Pub Date : 2022-09-26DOI: 10.32552/2022.actamedica.788
M. Ibanoglu, Seval Yılmaz Ergani, İrem Özge Uzunoğlu, Belgin Savran Üçok, Yıldız Akdaş Reis, Kadriye Yakut Yücel, C. Iskender, Yaprak Engin Üstün
Objective: Hydatiform mole (HM) is a non-malignant form of gestational trophoblastic disease (GTD) characterized by failure of normal fetal development and overgrowth of trophoblasts. With this retrospective cohort study, we planned to determine the incidence of PHM, etiology and progression rates to Gestational trophoblastic neoplasia (GTN) during the COVID-19 epidemic. Materials and Method: This retrospective cohort study was conducted in Ankara Etlik Zübeyde Hanım Women’s Health Training and Research Hospital Early Pregnancy Assessment Unit between March 2016 and February 2022. Patients who underwent therapeutic curettage (T/C) with the diagnosis of missed abortion, intrauterine exitus (IUEX), molar pregnancy or incomplete abortion after single spontaneous pregnancy were included in the study. The study group consisted of 138 patients who were diagnosed with partial hydatiform mole as a result of pathological examination in this process. There were 135 patients in the control group. Results: The number of patients who applied during the pandemic period and were diagnosed with PHM was 62 (44.92%). The mean age of the patients in the study group was 31.97±8.26 years. The mean body mass index of these patients was 26.38±5.13 m2/kg. The mean paternal age in the study group was 34.95±8.32 years, and it was higher than the paternal age of the patients in the control group (p=0.028). While the incidence of PHM was 1.22/1000 births in our hospital in 2019, this figure was calculated as 3.79/1000 births in 2020. The incidence of progression to GTN at 4 years before the pandemic was 0.02/1000 births; In 2020-2021, this rate was calculated as 0.25/1000 births. Conclusion: During the pandemic period, along with the increase in the incidence of PHM compared to the pre-pandemic period, an increase in the incidence of progression to GTN disease was detected.
目的:葡萄胎(HM)是一种以胎儿正常发育失败和滋养细胞过度生长为特征的非恶性妊娠滋养细胞疾病(GTD)。通过这项回顾性队列研究，我们计划确定在COVID-19流行期间PHM的发病率、病因和妊娠滋养细胞瘤(GTN)的进展率。材料与方法:本回顾性队列研究于2016年3月至2022年2月在安卡拉Etlik z beyde Hanım妇女健康培训与研究医院早期妊娠评估科进行。本研究纳入了诊断为漏产、宫内排出、磨牙妊娠或单次自然妊娠后不完全流产的治疗性刮宫(T/C)患者。研究组由138例在此过程中经病理检查诊断为部分葡萄胎的患者组成。对照组135例。结果:大流行期间申请并确诊PHM的患者62例(44.92%)。研究组患者平均年龄为31.97±8.26岁。患者的平均体重指数为26.38±5.13 m2/kg。研究组患者的平均父亲年龄为34.95±8.32岁，高于对照组(p=0.028)。2019年我院PHM发病率为1.22/1000例，2020年计算为3.79/1000例。大流行前4年进展为GTN的发生率为0.02/1000个新生儿;在2020-2021年，这一比率计算为0.25/1000。结论:在大流行期间，与大流行前相比，随着PHM发病率的增加，检测到进展为GTN疾病的发病率增加。
{"title":"Does COVID-19 Affect the Course of Trophoblastic Gestational Disease in Partial Hydatidiform Moles; Is It A Viral or A Pandemic?","authors":"M. Ibanoglu, Seval Yılmaz Ergani, İrem Özge Uzunoğlu, Belgin Savran Üçok, Yıldız Akdaş Reis, Kadriye Yakut Yücel, C. Iskender, Yaprak Engin Üstün","doi":"10.32552/2022.actamedica.788","DOIUrl":"https://doi.org/10.32552/2022.actamedica.788","url":null,"abstract":"Objective: Hydatiform mole (HM) is a non-malignant form of gestational trophoblastic disease (GTD) characterized by failure of normal fetal development and overgrowth of trophoblasts. With this retrospective cohort study, we planned to determine the incidence of PHM, etiology and progression rates to Gestational trophoblastic neoplasia (GTN) during the COVID-19 epidemic.\u0000Materials and Method: This retrospective cohort study was conducted in Ankara Etlik Zübeyde Hanım Women’s Health Training and Research Hospital Early Pregnancy Assessment Unit between March 2016 and February 2022. Patients who underwent therapeutic curettage (T/C) with the diagnosis of missed abortion, intrauterine exitus (IUEX), molar pregnancy or incomplete abortion after single spontaneous pregnancy were included in the study. The study group consisted of 138 patients who were diagnosed with partial hydatiform mole as a result of pathological examination in this process. There were 135 patients in the control group.\u0000Results: The number of patients who applied during the pandemic period and were diagnosed with PHM was 62 (44.92%). The mean age of the patients in the study group was 31.97±8.26 years. The mean body mass index of these patients was 26.38±5.13 m2/kg. The mean paternal age in the study group was 34.95±8.32 years, and it was higher than the paternal age of the patients in the control group (p=0.028). While the incidence of PHM was 1.22/1000 births in our hospital in 2019, this figure was calculated as 3.79/1000 births in 2020. The incidence of progression to GTN at 4 years before the pandemic was 0.02/1000 births; In 2020-2021, this rate was calculated as 0.25/1000 births.\u0000Conclusion: During the pandemic period, along with the increase in the incidence of PHM compared to the pre-pandemic period, an increase in the incidence of progression to GTN disease was detected.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"47 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77591914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-26DOI: 10.32552/2022.actamedica.690
