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Akar E.,Sevket Yilmaz Research and Education Hospital
Turk Toraks Dergisi | Year: 2014

Chest wall tuberculosis is usually characterized by a painful soft solitary swelling on the chest wall. This mass, referred to as cold abscess, is a rare presentation of extrapulmonary tuberculosis. Lungs are the primary site of infection in most of the patients. A 40-year-old female patient without any chronic diseases or a history of tuberculosis underwent fine needle aspiration biopsy of a mass in the parasternal region. Histopathological diagnosis was consistent with granulomatous abscess. The aspiration material was positive for acid-fast bacilli. Surgical debridement was planned. The mass was totally excised under general anaesthesia. Pathological diagnosis was tuberculous granuloma. The rib below the mass and the sternal margin were intact. After the surgery, the patient was started on quadruple antituberculosis therapy (ethambutol, pyrazinamide, isoniazid, rifampicin). The patient was discharged on postoperative day 2. No recurrence was noted in the periodic controls performed for 4 times at 3-month intervals. © 2014 by Turkish Thoracic Society. Source


Kaymakci M.,Balikesir University | Cikriklar H.I.,Sevket Yilmaz Research and Education Hospital | Pay G.,Balikesir Hospital
Journal of International Medical Research | Year: 2013

Objective: Patients with sinus headaches usually complain of pain and pressure sensation around the sinuses and periorbital area; most are misdiagnosed with sinusitis and receive unnecessary treatment. This prospective study investigated the aetiology of sinus headache in patients with negative endoscopic or computed tomography (CT) scan findings. Methods: This multicentre study included patients who could be followed regularly after being admitted to otorhinolaryngology outpatient or emergency units due to sinus headache, in whom endoscopic and radiological examinations did not show sinonasal pathology. The study group comprised patients with primary headache, according to International Headache Society criteria. Participants were followed monthly for 3 months and treatment response was evaluated as complete remission, partial remission or no response. Results: The study included 98 patients. The main reason for diagnosing and treating sinus headaches that arose from neurovascular events was attributed to the accompanying symptoms, e.g. nasal obstruction, nasal discharge and sinus sensitivity. Conclusions: A better understanding of vascular event-derived headaches (especially migraine) and a detailed examination of patients via endoscopy and CT scanning are expected to minimize misdiagnosis rates, in patients with sinus headaches. © The Author(s) 2013. Source


Guclu M.,Sevket Yilmaz Research and Education Hospital | Guclu M.,Uluda University | Oz Gul O.,Uluda University | Cander S.,Sevket Yilmaz Research and Education Hospital | And 5 more authors.
Journal of Diabetes Research | Year: 2015

Aim. To investigate the efficacy of combined therapy of insulin and rosiglitazone on metabolic and inflammatory parameters, insulin sensitivity, and adipocytokine levels in patients with type 1 diabetes mellitus (type 1 DM). Material and Methods. A total of 61 adults with type 1 DM were randomly and prospectively assigned in open-label fashion to take insulin and rosiglitazone 4 mg/day (n=30) or insulin alone (n=31) for a period of 18 weeks while undergoing insulin therapy without acute metabolic complications. Results. Combination therapy did not significantly improve metabolic and inflammatory parameters, insulin sensitivity, and adiponectin levels. While leptin and resistin levels decreased in both groups (group 1: resistin 6.96 ± 3.06 to 4.99 ± 2.64, P=0.006; leptin 25.8 ± 17.6 to 20.1 ± 12.55, P=0.006; group 2: resistin 7.16 ± 2.30 to 5.57±2.48, P=0.031; leptin 16.72 ± 16.1 to 14.0 ± 13.4, P=0.007) Hgb and fibrinogen levels decreased only in group 1 (Hgb 13.72 ± 1.98 to 13.16 ± 1.98, P=0.015, and fibrinogen 4.00 ± 1.08 to 3.46 ± 0.90, P=0.002). Patients in both groups showed weight gain and the incidence of hypoglycemia was not lower. Discussion. The diverse favorable effects of TZDs were not fully experienced in patients with type 1 DM. These results are suggesting that insulin sensitizing and anti-inflammatory characteristics of TZDs were likely to be more pronounced in patients who were not totally devoid of endogenous insulin secretion. © 2015 Metin Guclu et al. Source


Guclu M.,Sevket Yilmaz Research and Education Hospital | Cander S.,Sevket Yilmaz Research and Education Hospital | Kiyici S.,Sevket Yilmaz Research and Education Hospital | Vatansever E.,Sevket Yilmaz Research and Education Hospital | And 2 more authors.
BMC Endocrine Disorders | Year: 2015

Bacground: To assess the contribution of macroprolactin to high serum prolactin levels and their association with thyroid status and thyroid autoimmunity during pregnancy. Methods: 138 pregnant women who suspected of having thyroid dysfunction were studied and divided into three groups according to the thyroid status; group 1; euthyroidism (n 40), group 2; hypothyroidism (n 54), and group 3; hyperthyroid (n 44). Polyethylene glycol (PEG) precipitation method was used for detection of macroprolactin. A percentage recovery of 40 % or less is considered as macroprolactinemia. If macroprolactin was negative, the percentage of monomeric prolactin recovery (monoPRL %) after PEG precipitation was used for comparison between the groups. Results: Macroprolactinemia was found in two patients (1.4 %) one from hypothyroid and other from euthyroid group. Basal prolactin levels in these patients were 400 and 403 ng/mL respectively. Referring to all patients, there was no correlation between PRL, macroPRL or monoPRL % with thyroid hormone status and also with the serum levels of thyroid antibodies (p > 0.05). A positive correlation was observed between the serum levels of PRL with TSH (p = 0.014 and r = 0.219), while a negative correlation was found with FT4 (p = 0.011 and r = -0.227). Conclusions: Despite the fact that serum prolactin levels were found to be high during pregnancy, the contribution of macroprolactin was found to be insignificant in our study. Unlike other auto immune diseases, we could not find any relationship between thyroid autoimmunity and PRL, macroPRL or monoPRL %. These results confirmed that measured prolactin was quite homogeneous during pregnancy. © 2015 Guclu et al. Source

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