Aetiopathogenetic mechanisms that lead to autoimmune diseases are complex, but Urinary tract infection (UTI) and cytokines have been suggested to mediate important effects. Methods: UTI and serum levels of three cytokines (IL-2, IL-4 and IL-17A) were assessed in 98 rheumatoid arthritis (RA), 33 ankylosing spondylitis (AS) and 20 systemic lupus erythematosus (SLE) Iraqi patients, as well as 45 controls. Results: Out of 151 systemic autoimmunity patients, 23.8% were observed to have UTI, and such frequency was approximated in RA, AS and SLE (23.5, 27.3 and 20.0%, respectively), while in controls, it was 11.1%. Two pathogens were identified as a cause of UTI; E. coli and Proteus spp. In total patients, E. coli was present as a single causative pathogen in 10.6%, while for Proteus spp. it was 8.6%, in addition to 4.6% of mixed infection. The corresponding frequencies were 10.2, 8.2 and 5.1% in RA, 15.2, 6.1 and 6.1% in AS, 5.0, 15.0 and 0.0 in SLE and 8.9, 0.0 and 2.2% in controls, respectively. IL-2 was significantly increased in total patients (21.68 vs. 9.66 pg/ml), as well as RA, AS and SLE (25.10, 24.06 and 14.16 pg/ml, respectively) compared to controls. A similar increase was observed in UTI+ve versus UTI-ve cases in total patients, AS and SLE, but not RA or controls. Such differences were less clear in IL-4, while IL-17A showed no significant variations. Conclusion: UTI represents an important clinical complication in systemic autoimmunity and IL-2 also has its role in the pathogenesis.

Introduction: A pilonidal sinus(PNS) is an infected tract at the natal cleft under the skin between the buttocks. It is a common problem in primary care due to the high recurrence followingsurgery. The patient treated here had a recurrent pilonidal sinus after three previous surgeries. Methods: The patient was operated by excision of the tract and closure of the wound. Results: The wound healed in two stages as explained in the study. Conclusion: The possible reason for reccurrence was detected and it was managed. Healing was complete and follow up after one year revealed no recurrence.

PURPOSE: This study tried to evaluate the effectiveness of combined treatment using radiation therapy and concurrent cisplatin as a radiosensitizer in the management of locally advanced head and neck cancer. MATERIALS AND METHODS: From January 1995 to August 1998, 29 evaluable patients with locally advanced head & neck cancers (AJCC stage II-IV) were received curative radiation therapy (total 70-75.6 Gy/35 -42 fractions , 1.8-2 Gy/fraction) and concurrent cisplatin chemotherapy (100 mg/m2, D1, D22, D43). The neck dissections were performed for residual lymphadenopathy. Follow- up ranged from 5 to 55 months (median 24 months). RESULTS: Twenty- one (72.4%) patients achieved clinical complete responses. The partial response and minimal response rates were 17.2% and 10.4%, respectively. Locoregional failure rate was 27.6%, and included 6 patients with local failures , 4 patients with regional failures, and 2 patients with combined local and regional failures. Four of 29 patients (13.8%) developed distant metastasis. The disease free survival rate at 3 years was 60%. Nasopharyngeal primary tumors or complete responders showed significantly higher disease free survival rate. The grade 3 mucositis and nausea/vomiting was noted in 34.5%, respectively. Major prolongation of radiation therapy duration was inevitable in three patients. Twenty- one patients (72.4%) completed 3 courses of cisplatin and 5 patients received 2 courses of cisplatin. Three patients received only one course of cisplatin due to nephrotoxicity and neurotoxicity, and then changed to 5- FU regimen. CONCLUSIONS: Concurrent cisplatin- radiation therapy in locally advanced head and neck cancer showed high response rate, reasonable locoregional control, and survival rate. As expected, acute toxicities were increased, but compliance to treatment was acceptable. Assess ment of the effect of the combination in this setting requires further accrual and follow- up.
Cisplatin* ; Compliance ; Disease-Free Survival ; Drug Therapy ; Head and Neck Neoplasms ; Head* ; Humans ; Lymphatic Diseases ; Mucositis ; Neck Dissection ; Neck* ; Neoplasm Metastasis ; Survival Rate

No abstract available.
Dietary Supplements* ; Fatigue*

No abstract available.
Diagnosis* ; Female ; Oligomenorrhea ; Polycystic Ovary Syndrome*

Defecography evaluates in real time the morphology of rectum and anal canal in a physiologic setting by injection of a thick barium paste into the rectum and its subsequent evacuation. Because of its ability of structural and functional evaluation, defecography is primarily performed for work up of patients with longstanding constipation, unexplained anal or rectal pain, residual sensation after defecation or suspected prolapse. Technique and interpretation of this examination are outlined in this review.
Anal Canal ; Barium ; Constipation ; Defecation ; Defecography ; Humans ; Pelvic Floor ; Prolapse ; Rectum ; Sensation

No abstract available.
Osteoarthritis*

Suffering is a human burden that may not be truly avoidable. In order to put that view in perspective we must examine suffering in a form as isolated from self-inflicted behavior as possible. The suffering of a child is one such example. The purpose of this study is to understand the meaning of suffering in the teenager and is to analyze difference of suffering in children and adult. The subjects of this study were 6 children (12year-17year) including in-patients and out-patients of a general hospital who were diagnosed as having cancer. The data was collected from October 10,1996 to April 15, 1997. Qualitative research methods of in-depth interview and participant observation were used for data collection. Data analysis progressed according to the fieldwork phases suggested by the Hybrid Model. According to the results of the study, the meaning of suffering in the teenager can be described as follows: Suffering is an inevitable experience of all human beings. When each child experiences pain and destroying child-adult relationship, suffering in which threaten one's personal integrity is perceived differently among each child depending on their personal inner factors, one's significant others, exterior circumstances and stimuli. Suffering brings severs and unendurable distress which accompany anguish, depression, anxiety and fear. This findings provide data for new insights of suffering. When caring for teenager who experience suffering, nurse need to consider the influence of suffering. Moreover, appropriate nursing interventions aimed at relieving suffering need to be developed.
Adolescent ; Adult ; Anxiety ; Child ; Data Collection ; Depression ; Hospitals, General ; Humans ; Nursing ; Outpatients ; Qualitative Research ; Statistics as Topic ; Stress, Psychological ; Child Health

No abstract available.

No abstract available.