Left ventricular twist in hypertrophic cardiomyopathy : Predictor of nonsustained ventricular tachycardia.

BACKGROUND: We investigated the efficacy of clinical and classic echocardiographic parameters in predicting the occurrence of nonsustained ventricular tachycardia (NsVT) in patients with hypertrophic cardiomyopathy (HCM). METHODS: The study comprised 59 patients with HCM (47 male, [80%]; mean age, 48.48 ± 14.16 years). Clinical, electrocardiographic, as well as classic two-dimensional and speckle-tracking echocardiography (STE) data were collected. All patients had Holter monitoring within 24-72 h of the echocardiographic examination. NsVT was defined as three or more consecutive premature wide QRS complexes with a heart rate of > 100 bpm. The patient population was categorized into groups based on the occurrence or absence of NsVT on the 24-h Holter recordings. RESULTS: NsVT was observed in 17 patients (29%). In these patients, higher twist (14.4 ± 3.8 vs.18 ± 7.9; p = 0.02), higher apical rotation (8.7 ± 4.2 vs. 12.2 ± 7; p = 0.02), higher sudden cardiac death risk score (4.4 ± 2.2 vs. 7 ± 3.3; p = 0.007), and decreased global longitudinal peak strain (GLPS; -12.8 ± 3.1 vs. -10.6 ± 2.8; p = 0.014) were observed. In the multivariate logistic regression analysis, including GLPS and twist, GLPS (Odds Ratio [OR]: 1.406; 95% CI: 1.087-1.818; p = 0.009) and twist (OR: 1.236; 95% CI: 1.056-1.446; p = 0.008) were found to be independent predictors of NsVT. In the receiver operating characteristic curve analysis, GLPS < -11.9% predicted NsVT with 82% sensitivity and 60% specificity (area under the curve [AUC]: 0.70; p = 0.014) and twist > 15.2° predicted NsVT with 70% sensitivity and 58% specificity (AUC: 0.69; p = 0.027). CONCLUSION: Decreased GLPS and increased twist were predictive of NsVT in HCM patients. Parameters that can easily be measured with STE can help detect patients who may develop arrhythmia.

Obsessive Compulsive Symptoms and Quality of Life in mothers of Children With Atopic Dermatitis / Síntomas obsesivo-compulsivos y calidad de vida en madres de niños con dermatitis atópica

Background and objectives: Atopic dermatitis is one of the most common skin disorders in children and it can negatively affect both children and their families. The purpose of this study was to investigate the effect of atopic dermatitis on quality of life related to maternal health and maternal obsessive compulsive symptoms. Methods: A cross-sectional study was conducted in the pediatric and dermatology polyclinics. The SCORAD index was used for determining the severity of disease, and the Maudsley Obsessive Compulsive Inventory (MOCI) and SF-36 form were applied to the participants’ mothers. Results: A total of 120 children and their mothers participated the study. Comparing the atopic dermatitis group and the healthy control group, no statistically significant differences were seen in terms of MOCI and SF-36 scores, except for the physical functioning subscore. Conclusion: The results showed that having a child with atopic dermatitis and the severity of the disease do not influence their mothers in terms of obsessive-compulsive symptoms and health-related quality of life, except for physical functioning scores (AU)

Antecedentes y objetivos: La dermatitis atópica es uno de los trastornos cutáneos infantiles más comunes, que puede afectar de manera negativa tanto a los niños como a sus familiares. El objetivo del presente estudio era investigar el efecto de la dermatitis atópica en la calidad de vida relacionada con la salud materna y los síntomas obsesivo-compulsivos maternos. Métodos: Se dirigió un estudio transversal en policlínicos pediátricos y dermatológicos. El índice SCORAD de utilizó para determinar la gravedad de la enfermedad, y el inventario de obsesiones-compulsiones de Maudsley y el cuestionario SF-36 se entregaron a las madres de los participantes. Resultados: En el estudio participaron un total de 120 niños y sus madres. Al comparar el grupo con dermatitis atópica con el grupo de control no se encontraron diferencias con significación estadística respecto a las puntuaciones en el inventario de obsesiones-compulsiones de Maudsley y SF-36, salvo por la subpuntuación de la función física. Conclusión: Los resultados demostraron que tener un hijo con dermatitis atópica y la gravedad de la enfermedad no influyen en las madres por lo que respecta a sus síntomas obsesivo-compulsivos ni su calidad de vida, salvo por las puntuaciones de función física (AU)

Obsessive Compulsive Symptoms and Quality of Life in mothers of Children With Atopic Dermatitis.

