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OBJECTIVES: Thyroid disorders are highly prevalent in patients with schizophrenia. Changes in the levels of thyroid hormones cause the occurrence of psychiatric disorders and affect the response to treatment. The aim of this study was to investigate the changes in thyroid hormone levels in patients with chronic schizophrenia, and to demonstrate any association between psychiatric symptoms and hormones. METHODS: Sixty-three patients with schizophrenia and 53 controls were included in this study. The serum levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) in patients and controls were tested by using the chemiluminescence immunoassay. Symptoms were assessed via the Positive and Negative Syndrome Scale (PANSS). RESULTS: The level of FT4 in the schizophrenia group was statistically significantly lower than the control group (p = 0.045). There was no significant difference between the clinical subtypes of schizophrenia and thyroid hormone levels. There was a mild negative correlation between PANSS negative subscale scores and levels of TSH (p = 0.023). CONCLUSION: These findings suggest that the subclinical hypothyroidism observed in the chronic schizophrenic patients may be associated with the treatment of neuroleptics. The possible alterations of thyroid hormones should be considered in chronic schizophrenic patients for treatment with neuroleptics.
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OBJECTIVE: The study aimed to evaluate respiratory virus infections in adult patients with hematological malignancies (HM). PATIENTS AND METHODS: The medical records of patients who were followed up by the hematology clinic at Basaksehir Çam and Sakura City Hospital between March 2021 and March 2023 with a diagnosis of HM and who underwent real-time polymerase chain reaction (RT-PCR) testing for nasopharyngeal/oropharyngeal specimens taken with suspected respiratory tract infection constituted the study data. RESULTS: Infections were symptomatic in 64.56% of patients, and the most common symptoms were fever (48.10%) and cough (18.99%). The mortality rate was 25.32% over a two-year period. When the samples were examined, positive test frequency was 43.04%, and the three most common pathogens were Influenza A (10.13%), SARS-CoV-2 (8.86%), and rhinovirus/enterovirus (7.59%). The frequency of positive tests from HMs was highest in patients with AML (p=0.042). Respiratory PCR kit positivity was higher in patients who had any symptoms (p=0.002) and cough (p=0.003). Test positivity was higher in patients with any pathological radiological finding (p=0.039) and ground glass appearance (p=0.010). The risk of death was found to be 5.848 times higher in patients with dyspnea compared to those without (OR: 5.848, 95% CI: 1.143-29.915, p=0.034). CONCLUSIONS: Respiratory tract virus panel PCR test positivity is more common in patients with HM presenting with respiratory tract infection symptoms in the presence of AML diagnosis, symptomatic infection, cough, radiological findings, and ground glass appearance. Mortality risk is high in HM patients with respiratory tract virus infection who have shortness of breath.
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Neoplasias Hematológicas , Leucemia Mieloide Aguda , Infecções Respiratórias , Viroses , Vírus , Humanos , Adulto , Estudos Retrospectivos , Tosse , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Reação em Cadeia da Polimerase em Tempo Real , DispneiaAssuntos
Abdome Agudo/diagnóstico por imagem , Abdome Agudo/etiologia , Angioedemas Hereditários/complicações , Angioedemas Hereditários/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Biomarcadores/sangue , Proteína Inibidora do Complemento C1/análise , Complemento C4/análise , Genes Dominantes , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Granuloma de Células Plasmáticas/diagnóstico , Hepatopatias/diagnóstico , Administração Oral , Adolescente , Biópsia , Diagnóstico Diferencial , Feminino , Glucocorticoides/administração & dosagem , Granuloma de Células Plasmáticas/tratamento farmacológico , Humanos , Hepatopatias/tratamento farmacológico , Imageamento por Ressonância Magnética , Tomografia Computadorizada EspiralRESUMO
