Short-term effects of periodontal therapy as an adjunct to anti-lipemic treatment.

OBJECTIVE: This study was conducted to assess the effect of improved periodontal health following periodontal treatment on metabolic lipid control of patients on anti-lipemic treatment. MATERIALS AND METHODS: The study population consisted of 20 patients aged 34-62 years with diagnoses of hyperlipidemia and chronic periodontitis. All patients used statin to treat their elevated levels of low-density lipoprotein cholesterol. Blood samples were obtained for measurement of serum lipids, fasting plasma glucose, and high sensitive C-reactive protein. Periodontal parameters, including plaque index, gingival index, probing pocket depth, clinical attachment level, and percentage of bleeding on probing, were evaluated. All parameters were assessed in each subject at baseline, after 3 months as a control (at the time of periodontal treatment), and 3 months after the non-surgical periodontal treatment that included scaling and root planning. RESULTS: All lipid parameters decreased after the periodontal treatment, but only the decreases in total cholesterol and low-density lipoprotein cholesterol levels reached statistical significance compared to baseline (P = 0.002 and P = 0.003, respectively). CONCLUSION: Improved periodontal health may influence metabolic control of hyperlipidemia and could be considered as an adjunct to the standard measures of hyperlipidemic patient care.

Attenuated vasodilator responses to K+ in essential hypertensive men.

To study limb vascular responses to K(+) in man, paired intrabrachial arterial infusions of isosmolar NaCl (control) and isosmolar KCl (0.077, 0.154, and 0.307 meq K(+)/min) in isosmolar NaCl were made in 20 normotensive men and 20 men with essential hypertension of mild to moderate severity. Limb blood pressures were monitored, limb blood flow was measured by indicator-dilution, and limb vascular resistance was calculated as mm Hg/ml flow/min/100 cm(3) limb volume. Measured concentrations of K(+) in limb venous plasma during infusion of 0.307 meq K(+)/min ranged from 4.8 to 9.0 meq/liter. Changes in limb venous hematocrit, sodium, calcium, magnesium, and osmolality were similar during control and KCl infusions. The infusions did not significantly change systemic blood K(+) concentration or blood pressures. Compared to NaCl, KCl decreased limb resistance (P < 0.05) in both normotensives and hypertensives, in a dose-related manner. Resting limb vascular resistances (IR) in hypertensives were greater (P < 0.05) than those in normotensives. Despite a positive correlation (P < 0.05) between IR and magnitude of response to K(+), responses in hypertensives to K(+) were not greater than those in normotensives. Further, analysis of covariance indicated that responses to 0.307 meq K(+)/min in hypertensives as a group were, in fact, less (P = 0.02) than those in normotensives. These results indicate that the vasodilator response to K(+) may be attenuated in a significant proportion of essential hypertensive men, as it is in renal hypertensive animals. These abnormal responses to K(+) in hypertensives may indicate an underlying defect in vascular K(+) metabolism.

Cold pressor test in diabetic autonomic neuropathy.

The tests for evaluating sympathetic dysfunction seen in diabetic patients are few and insensitive. For this reason, there are some difficulties in diagnosing sympathetic dysfunction and additional tests are required. The cold pressor test causes a strong sympathetic stimulus and this study investigated whether this test could be helpful in diagnosing sympathetic dysfunction. The cold pressor test was applied to a group of diabetic patients (n = 33) and a control group (n = 15). The mean systolic cold pressor response in diabetic patients was found similar to controls (9 +/- 1.4 vs. 10.6 +/- 1.2 mmHg). However the mean diastolic cold pressor response was significantly lower in diabetic patients as compared with the control group (7.7 +/- 1.0 vs. 12.0 +/- 1.1 mmHg, P < 0.05). Cardiovascular reflex tests were also applied to diabetic patients and deep breathing and orthostatic hypotension test results were used to categorize the patients with parasympathetic and/or sympathetic dysfunction. In patients with autonomic neuropathy the diastolic cold pressor response was smaller than the controls (6.9 +/- 1.3 vs. 12.0 +/- 1.1 mmHg, P < 0.05); however, in patients without autonomic neuropathy it was not significantly different from controls (8.7 +/- 1.8 vs. 12.0 +/- 1.1). The systolic cold pressor test results showed no difference between patients with or without parasympathetic dysfunction but diastolic cold pressor results in patients with sympathetic dysfunction were significantly lower than the results of the patients without sympathetic dysfunction (3.8 +/- 1.3 vs. 9.1 +/- 1.3 mmHg, P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Investigation of the effect of poorly controlled diabetes mellitus on erythrocyte life.

Erythrocyte half-life (Et-1/2) has been measured in 11 patients with poorly controlled blood sugar levels and compared with a normal control group to determine whether decreased red cell deformability, which occurs in diabetic patients, causes shortening of erythrocyte life or not. No difference was seen (Et-1/2 = 28.1 days in diabetic patients and 28.5 days in controls). There was also no correlation between Et-1/2 and glycosylated hemoglobin (HbA1) levels. It has been concluded that poorly controlled diabetes mellitus has no effect upon erythrocyte life.

A case of epididymo-orchitis and paravertebral abscess due to brucellosis.

