Abstract Background : The aim of the present study was to determine the prevalence, associated symptoms, and clinical outcomes of children with acute abdominal pain who had been admitted to an emergency department. Methods : Children aged between 2 and 16 years who presented to the emergency department of Cerrahpa?a Medical School, Istanbul University between July 2001 and August 2002 with acute abdominal pain were enrolled in this study. A questionnaire was completed each patient admitted to our pediatric emergency unit for acute abdominal pain. Data collected included presenting signs and symptoms, the hospital follow up for all children who returned within 10 days, test results, and telephone follow up. Results : The number of children referred to the emergency department was 7442, with 399 (5.4%) of these having acute abdominal pain. The mean age of the study population was 6.9 ± 3.5 years, and 201 of the patients were male. The five most prevalent diagnoses were: (i) upper respiratory tract infection and/or complicated with otitis media or sinusitis (23.7%); (ii) abdominal pain with uncertain etiology (15.4%); (iii) gastroenteritis (15.4%); (iv) constipation (9.4%); and (v) urinary tract infection (8%). The most common associated symptoms were decreased appetite, fever and emesis. Because of follow‐up deficiency the progress of 28 patients was not obtained. Eighty‐two children were referred to the department of pediatric surgery, but only 17 of 82 (20.7%) required surgical intervention (15 of these 17 for appendicitis). Eleven patients returned within 10 days for re‐evaluation, but the initial diagnosis was not changed. The complaints of 57 patients with uncertain etiology were resolved within 2 days. Conclusions : An acute complaint of abdominal pain was usually attributed to a self‐limited disease. However, the percentage of surgical etiology is not negligible. 相似文献
Background To evaluate the results of pars plana vitrectomy with peeling of the internal limiting membrane (ILM) in eyes with chronic macular oedema.Methods PPV with indocyanine green (ICG) assisted peeling of the ILM was performed in 33 eyes with diabetic (21 eyes) or non-diabetic (12 eyes) macular oedema. Postoperatively, resolution of macular oedema, improvement of visual acuity (VA) and complications were documented. The peeled membranes were submitted for light and transmission electron microscopic evaluation.Results The mean follow-up time was 12.2 months. The macular oedema decreased or was resolved in 17 (81%) eyes in the diabetic group and in 11 (92%) eyes in the non-diabetic group. VA improved by at least 2 lines in 11 (52%) eyes in the diabetic group and in 7 (58%) eyes in the non-diabetic group. The difference between visual acuity improvements of the two groups was not statistically significant (P>0.05). However, in the diabetic group the difference of visual improvement between cystoid and diffuse type of macular oedema eyes was statistically significant (14% versus 71%, P=0.02). Light and transmission electron microscopy showed the presence of ILM in all specimens. During the follow-up period no recurrence of macular oedema or epiretinal membrane formation was observed.Conclusion Pars plana vitrectomy with peeling of the ILM and epiretinal membrane leads to the resolution of macular oedema in the majority of eyes. This however, is not always associated with VA improvement. In diabetic eyes, cystoid type of macular oedema appears to be a poor prognostic factor for improved VA. 相似文献
The objective of the study was to evaluate arterial morphologic changes of early atherosclerosis and changes in procalcitonin (PCT) levels in patients with acromegaly according to disease activity. Thirty-three active and 20 inactive acromegaly patients followed at Endocrinology-Metabolism out-patient clinic of Cerrahpasa Medical Faculty between 2004 and 2008 were included in the study. Twenty gender and age matched healthy subjects were included as the control group. Intima-media thickness (IMT) of the carotid arteries was measured by ultrasonography. Blood was drawn for biochemical tests and the serum concentrations of C-reactive protein (CRP) and PCT. Intergroup analysis revealed no significant differences between Growth hormone (GH), insulin like growth factor-1 (IGF-1), and IMT (P?=?0.42, P?=?0.47 respectively). No significant differences were found in the fibrinogen, CRP and PCT levels of the acromegaly patients and the subjects in the control group (P?=?0.57, P?=?0.84, P?=?0.68 respectively). In the patients with IMT????1?mm, PCT (0.4 [IQR: 0.4?C0.55]) levels were significantly different from the patients without atherosclerosis (0.06 [IQR: 0.05?C0.12], P?<?0.001). The correlation between IMT and PCT (P?=?0.001, r?=?0.47) was more significant than the correlation between IMT and CRP (P?=?0.01, r?=?0.28). There was a positive correlation between IMT and atherosclerotic risk factors such as age (P?=?0.01, r?=?0.27) and body mass index (BMI; P?=?0.005, r?=?0.32). Our results showed that PCT increases before CRP and it can be useful for the assessment of premature atherosclerosis in acromegaly as well. 相似文献
