Behçet's disease is an inflammatory disease of unknown etiology which involves recurring oral and genital aphthous ulcers and ocular lesions as well as articular, vascular, and nervous system involvement. Focal segmental glomerulosclerosis (FSGS) is usually seen in viral infections, immune deficiency syndrome, sickle cell anemia, and hyperfiltration and secondary to interferon therapy. Here, we present a case of FSGS identified with kidney biopsy in a patient who had been diagnosed with Behçet's disease and received interferon-alpha treatment for uveitis and presented with acute renal failure and nephrotic syndrome associated with interferon.
Solid Pseudo-Papillary Neoplasia (SPN) is the rare tumors of the pancreas. The aim of the current study is documentation of the data of the patients. The data of patients with pancreatic neoplasm were presented to Gastroenterology Department between 2010 and 2014 were evaluated retrospectively. A database of the characteristics of these patients was developed, including demographic, laboratory, radiological, surgical and pathological features and the immuno-histochemical staining of tumor specimens. Analysis of 323 patients diagnosed with pancreas malignancies in our hospital between 2010 and 2014 demonstrated that 5 patients (1.5%) were diagnosed with SPN. Of these five patients, four were females and one was male. Their average age was 27 (range: 16-50). CA 19-9 levels were normal in four patients while slightly increase in one (60 U/mL (0-33)) and there were the other tumor markers under a normal range 5-10.3 cm diameter in size, mean: 7.6 cm. Immunohistochemical analysis demonstrated that CD10, CD56, Ki-67 and β-catenine was positive for all patients while other markers were variable. Progesteron and estrogen receptors were positive in histo-pathologic specimens of four patients. SPN is a rare tumor that develops principally in young women and has a good prognosis. Immunohistochemical staining is important in the differential diagnosis of SPN and estrogen positivity may have a role in pathogenesis of a limited patients.
Background/Aims: Obesity is an epidemic and its prevelance and number of patients underwent bariatric surgery continue to increase worldwide. This study aimed to evaluate endoscopic findings and co-morbidities, to investigate the prevelance of Helicobacter pylori (H. pylori) infection and the relationship between body mass index (BMI) and gastroesophageal sphincter incompetency in obese patients. Materials and Methods: An upper gastrointestinal system endoscopy and mucosal sampling were performed in all patients hospitalized for bariatric surgery. Age, gender, BMI, co-morbidities and endoscopic findings were recorded. Gastroesophageal sphincter incompetency was classified according to Hill classification. The patients were divided into two groups: group I, endoscopically normal and group II, endoscopically abnormal. Results: Total 127 patients were enrolled into prospective study. Of these, 93 (%73.2) were female and the mean age was 38.9±12.5 years (range: 16-68). Abnormal endoscopic findings and H. pylori were detected in 80.4% and 44.9% of patients, respectively. In group II, patients were older, BMI higher and H. pylori more prevalent (all statistically significant). Diabetes mellitus, hypertension and dyslipidemia were the most frequent common co-morbidities. Rate of multiple co-morbidities were more common in group II. Gastroesophageal sphincter incompetency in total group was observed in a rate of 46.5% and was weakly correlated with BMI. Conclusion: Four-fifths of obese patients have at least one endoscopic abnormal finding, three fourth at least one co-morbidity and half H. pylori positivity. Upper gastrointestinal system endoscopy should be performed routinely in all patients to predict and prevent complications following bariatric surgery.
Ecstasy is a drug, which causes serious side effects and sometimes it can be lethal. These effects are due to idiosyncratic reactions as a result of various stimulations in adrenergic receptors. Here we present a case of a 36-year-old male patient who was diagnosed with thrombotic thrombocytopenic purpura associated with the use of ecstasy. Plasmapheresis along with methylprednisolone treatment restores patient condition to normal.
Chronic lymphocytic leukemia (CLL) is a malignancy characterized by clonal proliferation and accumulation of B lymphocytes. Although leukaemic infiltration of the kidney is well recognized in CLL, acute renal failure (ARF) due to leukaemic infiltration is extremely rare. Here we present a case of ARF as the initial manifestation of CLL. The diagnosis was made by a kidney biopsy. Treatment with cyclophosphamide and prednisolone resulted in a completely improved renal function.
AimThe purpose of our study is to measure the awareness of hepatitis C among physicians employed in Istanbul, and investigate the relationship between awareness and the specialization field, age and presence of chronic hepatitis/positive family history.Material and methodsLevel of awareness of 125 family physicians and 76 internal medicine physicians, employed within Istanbul Province, on hepatitis C infection were evaluated using standard questionnaire. Relationship between their awareness and age, specialization, presence of any chronic hepatitis and chronic hepatitis C in any relatives were investigated.ResultsThe mean age of the physicians was 30.9 ±7.1 years (range: 23–45 years) and 58% of them were women. Seventy-five (37.3%) physicians were between ages of 23–28, 67 (33.3%) physicians were between ages of 29–32, and 59 (29.4%) physicians ages was greater than 32. Twenty-one (10.4%) physicians had hepatitis or a first-or second-degree relative with hepatitis. Physicians were found to be insufficient in answering the questions on hepatitis C virus transmission routes and who should be screened. When examined based on transmission routes, there were no significant differences between physicians’ specializations and positive familial history, but physicians aged 23–28 had significantly poorer awareness at some points. Internal medicine specialists had better awareness on screening tests compared to family physicians but there were no significant differences between positive familial history and physicians’ age.ConclusionsPhysicians’ awareness should be improved to prevent hepatitis C virus transmission and to identify existing conditions.
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