RESUMEN
There are several studies confirming an association between nicotine exposure and increase in aortic intima-media thickness (aIMT) as a pre-atherosclerotic lesion. The ω-3 FAs are on the other hand reported to have an anti-atherogenic effect. We aimed to evaluate histopathologically the effect of nicotine exposure during pregnancy and lactation period on fetal growth and aIMT at postnatal 45 days of age in rat pups living in the same conditions and to determine the protective effect of ω-3 FAs. Pregnant rats were assigned into four groups. In nicotine (N) group; pregnant rats received nicotine subcutaneously and extra-virgin olive oil by gavage during pregnancy from 1 to 21 days of gestation and lactation. In nicotine+ ω-3 FAs (N+O) group; nicotine was administered subcutaneously and ω-3 FAs by gavage, in omega-3(O) group; ω-3 FAs were administered by gavage and saline subcutaneously, in control(C) group; saline was administered subcutaneously and extra-virgin olive oil by gavage for the same period.The aIMT was found to be greatest in N+O group, which indicated a significant difference compared to the control group (p < 0.05). No statistically significant difference was found among other groups.Although the majority of studies on ω-3 FAs suggest a beneficial effect, our study showed that exposure to ω-3 FAs increased the aIMT (Tab. 2, Fig. 3, Ref. 25).
Asunto(s)
Aorta Abdominal/patología , Aterosclerosis/diagnóstico , Grosor Intima-Media Carotídeo , Ácidos Grasos Omega-3/toxicidad , Túnica Íntima/efectos de los fármacos , Animales , Aorta Abdominal/efectos de los fármacos , Aterosclerosis/inducido químicamente , Modelos Animales de Enfermedad , Femenino , Ratas , Ratas Sprague-Dawley , Túnica Íntima/patologíaRESUMEN
Early onset Marfan Syndrome (eoMFS) is a rare, severe form of Marfan Syndrome (MFS). The disease has a poor prognosis and most patients present with resistance to heart failure treatment during the newborn period. This report presents two cases of eoMFS with similar clinical features diagnosed in the newborn period and who died at an early age due to the complications related to the involvement of the cardiovascular system.
RESUMEN
A 16-day-old boy was admitted to our clinic with localized blisters on the neck, cheeks, earlobes, and oral cavity and with erythema on the toes, in addition to poor weight gain and respiratory distress. A physical examination revealed several erythematous plaques with tense bullae, multiple vesicles, and erosions on the left toes, neck, earlobes, and face as well as erosive lesions on the anterior part of the oral cavity, lips, and buccal mucosae. A bronchoscopic examination revealed bullous lesions in the upper respiratory tract and on the epiglottis. A skin biopsy suggested a diagnosis of bullous pemphigoid (BP). Because of the severe mucosal involvement, further investigations including various immunological techniques were performed. The case was diagnosed as BP associated with linear IgA bullous disease (LAD). Complete remission without any scarring was achieved after three weeks of oral methyl prednisolone treatment. A correct differential diagnosis of bullous diseases is important for determining the prognosis and expected response to treatment. To our knowledge, this is the first case of BP associated with LAD reported in literature.
Asunto(s)
Inmunoglobulina A/inmunología , Penfigoide Ampolloso/inmunología , Enfermedades de la Piel/inmunología , Broncoscopía , Comorbilidad , Técnica del Anticuerpo Fluorescente Directa , Glucocorticoides/administración & dosificación , Humanos , Recién Nacido , Masculino , Metilprednisolona/administración & dosificación , Penfigoide Ampolloso/epidemiología , Enfermedades de la Piel/epidemiologíaRESUMEN
There have been a few studies that examined the oxidative stress effects of nicotine during pregnancy and lactation. We aimed to determine the adverse effects of maternal nicotine exposure during pregnancy and lactation on oxidant-antioxidant system, and to determine a protective effect of ascorbic acid (Asc). Gravid rats were assigned into four groups. In Group 1, pregnant rats received 6-mg/kg/day nicotine subcutaneously during pregnancy from 1 to 21 days of gestation and lactation (until postnatal day 21). Group 2 received nicotine and Asc for the same period. In Group 3, the rats received nicotine during lactation. Control pregnant rats (Group 4) received only saline subcutaneously. Serum malondialdehyde (MDA), myeloperoxidase (MPO), and superoxide dismutase (SOD) levels were determined at 21 days of age. Nicotine exposure decreased birth weight and pregnancy weight gain. MDA values of the rat pups exposed to nicotine in both Groups 1 and 2 were higher than those of control and Group 3. SOD and MPO values of the groups were similar. Mean birth weight and serum MDA levels of Groups 1 and 2 were similar. Nicotine exposure via placental transfer increases oxidative stress as manifested by an increase in MDA level. Asc supplementation does not prevent the adverse effects of maternal nicotine exposure.
