The KBG syndrome: confirmation of autosomal dominant inheritance and further delineation of the phenotype

We report on a Turkish family in which the father and his two sons were diagnosed as having the KBG syndrome. Large upper central incisors were the diagnostic finding in all three patients along with mental retardation, cryptorchidism, skeletal abnormalities, and short stature. Our report clearly confirms that the inheritance is autosomal dominant in KBG syndrome, although a high male to female ratio has been observed in published cases.     

Iron oxide nanoparticles supported on biogenic silica derived from bamboo leaf ash for rhodamine B photodegradation

This research demonstrates the use of biogenic silica derived from bamboo leaf ash as a support for iron oxide nanoparticles. The preparation includes silica extraction from bamboo leaf ash and iron oxide nanoparticle impregnation into the silica gel under hydrothermal conditions, which is followed by calcination at 400 °C for 2 h. The physicochemical characterization includes X-ray diffraction analysis, gas sorption analysis, scanning electron microscopic analysis and transmission electron microscopic analysis. The light absorption capability and the band gap energy of the materials were determined by diffuse-reflectance UV–visible spectrophotometry. The materials obtained by varying the Fe content to 5 and 10% wt. were evaluated in rhodamine B photocatalytic degradation and photooxidation systems. It was found that the materials have a combined hematite and magnetite nanostructure, with the ratio of 9:10, and the particle sizes range from 10 to 40 nm. With a band gap energy of 2.27 eV, the prepared materials produce the successive photocatalytic degradation of rhodamine B. It was clarified that the formation of composite enhances stability and reusability of photocatalyst as shown by the stable initial rate at wide pH range and reuse for 5 cycles. Degradation mechanism is enhanced by the addition of H₂O₂ as an oxidant, and the investigation of the effect of scavengers shows that the degradation rate not only depends on radical formation but also on other species related to the formation of oxidizing agent.     

Fulminant Ocular Toxoplasmosis: The Hazards of Corticosteroid Monotherapy

Purpose: To describe fulminant toxoplasma retinochoroiditis induced by corticosteroid monotherapy.

Methods: Clinical records of nine patients were reviewed.

Results: All patients (five female, four male; aged 15–64 years) had been misdiagnosed as unilateral non-infectious uveitis and given systemic and/or local corticosteroid injections elsewhere. Mean disease duration before referral was 105.6 ± 71 (45–240) days. Visual acuity at presentation was <20/200 in six eyes. Average lesion size was 6.6 disc areas in eight eyes and all four quadrants were involved in one. Toxoplasma DNA was detected in eight tested eyes. Mean duration of anti-toxoplasmic therapy was 92.5 ± 37.1 days. Three eyes developed rhegmatogenous retinal detachment. Four patients underwent pars plana vitrectomy. Final visual acuity was <20/200 in five eyes.

Conclusions: Iatrogenic immunosuppression due to initial misdiagnosis may lead to an aggressive course and serious complications of ocular toxoplasmosis, a potentially self-limiting infection.     

人三角肌亚部化研究

本研究详细解剖了20侧人三角肌的起止点,肌纤维走向和排列方式以及神经支配特征,将三角肌分成三个亚部,即前部、中部和后部。前、后亚部分别位于肩关节的前方和后外方,肌纤维呈平行排列并向下外集中,中部在外侧,纤维排列成多羽状,与前、后部可明确区分。三个亚部的神经分布是独立的,前部由腋神经前干发出的一支较粗大分支支配。前干的较细分支进入中部,后干主要由后干的肌支支配。进入各部的神经分支未见交叉。作者在同期研究的三角肌三个亚部肌纤维型分布有显著差异则是此肌亚部化的有力佐证。     

Left Ventricular Dyssynchrony and Its Effects on Cardiac Function in Patients with Newly Diagnosed Hypertension

