Aortic Flow Propagation Velocity in Patients with Familial Mediterranean Fever: an Observational Study

BACKGROUND AND OBJECTIVES: Systemic inflammation has an important role in the initiation of atherosclerosis, which is associated with arterial stiffness (AS). Aortic flow propagation velocity (APV) is a new echocardiographic parameter of aortic stiffness. The relationship between systemic inflammation and AS has not yet been described in patients with familial Mediterranean fever (FMF). We aimed to investigate the early markers of AS in patients with FMF by measuring APV and carotid intima-media thickness (CIMT). SUBJECTS AND METHODS: Sixty-one FMF patients (43 women; mean age 27.3±6.7 years) in an attack-free period and 57 healthy individuals (36 women; mean age 28.8±7.1 years) were included in this study. The individuals with atherosclerotic risk factors were excluded from the study. The flow propagation velocity of the descending aorta and CIMT were measured to assess AS. RESULTS: APV was significantly lower (60.2±16.5 vs. 89.5±11.6 cm/sec, p<0.001) and CIMT was significantly higher (0.49±0.09 vs. 0.40±0.10 mm, p<0.001) in the FMF group compared to the control group. There were significant correlations between APV and mean CIMT (r=-0.424, p<0.001), erythrocyte sedimentation rate (ESR) (r=-0.198, p=0.032), and left ventricle ejection fraction (r=0.201, p=0.029). APV and the ESR were independent predictors of FMF in logistic regression analysis (OR=-0.900, 95% CI=0.865-0.936, p<0.001 and OR=-1.078, 95% CI=1.024-1.135, p=0.004, respectively). Mean CIMT and LVEF were independent factors associated with APV in linear regression analysis (β=-0.423, p<0.001 and β=0.199, p=0.017, respectively). CONCLUSION: We demonstrated that APV was lower in FMF patients and is related to CIMT. According to our results, APV may be an independent predictor of FMF.

A Rare Presentation of Follicular Lymphoma: Cerebellar Involvement, Successfully Treated with a Combination of Radiotherapy and Chemotherapy / Journal of the Korean Cancer Association, 대한암학회지

The central nervous system (CNS) is an important area of involvement for both high-grade, aggressive primary and secondary lymphomas. Although follicular lymphoma represents a low-grade histology, it may rarely present with CNS involvement. Here, we describe a patient diagnosed with follicular lymphoma who was presented with cerebellar involvement.

Modified outpatient dexamethazone, cytarabine and cisplatin regimen may lead to high response rates and low toxicity in lymphoma

Our purpose was to investigate the efficacy of and establish a toxicity profile for a modified regimen of dexamethasone, cytarabine and cisplatin [DHAP] for lymphoma outpatients. Fifty-one lymphoma patients, 26 with Hodgkin's disease and 25 with non-Hodgkin's lymphoma, were included. The patients' median age was 32 years [range: 17-61]. Twenty had progressive/refractory disease and 31 relapsed disease. Twenty-five were in clinical stage I/II and 26 in clinical stage III/IV before the initiation of salvage chemotherapy. DHAP consisted of dexamethasone [40 mg i.v. on days 1-4], cytarabine [2 g/m[2] i.v. as 3-hour infusion on days 2 in the evening and 3 in the morning] and cisplatin [35 mg/m[2] as 2-hour infusion on days 1-3] were administered every 21 days. A total of 154 cycles of modified DHAP were administered, with a median of 3 cycles per patient [range: 2-4]. The main toxicity was myelosuppression. WHO grade III-IV neutropenia and grade III-IV thrombocytopenia were observed in 27 [52.9%] and 21 [41%] patients, respectively. The overall response rate [85% for Hodgkin's disease and 95% for non-Hodgkin's lymphoma] was 88.3% [39.2% complete response and 49.1% partial response]. The results showed that this outpatient schedule of DHAP was well tolerated and an effective salvage regimen

Habitual snoring in primary school children: prevalence and association with sleep-related disorders and school performance

To determine the prevalence of habitual snoring [HS] and its association with both day- and nighttime symptoms, school performance and behavioral disturbances in a sample of primary school children. A cross-sectional study was performed on 1,605 children [819 boys and 786 girls] aged 7-13 years from 9 randomly selected primary schools located within the city limits of Isparta, Turkey. HS and sleep problems were assessed using a 55-item multiple-choice questionnaire. Of the 1,605 questionnaires, 1,164 were fully completed and returned, giving a response rate of 72.5%. The overall prevalence of snoring was 38.9%, while HS accounted for 3.5%. The prevalence of HS among boys [25,3.0%] was higher than among girls [16, 2.0%; chi[2] for trend: p < 0.001, OR: 1.92, 95% Cl: 1.01-3.66]. There was an association between younger age and HS, as children aged 7-8 years had the highest prevalence [chi[2] for trend: 0.054, OR: 1.85, 95% Cl: 0.81-4.22]. Habitual snorers had more daytime and nighttime symptoms. Allergic symptoms, daytime mouth breathing, shaking the child for apnea, restless sleep and hyperactivity were significant and independent risk factors and sleep-related symptoms for HS. A significant and independent association was found between poor school performance and hyperactivity, nocturnal enuresis, tooth grinding and low parental/ maternal education in multivariate analysis. Children with HS were more likely to have sleep-related daytime and nighttime symptoms. No significant association was determined between HS and poor school performance

Seroprevalence of fasciolosis and the difference of fasciolosis between rural area and city center in Isparta, Turkey

To investigate the seroprevalence of fasciolosis and the possible causes of differences between rural and city center. We undertook a multi-stage sampling analysis of data from Isparta, Turkey, between March and June 2004. Four hundred and fifteen individuals participants from Isparta center and 171 from Asagi Gokdere village were included in the study. Fasciola hepatica [F. hepatica] specific antibodies were analyzed using excretory-secretory [ES]-enzyme-linked immunosorbent assay [ELISA] method. Fasciola hepatica antibodies were detected as positive in 10 [2.4%] of 415 people whose sera were collected from the city center and 16 [9.3%] of 171 people from Asagi Gokdere village. The positivity rates between village and city center were found statistically significant. A statistical difference was noted for fasciolosis positivity between individuals who have ingested water cress and who have not. Fasciolosis was not detected in the individuals who used to wash vegetables with water containing vinegar. Most of the patients in this region reported consumption of uncooked or unwashed water cress. Watering channel is one of the major risk factors of fasciolosis. Therefore, it is essential to determine the watering systems in this region. Moreover, ES-ELISA would be useful in investigating the laboratory diagnosis of fasciolosis

Nosocomial Oral Myiasis by Sarcophaga sp. in Turkey

We present a case of oral myiasis in a 15-year-old boy with tuberculosis meningitis. The diagnosis was based on the visual presence of wriggling larvae about 1 cm in size and on the microscopic features of the maggots, especially those relating to stigmatic structures. The larvae were identified as third stage larvae of Sarcophaga sp.