Selçuk Tıp Dergisi Arşiv

Present study was performed to determine the methods for early diagnosis of necrotizing fasciitis (NF), to indicate the importance of the early surgery and its repetition when necessary, and to predict the prognosis using laboratory tests. Study was performed with 34 patients who were diagnosed NF between 2005 and 2010. Prognosis were retrospectively inspected in terms of the age, gender, etiology, predisposing factors, laboratory findings, the application period, the number of surgical debridement, infection location and culture result of the patients. The most important etiological factors were found to be surgical intervention and local soft tissue infection. Among the predisposing factors of obesity and diabetes were found to be the most common. All patients had laboratory risk indicator for necrotizing fasciitis (LRINEC) score of 7 or above. The mean LRINEC score was found to be 9.1. Abdominal, groin and perineum were the common infection locations. Only 11 patients admitted to the hospital, diagnosed and received treatment for NF within the first 48 hours after the first symptoms. The wound cultures were positive in 26 patients. Most commonly grown microorganisms were E. coli and K. pneumoniae. Four patients who died during treatment were advanced age (mean 74.7), admitted late (5-10 days), had high LRINEC scores (mean, 12) and chronic diseases (diabetes, obesity, chronic lymphocytic leukemia). The patients who have high LRINEC score, over the age of 65 and admitted in 5 days or more after the first symptoms, were observed to have poor prognosis. Whenever a patient is suspected to have NF, physical examination, laboratory tests and invasive diagnostic procedures should be performed immediately in order to have an early diagnosis.

Objective of this study was to determine the incidence and treatment results of retinopathy of prematurity among premature infants followed in Neonatal Intensive Care Unit and Ophthalmology Clinic, Meram Faculty of Medicine, Necmettin Erbakan University. Premature infants followed between January 2012 and June 2014 were included in the study. Infants were grouped according to birth weight and gestational age. Retinopathy of prematurity incidence, stage and percentage of infants who were treated with Argon laser were evaluated. Also, the treatment results and complications of treatment were determined. The mean gestational age and the mean birth weight of the 304 premature infants included in our study were 31.1 ± 2.3 (24-36) weeks and 1587.58 ± 454.49 (490- 3300) gr, respectively. Retinopathy of prematurity was detected in 24.7% (75/304) of the followed infants. Retinopathy of prematurity was recognized at the zone 2 (45 infants) most frequently, while at the zone 1 (1 infant) was least frequently. Stage 1 (43 infants) disease was occurred most frequently, however stage 3 (3 infants) was observed least frequently. There was no premature infants in stage 4 and stage 5. Aggressive posterior retinopathy of prematurity was diagnosed in only one premature infant. A total of 45 (%60) premature infants having retinopathy of prematurity had also plus disease. Argon laser treatment was applied to 22 (%29.3) premature infants with favorable results in all of them. As an important disease retinopathy of prematurity composes a great risk of blindness for infants with small gestational age and low birth weight. Argon laser treatment of eyes with retinopathy of prematurity seems to be an effective and safe alternative.

Several studies reported increased CD4/CD8 ratio in patients with mycosis fungoides (MF). A parallel relationship was indicated between tumor progression and elevated matrix metalloproteinase (MMP) levels. The aim of this study was to evaluate levels of CD4, CD8 and MMP-9, which is an indicator of tumoral invasion, in before and after treatment of MF patients. A total of 10 control patients and 32 patients with plaque stage MF pathologically diagnosed as nonspecific chronic dermatosis were included. Biopsies were taken at the Department of Dermatology, Meram Faculty of Medicine, Selçuk University. Phototherapy was performed for 3 months on all patients diagnosed with MF and control biopsies were taken at the end of 3 months. In 20 patients, there were no findings in favor of MF was diagnosed. MF pathological findings were observed in the other 12 patients. For histopathological examination, sections were taken from a sufficient number of control groups and as well as groups of MF patients before and after treatment. CD4, CD8 and MMP-9 immunohistochemical staining was performed at the Department of Pathology, Meram Faculty of Medicine. Intraepithelial MMP-9 and subepithelial CD4/CD8 values were found to be significantly higher in MFA patients having no benefit from the treatment. It was determined that subepithelial MMP-9, intraepithelial and subepithelial CD4/CD8 values were significantly lower after treatment in the MF patients who had benefit for the treatment. Comparing with the controls, CD4/CD8 and MMP 9 levels were significantly higher in MF patients, and these levels were observed to be decreased in patients who respond well to treatment. Findings of this study were concordant with literature.

Although it remains relatively stable childhood cancer rates in the last two years, thanks to advances in early diagnosis and treatment there has been a serious decline in the mortality rate. Despite all these developments, it still experienced today that children diagnosed with cancer 75% more than they can not survive more than five years. Before cancer treatment, oral and dental health problems may impair during and after the child’s health and quality of life. Therefore, pediatric dentists, the provision of oral hygiene and dental treatment needs of these patients have a very important place.

Meckel’s diverticulum is a rare cause of mechanical intestinal obstruction in adults. Due to non-specific symptoms and preoperative diagnosis of this rare condition, surgeons should keep in mind. A 28-year-old male patient was admitted to our emergency department with abdominal pain, nausea and vomiting for about 8 hours before onset. The patient was diagnosed as acute small bowel obstruction and underwent emergency surgery. At operation a torsioned ileum due to Meckel’s diverticulum 60 cm proximal to ileocecal valve and small bowel distention proximal to this site was seen. Ileum was detorsioned and Meckel’s diverticulum resection was performed. The patient was discharged on postoperative day 3. Histopathologic specimen were reported as Meckel’s diverticulum in 3x2x1cm size.

Lipodermatosclerosis is a progressive dermatosis, which is closely related with chronic venous insufficiency. Lipodermatosclerosis has been clinically classified into acute, subacute and chronic stages. Acute phase, which also represents a sequelae of chronic venous insufficiency, is commonly misdiagnosed as cellulitis, since typical clinical presentation closely resembles cellulitis with extremely painful, indurated plaques with intense erythema and edema affecting distal parts of the lower extremities. Chronic lipodermatosclerosis is much more common than acute lipodermatosclerosis and this form is easily recognized with clinical examination. Chronic lipodermatosclerosis is more common in women, indeed up to 90% of the reported cases are women in their middle ages. Here, we report a young male patient with chronic lipodermatosclerosis on right lower extremity, which had been developed in the presence of chronic venous insufficiency. We point out and highlight the clinical characteristics of this patient as chronic lipodermatosclerosis is less frequently observed in young males.