Güneş Güner, F. Söylemezoğlu
Hippocampal sclerosis (HS) is evaluated in 3 categories by the latest (2013) ILAE classification. The distinction between these categories rely on the histopathological assessment of pyramidal neuron loss in 4 CA sectors. In order to evaluate neuron loss assessment done manually by a neuropathologist, cell counts were carried out from representative photomicrographs of each section. NeuN immunohistochemistry was applied on hippocampus sections of 28 samples of epilepsy surgery, photographed at x100 magnification to represent each of the 4 sectors, and neuron density was calculated per photo. This density data was compared to the pathology reports’ diagnoses. HS type 1 cases were predominant (n=23) with few type 2 and type 3 cases (3 and 2, respectively). Percentage of neuron loss calculated per photos, ILAE classification guidelines and pathological diagnoses rendered without any calculation were relatively well-correlated; with HS type 2 and 3 displaying slight changes from recommendations. Data also display accurate pathological diagnoses of HS without special equipment or cell density calculation. HS types 2 and 3 in Turkey may display variant cell density properties which may warrant further clarification.
{"title":"Morphometry in Classification of Hippocampal Sclerosis","authors":"Güneş Güner, F. Söylemezoğlu","doi":"10.32552/2022.actamedica.690","DOIUrl":"https://doi.org/10.32552/2022.actamedica.690","url":null,"abstract":"Hippocampal sclerosis (HS) is evaluated in 3 categories by the latest (2013) ILAE classification. The distinction between these categories rely on the histopathological assessment of pyramidal neuron loss in 4 CA sectors. In order to evaluate neuron loss assessment done manually by a neuropathologist, cell counts were carried out from representative photomicrographs of each section. NeuN immunohistochemistry was applied on hippocampus sections of 28 samples of epilepsy surgery, photographed at x100 magnification to represent each of the 4 sectors, and neuron density was calculated per photo. This density data was compared to the pathology reports’ diagnoses. HS type 1 cases were predominant (n=23) with few type 2 and type 3 cases (3 and 2, respectively). Percentage of neuron loss calculated per photos, ILAE classification guidelines and pathological diagnoses rendered without any calculation were relatively well-correlated; with HS type 2 and 3 displaying slight changes from recommendations. Data also display accurate pathological diagnoses of HS without special equipment or cell density calculation. HS types 2 and 3 in Turkey may display variant cell density properties which may warrant further clarification.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"201 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76001666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-21DOI: 10.32552/2022.actamedica.648
Abdurrahman Akyüz, B. Aslan, F. Işık, M. Çap, İlyas Kaya, Ö. Atlı, Ü. İnci, E. Taştan, Ö. Bilge, M. Okşul, M. Karahan
Objective: Our aim in this study was to determine whether statins with anti-inflammatory and antithrombotic properties reduce in-hospital mortality in Covid-19 patients. Materials and Methods: 1752 patients hospitalized with the diagnosis of Covid-19 between September and December 2020 were retrospectively analyzed. The patients were grouped according to statin use and their characteristics were compared. The parameters associated with mortality were examined. Results: For the patients, the median age was 64 years (53-74 interquartile range [IQR]), 804 (45.9%) were over the age of 65, 903 (51.5%) were male, 167 (9.5%) were using statins, and mortality developed in 381 (21.7%) of the patients. The multivariate logistic regression model was applied using statistically significant parameters in the univariate analysis of mortality development. The group using statins was included in the regression model because it was statistically borderline significant (p=0.052). According to this model; increased age (odds ratio (OR) =1.051, 95% confidence interval (CI) 1.039-1.063, p<0.001), male gender (OR=1.002, 95%CI 0.993-1.010, p=0.705), decrease in lymphocyte count (OR=0.452, 95%CI 0.337-0.607, p<0.001) increase in potassium level (OR=1.306, 95%CI 1.025-1.664, p=0.031), increase in aspartate transaminase (AST) level (OR=1.004, 95%CI 1.001-1.007, p=0.003), increase in D-dimer level (OR=1.000, 95%CI 1.000-1.000, p=0.011), increase in procalcitonin level (OR=1.027, 95%CI 1.000-1.053, p=0.046), increase in CRP level (OR=1.007, 95%CI 1.005-1.008, p<0.001), and the development of myocardial injury (OR=3.045, 95%CI 1.864-4.976, p<0.001) was found to be associated with increased mortality. Statin use (OR=1.221, 95% CI 0.759-1.966, p=0.410) was not associated with mortality. Conclusion: According to our study, statin use was not associated with an increase or decrease in-hospital mortality in patients hospitalized with a diagnosis of Covid-19.