The aim of this study was to investigate the effect of body habitus, dimensions of the thoracic cavity, location of the carina within the mediastinum, and left atrial size on tracheal carinal angle using CT scan. The study population was drawn from the patients referred to CT scan for various indications. A total of 120 patients (65 men and 55 women; age range 17-85 years; mean age 56 years) who denied a history of prior thoracic surgery, and in whom CT scan excluded pulmonary fibrosis, moderate or severe emphysema, atelectasis, intrathoracic mass or adenopathy, pericardial or pleural effusion were prospectively enrolled. The interbronchial (IBA) and subcarinal (SCA) angles were measured on coronal reformatted images. The presternal and retrovertebral fat thickness, the anteroposterior and transverse diameters of the thorax, the distances from carina to the sternum and to the vertebral column were obtained at the level of carina. Three orthogonal dimensions and the volume of the left atrium were also assessed. The mean interbronchial angle was 77 degrees +/-13 degrees (range 49-109 degrees ) and subcarinal angle was 73 degrees +/-16 degrees (range 34-107 degrees ). IBA positively correlated with the female gender (r=0.25, p=0.007), body mass index (r=0.28, p=0.002), presternal (r=0.40, p=0.001) and retrovertebral fat thickness (r=0.31, p=0.001). The interbronchial angle was significantly greater in obese patients compared with lean patients (p=0.02). Both IBA and SCA were positively correlated with the left atrial volume (r=0.40, p=0.001 and r=0.34, p=0.001, respectively), and its transverse and craniocaudal dimensions. The carina-vertebral column distance inversely correlated with IBA (r=-0.42, p=0.001) and SCA (r=-0.41, p=0.001). The size of the thoracic cavity did not show significant relation to tracheal bifurcation angle. Tracheal bifurcation angle ranges widely in normal subjects, and absolute measurements of the carinal angle is of little diagnostic value. In addition to left atrial enlargement, female gender, obesity and close situs of carina relative to vertebral column are associated with greater tracheal bifurcation angle.
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Tomografia Computadorizada Espiral/métodos , Traqueia/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Átrios do Coração/anatomia & histologia , Átrios do Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/patologia , Caracteres Sexuais , Traqueia/anatomia & histologiaRESUMO
The aim of this study was to investigate the effects of intra-articular hyaluronic acid (HA) on symptoms, functional outcome, and changes in articular cartilage assessed by magnetic resonance imaging (MRI) in patients with knee osteoarthritis. Thirty patients were randomly assigned to treatment with HA (hylan G-F 20, Synvisc) or saline. The treatment group consisted of 20 patients receiving three weekly injections of HA into one or both knees (30 knees). The control group consisted of ten patients receiving three intra-articular injections of 2 ml saline at the same intervals (ten knees). To determine the effectiveness of the HA therapy, all patients were assessed prior to the injections (baseline) and after the 1st, 2nd, 3rd, and 8th weeks. Assessment comprised the following: pain at rest, at night, and on walking using a visual analogue scale (VAS); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and function scores; 15-m walking time; need for analgesics; and evaluation of treatment by the patients. MRI of patellofemoral (PF) articular cartilage was also examined before and after the course of injections at the 8th week. When compared to placebo, a significant statistical difference was found in all clinical parameters. On MRI, although the difference in the PF joint cartilage quality in the HA group before and after the treatment was statistically significant (p < 0.05), this significance was not detected between the groups after the treatment (p > 0.05). After the HA injections, a significant analgesic effect was seen as early as the 3rd week continuing up to the 8th week and functional improvement was seen at the 8th week. In conclusion, intra-articular injections of HA is an effective choice of treatment in patients with knee osteoarthritis.
