Abstract
Hyperthyroidism is not a rare entity in pregnancy and 85% of these cases attributed to Graves' disease (GD). There is no therapeutic modality for GD considered as totally safe in pregnancy. ...Fetal and neonatal risks of maternal hyperthyroid disease are related to the hyperthyroidism itself and/or to the medical treatment of the disease. There are no data supporting an association between congenital anomalies in the fetus and propylthiouracil (PTU). Hepatotoxicity, cytopenias - especially agranulocytosis and quite rarely, angioedema, may be seen as side effects of PTU. In this case report, we examine an instance of Graves' hyperthyroidism diagnosed during pregnancy. In this case, a serious side effect during anti-thyroid drug usage was encountered, eventually resulting in surgery in the second trimester. This intervention was assisted by the use of plasmapheresis to obtain rapid normalization of serum thyroid hormone levels.
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•Nickel containing mesoporous (silica and silica-alumina) and microporous (Beta zeolite) were prepared by ion exchange.•Ni2+ counterions were identified as the main active sites for ...ethene oligomerization.•1-butene and 2-butenes were both primary products over the Ni/Beta zeolite catalysts, suggesting that the reaction proceeds via the Cossee-Arlman mechanism.
Nickel-containing mesoporous (using Al2O3 or SiO2-Al2O3 support) and microporous (using nano- or micro-crystalline Beta zeolite support) catalysts were prepared by ion exchange and characterized by XRD, SEM, N2-adsorption, MP-AES and FTIR. The samples were subjected to testing as ethene oligomerization catalysts at T=120°C, Ptotal=29bar, Pethene=11.6–25.1bar. All catalysts were active for ethene oligomerization, and linear butenes were the main gaseous products. However, catalyst deactivation due to retained long-chain alkenes was observed. Ethene partial pressure variation experiments showed that the reaction order in ethene for butene formation was 1.5–1.7 for the mesoporous, and 2.0 for the microporous catalysts. Contact time variation experiments carried out with the microporous catalysts at Pethene=18bar showed that product selectivity was independent of ethene conversion, and suggested that 1-butene and 2-butenes are primary products. This result is consistent with the Cossee-Arlman mechanism. The nature of the active sites was investigated with FTIR spectroscopy with CO as probe molecule. The results point to Ni2+-counterions as the preeminent active sites, while we suggest that Ni-sites grafted on silanol groups and NiO particles are spectators.
This study investigated which anatomic landmarks were most useful for correct and safe incision placement in carpal tunnel surgery. Kirschner wires were attached to the hands to mark previously ...defined landmarks. The bony attachments of the transverse carpal ligament, which were identified previously, were drawn on an anteroposterior digital x-ray of the hand, with the thumb in full abduction. The relationship between anatomic landmarks and these bony attachments were examined. In all hands, either the line along the third web space or the crease between the thenar and the hypothenar regions, or both, were on the ulnar half of the transverse carpal ligament. During incision placement, we recommend selecting the most ulnar choice between the line drawn along the third web space and the crease between the thenar and hypothenar regions in order to be at safe distance from the recurrent motor branch of the median nerve.
Universal ultrasound screening has led to overtreatment and higher follow-up rates than are found with clinical examination alone because of high incidence of physiologically immature hips (type IIa) ...in the first weeks of life. The ability to predict future acetabular development in physiologically immature hips (type IIa) would therefore help to reduce overtreatment and unnecessary follow-up.
We described the γ-angle to assess the femoral head coverage by the acetabular roof, which is measured between the baseline defined by Graf and the cartilaginous edge line connecting the inferior point of the iliac bone (lower limb) to the medial corner of the acetabular labrum. We retrospectively analyzed ultrasonographic findings of infants with developmental dysplasia of the hip diagnosed in our hospital and infants with normal hips screened in our hospital. Group 1 (35 hips) consists of type IIa hips at initial examination and went on to develop into dysplastic hips at follow-up. Group 2 (279 hips) consists of type IIa hips at initial examination and went on to develop into normal hips (type I) at follow-up.
The γ-angles of type IIa hips that developed into type I hip at follow-up ranged between 77 and 82. The γ-angles of type IIa hips that developed into hip dysplasia ranged between 72 and 78. All type IIa hips that had γ-angles >78 degrees developed into normal hips. We also observed that all type IIa hips that had γ-angles <77 degrees developed into dysplasia.
The amount of cartilage mass covering the femoral head, which is a part of the acetabular roof, can therefore provide information about future acetabular development. This paper describes a new method of measurement (the γ-angle) that assesses the extent of the cartilage coverage of the femoral head, which can predict acetabular development. Its use would decrease the rates of unnecessary follow-up and treatment.
Level II (development of diagnostic criteria on the basis of consecutive patients).