{"title":"The Effect of Statin Use on In-Hospital Mortality in Covid-19 Patients","authors":"Abdurrahman Akyüz, B. Aslan, F. Işık, M. Çap, İlyas Kaya, Ö. Atlı, Ü. İnci, E. Taştan, Ö. Bilge, M. Okşul, M. Karahan","doi":"10.32552/2022.actamedica.648","DOIUrl":"https://doi.org/10.32552/2022.actamedica.648","url":null,"abstract":"Objective: Our aim in this study was to determine whether statins with anti-inflammatory and antithrombotic properties reduce in-hospital mortality in Covid-19 patients.\u0000Materials and Methods: 1752 patients hospitalized with the diagnosis of Covid-19 between September and December 2020 were retrospectively analyzed. The patients were grouped according to statin use and their characteristics were compared. The parameters associated with mortality were examined.\u0000Results: For the patients, the median age was 64 years (53-74 interquartile range [IQR]), 804 (45.9%) were over the age of 65, 903 (51.5%) were male, 167 (9.5%) were using statins, and mortality developed in 381 (21.7%) of the patients. The multivariate logistic regression model was applied using statistically significant parameters in the univariate analysis of mortality development. The group using statins was included in the regression model because it was statistically borderline significant (p=0.052). According to this model; increased age (odds ratio (OR) =1.051, 95% confidence interval (CI) 1.039-1.063, p<0.001), male gender (OR=1.002, 95%CI 0.993-1.010, p=0.705), decrease in lymphocyte count (OR=0.452, 95%CI 0.337-0.607, p<0.001) increase in potassium level (OR=1.306, 95%CI 1.025-1.664, p=0.031), increase in aspartate transaminase (AST) level (OR=1.004, 95%CI 1.001-1.007, p=0.003), increase in D-dimer level (OR=1.000, 95%CI 1.000-1.000, p=0.011), increase in procalcitonin level (OR=1.027, 95%CI 1.000-1.053, p=0.046), increase in CRP level (OR=1.007, 95%CI 1.005-1.008, p<0.001), and the development of myocardial injury (OR=3.045, 95%CI 1.864-4.976, p<0.001) was found to be associated with increased mortality. Statin use (OR=1.221, 95% CI 0.759-1.966, p=0.410) was not associated with mortality.\u0000Conclusion: According to our study, statin use was not associated with an increase or decrease in-hospital mortality in patients hospitalized with a diagnosis of Covid-19.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"382 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77760954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-21DOI: 10.32552/2022.actamedica.763
Ecem Bostan
Objectives: As Covid-19 infection continues to affect both the pediatric and adult populations, new-onset and pre-existing skin diseases in addition to the skin diseases with exacerbation, are frequently being reported as the cutaneous manifestations of the pandemic. In the present study, the aim was to investigate the impact of Covid-19 pandemic on the clinical course of the skin diseases observed in the pediatric population. Materials and Methods: A web-based survey related to the cutaneous disorders seen in the pediatric population (0-18 years) prior to the pandemic and during the pandemic, was formed. The survey was spread using snowball sampling method. The questionnaire was asked to be filled by the parents. Demographical data, Covid-19 related questions, the presence of the new-onset skin disorders and the clinical course of the pre-existing cutaneous diseases during the pandemic were questioned. Results: Two hundred ninety one children aged between 0-18 years, were included in the study. The mean age was 11.3 ± 4.6 years. One hundred sixty four respondents were female; whereas 127 were male. Ninety seven cases were tested for SARS-CoV-2, 41 had positive RT-PCR result. During the pandemic, 65 children had at least one new-onset cutaneous disease: the most common ones were pruritus (n=23, 35.4%), xerosis (n=17,26.2%), acne vulgaris (n=11, 16.9%) and seborrheic dermatitis (n=11, 16.9%). There was no statistically significant relationship between the presence of any new-onset skin disease during the pandemic and being diagnosed with Covid-19 (p=0.73). However, there was a statistically significant relationship between the number of new-onset acne vulgaris cases and median duration of mask wearing during the pandemic (p=0.025). Conclusion: The present study shows that the era of the Coronavirus disease, has led to the emergence of new-onset skin problems in the pediatric population due to the use of personal protective equipment. Psychosocial burden of the pandemic also seems to have an impact on the pediatric skin disorders.