BACKGROUND AND OBJECTIVES: Atopic dermatitis is one of the most common skin disorders in children and it can negatively affect both children and their families. The purpose of this study was to investigate the effect of atopic dermatitis on quality of life related to maternal health and maternal obsessive compulsive symptoms. METHODS: A cross-sectional study was conducted in the pediatric and dermatology polyclinics. The SCORAD index was used for determining the severity of disease, and the Maudsley Obsessive Compulsive Inventory (MOCI) and SF-36 form were applied to the participants' mothers. RESULTS: A total of 120 children and their mothers participated the study. Comparing the atopic dermatitis group and the healthy control group, no statistically significant differences were seen in terms of MOCI and SF-36 scores, except for the physical functioning subscore. CONCLUSION: The results showed that having a child with atopic dermatitis and the severity of the disease do not influence their mothers in terms of obsessive-compulsive symptoms and health-related quality of life, except for physical functioning scores.

Erratum:Preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as new prognostic factors for patients with colorectal cancer.

In this article published in Volume 21, issue 5, the authors' names appeared in the Pubmed abstract as: "Mahsuni Sevinc M, Riza Gunduz U, Kinaci E, Armagan Aydin A, Bayrak S, Umar Gursu R, Gunduz S". The correct authors' names are: "Sevinc MM, Gunduz UR, Kinaci E, Aydin AA, Bayrak S, Gursu RU, Gunduz S" This error appeared only in the PubMed database and not in the print form of the Journal.

Dilatation of the cervix at non-labour caesarean section: Does it improve the patients' perception of pain post-operatively?

Our aim was to determine the effect of cervical dilatation at non-labour caesarean section on post-operative pain and maternal morbidity. This prospective, randomised, single-blinded trial was conducted from March 2013 to February 2014. In all, 199 patients were enrolled in the study: 102 in non-dilated group and 97 in cervical dilatation group. Based on Visual Analogue Scale, there were no significant differences between the two groups on post-operative 8th, 24th and 48th hour pain scores. We observed thinner endometrial cavity thickness, shorter operation time and shorter hospitalisation duration in cervical dilatation group. However, change in haemoglobin concentrations and puerperal fever rates were found to be comparable between the groups. In conclusion, intra-operative cervical dilatation does not seem to benefit in terms of post-operative pain, change in haemoglobin concentrations or puerperal fever.

Ceraflex versus Amplatzer occluder for secundum atrial septal defect closure. Multicenter clinical experience.

AIM: The Ceraflex atrial septal defect occluder is an alternative device to the Amplatzer septal occluder with some structural innovations including flexible connection, increased flexibility, and minimized amount of implant material. We evaluated the efficiency and safety of the Ceraflex septal occluder device in percutaneous closure of secundum atrial septal defects. PATIENTS AND METHODS: This was a prospective, nonrandomized, multicenter study of patients undergoing transcatheter closure for an atrial septal defect with the Ceraflex and the Amplatzer septal occluder devices. A clinical evaluation and follow-up transthoracic echocardiography were performed at 1, 6, and 12 months. RESULTS: Between 2010 and 2014, 125 patients underwent atrial septal defect closure with the Ceraflex septal occluder (n = 58) and the Amplatzer septal occluder (n = 67) under transesophageal echocardiography guidance. Patient characteristics, the stretched size of the defect, device size, and fluoroscopy time were similar between the groups. The immediate and follow-up complete occlusion rates for both groups were 100%. There was no device embolization, procedure-related stroke, or pericardial effusion. CONCLUSIONS: The Ceraflex septal occluder is a safe and efficient device for closure of secundum atrial septal defects with no procedural complications. The Ceraflex has similar outcomes when compared with the Amplatzer septal occluder device. The advantage of the Ceraflex septal occluder device is that it can be deployed without the tension of the delivery catheter.

Role of anticardiolipin antibodies in the pathogenesis of prosthetic valve thrombosis: An observational study.

