Turkish Journal of Internal Medicine

Journal Information
EISSN : 2687-4245
Current Publisher: Turkish Journal of Internal Medicine (10.46310)
Total articles ≅ 95
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Berfu Korucu, Hasan Haci, Elif Burcu Bali, Mehmet Kürşat Derici, Galip Guz
Turkish Journal of Internal Medicine; doi:10.46310/tjim.882813

Abstract:
Background: Anemia is one of the most prevalent complications of chronic kidney disease (CKD). In CKD-related anemia, circulating erythrocytes have a decreased life span. Paraoxonase-1 (PON1) activity is one of the essential factors protecting cell membranes, e.g., erythrocytes, from lipid peroxidation under normal conditions. In this study, we investigated PON1 activity in hemodialysis (HD) patients with and without erythropoiesis-stimulating agents (ESA) therapy and the possible relationship of PON1 activity levels with the ESA dose required. Methods: This study is composed of patients undergoing HD with a minimum dialysis vintage of six months. We excluded cases with an active infection, cardiovascular events and malignancy, hypo- or hyperthyroidism, central venous catheters, iron deficiency, cystic kidney diseases, nephrectomy, and routine C-reactive protein (CRP) levels higher than reference range within the last six months. Results: Baseline characteristics, laboratory parameters, oxidative stress, and systemic inflammatory indices were similar between groups. The mean PON1 activity of the ESA+ group was significantly lower than the ESA– group (191.4 ±118.8 and 488.1±174.9,respectively; p<0.001). Cumulative ESA doses and PON1 activity were significantly and negatively correlated (R=-0.736, p<0.001). Conclusion: The results of this study suggest that lower PON1 activity in HD patients is associated with the requirement for ESA therapy, presumably due to decreased life span of erythrocytes. Further studies examining the relationship between PON1 activity and ESA treatment requirements are necessary to reveal new treatment goals for CKD-related anemia.
Hale Turnaoğlu, Feride Pınar Altay, Feride Kural Rahatli, Yusuf Bozkuş, Özlem Turhan Iyidir, Kemal Murat Haberal
Turkish Journal of Internal Medicine; doi:10.46310/tjim.869648

Abstract:
Introduction The aim of our study was to investigate the effect of thyroid dysfunction on tendons and the contribution of Acoustic Radiation Force Impulse (ARFI) elastography to the diagnosis of tendinopathy. Methods Eighty Achilles tendons of 40 patients under levothyroxine treatment, who had previously known hypothyroidism but high serum thyroid stimulating hormone levels, and 80 Achilles tendons of 40 healthy individuals were evaluated with ARFI (Virtual Touch Quantification®). 19 of 40 of the patients with hypotiroidism’ Achilles tendons were re-evaluated after thyroid stimulating hormone levels reached to normal limits following the adjustments in thyroid hormone replacement therapy. The middle portion of the each Achilles tendon was chosen for the examination. Every examination consisted of three to five independent measurements (shear wave velocity- meters per second). The mean shear wave velocity value was calculated for each tendon, and used for statistical analysis. Results The stiffness values of both left and right Achilles tendons, represented as shear wave velocity, were similar in patients with hypothyroidism and control group. There was no significant difference between the Achilles tendon shear wave velocity measurements of 19 of 40 hypothyroidism patients who were re-evaluated after the adjustments in thyroid hormone replacement therapy. Conclusions The lack of significant difference in Achilles tendon stiffness between non-naive hypothyroid patients and the control group may be explained as a positive clinical effect of thyroid hormone replacement therapy.
Gökhan Öztürk
Turkish Journal of Internal Medicine, Volume 3, pp 113-116; doi:10.46310/tjim.876357

Abstract:
The hydatid cysts disease is a parasitic cystic infection of the liver, lungs, and other organs, caused by Echinococcus granulosus. It is mostly seen in the sheep and cattle farms, which have poor health conditions. It is endemic in the eastern and southwestern regions of Türkiye. The big cysts that are seen in the lungs are called a huge pulmonary cyst. And it is a particular clinic situation. The symptoms of the disease are cough, chest pain, dyspnoea, hemoptysis, or allergic reactions. The hemoptysis could be seen when these cysts rupture. The use of anthelmintic drugs to treat the pulmonary hydatid cysts could cause cyst rupture. The surgery must be the first choice of treatment. In our case, we discussed the two huge pulmonary hydatid cysts in the upper left lobe of the lung which were treated with thoracotomy.
Sefa Erdi Ömür, Çağrı Zorlu
Turkish Journal of Internal Medicine, Volume 3, pp 127-130; doi:10.46310/tjim.873267

Abstract:
Cardiac amyloidosis (CA); It can be referred to as a progressive cardiomyopathy that occurs as a result of the accumulation of endogenous proteins in the form of amyloid fibrils, whose folding is disrupted in the kidney, liver, gastrointestinal system, soft tissue and heart. The course of the disease depends on the involvement of the organs and treatment options depending on the source of the protein. Immunoglobulin light chain (AL) amyloidosis and transtretin (TTR) amyloidosis are the most common CA types. While AL amyloidosis is more common in the heart and kidney, TTR amyloidosis is more common in the heart. Although CA is not considered a common disease, TTR amyloidosis is observed in approximately 15% of patients with heart failure with preserved ejection fraction and severe aortic stenosis. CA diagnosis; It can be placed by echocardiography (ECHO), magnetic resonance or nuclear scintigraphy methods. At the same time, genetic analysis, biopsy and histopathological tests are also useful for early diagnosis. After the diagnosis, antiplasma treatment or stopping the produced protein constitute the main lines of the treatment.
Mehmet Sezen, Abdülmecit Yildiz, Kamil Dilek, Mustafa Güllülü, Mahmut Yavuz, Ayşegül ORUÇ, Mehmet Fethullah Aydin, Alparslan Ersoy
Turkish Journal of Internal Medicine, Volume 3, pp 107-109; doi:10.46310/tjim.876204