{"title":"The Impact of Covid-19 Pandemic on the Clinical Course of Pediatric Skin Disorders: A Cross-Sectional Study","authors":"Ecem Bostan","doi":"10.32552/2022.actamedica.763","DOIUrl":"https://doi.org/10.32552/2022.actamedica.763","url":null,"abstract":"Objectives: As Covid-19 infection continues to affect both the pediatric and adult populations, new-onset and pre-existing skin diseases in addition to the skin diseases with exacerbation, are frequently being reported as the cutaneous manifestations of the pandemic. In the present study, the aim was to investigate the impact of Covid-19 pandemic on the clinical course of the skin diseases observed in the pediatric population.\u0000Materials and Methods: A web-based survey related to the cutaneous disorders seen in the pediatric population (0-18 years) prior to the pandemic and during the pandemic, was formed. The survey was spread using snowball sampling method. The questionnaire was asked to be filled by the parents. Demographical data, Covid-19 related questions, the presence of the new-onset skin disorders and the clinical course of the pre-existing cutaneous diseases during the pandemic were questioned.\u0000Results: Two hundred ninety one children aged between 0-18 years, were included in the study. The mean age was 11.3 ± 4.6 years. One hundred sixty four respondents were female; whereas 127 were male. Ninety seven cases were tested for SARS-CoV-2, 41 had positive RT-PCR result. During the pandemic, 65 children had at least one new-onset cutaneous disease: the most common ones were pruritus (n=23, 35.4%), xerosis (n=17,26.2%), acne vulgaris (n=11, 16.9%) and seborrheic dermatitis (n=11, 16.9%). There was no statistically significant relationship between the presence of any new-onset skin disease during the pandemic and being diagnosed with Covid-19 (p=0.73). However, there was a statistically significant relationship between the number of new-onset acne vulgaris cases and median duration of mask wearing during the pandemic (p=0.025).\u0000Conclusion: The present study shows that the era of the Coronavirus disease, has led to the emergence of new-onset skin problems in the pediatric population due to the use of personal protective equipment. Psychosocial burden of the pandemic also seems to have an impact on the pediatric skin disorders.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"50 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79939922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-27DOI: 10.32552/2022.actamedica.665
Y. Özsürekçi, Ö. Tekşam, Ü. Şahiner, E. Özmert, M. Ceyhan
Coronavirus disease 2019 (COVID-19) has become a public health threat to people all over the world and it has stretched hospital resources since the beginning of the pandemic. Available reports to date showed that COVID-19 seems to be less common in children. However, the number of pediatric patients is increasing and a lower number of pediatric patients does not necessarily mean that children are less susceptible to the infection. On the other hand, it is shown that preparedness and response to the COVID-19 disease pandemic in the hospital caring for children are extremely variable. The main target during a pandemic is to maintain high quality and high-efficiency care, with emphasis on patient and provider safety. A documented pandemic plan, simulation training, appropriate use of personal protective equipment (PPE), and appropriate isolation areas in the hospital and also in the emergency department are essential components of pandemic response. Therefore, respiratory hygiene, proper patient placement/ isolation, handling and cleaning of patient care equipment, devices, and environment and procedure safety are all important for effective working flow and reliable working environment in the hospital. Early recognition and isolation of a patient with COVID-19 may help decrease exposure to the other patients and healthcare personnel. The use of a strict surveillance and management protocol during outbreaks of highly virulent viruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), through dedicated patient pathways, adoption of personal protective equipment for health care personnel, and use of nasopharyngeal screening of all admitted children and possibly all healthcare personnel should be recommended. Therefore, we developed a protocol addressing reception, risk management, and hospitalization of suspected SARS-CoV-2 cases at the pediatric emergency department, pediatric wards, and outpatient clinics aimed at containing intrahospital transmission of the infection. Our pandemic response planning was characterized by close collaboration among the head of our hospital, department of pediatrics, pediatric emergency department, pediatric infection control committee, and front-line staff as well as optimization of communication channels. In this article, we aimed to share our experiences of how to handle pediatric patients with COVID-19 in our university hospital from all aspects including prevention of possible transmissions during the first few months of the COVID-19 pandemic.