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Cartilagem Articular/patologia , Ácido Hialurônico/análogos & derivados , Imageamento por Ressonância Magnética/métodos , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/tratamento farmacológico , Cartilagem Articular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Humanos , Ácido Hialurônico/administração & dosagem , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Medição da Dor , Probabilidade , Estudos Prospectivos , Amplitude de Movimento Articular/fisiologia , Recuperação de Função Fisiológica , Valores de Referência , Medição de Risco , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
The study was designed to investigate the effect of patient position on the detection of ureteral jets in normal pregnancy. The number of jets was recorded for 1 min using colour Doppler ultrasound in 26 healthy asymptomatic gravid women between 16 weeks and 34 weeks gestation. Each patient was examined in the supine position and in both the right and left lateral decubitus positions. Ureteral jets were present on at least one side in 24 patients in the supine position compared with 26 women in the lateral decubitus position. 13 (54%) of the 24 patients in whom jets were seen in the supine position had jets on only one side. A mean of 1.80 jets x min(-1) was detected on the right side and 3.23 jets x min(-1) on the left (p=0.046) in the supine position. In the contralateral decubitus position, jets were detected on the right side in 22 (85%) women and on the left in 25 (96%) women. A mean of 3.07 jets x min(-1) was detected on the right and 4.15 jets x min(-1) on the left. The difference in the frequency of ureteral jets between the supine and lateral decubitus positions was significant (p=0.004 for the right; p=0.011 for the left). However, the difference in the detection rate was significant on only the right side (p=0.016 for the right; p=0.063 for the left). 10 (77%) of 13 patients in whom unilateral absence of ureteral jets was noted had detectable jets in the lateral decubitus position. Our findings demonstrated the utility of the lateral decubitus position in the evaluation of ureters suspicious for obstruction. However, caution is still recommended in diagnosing ureteral obstruction if jets are persistently absent after this manoeuvre.
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Postura , Complicações na Gravidez/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Obstrução Ureteral/diagnóstico por imagem , Adolescente , Adulto , Feminino , Humanos , Gravidez , Complicações na Gravidez/fisiopatologia , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Decúbito Dorsal , Obstrução Ureteral/fisiopatologia , UrodinâmicaRESUMO
MRI features are described in a case of gastric schwannoma. A large, discretely marginated, multilobular mass was seen adjacent to the gastric antrum with the epicentre of the mass in the gastrocolic ligament. The overall signal pattern was low on T(1) weighted images and moderate to markedly elevated on T(2) weighted images. Post-gadolinium sequences demonstrate slow but fairly uniform enhancement throughout the mass.
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Imageamento por Ressonância Magnética , Neurilemoma/diagnóstico , Neoplasias Gástricas/diagnóstico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
High resolution CT findings of pulmonary involvement are described in a patient with adult type Gaucher's disease. Although the reticular pattern on the chest radiograph was typical, appearance of pulmonary involvement on high resolution CT has not been demonstrated in the literature. High resolution CT demonstrated interlobular septal and intralobular interstitial thickening, irregular interfaces at the pleural surfaces and ground-glass appearance, corresponding to both the alveolar and the interstitial components of the pulmonary involvement.
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Doença de Gaucher/complicações , Doença de Gaucher/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pneumopatias/etiologia , Tomografia Computadorizada por Raios X , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The flow pattern in intrarenal veins depends on renal parenchymal histology and cardiac physiology. The intrarenal venous impedance index obtained by Doppler ultrasound is related to compliance in vein, and can be helpful in the assessment of renal parenchymal compliance. The purpose of this study was to determine whether normal pregnancy has a significant effect on intrarenal venous blood flow, and assess if the physiological pyelocaliectasis causes a measurable reduction in venous impedance indexes in pregnant women. Doppler ultrasound of intrarenal veins was performed in 35 asymptomatic pregnant women in the second and third trimester of gestation, and in 24 non-pregnant healthy women. After grading the degree of hydronephrosis, venous impedance index was obtained from the interlobar veins. The venous waveforms in pregnant women showed diminished phasic oscillations owing to elevated pre-systolic flow. The mean venous impedance indexes in pregnant women were significantly lower than the values in non-pregnant subjects, 0.30+/-0.10 versus 0.44+/-0.06 in the right (p<0.001), and 0.36+/-0.11 versus 0.41+/-0.07 in the left kidney (p=0.03). There was an inverse correlation between the grade of pelvicalyceal dilatation and the venous impedance indexes in both kidneys in pregnant women (r=-0.62, p<0.001 for the right kidney, and r=-0.38, p=0.05 for the left kidney). An abnormally reduced venous impedance index in pregnant women can at least in part be explained by reduced vascular compliance from increased interstitial pressure subsequent to partial obstruction of ureters by the gravid uterus, and caution should be exercised in interpreting it as a sign of pathological ureteral obstruction.
