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Orbital Doppler ultrasonography evaluation in patients with ankylosing spondylitis: A prospective study. 强直性脊柱炎患者的眼眶多普勒超声评估:前瞻性研究。
Pub Date : 2024-06-26 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.54514
Omer Faruk Sevinc, Sibel Alisan Alimoglu, Sumeyye Merve Turk, Emel Gonullu, Onur Taydas

Objective: Our aim in this study is to compare patients with ankylosing spondylitis (AS), a rheumatologic disease that can cause eye involvement and the normal population in terms of orbital Doppler findings, which is an inexpensive and easily applicable method that can be used in early diagnosis and follow-up.

Methods: The study was planned prospectively. The data of patients with AS were compared to those of age- and gender-matched healthy volunteers. A total of 42 participants, 23 (54.8%) males and 19 (45.2%) females, with a mean age of 42.4±12.6 years were included in the study. In addition to demographic information, such as age and gender, the diameter, peak systolic velocity, end-diastolic velocity, mean velocity, resistive index, pulsatility index, and blood flow volumes of the central retinal artery of the left eye were measured using spectral Doppler ultrasonography.

Results: According to the comparison of the patients with and without AS according to orbital Doppler ultrasonography findings, the mean velocity, resistive index, and volume measurements of the patients with AS were significantly higher than those without AS (p=0.028, p=0.039, and p=0.038, respectively). However, in the subgroup analysis of the AS group, the Doppler findings did not significantly differ between the patients with and without anterior uveitis.

Conclusion: In the patient group with AS, independent of anterior uveitis (AU), there was a difference in Doppler parameters and therefore in ophthalmic vasculature. In patients with AS, orbital vascularity changes can be detected with orbital Doppler US before clinical signs appear.

研究目的本研究旨在比较强直性脊柱炎(AS)患者和正常人群的眼眶多普勒检查结果,强直性脊柱炎是一种可导致眼部受累的风湿性疾病:方法:本研究为前瞻性研究。方法:该研究为前瞻性计划,将强直性脊柱炎患者的数据与年龄和性别匹配的健康志愿者的数据进行比较。共有42人参与了研究,其中男性23人(54.8%),女性19人(45.2%),平均年龄为(42.4±12.6)岁。除年龄和性别等人口统计学信息外,研究人员还使用频谱多普勒超声技术测量了左眼视网膜中央动脉的直径、收缩峰值速度、舒张末期速度、平均速度、阻力指数、搏动指数和血流量:根据眼眶多普勒超声检查结果对有强直性脊柱炎和无强直性脊柱炎患者进行比较,有强直性脊柱炎患者的平均速度、阻力指数和血流量测量值明显高于无强直性脊柱炎患者(分别为P=0.028、P=0.039和P=0.038)。然而,在强直性脊柱炎组的亚组分析中,前葡萄膜炎患者和非前葡萄膜炎患者的多普勒结果没有明显差异:结论:在强直性脊柱炎患者组中,与前葡萄膜炎(AU)无关,多普勒参数存在差异,因此眼部血管也存在差异。在强直性脊柱炎患者中,眼眶多普勒超声检查可在临床症状出现之前发现眼眶血管的变化。
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引用次数: 0
Sexuality and sexual dysfunction in patients with psoriatic arthritis: A cross-sectional study. 银屑病关节炎患者的性生活和性功能障碍:横断面研究
Pub Date : 2024-06-25 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.75317
Jokasta Nunes Lobo, Lysiane Maria Adeodato Ramos, Andrea Rocha de Saboia Mont'Alverne, Jozélio Freire de Carvalho, Carlos Ewerton Maia Rodrigues

Objective: Psoriatic arthritis (PsA) is a chronic inflammatory disorder affecting the joints, skin and entheses. Despite the importance of the topic, few studies have investigated the association between PsA and sexual function. The purpose of this study was to assess sexuality and the prevalence of sexual dysfunction (SD) in patients with PsA.

Methods: This was an observational, cross-sectional single-center study on 23 PsA patients (male=12; female=11) evaluated with 2 male questionnaires (MSQ= Male Sexual Quotient, and IIEF=International Index of Erectile Function) and 2 female questionnaires (FSQ= Female Sexual Quotient, and FSFI=Female Sexual Function Index) validated for Brazilian Portuguese, in order to determine changes in sexual function. Clinical parameters, musculoskeletal activity and skin activity were also analyzed to identify factors associated with SD.

Results: The mean age was 52.1±9.7 years (males) and 49.1±9.6 years (females). Clinically, the patients had low skin and peripheral joint disease activity or were in remission. The mean time of PsA was 10±6.2 years, and 65.2% had a steady sexual partner. The mean MSQ score was 75.8±16.8. The prevalence of SD was 91.7% in men (IIEF), with a predominance of mild SD. The mean FSQ score was 64.9±24.1. The prevalence of SD was 72.7% in women (FSFI), with low domain scores. Also, a significant association was found between female age and total and domain-specific FSFI scores. PASI (Psoriasis Area and Severity Index) and the general satisfaction domain (IIEF) were significantly correlated.

Conclusion: This study found a high prevalence of SD in PsA patients. Age had a negative impact on female sexual function. Physicians need to be more aware of SD in this population to provide early multidisciplinary treatment and minimize the impact of the disease on the quality of life of patients and their partners.