BACKGROUND: Prosthetic valve thrombosis (PVT) is serious complication of valvular replacement surgery, and increased levels of anticardiolipin antibodies (aCL) are associated with thrombosis. The aim of this study was to evaluate the role of aCL in the development of PVT. PATIENTS AND METHODS: We studied the aCL IgM and IgG levels in 114 patients with PVT and 80 healthy patients with prosthetic valves without PVT or a history of thrombosis. All patients underwent detailed transthoracic, transesophageal echocardiographic and clinical examinations. Blood samples were obtained after transesophageal echocardiography. Tests were repeated 12 weeks apart in patients with aCL IgM or IgG positivity. RESULTS: The mean age, sex, presence of atrial fibrillation and cardiovascular risk factors, elapsed time after surgery, and prosthetic valve type and location were similar between patients with PVT and those without. Ineffective anticoagulation was significantly higher among patients with PVT (p < 0.001). The aCL IgM values were significantly higher and positive (> 40 MPL) in the PVT group compared with the control group (10.58 ± 15.90 MPL to 3.70 ± 2.30 MPL, p < 0.001; 7.0 to 0 %, p = 0.016, respectively). The aCL IgG values were significantly higher and positive (> 40 GPL) in the PVT group compared with the control group (12.04 ± 17.58 GPL to 3.83 ± 2.56 GPL, p < 0.001 and 7.9 to 0 %, p = 0.01, respectively). According to international consensus documents, 16 patients had antiphospholipid syndrome. Ineffective anticoagulation and aCL IgM and IgG positivity were independent predictors of PVT in logistic regression analysis (multivariate r(2)= 0.648; p < 0.001, OR= 21.405, 95 %CI= 8.201-55.872; p = 0.008, OR= 1.322, % 95CI= 1.076-1.626; p = 0.005, OR= 1.288, 95 %CI= 1.079-1.538). CONCLUSION: Since the presence of aCL IgM and IgG positivity may cause a tendency toward PVT, these values should be examined in all patients with PVT.

Complete response of primary bladder adenocarcinoma with the FOLFOX4 regimen.

INTRODUCTION: Primary adenocarcinoma of the bladder is a very rare disease that is difficult to treat. In this paper, we report the second case in the literature with primary mucinous adenocarcinoma of the bladder which showed complete response to FOLFOX4 (fluorouracil, leucovorin, oxaliplatin) chemotherapy regimen. CASE REPORT: A 41-year-old man was admitted to our hospital with a diagnosis of primary adenocarcinoma of the bladder. Due to the similarity in histology with colon carcinoma, a FOLFOX4 regimen was started. Complete response was achieved at the end of this treatment. Today the patient is free of local or systemic disease. CONCLUSION: FOLFOX4 regimen may be a treatment option for primary adenocarcinoma of the bladder.

Factors predicting lapatinib efficacy in HER-2+ metastatic breast carcinoma: Does it work better in different histologic subtypes?

CONTEXT: Introduction of trastuzumab, a recombinant monoclonal antibody against the extracellular domain of HER-2, is a cornerstone in the treatment of HER-2+ breast carcinoma. However, many cancers that have an initial response to trastuzumab will progress some time later. After progression on trastuzumab-based first-line treatment, there are several options. Although TDM-1 (Trastuzumab emtansine) has prolonged progression-free survival (PFS) and overall survival in patients previously treated with trastuzumab and taxane, it is still not available in Turkey. Patients may be switched to lapatinib (an oral tyrosine kinase inhibitor targeting both HER-1 and HER-2), or they may re-challenge with trastuzumab. There is no clear definition of the patients who should be switched to lapatinib. AIM: In this study, we investigated the factors predicting the efficacy of lapatinib. SUBJECTS AND METHODS: Totally, 94 patients treated with lapatinib for metastatic breast carcinoma was included in our study. Retrospective data including pathology, treatments and treatment results, metastatic sites, and laboratory tests were collected. RESULTS: Progression-free survival was 9.1 months. Histologic subtypes other than invasive ductal carcinoma and liver metastasis were inversely related with PFS. Overall survival was 22.1 months, and patients with histologic subtypes other than invasive ductal carcinoma and who progress with brain metastasis had a worse prognosis. CONCLUSION: Clinicians should give attention to histologic subtype and metastatic sites when choosing patients for lapatinib treatment.

Line of abiraterone acetate in castration-resistant metastatic prostate cancer--Does it matter? report of a multi-institutional experience.

