Medeniyet medical journal最新文献

Objective: Smoking causes cardiovascular risk, which may alter the stability between the production and degradation of the extracellular matrix. Matrix metalloproteinase-9 (MMP-9) is a zinc-containing endopeptidase that degrades the extracellular matrix and is involved in tissue remodelling and several physiological processes. As a result, smoking-induced elevated serum MMP-9 levels, particularly at a younger age, raise the risk of coronary heart disease (CHD). Thus, this study aimed to determine the possible relationship between smoking-induced circulating MMP-9 and the risk of cardiovascular disease in young smokers.

Methods: In this cross-sectional study, the patients were divided into three groups. Each group contains 120 study participants. Group one consisted of 120 healthy individuals with no physical and mental illness, group two consisted of 120 active smokers with a heart disease, and group three consisted of 120 active smokers with a heart disease and diabetes, who attended Sri Ramaswamy Memorial Hospital for cardiology checkup at the age of 20-55 years. The serum MMP-9, high-sensitivity C-reactive protein (hs-CRP), and apolipoprotein-E (APO-E) levels were analyzed using the ELISA method, and the lipid levels were measured enzymatically using AU480 automatic analyzer (Beckman Coulter).

Results: Compared with non-smokers, the study shows that the mean serum MMP-9, hs-CRP, and APO-E levels were significantly higher in smokers (p<0.001). A strong relationship was also found between MMP-9 and hs-CRP, APO-E, smoking load, and smoking intensity.

Conclusions: A significant association was found between cigarette smoking with MMP-9, and relative exposure to circulating inflammation markers plays a potential role in the pathogenesis of CHD.

Sinonasal lobular capillary hemangiomas (LCH) are rare benign vascular lesions commonly arising from the nasal septum. Nasopharyngeal, nasal mid-turbinate, and anterior nasal swabbing is the preferred method of screening for coronavirus disease-2019 (COVID-19). Herein, we present a case of a sinonasal LCH in a child after continuous self-tests for COVID-19, with an anterior nasal swab. The child presented with a well-defined red mass in the anterior part of the nasal septum, which was removed endoscopically. Histopathology revealed a LCH. This is the first report of a complication other than epistaxis with the use of an anterior nasal swab. Our literature review identified 32 studies reporting complications of COVID-19 screening. Cerebrospinal fluid leaks and foreign body retention are the most common ones. A proper specimen collection technique and a quick patient history with an emphasis on risk factors are the best practices to prevent complications from COVID-19 screening.

Objective: This study aimed to evaluate the difference in predicting the pathological stage of retropubic radical prostatectomy (RRP) and biochemical recurrence (BCR) in patients with Prostate Imaging Reporting and Data System (PIRADS) scores of 3 and 4 on biparametric prostate magnetic resonance imaging (bpMRI) compared to patients who upgraded from PIRADS 3 to PIRADS 4 based on the contrast-enhanced PIRADS version 2.1.

Methods: This study evaluated 107 patients who underwent RRP and had preoperative multiparametric prostate magnetic resonance imaging (mpMRI) and were followed regularly. Group 1 included 31 patients evaluated as PIRADS 3 in both bpMRI and mpMRI, group 2 included 31 patients evaluated as PIRADS 3 in bpMRI and PIRADS 4 in mpMRI, and group 3 included 45 patients evaluated as PIRADS 4 without contrast. Comparisons were made between groups 1 and 2 and between groups 2 and 3.

Results: No significant difference was found between the groups in terms of demographic data, preoperative or postoperative radiology, and pathology findings. Extraprostatic extension positivity and BCR were more common in group 2 compared to group 1 although not significant. Multivariate regression analysis was performed to determine the risk factors in predicting BCR, which revealed the positivity of seminal vesicle invasion and high pathological stage in the pathology report as significant factors. Prostate-specific antigen (PSA) and PSA density were higher in group 3 than in group 2, but without significance.

Conclusions: This study revealed that mpMRI did not contribute in predicting BCR after RRP compared to bpMRI.

