PubMed Health⌕ Search

Biomedical subjects

U Emre

Publications and source records attributed to U Emre.

12 recordsLinked to original sources

Encephalomyelitis following mumps.

STUDY DESIGN: A case report with review of literature since 1961. SETTING: Departments of Neurology and Radiology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey. METHOD: A 22-year-old male patient diagnosed and treated as mumps encephalomyelitis is described. The clinical findings of the patient and the difficulties in differential diagnosis are discussed with the help of previously reported eight adult cases. RESULTS: Increased T2 signals in the spinal cord from C4 to C6 and T5 to T10 were seen by magnetic resonance imaging. This was the largest spinal involvement in the reported mumps cases. He was treated with supportive therapy oral steroids and early rehabilitation. On the sixth month, his neurological examination revealed bilateral 2/5 paresis in lower extremities. CONCLUSION: Encephalomyelitis following mumps is an uncommon but serious event in adults.

Adult↗

Validity and reliability of Turkish translation of Migraine Disability Assessment (MIDAS) questionnaire in patients with migraine.

The Migraine Disability Assessment (MIDAS) questionnaire is a brief, self-administered questionnaire which is designed to quantify headache-related disability in a 3-month period. We have tested a Turkish version of the MIDAS questionnaire in 60 migraine patients. Sixty of the clinically diagnosed migraine headache sufferers were enrolled in a 90-day diary study and completed the MIDAS questionnaire in the first, 21st and the last day of the 90-day study. The scores taken from the diary and the scores of the MIDAS taken at different times were evaluated by the correlation tests of both Pearson and Spearman for each question and total scores. Cronbach's scores taken from the diary and taken from the test of the MIDAS which was applied at different times were evaluated. Pearson's correlation on the responses in the initial MIDAS questions was between 0.44 (reduced productivity in household chores) and 0.78 (missed work or school days). The correlation of the Spearman was similar to the Pearson values. As a result, we found that the overall score of the MIDAS has a good reliability and its internal consistency is also good (Cronbach's alpha 0.87). These findings support the use of the MIDAS questionnaire as a clinical and research tool on Turkish patients.

Adult↗

Evaluation of Chlamydia immunoglobulin M (IgM), IgG, and IgA rELISAs Medac for diagnosis of Chlamydia pneumoniae infection.

Chlamydia pneumoniae is an important pathogen responsible for a variety of respiratory diseases in humans. Cell culture remains the most specific method for C. pneumoniae diagnosis, but it is labor-intensive and time-consuming. Thus, serology, particularly microimmunofluorescence (MIF) testing, is frequently utilized. However, the MIF test has a significant subjective component. We evaluated a new serological test: Chlamydia Immunoglobulin M (IgG, IgA, and IgM rELISAs Medac, based on a recombinant Chlamydia-specific lipopolysaccharide (LPS) fragment, for the diagnosis of C. pneumoniae infection. The results of this study demonstrated that the use of rELISAs Medac with single sera does not appear to be sensitive or specific for diagnosis of C. pneumoniae infection compared to culture. In children, sensitivities of the rELISAs compared to culture did not exceed 34.2%, and the specificities ranged from 68.4% (IgG) to 91.2% (IgA). In adults, the sensitivities of the rELISAs were slightly higher, up to 77.8% (IgA or IgG), but the specificities ranged from a very low 20.8% for IgA or IgG to 81.1% for IgM. When multiple sera were tested, the results of the rELISAs Medac correlated with culture results in five of eight (62.5%) patients. However, this offers only a retrospective diagnosis, which makes it difficult to manage these patients prospectively.

Adolescent↗

Chlamydia pneumoniae infection in patients with cystic fibrosis.

The prevalence of atypical community-acquired infections as acute pulmonary exacerbations in patients with cystic fibrosis was prospectively studied. Thirty-two patients admitted to the hospital because of acute pulmonary exacerbations and 24 clinically stable patients seen for their routine visits were examined. The prevalence of infection with Chlamydia pneumoniae was assessed by culture and serology, and the presence of IgE to C. pneumoniae was studied by immunoblotting. A subgroup of patients was also examined for the presence of Mycoplasma pneumoniae infection. C. pneumoniae was isolated from four patients presenting with acute pulmonary exacerbations (12.5%) and from none of the stable patients; all patients for whom cultures were positive also had IgE to C. pneumoniae. Polymerase chain reaction analysis for M. pneumoniae was not positive for any patient, and only one patient with an acute exacerbation had an antibody titer compatible with a recent infection. We conclude that infection with C. pneumoniae is associated with acute pulmonary exacerbations in some patients with cystic fibrosis and that it may trigger the production of IgE specific to C. pneumoniae, thus leading to bronchial reactivity in these patients.

Adolescent↗

Effect of hydrocortisone succinate on growth of Chlamydia pneumoniae in vitro.

We examined the effect of hydrocortisone succinate on the growth of three isolates of Chlamydia pneumoniae in vitro. There was a significant increase in the number of inclusions seen in two of the C. pneumoniae strains in the presence of hydrocortisone. There was no significant increase in the number of inclusions with various concentrations of hydrocortisone over time. The addition of hydrocortisone did not affect the in vitro activities of azithromycin, erythromycin, and doxycycline against C. pneumoniae.

Chlamydophila pneumoniae↗

Effect of transfusion in acute chest syndrome of sickle cell disease.

