Beyhan Özyurt

An evaluation of quality of life of mothers of children with enuresis nocturna

The aim of this study was to evaluate the impact of enuresis nocturna on quality of life of the mothers. Mothers who have a child with monosymptomatic nocturnal enuresis (n = 28) and mothers who have a child without any health problems (n = 38) were enrolled in the study. Groups were in balance for background variables (child’s age, gender, and number of siblings; mother’s age, marital status, highest year of education completed, and occupation; presence of health insurance; and type of residence). Short-Form Health Survey (SF-36) Questionnaire, the Beck Depression Inventory (BDI), and Spielberg’s State-Trait Anxiety Inventory (STAI) were applied to all mothers. The mothers of children with enuresis had significantly lower quality-of-life scores in the SF-36 for the bodily pain (p = 0.015) and role emotional (p = 0.014) subscales. We observed significant difference between groups according to BDI; mean score was higher in mothers who have a child with enuresis nocturna (p = 0.017). There was no significant difference between groups according to the STAI. Significant differences according to bodily pain and role emotional subscales of SF-36, and the BDI scores, show that the mothers were negatively affected by having a child with monosymptomatic nocturnal enuresis.

CT study on morphometry of frontal sinus

The aim of this study was to determine the prevalence and morphological characteristics of the frontal sinus in an adult population. This study was conducted retrospectively on paranasal CT scans in the axial and coronal planes of 300 cases (123 male and 177 female). The mean age was 40.74 ± 13.34 (range 20–83). Measurements of the width, height and anteroposterior length for each sinus and total width were obtained from CT scans. Measurements were compared statistically with relation to side and sex. The cases were divided into subgroups according to age for each sex and each measurement parameter was also compared among the subgroups. All measurements tended to be larger on the left side and were significantly larger in males than females. There was a significant difference in the anteroposterior lengths of right and left sides in both males and females and height for males and width for females. In both sexes, the highest values of measurements were usually observed at the 31–40 age group and there was a tendency to decrease with aging. The larger diameters of the left frontal sinus imply that it may be more possibly violated during surgical interventions. Morphometric features differed significantly in the two sexes at different ages and comparison with previous studies presented great regional variability. The size of the frontal sinus was seen to be related to age and sex. The knowledge provided in the present study is useful for some surgical procedures and widens the anthropometric knowledge of humanity. Clin. Anat. 21:287–293, 2008.

Vitamin D receptor gene polymorphism in children with urinary tract infection

It is known that small alterations leading to different vitamin D receptor (VDR) alleles affect resistance or susceptibility to infections. In this study, we examined VDR gene polymorphisms in urinary tract infections (UTI), which are common and an important cause of morbidity in children and subsequently of renal scar formation. We evaluated 92 patients diagnosed with UTI and 105 children without prior history of UTI as a control group. The VDR gene polymorphisms BsmI, FokI, ApaI, and TaqI were evaluated in patients and controls. BsmI polymorphism genotype distribution was similar between groups. There was a significant difference between groups for FokI (p = 0 < 001); for the ff genotype, the risk of UTI was significantly increased (p < 0.01) ,at 3.94 times higher (odds ratio = 3.94; 95% confidence interval 1.71-9.09). ApaI polymorphism was significantly increased in the control group (p < 0.01) and evaluated as a protective factor. Comparing the TaqI genotype between groups, there was no statistically significant difference, but in both Tt and tt genotypes, there was minimal increased risk of UTI. The results of this study suggest that VDR gene polymorphisms can be important for susceptibility to UTI and renal scar formation. Association between VDR polymorphisms and UTI is in accordance with the understanding of how vitamin D modulates the immune response against infections.

Relationship between BODE index, quality of life and inflammatory cytokines in COPD patients

