Informes de casos clínicos y médicos

Objectives: To describe the clinical course and three year follow-up of the youngest case of IgA nephropathy (IgAN).
Method: Retrospective case note review.
Result: A 26 month old girl presented with after intermittent macroscopic haematuria, nephrotic syndrome without hypertension or renal dysfunction. She had 3+ proteinuria and 3+ of haematuria on urinary dipstick testing. Her urine showed >500 × 106/L red without white cells or growth on culture and albumin: creatinine ratio of 253 mg/mmol without hypercalciuria. She was hypoalbuminaemic at 25 g/L. Her ASO titre and complements were normal with elevated IgA of 1.57 g/L. Her renal biopsy demonstrated IgA nephropathy (IgAN) with diffuse global mesangial proliferative glomerulonephritis with associated diffuse strong granular mesangial IgA deposition. She was commenced on an ACEI together with fısh-oil supplements. She had evidence of hyperfiltration without proteinuria, macroscopic haematuria or hypertension at follow-up of three years.
Conclusion: This is the youngest published case of IgA nephropathy. Detecting IgA nephropathy early may offer the possibility of treatment to prevent progression of the disease.

51-year-old male with adrenomyeloneuropathy required a video-assisted thorascopic surgery (VATS) for left parapneumonic empyema, likely from recurrent micro-aspirations. General anesthesia and surgery were uneventful. The patient met extubation criteria and was transferred to the intensive care unit (ICU). He required re-intubation post-operatively for hypoxemia and was started on total parenteral nutrition (TPN) and a propofol infusion. He continued to weaken post-operatively, received a percutaneous gastrostomy tube and a tracheostomy, and was transferred to a long-term acute care facility. A poor understanding of the pharmakokinetics of propofol and TPN on adrenomyeloneuropathy may have caused the rapid progression of this rare disease.

In chronic hepatitis C (CHC) treatment, direct acting antiviral agents (DAAs) are strongly effective and well tolerated, whereas with new DAAs, virological failures are common. At present, no data exists for RAVs of DAAs in Turkey. Genotypic resistance testing was performed by viral population sequencing of the NS3, NS5A and NS5B regions using plasma samples. The patient treatment-experienced with pegylated interferon- ribavirin was treated with 12-week course of ledipasvir/sofosbuvir and ribavirin. Three months after completing the treatment, virological relapse was occurred. Molecular analysis demonstrated that Y93H as a cross - resistant mutation for NS5A region related resistance mutation was determined. In addition, S282G and C316S were determined as amino acid substitution for NS5B region. This case shows that resistance testing for RAVs after virological failure with DAAs must be performed for the new DAA regime for CHC patients

The frequency and significance of a Tillaux-Chaput (TC) fracture remains unclear, and there is no consensus on the treatment strategies for this type of fracture. We report on the first case of a severe TC fracture with malunion that extended into the joint, and it was successfully treated with corrective osteotomy.

El presente estudio describe la composición química y los componentes antioxidantes de los dátiles, las semillas de dátiles y la cáscara de palma. Se determinaron por HPLC el tocoferol, los compuestos fenólicos, el ácido benzoico, el ácido cinámico, la quercetina y el kaempferol de los dátiles, las semillas de dátiles y la cáscara de palma. Los dátiles contenían altas cantidades de fenoles totales 2515,6 mg/100 g y tocoferol 22,722 μg/100 g, mientras que la cáscara de palma contenía altas cantidades de taninos totales 1728,03 mg/100 g. Las semillas de dátiles contenían altas cantidades de kaempferol 14,878 mg/100 g y ácido protocatéquico 6,672 mg/100 g. Se evaluó la actividad antioxidante de los dátiles, las semillas de dátiles y la cáscara de palma y se exhibieron 91,87, 81,85 y 63,77 %, respectivamente. Nuestros hallazgos demuestran que los dátiles, las semillas de dátiles y la cáscara de palma pueden considerarse una buena fuente de antioxidantes naturales.