Deniz Çalışkan

The prevalence of Behçet's disease above the age of 10 years. The results of a pilot study conducted at the Park Primary Health Care Center in Ankara, Turkey.

PURPOSE The aim of this study was to determine the prevalence of Behçet’s disease above the age of 10 years by means of a population-based study. METHODS The epidemiological investigation (cross-sectional study) was made between May 1997 and May 1998 at the Park Primary Health Care Center, which is one of the education and research divisions of the Department of Public Health, Faculty of Medicine, Ankara University. The research aimed to cover all 17,256 (49.2% male, 50.8% female) inhabitants over 10 years of age living in this area. The screening team first surveyed and selected patients with recurrent aphthous stomatitis. These patients were further examined, free of charge, in the Preventive Ophthalmology Unit of the Public Health Center, at Ibni Sina Hospital’s Behçet Center or in other clinics if necessary. In this study the International Study Group For Behçet’s disease Criteria were used. RESULTS As the final result of the screening, 11 female and 5 male patients with Behçet’s disease were found (female/male = 2.2). These patients represented 9 already known and 7 newly diagnosed cases of Behçet’s disease. The prevalence of Behçet’s disease over 10 years of age is 0.11%. CONCLUSION The existing regional prevalance studies conducted in Turkey have indicated that the real number of Behçet’s patients in our country is markedly higher than the number of registered patients. Therefore the National Behçet’s Disease Commity and Surveillance System was founded by our research group in December 1999.

The prevalence of blindness and low vision in older onset diabetes mellitus and associated factors: A community-based study

Purpose This community-based study was conducted to assess the prevalence and related factors of low vision and legal blindness in older onset diabetic patients (diagnosed at age 30 and older). Methods All known diabetic patients who live in the four primary health care center region Abidinpaşa Ankara, Turkey (total population: 96,348) were included in this cross-sectional study. The prevalence of known diabetes mellitus is 2.2%, of which 96.6% are older onset and 3.4% are younger onset. Results In the older onset diabetes group (1289 cases), 10.8% of the population had low vision and only 2.7% had legal blindness. Diabetic retinopathy (DR) was observed in 23.6% of the patients with low vision (42% proliferative DR) and in 62.9% of the patients with legal blindness (90.1% proliferative DR). Conclusions In older onset diabetic patients with low vision, nonproliferative retinopathy was a more frequent cause of impaired vision than proliferative retinopathy. Low vision and legal blindness caused by retinopathy were significantly associated with sex, age at examination, age at diagnosis, duration of diabetes, type of diabetes treatment, and hypertension in univariate analysis. However, in logistic regression analysis, low vision and legal blindness caused by retinopathy were found to be associated with longer duration of diabetes (≥15 years), use of insulin, and hypertension.

Validation and reliability of the Cardiff Visual Ability Questionnaire for Children using Rasch analysis in a Turkish population

Aim To develop a Turkish version of the 25-item Cardiff Visual Ability Questionnaire for Children (CVAQC) and to evaluate the validity and reliability of the questionnaire. Methods The study involved two main phases. The first phase involved a cross-cultural adaptation of the CVAQC from English into Turkish. The second phase involved the completion of the Turkish version of the CVAQC by 150 partially sighted children (6–18 years old) and validity and reliability checks. Extent and construct validity were investigated using Rasch analysis and reliability by internal consistency and person separation index (PSI). Results An adequate conceptual equivalence was achieved following the linguistic adaptation process. The dataset for validation comprised 150 participants, 88 (58.7%) of whom were male. Evidence of disordered thresholds was found for one item (item 17). This item was recorded by collapsing two categories and ordered thresholds were evident. All items of the CVAQC were found to fit the Rasch model (χ² (df)=59.90 (2), p=0.159). The internal construct validity was good (mean item fit (SD) −0.054 (1.132), person fit (SD) −0.629 (2.079)) indicating a single underlying construct. The reliability was good with Cronbachs α of 0.91 and PSI of 0.94. Differential item functioning (DIF) was tested for age, sex, diagnosis, degree of visual impairment, and comorbidity. Evidence of DIF was found on age for one item (item 10, reading the board at school). Conclusions The Turkish version of the CVAQC is a valid, reliable, and unidimensional questionnaire for partially sighted children aged 6–18 years. Trial registration number Ankara University Ethics Committees registry number 06-177-12.

Risk Factors and Frequency of Ingrown Nails in Adult Diabetic Patients

&NA; The present study evaluated the properties of nails, frequency of ingrown nails in patients with type 2 diabetes mellitus (DM), risk factors for developing ingrown nails, and effect of diabetic polyneuropathy and vasculopathy on the development and outcome of ingrown nails. Our 6‐month epidemiologic prospective study included 300 patients with type 2 DM attending a DM outpatient clinic for routine examinations. The general characteristics and foot changes of the study population were investigated. Diabetic polyneuropathy and vasculopathy were evaluated using a biothesiometer, monofilament tests, and arterial Doppler ultrasonography. The frequency of ingrown nails was 13.6%. Multivariate analysis with logistic regression showed that body mass index (odds ratio [OR] 1.077, 95% confidence interval [CI] 1.007 to 1.15; p = .03), previous trauma (OR 2.828, 95% CI 1.017 to 7,867, p = .042), a weak dorsalis pedis pulse (OR 2.72, 95% CI 1.17 to 6.30, p = .02), trimming type (OR 2.3, 95 CI 1.06 to 4.98), p = .35), onychogryphosis (OR 9.036, 95% CI 2.34 to 34.87, p = .001), and subungual hyperkeratosis (OR 4.3, 95% CI 1.99 to 9.3, p = .001) were predictive variables for ingrown nails in our population. The incidence of onychomycosis was significantly greater in patients with ingrown nails (p = .032) than in patients without ingrown nails. The nail curvature ratio was greater in the patients with ingrown nails than in the group with normal nails. Arterial Doppler ultrasound examinations showed peripheral arterial disease in 19 patients (46.9%) with ingrown nails. The prevalence of ingrown nails was greater in the patients with DM than in the healthy population. Our results indicate that nail type, nail morphology, and diabetic vasculopathy affect the formation and evolution of ingrown nails. &NA; Level of Clinical Evidence: 3

Clinical Characteristics and Low Vision Rehabilitation Methods for Partially Sighted School-Age Children

Objectives: To determine the clinical features and the distribution of diagnosis in partially sighted school-age children, to report the chosen low vision rehabilitation methods and to emphasize the importance of low vision rehabilitation. Materials and Methods: The study included 150 partially sighted children between the ages of 6 and 18 years. The distribution of diagnosis, accompanying ocular findings, visual acuity of the children both for near and distance with and without low vision devices, and the methods of low vision rehabilitation (for distance and for near) were determined. The demographic characteristics of the children and the parental consanguinity were recorded. Results: The mean age of children was 10.6 years and the median age was 10 years; 88 (58.7%) of them were male and 62 (41.3%) of them were female. According to distribution of diagnoses among the children, the most frequent diagnosis was hereditary fundus dystrophies (36%) followed by cortical visual impairment (18%). The most frequently used rehabilitation methods were: telescopic lenses (91.3%) for distance vision; magnifiers (38.7%) and telemicroscopic systems (26.0%) for near vision. A significant improvement in visual acuity both for distance and near vision were determined with low vision aids. Conclusion: A significant improvement in visual acuity can be achieved both for distance and near vision with low vision rehabilitation in partially sighted school-age children. It is important for ophthalmologists and pediatricians to guide parents and children to low vision rehabilitation.