目的:银屑病关节炎(PsA)是一种影响关节、皮肤和粘膜的慢性炎症性疾病。尽管这一主题非常重要,但很少有研究调查 PsA 与性功能之间的关系。本研究旨在评估 PsA 患者的性能力和性功能障碍(SD)的发生率:这是一项观察性、横断面单中心研究,研究对象为 23 名 PsA 患者(男=12;女=11),使用 2 份男性问卷(MSQ=男性性商和 IIEF=国际勃起功能指数)和 2 份女性问卷(FSQ=女性性商和 FSFI=女性性功能指数)进行评估,这 2 份问卷已在巴西葡萄牙语中验证,目的是确定患者性功能的变化。此外,还对临床参数、肌肉骨骼活动和皮肤活动进行了分析,以确定与 SD 相关的因素:平均年龄为(52.1±9.7)岁(男性)和(49.1±9.6)岁(女性)。临床上,患者的皮肤和外周关节疾病活动度较低或处于缓解期。患PsA的平均时间为(10±6.2)年,65.2%的患者有稳定的性伴侣。平均 MSQ 得分为 75.8±16.8。男性 SD 患病率为 91.7%(IIEF),以轻度 SD 为主。FSQ 平均得分为 64.9±24.1。女性 SD 患病率为 72.7%(FSFI),领域得分较低。此外,研究还发现女性年龄与 FSFI 总分和特定领域得分之间存在明显关联。PASI(银屑病面积和严重程度指数)和一般满意度领域(IIEF)之间存在显著相关性:本研究发现,PsA 患者的 SD 患病率很高。年龄对女性性功能有负面影响。医生需要提高对这一人群中SD的认识,以便及早提供多学科治疗,尽量减少疾病对患者及其伴侣生活质量的影响。
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引用次数: 0
Evaluation of epidemiological, clinical, laboratory and treatment characteristics of Crimen Congo hemorrhagic fever patients: Results of a 10-year analysis. 评估克里门刚果出血热患者的流行病学、临床、实验室和治疗特点:十年分析结果。
Pub Date : 2024-06-25 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.09815
Mustafa Arslan, Senol Comoglu

Objective: Crimean-Congo hemorrhagic fever (CCHF) is a viral zoonosis transmitted by ticks and may have an acute and severe course with fever, bleeding, muscle aches, headache, diarrhea, weakness, and similar non-specific symptoms. This study aimed to determine the distribution of CCHF cases in Amasya province, which is endemic for this disease, according to districts, epidemiological, clinical, laboratory, and treatment characteristics.

Methods: The characteristics of 88 CCHF cases over 18 who were admitted to our clinic and treated between January 2013 and January 2023 were evaluated retrospectively. Demographic data such as age, gender, occupation, district of residence, history of tick contact, the incubation period of the disease, period of development of the disease (months, years), length of hospital stay, symptoms, physical examination and laboratory findings, blood product replacement therapies applied, recovery and mortality status of the patients were reached by scanning the patient files.

Results: The mean age (±standard deviation) of 88 cases was 48±18 years, and 53 (60.2%) were male. Of the patients, 68 (77.3%) were engaged in farming and animal husbandry, and 79 (89.7%) lived in villages and hamlets. Tasova district had the highest frequency of cases, with 29 (32.9%) patients. June was the most common month for the disease, with 31 (35.2%) cases. The most common symptom on admission was fatigue, with a rate of 93%. Other symptoms included myalgia and arthralgia (83.2%), fever (65%), headache (64.4%), nausea-vomiting (43.5%), conjunctival hyperemia (35.2%), and diarrhea (21.7%). In clinical follow-up, bleeding was missed in 15 (17.04%) patients. On admission to the hospital, there were elevated levels of thrombocytopenia (92%), leukopenia (84.1%), aspartate aminotransferase and alanine aminotransferase (86.3%), creatinine phosphokinase (71.6%), and lactate dehydrogenase (76.1%). None of the patients were given ribavirin treatment. Our mortality rate was 3.40% with three patients.

Conclusion: Amasya is an endemic area for CCHF with all its districts. In our province's spring and summer months, tick contact history and the farming-livestock profession should be questioned in patients with fever complaints in clinic admissions, especially emergency services. In the case of the detection of thrombocytopenia in these patients, CCHF should be kept in mind.

