Objective: Ivermectin and sulphadiazine were tested individually to determine their in vitro effects on Toxoplasma gondii grown in human epidermoid larynx carcinoma (Hep-2) cell culture.Study Design: In-vitro study.Material and Methods: Toxoplasma growth was quantities by an enzyme immunoassay performed directly on the fixed cultures, using a rabbit anti-T. gondii immunoglobulin G as the first antibody and a phosphatase-labeled anti-rabbit immunoglobulin G as the second antibody. For each drug, regression models were used to quantify the relationship between optical density values and antimicrobial agent concentrations in the cultures.Results: The 50% inhibitory concentrations (IC50) of ivermectin and sulphadiazine were found to be 0.2 μg/mL and 7.3 μg/mL after 48 h of exposure, respectively. None of the concentrations tested for each drugs demonstrated toxicity to Hep-2 cells after 72 h of incubation. Conclusion:These results indicate that ivermectin significantly inhibited replication of the tachyzoites of T. gondii RH strain.
Objectives: This study aims to assess the treatment administered in patients with diabetic foot infections and palliative care services in the palliative care unit of our hospital. Patients and methods: File information of nine male patients (mean age 51.37±11 years; range 38 to 66 years) treated in our hospital's palliative care unit as of its opening date of 12 June 2013 and diagnosed as diabetic foot infection was retrospectively analyzed. Results: Patients' mean diabetes age was 9.12±6.9 years. Four patients had previously undergone amputation due to diabetic foot infection. All patients were receiving intensive insulin therapy. Patients' mean glycosylated hemoglobin value was 9.2±3.7, mean fasting blood glucose value was 178 mg/dL, and postprandial blood glucose value was 262 mg/dL. Primary treatments administered in patients were blood sugar regulation, palliative support, combined broad-spectrum antibiotherapy, daily wound dressing, and hyperbaric oxygen therapy. Also, diabetic patient training was prioritized. Conclusion: The treatment of diabetic foot infection requires a multidisciplinary approach. Internal medicine, orthopedics, infectious diseases clinic, and wound care services are involved in disease management. We believe that awareness trainings for diabetic patients regarding all complications of diabetes including diabetic foot are a significant part of the management of this disease.Keywords: Diabetes; foot ulcers; prevention.Assessment of diabetic foot infections treated in palliative care unit of our hospital ÖZ Amaç: Bu çalışmada hastanemizin palyatif bakım biriminde diyabetik ayak enfeksiyonu olan hastalara uygulanan tedavi ve palyatif bakım hizmetleri değerlendirildi. Hastalar ve yöntemler: Hastanemizin 12 Haziran 2013'te açılan palyatif bakım biriminde açılış tarihinden itibaren tedavi gören, diyabetik ayak enfeksiyonu tanısı konulmuş dokuz erkek hastanın (ort. yaş 51.37±11 yıl; dağılım 38-66 yıl) dosya bilgileri geriye dönük olarak incelendi. Bulgular: Hastaların diyabet yaş ortalaması 9.12±6.9 yıl idi. Dört hasta daha önce diyabetik ayak enfeksiyonu nedeniyle amputasyon geçirmişti. Hastaların hepsi intensif insülin tedavisi almakta idi. Hastaların ortalama glikozillenmiş hemoglobin değeri 9.2±3.7, ortalama açlık kan şekeri değeri 178 mg/dL ve tokluk kan şekeri değeri 262 mg/dL idi. Hastalara uygulanan başlıca tedaviler kan şekeri regülasyonu, palyatif destek, kombine geniş spektrumlu antibiyoterapi, günlük yara pansumanı ve hiperbarik oksijen tedavisi idi. Ayrıca, diyabetik hasta eğitimine önem verildi. Sonuç: Diyabetik ayak enfeksiyonu tedavisi multidisipliner bir yaklaşım gerektirmektedir. Hastalık yönetiminde dahiliye, ortopedi, enfeksiyon hastalıkları kliniği ve yara bakım hizmetleri rol almaktadır. Diyabetik hastalar için diyabetik ayak dahil diyabetin tüm komplikasyonlarına ilişkin farkındalık eğitimlerinin bu hastalığın yönetiminin önemli bir parçası olduğu kanaatindeyiz.
