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Is Pipelle biopsy really adequate for diagnosing endometrial disease?

Tanriverdi H.A. | Barut A. | Gün B.B. | Kaya E.

Article | 2004 | Medical Science Monitor10 ( 6 )

Backgound: The purpose of our research was to determine the reliability and accuracy of the Pipelle device in acquiring an adequate and representative endometrial sample and to compare it with D&C histology. Material/Methods: A total of 127 women were prospectively included in the study. After Pipelle endometrial sampling, classic dilatation and curettage (D&C) was performed. The histological results of both techniques were compared to assess the accuracy of Pipelle sampling. Prior to endometrial sampling, transvaginal ultrasonography was performed to determine endometrial thickness and pathological lesions, and to exclude other pat . . .hologies confined to the pelvis. The outcome measures were specimen adequacy and comparability of histological diagnosis between the Pipelle specimen and the D&C specimen. Results: Although no patient had a failed biopsy procedure, 13 patients had insufficient tissue in the D&C group, and 29 patients in the Pipelle group. In 100 of 127 patients (79%), the Pipelle endometrial histology results were in agreement with the D&C histology results. Pipelle biopsy was unable to diagnose 1 of 5 endometrial hyperplasia cases. Conclusions: The Pipelle device is a limited endometrial sampling technique for obtaining an adequate and representative endometrial sample. It should be reserved for those patients in whom there is only a minimal risk for endometrial carcinoma, hyperplasia and polyps. Any failure to obtain an endometrial specimen would suggest performing a full endometrial curettage, especially in anamnestically- and sonographically- determined patients at high risk for endometrial cancer Daha fazlası Daha az

Evaluation of social and demographic characteristics of incest cases in a university hospital in Turkey

Yildirim A. | Ozer E. | Bozkurt H. | Ozsoy S. | Enginyurt O. | Evcuman D. | Yilmaz R.

Article | 2014 | Medical Science Monitor20 , pp.693 - 697

Background: Incest is defined as any sexual activity between close blood relatives including step relatives and family members who are forbidden by law to marry. It is a problem that can be seen in all the social classes in developed and undeveloped societies. The World Health Organization classifies this problem as a silent health emergency. Father-daughter incest is reported to be the most common incest type followed by the other types like brother- sister, sister-sister and mother-son incest. Material/Methods: Subjects for this study were recruited from a sample of incest cases referred to Forensic Medicine Department of Gaziosma . . .npasa University Medical Faculty Hospital between 2008 and 2012. Data involved social and demographic characteristics and clinical features of victims, perpetrators and the families. The ethical committee of the faculty of medicine approved the study. Results: The study sample consisted of 43 incest cases (36 females and 7 males) with an age rage 4-40 years. Two third of the victims were under 18 years old. All perpetrators were males. Father - daughter incest (34.9%) was found to be most common incest type followed by brother - sister incest (14%). 75% of the perpetrators were family members and relatives with consanguinity while 25% of them were not consanguineous but faithful and intimate relatives to victims. Conclusions: Increasing awareness about incest and its damaging effects is so important and clinicians should keep in mind sexual abuse or incest when examining the risky population. Multidisciplinary approach is necessary for determining short term or long term results and preventing the negative consequences of incest. © Med Sci Monit, 2014 Daha fazlası Daha az

Potential drug–drug interactions with antimicrobials in hospitalized patients: A multicenter point-prevalence study

Kuscu F. | Ulu A. | Inal A.S. | Suntur B.M. | Aydemir H. | Gul S. | Ecemis K.

Article | 2018 | Medical Science Monitor24 , pp.4240 - 4247

Background: Improper use of antimicrobials can cause adverse drug events and high costs. The purpose of this study was to investigate the frequency and potential drug–drug interactions associated with antimicrobials among hospitalized patients. Material/Methods: This study was conducted on the same day in 5 different hospitals in Turkey. We included patients aged ?18 years who received at least 1 antimicrobial drug and at least 1 of any other drug. The Micromedex® online drug reference system was used to control and describe the interactions. Drug interactions were classified as con-traindicated, major, moderate, and minor. Results: . . . Potential drug–drug interactions with antimicrobials were 26.4% of all interactions. Five (42%) of 12 contra-indicated interactions and 61 (38%) of 159 major interactions were with antimicrobials. Quinolones, triazoles, metronidazole, linezolid, and clarithromycin accounted for 173 (25.7%) of 673 prescribed antimicrobials, but were responsible for 141 (92.1%) of 153 interactions. In multivariate analysis, number of prescribed antimicrobials (odds ratio: 2.3001, 95% CI: 1.6237–3.2582), number of prescribed drugs (odds ratio: 1.2008, 95% CI: 1.0943–1.3177), and hospitalization in the university hospital (odds ratio: 1.7798, 95% CI: 1.0035–3.1564) were independent risk factors for developing drug interactions. Conclusions: Due to risk of drug interactions, physicians should be more cautious when prescribing antimicrobials, particularly when prescribing quinolones, linezolid, azoles, metronidazole, and macrolides. © Med Sci Monit Daha fazlası Daha az

Prophylactic anticonvulsants in patients undergoing craniotomy: A single-center experience

Kale A.