Asunto(s)
Antioxidantes/farmacología , Ácido Ascórbico/farmacología , Exposición Materna , Nicotina/toxicidad , Estrés Oxidativo/efectos de los fármacos , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Animales , Animales Recién Nacidos , Peso al Nacer/efectos de los fármacos , Femenino , Desarrollo Fetal/efectos de los fármacos , Inyecciones Subcutáneas , Lactancia/efectos de los fármacos , Masculino , Malondialdehído/sangre , Oxidorreductasas/metabolismo , Embarazo , RatasRESUMEN
Proximal humerus fracture is a common arm trauma and rarely occurs with vascular injury which however is a serious complication. In this case report, we present a long segment dissection of the axillary and brachial arteries as a rare complication due to fragmented proximal humerus fracture and shoulder dislocation. An 80-year old female patient was seen at the emergency department. Radiograph examination has revealed a fragmented proximal humerus fracture besides dislocation of the head of humerus towards the axillary area. On vascular examination, acute arterial occlusion such as absence of radial and ulnar pulses were observed in her left hand. The patient was immediately taken to the operating room. The dissection included the entire segment approximately 20cm between the distal subclavian artery and the distal brachial artery. This injured segment was removed and a 6mm Polytetrafluroethylene (PTFE) graft with rings was interpositoned between subclavian and brachial arteries. This case is a rarity because of such a significant complication after a small injury. Axillary artery injuries caused by humeral neck fractures are rare but should not be missed by the physician.
RESUMEN
BACKGROUND: Lipid metabolism has an important role in fetal development during the late stage of gestation, including growth and fat accretion in utero, increasing amniotic fluid lecithin levels with maturation of pulmonary function and changes in the levels of minor phospholipids in amniotic fluid. OBJECTIVE: The aim of this study was to compare the maternal and cord lipid profiles of preterm infants with respiratory distress syndrome (RDS) and a control group without RDS. METHOD: The study groups consisted of 166 preterm infants with gestational ages ranging from 25 to 36 weeks, and birth weights ranging from 748 to 2495 g. Of these infants, 57 developed RDS and 109 infants served as controls. The infants were divided into four gestational age groups (34 to 36, 31 to 33, 28 to 30 and 25 to 27 weeks). Stepwise linear regression analyses were performed to determine independent contribution of each lipid parameter of the infants to their characteristics and mothers' variables. RESULT: Total cholesterol, high-density and low-density lipoproteins (LDL) cholesterols levels were lower in infants with RDS and in their mothers than in controls, and maternal lipid profile was related to those of their infants (P<0.05). Pregravid body mass index (BMI) was related to triglyceride levels of the infants, and weight gain during pregnancy was related to LDL cholesterol levels of the infants (P<0.05). CONCLUSION: RDS is accompanied with lipid alteration in infants and their mothers. Pregravid BMI and weight gain during pregnancy might have a prognostic significance in the prediction of respiratory distress in early neonatal period.