Objective. Adrenal incidentaloma are lesions which are stated incidentally by imaging methods when there is no suspicion of any disease in adrenal gland. Inappropriate Jak2 signaling causes some solid and hematological malignancies. But the Jak2 mutation has not been previously evaluated with regard to adrenal tumors. In this study, we aimed to positivity of the Jak2 mutation in patients with non functioning adrenal incidentaloma (NFAI).Methods. 45 (38 female-7 male) patients, who were followed due to NFAI at Tepecik Training and Research Hospital, Department of Endocrinology and Internal Medicine between February 2014 and March 2015, and 45 (31 female-14 male) healthy controls were included in the study.Results. The average age was 54.02±11.7 years and 38 patients were female, 7 were men. All patients underwent the following analyses for excluding a functioning adrenal mass, overnight dexamethasone suppression test, 24 hour urinary metanephrine and normetanephrine, plasma aldosterone/ renin activity ratio. Jak2 mutation of the patients who were diagnosed as NFAI was all negative. Conclusion.We could not identify the JAK2 gene mutation positivity in any sample. Since other possible mechanisms may throw fresh light on the etiology of adrenal incidentaloma, further clinical studies are needed on this subject.
Bardet Biedl syndrome (BBS) is characterized by obesity, retinitis pigmentosa, hypogonadism, mental retardation and polydactyly. Additionally, renal, cardiac and neurological manifestations may be seen. We report a case of BBS with chronic kidney disease (CKD) at the age of 43.
ÖZAmaç: Adrenal insidentalomalar (Aİ), adrenal beze ilişkin herhangi bir hastalık kuşkusu olmadığı bir durumda görüntüleme yöntemleri ile rastlantı sonucu saptanan kitlelerdir. Abdominal ultrasonografinin (USG) ve bilgisayarlı tomografinin (BT) kullanımının artması ile adrenal kitlelerin veya bir insidentalomanın tespit edilme sıklığı da artmıstır. Bu yüzden bu çalışmada Aİ tanısı alan hastaların radyolojik, biyokimyasal ve klinik olarak değerlendirilerek analiz etmek istedik. Yöntemler: Çalışmaya Şubat 2014 ile Şubat 2015 tarihleri arasında Tepecik Eğitim ve Araştırma Hastanesi Endokrinoloji ve Dahiliye polikliniklerine başvuran AI tanısı konulan 64 hasta (53 kadın, 11 erkek) dahil edildi. Hastaların fizik muayene ve var olan USG, BT ve magnetik rezonans görüntüleme (MRG) sonuçları biyokimyasal analizleri kaydedildi. Bulgular: Hastaların yaş ortalaması 56,02±11,698 yıl olup 53'ü kadın, 11'i erkek şeklindedir. Tüm hastalara 1 mg deksametazon testi yapılmış olup, idrar metanefrin ve normetanefrin düzeyi bakılmıştır. HT ve/veya hipokalemisi olanlarda serum aldosteron ve renin düzeyi de bakıldı. Hastalarımızdan 9'u subklinik Cushing sendromu (SCS), biri aldosteronoma ile uyumlu değerlendirilirken hiçbirinde feokromasitoma lehine bulgu saptanmadı. Sonuç: Adrenal bezde saptanan rastlantısal kitleler iyi araştırılmalı, tanı, tedavi yönetimi ve sonrasında takipleri dikkatli yapılmalıdır.Anahtar kelimeler: Adrenal insidentaloma, subklinik Cushing sendromu, aldosteronoma ABSTRACT Objective: Adrenal incidentalomas are mass lewsion which are detected incidentally by imaging methods when there is no suspicion of any disease involving adrenal gland. Increased use of abdominal ultrasound (US) and abdominal tomography (CT) scanning has led to the frequent finding of an unexpected adrenal mass, or an incidentaloma. Methods: Sixty-four (53 female-11 male) patients, who were followed due to AI at Tepecik Training and Research Hospital Department of Endocrinology and Internal Medicine between February 2014 and February 2015 period were included in the study. Results of physical examination, USG, MRG and BT were recorded. Results: The mean age of the patients (53 female, and 11 female patients) was 56.02±11.698 years. All patients underwent overnight 1 mg dexamethasone suppression test, 24 hour urinary metanephrine and normetanephrine tests, plasma aldosterone/ renin activity ratio was calculated following analyses to exclude a functioning adrenal mass. Subclinical Cushing syndrome (SCS) in 9, and one aldosteronoma patient were detected, while in none of the patients any evidence was not noted. Conclusion:The results of our study indicated that incidentally diagnosed adrenal masses can be hormonally active or even malignant. So, diagnosis, treatment and follow-up of these kinds of masses should be done carrefully.
Idiopathic systemic capillary leak syndrome (ISCLS) is characterized by a triad of hypotension, hemoconcentration and hypoalbuminemia due to a shift of intravascular fluid and albumin to the extravascular area. We describe a hypovolemic patient with hemoconcentration and hypoalbuminemia who was successfully treated with high-dose intravenous immunoglobulins (IVIG). The purpose of this case report is to discuss the clinical management of idiopathic systemic capillary leak syndrome on the background of relevant literature review.
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