Ayşe Emel Önal

Evaluation of oxidative stress and antioxidant profile in patients with oral lichen planus

OBJECTIVE The aim of this study was to assess oxidative stress and antioxidant profile in patients with oral lichen planus (OLP) using serum and salivary samples and to compare these biomarkers in a group of healthy subjects. PATIENTS AND METHODS Twenty-one recently diagnosed patients with OLP and 20 healthy controls with matched periodontal status were recruited to the study. Total antioxidant activity (TAA) and lipid peroxidation product malondialdehyde (MDA) in both serum and saliva were determined. Univariate comparisons between the two groups were made for quantitative and categorical variables to determine any significant differences. RESULTS In OLP patients, total antioxidant defense (TAA) was significantly lower than that in healthy subjects in their serum samples (P = 0.01). Salivary MDA levels were significantly higher in the OLP group compared with healthy subjects (P = 0.03). A significant correlation was found between serum and saliva TAA estimates in patients with OLP (r = 0.714 and P = 0.0001) and in the control group (r = 0.69 and P = 0.001). Significant correlation was also found between serum and saliva MDA values in control group (r = 0.464 and P = 0.04). A significant inverse correlation was found between salivary MDA and TAA values in the control group (r = -0.598 and P = 0.005). CONCLUSIONS The findings of this study suggest an increased oxidative stress and imbalance in the antioxidant defense system in biological fluids of patients with OLP. These findings may reflect the disease phenomenon of OLP rather than a causal effect and their role in pathogenesis and transformation of OLP to cancer, if any, needs further elucidation.

Evaluation of the clinical efficacy of conservative treatment in the management of carpal tunnel syndrome

IntroductionCarpal tunnel syndrome (CTS) is impingement of the median nerve at the wrist. The aim of this study was to compare the effectiveness of tendon and nerve gliding exercises with standard conservative treatment (SCT), which consists of splinting and local steroid injections, in the treatment of CTS.MethodsThis study was a prospective, randomized, single-blind trial. Patients were randomized into three groups: treatment with SCT (Group 1); SCT and tendon and nerve gliding exercises (Group 2); tendon and nerve gliding exercises only (Group 3). A symptom total point score was obtained from five symptoms: hand pain, tingling, numbness, nocturnal numbness, and interrupted sleep. The functional status of the hand was determined by assessing seven daily living activities: writing, buttoning clothes, gripping a telephone receiver, opening jars, doing housework, carrying grocery bags, and bathing. Standard physical examinations (Tinel’s test, Phalen’s test, reverse Phalen’s test, and the compression test) were also performed.ResultsA total of 111 patients who were diagnosed with intermediate-stage CTS were included in the study. At the end of treatment, significant improvements in symptoms and functionality were detected in all groups. However, the recovery of patients in Groups 1 (n=41) and 2 (n=35) were found to be significantly greater than that of patients in Group 3 (n=35; P<0.001). Patient satisfaction was investigated a mean of 11 months after treatment. Percentages of asymptomatic patients in Group 1 and Group 2 were significantly higher than in Group 3 (P=0.02 and P=0.04, respectively).ConclusionIn the intermediate stage of CTS, SCT was an effective treatment to improve symptoms and functional status. Tendon and nerve gliding exercises alone were inferior to either SCT alone or SCT in combination with gliding exercises.

The prevalence of and risk factors for hypertension in adults living in Istanbul.

The prevalence of and risk factors for hypertension were determined among habitants in the European side of Istanbul who are 25 years and older. Eight administrative districts were selected with the method of simple random sampling. The participants were selected through systematic calling from address lists. Between 17 and 22 June 2002, the questionnaires were applied to the participants in a face‐to‐face interview; then arterial blood pressures, body weights and heights of the participants were measured. Of 423 adults participating in the study, 35.5% were hypertensive; 35.9% were obese, 27.9% were overweight and 2.1% were underweight. Risk factors for hypertension such as age, gender, educational status, social security, family history of hypertension and cardiovascular disease, medical history of diabetes and congestive heart failure, smoking and alcohol use, and body mass index in the hypertensive and non‐hypertensive groups were investigated by means of logistic regression analysis. Age [odds ratio (OR): 5.20, 95% confidence interval (CI): 2.18–12.40], body mass index (OR: 2.22, 95% CI: 1.57–3.16) and smoking (OR: 0.72, 95% CI: 0.55–0.95) were found to be correlated with hypertension. The results showed that the prevalence of hypertension was high in Istanbul, and obesity, being overweight and advanced age were the risk factors for hypertension.