目标:克里米亚-刚果出血热(CCHF克里米亚-刚果出血热(CCHF)是一种由蜱虫传播的病毒性人畜共患病,病程急且严重,可伴有发热、出血、肌肉酸痛、头痛、腹泻、虚弱和类似的非特异性症状。本研究旨在根据地区、流行病学、临床、实验室和治疗特点,确定该病流行的阿马西亚省的 CCHF 病例分布情况:回顾性评估了 2013 年 1 月至 2023 年 1 月期间本诊所收治的 88 例 18 岁以上 CCHF 病例的特征。通过扫描患者档案,获得患者的年龄、性别、职业、居住地区、蜱虫接触史、疾病潜伏期、疾病发展期(月、年)、住院时间、症状、体格检查和实验室检查结果、应用的血液制品替代疗法、康复和死亡状况等人口统计学数据:88 例患者的平均年龄(± 标准差)为 48±18 岁,其中 53 例(60.2%)为男性。患者中有 68 人(77.3%)从事农业和畜牧业,79 人(89.7%)居住在村庄和村落。塔索瓦区的发病率最高,有 29 名患者(32.9%)。6 月是最常见的发病月份,有 31 例(35.2%)患者。入院时最常见的症状是疲劳,比例为 93%。其他症状包括肌痛和关节痛(83.2%)、发热(65%)、头痛(64.4%)、恶心呕吐(43.5%)、结膜充血(35.2%)和腹泻(21.7%)。在临床随访中,有 15 例(17.04%)患者漏诊出血。入院时,血小板减少(92%)、白细胞减少(84.1%)、天门冬氨酸氨基转移酶和丙氨酸氨基转移酶(86.3%)、肌酐磷酸激酶(71.6%)和乳酸脱氢酶(76.1%)水平升高。所有患者均未接受利巴韦林治疗。3名患者的死亡率为3.40%:结论:阿马西亚及其所有地区都是慢性阻塞性肺疾病的流行区。在我省的春夏季节,应询问门诊,尤其是急诊中发热主诉患者的蜱虫接触史和农牧业职业。如果在这些患者中发现血小板减少症,则应注意慢性阻塞性肺病。
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引用次数: 0
Ultrasonographic evaluation of changes in the joint before and after intra-articular injection in children with juvenile idiopathic arthritis. 用超声波评估幼年特发性关节炎患儿关节内注射前后的变化。
Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2024.55481
Seyma Turkmen, Betul Sozeri

Objective: The aim of this study is to ultrasonographically (US) evaluate the course of the knee joint in oligoarticular juvenile idiopathic arthritis (JIA) patients who received intra-articular steroid (IAS) application to the knee joint.

Methods: 237 knee joints of 175 patients with oligoarticular JIA were evaluated retrospectively. The patients were divided into two groups: those who received only IAS therapy and those who were methotrexate to IAS therapy. Synovial fluid grade changes, synovial proliferation in B mode examination and power Doppler (PD) changes were evaluated with musculoskeletal ultrasonography (MSUS) separately for each joint before the treatment and at the 2nd, 6th and 12th weeks of the treatment.

Results: The percentages of regression in synovial fluid grade at the second, sixth, and 12th weeks were respectively 73.4%, 88.6%, and 89.0% (n=174, 210, 211, respectively). Meanwhile, the percentages of regression in PD grade were 69.2%, 82.7%, and 84.0% (n=164, 196, 199, respectively). At the second, sixth and 12th weeks, the percentage of those with synovial fluid grade 0 was 24.1%, 54.9%, 73.4%, respectively (n=57, 130, 174, respectively), while the percentage of those with PD grade 0 was 39.7%, 67.9%, 80.6%, respectively (n=94,161,191, respectively). The percentage of those without synovial proliferation in the second, sixth and 12th weeks was found to be 26.2%, 54.9%, 73.8% respectively (n=62, 130, 175, respectively). The mean time to regression of synovial fluid, synovial proliferation, and PD in the only IAS group was significantly short. The percentage of synovitis regression was higher in the only IAS group at all weeks. This difference was especially more pronounced in the early period. When the 12th-week results were evaluated, there was no difference between the two groups.

Conclusion: This study highlights the utility of MSUS in evaluating the early results of IAS therapy applied to the knee joint in oligoarticular JIA patients.

