Kounis syndrome associated with benzathine penicillin G use: A case report

Kounis syndrome is a life-threatening medical condition that causes severe allergic reaction and acute coronary syndrome. Benzathine penicillin G is one of the most widely used antibiotics in clinical practice, but it can enhance both allergic and hypersensitivity complications. In this report, we describe the case of a 42-year-old man admitted to our hospital who presented with cryptic tonsillitis accompanied by angioneurotic edema, chest pain, and electrocardiographic variations. The patient was diagnosed with Kounis syndrome and treated with oral antihistamines and prednisolone. He was discharged following a complete recovery and regression of electrocardiographic abnormalities within 72 hours.     

The Association of Alagille Syndrome and Craniosynostosis

Alagille syndrome is associated with various ocular abnormalities, including pseudopapilledema or optic disk edema due to increased intracranial pressure. Several mechanisms have been proposed to explain the mechanism of intracranial hypertension in Alagille syndrome. Craniosynostosis is an unusual but significant cause of increased intracranial hypertension in Alagille syndrome. It has recently been demonstrated in animal models that Jagged1 gene in which mutations are responsible for Alagille syndrome may also take part in cranial suture formation. We report a child with Alagille syndrome and craniosynostosis who presented with pruritus, elevated liver enzymes, and suspected increased intracranial pressure.     

Neurofibromatosis Type 1 and Primary Hyperparathyroidism with Spinal Deformity and Osteoporosis

The association of Neurofibromatosis type 1(NF1) and primary hyperparathyroidism (PHPT) is a well described but very rare entity. This association supports the hypothesis of a variant of multi-endocrine neoplasia syndrome. We report a 52-year-old woman with NF1, PHPT and spinal deformity. She had cutaneous lesions of neurofibromatosis. X-ray imaging has shown severe kyphoscoliosis and bone mineral density measurement has revealed severe osteoporosis. Significant increases in blood calcium and parathormon level were measured. Parathyroid adenoma was determined by ultrasound and MIBI scan. Hyperparathyroidism and hypercalcaemia resolved after surgical removal of adenoma. The general condition of the patient was improved significantly after two months of medical and physical therapy. All NF1 patients who have severe skeletal deformities, osteoporosis, and motor activity loss should be investigated for the concurrence of PHPT.     

Paraoxonase Activity in Glomerulonephritic Patients

Background. Cardiovascular disease is the most common cause of morbidity and mortality in patients with chronic renal failure. Glomerulonephritic patients have an increased risk for cardiovascular disease, but its etiology is unclear. It is known that an increase in oxidizability of apolipoprotein B-containing lipoproteins has a key role in the initiation of atherosclerosis, and paraoxonase enzyme activity particularly has a preventive role against atherosclerosis. The aim of the present study was to evaluate the oxidizability of apolipoprotein B-containing lipoproteins, serum, and urinary paraoxonase/arylesterase activities in glomerulonephritis patients who had normal lipid parameters and creatinine levels. Methods. Thirty-two patients with glomerulonephritis and 22 healthy controls were included in this study. A total of 32 patients (including nine with membranous GN, eight with immunoglobulin A nephropathy, eight with mesangial proliferative GN, five with focal-segmental glomerulosclerosis, one with diffuse proliferative GN, and one with minimal chance disease having biopsy proven GN) were enrolled into the study. We compared serum and urinary paraoxonase, arylesterase, serum lipids, urea, creatinine, hemoglobin, total protein and albumin values between groups. Results. Serum urea, creatinine, total protein, albumin, uric acid, hemoglobin, and lipid parameters were similar in the glomerulonephritis and control groups (p > 0.05). PON1 activity was significantly lower in GN group than controls, but there was no statistically significant difference on arylesterase activity between groups. Oxidizability of apolipoprotein B-containing lipoproteins was significantly higher in GN group than controls. Conclusion. Our study shows that the findings of normal serum levels of creatinine, lipids, and proteins increased the oxidizability of apolipoprotein B-containing lipoproteins, and any decrease in PON1 activity in patients diagnosed with GN should be considered important. Hence, the immediate commencement of preventive as well as curative treatment in other to avoid the risk of cardiovascular and renal problems would be a correct approach.     

Magnetic resonance imaging findings of intracranial hypotension

Neurological Sciences - This study aims to evaluate the differences in the sizes and configurations of various structures on brain MRIs of patients with intracranial hypotension (ICH) compared to...     

Impact of toilet hygiene training program: results from 11- to 16-year-old secondary school Turkish children

Objectives

The purpose of the study is to evaluate the effectiveness of toilet hygiene education in secondary school students.

Methods

The study was quasi-experimental with a pre-test–post-test design and includes a control group. The study was conducted at a secondary school in Istanbul, Turkey with 100 students (50 students for experiment and 50 students for control). The experiment and control groups were in the same school population. Data were collected with the student information form and toilet hygiene evaluation form (THEF), which were developed by the researchers.

Results

When we examined the toilet hygiene techniques used by the students, they indicated 58 % (n = 58) wiped perinea from front to back, 25 % (n = 25) back to front and 17 % (n = 17) randomly. It was found that 69 % (n = 69) of the students changed their underwear every 2–3 days; 80 % (n = 80) were trained by parents on toilet hygiene. Total THEF scores, which were obtained pre and post (shortly after) education, showed significant differences in the experiment group (p = 0.000). Total THEF scores obtained post education (shortly after and 1 month later) showed significant differences in the experiment group (p = 0.009).

Conclusions

The toilet hygiene education program is found to be successful in secondary school students.     

Insights into major facilitator superfamily domain-containing protein-2a (Mfsd2a) in physiology and pathophysiology. What do we know so far?

Major facilitator superfamily domain-containing protein-2a (Mfsd2a) which was considered as an orphan transporter has recently gained attention for its regulatory role in the maintenance of proper functioning of the blood–brain barrier. Besides the major role of Mfsd2a in maintaining the barrier function, increasing evidence has emerged with regard to the contributions of Mfsd2a to various biological processes such as transport, cell fusion, cell cycle, inflammation and regeneration, managing tumor growth, functioning of other organs with barrier functions or responses to injury. The purpose of this article is to review the different roles of Mfsd2a and its involvement in the physiological and pathophysiological processes primarily in the central nervous system and throughout the mammalian body under the lights of the current literature.