Subacute sclerosing panencephalitis surveillance study in Istanbul

The exact incidence rate of subacute sclerosing panencephalitis (SSPE) in Turkey (and in Istanbul) is not known. We have conducted an active surveillance study to determine the epidemiological characteristics and the incidence rate of SSPE in Istanbul between the dates July 1, 2002 and July 1, 2004. We found that the incidence of SSPE in Istanbul is 2 per million. By logistic regression analysis, risk factors in SSPE development are determined as being at younger ages (OR: 1.199, 95%CI=1.047-1.372, P=0.009), living in crowded households (OR: 1.430, 95%CI=1.039-1.968, P=0.028), low education level of the mother (OR: 0.123, 95%CI=0.034-0.447, P=0.001), low household income (OR: 0.413, 95%CI=0.234-0.728, P=0.002), infants being born out of Marmara region (Istanbul is in Marmara region of Turkey) (OR: 0.358, 95%CI: 0.172-0.746, P=0.006), infants not being vaccinated against measles (OR: 0.495, 95%CI: 0.312-0.786), infants having had measles before (OR: 0.235, 95%CI: 0.135-0.411). As a result, it is found in this study that SSPE is mostly related to having measles infection, and measles vaccination is found to be highly protective against SSPE. This is the first epidemiological study in SSPE from Turkey that conveys the incidence rate in Istanbul.

Association of HLA phenotypes of end-stage renal disease patients preparing for first transplantation with anti-HLA antibody status

Patients with pre-transplantation high levels of panel reactive antibody (PRA) have an increased risk of graft failure, and renal transplantation in sensitized patients remains a highly significant challenge worldwide. The influence of anti-human leukocyte antigen (HLA) antibodies on the development of rejection episodes depends on patient-specific clinical factors and differs from patient to patient. The HLA typing of the recipient might influence the development of anti-HLA antibodies. Some HLA antigens appear to be more immunogenic than others. The aim of this study is to demonstrate the distribution of HLA phenotypes in PRA-positive and PRA-negative end-stage renal disease (ESRD) patients on the basis of having sensitizing events or not. Our study included 642 (mean age: 41.54; female/male: 310/332) ESRD patients preparing for the first transplantation and who are on the cadaveric kidney transplantation waiting list of Istanbul Medical Faculty in 2008–2009. Class I HLA-A,B typing was performed by complement-dependent cytotoxicity (CDC) method, whereas class II HLA-DRB1 typing was performed by low-resolution polymerase chain reaction (PCR)-sequence-specific primer (SSP). All serum samples were screened for the presence of IgG type of anti-HLA class I- and II-specific antibodies by enzyme-linked-immunosorbent assay (ELISA). PRA-negative group consisted of 558 (86.9%) and PRA-positive group included 84 (13.1%) patients. We have found statistically significant frequency of HLA-A3 (p = 0.018), HLA-A66 (p = 0.04), and HLA-B18 (p = 0.006) antigens in PRA-positive patients and DRB1*07 (p = 0.02) having the highest frequency in patients with sensitizing event history but no anti-HLA development suggesting that DRB1*07 might be associated with low risk of anti-HLA antibody formation.

Impact of HLA on the Underlying Primary Diseases in Turkish Patients with End-Stage Renal Disease

The number of patients with end stage renal disease (ESRD) is increasing faster than the number of renal transplantations performed per year worldwide. Of the primary diseases leading to ESRD, diabetic nephropathy is the leading cause. The purpose of the present study is to investigate the association of HLA with the primary diseases leading to ESRD in Turkish patients. A total of 3230 individuals comprising 587 ESRD patients and 2643 healthy controls were enrolled into the study. Class I HLA-A, -B typing was performed by CDC method, while class II HLA-DRB1 typing was performed by low resolution PCR-SSP. We found a significant negative association between almost all A locus antigens and primary disease groups classified as chronic glomerulonephritis and hypertensive nephrosclerosis (p < 0.05). HLA-B58 and HLA-DRB1*03 significantly correlated with amyloidosis and diabetic nephropathy, respectively. Determination of HLAs as risk factors for primary diseases leading to ESRD might be beneficial in preventing progression to ESRD and recurrence of the primary disease post-transplantation.

Microbiological Evaluation of Indoor Air of Kindergartens in Fatih District of Istanbul

Objective: The aim of this study was to determine the total mould and bacteria levels in the kindergartens in Istanbul City, Fatih District. Materials: This is a cross sectional study and was performed in 15 preschool institutions in Fatih district in May 2007. Methods: Merck Air Sampler Mas 100 was used for measurements. Results: The total amounts of bacteria grown in the stations measured (classroom, lunch room, kitchen and toilets) were as follows: 946.43 ± 1033.79 CFU·m−3 in the morning and 849.29 ± 594 CFU·m−3 in the afternoon. Total mould numbers were 489.64 ± 441.25 CFU·m−3 in the morning and 993.39 ± 1013.52 CFU·m−3 in the afternoon. Cladosporium spp. and Aspergillus spp. were found to be the most commonly reproduced mould species. The total mould levels were found to be higher in stations with aluminium window framing and floor carpeting. Furthermore, when compared in terms of total mould levels, there was no difference between concrete and brick buildings; and also, total bacteria count was higher in brick buildings during the morning measurements. Conclusion: For providing a better indoor air quality in kindergartens, natural ventilation, polyvinyl chloride windows, concrete building, minimum furniture and textile materials (sofas, cushions, curtains and kids’ clothing) are preferable.

