Seçkin Ulusoy

The “physician on call patient engagement trial” (POPET): measuring the impact of a mobile patient engagement application on health outcomes and quality of life in allergic rhinitis and asthma patients

In this prospective, multicenter, randomized, controlled, double‐blind study, we investigated the impact of a mobile patient engagement application on health outcomes and quality of life in allergic rhinitis (AR) and asthma patients.

Aesthetic analysis of the ideal eyebrow shape and position

The aesthetic importance of the eyebrow has been highlighted for centuries. In this paper, we investigated ideal eyebrow. Eyebrows and eyelids, varies among different races, ages and genders. It is considered to be of primary importance in facial expression and beauty. We present one form of the ideal eyebrow aesthetic and discuss methods of optimising surgical results. For the modern acceptable concept of the ideal brow, the medial brow should begin on the same vertical plane as the lateral extent of the ala and the inner canthus and end laterally at an oblique line drawn from the most lateral point of the ala through the lateral canthus. The medial and lateral ends of the brow lie approximately at the same horizontal level. The apex lies on a vertical line directly above the lateral limbus. Individual perceptions and expectations also differ from person to person. The brow should over lie the orbital rim in males and be several millimetres above the rim in female. Male tend to have a heavier, thicker brow with a little arch present. There are some pitfalls in brow aesthetics. Overelevation creates an unnatural, surprised and unintelligent look which is the most common surgical mistake in brow lifting. Medial placement of the brow peak would create an undesired ‘surprised’ appearance. Moreover, a low medial brow with a high lateral peak induces an angry look. Overresection of the medial brow depressors may lead to widening and elevation of the medial brow, which creates an insensitive look and can also lead to glabellar contour defects. It is impossible to define an ideal eyebrow that is suitable for every face. However, one must consider previously described criteria and other periorbital structures when performing a brow surgery.

A New Oxidative Stress Marker for Thiol-Disulphide Homeostasis in Seasonal Allergic Rhinitis:

Background Reactive oxygen species has a crucial role in the pathogenesis of many diseases. Reactive oxygen species has been effectively documented in patients with asthma, but very little research has been reported in subjects with allergic rhinitis. Objectives To investigate thiol (SH)–disulfide (SS) homeostasis, a new oxidative stress marker present in patients with seasonal allergic rhinitis (SAR). Methods A total of 64 subjects, including 32 patients with SAR and 32 healthy controls, were included in the study. We measured the SH levels as a marker of antioxidant protection and SS as a marker related to oxidant stress. Sera specimens were taken from patients with SAR during exacerbation and during asymptomatic time periods. In addition, sera samples from the control group were also obtained during the pollen season to compare with those from patients with SAR. Results In patients with SAR, during exacerbation periods, SH, SS, % SS/SH, % SS to total SH (TT), and % SH/TT were significantly different (p < 0.05) than in patients with SAR during asymptomatic periods. Although SS was significantly higher in patents with SAR during exacerbation periods, SH was significantly higher in patients with SAR during asymptomatic periods. Patients with SAR during asymptomatic periods and the control group did not significantly differ (p > 0.05) regarding SH, SS, TT, % SS/SH, % SS/TT, and % SH/TT. Conclusion SAR is a disorder that elevates systemic oxidative stress and reduces antioxidant enzyme activities. Our results shed light on the etiopathogenesis of the disease and can help develop new therapeutic approaches.

Thiol/disulfide homeostasis as a novel indicator of oxidative stress in obstructive sleep apnea patients.

The aim of the present study was to assess thiol/disulfide (SS) homeostasis as a novel indicator of oxidative stress in patients with obstructive sleep apnea (OSA) and to investigate the effect of continuous positive airway pressure (CPAP) therapy on oxidative parameters.