{"title":"COVID-19 Pandemic Experience in a Tertiary Care Center in Turkey: What have We Learned?","authors":"Y. Özsürekçi, Ö. Tekşam, Ü. Şahiner, E. Özmert, M. Ceyhan","doi":"10.32552/2022.actamedica.665","DOIUrl":"https://doi.org/10.32552/2022.actamedica.665","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) has become a public health threat to people all over the world and it has stretched hospital resources since the beginning of the pandemic. Available reports to date showed that COVID-19 seems to be less common in children. However, the number of pediatric patients is increasing and a lower number of pediatric patients does not necessarily mean that children are less susceptible to the infection. On the other hand, it is shown that preparedness and response to the COVID-19 disease pandemic in the hospital caring for children are extremely variable. The main target during a pandemic is to maintain high quality and high-efficiency care, with emphasis on patient and provider safety. A documented pandemic plan, simulation training, appropriate use of personal protective equipment (PPE), and appropriate isolation areas in the hospital and also in the emergency department are essential components of pandemic response. Therefore, respiratory hygiene, proper patient placement/ isolation, handling and cleaning of patient care equipment, devices, and environment and procedure safety are all important for effective working flow and reliable working environment in the hospital.\u0000Early recognition and isolation of a patient with COVID-19 may help decrease exposure to the other patients and healthcare personnel. The use of a strict surveillance and management protocol during outbreaks of highly virulent viruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), through dedicated patient pathways, adoption of personal protective equipment for health care personnel, and use of nasopharyngeal screening of all admitted children and possibly all healthcare personnel should be recommended. Therefore, we developed a protocol addressing reception, risk management, and hospitalization of suspected SARS-CoV-2 cases at the pediatric emergency department, pediatric wards, and outpatient clinics aimed at containing intrahospital transmission of the infection. Our pandemic response planning was characterized by close collaboration among the head of our hospital, department of pediatrics, pediatric emergency department, pediatric infection control committee, and front-line staff as well as optimization of communication channels. In this article, we aimed to share our experiences of how to handle pediatric patients with COVID-19 in our university hospital from all aspects including prevention of possible transmissions during the first few months of the COVID-19 pandemic.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"30 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90534115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-24DOI: 10.32552/2022.actamedica.733
Çiğdem Tura Bahadır, S. Bahadır
Objective: Carpal tunnel syndrome in diabetic patients differ in some aspects from those in the nondiabetic population. The study was designed to evaluate the diagnostic accuracy of widely used provocative tests in the diabetic population in comparison to nondiabetic population. Materials and Methods: 87 nondiabetic and 25 diabetic hands symptomatic hands suspicious of carpal tunnel syndrome were included in this retrospective study. The presence of carpal tunnel syndrome is confirmed by nerve conduction studies. The hands were divided into DM- and DM+ groups based on patients’ diabetes mellitus history. From patient records, results of Tinel’s, Phalen’s, Durkan’s, median nerve compression, and scratch collapse tests were obtained. Sensitivity, specificity, positive predictive value, and negative predictive values of tests are calculated for each population and then compared with each other. Results: Tinel’s test had a higher sensitivity in the diabetic population. All other tests’ accuracies in diabetic patients were similar to those in diabetic patients. None of the tests had a high enough sensitivity to be used alone in either group. Scratch collapse test had very high specificity in both groups but very low sensitivity. Conclusion: The studied provocative tests have comparable accuracy for carpal tunnel syndrome in diabetic patients to those in nondiabetic patients, with Tinel even having higher sensitivity. But excluding scratch collapse test, none of the tests is strong enough to achieve a diagnosis and none is sensitive enough to rule out a disease.
