PURPOSE: We describe the epidemiological and clinical characteristics and the efficacy of a delayed initiation to therapy in an oropharyngeal tularemia outbreak in Duzce, Turkey. MATERIALS AND METHODS: Between March and June 2000, 22 patients with tularemia were diagnosed by microagglutination tests. RESULTS: Oropharyngeal and ulceroglandular forms of the disease were discovered. Most of the cases were oropharyngeal (19 cases). The most common symptoms were sore throat (95.4%) and fever (90.9%). Lymphadenopathy (95.4%) and pharyngeal hyperemia (81.8%) were usually observed signs. The lymphadenopathies were localized especially in the left cervical region (66.7%), a finding that has not been previously reported in the literature. The time between the onset of the symptoms and diagnosis was 40.7 +/- 22.8 (10 - 90) days. The patients were treated with streptomycin plus doxycycline and ciprofloxacin. The patients' recoveries took up to 120 days. CONCLUSION: This report describes the first outbreak of tularemia in northwest Turkey. Tularemia may occur in any region where appropriate epidemiological conditions are found and should be kept in mind for differential diagnosis in oropharyngeal symptoms. Late initiation of therapy may delay complete recovery. In this outbreak, cervical lymph nodes predominantly localized on the 1eft side were found, which had not been previously reported.
Adolescent ; Adult ; Aged ; Child ; Diagnosis, Differential ; Disease Outbreaks/*statistics & numerical data ; Female ; Humans ; Lymph Nodes/pathology ; Lymphatic Diseases/*microbiology/*pathology ; Male ; Middle Aged ; Oropharynx ; Tularemia/*epidemiology/*pathology ; Turkey/epidemiology ; Water ; Young Adult

STUDY DESIGN: A retrospective study. PURPOSE: The aim of this study is to compare the efficacy and outcome of vertebroplasty compared with unipedicular and bipedicular kyphoplasty for the treatment of osteoporotic vertebral compression fractures in terms of pain, functional capacity and height restoration rates. OVERVIEW OF LITERATURE: The vertebroplasty procedure was first performed in 1984 for the treatment of a hemangioma at the C2 vertebra. Kyphoplasty was first performed in 1998 and includes vertebral height restoration in addition to using inflation balloons and high-viscosity cement. Both are efficacious, safe and long-lasting procedures. However, controversy still exists about pain relief, improvement in functional capacity, quality of life and height restoration the superiority of these procedures and assessment of appropriate and specific indications of one over the other remains undefined. METHODS: Between 2004 and 2011, 296 patients suffering from osteoporotic vertebral compression fracture underwent 433 vertebroplasty and kyphoplasty procedures. Visual analogue scale (VAS), the Oswestry Disability Index (ODI) and height restoration rates were used to evaluate the results. RESULTS: Mean height restoration rate was 24.16%+/-1.27% in the vertebroplasty group, 24.25%+/-1.28% in the unipedicular kyphoplasty group and 37.05%+/-1.21% in the bipedicular kyphoplasty group. VAS and ODI scores improved all of the groups. CONCLUSIONS: Vertebroplasty and kyphoplasty are both effective in providing pain relief and improvement in functional capacity and quality of life after the procedure, but the bipedicular kyphoplasty procedure has a further advantage in terms of height restoration when compared to unipedicular kyphoplasty and vertebroplasty procedures.
Fractures, Compression* ; Hemangioma ; Humans ; Inflation, Economic ; Kyphoplasty* ; Osteoporosis ; Quality of Life ; Retrospective Studies ; Spine ; Vertebroplasty*

Gastric hemangiomas are rare benign vascular tumors that can cause severe gastrointestinal system bleeding. We presented the case of a neonate with fresh bleeding and melena from the orogastric tube and detected gastric hemangioma in esophagogastroduodenoscopic examination. Propranolol is widely used in treatment of cutaneous hemangiomas and non-gastric gastrointestinal system hemangiomas. However, the surgical approach is preferred for treating gastric hemangiomas, and there are few reports of gastric hemangiomas associated with non-surgical treatment. Gastric hemorrhage decreased with antacid and somatostatin treatment. Propranolol treatment was initiated before the surgery decision. After three weeks of treatment, we observed regression in the hemangioma with endoscopic evaluation. During the course of treatment, the patient's gastrointestinal system bleeding did not recur, and there were no side effects associated with propranolol.
Hemangioma* ; Hemorrhage ; Humans ; Infant, Newborn* ; Melena ; Propranolol* ; Somatostatin ; Stomach

PURPOSE: Anastomotic leakage in colorectal surgery is a very important issue. Although many studies have shown the positive effects of enteral glutamine (Gln) on anastomotic healing, none has assessed the effects of administering Gln via an enema for anastomotic healing. To fill this study gap, this study investigated the intraluminal effect of administration of Gln enema on the healing of colonic anastomosis in a rat model. METHODS: Thirty Wistar albino rats were divided into three groups containing 10 rats each and were subjected to distal left colon transection and anastomosis. Postoperatively, group I (the control group) was administered no treatment, group II was administered daily placebo enemas containing physiological saline, and group III was administered daily 2% L-Gln enemas. After sacrifice on postoperative day 5, anastomotic healing, burst pressure, tissue hydroxyproline levels, and histological parameters were measured, and group values were compared via statistical analysis. RESULTS: Group III was found to have the highest mean bursting pressure and tissue hydroxyproline levels and the lowest mean ischemia score. While the values of these parameters were not found to differ significantly among the groups, the lack of significance may have been due to the limited number of subjects examined. CONCLUSION: Administration of a Gln enema may have a positive effect on anastomosis in terms of bursting pressure and histopathological parameters. Future research should examine administration of a preoperative Gln enema as a means of decreasing the traumatic effects of the enema and identifying its applicability in surgical practice.
Anastomosis, Surgical ; Anastomotic Leak ; Animals* ; Colon* ; Colorectal Surgery ; Enema* ; Glutamine* ; Hydroxyproline ; Ischemia ; Models, Animal ; Rats