研究目的方法:对175例少关节型幼年特发性关节炎(JIA)患者的237个膝关节进行回顾性评估。这些患者被分为两组:只接受 IAS 治疗的患者和在 IAS 治疗基础上使用甲氨蝶呤的患者。在治疗前、治疗第2周、第6周和第12周,用肌肉骨骼超声(MSUS)分别评估每个关节的滑液分级变化、B型检查中的滑膜增生和动力多普勒(PD)变化:第2周、第6周和第12周的滑液分级消退率分别为73.4%、88.6%和89.0%(人数分别为174、210和211)。同时,PD 级的消退率分别为 69.2%、82.7% 和 84.0%(样本数分别为 164、196 和 199)。在第2周、第6周和第12周,滑液等级为0级的患者比例分别为24.1%、54.9%和73.4%(人数分别为57、130和174),而PD等级为0级的患者比例分别为39.7%、67.9%和80.6%(人数分别为94、161和191)。第2周、第6周和第12周没有滑膜增生的患者比例分别为26.2%、54.9%和73.8%(人数分别为62、130和175)。仅使用 IAS 组的滑液、滑膜增生和 PD 的平均消退时间明显较短。在所有周数中,仅 IAS 组滑膜炎消退的百分比都更高。这种差异在早期尤为明显。在评估第 12 周的结果时,两组之间没有差异:本研究强调了 MSUS 在评估少关节型 JIA 患者膝关节 IAS 治疗早期效果方面的实用性。
{"title":"Ultrasonographic evaluation of changes in the joint before and after intra-articular injection in children with juvenile idiopathic arthritis.","authors":"Seyma Turkmen, Betul Sozeri","doi":"10.14744/nci.2024.55481","DOIUrl":"10.14744/nci.2024.55481","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to ultrasonographically (US) evaluate the course of the knee joint in oligoarticular juvenile idiopathic arthritis (JIA) patients who received intra-articular steroid (IAS) application to the knee joint.</p><p><strong>Methods: </strong>237 knee joints of 175 patients with oligoarticular JIA were evaluated retrospectively. The patients were divided into two groups: those who received only IAS therapy and those who were methotrexate to IAS therapy. Synovial fluid grade changes, synovial proliferation in B mode examination and power Doppler (PD) changes were evaluated with musculoskeletal ultrasonography (MSUS) separately for each joint before the treatment and at the 2<sup>nd</sup>, 6<sup>th</sup> and 12<sup>th</sup> weeks of the treatment.</p><p><strong>Results: </strong>The percentages of regression in synovial fluid grade at the second, sixth, and 12<sup>th</sup> weeks were respectively 73.4%, 88.6%, and 89.0% (n=174, 210, 211, respectively). Meanwhile, the percentages of regression in PD grade were 69.2%, 82.7%, and 84.0% (n=164, 196, 199, respectively). At the second, sixth and 12<sup>th</sup> weeks, the percentage of those with synovial fluid grade 0 was 24.1%, 54.9%, 73.4%, respectively (n=57, 130, 174, respectively), while the percentage of those with PD grade 0 was 39.7%, 67.9%, 80.6%, respectively (n=94,161,191, respectively). The percentage of those without synovial proliferation in the second, sixth and 12<sup>th</sup> weeks was found to be 26.2%, 54.9%, 73.8% respectively (n=62, 130, 175, respectively). The mean time to regression of synovial fluid, synovial proliferation, and PD in the only IAS group was significantly short. The percentage of synovitis regression was higher in the only IAS group at all weeks. This difference was especially more pronounced in the early period. When the 12<sup>th</sup>-week results were evaluated, there was no difference between the two groups.</p><p><strong>Conclusion: </strong>This study highlights the utility of MSUS in evaluating the early results of IAS therapy applied to the knee joint in oligoarticular JIA patients.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 3","pages":"241-248"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The clinical and immunological characteristics of common variable immunodeficiency in adults and older adults. 成人和老年人常见可变免疫缺陷症的临床和免疫学特征。
Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.49699
Eray Yildiz, Fatih Colkesen, Recep Evcen, Filiz Sadi Aykan, Mehmet Kilinc, Gokhan Aytekin, Sevket Arslan

Objective: The aim of this study was to determine the clinical and immunological characteristics of older adults with common variable immunodeficiency (CVID).

Methods: Patients aged ≥18 years who were followed up with the diagnosis of CVID between 2015 and 2020 were included in the study. The patients were separated into two age groups according to the age at diagnosis: the adult group, aged 18-65 years (n=49) and the older adult group, aged ≥65 years (n=11).

Results: Splenomegaly (55.1% vs. 9.1%, p=0.006), bronchiectasis (53.0% vs. 9.1%, p=0.008), and autoimmunity (42.8% vs. 9.1%, p=0.036) were determined to be more common in the adult group than in the older adults. A similar frequency of malignancy was seen in both groups (6.1% vs. 9.1%, p=0.721). There were significantly more patients with no comorbidity in the older adult group than in the adult group (45.5% vs. 16.3%, p=0.034). Serum IgG and IgA levels were determined to be significantly higher in the older adult group than in the adult group (p=0.001 for all). The CD19+ B-cell count at the time of diagnosis was determined to be lower and the CD19+CD27+IgD- switched memory B-cells and CD16+CD56+ natural killer cell counts were higher in the older adults than in the adult group (p=0.016, p=0.032, p=0.044, respectively).

Conclusion: Knowledge of clinical and immunological differences in older adult CVID patients may be of benefit in polyclinic follow-up and in respect of changes to be made to the treatment plan.

