Hafize Sezer

Anticardiolipin antibody positivity in diabetic patients with and without diabetic foot

Anticardiolipin (aCL) antibodies may play a role in the enhancement of platelet aggregation and/or progression of the macrovascular diabetic complications. Also, aCL antibodies may cause or promote ischemia and thrombosis. Therefore, we aimed to investigate IgG aCL and IgM aCL antibodies positivity in type 2 diabetic patients with and without ischemic diabetic foot. In this case-control study, we examined 40 diabetic patients without diabetic foot problem and 35 diabetic patients with ischemic diabetic foot. Forty diabetic patients (19 females, 21 males) without diabetic foot served as Group 1 and 35 diabetic patients (17 females, 18 males) who had ischemic diabetic foot served as Group 2. In the control group, 35 nondiabetic healthy subjects (18 females, 17 males) were included in Group 3. The groups were similar in age and sex, which is not statistically significant (P>.05). There was no difference in the IgG aCL antibodies positivity between Groups 1 and 3 (P>.05). However, IgG aCL antibodies positivity in Group 2 was significantly higher than those of the other groups (P<.05). IgG aCL antibodies were found positive in 10% (4/40) of Group 1, 34.3% (12/35) of Group 2 and 8.6% (3/35) of Group 3. When Groups 1 and 2 were compared, the odds ratio adjusted for age, gender, hypertension, coronary artery disease history, cigarette smoking, duration of diabetes mellitus, cholesterol, and haemoglobin A(1C) (HbA1c) was 6.8 [95% confidence interval (CI), 1.41-32.66; P=.016] for aCL positivity. In conclusion, although available evidence does not prove a causal association between positivity of aCL and diabetic foot, we believe that a causal association is supported by the data obtained from this study.

The seven flap Z-plasty revisited

Although multiple Z-plasties are widely used for burn contractures, the seven flap Z-plasty procedure has not gained wide acceptance in plastic surgery practice. However, the technique has the advantage of achieving more elongation than other Z-plasty techniques. The technique safely performed with satisfactory results in 31 cases.

Systemic Prolidase Activity and Oxidative Stress in Keratoconus

ABSTRACT Aim: Our aim was to evaluate the serum prolidase activity, total antioxidant capacity (TAC) and total oxidant status (TOS) in patients with keratoconus. Material and method: A total 69 keratoconus patients and 72 control subjects with similar age and gender were evaluated within the scope of this study. The keratoconus group was divided into four stages with the modified Krumeich classification. Serum prolidase activity, TAC and TOS were measured and compared between the patient and control groups. Results: The median serum prolidase enzyme activity value was 528.3 (684.1–416.7) U/L in the keratoconus group and 606.2 (812.9–482.3) U/L in the control group. The difference between the groups was statistically significant (p = 0.027). The median TAC value was 1.24 (1.37–1.05) mmol/L in the keratoconus group and 1.29 (1.38–1.18) mmol/L in the control group. The median TOS value was 2 (4–1) μmol/L in the keratoconus group and 3 (4–2) μmol/L in the control group. There was no statistically significant difference between the two groups in terms of TAC or TOS (p = 0.113 and p = 0.366, respectively). There was a positive correlation between TAC and TOS in keratoconus group but not in the control group (r = 0.670, p = 0.001 and r = 0.141, p = 0.241, respectively). No significant relationship was seen between the keratoconus group stages and serum prolidase activity, TAS or TOS (p = 0.894, p = 0.155 and p = 0.381, respectively). Conclusion: In conclusion, a significant relationship was found between decreased serum prolidase activity and keratoconus but there was no significant relationship between keratoconus and serum TAC or TOS.

The frequency of exfoliation syndrome in the central anatolia region of Turkey.

Aim. The aim of this study was to investigate the frequency of exfoliation syndrome in the Central Anatolia region of Turkey and to evaluate its relationship with cardiovascular and ocular diseases. Methods. Patients over the age of 45 years who presented to the clinic were included in the study. All cases underwent a comprehensive ophthalmology examination. Exfoliation syndrome was diagnosed with the presence of exfoliative material on the lens anterior capsule or iris on slit lamp examination. The patients were divided into two groups as the exfoliation syndrome group and nonexfoliation syndrome group according to the presence of exfoliative material. Results. Exfoliative material was found in one or both eyes of 212 of the 2103 patients (10.1%) evaluated within the scope of the study. A significant relationship was found between exfoliation syndrome and increasing age and male gender. A significant relationship was found between exfoliation syndrome and glaucoma, cataracts, age-related macular degeneration, and phacodonesis. While no relationship was found between exfoliation syndrome and hypertension or diabetes mellitus, a significant relationship was found with coronary artery disease. Conclusion. The unilateral or bilateral exfoliation syndrome frequency was 10.1% in this hospital-based study. A statistically significant relationship was found between exfoliation syndrome and advancing age, gender, and coronary artery disease.

The prevalence of exfoliation syndrome in Turkey

To investigate the prevalence of the exfoliation syndrome and its relationship with ocular and cardiovascular diseases in the Central Anatolia region of Turkey.

Proper Evaluation of Factors Affecting Oxidative Status

We would first like to thank the authors for their interest in our study. Uric acid and unconjugated bilirubin are strong antioxidantmolecules as the authorsmention.,We are not aware of any studies on the relationship between hyperuricemia, hyperbilirubinemia, and keratoconus. However, Saijyothi et al. have reported higher tear uric acid concentration in keratoconus patients than the control group. Total oxidant status (TAS) and total antioxidant capacity (TAC) are influenced by systemic disorders and inflammatory conditions as again mentioned by the authors. We believe that we have omitted some exclusion criteria of the study. Wewould like to thank the authors for their careful evaluation.We excluded any patients with a systemic disorder, known systemic inflammation, or clinical conditions or who were currently being treated with anti-inflammatory medication or antioxidants/vitamins in both the keratoconus and the control groups in our study. The keratoconus group had no known disorder besides keratoconus and the control group had no known disorders. However, the serum TOS and TAC in the keratoconus group were not significantly different than the control group. The oxidative stress index (OSI) can provide additional information about the oxidative status as mentioned. We reevaluated our data accordingly. We calculated the oxidative stress index using the OSI (arbitrary unit) = TOS (mmol H2O2 equiv./L)/TAC (mmol Trolox Equiv./L). 5 The median OSI value was 2.12 (3.67–0.80) in the keratoconus group and 2.15 (3.39–1.44) in the control group. The difference was not statistically significant (p = 0.601). In conclusion, we think that there was no error in selecting the keratoconus and control group subjects, but information had been omitted. We did not find any difference between the groups regarding the OSI evaluation that could have made an extra contribution to the article. We thank the authors for pointing out the deficiency in the article and their contribution.