OBJECTIVE: We present our data comparing retrospectively the efficacy of abiraterone and cabazitaxel in patients who progress after docetaxel treatment. PATIENTS AND METHODS: The study included 56 patients diagnosed with hormone-refractory metastatic prostate cancer who were previously treated with abiraterone therapy at four oncology centers in Turkey. RESULTS: With abiraterone, the patients had a median progression-free survival (PFS) of 5.9 months (95% confidence interval (CI) for hazard ratio (HR) (4.4-7.4)) and an overall survival of 13.4 months (95% CI for HR (5.5-21.3)). When we compared the disease-free survival (DFS) of reference patients treated with cabazitaxel as a second-line treatment with those receiving second-line abiraterone therapy, there was no significant difference. (PFS = 5.9 months with cabazitaxel vs. 6.7 months with abiraterone, P = 0.213). CONCLUSION: This study has shown that in our experience abiraterone acetate is an effective agent in metastatic castration-resistant prostate cancer (mCRPC) regardless of the line of treatment.

Can positron emission tomography-computed tomography predict response in locally advanced rectal cancer patients treated with induction folinic acid and 5-florouracil?

OBJECTIVE: The aim of this study was to determine the pathological complete response rates in a group of locally advanced rectal cancer patients who underwent chemoradiotherapy (CRT) after treatment with induction folinic acid and 5-florouracil (FOLFOX) chemotherapy and the relationship between the complete response and positron emission tomography-computed tomography (PET-CT). MATERIALS AND METHODS: The files of 239 patients who were diagnosed with rectal cancer between January 2008 and January 2012 were evaluated retrospectively. Of these, there were 24 locally advanced rectal cancer patients who met the following criteria: They were administered CRT after receiving four courses induction oxaliplatin, FOLFOX and they underwent PET-CT for staging and for the evaluation of their response to FOLFOX treatment. Of these 24 patients, 20 operable patients were included in the study. RESULTS: The pathological complete response was obtained in seven patients (35%) who were operated on and then given induction four courses FOLFOX chemotherapy and CRT. We determined that age, gender, clinical stage at diagnosis and PET-CT before and after induction chemotherapy were not predictive of the pathological complete response to tumor fluorodeoxyglucose uptake activity. CONCLUSION: The rates of pathological complete response were increased in locally advanced rectal cancer patients who underwent short-term induction chemotherapy. Although the PET-CT has retained its importance in predicting pathological complete response, there is still a need for studies with a larger number of patients and long-term follow-ups.

A reference finding rarely seen in primary hyperparathyroidism: brown tumor.

Primary hyperparathyroidism is an endocrinopathy which is characterized with the hypersecretion of parathormone. During the progress of the disease bone loss takes place due to resorption on the subperiosteal and endosteal surfaces. Brown tumor is a localized form of osteitis fibrosa cystica, being part of the hyperparathyroid bone disease. It is rarely the first symptom of hyperparathyroidism. Nowadays, the diagnosis is made at an asymptomatic or minimally symptomatic stage. We present a male patient presented with a massive painless swelling in the left maxilla as the first manifestation of primary hyperparathyroidism due to a parathyroid adenoma. Parathyroidectomy was performed, and there was a regression of the bone lesion, without the need of performing other local surgical procedures.

Slurry analysis of cadmium and copper collected on 11-mercaptoundecanoic acid modified TiO2 core-Au shell nanoparticles by flame atomic absorption spectrometry.

Separation/preconcentration of copper and cadmium using TiO(2) core-Au shell nanoparticles modified with 11-mercaptoundecanoic acid and their slurry analysis by flame atomic absorption spectrometry were described. For this purpose, at first, titanium dioxide nanoparticles were coated with gold shell by reducing the chloroauric acid with sodium borohydride and then modified with 11-mercaptoundecanoic acid. The characterization of modified nanoparticles was performed using ultra-violet spectroscopy and dynamic light scattering. Copper and cadmium were then collected on the prepared sorbent by batch method. The solid phase loaded with the analytes was separated by centrifugation and the supernatant was removed. Finally, the precipitate was slurried and directly aspirated into the flame for the determination of analytes. Thus, elution step and its all drawbacks were eliminated. The effects of pH, amount of sorbent, slurry volume, sample volume and diverse ions on the recovery were investigated. After optimization of experimental parameters, the analytes in different certified reference materials and spiked water samples were quantitatively recovered with 5% RSD. The analytes were enriched up to 20-fold. Limits of detection (N=10, 3σ) for copper and cadmium were 0.28 and 0.15 ng mL(-1), respectively.

A preliminary trial to determine whether prevention of dark adaptation affects the course of early diabetic retinopathy.

