Mehmet Kirnap

A comparative study of the effects of electrical stimulation and laser treatment on experimental wound healing in rats.

We investigated the effects of electrical stimulation (ES) and laser treatment on wound healing in rats. A randomized-controlled trial, conducted at the Experimental and Clinical Research Centre of Erciyes University (Kayseri, Turkey), divided 124 healthy female Swiss-Albino rats into four groups. A 6 cm linear incision was made at the dorsal skin of all rats. Group 1 was given a constant direct current of 300 microA for 30 min per day. The current was applied in negative polarity for the first 3 days and in positive polarity for the next 7 days. Group 3 received a full-contact, continuous gallium-arsenide (GaAs) laser therapy, with a wavelength of 904 nm, an energy density of 1 J/cm2, and an average power of 6 mW for 10 min per day. The remaining two groups (Groups 2 and 4) were considered the control groups and received sham treatment. All groups were treated for 10 days. Histopathologic and biochemical evaluations were conducted on 10 rats from each group on the 4th and 10th days, and wound breaking strength was measured for biomechanical evaluation on the 25th day of the study. Both ES and laser treatment proved significantly effective in the inflammatory phase compared with control groups (p < 0.05); however, the ES was even more effective than laser treatment, with more significant results (p < 0.05). In the proliferation and maturation phases, while ES and laser treatment were both found to be significantly effective treatment methods compared with the control groups, no statistically significant difference was observed between the two treatment groups (p > 0.05). Although ES and laser treatment both were effective in the maturation phase, increasing wound breaking strength compared with their control groups (p < 0.05), there was no statistically significant difference between the two treatment groups (p > 0.05). We conclude that ES and laser treatment both have beneficial effects during the inflammatory, proliferation, and maturation phases of a wound. Both ES and laser treatment can be used successfully in decubitis ulcers and chronic wounds, in combination with conventional therapies such as daily care and debridement of wounds; however, ES has more beneficial effects during the inflammatory phase in some parameters than laser treatment.

Increased advanced oxidation protein products in Behcet's disease: a new activity marker?

Background  Behçets disease (BD) is a chronic inflammatory disease with unknown pathogenesis. As various functions of neutrophils in peripheral blood, such as chemotaxis, phagocytosis and generation of reactive oxygen species (ROS) increase in BD, ROS‐mediated oxidative stress related to neutrophil activation may have an important role in the pathogenesis of BD.

The relation between tooth loss and bone mass in postmenopausal osteoporotic women in Turkey: a multicenter study

Abstract. The purpose of this study was to investigate the associations of tooth loss with skeletal bone mass, years since menopause, educational level, current smoking status, dietary calcium intake, and number of pregnancies in postmenopausal osteoporotic women in Turkey. The study population consisted of 1171 postmenopausal women aged 40–86 years (mean age, 61.19 ± 7.28 years). A detailed history was obtained from all women, including relevant lifestyle parameters, risk factors, and measurements of weight and height. Women were separated into three groups according to the number of teeth remaining as group 1 (edentulous, 457 women), group 2 (10 or fewer teeth, 232 women), and group 3 (more than 10 teeth remaining, 482 women). There was no significant difference among the three groups in mean age and menopausal age (P < 0.05). Body mass index of group 1 was significantly higher than that of group 2 (P < 0.01). Educational level was significantly different between three groups: groups 1 and 2 (P < 0.001), groups 1 and 3 (P < 0.0001), and groups 2 and 3 (P < 0.001). Educational level was lowest in group 1 and highest in group 3. Despite a low ratio of cigarette smoking in general, a smoking habit was most prevalent in group 3 and least in group 2. The ratio of women receiving adequate calcium was significantly lower in group 1 than in other groups (P < 0.001); mean calcium intake was similar in all groups. The number of pregnancies was significantly higher in group 1 than in other groups (P < 0.001). Lumbar bone mineral density (BMD) of group 1 was significantly lower than that of groups 2 and 3 (P < 0.001). Although no significant difference was found between groups 1 and 3, femoral neck BMD of group 2 was less than in others, and differences between groups 1 and 2 and between groups 2 and 3 (P < 0.001) were significant. Lumbar bone mineral content (BMC) of group 1 was significantly lower than that of groups 2 and 3 (P < 0.001), and lumbar BMC in group 2 was significantly higher than in group 3 (P < 0.05). Femoral neck BMC in group 1 was significantly higher than in groups 2 and 3 (P < 0.001). In conclusion, lumbar BMD and BMC in the edentulous group were significantly lower, whereas femoral neck BMD and BMC were significantly higher in edentulous group compared with the others. Our findings indicated that improvement in lifestyle factors and nutritional strategies for the treatment and prevention of osteoporosis may have additional benefit in reducing tooth loss.