Background and aimsRecently a multidimensional grading system based on the body mass index (B), degree of airflow obstruction (O), dyspnea (D) and exercise capacity (E) - the BODE index - has begun to be used increasingly for the evaluation of chronic obstructive pulmonary disease (COPD) patients. The aim of our study was to investigate the relationship between the BODE index and disease duration, annual exacerbation and hospitalization rates, health related quality of life and systemic inflammatory markers like C-reactive protein (CRP), tumor necrosis factor (TNF)-α and interleukin (IL)-8.Materials and methodsIn 88 stable COPD patients we evaluated the body-mass index, pulmonary function tests, Modified Medical Research Council dyspnea scale and six-minute walk test (6 MWT). BODE scores were determined. Disease duration, number of exacerbations and hospitalization in the previous year were recorded. We also performed arterial blood gases analysis, administered the St. Georges Respiratory Questionnaire (SGRQ) and measured serum levels of CRP, TNF-α, IL-8.ResultsAccording to BODE score 52% of patients were BODE 1, 21% BODE 2, 15% BODE 3 and 12% were BODE 4. There was a significant relationship between BODE index and COPD stage as classified according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) (p < 0.001). Correlations between BODE score and disease duration (p = 0.011), number of exacerbations (p < 0.001) and hospitalizations (p < 0.001) in the last year were also observed. SGRQ symptom, activity, emotion scores and total scores were found to be significantly correlated to BODE (p < 0.001). Serum CRP levels and BODE were also correlated (p = 0.014); however, no correlation was found between serum levels of TNF-α and IL-8 and BODE.ConclusionsAs the BODE index shows a strong correlation with various prognostic and follow up parameters of COPD and systemic inflammation, its use should be considered for the evaluation of COPD patients.RiassuntoRazionale e scopiNella valutazione dei pazienti con broncopneumopatia cronica ostruttiva (BPCO) è recentemente invalso l’uso in modo crescente di un sistema multidimensionale di misura basato su indice di massa corporea (B), entità dell’ostruzione funzionale respiratoria (O), dispnea (D) e capacità di esercizio fisico (E): l’indice BODE. Scopo del nostro studio era valutare la correlazione tra l’indice BODE e la storia di malattia, il numero di riacutizzazioni annue e il tasso di ospedalizzazioni, la qualità della vita legata alla salute e marker infiammatori sistemici come la proteina C reattiva (PCR), il fattore di necrosi tumorale (TNF)-α e l’interleuchina (IL)-8.Materiali e metodiAbbiamo valutato in 88 pazienti con BPCO stabile l’indice di massa corporea, le prove di funzionalità respiratoria, la scala Modified Medical Research Council della dispnea ed il test del cammino di 6 minuti (6MWT). Sono stati calcolati i punteggi BODE. Sono state registrate la durata della malattia, il numero di riacutizzazioni e di ospedalizzazioni nell’anno precedente. Inoltre sono state effettuate l’emogasanalisi, il St. George’s Respiratory Questionnaire (SGRQ) e determinati i livelli serici di PCR, TNF-α e IL-8.RisultatiSecondo il punteggio BODE 52% dei pazienti erano BODE 1, 21% BODE 2, 15% BODE 3 e 12% erano BODE 4. La correlazione era significativa (p < 0,001) tra indice BODE e stadio della BPCO determinato secondo la stadiazione del Global Initiative for Chronic Obstructive Lung Disease (GOLD). Erano significative anche le correlazioni tra punteggio BODE e durata di malattia (p = 0,011), numero di riacutizzazioni (p < 0,001) e ospedalizzazioni (p < 0,001) nell’ultimo anno. Il punteggio totale del SGRQ e dei campi sintomi, attività e emozioni era significativamente correlato al BODE (p < 0,001). Anche i livelli serici di PCR e il BODE erano correlati (p = 0,014), mentre non si è rilevata alcuna correlazione tra TNF-α e IL-8 con il BODE.ConclusioniDal momento che l’indice BODE mostra una forte correlazione con vari indici di prognosi, di follow up ed infiammatori nella BPCO, una sua applicazione sistematica dovrebbe essere presa in considerazione nella valutazione dei pazienti con BPCO.

A comparative analysis of the decongestive effect of oxymetazoline and xylometazoline in healthy subjects