Leptin is a peptide hormone that has a role in the regulation of body weight and has effects on metabolic, neuroendocrine, reproductive and hematopoietic systems. Breast cancer has also been ...associated with obesity and reproductive hormones, especially estradiol. Only a few studies have investigated the relation between plasma leptin and risk of breast cancer and only one study evaluated the effect of tamoxifen on leptin levels in patients with breast cancer.
We investigated serum leptin levels in gender-, body mass index (BMI)- and age-matched breast cancer patients and healthy individuals (58 of each).
Serum leptin levels were measured by radioimmunoassay (Human Leptin RIA Kit). Serum leptin levels in the breast cancer patients were significantly higher than those in the control group (27.00 versus 17.65 ng/ml, p = 0.019). There were no differences with respect to BMI and age between control and breast cancer patients. There were no significant differences in BMI and leptin levels between pre- and postmenopausal patients (27.00 +/- 1.39 and 27.19 +/- 0.81 kg/m(2), 26.81 +/- 6.25 and 27.06 +/- 2.98 ng/ml) (p > 0.05). We found no difference in serum leptin level between early and late stages of patients (22.38 versus 31.30 ng/ml, p = 0.086). However, the serum leptin level in patients using tamoxifen was significantly higher than that of patients not using tamoxifen (32.71 and 19.39 ng/ml, respectively p = 0.009). There was no correlation between CA 15-3 and leptin level (r = 0.069, p = 0.610).
High serum leptin levels seen in breast cancer patients are not related to stage of the disease or to cancer itself but may be associated with the use of tamoxifen.
Ankaferd Blood Stopper (ABS), which is a standardized mixture of herbal extracts obtained from five plants, has been proven as an efficient hemostatic agent and is still used in emergency situations. ...It is not known exactly if decreased bleeding has positive or negative effects on muscle healing and fibrosis, so the purpose of this study was to test the effect of ABS on muscle healing and morphology.
A total of 66 outbred Wistar rats were divided into three control and three experimental subgroups. In the experimental groups, ABS was sprayed on the cut surface of the soleus. In the control groups, a saline solution was sprayed on the cut surface of the soleus. Subgroups were euthanized after 2 weeks, 3 weeks and 4 weeks, respectively. In each subgroup, eight rats were used for the biomechanical study to determine muscle healing and three rats were used for the histopathological investigation.
Although muscle strength in the control groups was lower than that of the experimental groups in early weeks, no differences were found between the control and the experimental groups at 4 weeks.
ABS has no negative effect on muscle healing. We also observed that ABS accelerated muscle healing compared to the control group. ABS could be used in hemostasis of open fractures and elective orthopedic surgeries.
We have performed a prospective evaluation of the efficacy, safety and convenience of the transdermal therapeutic system – fentanyl (TTS‐F) in Turkish cancer patients when it was newly available in ...Turkey. Ninety‐nine patients with historically confirmed malignancy and pain entered the study; the mean age was 55.1 (16–58) years. The study duration was 28 days. Transdermal therapeutic system – fentanyl was used in opioid‐naïve or pre‐treated patients. Most patients reported a decrease in pain severity. Use of rescue medication decreased from day 4 to day 28. The majority of patients rated patch convenience of use as excellent. A total of 22.2% of patients experienced adverse events that were either probably related or very likely to be related to the study drug. The majority of the adverse events mentioned were related to the digestive system. Eighteen serious adverse events were reported by 13 patients. Six events were doubtfully related, and 12 events were not related to the study drug. Four patients died during the trial. None of these deaths was attributed to the study drug. In conclusion, the trial showed that TTS‐F is easily managed, effective and will help to enable the appropriate opioid administration to patients who are suffering from cancer pain in Turkey.
The aim of this study was to evaluate the alterations in eccentric evertor/concentric invertor strength ratio and their importance in the chronically unstable ankle. Eight patients with chronic ankle ...instability (CAI) and nine healthy individuals participated in this study. Isokinetic concentric and eccentric invertor and evertor muscle strength measurement was carried out at an angular velocity of 120°·sec(-1) by measuring maximal force moments (torque) during isokinetic ankle inversion and eversion movements. Functionally, evertor/invertor muscle strength ratios (E/I strength ratio) were calculated separately based on peak moment and angle-specific moments obtained at 0°, 5°, 10°, 15°, 20° ankle joint angles. Peak and angle-specific eccentric evertor strength values at 0°, 5°, 10°, 15°, 20° were significantly lower in the chronic ankle instability (CAI) group. In spite of this, no differences were obtained for peak and angle-specific concentric invertor torque values. Eccentric evertor/concentric invertor strength (Eecc/Icon) ratios were also significantly lower in the CAI group, but only at 15° and 20°. Eccentric evertor muscle torque and end range (15°-20°) Eecc/Icon strength ratio for the chronically unstable ankle were significantly different from those for the healthy ankle. For this reason, measurements of end range eccentric/concentric strength ratios are more valuable in monitoring chronic ankle injuries and rehabilitation should include not only concentric muscle strengthening but also eccentric muscle strengthening, particularly for the evertor muscles.