OBJECTIVE: To study the effects of transfusion on the clinical course and oxygenation indexes of children with sickle cell disease and acute chest syndrome. METHODS: During a 2-year period, 36 children with sickle cell disease admitted with a total of 40 episodes of acute chest syndrome were examined. Patients were given a clinical severity score indicative of the degree of respiratory distress. Arterial blood gas values were determined 4 to 24 hours before and 12 to 24 hours after transfusion, and indexes of oxygenation were calculated; six patients who were not given transfusions also had blood gases measured on admission and approximately 24 hours later for comparison. RESULTS: Blood transfusion was administered during 27 episodes (67.5%); 20 children received a simple packed cell transfusion, four had a partial packed cell exchange transfusion, and three had a simple transfusion followed by whole blood exchange transfusion because of worsening clinical symptoms. Although there was no significant change in oxygenation indexes for the six patients not treated with transfusion, there was significant improvement in all indexes after transfusion. The transfused group had more severe disease on admission, but there was no significant difference in duration of fever, tachypnea, retractions, or hospital stay between the transfusion and the nontransfusion groups. CONCLUSION: Blood transfusion, even simple transfusion of packed erythrocytes, significantly improves oxygenation in children with acute chest syndrome and is a valuable adjunct to therapy.

Acute Disease↗

Detection of anti-Chlamydia pneumoniae IgE in children with reactive airway disease.

An association of Chlamydia pneumoniae infection and reactive airway disease has been demonstrated in children. To determine if C. pneumoniae infection triggers production of C. pneumoniae-specific IgE, sera were examined from 45 children with and without C. pneumoniae infection. Anti-C. pneumoniae IgE was demonstrated by immunoblotting in 12 (85.7%) of 14 culture-positive asthmatic patients with wheezing compared with only 1 (9.1%) of 11 culture-positive patients with pneumonia, 2 (18.2%) of 11 culture-negative asthmatic children with wheezing, and 2 (22.2%) of 9 culture-negative asymptomatic patients. The most commonly recognized proteins were at 98 (82.4%), 78 (58.8%), 58-60 (70.6%), and 36 kDa (64.7%). The presence of anti-C. pneumoniae IgE by immunoblotting was not associated with the presence of anti-C. pneumoniae IgG and IgM by microimmunofluorescence. These results suggest that production of specific IgE may be an underlying mechanism leading to reactive airway disease in some patients with C. pneumoniae infection.

Adolescent↗

The association of Chlamydia pneumoniae infection and reactive airway disease in children.

OBJECTIVE: To determine the possible association of Chlamydia pneumoniae infection and reactive airway disease in children. DESIGN: Prospective observational study. SETTING: Pediatric emergency department in Children's Medical Center of Brooklyn (NY), Kings County Hospital Center. PARTICIPANTS: One hundred eighteen children with acute episodes of wheezing and 41 age- and sex-matched healthy controls, aged 5 to 16 years. INTERVENTIONS: Children with cultures positive for C pneumoniae were treated with antibiotics. MEASUREMENTS/MAIN RESULTS: Cultures for C pneumoniae and serum samples for antibody testing were obtained from subjects and healthy controls. We isolated C pneumoniae from 13 (11%) children with wheezing and from two (4.9%) controls. Seven (58.3%) of 12 children with positive cultures had no detectable antibody to C pneumoniae and only three (25%) children had serologic evidence of acute infection. Six children had positive cultures on multiple occasions, ranging from 1 to 5 months. The children with wheezing were treated with erythromycin or clarithromycin, a new macrolide antibiotic approved for use in adults; all eventually had a negative culture. Nine (75%) of these children demonstrated clinical and laboratory improvement of the reactive airway disease after the eradication of chlamydial infection. CONCLUSIONS: Infection with C pneumoniae can trigger acute episodes of wheezing in children with asthma. Treatment of C pneumoniae infection may improve the course of reactive airway disease in these patients.

Adolescent↗

Alveolar-arterial oxygen gradient in acute chest syndrome of sickle cell disease.

In 44 episodes of acute chest syndrome of sickle cell disease occurring in 37 children, simple clinical severity score, duration of hospital stay, transfusion data, and alveolar-arterial oxygen gradient were analyzed as indicators of severity of disease. The alveolar-arterial oxygen gradient, measured during breathing of room air, proved, on multivariate analysis, to be the strongest predictor of both clinical severity and the need for blood transfusion.

Acute Disease↗

Distal muscular dystrophy of the Miyoshi type.

OBJECTIVE: Miyoshi myopathy is an autosomal recessive muscular dystrophy. It is characterized by distal muscle involvement, especially the gastrocnemius and soleus. The disease starts with weakness and atrophy of the calves. MATERIAL AND METHODS: Here we report on 2 patients, brother and sister, from a Turkish family. Onset of the disease was at the age of 20 and 26 years of age, respectively. In both siblings, there was an early and predominant involvement of the distal muscles of the lower limbs. Creatine kinase activity was elevated 50- to 100-fold above normal values. RESULTS: Electromyography revealed a myopathic pattern. Histology of the biceps muscles indicated some myopathic changes consistent with muscular dystrophy. Occurrence in only these 2 siblings with no other family members was indicative of an autosomal recessive inheritance. CONCLUSIONS: We describe the distinctive clinical features in 2 siblings of a Turkish family with MM as differential diagnosis and histological change.

Adult↗