{"title":"The accuracy of provocative tests on diabetic patients with suspected carpal tunnel syndome and comparison with nondiabetics","authors":"Çiğdem Tura Bahadır, S. Bahadır","doi":"10.32552/2022.actamedica.733","DOIUrl":"https://doi.org/10.32552/2022.actamedica.733","url":null,"abstract":"Objective: Carpal tunnel syndrome in diabetic patients differ in some aspects from those in the nondiabetic population. The study was designed to evaluate the diagnostic accuracy of widely used provocative tests in the diabetic population in comparison to nondiabetic population. \u0000Materials and Methods: 87 nondiabetic and 25 diabetic hands symptomatic hands suspicious of carpal tunnel syndrome were included in this retrospective study. The presence of carpal tunnel syndrome is confirmed by nerve conduction studies. The hands were divided into DM- and DM+ groups based on patients’ diabetes mellitus history. From patient records, results of Tinel’s, Phalen’s, Durkan’s, median nerve compression, and scratch collapse tests were obtained. Sensitivity, specificity, positive predictive value, and negative predictive values of tests are calculated for each population and then compared with each other. \u0000Results: Tinel’s test had a higher sensitivity in the diabetic population. All other tests’ accuracies in diabetic patients were similar to those in diabetic patients. None of the tests had a high enough sensitivity to be used alone in either group. Scratch collapse test had very high specificity in both groups but very low sensitivity. \u0000Conclusion: The studied provocative tests have comparable accuracy for carpal tunnel syndrome in diabetic patients to those in nondiabetic patients, with Tinel even having higher sensitivity. But excluding scratch collapse test, none of the tests is strong enough to achieve a diagnosis and none is sensitive enough to rule out a disease.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"29 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82300023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-24DOI: 10.32552/2022.actamedica.674
Müge Topcuoğlu, B. Ci̇nemre, Ali Erdoğan, N. Nabiyeva
Objective: This study aims to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) treatment in a group of treatment-resistant obsessive-compulsive disorder (OCD) patients and to examine the relationship between various sociodemographic and clinical variables and treatment response. Materials and Methods: Data including The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) scores and various clinical and sociodemographic characteristics of 27 treatment-resistant OCD patients who received 30 sessions of low-frequency rTMS (LF-rTMS) treatment on the left dorsolateral prefrontal cortex (DLPFC) were analyzed. Results: Mean Y-BOCS scores decreased significantly across week 0 and the 3rd week (t(26)=10.59, p<.001) and continued to decrease significantly across weeks 3 and 6 (t(26)=11.47, p<.001). 21(78%) patients were responders with at least a %25 decrease in the mean Y-BOCS scores, and 10(47.6%) of these 21 patients also met the complete response criteria with a 35% or more reduction in Y-BOCS. No significant difference was observed between responders and non-responders regarding various clinical and sociodemographic variables. The only reported side effects were headaches and local scalp tenderness, which improved in a short time. Conclusion: This descriptive study has demonstrated the efficacy of a long-duration LF-rTMS application on the DLPFC in a group of drug-resistant OCD patients. This finding might contribute to the available literature, especially in drawing out a standardized treatment protocol in these cases.