研究目的本研究旨在确定常见变异性免疫缺陷症(CVID)老年人的临床和免疫学特征:研究纳入了 2015 年至 2020 年期间随访的确诊为 CVID 的年龄≥18 岁的患者。根据诊断时的年龄将患者分为两个年龄组:18-65 岁的成人组(49 人)和≥65 岁的老年组(11 人):结果:成人组比老年人组更常见脾大(55.1% vs. 9.1%,P=0.006)、支气管扩张(53.0% vs. 9.1%,P=0.008)和自身免疫(42.8% vs. 9.1%,P=0.036)。两组患者的恶性肿瘤发病率相似(6.1% 对 9.1%,P=0.721)。老年人组中无合并症的患者明显多于成年人组(45.5% 对 16.3%,P=0.034)。经测定,老年人组的血清 IgG 和 IgA 水平明显高于成人组(P=0.001)。确诊时的 CD19+ B 细胞计数较低,而老年人组的 CD19+CD27+IgD- 交换记忆 B 细胞和 CD16+CD56+ 自然杀伤细胞计数高于成人组(分别为 p=0.016、p=0.032、p=0.044):结论:了解老年 CVID 患者在临床和免疫学方面的差异,有助于综合医院的随访和治疗方案的调整。
{"title":"The clinical and immunological characteristics of common variable immunodeficiency in adults and older adults.","authors":"Eray Yildiz, Fatih Colkesen, Recep Evcen, Filiz Sadi Aykan, Mehmet Kilinc, Gokhan Aytekin, Sevket Arslan","doi":"10.14744/nci.2023.49699","DOIUrl":"10.14744/nci.2023.49699","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the clinical and immunological characteristics of older adults with common variable immunodeficiency (CVID).</p><p><strong>Methods: </strong>Patients aged ≥18 years who were followed up with the diagnosis of CVID between 2015 and 2020 were included in the study. The patients were separated into two age groups according to the age at diagnosis: the adult group, aged 18-65 years (n=49) and the older adult group, aged ≥65 years (n=11).</p><p><strong>Results: </strong>Splenomegaly (55.1% vs. 9.1%, p=0.006), bronchiectasis (53.0% vs. 9.1%, p=0.008), and autoimmunity (42.8% vs. 9.1%, p=0.036) were determined to be more common in the adult group than in the older adults. A similar frequency of malignancy was seen in both groups (6.1% vs. 9.1%, p=0.721). There were significantly more patients with no comorbidity in the older adult group than in the adult group (45.5% vs. 16.3%, p=0.034). Serum IgG and IgA levels were determined to be significantly higher in the older adult group than in the adult group (p=0.001 for all). The CD19+ B-cell count at the time of diagnosis was determined to be lower and the CD19+CD27+IgD- switched memory B-cells and CD16+CD56+ natural killer cell counts were higher in the older adults than in the adult group (p=0.016, p=0.032, p=0.044, respectively).</p><p><strong>Conclusion: </strong>Knowledge of clinical and immunological differences in older adult CVID patients may be of benefit in polyclinic follow-up and in respect of changes to be made to the treatment plan.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 3","pages":"201-207"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of macrolide susceptibility of Legionella pneumophila isolated from public buildings' water systems in Turkiye. 评估从土耳其公共建筑供水系统中分离出的嗜肺军团菌对大环内酯类药物的敏感性。
Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.70104
Ahmet Aktas, Fatma Koksal Cakirlar

Objective: Legionella pneumophila (Lp) is aerobic, non-spore forming Gram-negative bacteria, which is ubiquitous in freshwater habitats, such as rivers and hot springs, as well as colonizing artificial aquatic environments. The ability of Lp to grow intracellularly within pulmonary macrophages is a prerequisite for the development of infection. Therefore, macrolides can achieve appropriate therapeutic concentrations in eukaryotic cells, such as azithromycin. This study aimed to investigate the macrolides susceptibility of Lp.

Methods: Pre-flash water samples (n=143) were collected from the public buildings (hospitals and hotels) water system in Istanbul. Colonies were confirmed as Lp ST1, ST2-14, and non-pneumophila Lp using latex agglutination kit.

Results: 30 Lp were detected in hospital (n=23) and hotel (n=7) water systems using latex agglutination. Regardless of serotype and excluding strains without zone formation (≥256 mg/L), the main MIC values of azithromycin, erythromycin and clarithromycin were 0.61 mg/L (range 0.047-1 mg/L), 0.47 mg/L (range 0.047-1 mg/L) and 0.44 mg/L (range 0.047-1 mg/L), respectively. The MIC50 and MIC90 values for macrolides were 0.5 and 3 mg/L for azithromycin, respectively; 0.38 and 1 mg/L for erythromycin, respectively; and 0.5 and 1 mg/L for clarithromycin, respectively. We compared the MIC values of the strains for all antimicrobial agents tested without serotype discrimination. We did not find a significant difference between the MIC values of the antibiotics (p=0.16).

Conclusion: Although the data obtained from our study do not fully reflect the breakpoints, further epidemiological studies are needed to standardize MIC values.