Asunto(s)
Recien Nacido Prematuro , Lípidos/sangre , Síndrome de Dificultad Respiratoria del Recién Nacido/sangre , Adulto , Índice de Masa Corporal , Estudios de Casos y Controles , Colesterol/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Femenino , Sangre Fetal/metabolismo , Edad Gestacional , Humanos , Recién Nacido , Madres , Embarazo , Triglicéridos/sangreRESUMEN
In this retrospective study we evaluated the method of acute shortening and distraction osteogenesis for the treatment of tibial nonunion with bone loss in 17 patients with a mean age of 36 years (10 to 58). The mean bone loss was 5.6 cm (3 to 10). In infected cases, we performed the treatment in two stages. The mean follow-up time was 43.5 months (24 to 96). The mean time in external fixation was 8.0 months (4 to 13) and the mean external fixator index was 1.4 months/cm (1.1 to 1.8). There was no recurrence of infection. The bone evaluation results were excellent in 16 patients and good in one, while functional results were excellent in 15 and good in two. The complication rate was 1.2 per patient. We conclude that acute shortening and distraction osteogenesis is a safe, reliable and successful method for the treatment of tibial nonunion with bone loss, with a shorter period of treatment and lower rate of complication.
Asunto(s)
Fracturas no Consolidadas/cirugía , Osteogénesis por Distracción/métodos , Fracturas de la Tibia/cirugía , Adolescente , Adulto , Enfermedades Óseas Infecciosas/diagnóstico por imagen , Enfermedades Óseas Infecciosas/fisiopatología , Enfermedades Óseas Infecciosas/cirugía , Niño , Femenino , Fijación de Fractura/métodos , Fracturas no Consolidadas/diagnóstico por imagen , Fracturas no Consolidadas/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Osteoporosis/diagnóstico por imagen , Osteoporosis/fisiopatología , Osteoporosis/cirugía , Complicaciones Posoperatorias , Radiografía , Reoperación , Estudios Retrospectivos , Fracturas de la Tibia/diagnóstico por imagen , Fracturas de la Tibia/fisiopatología , Resultado del TratamientoRESUMEN
The prevalences of hemoglobin S (HbS) and ß-thalassemia (ß-thal) are high in Mersin, Turkey. In this study, the results of a five-year premarital screening program in Mersin province are reported. A total of 79,000 persons including 31,498 couples were screened in this program. Hematological analyses and electrophoresis were done to identify carriers. The results were given confidentially and at-risk couples were counselled on reproductive options and prenatal diagnosis. The carrier rates of hemoglobins (Hb) (HbS, HbD, HbE) and of ß-thal were 1.21%, 0.17%, 0.04% and 2.04%, respectively. One hundred and thirty-four couples were at-risk, of whom 67.2% had health insurance. Twenty-seven couples did not become pregnant, six were divorced and 11 could not be reached. Of the 135 pregnancies, 80 had prenatal diagnosis. Five stillbirths occurred, and 18 homozygous babies were born to couples that did not seek prenatal diagnosis. Two families with prenatal diagnosis had affected babies: one was a late referral and the other due to religious reasons. For a successful screening program, emphasis must be on extensive and intensive informative programs for the public as a whole. Prenatal diagnosis should be offered free of charge as a basic public service. For a healthy population, knowledge and a shared responsibility between the public and the government are necessary.
RESUMEN
Congenital asymmetric crying facies, a minor congenital anomaly due to unilateral absence or hypoplasia of the depressor anguli oris muscle, is associated at times with major congenital anomalies. A large number of asymmetric crying facies cases with chromosome 22q11 microdeletions have presently been reported. Fluorescence in situ hybridization (FISH) analysis for 22q11 deletion was performed on 8 infants with asymmetric crying facies. Five of our patients had at least one associated systemic anomaly. Two of 5 patients had conotruncal heart disease (Cayler cardiofacial syndrome). In three of the affected infants, we failed to reveal additional congenital malformation. The 22q11 deletion was present in only one patient. This baby had congenital hypoparathyroidism, severe neonatal hypocalcaemia and tetralogy of Fallot. We suggest, a 22q11 deletion should be excluded not in all cases but in cases with Cayler cardiofacial syndrome and in ACF associated with additional congenital anomalies.