Article | 2018 | Medical Science Monitor24 , pp.2578 - 2582

Background: There is no consensus on the efficacy of seizure prophylaxis in patients undergoing craniotomy. Some studies show that antiepileptic use decreases the risk of seizures, but other studies do not support this. The present study investigated the role of antiepileptic drugs in patient undergoing craniotomy due to various intracranial pathologies. Material/Methods: A retrospective review was performed in adult patients undergoing craniotomy between January 2013 and June 2017. Results of 282 patients who did not have a history of seizures and had craniotomies for various reasons were included. In all patients with craniotomy p . . .lanned, prophylactic AEDs were initiated pre-operatively. Results: The incidence of postoperative seizures was 17.7% when all craniotomized patients were considered. The most commonly used anticonvulsant agent was phenytoin (75.2%). No serious antiepileptic drug reaction occurred requiring cessation of treatment. Conclusions: Prophylactic antiepileptic treatment of patients undergoing craniotomy should not be continued beyond the first perioperative week if there is no serious brain injury. The intra- or extra-axial placement of the tumor affects the prophylaxis. Further randomized controlled studies are warranted in the future to investigate the efficacy of these medications. © Med Sci Monit Daha fazlası Daha az

Autopsy evaluation of coal mining deaths in the city of Zonguldak, Turkey

Ozer E. | Yilmaz R. | Evcuman D. | Yildirim A. | Cetin I. | Kocak U. | Ergen K.

Article | 2014 | Medical Science Monitor20 , pp.438 - 443

Background: In this study, our aim was to evaluate the fatal occupational accidents that occurred in Zonguldak coal mines between the years 2005-2008. Material/Methods: We retrospectively evaluated 42 fatal coal mine occupational accidents in Zonguldak (Turkey) between the years 2005-2008. The forensic records of autopsies referred to the chief prosecutors' office during 2005-2008 were reviewed retrospectively. There were 42 cases. The cases were evaluated with respect to age, mechanism of injury, body region of wound, cause of death, and legality of the mine. Results: Ages of the deceased ranged between 17 and 52 (median: 32.9 yrs) . . .. Deaths were mostly in the 21-30 (35.8%), and 31-40 (30.9%) age groups. Only 1 case was younger than 18 years of age. Review of occupational fatalities has revealed that fatal accidents occurred mostly (76.2%) in the private, and fewer (23.8%) in the public mining enterprises. Crime scene investigation findings have demonstrated that of all occupational deaths (total n=42), 27 (64.3%) were due to subsidence, followed by methane gas poisoning (n=6, 14.2%), tram crash (n=3, 7.1%), log falls (n=2, 4.8%), electrocution (n=2, 4.8%), and methane explosion (n=2, 4.8%). Conclusions: Despite laws and regulations concerning mining and because of problems in their implementation, Turkey leads the world in work-related accidents, occupational injuries, and deaths. Evaluation of autopsy findings of deaths in fatal occupational accidents occurring in coal mines is quite important in planning to decrease rates of occupational fatalities. © Med Sci Monit Daha fazlası Daha az

Dyspeptic complaints after 20 weeks of gestation are not related to Helicobacter pylori seropositivity

Tanriverdi H.A. | Ustundag Y. | Tekin I.O. | Barut A.

Article | 2005 | Medical Science Monitor11 ( 9 ) , pp.438 - 443

Background: This study was to test whether an association exists between Helicobacter pylori seropositivity and severity of dyspeptic symptoms after 20 weeks of gestation in pregnant women. Material/Methods: Pregnant women (n=103) with gestational ages between 20-41 weeks and healthy non-pregnant women (controls, n=79) were prospectively enrolled in the study. Anti-H. pylori IgG serum antibody was tested to establish seropositivity. The dyspeptic symptoms were evaluated by the Glasgow Dyspepsia Severity Score in the pregnant group and classified as asymptomatic (score 0), mildly symptomatic (score 1-5), and severely symptomatic (sco . . .re ?6). The severity of dyspeptic symptoms was compared in pregnant women with H. pylori seropositivity, and pregnant and non-pregnant women were compared for H. pylori seropositivity and prevalence of dyspeptic symptoms. The results were analyzed using Student's t, Mann-Whitney-U, and chi-square tests. Results: The prevalence of H. pylori seropositivity was not different among pregnant and non-pregnant women. The median dyspeptic scores were 5 and 4, respectively, for H. pylori seropositive and negative pregnant women. Dyspeptic scores of H. pylori seropositive pregnant women were not different from those of uninfected pregnant women. H. pylori seropositivity did not differ among asymptomatic and mildly and severely symptomatic pregnant women. The non-pregnant women were more often asymptomatic than pregnant women. Conclusions: Our findings do not support any association between H. pylori seropositivity and severity of dyspeptic symptoms in late pregnancy. It seems unreasonable to screen women in late pregnancy for H. pylori seropositivity, even if they suffer from severe dyspeptic symptoms. © Med Sci Monit, 2005 Daha fazlası Daha az

Evaluation of lipid peroxidation, oxidant/antioxidant status, and serum nitric oxide levels in alopecia areata

Koca R. | Armutcu F. | Altinyazar H.C. | Gürel A.