目的:嗜肺军团菌(Lp)是一种需氧、无芽孢的革兰氏阴性细菌,在淡水栖息地(如河流和温泉)中无处不在,也可在人工水生环境中定植。Lp 能够在肺巨噬细胞内生长,这是形成感染的先决条件。因此,大环内酯类药物可在真核细胞内达到适当的治疗浓度,如阿奇霉素。本研究旨在调查 Lp 对大环内酯类药物的敏感性:方法:从伊斯坦布尔的公共建筑(医院和酒店)供水系统收集闪蒸前水样(n=143)。使用乳胶凝集试剂盒确认菌落为 Lp ST1、ST2-14 和非嗜肺菌 Lp:结果:使用乳胶凝集法在医院(23 个)和酒店(7 个)供水系统中检测到 30 种 Lp。无论血清型如何,排除未形成区域(≥256 mg/L)的菌株,阿奇霉素、红霉素和克拉霉素的主要 MIC 值分别为 0.61 mg/L(范围为 0.047-1 mg/L)、0.47 mg/L(范围为 0.047-1 mg/L)和 0.44 mg/L(范围为 0.047-1 mg/L)。大环内酯类药物的 MIC50 和 MIC90 值分别为:阿奇霉素 0.5 和 3 毫克/升;红霉素 0.38 和 1 毫克/升;克拉霉素 0.5 和 1 毫克/升。在不区分血清型的情况下,我们比较了菌株对所有抗菌药物的 MIC 值。我们没有发现抗生素 MIC 值之间存在明显差异(P=0.16):尽管我们的研究数据并不能完全反映断点,但仍需进一步开展流行病学研究,以统一 MIC 值。
{"title":"Assessment of macrolide susceptibility of <i>Legionella pneumophila</i> isolated from public buildings' water systems in Turkiye.","authors":"Ahmet Aktas, Fatma Koksal Cakirlar","doi":"10.14744/nci.2023.70104","DOIUrl":"10.14744/nci.2023.70104","url":null,"abstract":"<p><strong>Objective: </strong><i>Legionella pneumophila</i> (Lp) is aerobic, non-spore forming Gram-negative bacteria, which is ubiquitous in freshwater habitats, such as rivers and hot springs, as well as colonizing artificial aquatic environments. The ability of Lp to grow intracellularly within pulmonary macrophages is a prerequisite for the development of infection. Therefore, macrolides can achieve appropriate therapeutic concentrations in eukaryotic cells, such as azithromycin. This study aimed to investigate the macrolides susceptibility of Lp.</p><p><strong>Methods: </strong>Pre-flash water samples (n=143) were collected from the public buildings (hospitals and hotels) water system in Istanbul. Colonies were confirmed as Lp ST1, ST2-14, and non-pneumophila Lp using latex agglutination kit.</p><p><strong>Results: </strong>30 Lp were detected in hospital (n=23) and hotel (n=7) water systems using latex agglutination. Regardless of serotype and excluding strains without zone formation (≥256 mg/L), the main MIC values of azithromycin, erythromycin and clarithromycin were 0.61 mg/L (range 0.047-1 mg/L), 0.47 mg/L (range 0.047-1 mg/L) and 0.44 mg/L (range 0.047-1 mg/L), respectively. The MIC50 and MIC90 values for macrolides were 0.5 and 3 mg/L for azithromycin, respectively; 0.38 and 1 mg/L for erythromycin, respectively; and 0.5 and 1 mg/L for clarithromycin, respectively. We compared the MIC values of the strains for all antimicrobial agents tested without serotype discrimination. We did not find a significant difference between the MIC values of the antibiotics (p=0.16).</p><p><strong>Conclusion: </strong>Although the data obtained from our study do not fully reflect the breakpoints, further epidemiological studies are needed to standardize MIC values.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 3","pages":"214-218"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mid-term survivorship and clinical results of cementless total hip arthroplasty for steroid-induced avascular necrosis. 无骨水泥全髋关节置换术治疗类固醇引起的血管性坏死的中期存活率和临床效果。
Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.38107
Muhammed Enes Karatas, Bahattin Kemah, Mehmet Salih Soylemez, Necdet Saglam

Objective: The purpose of the present study was to evaluate the mid-term implant survivorship, modes of failure, radiographic results, and clinical outcomes of current cementless total hip arthroplasty (THA) treatment designs for steroid-induced avascular necrosis (AVN).

Methods: A time span of 5 years between January 2012 and November 2017 was scanned to accommodate 5 years of follow-up and a total of 15 patients (18 hips), who had undergone implantation of ultra-high molecular weight polyethylene (UHMWPE) and newly designed other head and liner components, were included in the study. Only patients operated for steroid-induced AVN were included in the study. Patients with alcohol-induced, idiopathic, and traumatic AVN were excluded from the study. The primary outcomes were the assessments of Harris Hip Score (HHS) and the presence of loosening, osteolysis, polyethylene wear or a reoperation (with or without revision of components). The fixation of cementless femoral components was assessed according to Engh criteria.

Results: The study group consisted of 18 hips from 15 patients. The mean age was 47.6±8.1 (29-55) years. A cementless femoral stem and acetabular cup were used for all patients. Septic loosening was detected in all components of one patient (5.6%). The mean HHS score was 83.3±7.2 (60-92) for all patients. Of the 18 hips, 83% (15 hips), 5.6% (1 hip), 5.6% (1 hip), and 5.6% (1 hip) had good, poor, fair, and excellent HHS scores. Ceramic or polyethylene liner wear was not detected in any of the patients. The Engh Grading Scale revealed a "bone ingrowth" in 16 (89%) hips, "suspected in-growth" in 1 (5.6%) hip and "suboptimum but stable" femoral fixation in a patient with septic loosening (5.6%) just before revision surgery. There was no significant correlation between femoral stem design and Engh score (p=0.842).

Conclusion: Modern total hip arthroplasty systems, including ceramic on ceramic or ceramic on polyethylene headliner options with cementless femoral stem, offer promising mid-term survivorship and positive clinical outcomes for steroid-induced AVN treatment. However, studies including long-term follow-ups with larger sample size are needed to obtain more precise data.