Comparison of the effects of laser and ultrasound treatments on experimental wound healing in rats.

A randomized controlled study investigated the effects of ultrasound and laser treatments on wound healing in rats. The duration of the inflammatory phase decreased with both laser and ultrasound treatments; however, laser was more effective than ultrasound, with more significant results. The proliferation phase showed, for both treatments, an increase in the level of hydroxyproline and the number of fibroblasts, as well as stimulation of the collagen synthesis and the composition. Laser treatment was again more effective than ultrasound. The wound breaking strength was significantly higher with both treatments, and no statistically significant difference emerged between the laser and ultrasound groups, although laser treatment provided a much greater increase in the wound breaking strength than ultrasound. Both treatments have beneficial effects on the inflammatory, proliferation, and maturation phases of wound healing. Both can be used successfully for decubitis ulcers and chronic wounds, in conjunction with conventional therapies such as debridement and daily wound caring. However, laser treatment was more effective than ultrasound in the first two phases of wound healing.

Correlations among enthesitis, clinical, radiographic and quality of life parameters in patients with ankylosing spondylitis.

Abstract Objectives. To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). Methods. A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Results. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Conclusions. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS.

Acrodysostosis associated with hypercalcemia.

An 18-year-old man was admitted to the clinic complaining of deterioration in the function of his hands and feet. The clinical examination revealed that his movements were clumsy and that he had disproportionally short limbs. In addition, he also had facial abnormalities of frontal bossing, hypertelorism, maxillary hypoplasia, broad low nasal bridge, short upturned nose with anteverted nostrils and triangular mouth. All extremities appeared short with stubby fingers and toes and with broad hands and wrinkling of the dorsal skin. Chromosomal analysis showed a normal (46, XY) karyotype. X-ray studies revealed broad, short metacarpals and phalanges with cone-shaped epiphyses and brachycdactyly and a diagnosis of peripheral dysostosis was confirmed by the characteristic radiographic appearance of the hands. Serum calcium and alkaline phosphatase levels were high, parathormone (PTH) was low, but 25 (OH) Vitamin D, albumin, and 24 hour urine calcium levels were in the normal range. Based on these findings, a diagnosis of acrodysostosis associated with hypercalcemia was made. To the best of our knowledge, this represents the first description of this syndrome.

Prevalence of Rheumatoid Arthritis and Spondyloarthritis in Turkey: A Nationwide Study

Objectives This study aims to estimate the prevalence of rheumatoid arthritis (RA) and spondyloarthritis (SpA) in Turkey using the same telephone questionnaire developed for screening RA and SpA in France and used in Serbia and Lithuania. Material and methods The study was performed in two steps. In step I, the French questionnaire was translated into Turkish and validated through a group of 200 patients (80 males, 120 females; mean age 44.0±13.1 years; range 19 to 75 years) followed up at the rheumatology departments of University Hospitals in Antalya and Ankara. In step II, the validated Turkish questionnaire was administered face-to-face to randomly selected 4,012 subjects (1,670 males, 2,342 females; mean age 41.5±16.8 years; range 16 to 97 years) by trained general practitioners across the country, in 25 prov- inces for case detection. The subjects who were suspected of having RA or SpA in accordance with the questionnaire were invited to the nearest university hospital for rheumatologic examination in order to confirm the diagnosis. Results In step II, a total of 25 subjects (2 males, 23 females) were diagnosed as RA. The standardized RA prevalence for the general population of Turkey was calculated as 0.56% (95% confidence interval [CI]; 0.33-0.79), 0.10% (95% CI; -0.05-0.25) for males and 0.89% (95% CI; 0.51-1.27) for females. A total of 18 subjects (3 males, 15 females) were diagnosed as SpA. The standardized SpA prevalence for the general population of Turkey was 0.46% (95% CI; 0.25-0.67), 0.17% (95% CI; -0.03-0.37) for males and 0.65% (95% CI; 0.32-0.98) for females. The prevalence of RA was highest in the Northern region (2.00%) and the prevalence of SpA was highest in the Central region (1.49%). Conclusion The prevalences of RA and SpA in Turkey are close to each other and there are significant inter-regional variations in prevalences of both RA and SpA.