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Biomedical subjects

E Onur

Publications and source records attributed to E Onur.

12 recordsLinked to original sources

Anxiety disorder in patients with non-specific chest pain in the emergency setting.

OBJECTIVES: Many patients who have been discharged from the emergency department (ED) with a diagnosis of "non-specific chest pain" (NSCP) have anxiety disorder (AD), a commonly missed entity in acute care. The objective of this study was to delineate characteristic properties that could enhance recognition of AD in ED patients admitted with NSCP. METHODS: All patients between 18 and 65 years of age diagnosed with NSCP were enrolled. The Hospital Anxiety and Depression Scale (HADS) anxiety subscale was used as a screening test for AD. The patients with high HADS scores (> or = 10) were evaluated by a psychiatrist for AD. RESULTS: In total, 157 patients were enrolled in the study. HADS scores were found to be "high" (> or = 10) in 49 patients (31.2%). Patients with high HADS scores had a higher frequency of associated symptoms (p = 0.004). Dizziness or lightheadedness, chills or hot flushes, and fear of dying were found to have been reported more frequently by patients with high anxiety scores. Of the group with high score, 33 patients (67.3%) were interviewed by a psychiatrist, and 23 (69.7%) of these patients were diagnosed with AD. Associated symptoms were described by 21 patients with AD (91.3%). Of those with AD, 18 (78.3%) had been previously admitted to the ED with chest pain. Atypical chest pain was described by 21 patients (91.3%). CONCLUSIONS: Physicians should always consider AD in patients presenting to the ED with chest pain after ruling out organic aetiology. Patients' definition of atypical pain, recurrent admissions to ED, and presence of associated symptoms such as dizziness, chills or hot flushes, and fear of dying could aid in considering AD.

Adolescent↗

Laparoscopic repair of an internal supravesical hernia: a rare hernia causing small bowel obstruction.

The application of diagnostic laparoscopy in emergency surgery has facilitated a wide range of endoscopic operative procedures. We report an extremely rare case of a patient who had a bowel obstruction caused by an internal supravesical hernia that was repaired via a minimally invasive technique. Abdominal computed tomography (CT) showed signs of small bowel obstruction: the cause was thought to be an invagination due to a small bowel tumor. Laparoscopic exploration of the dilated small bowel segments allowed the diagnosis of supravesical hernia. Reduction was performed with slight traction, and the hernial orifice was closed with intracorporeal sutures. To our knowledge, this is the first repair of an internal supravesical hernia ever to receive herniorraphy based on laparoscopic techniques. The mean starting time for bowel-function and mean hospital stay following the laparoscopic release of the intestinal obstruction were significantly shorter than is typically seen with standard techniques.

Diagnosis, Differential↗

Clitoromegaly in type 2 neurofibromatosis: a case report and review of the literature.

OBJECTIVE: Genitourinary neurofibromatosis (NF) is a rare disorder and clitoral involvement has been reported infrequently. In the English literature there are only 26 reported cases with clitoral involvement in NF. CASE: A 28-year-old female with clitoral enlargement, previously diagnosed with NF 2, was successfully treated by removal of the clitoral mass that increased in size during the previous two years. Clitoroplasty was performed while preserving the glans of clitoris. Histopathologic examination revealed plexiform neurofibroma. CONCLUSION: To the best of our knowledge the patient is the 27th reported clitoromegaly case with NF, but the first case reported with NF 2 or central NF in the English literature.

Adult↗

Age and gender dependent alterations in the activities of glutathione related enzymes in healthy subjects.

OBJECTIVES: Oxidative stress as a result of increased free radical production is implicated in the pathogenesis of several diseases. Specific antioxidant enzymes have a crucial role in the prevention of these deleterious effects. Since the activities of these enzymes differ significantly in different populations and seem to be affected by various environmental factors, in this study we aimed to determine the reference values of glutathione related antioxidant enzyme activities in the erythrocytes of healthy subjects and to investigate the possible variations as a function of age and gender in a healthy Turkish Mediterranean population. DESIGN AND METHODS: 130 healthy subjects (12-90 yr, 82 females, 48 males) were divided into six different age groups. Erythrocyte glutathione peroxidase (GSH-PX), glutathione reductase (GR) and glutathione-s-transferase (GST) activities were measured on a Hitachi 704 autoanalyser by the modification of previously described manual UV spectrophotometric methods. RESULTS: No significant differences were observed in erythrocyte GSH-PX, GR and GST activities between different age groups. Overall, GST activities were significantly higher in females compared with males (8.08 +/- 1.39, 6.88 +/- 1.51 U/g Hb respectively, mean +/- SD, p < 0.001). A significant positive correlation between GSH-PX and GR activities was observed (r = 0.49, p < 0.001). CONCLUSION: The results of this study suggested that the activities of GSH-PX, GR and GST did not depend. GST activities overall were higher in females. The reference values that we obtained were different than the previous reports. This situation implies that each population should determine its own reference values and should investigate the influence of environmental factors and life style habits on the activities of these enzymes that constitute a major part of the antioxidant defense system in the human organism.

Adolescent↗

In utero MR imaging and management of foetal hydrocephalus and NTDs in the third trimester.

Although ultrasound (US) remains the gold standard in foetal imaging, in utero magnetic resonance (MR) imaging of the foetal nervous system may be useful in the late stages of pregnancy. The authors performed MR scanning in pregnant women in whose foetuses US examination had shown hydrocephalus and neural tube defects (NTDs). These cases are definitely diagnosed as hopeless at such a late stage. In this report, three pregnant patients are presented to illustrate the morphological imaging features, and their outcome is discussed. This report is an example of how radiological investigations can be most valuable, when US and MR imaging are used as complementary in imaging of the foetuses.

Adult↗

Prolactin and cortisol levels during spontaneous and oxytocin induced labour and the effect of meperidine.

The effect of stress during labour on the plasma concentration of prolactin and cortisol was studied in 30 healthy multiparous women. The plasma concentrations of prolactin and cortisol were measured by radioimmunoassay during oxytocin induced labour, spontaneous labour, delivery and postpartum 24 h. The parturients were divided into three groups. The first group was given oxytocin for the induction of labour, the second group was also given oxytocin for the induction of labour and 100 mg of meperidine was administered intramuscularly for relief of pain and anxiety, and the third group was the control group with normal parturients who did not receive any medication. The prolactin levels showed a fall during labour in all the groups, but this fall was more marked in the first group where stress was evident. The concentrations of cortisol tended to increase during labour and reached a maximum at delivery in all three groups but in the meperidine group this level was significantly lower than the first and control groups. These results give further support to the hypothesis that maternal stress leads to a reduced concentration of prolactin and increased concentration of cortisol whereas relief of pain and maternal anxiety with meperidine lessens both effects.

Delivery, Obstetric↗