BackgroundOxymetazoline and xylometazoline are locally effective and direct acting drugs that relieve nasal congestion. The aim of this study was to objectively determine and compare the decongestive effects of oxymetazoline and xylometazoline in healthy subjects.MethodsThe study population comprised thirty healthy adults. All subjects underwent active anterior rhinomanometry (AARhm) and acoustic rhinometry (AR) tests following the application of oxymetazoline, xylometazoline, or placebo (physiological saline). The change in nasal resistance, nasal airflow, and different cross-sectional areas (CSAs) of the nasal cavity in the subjects were examined for each solution separately. The measurements were obtained over a 1-h period (baseline and 1, 15, 30, and 60 min post-dosing). All results were analyzed using the Kruskal–Wallis test and the Mann–Whitney U test.ResultsA total of 6,300 measurements of AARhm and AR were obtained. The application of placebo did not cause a statistically significant change in nasal resistance, nasal airflow, and CSAs (CSA1, 2, and 3, respectively) of the nasal cavity. In contrast, statistically significant changes in nasal resistance (inspiration p = 0.000 and p = 0.004; expiration p = 0.000 and p = 0.000), nasal airflow (inspiration p = 0.000 and p = 0.004; expiration p = 0.000 and p = 0.000), and CSAs of the nasal cavity (CSA2 p = 0.000 and p = 0.000, CSA3 p = 0.000 and p = 0.00), with the exception of CSA1 (p = 0.982 and p = 0.994), were obtained after the application of oxymetazoline and xylometazoline. A comparison of oxymetazoline and xylometazoline based on nasal resistance, nasal airflow, and CSAs of the nasal cavity demonstrated no statistically significant difference, except for CSA3.ConclusionOxymetazoline and xylometazoline are fast-acting and potent topical decongestants that have similar decongestive effects.

Factors affecting the interval from diagnosis to treatment in patients with lung cancer.

AIMS AND BACKGROUND We aimed to investigate the factors affecting the interval from the beginning of the symptoms until diagnosis and treatment in patients with lung cancer. METHODS Records of 119 lung cancer patients diagnosed in our pulmonary diseases clinic between 2004 and 2006 were evaluated retrospectively. Demographic data, histopathological tumor type, TNM stage, ECOG performance status, presence of endobronchial lesions, and radiological localization of the tumor were determined. Intervals from the first symptom to contacting a doctor, to diagnosis and to treatment were calculated. The interval from first admission to a clinic and referral to a chest physician was also calculated. RESULTS Of 119 patients, 74% were diagnosed as non-small cell and 26% were as small cell lung cancer. Forty-eight percent of the patients were at stage 3B and 36% were at stage 4. ECOG performance status was 0 in 6%, 1 in 52%, 2 in 36%, 3 in 3%, and 4 in 2%. Endobronchial lesions were observed in 50% of the patients, and the lesions had a central radiological localization in 59%. Fifty-four percent of the patients presented to a chest physician first. Patients who first presented to an internal medicine clinic were referred to our pulmonary disease clinic significantly later than those who presented to other clinics (P = 0.005). The median period from the beginning of the symptoms until contacting a doctor was 35 days (range, 1-387), until diagnosis was 49 days (range, 12-396), and until beginning the treatment was 57 (range, 9-397) days. The presence of endobronchial lesions, radiological localization, TNM stage and ECOG performance status were not found to be related to the intervals from the first symptom to presentation to a doctor, to diagnosis or to the beginning of the treatment. CONCLUSIONS Lung cancer patients consult a doctor after a relatively long symptomatic period. Patient delays may be shortened by increasing the awareness of patients about lung cancer symptoms. Diagnostic procedures should be performed more rapidly to shorten doctor delays.

Incidence of intestinal parasites detected in the Department of Parasitology in Celal Bayar University Hospital between 2006 and 2010

OBJECTIVE Results of 17.711 patien admitted to the Department of Parasitology in Celal Bayar University Hospital for parasitological stool examination between January 2006 and December 2010 were evaluated. METHODS All stool samples were examined with wet mounts, formalin ethyl acetate concentration and trichrome staining methods. In addition, cellophane tape preparations from 5952 patients were evaluated. RESULTS Intestinal parasites were detected in 2337 (13.12%) of 17.711 patients who were admitted during a five year period. The highest parasite infected individual ratio (16.69%) was found in 2008. The most frequently identified intestinal parasites were Blastocystis spp. 1353 (7.64%) and Giardia intestinalis 348 (1.96%) in stool samples, with Enterobius vermicularis 253 (4.25%) in cellophane tape preparations. Two or more parasites were detected in 158 (6.76%) of the positive cases. The mean age of persons identified as having a parasite was 21.9. Parasite incidence was 10.7% in females, and 13.6% in males (p < 0.001). The highest ratio was 23.8% in patients who lived in rural areas when all positive cases were evaluated in terms of settlement areas. CONCLUSION While Blastocystis spp., E. vermicularis and G. intestinalis were the most frequently detected intestinal parasites in our province, intestinal parasites still remain important despite advances in infrastructure in recent years.