UNLABELLED: This study was designed to determine whether a new form of treatment of diabetic retinopathy (DR) was acceptable to patients and whether reduction in the maximal activity of rods in diabetes could affect the progress of DR. METHODS: In 12 patients, trans-lid retinal illumination of one eye was employed during sleep to prevent the depolarisation of rods and thus reduce their metabolic activity. TECHNIQUES: A headband was used to place a source of chemical light over one eye, with its fellow as a control. MEASUREMENTS: Colour contrast thresholds were measured before and after a period of treatment in treated eyes, and the changes were compared to those in untreated fellow eyes, and areas of 'dark retinal anomalies' (microaneurysms, dot haemorrhages) were measured at the same time points. RESULTS: Patients found this intervention to be acceptable, and no adverse effects were noted. In the majority of cases, and for each outcome measure, the treated eyes improved relative to their fellows. The intervention significantly reduced the tritan thresholds in treated eyes relative to their fellows (P=0.03), and the area of dark retinal anomalies decreased in treated eyes and increased in untreated eyes, with a similar probability. CONCLUSIONS: The study showed that this intervention is safe. Although the study was not powered to study efficacy, the results are promising and consistent with other reports that indicate the retina in DR is suffering from hypoxia; however, further trials should be undertaken.

Spectrofluorimetric determination of trace aluminum in diluted hemodialysis solutions.

In this study, a spectrofluorimetric method has been developed for the determination of aluminum based on the formation of an aluminum complex with N,N'-disalicylidene-1,3-diamino-2-hydroxypropane (DSAHP). The most suitable pH, solvent medium, complex formation time, Schiff base concentration and temperature were determined. The excitation and emission wavelengths were 270 and 437 nm, respectively, in which the DSAHP-Al complex gave the maximum fluorescence intensity at pH 3.0 and 6.0 in 50% dioxan-50% water medium. Under these conditions, calibration curves were obtained in three different linear limits, and was found that aluminum could be detected within the concentration limit of 0-10.0 microM and the lowest detection limit being 0.27 ng ml(-1). The stoichiometry of the DSAHP-Al complex was also determined spectrofluorimetrically under optimal conditions and the molar ratio of DSAHP-Al was calculated as 2:1. Using the developed method, aluminum was detected in hemodialysis solutions, and the results obtained were similar and comparable with those obtained using the method described in the British Pharmacopoeia within 95% confidence limits. This method can be used successfully for the routine determination of aluminum because it is quick, requires less amount of reactives, is sensitive, reliable and reproducible.

Multiple giant molluscum contagiosum in a renal transplant recipient.

Atypical presentations of molluscum contagiosum (MC) infection can be expected in renal transplant recipients, as a result of long-term immunosuppression. However, giant MC has rarely been reported in this population. We present a 28-year-old female renal transplant recipient receiving immunosuppressive therapy who developed multiple giant MC lesions on her axillary folds. The lesions were treated successfully with curettage and electrocauterization.

Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population.

A key objective of successful nonsurgical endodontic treatment is obturation of the root canal systems. One factor in achieving this goal is the knowledge of possible root canal morphologies. Root canal morphology may exhibit variation as a result of many factors, including ethnic origin. In this study, 1400 male and 1400 female extracted mandibular and maxillary permanent teeth were evaluated for patterns in root canal morphology. The mandibular and maxillary teeth were divided into seven groups of tooth type (e.g. centrals, laterals, canines, first premolars, second premolars, first molars, and second molars), subdivided into gender, and classified by root canal morphologies. Vertucci's classification was taken as a reference during the evaluation. Although a majority of the specimens corresponded to this classification scheme, the analysis of this large data set revealed 14 additional root canal morphologies.

Nursing care in spinal cord injuries in Turkey.

The organized management of spinal cord injury is a team activity and the nurse is at the central position of that team. Nursing activities and caring should be superior in a spinal cord injury rehabilitation department. Nevertheless, nurses seldom undertake caring activities and usually perform therapeutic activities in developing countries. We recorded the care of 15 spinal cord injured patients around the clock for 10 working days. We asked the nurses, patients and their family carers to record every activity they performed on the forms. The activities were as follows: Oral care, face care, hand care, foot care, nail care, genitalia care, perineal care, catheterization, head bath, bed bath, bath, positioning, mobilization, exercising, wound dressing, room activities and the other nursing activities. The total number of nursing activities, performed was 3573. Subtotals were as follows: 2545 caring activities, 364 room activities, and 664 other nursing activities. While nurses performed 550 of the caring activities, patients and their family carers performed 988 and 1007 patient care activities. The distribution of the nurses' activities was as follows: 40% for caring, 11% for room activities, 48% for others. We discuss the importance of caring activities and the role of nurses in the rehabilitation team.