Article | 2005 | Medical Science Monitor11 ( 6 ) , pp.438 - 443

Background: The pathophysiology of alopecia areata (AA) has not been clearly defined; however, it appears as a tissue-restricted autoimmune disease mediated by T lymphocytes. Immunohistochemical studies have shown peri- and infra-follicular inflammatory infiltrate which damages hair follicles. We analyzed the role of lipid peroxidation and oxidant-antioxidant enzymes in the pathogenesis of AA. Material/Methods: Twenty-four patients with AA and 20 age- and sex-matched healthy controls were enrolled in this study. We analyzed serum levels of malondialdehyde (MDA) and nitric oxide (NO) and the serum activities of superoxide dismutase ( . . .SOD) and xanthine oxidase (XO) in patients with AA and control subjects. Results: The levels of MDA and NO (nitrite/nitrate) and the activity of XO in serum of patients with AA (0.76±0.34 nmol/ml, 14.88±6.40 nmol/ml, and 0.34±0.10 U/ml, respectively) were significantly higher than those of controls (0.35±0.09 nmol/ml, 10.71±1.75 nmol/ml, 0.11±0.03 U/ml; Daha fazlası Daha az

The evaluation of serum cystatin C, malondialdehyde, and total antioxidant status in patients with metabolic syndrome

Demircan N. | Gürel A. | Armutcu F. | Ünalacak M. | Aktunç E. | Atmaca H.

Article | 2008 | Medical Science Monitor14 ( 2 ) , pp.438 - 443

Background: This study was designed to determine if serum cystatin C (Cys C) levels are affected by metabolic syndome and whether they correlate with lipid peroxidation and total antioxidant status (TAS) in this disorder. Material/Methods: Cases with metabolic syndrome diagnosed according to the ATP III criteria (18 females, 12 males) were compared with healthy control subjects (20 females, 17 males) matched by age and gender. Plasma Cys C, malondialdehyde (MDA), and TAS levels were studied. Results: Compared with the controls, Cys C and MDA levels were significantly higher (p

Emphysema and airflow obstruction in non-smoking coal miners with pneumoconiosis

Altınsoy B. | Öz İ.İ. | Erboy F. | Tor M. | Atalay F.

Article | 2016 | Medical Science Monitor22 , pp.4887 - 4893

Background: Accumulating evidence shows that functional impairment in subjects with coal workers’ pneumoconiosis (CWP) is principally due to emphysema and airflow obstruction, rather than underlying restrictive mechanisms. However, cigarette smoking has remained a major confounder. The aim of this study was to assess whether coal dust exposure was associated with emphysema and/or airflow obstruction in the absence of smoking history. Material/Method: The subjects evaluated for possible pneumoconiosis between 2013 and 2015 were retrospectively enrolled into this study. After excluding those with history of smoking, tuberculosis, or l . . .ung cancer, the study population was a total of 57 subjects. The emphysema severity and airflow obstruction were quantified by computed tomographic densitometry analysis and spirometry, respectively. For comparability regarding emphysema, 9 age- and sex-matched nonsmoker (n=9) control subjects without known lung disease were randomly selected from a radiology database. Results: Emphysema severity was significantly higher in the CWP group compared with the control group (15% vs. 4%, p<0.001). The median percent emphysema and percentage of those with FEV1/FVC <0.7 was 13% and 37% in subjects with simple CWP and 18% and 67% in subjects with complicated CWP, respectively. Percent emphysema and Perc15 (15th percentile of the attenuation curve) was correlated with FEV1/FVC (r=–0.45, r=–0.47) and FEF25–75 (r=–0.36, r=–0.56), respectively, but not with perfusion score. A linear regression analysis showed that factors associated with emphysema were FEV1/FVC (b=–0.24, p=0.009) and large opacity (ß=–3.97, p=0.079), and factors associated with FEV1/FVC were percent emphysema (ß=–0.51, p=0.018) and tenure (ß=–0.63, p=0.044). Conclusions: Our results support the observation that coal dust exposure is associated with emphysema and airflow obstruction, independent of smoking status. © Med Sci Monit, 2016 Daha fazlası Daha az

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