Analysis of the association of chronic spontaneous urticaria with interlekin-4, -10, transforming growth factor-β1, interferon-γ, interleukin-17A and -23 by autologous serum skin test

Aim To contribute to the understanding of the pathogenesis of chronic spontaneous urticaria (CSU) by identifying its relationship with autoimmunity and cytokines using the autologous serum skin test (ASST) and peripheral blood mononuclear cell culture (PBMC) method. Material and methods Interleukins (IL)-4, IL-10, transforming growth factor (TGF-β1), interferon (IFN)-γ, IL-17A, and IL-23 levels in cell supernatants obtained by the PBMC method were measured using ELISA. Disease activity was assessed by determining the urticaria activity score (UAS). Results A total of 40 patients diagnosed with CSU participated in this study. Twenty patients had positive ASST results, and 20 had negative results. The control group included 20 healthy volunteers. We found that the IL-23 (p = 0.01), IL-10 (p = 0.04) and IL-4 (p = 0.04) levels of the patient groups were significantly lower compared with those of the control group. The IL-23 (p = 0.009), IL-10 (p = 0.009), IL-4 (p = 0.001), and IL-17 (p = 0.05) levels of the ASST(–) patient group were significantly lower compared with those of the control group. In addition, the IL-4 (p = 0.03) and IFN-γ (p = 0.05) levels of the ASST(+) patient group were significantly lower compared with those of the control group, and the ASST(+) patients had a significantly higher UAS than the ASST(–) patients (p = 0.021). Conclusions These results, when considered together with current reports in the literature, indicate that immune dysregulation occurs in the pathogenesis of CSU, causing cytokine imbalance.

Allergic rhinitis and its relationship with autoimmune thyroid diseases.

Background Autoimmune thyroid diseases are the most common of all autoimmune diseases. In the literature, Hashimoto thyroiditis (HT) is considered to be a T-helper (Th) type 1 dominant condition, and Graves disease is considered a Th2-dominant condition. Objective The aim of this study was to highlight a new aspect of the relationships among Th cell subgroups by determining the incidence of autoimmune thyroid disease in patients with allergic rhinitis (AR). Methods Patients were diagnosed with AR based on their medical histories, physical examinations, and skin-prick test results in an outpatient clinic. The levels of free triiodothyronine, free thyroxine, thyroid-stimulating hormone, thyroid peroxidase antibodies, and thyroglobulin antibodies were measured in peripheral blood samples from all study subjects. Results A total of 1239 patients with AR and 700 consecutive, age- and sex-matched healthy subjects were included in the study. Thyroid function tests showed that 1037 patients with AR (83.7%) had normal thyroid function, 171 (13.8%) had euthyroid HT, and 31 (2.5%) had hypothyroid HT. Among the control subjects, thyroid function test results showed that 688 subjects (98.2%) had normal thyroid function, 10 subjects (1.4%) had euthyroid HT, and 2 subjects(0.4%) had hypothyroid HT. Conclusion The incidence of HT in the general population is 1.5%; in contrast, it was observed in 16.3% of our patients with AR, which represented a much higher rate than that in the overall population. Graves disease was not detected in our study subjects. A high incidence of HT in patients with AR, in which Th2 responses are dominant, indicates that further studies of the relationships among atopy, autoimmune diseases, and Th cell subgroups are needed.

The importance of metric view for photodocumentation of facial reconstructive surgery: a single blinded survey

Photodocumentation is an essential part of dermatooncology and reconstructive surgery. The purpose of this study is to suggest an imaging technique named metric view (photograph of the lesion with a surgical ruler) and to assess the accuracy of different views. Frontal, close-up and metric views were taken from the lesions of ten different cases. All the photographs were showed to 30 medical professionals and a prediction about the size of the lesion was requested individually. The relationship between the prediction values for three views and the exact size of the lesions were statistically analysed. The precise prediction of the exact size was only achieved in metric view of one case. In addition, the most approximate prediction values were obtained in metric views. The statistical analysis demonstrated that there was no statistically significant difference between the prediction values for metric view and exact size of the lesions in half of the cases. In contrast, statistically significant differences were detected in almost all of the prediction values for frontal and close-up views. Frontal and close-up views are not adequate to represent the size of the lesions. Metric view may enable a rational solution for a better representation.