Brucellosis is a zoonotic infection involving many systems and it is widespread in Turkey. Involvement of muscular and skeletal systems is a common complication of brucellosis. Involvement of genitourinary system (epididymo-orchitis) is a rarer complication (Sözen TH. Infeksiyon Hastaliklari. 1996; pp. 486-493; Edward J. Young. Principles and Practice of Infectious Diseases, Vol. 2, 5th edn. 2000; pp. 22386-22393). Brucellosis accompanied by abscess formation in the vertebra is frequently seen in the elderly and patients with a chronic disease (Sözen TH. Infeksiyon Hastaliklari. 1996; pp. 486-493; Edward J. Young. Principles and Practice of Infectious Diseases, Vol. 2, 5th edn. 2000; pp. 22386-22393; Af-Eissa YA, Kambal AM et al. Ann Rheum Dis 1990;49 : 896-900; Colmenore JD, Cisneron JM, Orjuela DL et al. Infection 1992; 20: 38-42). Brucellosis accompanied by paravertebral abscess and epididymo-orchitis is extremely rare. In this report, we present a case of epididymo-orchitis and paravertebral abscess due to brucellosis.

[Comparison of latex agglutination and coagglutination methods for the determination of bacterial antigens in cerebrospinal fluid]. / Beyin omurilik sivisindaki bakteriyel antijenlerin belirlenmesinde, lateks aglütinasyon ve koaglütinasyon yöntemlerinin karsilastirilmasi.

The latex agglutination and coagglutination tests were used to demonstrate specific bacterial antigens in cerebrospinal fluid of patients with bacterial meningitis. Latex agglutination was more sensitive than coagglutination. It detected 90% (18/20) of culture positive CSF specimens, whereas coagglutination detected 60% (12/20). Antigens were also detected by latex agglutination in seven of seven additional cerebrospinal fluid specimens after 32-48 hours of antimicrobial therapy, but four of seven by coagglutination.

[Determination of bacterial antigens by latex agglutination tests in cultured cerebrospinal fluid specimens from bacterial meningitis]. / Bakteriyel menenjitli olgularin beyin omurilik sivisi örneklerinde, lateks aglütinasyon yöntemi ile bakteriyel antijenlerin belirlenmesi.

Between December 1988 and February 1991, the latex agglutination test was evaluated for its ability to detect the antigens of N. meningitidis, S. pneumoniae and H. influenzae in the samples of cerebrospinal fluid (CSF) of 57 patients with bacterial meningitis. Totally antigens were detected in 34 of 42 (80.9%) patients with bacterial meningitis proven by culture. Latex agglutination was positive in 60% of CSFs for N. meningitidis, 88.2% of CSFs for S. pneumoniae and 100% of CSFs for H. influenzae. Antigens were detected in 7 of 9 (77.8%) patients with no bacterial organisms grown on CSF culture but seen on microscopy after Gram staining. No antigens were identified in CSFs of 4 patients with culture and gram stain negative. 32-48 hours after the treatment started, the CSF samples were obtained again from 11 patients and antigens were detected in 9 of them.

[Case report: a brain hydatid cyst]. / Olgu raporu: beyinde kist hidatik olgusu.

Hydatid cyst is a zoonotic infection caused by larval stage of Echinococcosis granulosus. Although any organ may be involved, bone, brain and heart involvements are uncommon. The brain involvement rate varies from 1% to 3% in hydatid disease. In this report, a 42 years old female patient has been presented in whom brain hydatic cyst was diagnosed by radiological and histopathological findings.

[Case report: brucellosis complicated by epididymo-orchitis and paravertebral abscess]. / Olgu raporu: epididimo-orsit ve paravertebral abseli brusellozis.

Brucellosis which is a zoonotic infection involving many systems, is widespread in Turkey. Although muscular and skeletal system involvements are common, genitourinary system complications (epididymo-orchitis) are observed rarely. Brucellosis accompanied by abscess formation in the vertebra is generally seen in the elderly and patients with chronic diseases, while epididymo-orchitis in young patients. However, it is very unusual to detect these two complications together. In this report, a case of 42 years old male patient with epididymo-orchitis and paravertebral abscess due to brucellosis, has been presented.

Should Targeted Biopsy be Performed in Patients Who Have Only Pi-rads 3 Lesions?