Evaluation of Air Quality in the City of Istanbul during the Years 2013 and 2015

Air pollution has been the most important health issue in recent years. In this study, the aim was to evaluate the results of regular measurements of air pollutants PM10 (Particulate Matter of 10 Microns in Diameter) and SO2 (Sulfur Dioxide) concentrations in the city of Istanbul by taking the years 2013 and 2015 as a sample. The data were obtained through the website http://www.havaizleme.gov.tr, which was published by the Administration of Marmara Clean Air Center of Ministry of Environment and Urbanization in Turkey. For the years 2013 and 2015, the mean SO2 concentration was 8.35 ± 6.04 and 10.60 ± 7.16 μg/m. The mean PM10 concentration was 73.06 ± 30.63 μg/m for 2013 and 51.57 ± 18.84 μg/m for 2015. The acceptable upper limit values by WHO (World Health Organization) for daily mean SO2 and PM10 concentrations respectively are 20 μg/m and 50 μg/m. In Istanbul, SO2 concentrations were above the upper limit values recommended by WHO, but PM10 concentrations during 2013 and 2015 were over the recommended limit values by WHO. As the particulate matter pollution is at high concentrations during these two years, it has shown that air pollution emerges as a problem awaiting solutions in Istanbul, where is industrially intense, highly populated and also with high traffic density.

0-14 aged children's health in the European section of Istanbul

PURPOSE: Prevention of serious disease in children is one of the important public health problems. In this study, the aim was to investigate acute diseases and especially diseases controlled primarily by vaccination in a study of children ages 0-14 and residing in the European section of Istanbul. METHODS: Using simple random sampling, children were identified in eight administrative districts in the European section of Istanbul by a non-governmental organization using address lists. The families of the children selected were initially contacted by telephone using a standardized approach during June 17-20, 2002. The parents of the 211 children (ages 0-14 years old) selected were interviewed in person. Information was sought on demographic characteristics, acute illnesses experienced by the children, immunization status, accidents, and whether or not the mother and father were related to one another. RESULTS: Among 211 children, 46.4% (n:98) were girls and 53.6% (n:113) were boys. The average age of the children were 7.08 3.91. A history of the following infectious diseases was reported: measles in 37% (n:78), mumps in 35.5% (n:75), rubella in 14.7% (n:31), varicella in 53.1% (n:112), tonsillitis in 14.7% (n:31), otitis media in 19.9% (n:42) lower respiratory system diseases in 11.4% (n:31), acute gastroenteritis in 32.2% (n:68) meningitis in 1.9% (n:4), febrile convulsions in 11.4% (n:24), hepatitis in 1.9% (n:4), and accidents in 9.5% (n:20). A total of 26.1% (n:55) of the children’s parents were related to each other. Parents of 82.5% (n:174) of the children reported that their child had been vaccinated against measles, 69.7% (n:147) against mumps, 60.7% (n:128) against rubella, 39.8% (n:84) against varicella, 11.8% (n:24) against haemophilus influenzae, and 35.1% (n:74) against hepatitis B. CONCLUSION: Although many infectious diseases in children are preventable by vaccination, these diseases remain as a substantial health problem in developing countries such as Turkey. The results reveal the need to reinforce routine immunization of children.

Hypertension prevalence and risk factors in adults in Istanbul

FGD was significantly higher (P 0.0001) in inactive IBD (81.9%; 78.8-85.0) than in Canadian householders (61.7%; 58.964.5). The prevalence of a functional bowel disorder (51.7%), irritable bowel syndrome (20.9%) and functional diarrhea (15.5%) in inactive IBD were significantly greater (P 0.01) than in Canadian householders at 41.6%, 12.1% and 8.5%, respectively. The prevalence of functional anorectal disorders at 53.7% and functional incontinence at 35.8% were also significantly higher (p 0.001) in inactive IBD compared with Canadian householders at 22.6% and 6.9%, respectively. Age and smoking were the strongest predictors of a FGD in inactive IBD while age and anxiety were the strongest predictors of FGD in inactive CD. CONCLUSION: FGDs, primarily bowel and anorectal, are significantly more prevalent in patients with inactive IBD compared to Canadian householders and may be easily confused with active IBD. (partially funded by IOIBD)