研究目的本研究旨在评估目前无骨水泥全髋关节置换术(THA)治疗类固醇引起的血管坏死(AVN)的中期植入存活率、失败模式、放射学结果和临床疗效:方法:扫描2012年1月至2017年11月的5年时间跨度,进行5年随访,共纳入15名患者(18个髋关节),他们接受了超高分子量聚乙烯(UHMWPE)和新设计的其他头和衬垫组件植入手术。只有因类固醇引起的 AVN 而接受手术的患者才被纳入研究范围。酒精诱发、特发性和外伤性 AVN 患者不在研究范围内。研究的主要结果是哈里斯髋关节评分(HHS)以及是否出现松动、骨溶解、聚乙烯磨损或再次手术(无论是否对组件进行翻修)。无骨水泥股骨组件的固定情况根据Engh标准进行评估:研究组由 15 名患者的 18 个髋关节组成。平均年龄为 47.6±8.1 (29-55) 岁。所有患者均使用无骨水泥股骨柄和髋臼杯。一名患者(5.6%)的所有组件均发现化脓性松动。所有患者的平均HHS评分为83.3±7.2(60-92)分。在18个髋关节中,83%(15个髋关节)、5.6%(1个髋关节)、5.6%(1个髋关节)和5.6%(1个髋关节)的HHS评分为好、差、一般和优。所有患者均未发现陶瓷或聚乙烯衬垫磨损。Engh分级表显示,16个(89%)髋关节出现 "骨质增生",1个(5.6%)髋关节出现 "疑似骨质增生",1个(5.6%)患者在翻修手术前出现化脓性松动(5.6%),股骨固定 "不理想但稳定"。股骨柄设计与Engh评分之间无明显相关性(P=0.842):结论:现代全髋关节置换系统,包括陶瓷上陶瓷或陶瓷上聚乙烯顶板选项和无骨水泥股骨柄,为类固醇诱发的AVN治疗提供了良好的中期存活率和积极的临床结果。不过,要获得更精确的数据,还需要进行样本量更大的长期随访研究。
{"title":"Mid-term survivorship and clinical results of cementless total hip arthroplasty for steroid-induced avascular necrosis.","authors":"Muhammed Enes Karatas, Bahattin Kemah, Mehmet Salih Soylemez, Necdet Saglam","doi":"10.14744/nci.2023.38107","DOIUrl":"10.14744/nci.2023.38107","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of the present study was to evaluate the mid-term implant survivorship, modes of failure, radiographic results, and clinical outcomes of current cementless total hip arthroplasty (THA) treatment designs for steroid-induced avascular necrosis (AVN).</p><p><strong>Methods: </strong>A time span of 5 years between January 2012 and November 2017 was scanned to accommodate 5 years of follow-up and a total of 15 patients (18 hips), who had undergone implantation of ultra-high molecular weight polyethylene (UHMWPE) and newly designed other head and liner components, were included in the study. Only patients operated for steroid-induced AVN were included in the study. Patients with alcohol-induced, idiopathic, and traumatic AVN were excluded from the study. The primary outcomes were the assessments of Harris Hip Score (HHS) and the presence of loosening, osteolysis, polyethylene wear or a reoperation (with or without revision of components). The fixation of cementless femoral components was assessed according to Engh criteria.</p><p><strong>Results: </strong>The study group consisted of 18 hips from 15 patients. The mean age was 47.6±8.1 (29-55) years. A cementless femoral stem and acetabular cup were used for all patients. Septic loosening was detected in all components of one patient (5.6%). The mean HHS score was 83.3±7.2 (60-92) for all patients. Of the 18 hips, 83% (15 hips), 5.6% (1 hip), 5.6% (1 hip), and 5.6% (1 hip) had good, poor, fair, and excellent HHS scores. Ceramic or polyethylene liner wear was not detected in any of the patients. The Engh Grading Scale revealed a \"bone ingrowth\" in 16 (89%) hips, \"suspected in-growth\" in 1 (5.6%) hip and \"suboptimum but stable\" femoral fixation in a patient with septic loosening (5.6%) just before revision surgery. There was no significant correlation between femoral stem design and Engh score (p=0.842).</p><p><strong>Conclusion: </strong>Modern total hip arthroplasty systems, including ceramic on ceramic or ceramic on polyethylene headliner options with cementless femoral stem, offer promising mid-term survivorship and positive clinical outcomes for steroid-induced AVN treatment. However, studies including long-term follow-ups with larger sample size are needed to obtain more precise data.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 3","pages":"219-224"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The relationship between Brucella infection and aortic stiffness in children. 儿童布鲁氏菌感染与主动脉僵硬之间的关系。
Pub Date : 2024-06-12 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.56198
Hatice Uygun, Celal Varan, Nurettin Erdem, Sibel Yavuz, Mehmet Turgut

Objective: In this study, it was aimed to show whether Brucella infection, which causes various cardiovascular complications in children, can lead to an increase in aortic stiffness with a noninvasive method, echocardiography.

Methods: Children who were diagnosed with Brucella infection and who had tachycardia, chest pain and murmur that were not related to body temperature increase during the treatment were evaluated cardiologically and had echocardiographic examination, were included in the study. Aortic strain, aortic distensibility measurement results and aortic stiffness index of the patients in the patient and control groups were calculated.

Results: Our study included 53 cases with a mean age of 11.43±4.13 years in the patient group and 68 cases with a mean age of 10.16±3.61 years in the control group. We found that systolic blood pressure was lower in the patient group than in the control group (p=0.014). In the analysis of laboratory parameters, blood glucose level was found to be significantly higher in the patient group (p=0.001). In the statistical evaluation of aortic strain, aortic stiffness index and aortic distensibility measurement results between the patient and control groups, no statistically significant difference was found between the groups (p=0.287, p=0.784, p=0.208).