Abstract:
Sjogren's syndrome (SjS) is a chronic, slow-progressing, autoimmune and lymphoproliferative disease. The main symptoms of the syndrome are xerostomia and keratoconjuctivitis sicca as a result of chronic inflammatory infiltration of the salivary and lacrimal glands. Focal Segmental Glomerulosclerosis complicating primary Sjögren's syndrome is extremely rare. We report on a 39-year-old woman with 5 years history of sjogren syndrome who was found to have nephrotic syndrome. Histopathological findings in kidney biopsy compatible with focal segmental glomerulosclerosis. Steroid therapy was initiated (oral prednisolone at a dose of 15 mg/day) and Cyclosporine 2 * 100mg/d. FSGS, which is associated with sjögren's syndrome, was considered suitable for the presentation because of its rare occurrence
Tuba Erürker Öztürk
Turkish Journal of Internal Medicine, Volume 3, pp 110-112; doi:10.46310/tjim.876345

Abstract:
Echinococcus granulosis commonly involve the liver and are mostly seen in Turkey . One of the early complication following the surgery for liver hydatid cyst is biliary leakage (B.L.) which’s incidence is %4.5-26. Endoscopic sphincterotomy (E.S.) and biliary stenting are usually successful in treating B.L. In this case, I’m presenting endoscopic treatment for the B.L. after the liver hydatid cyst operation.
Murat Çalapkulu, Muhammed Erkam Sencar, Ilknur Öztürk Ünsal, Hakan Düğer, Mustafa Özbek, Erman Çakal
Turkish Journal of Internal Medicine, Volume 3, pp 123-126; doi:10.46310/tjim.877025

Abstract:
Ganglioneuroma (GN) is a rarely seen benign tumor originating from neural crest cells and consisting of ganglion and Schwann cells. Adrenal GNs occur most frequently in the fourth and fifth decades of life. They have an equal frequency in male and female patients and are usually found incidentally during imaging. It is not related to hormonal activity and is clinically asymptomatic. We aimed to present a 49-year-old female patient whose magnetic resonance image performed for abdominal pain was found a biochemically normal mass in the right adrenal gland and then was pathologically diagnosed as GN after right adrenalectomy.
Şeyda Günay, Osman Akın SERDAR, Dilek Yeşilbursa, Sümeyye Güllülü, Naile Bolca Topal
Turkish Journal of Internal Medicine, Volume 3, pp 117-119; doi:10.46310/tjim.868729

Abstract:
Introduction: Peripartum cardiomyopathy is a rare disease that is difficult to diagnose and treat. Clinical findings are similar with heart failure. New treatments are needed in addition to the treatment of heart failure. Case Report: A 32-year-old woman presented with symptoms of heart failure 4 days after first delivery. Chest X-ray showed cardiomegaly. Serum BNP level was high. Transthoracic echocardiography (TTE) indicated dilated left atrium and left ventricle, severe mitral regurgitation and ventricular dysfunction. The global longitudinal strain was – 9.1%. Cardiac magnetic resonance imaging (MRI) revealed mid-myocardial staining detected in late phase images. Concomitant bromocriptine (2,5 mg po twice a day for 15 days and then 2,5 mg po once a day for 15 days) was used with standard heart failure therapy. At 6 months, TTE and cardiac MRI revealed normal biventricular function and size. Global longitudinal strain was –14%. Conclusion: Patients with peripartum cardiomyopathy may benefit from bromocriptine.
Ezel Elgun, , Bedrettin Orhan, Fahir Özkalemkaş,
Turkish Journal of Internal Medicine, Volume 3, pp 131-133; doi:10.46310/tjim.876139

Abstract:
Hairy cell leukemia (HCL) is a rare chronic lymphoproliferative disease. LSV is characterized by inflammation of small vessels. Its association is rare in the literature and HCL can be seen in LSV etiology, although the relationship between the 2 diseases is far from clear. Here, we aimed to present a case with constitutional symptoms, palpable purpuric lesions on the body and diagnosed as HCL from bone marrow biopsy.
Mehmet Sezen, Abdülmecit Yildiz, Mahmut Yavuz, Kamil Dilek, Mustafa Güllülü, Ayşegül ORUÇ, Mehmet Fethullah Aydin, Alparslan Ersoy
Turkish Journal of Internal Medicine, Volume 3, pp 120-122; doi:10.46310/tjim.877028

Abstract:
Autoimmune hemolytic anemia (AIHA) is a rare disease with a rate of 1-3 in 100,000 in adults. AIHA are defined as primary (idiopathic) or secondary depending on the presence or absence of accompanying disease. Secondary causes include drugs, immunodeficiencies, infections, other autoimmune diseases, or malignancies. Here, we report an 42-year-old female presented to us with diarrhea, nausea-vomiting, fever, chills and jaundice for two days. Hematological investigations revealed hemolytic anemia. Direct Coombs test was positive. The patient was diagnosed acute tubuler necrosis with autoimmune hemolytic anemia. Methylprednisolone 40 mg/day was started considering autoimmune hemolytic anemia. She was on hemodialysis at regular intervals. After 4 weeks, the patient was symptomatically improved with remission of acute tubuler necrosis and hemolytic anemia. In our case, the association of AIHA due to acute gastroenteritis and acute tubular insufficiency was considered suitable for the presentation because of its rare occurrence.
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