The importance of hypophosphatemia in the clinical management of primary hyperparathyroidism.

AIM: The levels of serum phosphorus (P) are low or low-normal in primary hyperparathyroidism (PHPT), and there is an inverse relationship between the levels of parathormone (PTH) and P. However, when considering the diagnostic and surgical indication criteria of PHPT, serum P levels are generally ignored. The aim of this study was to retrospectively evaluate the association of serum P levels with the clinical outcomes of PHPT. MATERIALS AND METHODS: A retrospective evaluation was made of the data of 424 consecutive patients (370 females, 54 males) with PHPT who presented at our centre. RESULTS: The mean age of the study population was 57 ± 11.68 years. The mean P was 2.57 ± 0.53 mg/dl. Asymptomatic disease was determined in 199 (47%) patients. Male patients had significantly lower levels of P. Symptomatic patients and patients with renal stones, vitamin D < 20 µg/l, calcium level ≥ 11.2 mg/dl, 24 h urinary calcium > 400 mg/day, or hypomagnesemia, were seen to have significantly lower levels of P (p < 0.05). Hypophosphatemia (hypoP) was found in 202 of 424 patients (47%), and these patients had a higher rate of symptomatic disease (63% to 44%, p < .0001). Of the 61 (88%) patients with moderate hypoP, 54 (88%) had at least one of the surgical criteria. A statistically significant increase in the incidence of hypoP was determined in symptomatic and male patients. In the patients with hypoP, serum PTH and urine calcium levels were found to be higher, and lumbar T-scores and serum vitamin D levels were lower. The patients with hypoP had higher rates of renal stones and osteoporosis (p < 0.05). CONCLUSIONS: The current study results show that hypoP is associated with a higher risk of osteoporosis and renal stones in PHPT patients. Even if patients are asymptomatic, moderate hypoP may be associated with poor outcomes of PHPT. Therefore, moderate hypoP may be a new criterion for parathyroidectomy, regardless of hypercalcemia level.

A green approach for the treatment of dye and surfactant contaminated industrial wastewater / Uma abordagem verde para o tratamento de águas residuais industriais contaminadas por tintas e surfactantes

Abstract Synthetic dyes, particularly reactive and acid dyes, are commonly used in the textile industry because of their advantages as excellent color fastness and brightness. Also, surfactants are used for an increment of coloring success in the textile industry. One of the major problems concerning textile wastewater is the treatment of the effluents containing both dyes and surfactants. Biological treatment systems are recommended as useful, economic and eco-friendly methods for treatment of industrial wastewater. The purpose of this study was to investigate the binary removal of a textile dye and a surfactant by growing Aspergillus versicolor culture in molasses medium. The effect of dye and surfactant concentration on the removal of dye and surfactant was determined. This study resulted that 100% of the surfactant and dye molecules removed together with the formation of a dye-surfactant complex by fungus. It is concluded that binary removal systems are very efficient for industrial wastewater treatment.

Resumo Os corantes sintéticos, particularmente corantes reativos e ácidos, são comumente usados ​​na indústria têxtil devido às suas vantagens como excelente solidez da cor e brilho. Além disso, os surfactantes são usados ​​para incrementar o sucesso da coloração na indústria têxtil. Um dos principais problemas relativos às águas residuais têxteis são o tratamento dos efluentes contendo corantes e surfactantes. Os sistemas de tratamento biológico são recomendados como métodos úteis, econômicos e ecológicos para o tratamento de efluentes industriais. O objetivo deste estudo foi investigar a remoção binária de um corante têxtil e um surfactante, cultivando a cultura Aspergillus versicolor em meio de melaço. O efeito das concentrações de corante e surfactante nas remoções de corante e surfactante foi determinado. Este estudo resultou na remoção de 100% das moléculas de surfactante e corante juntamente com a formação de um complexo corante-surfactante por fungos. Conclui-se que os sistemas de remoção binária são muito eficientes no tratamento de efluentes industriais.

A green approach for the treatment of dye and surfactant contaminated industrial wastewater

Abstract Synthetic dyes, particularly reactive and acid dyes, are commonly used in the textile industry because of their advantages as excellent color fastness and brightness. Also, surfactants are used for an increment of coloring success in the textile industry. One of the major problems concerning textile wastewater is the treatment of the effluents containing both dyes and surfactants. Biological treatment systems are recommended as useful, economic and eco-friendly methods for treatment of industrial wastewater. The purpose of this study was to investigate the binary removal of a textile dye and a surfactant by growing Aspergillus versicolor culture in molasses medium. The effect of dye and surfactant concentration on the removal of dye and surfactant was determined. This study resulted that 100% of the surfactant and dye molecules removed together with the formation of a dye-surfactant complex by fungus. It is concluded that binary removal systems are very efficient for industrial wastewater treatment.