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Rim/irrigação sanguínea , Gravidez/fisiologia , Veias Renais/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Dilatação Patológica/diagnóstico por imagem , Feminino , Humanos , Rim/diagnóstico por imagem , Complicações na Gravidez/diagnóstico por imagem , Segundo Trimestre da Gravidez/fisiologia , Terceiro Trimestre da Gravidez/fisiologia , Circulação Renal/fisiologia , Veias Renais/fisiologia , Ultrassonografia Doppler em Cores , Obstrução Ureteral/diagnóstico por imagem , Resistência Vascular/fisiologiaRESUMO
A case of medullary nephrocalcinosis developing in the course of vesicoureteral reflux is described. It is suggested that the probable mechanism of nephrocalcinosis was the stagnation of urine in collecting tubules favouring precipitation of calcium salts.
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Nefrocalcinose/diagnóstico , Nefrocalcinose/etiologia , Refluxo Vesicoureteral/complicações , Pré-Escolar , Humanos , Medula Renal , MasculinoRESUMO
Paranasal sinus obliteration is described in a patient with adult type Gaucher's disease. Plain radiographs and computed tomography showed obliteration of paranasal sinuses due to medullary expansion of surrounding bone. The mandible and maxilla are rarely affected in Gaucher's disease and obliteration of paranasal sinuses due to bony expansion has not previously been reported.
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Doença de Gaucher/diagnóstico por imagem , Seio Maxilar/diagnóstico por imagem , Seio Esfenoidal/diagnóstico por imagem , Adolescente , Feminino , Doença de Gaucher/complicações , Humanos , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/etiologia , RadiografiaRESUMO
A 37-year-old male with a persistent increased parathyroid hormone level, after subtotal thyroidectomy and parathyroidectomy, was referred for scintigraphic localization of a possible ectopic parathyroid adenoma. Tc-99m pertechnetate and Tc-99m MIBI scintigraphy were performed on separate days. There was marked uptake of both tracers in the mediastinum, which at surgery was confirmed to be an extrathyroidal parathyroid adenoma. Hypervascularity was suggested as a possible explanation for rare cases of pertechnetate avid parathyroid adenomas. And Tc-99m MIBI scintigraphy proved to be a successful imaging procedure for ectopic parathyroid tissue.
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Adenoma/diagnóstico por imagem , Coristoma/diagnóstico por imagem , Neoplasias do Mediastino/diagnóstico por imagem , Glândulas Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/diagnóstico por imagem , Adulto , Humanos , Masculino , Mediastino/diagnóstico por imagem , Traçadores Radioativos , Cintilografia , Compostos Radiofarmacêuticos , Pertecnetato Tc 99m de Sódio , Tecnécio Tc 99m SestamibiRESUMO
BACKGROUND AND OBJECTIVES: Antimycobacterial susceptibility tests take weeks, and delayed therapy can lead to spread of Mycobacterium tuberculosis. Therefore, rapid, accurate and cost-effective methods are required for proper therapy selection. In this study, the Mycobacteria growth indicator tube (MGIT) and epsilometer test (Etest) methods were compared to the agar proportion method for susceptibility testing of Mycobacterium tuberculosis. MATERIALS AND METHODS: The susceptibility tests against isoniazid (INH), rifampin (RIF), streptomycin (STM) and ethambutol (ETM) of 51 M. tuberculosis complex isolates were analyzed by the MGIT, Etest and agar proportion methods. RESULTS: The concordance between MGIT/Etest and agar proportion methods was 98% for INH and 100% for RIF, STM, ETM. There were not statistically significant differences in results of the susceptibility tests between MGIT/Etest and the reference agar proportion method. CONCLUSION: The results have shown that MGIT and Etest methods can be used instead of the agar proportion method, because these two methods are more rapid and easier than the agar proportion method.