Asunto(s)
Anomalías Múltiples/genética , Deleción Cromosómica , Cromosomas Humanos Par 22/genética , Llanto , Asimetría Facial/genética , Facies , Asimetría Facial/complicaciones , Femenino , Humanos , Hipocalcemia/complicaciones , Hipoparatiroidismo/complicaciones , Hipoparatiroidismo/congénito , Hibridación Fluorescente in Situ , Recién Nacido , Masculino , Tetralogía de Fallot/complicaciones , Tetralogía de Fallot/genéticaRESUMEN
This study investigated the effects of chronic peritoneal dialysis on thyroid function and thyroid volume of patients with chronic renal failure (CRF). We measured the levels of serum and dialysate thyroid hormones [total thyroxine (TT4), total triiodothyronine (TT3), free thyroxine (fT4), and free triiodothyronine (fT3)], thyrotropin (TSH), thyroglobulin (Tg), and thyroid volume in 10 children on chronic peritoneal dialysis [9 continuous ambulatory peritoneal dialysis (CAPD), 1 continuous cycling peritoneal dialysis (CCPD)] at baseline and after one year. Serum levels in patients were compared with those in age- and sex-matched healthy children and were scored as normal, low, or high. At the beginning of study, serum levels were low for TT3 in 1 patient, for fT3 in 8 patients, for fT4 in 3 patients, and for Tg in 1 patient; serum TSH was high in 1 patient. At the end of study, serum levels were low for TT3 in 2 patients, for TT4 in 2 patients, for fT3 in 9 patients, for fT4 in 4 patients, for TSH in 2 patients, and for Tg in 3 patients. At the start of the study, only TSH and Tg levels could be detected in peritoneal dialysate; other parameters could not be measured. One year later, levels of TSH had decreased in 6 patients and increased in 3 patients, and Tg had increased in 8 patients, compared with baseline levels. To determine the effect of CAPD, baseline results were compared with mean levels at the end of the study. Although the mean levels of all parameters, except Tg, had decreased after one year, only the decrease in serum TSH was statistically significant. On the other hand, only the levels of Tg increased significantly in peritoneal dialysate. The mean value of thyroid volume also decreased after a year, but all values were within the normal range, and the decrease was not significant. No correlation was found between dialysis duration and any parameter after one year. In conclusion, we found a decrease in serum thyroid hormones, thyroid volume, and TSH in chronic peritoneal dialysis patients. We suggest that the low TSH levels cannot be explained by loss in peritoneal dialysate and may be due to impairment of pituitary function.
Asunto(s)
Hipotiroidismo/etiología , Diálisis Peritoneal Ambulatoria Continua/efectos adversos , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Fallo Renal Crónico/terapia , Masculino , Tiroglobulina/análisis , Hormonas Tiroideas/sangre , Tirotropina/análisis , Tiroxina/análisis , Triyodotironina/análisisRESUMEN
ß-thalassemia and sickle cell anemia (SCA) are major health problems in Çukurova. Screening studies have been carried on in this region for many years. The government started premarital screening programme and prenatal diagnosis has been done in Çukurova University Medical Faculty since 1992. In spite of all these, the prevention programme has not been successful. The purpose of this study was to start an education programme to increase the awareness of the people for these severe hereditary diseases. The target population was the 8th grade students. A visual presentation was given to students on Thalassemia and SCA after examining the curriculum in the Biology and/or the Science books. A total of 1221 students in seven Elementary Schools were informed. A questionnaire was given to five schools before the presentation and to two after the presentation. The comparison of the two group's result showed that the information given was well received. Thus, an extensive education programme encompassing doctors, health personel, civil and religious leaders and the support of the government will result in nil SCA and Thalassemia births.