Antileukotrienes in adenotonsillar hypertrophy: a review of the literature

We assessed the use of antileukotrienes for treating adenotonsillar hypertrophy. We reviewed the current literature on the anatomy of adenotonsillar tissue, adenotonsillar hypertrophy/hyperplasia (and the associated pathophysiology and symptoms), and the effects of antileukotrienes used to treat adenotonsillar hypertrophy. Leukotrienes (LTs) are inflammatory mediators produced by a number of cell types, including mast cells, eosinophils, basophils, macrophages, and monocytes. There are several types (e.g., LTA4, LTB4, LTC4, LTD4, and LTE4). By competitive binding to the cysLT1 receptor, LT-receptor antagonist drugs such as montelukast, zafirlukast, and pranlukast block the effects of cySHLTs, improving the symptoms of some chronic respiratory diseases. High numbers of LT receptors have been found in the tonsils of children with obstructive sleep apnea. Antileukotrienes reduce the apnea–hypopnea index and adenotonsillar inflammation. Antileukotrienes may be useful for children with adenotonsillar hypertrophy due to their anti-inflammatory effects, which help to reduce adenotonsillar inflammation.

Does iron deficiency anemia affect olfactory function

Abstract Conclusion This study found a negative effect of IDA on olfactory function. IDA leads to a reduction in olfactory function, and decreases in hemoglobin levels result in further reduction in olfactory function. Objective This study examined the effects of iron-deficiency anemia (IDA) on olfactory function. Method The study enrolled 50 IDA patients and 50 healthy subjects. Olfactory function was evaluated using the Sniffin’ Sticks olfactory test. The diagnosis of IDA was made according to World Health Organization (WHO) criteria. Results Patients with IDA had a significantly lower threshold, discrimination, and identification (TDI) value, and a lower threshold compared with the control group. However, there were no significant differences between the groups in terms of smell selectivity values.

Effects of Use of a Continuous Positive Airway Pressure Device on Glaucoma

Background The aim of this study was to investigate the prevalence of glaucoma in obstructive sleep apnea syndrome (OSAS) and to determine the efficacy of the equipment used in the treatment of this disease. Material/Methods In this cross-sectional study, 38 patients with OSAS used the continuous positive airway pressure (CPAP) device (Group 1) and 32 patients with OSAS refused CPAP device (Group 2). Thirty-six patients did not have OSAS (Group 3). Results Patient age, gender, height, weight, and neck circumference did not differ among groups (p>0.05); and the apnea-hypopnea index (AHI) and respiratory disturbance index (RDI) values did not differ between Groups 1 and 2 (p>0.05). Vision and pachymetric values did not differ among groups (p>0.05). The IOP was significantly higher in Group 2 than in Group 1 (p<0.05) but did not differ between Groups 1 and 3 (p>0.05). The fundus C/D ratio was significantly higher (p<0.05) in Group 2 than in the other groups but did not differ between Groups 1 and 3 (p>0.05). In Group 1, 2, and 3, 5.2%, 12.5%, and 0%, respectively, of patients had glaucoma. Conclusions OSAS should be considered a significant risk factor for glaucoma. Eye tests may help to identify individuals with undiagnosed OSAS, and such testing of patients with diagnosed OSAS may allow early detection of glaucoma and referral of such patients for CPAP therapy to prevent development of complications.

The Effects of Nasal Packing and Transseptal Suturing After Septoplasty on Olfactory Function, Patient Comfort, and Mucociliary Clearance.

Background:This study compared the effects of nasal packing and transseptal suturing after septoplasty by evaluating olfactory function, pain, and mucociliary clearance. Methods:The study enrolled 39 patients diagnosed with isolated septal deviation. The patients were randomly assigned to 2 groups. In Group A (n = 21), transseptal sutures were placed for septal stabilization after the septoplasty. In Group B (n = 18), both nasal passages were packed with Merocel tampons after the septoplasty. It was made Sniffin Sticks test, sacchranirine test, and pain and discomfort scales preoperatively, 1 week postoperatively and 3 months postoperatively on all patients. Results:There was no postoperative bleeding, submucoperichondrial haematoma, or abscess formation in either group. The postoperative discomfort and pain scores were increased in Group B (the packing group) in our study, the mucociliary clearance improved after septoplasty in both groups, and there was no significant difference in mucociliary clearance between the 2 groups. The odor threshold, odor identification, and odor discrimination were significantly increased 3 months postoperatively, but not 1 week postoperatively. Conclusions:Nasal packing causes more discomfort and pain than transseptal suturing, while there was no significant difference in olfactory functions or the mucociliary clearance after septoplasty between nasal packing and transseptal suturing.