Objective: The current study aimed to determine the onset of sesamoid bones (Sbs) ossification at the thumb metacarpophalangeal (MCP) joint of the hand and its relationship with puberty.

Methods: This retrospective radiographic study included patients aged 5-17 years. The presence of Sbs was investigated separately for each age group. Patients were classified based on their age, gender, and the presence of radial and ulnar sesamoids.

Results: A total of 1,020 radiographs from 939 patients were analyzed. Sbs began to ossify in girls at the age of 8 years and in boys at the age of 9 years. The ulnar-radial sesamoids were present in all individuals in the same age group at the age of 13-14 years in girls and 15 years in boys. The age at which 50% of the individuals in the same age group had a sesamoid was 10.4 years in girls and 11.9 years in boys on the radial side, 9.5 years in girls, and 11.5 years in boys on the ulnar side.

Conclusions: In all individuals, the time between the onset of sesamoids of the MCP joint and development corresponds to the physiological period of puberty. However, the age at which puberty begins coincides with the time when Sbs begin to ossify in 50% of both sexes in the same age group.

Objective: In December 2019, severe acute respiratory syndrome coronavirus-2, which emerged in Wuhan, China, spread rapidly and created a pandemic. Coronavirus disease-2019 (COVID-19) can affect different organ systems, including the skin. Recently, COVID-19 cases with skin lesions of different clinicopathological features have been published. This study aimed to present the histopathological features of 19 COVID-19 cases with cutaneous findings and discuss them in light of the literature.

Methods: Skin biopsy specimens of 19 patients with skin rashes associated with COVID-19 were evaluated histopathologically and clinically.

Results: Clinical manifestations of rashes developed in eight female, seven male, and four pediatric patients with COVID-19. Urticaria/urticarial vasculitis (n=7), maculopapular eruption (n=7), panniculitis (n=2), purpuric eruptions (n=2), and livedoid-like lesions were noted. Histopathologically, besides the inflammatory findings, the most striking feature was that the vessels were more or less affected in almost all cases.

Conclusions: Cutaneous lesions associated with COVID-19 are increasingly being reported. We believe that every data presented about this disease, which has many unknowns, will shed light on future research. Every case can lead us a new way.

Objective: Acromegaly is a rare disease associated with increased mortality. Reports on coronary artery disease in acromegaly are controversial. This study aimed to investigate the possible association of epicardial adipose tissue thickness with cardiovascular risk in patients with acromegaly.

Methods: The study included 38 patients followed up with the diagnosis of acromegaly and 29 healthy controls. Patients with acromegaly were divided into controlled and uncontrolled acromegaly groups based on insulin-like growth factor-1 levels. Epicardial adipose tissue thickness measurements were obtained from chest computed tomography, and laboratory data were extracted from patient files.

Results: Twenty-nine patients (76.3%) had controlled acromegaly. Eleven patients with acromegaly had diabetes mellitus (28.9%), 18 (47.4%) had hypertension, and 27 (71%) had a concomitant chronic disease. Epicardial adipose tissue thickness was significantly increased in the acromegaly group (p<0.001). No significant difference was observed between the controlled and uncontrolled acromegaly groups in terms of the epicardial adipose tissue thickness. Age was the only parameter that was significantly correlated with the epicardial adipose tissue thickness. When the Framingham risk score was calculated, the 10-year cardiovascular risk of patients with acromegaly was 5.63%.

Conclusions: The epicardial adipose tissue thickness is increased in acromegaly. However, this increase may not have clinical relevance in terms of cardiovascular risk.

Objective: Henoch-Schönlein purpura (HSP) is a small vessel vasculitis and palpable purpura, with arthritis, gastrointestinal as abdominal pain, and renal involvement as typical clinical findings. The most important prognostic factor for HSP vasculitis is renal involvement. This study aimed to investigate the relationship between clinical, laboratory, and histopathologic findings of children with HSP nephritis with long-term renal prognosis.

Methods: This retrospective study included children with HSP nephritis between January 2010 and December 2019. Initial clinical presentation, laboratory findings, and kidney biopsy results were obtained, and treatment modalities were recorded and classified using the Meadow classification and grouped into mild and severe cases. Additionally, data at the last follow-up were analyzed and classified.