Resumo Os corantes sintéticos, particularmente corantes reativos e ácidos, são comumente usados na indústria têxtil devido às suas vantagens como excelente solidez da cor e brilho. Além disso, os surfactantes são usados para incrementar o sucesso da coloração na indústria têxtil. Um dos principais problemas relativos às águas residuais têxteis são o tratamento dos efluentes contendo corantes e surfactantes. Os sistemas de tratamento biológico são recomendados como métodos úteis, econômicos e ecológicos para o tratamento de efluentes industriais. O objetivo deste estudo foi investigar a remoção binária de um corante têxtil e um surfactante, cultivando a cultura Aspergillus versicolor em meio de melaço. O efeito das concentrações de corante e surfactante nas remoções de corante e surfactante foi determinado. Este estudo resultou na remoção de 100% das moléculas de surfactante e corante juntamente com a formação de um complexo corante-surfactante por fungos. Conclui-se que os sistemas de remoção binária são muito eficientes no tratamento de efluentes industriais.

Demographical, laboratory and associated findings in patients with perniosis.

BACKGROUND: Perniosis is a cold-induced inflammatory disorder of the acral areas. The objective of this study was to investigate the demographic characteristics, associated factors, clinical and laboratory findings in patients with perniosis and to compare those findings between patients who had recurrent and acute disease. METHODS: Thirty-four patients with perniosis were investigated retrospectively for age, gender, occupation, smoking and diet histories, associated diseases, family history of perniosis, precipitating factors, the month of onset and the duration of perniosis, the distribution of the lesions and the results of laboratory investigations. RESULTS: Fifteen patients were male and 19 were female. The ages of the patients ranged from 15 to 57 years. Thirteen patients were working as sales people, which was the most common occupation. Sixteen patients were smokers. While 25 of the patients had encountered perniosis for the first time, in 9 of the patients, there were recurrent lesions. Diseases other than perniosis were recorded in 6 of the patients. The laboratory tests revealed mild leukopenia in 2, antinuclear antibody (ANA) positivity in 3, mild rise in albumin level in serum protein electrophoresis in 1 patient. ANA positivity was significantly higher in patients with recurrent disease. CONCLUSION: Perniosis was more common in women and below 40 years. We found no significant laboratory findings except ANA positivity in patients with recurrent perniosis.

Sperm retrieval and live birth rates in presumed Sertoli-cell-only syndrome in testis biopsy: a single centre experience.

We aimed to investigate sperm retrieval rates (SRR) by testicular sperm extraction (TESE), factors affecting SRR, and fertilization rate (FR), implantation rate (IR), clinical pregnancy rate (CPR) and live birth rate (LBR) in patients with presumed Sertoli-cell-only syndrome in testis biopsy (SCOS). We retrospectively evaluated files of 134 patients with SCOS who underwent TESE. Group I were patients in whom spermatozoa were retrieved and Group II were patients in whom no spermatozoa could be retrieved. SRR, Follicle stimulating hormone (FSH), Luteinizing hormone (LH), and testosterone levels, and the volume of testicles were compared between groups. In addition, FR, IR, CPR and LBR were determined. Sperm retrieval was achieved in 37 (27.6%) patients (Group I), and the remaining 97 (72.4%) patients made Group II. There were no significant differences in age, infertility time, testicular volume, serum FSH, LH and testosterone levels between Groups I and II (p > 0.05). Intracytoplasmic sperm injection (ICSI) was performed in 36 patients. FR, IR, and CPR were 60.86 ± 23.03, 36.53 ± 41.78 and 51.3% respectively. Cycle and patient based LBRs were 37.8 and 45.1% respectively. SRR in SCOS is lower than patients with non-obstructive azoospermia (NOA) in general. No parameters to predict spermatozoa retrieval were determined. In patients with SCOS, ICSI achieves similar live birth rate to other patients with NOA.

Giant congenital melanocytic naevus associated with Dandy-Walker malformation, lipomatosis and hemihypertrophy of the leg.