RESUMEN
The aim of this study was to identify the resistance genes and genetic relationship of carbapenemase-resistant Klebsiella pneumoniae (CRKP) identified in a tertiary university hospital in Turkey. During the study, CRKP was isolated from 137 patients. Resistance genes were studied in 94 isolates. Among these isolates, most of the CRKP produced only oxacillinase (OXA)-48 (91.5%); however, 4.3% of the isolates produced only New Delhi metallo-beta-lactamase 1 (NDM-1), 1% produced both OXA-48 and NDM-1, and 3.2% produced imipenem. This study adds Turkey to the growing list of countries with NDM-1-producing bacteria and shows that NDM-1 may easily spread worldwide.
Asunto(s)
Antibacterianos/farmacología , Carbapenémicos/farmacología , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/genética , Resistencia betalactámica , beta-Lactamasas/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Hospitales Universitarios , Humanos , Lactante , Recién Nacido , Klebsiella pneumoniae/aislamiento & purificación , Masculino , Persona de Mediana Edad , Centros de Atención Terciaria , Turquía , Adulto JovenRESUMEN
@#Proximal humerus fracture is a common arm trauma and rarely occurs with vascular injury which however is a serious complication. In this case report, we present a long segment dissection of the axillary and brachial arteries as a rare complication due to fragmented proximal humerus fracture and shoulder dislocation. An 80-year old female patient was seen at the emergency department. Radiograph examination has revealed a fragmented proximal humerus fracture besides dislocation of the head of humerus towards the axillary area. On vascular examination, acute arterial occlusion such as absence of radial and ulnar pulses were observed in her left hand. The patient was immediately taken to the operating room. The dissection included the entire segment approximately 20cm between the distal subclavian artery and the distal brachial artery. This injured segment was removed and a 6mm Polytetrafluroethylene (PTFE) graft with rings was interpositoned between subclavian and brachial arteries. This case is a rarity because of such a significant complication after a small injury. Axillary artery injuries caused by humeral neck fractures are rare but should not be missed by the physician.
RESUMEN
Irreducible Galeazzi fracture-dislocation is a rare injury. Structures that mechanically block the reduction are usually soft tissues. We present an irreducible case due to distal ulnar intra-articular fracture.
Asunto(s)
Luxaciones Articulares/complicaciones , Fracturas del Radio/complicaciones , Fracturas del Cúbito/complicaciones , Adulto , Clavos Ortopédicos , Hilos Ortopédicos , Fijación Interna de Fracturas , Humanos , Luxaciones Articulares/cirugía , Masculino , Fracturas del Radio/cirugía , Insuficiencia del Tratamiento , Fibrocartílago Triangular/cirugía , Fracturas del Cúbito/cirugía , Articulación de la Muñeca/cirugíaRESUMEN
In the present study Trichosporon mucoides infections in 3 premature newborns are reported.
Asunto(s)
Enfermedades del Prematuro/microbiología , Micosis/microbiología , Trichosporon/aislamiento & purificación , Femenino , Humanos , Recién Nacido , Enfermedades del Prematuro/tratamiento farmacológico , Masculino , Micosis/tratamiento farmacológicoRESUMEN
PURPOSE: To determine the prevalence of anaemia and iron-deficiency anaemia (IDA) in Kahramanmaras, a province in the south-eastern Anatolia. METHODS: The study was performed on 1491 persons of both sexes aged 2-69. All were volunteers. Haematological parameters were determined and haemoglobin (Hb) electrophoresis was carried out in all subjects, and only for those with haemoglobin levels below normal were subsequent measurements of ferritin and Hb A2 made to detect iron deficiency and rule out beta-thalassaemia. RESULTS: The means of all the haematological parameters for all age groups and sexes were found to be lower than the reference values given in the literature. Anaemia was found to be present in all age groups, especially in children aged 2-5 yr and women aged 19-40 yr (34.5% and 40.0%, respectively). IDA in the same age groups was 15.5% and 23.8%, respectively. CONCLUSION: The high rate of IDA raises serious concern about nutritional disease risks in the region. An inexpensive oral iron therapy and education as to the importance of iron for their health would help to provide optimal health for the population concerned, especially for mothers-to-be and children.