{"title":"Repetitive Transcranial Magnetic Stimulation in a Group of Treament-Resistant Obsessive-Compulsive Disorder Patients: A Descriptive Study","authors":"Müge Topcuoğlu, B. Ci̇nemre, Ali Erdoğan, N. Nabiyeva","doi":"10.32552/2022.actamedica.674","DOIUrl":"https://doi.org/10.32552/2022.actamedica.674","url":null,"abstract":"Objective: This study aims to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) treatment in a group of treatment-resistant obsessive-compulsive disorder (OCD) patients and to examine the relationship between various sociodemographic and clinical variables and treatment response.\u0000Materials and Methods: Data including The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) scores and various clinical and sociodemographic characteristics of 27 treatment-resistant OCD patients who received 30 sessions of low-frequency rTMS (LF-rTMS) treatment on the left dorsolateral prefrontal cortex (DLPFC) were analyzed.\u0000Results: Mean Y-BOCS scores decreased significantly across week 0 and the 3rd week (t(26)=10.59, p<.001) and continued to decrease significantly across weeks 3 and 6 (t(26)=11.47, p<.001). 21(78%) patients were responders with at least a %25 decrease in the mean Y-BOCS scores, and 10(47.6%) of these 21 patients also met the complete response criteria with a 35% or more reduction in Y-BOCS. No significant difference was observed between responders and non-responders regarding various clinical and sociodemographic variables. The only reported side effects were headaches and local scalp tenderness, which improved in a short time.\u0000Conclusion: This descriptive study has demonstrated the efficacy of a long-duration LF-rTMS application on the DLPFC in a group of drug-resistant OCD patients. This finding might contribute to the available literature, especially in drawing out a standardized treatment protocol in these cases.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"34 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77337551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-24DOI: 10.32552/2022.actamedica.682
Seçil Demirkol Canlı
Objective: Stromal cells in the tumor microenvironment (TME) are among the main players of carcinogenesis. Cancer-associated fibroblasts (CAFs) residing in tumor stroma are involved in cancer progression through various mechanisms, supporting tumor growth, cellular motility and invasiveness. The discovery of markers predicting recurrence risk in colorectal cancer (CRC) have led to the generation of several gene panels, including Coloprint. This study aimed to understand the impact of a CAF-rich and a CAF-poor TME on the performance of the prognostic markers in Coloprint. Materials and Methods: Publicly available transcriptomic data of CRC tumors were used to generate tumor sub-groups based on CAF specific gene expression. Subsequently, prognostic relationships of Coloprint genes were assessed within these subgroups. Results and Conclusion: Our data revealed that prognostic performance of Coloprint genes differed dramatically between CAF stratified subgroups compared to non-stratified analysis. We have found that multiple genes lost their prognostic significance and several genes showed an association in the opposite direction. 9 out of 17 genes were differentially expressed in at least one of the CAF-specific subgroups and majority of the genes predicted prognosis independent of CAF levels. These findings showed that the performance of the prognostic markers can vary significantly among CAF-poor and CAF-rich groups. Therefore testing potential biomarkers within such biological sub-groups may contribute to the development of more specific gene panels.
{"title":"Evaluation of Prognostic Markers in Cancer-associated Fibroblast Based Sub-groups of Colorectal Cancer","authors":"Seçil Demirkol Canlı","doi":"10.32552/2022.actamedica.682","DOIUrl":"https://doi.org/10.32552/2022.actamedica.682","url":null,"abstract":"Objective: Stromal cells in the tumor microenvironment (TME) are among the main players of carcinogenesis. Cancer-associated fibroblasts (CAFs) residing in tumor stroma are involved in cancer progression through various mechanisms, supporting tumor growth, cellular motility and invasiveness. The discovery of markers predicting recurrence risk in colorectal cancer (CRC) have led to the generation of several gene panels, including Coloprint. This study aimed to understand the impact of a CAF-rich and a CAF-poor TME on the performance of the prognostic markers in Coloprint.\u0000Materials and Methods: Publicly available transcriptomic data of CRC tumors were used to generate tumor sub-groups based on CAF specific gene expression. Subsequently, prognostic relationships of Coloprint genes were assessed within these subgroups.\u0000Results and Conclusion: Our data revealed that prognostic performance of Coloprint genes differed dramatically between CAF stratified subgroups compared to non-stratified analysis. We have found that multiple genes lost their prognostic significance and several genes showed an association in the opposite direction. 9 out of 17 genes were differentially expressed in at least one of the CAF-specific subgroups and majority of the genes predicted prognosis independent of CAF levels. These findings showed that the performance of the prognostic markers can vary significantly among CAF-poor and CAF-rich groups. Therefore testing potential biomarkers within such biological sub-groups may contribute to the development of more specific gene panels.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"22 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79229911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-19DOI: 10.32552/2022.actamedica.637
D. Gülseren, Ecem Bostan, N. Akdoğan, B. Yalıcı-Armağan, S. Doğan, S. Ersoy-Evans, G. Elçin, A. Karaduman
Objective: Isotretinoin is generally chosen as the first line treatment of nodulocystic acne. Close laboratory monitoring is a general practice for many dermatologists to be on the safe side due to the laboratory side effects of isotretinoin. We aimed to determine the laboratory side effects of oral isotretinoin and optimal frequency interval for laboratory monitoring during isotretinoin treatment. Materials and Methods: One hundred patients who were under oral isotretinoin therapy were included in the study; serum lipid levels along with liver transaminase levels were recorded at the baseline, 1-, 3- and 6- months of the therapy. Results: We found that there might be slight elevations in serum aspartate transaminase and lipid levels during isotretinoin therapy (p<0.05, for all). However, statistically significant elevations were observed within the first month of isotretinoin therapy. Conclusions: Frequent laboratory monitoring might not be necessary for all acne patients undergoing isotretinoin therapy. Patients should be screened at the first month of the therapy and then, the intervals can be extended.