A 30-year-old woman presented with congenital hyperpigmented plaques and multiple tumoral lesions. Her left leg was hypertrophic, although the bones were normal. Dermatological examination revealed hyperpigmented macules and plaques with hair on the legs, abdominal and lumbar areas (covering > 60% of the total body surface) and multiple naevi on the face, arms, back and chest. Multiple soft masses of various sizes, some of which colocalized with hyperpigmented plaques, were seen on the trunk and legs. Malignant melanoma was excluded by histopathological examinations of multiple biopsy specimens obtained from the pigmented lesions. Histopathological examination of one of the soft masses showed that it was a lipoma. Cranial magnetic resonance imaging and computed tomography scans showed an enlarged fourth ventricule and vermis hypoplasia (Dandy-Walker malformation; DWM). Neurocutaneous melanosis is a rare combined abnormality of the skin and central nervous system. A few case reports relating to the coexistence of giant congenital melanocytic naevus, lipomatosis and hemihypertrophy have been published in the literature. We report this very rare case of giant melanocytic naevus with lipomatosis, hemihypertrophy of the leg, and DWM.

Statin therapy and diabetic skin.

PURPOSE: Statins are widely used drugs for reducing cholesterol levels. The aim of this study was to observe the effects of statin therapy on skin histopathology in both normal and diabetic mice. METHODS: 45 Swiss albino mice were studied in 4 sub-groups: control, statin-treated control, diabetic, and statin-treated diabetic. The first group was diabetic-induced with 250 mg/kg of streptozosin administered intravenously. The second group served as the control. Four weeks after streptozosin injection, both diabetic and control groups were divided into 2 sub-groups and 1 mg/kg/d simvastatin was injected for 14 d intraperitoneally to form the statin-treated control and statin-treated diabetic groups. The remaining 2 groups formed the untreated control and untreated diabetic groups. Histopathological examination of the skin was made with haematoxylin eosin staining under a light microscope. RESULTS: There was no apparent difference between the groups in epidermal thickness, proliferative activity, dermal thickness and composition. Cystic dilatations in the infundibulum of hair follicles with distorted and smaller sebaceous glands were seen in the statin-treated control, diabetic, and statin-treated diabetic groups. CONCLUSION: We conclude that there is altered lipid synthesis in the sebaceous glands in both diabetic and statin-treated groups.

Impression cytology and ocular characteristics in ocular rosacea.

PURPOSE: To examine clinical findings and histologic changes on the conjunctival surface in ocular rosacea. METHODS: Thirty-five patients with ocular rosacea and 30 normal subjects underwent dermatologic and ocular examinations. Tear film break-up time, Schirmer tests with and without topical anesthesia, and conjunctival impression cytology were done. Patients were divided into the following groups according to quantity of ocular signs: mild (Group 1), moderate (Group 2), and severe (Group 3). Impression cytology was performed on both upper-bulbar and intrapalpebral inferonasal-bulbar conjunctiva. RESULTS: Patients had significant cell alteration on the conjunctival surface compared with normal eyes. The most frequent ocular signs and symptoms were feelings of dryness and blepharitis. Average tear break-up times for patients with ocular rosacea were 8.2 seconds in Group 1, 5.69 seconds in Group 2, and 5 seconds in Group 3 (17.2 seconds in normal subjects). Schirmer test results with anesthesia were 11.5 mm, 7.6 mm, and 5.0 mm, and without anesthesia were 14.8 mm, 13.6 mm, and 7.0 mm, in Groups 1, 2, and 3, respectively. These results were 18.7 mm with anesthesia and 24.7 mm without anesthesia in normal controls. Schirmer tests and tear film break-up time were significantly lower in patients with ocular rosacea than in normal controls (p < 0.05). Impression cytology showed that both upper bulbar and inferonasal interpalpebral bulbar ocular surface had significant cell alterations compared with those obtained from normal subjects. CONCLUSIONS: Patients with ocular rosacea not only had decreased tear production but also tear instability. Ocular surface epithelium had significant degeneration in patients compared with normal subjects.

Bilateral keratoconus associated with Hashimoto's disease, alopecia areata and atopic keratoconjunctivitis.

Keratoconus is a progressive non-inflammatory corneal ectasia. Alopecia areata is complete loss of hair patches on the hairy areas of the body in association with some ocular manifestations such as cataract, or disorders of the conjunctiva, iris, lens, choroid and retina pigment epithelium. A ten-year-old patient with atopic keratoconjunctivitis, keratoconus and alopecia areata is presented. This patient has also been receiving treatment for Hashimoto thyroiditis (chronic lymphocytic thyroiditis) for more than three years. The possible association of keratoconus with multisystem autoimmune disease is discussed.