Hemodialysis-related headache and how to prevent it.

BACKGROUND AND PURPOSE: Hemodialysis (HD) may have some adverse effects on the nervous system. Headache is the most commonly reported neurological symptom amongst HD patients. Our aim was to determine the frequency, clinical characteristics and triggering factors of HD-related headache (HRH) and to evaluate preventive strategies for reducing HRH. METHOD: In all, 494 patients were included. Comparative controls (CC) were classified within the same patients without headache. Arterial systolic/diastolic blood pressure, blood urea nitrogen (BUN) and creatinine were correlated before/after one HD. The urea reduction ratio during the dialysis session was determined. RESULTS: A total of 175 patients (35.4%) with a mean age of 57.3 ± 15.7 years were diagnosed with HRH. HRH was more common in males (P < 0.001). Headache was started a mean of 2.90 ± 0.86 h after the HD. The common localization of pain was reported to be bifrontal in 41.7% (n = 73). The mean duration of headache was 6.22 ± 7.8 h, with a duration of ≤4 h reported by 64.0% of patients. The mean Visual Analog Scale score was 5.64 ± 2.05. The differences between pre/post-dialysis BUN values were 94.6 ± 31.1 in HRH patients and 86.8 ± 28.5 in the CC group (P = 0.006). The systolic blood pressure difference between the pre/post-dialysis measurements was 22.4 ± 16.5 mmHg in HRH patients and 12.8 ± 19.4 mmHg in CC(P < 0.001). Patients with HRH had significantly higher mean systolic and diastolic blood pressure pre-dialysis values (systolic, P = 0.002; diastolic, P < 0.001). The differences in systolic/diastolic blood pressure between pre/post-dialysis were higher in the HRH group (P < 0.001, P = 0.001, respectively). CONCLUSION: Regulating the frequency and timing of dialysis may provide better management in HRH with high BUN levels and high pre-dialysis blood pressure.

Association between survivin gene promoter -31G/C and -644C/T polymorphisms and non-small cell lung cancer.

Lung cancer is the most common cancer worldwide. Survivin is one of the first reported inhibitors of apoptosis proteins, which is an important family of proteins that regulate apoptosis. The survivin gene is located on human chromosome 17q25, which is composed of 142 amino acids. A common polymorphism of the survivin gene promoter -31G/C has been shown to influence cancer risk. This genetic variant has been associated with overexpression of survivin at both protein and mRNA levels in cancer cells. We examined promoter (-31G/C) genotype frequency in a patient group (N = 146), 77.4% GG, 18.5% GC, 4.1% CC, and in a control group (N = 98), 57.1% GG, 34.7% GC, 8.2% CC. These distributions were significantly different. Promoter (-644C/T) genotype frequency in the patient group was 40.4% TT, 48.6% TC, 11% CC, and in the control group it was 55.1% TT, 40.8% TC, 4.1% CC; these distributions were also significantly different. Individuals carrying the survivin 31 GC genotype and those carrying the survivin 644 CC genotype had a significantly decreased risk of having non-small cell lung cancer.

Evaluation of the factors associated with sublingual varices: a descriptive clinical study.

BACKGROUND: Age is considered as an important factor for the development of sublingual varices (SV). It has been suggested that some other conditions such as gender, systemic diseases, smoking, denture wearing may play a role in aetiology. However, there are a limited number of studies investigating these associations. This study was perform to evaluate association between SV and the conditions which are described as possible risk factors previously. MATERIALS AND METHODS: A total of 691 patients (470 females, 221 males) who attended for comprehensive clinical examination were included in the study. Age, gender, systemic health, venous varix of the lower extremities, smoking status, denture wearing were recorded during the history taking. SV were classified into two categories: stage 0 (few or none visible) and stage 1 (moderate or severe). Tongue photographs were taken from a group of these patients. For the evalu- ation of intra-observer reliability, 60 photographs of tongue were re-evaluated by the same observer. Intra-observer reliability was evaluated using Kappa statistics. Pearson c2 test and Fisher's exact test were used to assess SV in relation to each variable, and variables showing associations with p < 0.05 were selected for the multivariable analysis, then logistic regression analysis was applied. RESULTS: Kappa value of intra-observer reliability was 0.91. SV were significantly associated with age (odds ratio [OR] = 1.08, p = 0.000), hypertension (OR = 2.3, p = 0.007) and denture wearing (OR = 2.17, p = 0.02). CONCLUSIONS: The presence of SV is associated with hypertension and denture wearing as well as aging. More detailed studies are needed to prove causative relations between SV and systemic diseases.