{"title":"Monitoring Serum Lipid Profile and Liver Transaminase Levels During Isotretinoin Therapy","authors":"D. Gülseren, Ecem Bostan, N. Akdoğan, B. Yalıcı-Armağan, S. Doğan, S. Ersoy-Evans, G. Elçin, A. Karaduman","doi":"10.32552/2022.actamedica.637","DOIUrl":"https://doi.org/10.32552/2022.actamedica.637","url":null,"abstract":"Objective: Isotretinoin is generally chosen as the first line treatment of nodulocystic acne. Close laboratory monitoring is a general practice for many dermatologists to be on the safe side due to the laboratory side effects of isotretinoin. We aimed to determine the laboratory side effects of oral isotretinoin and optimal frequency interval for laboratory monitoring during isotretinoin treatment.\u0000Materials and Methods: One hundred patients who were under oral isotretinoin therapy were included in the study; serum lipid levels along with liver transaminase levels were recorded at the baseline, 1-, 3- and 6- months of the therapy.\u0000Results: We found that there might be slight elevations in serum aspartate transaminase and lipid levels during isotretinoin therapy (p<0.05, for all). However, statistically significant elevations were observed within the first month of isotretinoin therapy.\u0000Conclusions: Frequent laboratory monitoring might not be necessary for all acne patients undergoing isotretinoin therapy. Patients should be screened at the first month of the therapy and then, the intervals can be extended.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"6 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84724788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-16DOI: 10.32552/2022.actamedica.742
Yasuhiro Horiuchi
Palmoplantar pustulosis is strongly suggested the involvement of oral bacteria, but the cause of geographic tongue remains unknown. A 20-year-old female patient described a 1-2 year history of geographic tongue with irregular, smooth, red patches on parts of the tongue. She also presented several pustules, accompanied by delimited erythematous skin patches on both soles. One month after the first visit, when she returned for follow-up, the skin condition had progressed further, and pustules and scales became more prominent. Tongue rinses with commercial mouth washes were tried, but the condition of the lesions fluctuated between improvement and exacerbation. This report presents a rare case of the coexistence of geographic tongue and palmoplantar pustulosis in a young female patient.
{"title":"Coexistence of Geographic Tongue and Palmoplantar Pustulosis: A Case Report","authors":"Yasuhiro Horiuchi","doi":"10.32552/2022.actamedica.742","DOIUrl":"https://doi.org/10.32552/2022.actamedica.742","url":null,"abstract":"Palmoplantar pustulosis is strongly suggested the involvement of oral bacteria, but the cause of geographic tongue remains unknown. A 20-year-old female patient described a 1-2 year history of geographic tongue with irregular, smooth, red patches on parts of the tongue. She also presented several pustules, accompanied by delimited erythematous skin patches on both soles. One month after the first visit, when she returned for follow-up, the skin condition had progressed further, and pustules and scales became more prominent. Tongue rinses with commercial mouth washes were tried, but the condition of the lesions fluctuated between improvement and exacerbation. This report presents a rare case of the coexistence of geographic tongue and palmoplantar pustulosis in a young female patient.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"2013 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87987876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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