Modified Mallampati Score Improves Specificity of STOP-BANG Questionnaire for Obstructive Sleep Apnea.

Background: An accurate, clinical screening tool for obstructive sleep apnea (OSA) that identifies patients for further diagnostic testing would assist in the diagnosis of this comorbidity. One example, the STOP-BANG questionnaire (SBQ), has been validated as a screening tool with high sensitivity. However, its specificity may result in a high false-positive rate. The aim of this study to determine if addition of the Modified Mallampati score to the SBQ improves its specificity. Methods: The authors studied 162 patients referred to the Sleep Disorders Clinic at Yedikule Chest Disease Education and Research Hospital. All patients were prospectively screened for risk of OSA using the SBQ, their oral anatomy was assessed by Modified Mallampati scoring, and sleep quality characterized by polysomnography. Polysomnography results were reviewed when available and the predictive performance of the SBQ and the modified SBQ scoring models were compared. Results: In the authors’ study an SBQ score ≥3 yielded sensitivities of 0.85, 0.86, and 0.91 for Apnea–Hypopnea Index (AHI) ≥5/h, AHI ≥15/h, and AHI ≥30/h, respectively, and specificities of 0.09, 0.10, and 0.18. The modified SBQ with a cutoff of ≥4 (>3) points for AHI levels of >5, >15, and >30 yielded respective sensitivities of 0.84, 0.86, and 0.91 and specificities of 0.25, 0.26, and 0.27. Conclusions: The authors results from indicated the modified SBQ with a cutoff of >3 points in this study was more specific than the standard SBQ but no less sensitive, and may be used in identifying OSA patients for further diagnostic evaluation or avoiding unnecessary testing.

Response to comment: An objective assessment of halitosis in children with adenoid vegetation during the pre- and postoperative periods

We greatly appreciate the readers valuable comment. We completely agree with the reviewer that the diagnosis of allergic rhinitis (AR) is based on history, physical examination, and allergy tests. However, in many cases, especially in children, we tend to prefer noninvasive procedures. Therefore, in our study, patients with suspicious AR history or suspicious AR findings on endoscopic examination were excluded. As we mentioned in the Discussion section, one of the limitations of our study was the small sample size. Although adenoid hypertrophy is a common childhood disease, few potential participants met all the criteria. Therefore, the adenoid hypertrophy group included only 40 patients. A detailed history was obtained, and nasal endoscopy was performed with a rigid pediatric nasal endoscope in all subjects to visualize all anatomic details, differentiate nasal pathologies, and assess estimated adenoid size. Recently, a significant relationship was reported between endoscopic findings and the perception of nasal symptoms in children with AR [1]. AR is a common chronic disorder characterized by typical symptoms, including itchy nose, sneezing, rhinorrhea, and nasal obstruction. The nasal mucosa is particularly exposed to allergens and represents the site of local inflammation in AR. Nasal inflammation induces the occurrence of anatomic changes that may be easily observed during endoscopy. The typical endoscopic picture in children with AR is characterized by hypertrophic turbinates with relevant edema of the inferior turbinate head. This edema is usually localized and sectorial and may cause contact between the inferior turbinate and the lateral wall. In addition, pale turbinates are considered by most physicians to be a sign of AR [2]. It also does not seem possible that allergic inflammation is capable of causing adenoid hypertrophy without causing any nasal anatomic changes that may be observed by endoscopic examination. Because of the invasive nature of allergy tests, Ameli et al. investigated whether the diagnosis of allergic rhinitis in children could be made by anamnesis and endoscopic examination. They reported that endoscopic features associated with clinical symptoms could precede the classical AR diagnosis based on allergy tests in children. Furthermore, they reported that about 20% of children with suspected AR were negative on the skin prick test despite both clinical and endoscopic suspicions. In other words, localized edema might