Results: A total of 90 children (59 male) with a mean age of 8.8±3.2 years were included. According to initial clinical findings, 18 children were in the Meadow's severe group. Fifteen (15/72) children in the mild group and all children in the severe group had undergone kidney biopsy. The severe group had higher histopathologic stages compared to the mild group (p=0.022). Immunosuppressive treatments were used in 44.4% of mild cases and 100% of severe cases (p<0.01). On follow-up, only four children (two in the mild group) had persistent proteinuria.

Conclusions: Severe clinical findings in the initial presentation were related to more intensive immunosuppressive treatment. Additionally, renal histopathological stages were higher in the severe group. Long-term follow-up for proteinuria is mandatory for all children with HSP nephritis, even with mild initial clinical findings.

Objective: In this study, we aimed to investigate the compatibility of modified Medical Research Council (mMRC) and COPD assessment test (CAT) scores of chronic obstructive pulmonary disease (COPD) patients in terms of evaluation of their symptom status.

Methods: The study was planned as a single-center, cross-sectional study. Statistically four separate receiver operating characteristic (ROC) curves of CAT scoring were generated for mMRC scores of 1 to 4.

Results: Two hundred twenty eight patients with stable COPD, mean age 64.2±8.2 and 88.6% male were included. A strong positive correlation was detected between CAT and mMRC (r=0.60, p<0.001). However, it was observed that 32 patients had mMRC<2 but CAT≥10, while 21 patients had CAT<10 but mMRC≥2. Thus, in 53 patients CAT and mMRC scores were not identical in terms of assessed symptom status. According to the ROC analysis, the mMRC scores of 1 to 4 were most compatible with the CAT scores of 10, 10, 15, and 20, respectively.

Conclusions: Expanding current data represents that CAT score of 10 could be more compatible with mMRC score of 1. Moreover we think although a high mMRC or CAT score may be sufficient to assign patients to high symptom groups, it is needed to evaluate mMRC and CAT together to assign a patient to a low symptom group. In this way misclassification of the patients with high symptoms due to insufficient symptom evaluation as if they have low symptoms can be prevented.

Salivary gland neoplasms (SGNs) are rare and heterogeneous tumors in the head and neck region. Although progress has been recently made in revealing the molecular landscape of salivary glands tumors, it is limited and appears to be the tip of the iceberg. Some genetic aberrations include chromosomal translocations, such as CRTC1/3-MAML2 in mucoepidermoid carcinoma, g MYB-NFIB gene fusions in adenoid cystic carcinoma, and PLAG1-HMGA2 gene changes in pleomorphic adenoma and carcinoma ex pleomorphic adenoma. These chromosomal translocations provide fresh insights into the molecular etiology of diverse SGNs and aid in their classification and in approaching treatment. In future, these genetic variations may serve as critical tools for diagnosing salivary gland tumors and optimizing the management as well as prognosis of patients. This review presents the most recent advances in the molecular pathology of salivary gland cancers, with an emphasis on distinguishing molecular features that can be used for optimizing current patient management.

Objective: The auditory brainstem response (ABR) test is usually applied during natural sleep, but it can also be conducted under anesthesia. This retrospective study aimed to compare the ABR findings of a general anesthesia group and a control group that underwent ABR test during natural sleep.

Methods: The anesthesia group consisted of 42 (mean age 44.5±20.3 months) children, and the control group included 58 children (36.1±16.1 months). The results of the click ABR test of the two groups were compared in terms of amplitude, latency, interpeak latencies, and hearing thresholds.

Results: The amplitudes of waves III and V were significantly decreased in the general anesthesia group compared with that in the control group. The ABR latencies of waves I and V and the interpeak latencies for I-V and III-V were prolonged in the anesthesia group compared with that in the control group. Moreover, the click threshold obtained in the anesthesia group was significantly higher than those of the control group.

Conclusions: Clinicians and audiologists should advise families to know the effects of general anesthesia on ABR and be cautious in interpreting the results obtained in ABR test performed under anesthesia.