EURO-MUSCULUS/USPRM. Basic Scanning Protocols for Ankle and foot.

In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned ankle/foot structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.

EURO-MUSCULUS/USPRM. Basic scanning protocols for knee.

In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned knee structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.

EURO-MUSCULUS/USPRM. Basic scanning protocols for hip.

In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned hip structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.

EURO-MUSCULUS/USPRM Basic Scanning Protocols for shoulder.

In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned shoulder structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.

EURO-MUSCULUS/USPRM Basic Scanning Protocols for elbow.

In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned elbow structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.

EURO-MUSCULUS/USPRM Basic Scanning Protocols for wrist and hand.

In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned wrist/hand structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.

The correlation of neurophysiological findings with clinical and functional status in patients following traumatic nerve injury.

In this study, we aimed to determine whether there is a correlation between the electrodiagnostic findings and the functional status, muscle strength and sensibility in patients with traumatic nerve injury to the wrists. We assessed 50 patients at a mean of 11.6 months (SD 5.85) (range 6-25) after nerve injury. Sensibility was assessed by monofilament testing. Motor function was evaluated by assessing the manual muscle grade of the abductor pollicis brevis and abductor digiti minimi muscles. Function was evaluated by the Sollerman Hand Function Test. The amplitudes of the compound muscle action potential and the sensory nerve action potential were determined by electroneuromyography. While the compound muscle action potential and sensory nerve action potential amplitudes had significant correlation with muscle grade and Semmes Weinstein Monofilament tests, there was no correlation with the functional scores.

Cost analysis and related factors in patients with traumatic hand injury.

The aim of this study was to measure the direct and indirect costs and factors influencing these costs in patients presenting following traumatic hand injury. We assessed patients aged 18-65 years who were in work. Hand injury severity and functional status were assessed. Direct costs, including medical care expenses, and indirect costs, including lost productivity, were calculated. Seventy-nine patients of a mean age of 32 years were included. The mean direct cost for each patient was $1772 (47% of total cost), and the indirect cost was $1891 (53% of total cost). Injury severity, time to return to work, and hospitalization time were the main parameters of increased total cost in a linear regression analysis.

Comparing the accuracy of panoramic and intraoral radiography in the diagnosis of proximal caries.

OBJECTIVES: The purpose of this study was to compare the diagnostic accuracy of panoramic and intraoral radiographic surveys in the diagnosis of proximal caries according to the different dental regions (maxillary and mandibular incisor, canine, premolar and molar). METHODS: In this study, full mouth series and panoramic radiographs of 79 patients were used. The radiographs were evaluated for proximal caries by three observers. The diagnostic accuracy of radiographic surveys for each dental region was assessed by means of receiver operating characteristic (ROC) curve analysis. RESULTS: Full mouth series was the most efficient method in the diagnosis of caries for incisor and canine teeth. However, full mouth series and combination of panoramic plus bitewings had similar diagnostic accuracy for premolar and molar teeth. CONCLUSIONS: Panoramic survey alone was not sufficient for the diagnosis of proximal caries for the entire dentition. The combination of panoramic plus bitewing plus anterior periapical survey exhibited a diagnostic accuracy for proximal caries that was comparable with full mouth series.