acne vulgaris

Acne vulgaris is a chronic inflammatory skin disease that mostly develops during adolescence and continues throughout adulthood. It affects the face, the main location of cosmetic appearance. Despite many developments in acne treatment, various combination therapies are needed to create the best option. Ninety patients were included in this study. We used the global acne grading system (GAGS) and the lesion counting and photographic standards that were used by Hayashi et al., to assess acne severity. The patients were randomly divided into three groups as group 1 (using only 5% BPO, twice a day), group 2 (using only the combination of 5% BPO + 3% erythromycin, twice a day), and group 3 (using only the combination of 4% niacinamide + 1% gallic acid + 1% lauric acid, twice a day). Thirty patients were included in each group. The scores were evaluated at weeks 0, 2, 4 and 8, and compared with each other. As a result of the study, all three treatment types were found to be effective. The combination of 4% niacinamide + 1% gallic acid + 1% lauric acid can be used as an alternative topical treatment for acne vulgaris to prevent resistance against topical antibiotics and the side effects of some other treatments.     

Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?

Background/aimThe aim of the study was to evaluate the effect of Controlling Nutritional Status (CONUT) score on the prognosis in patients with diffuse large B-cell lymphoma (DLBCL). Materials and methods The present study was a retrospective study. The CONUT score was calculated based on serum albumin, total cholesterol and lymphocyte levels. This study included a total of 266 patients, 131 (49.2%) were female and 135 (50.8%) were male. The median follow-up period was 51 months (range: 1–190).Results The median age was 64 years. The cut off CONUT was 1.5. There was a significant difference between patients with high (≥ 2) or low (< 2) CONUT scores in terms of overall survival (OS) and progression-free survival (PFS). The 5-year OS and PFS in patients with high CONUT score was 52.1% and 49.7%. The 5-year OS and PFS in patients with low CONUT score was 79.8% and 75.6% (p < 0.001). In the multivariate analysis for OS, age ≥ 65 years (HR = 1.80, p = 0.028), Eastern Cooperative Oncology Group (ECOG) > 1 (HR = 2.04, p = 0.006), stage IIIA–IVB disease (HR = 2.75, p = 0.001) and the CONUT score (HR = 1.15, p = 0.003) were found statistically significant. In the multivariate analysis for PFS, age ≥ 65 years (HR = 2.02, p = 0.007), stage IIIA–IVB disease (HR = 2.42, p = 0.002) and the CONUT score (HR = 1.19, p = 0.001) were found to be significant parameters. ConclusionHigh CONUT score reduces OS and PFS in DLBCL. CONUT score is an independent, strong prognostic index in patients with DLBCL.     

Relationship between history, laryngoscopy and esophagogastroduodenoscopy for diagnosis of laryngopharyngeal reflux in patients with typical GERD

The techniques used in the diagnosis of gastroesophageal reflux disease (GERD) have insufficient specificity and sensitivity in diagnosing laryngopharyngeal reflux (LPR). The purpose of this study was to evaluate the role of esophagogastroduodenoscopy (EGD) and laryngological examination in the diagnosis of LPR. A total of 684 diagnosed GERD and suspected LPR patients were prospectively scored by the reflux finding score (RFS) which was suggested by Koufman. A total of 484 patients with GERD who had RFS ≥7 were accepted as having LPR. 248 patients with GERD plus LPR on whom an endoscopic examination was performed were evaluated. As a control group, results from 82 patients with GERD who had RFS <7 were available for comparison. The GERD symptom score (RSS) was counted according to the existence of symptoms (heartburn/regurgitation) and frequency, duration, and severity. The reflux symptom index (RSI) suggested by Belafsky et al. was also evaluated. The relationship between esophageal endoscopic findings, RSS, RFS and RSI was investigated. Mean age was 46 ± 12 (19–80). The mean values of RSS, RFS, and RSI were 18.9 ± 7.7, 10 ± 2.2, 16.6 ± 11.9, respectively. Erosive esophagitis was detected in 75 cases (30%). Hiatus hernia was observed in 32 patients (13%). There was no correlation between RSS and RFS, RSI. The severity of esophagitis did not correlate with the severity of the laryngeal findings. LPR should be suspected when the history and laryngoscopy findings are suggestive of the diagnosis. EGD has no role in the diagnosis of LPR.     

The effects of parental monitoring on the quality of life and diet quality of adolescents with type 1 diabetes

International Journal of Diabetes in Developing Countries - The burdens of type 1 diabetes management in adolescence adversely affect their quality of life, reduce adherence to diet, and worsen...