Conclusion: In our study, where we tried to show a new parameter that could contribute to the increase in aortic stiffness, the results showed that Brucella infection was not a factor that increased aortic stiffness in the pediatric age group.

研究目的本研究旨在通过超声心动图这种无创方法,说明导致儿童各种心血管并发症的布鲁氏菌感染是否会导致主动脉僵硬度增加:方法:对确诊为布鲁氏菌感染的儿童进行心脏学评估和超声心动图检查,这些儿童在治疗期间出现心动过速、胸痛和杂音,且与体温升高无关。计算患者组和对照组患者的主动脉应变、主动脉舒张性测量结果和主动脉僵硬度指数:患者组 53 例,平均年龄(11.43±4.13)岁;对照组 68 例,平均年龄(10.16±3.61)岁。我们发现,患者组的收缩压低于对照组(P=0.014)。在实验室参数分析中,我们发现患者组的血糖水平明显高于对照组(P=0.001)。在对患者组和对照组的主动脉应变、主动脉僵硬度指数和主动脉舒张度测量结果进行统计评估时,未发现两组间存在统计学差异(P=0.287、P=0.784、P=0.208):在我们的研究中,我们试图显示一个可能导致主动脉僵硬度增加的新参数,结果显示布鲁氏菌感染并不是导致儿科年龄组主动脉僵硬度增加的因素。
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引用次数: 0
Penetrating abdominal stab and gunshot injuries: 10-year experience of a secondary public hospital located in a suburban area with solo surgeons. 腹部穿透性刀伤和枪伤:一家位于郊区、由外科医生单干的二级公立医院的 10 年经验。
Pub Date : 2024-06-11 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.32858
Nuray Colapkulu Akgul, Ozan Andac Erbil, Yahya Celik

Objective: Trauma care systems are life-saving significant implementations of a country's healthcare systems. Trauma care requires well-established trauma settings and organizations with experienced trauma teams including experienced emergency medicine, surgery and anesthesiology staff. This study aimed to investigate the outcomes of penetrating abdominal injuries treated by solo surgeons in a suburban area.

Methods: Medical records of the patients who were admitted to the emergency department with penetrating abdominal injuries between January 2012 and December 2021 were retrospectively analyzed. Patients were evaluated based on their injury sites and treatment approaches.

Results: In total, 110 patients with anterior abdominal penetrating injuries were enrolled in the study; 83 (75.4%) were stabbed and 27 (24.6%) had gunshot wounds. According to the injury site, there were 90 (81.8%) anterior; 11 (11%) right thoracoabdominal and 9 (7.2%) left thoracoabdominal injuries. Fifty-one (61.4%) stab wounds were treated with immediate laparotomy and 21 (41.1%) of these operations resulted in negative or nontherapeutic laparotomy. Also, 32 (38.6%) stab wounds were managed nonoperatively; three (9.3%) failed conservative management and received delayed laparotomy. All gunshot wounds were treated with immediate laparotomy and 14.8% resulted in either negative or nontherapeutic laparotomy. On-call surgeons were found to be more prone to perform immediate laparotomy on weekends when they were on call for 48 or 72 hours.

Conclusion: Being a solo surgeon may increase negative laparotomy rates of penetrating abdominal injuries. This high percentage (41.1%) of negative laparotomy rates can be reduced by establishing well-organized trauma teams.

目的:创伤救护系统是一个国家医疗保健系统中拯救生命的重要组成部分。创伤救治需要完善的创伤救治机构和组织,以及经验丰富的创伤救治团队,包括经验丰富的急诊科、外科和麻醉科工作人员。本研究旨在调查郊区由外科医生单独治疗腹部穿透伤的结果:方法: 对 2012 年 1 月至 2021 年 12 月期间急诊科收治的腹部穿透伤患者的病历进行回顾性分析。根据受伤部位和治疗方法对患者进行评估:共有 110 名前腹部穿透伤患者参与研究,其中 83 人(75.4%)为刀刺伤,27 人(24.6%)为枪伤。根据受伤部位,前腹部受伤的有 90 例(81.8%),右胸腹受伤的有 11 例(11%),左胸腹受伤的有 9 例(7.2%)。51例(61.4%)刺伤患者立即进行了开腹手术,其中21例(41.1%)的手术结果为阴性或非治疗性开腹。此外,32 例(38.6%)刺伤患者接受了非手术治疗;3 例(9.3%)保守治疗失败,接受了延迟开腹手术。所有枪伤都立即进行了开腹手术,14.8%的枪伤导致阴性或非治疗性开腹手术。当值班外科医生在周末值班48或72小时时,他们更容易立即进行开腹手术:结论:单人外科医生可能会增加穿透性腹部损伤的负性开腹手术率。通过建立组织严密的创伤团队,可以降低腹腔切开术失败率(41.1%)。
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引用次数: 0
Rendition on the impact of criteria for aspirates, needle size, preparation modalities of cytopathology, and edition of decision-making lexicons on divergent areas in Thyroidology. 关于抽吸标准、针头大小、细胞病理学制备方式和决策词典版本对甲状腺不同领域的影响的建议。
Pub Date : 2024-06-10 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.31549
Demet Sengul, Ilker Sengul
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引用次数: 0
期刊
Northern clinics of Istanbul
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