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Antituberculosos/farmacologia , Mycobacterium tuberculosis/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana/métodos , Mycobacterium tuberculosis/crescimento & desenvolvimentoRESUMO
The purpose of this study was to determine whether renal venous pulsations are affected by compression of the left renal vein (LRV) between the aorta and spine, and also to determine the clinical significance of incidentally detected retroaortic LRV. The study population was recruited from 783 consecutive patients undergoing abdominal CT examination for various indications. 22 patients with a retroaortic LRV were prospectively enrolled in this study, and 22 patients without renal disease served as a control group. After measuring the diameters of the central and peripheral portions of the LRV on CT images, the ratio (P/C) and difference (P-C) of the diameters were calculated. Doppler sonography of the interlobar arteries and veins of the left kidney was then performed to obtain impedance indices. Urine analysis of all subjects and scrotal colour Doppler ultrasound of male patients were also performed. The retroaortic LRV diameters were significantly narrower than the pre-aortic LRV diameters (p = 0.002). The left intrarenal venous impedance indices were significantly higher in the patients with retroaortic LRV (p = 0.026) and in the subgroups with P/C>2 (p = 0.020), with P-C>4 mm (p = 0.007) and without nutcracker-like associations (p = 0.006) than in control subjects, but no significant difference was noted between the arterial resistance indices. Haematuria (n = 8), proteinuria (n = 4), varicocele (n = 3) and collaterals (n = 1) were detected in the study group but not in the control group. In conclusion, incidentally detected retroaortic LRV appears to be associated with haematuria, proteinuria, varicocele and altered venous pulsatility. Further investigations are needed to understand the role of venous Doppler ultrasound in the nutcracker phenomenon.
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Doenças Vasculares Periféricas/diagnóstico por imagem , Artéria Renal/diagnóstico por imagem , Veias Renais/diagnóstico por imagem , Adulto , Idoso , Estudos de Casos e Controles , Constrição Patológica/diagnóstico por imagem , Constrição Patológica/fisiopatologia , Feminino , Hematúria/fisiopatologia , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/fisiopatologia , Estudos Prospectivos , Proteinúria/fisiopatologia , Artéria Renal/fisiopatologia , Veias Renais/fisiopatologia , Escroto/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Varicocele/diagnóstico por imagem , Varicocele/fisiopatologiaRESUMO
The purposes of this study were to establish the range of needs of women with breast cancer and to examine how women's needs might form clusters that could provide the basis for developing a standardized scale of needs for use by local breast care nurses in the evaluation of care. The sample consisted of 143 women with breast cancer who were admitted to the outpatient and inpatient oncology clinics in a university hospital in Erzurum, Turkey. The data were collected by questionnaire, and included demographic characteristics and the self-assessed support needs of women with breast cancer. Statistical analyses have shown that the standardized scale of needs has statistically acceptable levels of reliability and validity. The women's support needs mostly clustered in Family and Friends (79%) and After Care (78.3%). The most frequently required support category was Family and Friend; however, the women were in need of support of all categories. In terms of age ranges, there are statistically significant differences in relation to Femininity and Body Image, and Family and Friends of the seven categories. Women experienced a high level of needs associated with a diagnosis of breast cancer. The results in this study should increase awareness among cancer care professionals about a range of psychosocial needs and may help them target particular patient groups for particular support interventions.
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Neoplasias da Mama/terapia , Avaliação das Necessidades , Serviços de Saúde da Mulher/normas , Adulto , Idoso , Imagem Corporal , Neoplasias da Mama/psicologia , Saúde da Família , Feminino , Humanos , Programas de Rastreamento , Mastectomia/métodos , Pessoa de Meia-Idade , Apoio Social , Inquéritos e Questionários , Turquia , Saúde da Mulher , Serviços de Saúde da Mulher/organização & administraçãoRESUMO
Pneumosinus dilatans is a term used to describe a localized abnormal dilatation of one or more paranasal sinuses without radiological evidence of localized bone destruction, hyperostosis or mucous membrane thickening. The involvement of all paranasal sinuses and mastoid air cells has been named pneumosinus dilatans multiplex. Although the involvement of one or more paranasal sinuses has been reported widely, all paranasal sinuses and the concomitant involvement of mastoid air cells has been reported in only one case. Herein, we present three unusual cases of pneumosinus dilatans (one is a second case of pneumosinus dilatans multiplex in English literature, another is the first reported case of a frontal pneumosinus dilatans case associated with frontoethmoidal meningocele, mental retardation and facial asymmetry and the third one is pneumosinus dilatans with a huge arachnoid cyst) along with the review of relevant literature.