Objectives: Left ventricular (LV) systolic synchrony, defined as simultaneous peak contractions of corresponding cardiac segments, is well documented to be impaired in hypertension but its effect on LV function is not clear. The aim of this study was to assess the impacts of LV systolic dyssynchrony on LV function in newly diagnosed hypertensives. Methods: Forty-eight newly diagnosed hypertensive patients and 33 controls were enrolled. All study population underwent a comprehensive echocardiographic evaluation including tissue synchrony imaging. The time to regional peak systolic tissue velocity (Ts) in LV by 12 segmental models was measured and two parameters of systolic dyssynchrony were computed. Results: Baseline demographic characteristics were similar in both study groups. Dyssynchrony parameters prolonged in newly diagnosed hypertensive patients compared to controls: the standard deviation (SD) of 12 LV segments Ts (40.2 ± 21 vs. 26.2 ± 13.4, P = 0.003); the maximal difference in Ts between any 2 of 12 LV segments (123.3 ± 61.5 vs. 79.8 ± 37.9, P = 0.001). In multivariable analysis, Ts-SD-12 was found to be an independent predictor for systolic function (β=-0.29, P = 0.008). But, both diastolic and global functions were not independently related to Ts-SD-12. Conclusion: LV synchronization is impaired in newly diagnosed hypertensive patients. LV dyssynchrony is one of the independent predictors of systolic function in hypertensive patients.     

In vivo effect of losartan on platelet aggregation in patients with hypertension

The angiotensin II receptor, losartan, has been found to inhibit platelet aggregability to some extent in in vitro experiments. There have been conflicting results about the in vivo effects of losartan. We sought to clarify the in vivo effect of losartan on platelet aggregation. Forty patients with grade I essential hypertension were treated with losartan for 3 weeks. Platelet aggregation tests with adenosine diphosphate (ADP) and ristocetin were analyzed and compared before and at the end of the study. Losartan effectively decreased systolic (SBP) and diastolic (DBP) blood pressure. Mean SBP before and after treatment was 159.6 ± 12.8 and 149.2 ± 17.3mmHg, respectively. Mean DBP decreased from 93.7 ± 8.2 to 87.7 ± 10.3mmHg after treatment. The results of the platelet aggregation tests with ADP and ristocetin were not significantly different when both rate and amplitude of maximal aggregation were included. Peak platelet aggregation with ADP regarding the lowest light transmission in the aggregometer was 59.8% ± 24.3% before and 58.3% ± 18.1% after the treatment. The same variables with ristocetin were 66.8% ± 21.6% and 60.8% ± 23.3%, respectively. In vivo effects of losartan on platelet aggregation with ADP and ristocetin were insignificant.     

Leukocytoclastic vasculitis after the third dose of CoronaVac vaccination

Clinical Rheumatology -     

Emotional intelligence and leadership traits among family physicians

Objectives: High emotional intelligence and leadership traits are essential for physicians in managing their responsibilities and thus building successful interactions with patients. This study explored the relationship between emotional intelligence and leadership traits among family physicians.

Methods: Participants (2975 men, 972 women, mean = 42.0 ages, SD = 7.47) were family physicians working at family health-care centers across the seven geographical regions of Turkey who were contacted by e-mail. The Trait Emotional Intelligence Questionnaire (TEIQue) and Leadership Traits Tool were used to collect data. Data were analyzed concerning physicians’ sex, age, health-care experience, and geographical region. The correlation between Trait Emotional Intelligence (TEI) and leadership was also being examined.

Results: Our findings suggest that family physicians’ TEI differs based on sex, age, health-care experience, and the geographical region where they work. Women had higher mean values than did men for well-being, emotionality, and global TEI. Physicians aged younger than 29 years had the lowest mean values for emotional intelligence. As physicians’ health-care experience increased, they received higher scores for emotional intelligence. Physicians working in the Mediterranean had the highest mean TEI scores. There was a positive correlation between family physicians’ emotional intelligence and leadership traits. Higher emotional intelligence was correlated with increased leadership traits.

Conclusion: Emotional intelligence and leadership traits play crucial roles in increasing physicians’ personal and professional development. This may also increase physicians’ caregiving competencies and thus the quality of health services, as well as potentially decreasing physicians’ burnout and health-related costs.