Objective: To determine whether clinical or radiological parameters can predict clinically significant prostate cancer (csPC) in patients with the Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions. Patients and Methods: Data were obtained from 247 patients with PI-RADS 3 lesions on mpMRI and who had received a software guided transperineal/transrectal MRI/transrectal ultrasonography (MRI/TRUS) fusion prostate biopsy with concomitant standard systematic 12-core biopsy following mpMRI in the prostate cancer and prostate biopsy database of Turkish Urooncology Association, between 2016 and 2020. The cut-off values of clinical parameters were determined using receiver operating characteristic (ROC) curve analysis. Simple and multiple logistic regression analyses were performed to determine the clinical parameters in predicting csPC. Results: A total of 56 patients (22.6%) had prostate cancer, 23 (9.3%) of whom had csPC. In the lesion- based analysis, cancer detection rates (CDRs) of each lesion in targeted biopsy were found to be 6% and 5% for ISUP GG 1 and ISUP GG ≥ 2, respectively. In the patient-based analysis, clinically insignificant CDRs were significantly higher in systematic biopsy compared with targeted biopsy, whereas no significant difference was found in terms of clinically significant CDRs (p = 0.020 and p=0.422, respectively). The cut-off values were determined as 48.3 mL (AUC [95% CI] = 0.68 [0.53–0.82]) for prostate volume, and 0.213 ng/mL/mL (AUC [95% CI] = 0.64 (0.51–0.77]) for PSAD in predicting csPC. In the multiple logistic regression analysis, only PSAD was found to be an independent risk factor in predicting csPC (OR [95% CI]: 3.56 [1.15–10.91], p = 0.024). Conclusion: Since PSAD > 0.20 ng/mL/mL was found to be positive independent risk factor in predicting csPC, in the absence of advanced radiological parameters, PSAD could be used for the biopsy decision in patients with PI-RADS 3 lesions (AU)

Immunity to tetanus among adults in Turkey.

In 100 individuals > 18 y of age, living in urban or rural regions of Ankara, antitetanus immunoglobulin levels were determined using enzyme-linked immunosorbent assay and a brief questionnaire was administered. In total, 68% of subjects showed protective levels (> 0.01 IU/ml). Differences between rural (64%) and urban (72%) areas and between males (71.4%) and females (61.1%) were not significant (p > 0.05). Protective levels were found in 93.1% of subjects aged 18-30 y, 77.3% of those aged 30-40 y, 58.3% of those aged 40-50 y, 41.7% of those aged 50-60 y, 36.4% of those aged 60-70 y and 20% of those aged > 70 y. Only 35.7% of individuals aged > 50 y of age were found to be protected against tetanus (p = 0.004). The levels of antitetanus antibody in individuals vaccinated in the last 10 y were significantly higher than those in individuals vaccinated > 10 y ago and in those who did not remember the vaccination date (p = 0.009). Poor immunity against tetanus is a problem in elderly people in Turkey.

Behcet's disease associated with amyloidosis.

The association of Behcet's disease and amyloidosis is relatively rare. We present two patients with Behcet's disease who developed amyloidosis during the course of their illness. The relation of amyloidosis with Behcet's disease is not clear. We discuss the possible etiopathogenetic factors.

Classification of localized untreated prostate cancer based on 791 men treated only with radical prostatectomy: common ground for therapeutic trials and TNM subgroups.

PURPOSE: We examined cancer volume, percent Gleason grade 4/5 cancer, cancer location (peripheral versus transition zone), capsular penetration and biochemical cure rates in men undergoing radical prostatectomy to determine differences among clinical stages T1c, T2a, T2b and T2c. MATERIALS AND METHODS: Detailed chart reviews confirmed the precise clinical stages assigned to 791 consecutive men treated only with radical prostatectomy. All prostates were examined prospectively by the Stanford technique of 3 mm. step sections. For biochemical cure rates a subset of 366 men were followed for a minimum of 5 years. Failure was defined as prostate specific antigen Tosoh 0.07 ng./ml. or greater and rising. T1c was defined as impalpable cancer. RESULTS: T1c and T2a stages had half as much cancer volume as T2b and T2c cancers, 10 versus 25% Gleason grade 4/5 and half as much capsular penetration (30 versus 61%). Biochemical cure rates were 70 and 72% for T1c and T2a compared to 37 and 27% for T2b and T2c, respectively. Of T1c cancers 25% were in the transition zone compared to 7.9 to 9.9% of T2a to c cancers. CONCLUSIONS: T1c cancers are similar to T2a cancers in tumor volume and percent Gleason grade 4/5, the primary determinants of therapeutic failure. Minimal 5-year cure rates for T1c and T2a cancers are similar. Transition zone cancers are 2.5 times more common in T1c cancers than in palpable T2 tumors. T2a cancers like T1c cancers are highly favorable tumors and should be retained in TNM classifications. These data suggest that the 4 clinical stages of T1c to T2c can serve as a valid basis for comparing different therapeutic strategies.

Celsite port and catheter as an intraperitoneal access device in the treatment of ovarian cancer.

BACKGROUND AND OBJECTIVES: In ovarian cancer, development of safe and effective methods for providing long-term access to the peritoneal cavity has become increasingly important. METHODS: A modified Port-A-Cath (Celsite-port and catheters, B. Braun, Chasseneuil, France) was used in 56 patients with presumed epithelial ovarian cancer at the conclusion of primary or second-look laparotomy. In 37 patients, ports were located on the right costal margin in the midclavicular region and in 19 in the xiphoid region. RESULTS: In 56 catheters, 8 (13.8%) complications of severe or moderate degree during the treatment were registered. In-flow obstruction of device occurred in 6 patients, and there was 1 viscous perforation and 1 catheter related infectious peritonitis. Grade III-IV pain and in-flow obstruction were developed in the patients with ports implanted on the right costal margin but not with ports implanted in the xiphoid region. CONCLUSION: The complication rate of intraperitoneal access devices is comparatively low.