Background:The comparison of the electroencephalography (EEG) data with the patients' primary diagnosis and the relationship with the prognosis was assessed with this study in the cases that are being followed up with the diagnosis of metabolic encephalopathy (ME).Methods: A total of 306 patients who were being followed up due to ME between January 2009 and September 2011 were included in the study. The etiologic causes in the cases were detected as hyponatremia in 26.2%, hypoxic ischemic encephalopathy in 23.8%, renal failure in 14.4%, hepatic failure in 11.7%, diabetes mellitus in 8.2%, endocrinopathies except for diabetes mellitus in 8.8%, and hypernatremia in the remaining 6.9%. EEG examinations were performed with two different methods. Firstly, 269 of 367 EEGs were analyzed for baseline activity, divided in six stages.Results: Another assessment in EEG examination considering abnormal patterns was performed and 281 of 367 EEGs were taken into this assessment; reduction in the alpha, asynchronous slow waves, focal slow activities, triphasic waves, burst-suppression pattern, and generalized or focal spike-sharp activities were observed. There were no differences between the EEG groups statistically by age and sex. There were no statistical associations between diagnoses and the change of consciousness (P = 0.187). There was no significant correlation between EEG findings and diagnostic groups (P = 0.126); however, it was statistically shown that as the impaired consciousness increased, the EEG stages moved forward to worse stages (P < 0.001). Conclusion:We think that EEG examination does not contribute to the diagnosis of the etiology of the disease; however, it may be useful in follow-ups and prognosis in ME.
Hypospadias can be defined as a incomplete development of the urethra. Most hypospadias cases show spontaneous occurrence and have no clear cause because the genetic pathways of external genitalia formation are poorly understood. Familial tendency is associated with hypospadias. The brother of an affected boy may also have hypospadias, and this rate is approximately 9-17%. In this case report, we present three hypospadias cases with the same localization that have prolonged to three generations including grandfather, father and three sons. They were applied by their father for circumcision. The socio-economic status of the father was the main reason for the delay of elder brothers' circumcision. We revealed midshaft hypospadias without chordee in three brothers at physical examination. The father also told us he had the same disorder and our physical examination of the father supported hypospadias. Also according to the history taken from father, the grandfather had also hypospadias probably at the same localization. We performed tubularized incised urethral plate to these cases. In the light of these cases, we have thought that there should be a dominant gene responsible for formation of hypospadias.
Cerebral venous thrombosis (SVT) was defined for the first time in 1875. It is a rare entity that can occur with different clinics. Superior sagittal sinus is affected most (70-80%), then transverse, sigmoid, and in a lesser extent, cavernous sinus involvement is seen. Cortical and cerebellar veins may also be involved. A 22-year-old male patient presented to the emergency room with mental confusion and seizures. According to the information received from his relatives, he was actively involved in sports for 2 years. That he was using amino acid weighted and high-energy multi-vitamin complexes within a day, and monthly having an injection called Deca-Durabolin: (nandrolone decanoate), is learned. One week before his coming to the hospital, that he had cruciate ligament surgery on his left knee and that spinal anesthesia was administered to him during the operation is determined. Thereafter, it is learnt that he had generalized tonic-clonic seizure and impairment of consciousness was added when he came to the hospital. During the patient's neurologic examination in the emergency service, it is observed that his consciousness tended to fall asleep, and existing of bilateral papilledema and spontaneous movements in the right, and bilateral Babinski was positive. In brain computed tomography and magnetic resonance imaging (MRI) of the patient, in the left temporo-parieto-occipital hemorrhagic infarct and in venous MR angiography, in left transfer sinus, sigmoid sinus and jugular sinus complete thrombus, in right transfer and lateral sinus, reduction in blood stream and a view matched with thrombus were detected. On the 16th day of his hospitalization, brain death was determined in patient. At the arrival of the patient to the clinic, mental confusion, being male, to be accompanied by intracranial hemorrhage shows that poor prognosis.
Small-cell bladder cancer is a rare form and composes less than 1% of primary bladder malignancies. We present a case with a large small-cell bladder cancer leading to acute kidney failure clinic without gross hematuria. Computed tomography revealed that all the bladder walls were invaded by the extensive tumor and bilateral hydronephrosis. Double J stent for left side and nephrostomy tube for the right side were inserted, and bladder biopsy was taken by transurethral resection. Pathologic examination revealed small-cell bladder cancer. The patient did not accept chemotherapy. He died because of the acute renal failure 4 months later since the beginning.
Endobronchial lipoma is a rare neoplasm of the tracheobronchial tree and it may cause irreversible pulmonary damage due to recurrent pneumonia. Rarely, it may mimic bronchial asthma. We present a 53-year-old woman with an endobronchial lipoma, which had been treated as a bronchial asthma for four years. She also had developed recurrent pneumonia three times.
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