Prayer is one kind of worship that is composed of repetitive action during praying in Islam. The prayer is performed five
times a day, every Friday, bairams and death ceremonies. The aim of this study is to search the role of this repetitive action
on knee, hip osteoarthritis and osteoporosis. Forty-six patients who had been performing the prayer at least for 10 years,
and 40 patients who had not performed the prayer, were included in this prospective study. Each patient was evaluated with
standard questionnaire form, joint examination was done and various laboratory parameters were studied. Anterior–posterior
radiography of the pelvis and weight-bearing knees of each patient were examined. Each film was evaluated by two investigators
separately and first scored by using Kellgren and Lawrence (K&L) scale, then the width of the joint space of hips and knees
were measured directly using a steel ruler and recorded to the nearest half millimeter. Bone mineral density (BMD) of lumbar
spine and femur was measured. Patients having Heberden’s nodes, Bouchard’s nodes, and carpometacarpal disease were frequent
in worshiper group. Joint space width measurements and assessment according to K&L scale did not differ between worshipers
and non-worshipers. BMD of lumbar spine was decreased in worshipers and also decreased with patients having Heberden’s nodes,
Bouchard’s nodes, female gender and age. Prayer has no effect on knee and hip osteoarthritis, and may be related with hand
osteoarthritis. It seems to have negative effect on lumbar BMD, but further investigations are needed. 相似文献
Pituitary - Our aim was to investigate the changes in the composition of oral and gut microbiota in patients with newly diagnosed acromegaly and their relationship with IGF-1 levels. Oral and fecal... 相似文献
Hypophysitis is a heterogeneous condition that includes inflammation of the pituitary gland and infundibulum, and it can cause symptoms related to mass effects and hormonal deficiencies. We aimed to evaluate the potential role of machine learning methods in differentiating hypophysitis from non-functioning pituitary adenomas.
Methods
The radiomic parameters obtained from T1A-C images were used. Among the radiomic parameters, parameters capable of distinguishing between hypophysitis and non-functioning pituitary adenomas were selected. In order to avoid the effects of confounding factors and to improve the performance of the classifiers, parameters with high correlation with each other were eliminated. Machine learning algorithms were performed with the combination of gray-level run-length matrix-low gray level run emphasis, gray-level co-occurrence matrix-correlation, and gray-level co-occurrence entropy.
Results
A total of 34 patients were included, 17 of whom had hypophysitis and 17 had non-functioning pituitary adenomas. Among the 38 radiomics parameters obtained from post-contrast T1-weighted images, 10 tissue features that could differentiate the lesions were selected. Machine learning algorithms were performed using three selected parameters; gray level run length matrix-low gray level run emphasis, gray-level co-occurrence matrix-correlation, and gray level co-occurrence entropy. Error matrices were calculated by using the machine learning algorithm and it was seen that support vector machines showed the best performance in distinguishing the two lesion types.
Conclusions
Our analysis reported that support vector machines showed the best performance in distinguishing hypophysitis from non-functioning pituitary adenomas, emphasizing the importance of machine learning in differentiating the two lesions.
Takayasu's arteritis is an inflammatory vasculitis that primarily affects the aorta and its major brances. Delayed diagnosis is common, and is largely attributed to the variable and nonspecific presentation of the initial symptoms. Involvement of the obdominal aorta causes severe claudication of the lower extremities, and bypass surgery is required in some cases. We describe a case in which diagnosis was delayed. Total occlusion of the obdominal aorta was successfully treated with axillobifemoral bypass. 相似文献