Evaluation of t-PA, PAI-2, IL-1beta and PGE(2) in gingival crevicular fluid of rheumatoid arthritis patients with periodontal disease

AIMS: This study was undertaken to compare periodontal conditions, gingival crevicular fluid (GCF) levels of tissue-type plasminogen activator (t-PA), its inhibitor plasminogen activator inhibitor-2 (PAI-2), interleukin-1beta (IL-1beta), prostaglandin E(2) (PGE(2)) in rheumatoid arthritis (RA) patients and control groups. METHODS: Twenty-three RA patients, 17 systemically healthy patients with periodontal disease (PD), and 17 systemically and periodontally healthy subjects were recruited. GCF samples were obtained from two single-rooted teeth. Full-mouth clinical periodontal measurements were recorded at six sites/tooth. GCF samples were analysed using relevant ELISA kits. Data were tested statistically by appropriate tests. RESULTS: Total amounts of t-PA, PAI-2 and PGE(2) in GCF samples of the healthy control group were significantly lower than the other groups (p<0.05). The RA group exhibited a higher total amount of t-PA in GCF samples than the PD group (p<0.05). PAI-2, IL-1beta and PGE(2) total amounts were similar in RA and PD groups (p>0.05). CONCLUSION: The coexistence of RA and periodontitis does not seem to affect clinical periodontal findings or systemic markers of RA. Similar inflammatory mediator levels in RA and PD groups, despite the long-term usage of corticosteroids, non-steroidal anti-inflammatory drugs, suggest that RA patients may have a propensity to overproduce these inflammatory mediators.     

Effect of passive smoking on growth and infection rates of breast-fed and non-breast-fed infants

Background:  The aim of the present study was to determine the effect of passive tobacco smoking on growth and infection rate of infants, and to evaluate whether breast-feeding might be protective against harmful effects of cigarette smoke.
Methods:  A cross-sectional study on 254 6–7-month-old infants was carried out. A questionnaire was given to mothers; and infants' head circumference, bodyweight, height, and urinary cotinine levels were measured.
Results:  Multivariate analysis of factors influencing lower respiratory tract infections showed that smoking mothers increased the rate by 9.1-fold; breast-feeding decreased it by 3.3-fold; formula feeding at birth increased it by a factor of 15.2; another smoker at home increased it by a factor of 40.1. Multivariate analysis of factors influencing upper respiratory tract infections showed that smoking mothers increased the rate by a factor of 23; early formula feeding increased it by a factor of 62; breast-feeding decreased it by a factor of 5; smoking fathers increased it by a factor of 15. Multivariate analysis of factors influencing otitis media found that smoking mothers and fathers increased it by a factor of 9.4 and 6.15, respectively, and breast-feeding decreased it by a factor of 5.4.
Conclusion:  Tobacco smoke exposure of infants has negative consequences on growth, otitis media, and upper and lower respiratory tract infections. Breast-feeding promoted the growth of infants who were passively exposed to tobacco smoke and protected them against infections. Smoking should not be permitted in households with infants. When this is impossible, breast-feeding should be promoted to protect the infants against the health hazards of passive smoking.     

Development and evaluation of the Turkish matrix sentence test

Objectives: The Turkish matrix sentence test, TURMatrix, was developed for precise, internationally comparable speech intelligibility testing. Design: The TURMatrix comprises a base matrix of ten well-known Turkish names, numbers, adjectives, objects, verbs, from which syntactically fixed sentences were randomly composed. Test conduction may be in an open-set (standard), or closed-set response format. Homogeneity in intelligibility of the test material was optimized by applying level adaptations (maximal ± 3 dB) based on word-specific speech reception thresholds (SRTs). Test list equivalence was verified and reference values were determined. Study sample: Thirty-eight native listeners of Turkish with normal hearing. Results: After training, mean SRT and slope of the final test lists were ? 8.3 ± 0.2 dB SNR and 14.1 ± 1.0%/dB, respectively (fixed SNR measurements; inter-list variability). For adaptive measurements, average across listeners was ? 7.2 ± 0.7 dB SNR in the open-set and ? 7.9 ± 0.7 dB SNR in the closed-set response format. Mean SRT for adaptive measurements in the open-set response format in quiet was 20.3 ± 4.1 dB. Individual SRTs in quiet correlated more closely with audiograms than with SRTs in noise. Conclusions: The TURMatrix was developed according to European standards and provides reliable speech intelligibility measurements in noise and quiet.     

The relationship between ghrelin and adiponectin levels in breast milk and infant serum and growth of infants during early postnatal life

Ghrelin and adiponectin have been found in breast milk and are considered to take part in the regulation of growth and energy metabolism of infants. Our aims were to determine ghrelin and adiponectin levels in breast milk and serum samples of mothers and their infants, and to investigate the relationship between their levels and anthropometry of newborn infants during early postnatal life. Total and active ghrelin and adiponectin levels were studied in breast milk, and the serum samples of 25 healthy lactating women and their healthy fullterm infants were taken at the 1st and 4th months of life. Anthropometric measurements of infants were also performed during the study period. Breast milk and infant serum active ghrelin levels were found to be significantly increased at the 4th month of life compared with 1st month levels (p < 0.05). Maternal serum total ghrelin and infant serum adiponectin levels were found to be significantly reduced at the 4th month of life (p < 0.05). Breast milk active ghrelin levels were higher than the infant and maternal serum active ghrelin at the 1st and 4th months (p < 0.05). There was a negative significant correlation between the level of infant serum active ghrelin levels and BMI of infants at the 1st month. A positive significant correlation was found between the level of 1st month infant serum adiponectin levels and weight gain of infants during the study period. Fourth month infant serum adiponectin were also positively correlated with weight and BMI of infants at the 4th month and the weight gain during study period. There was a positive significant correlation between the level of 4th month breast milk active ghrelin and weight gain of infants during the study period. Ghrelin and adiponectin are involved in postnatal growth of infants. Ghrelin in breast milk also seems to be related to the growth of infants during early postnatal life. The sources of these peptides in breast milk are probably both maternal serum and breast tissue itself.     

Is it possible to create a slit-like meatus without incising the urethral plate?

A series of hypospadias repairs using the Mathieu and V-incision-sutured (MAVIS) technique, aiming to achieve a normal-looking,vertical, slit-like meatus in 32 patients was reviewed. A Mathieu procedure was performed in 26 patients as a primary repair and in 3 as a rescue operation. In another 3 patients who had severe proximal hypospadias with failed repair, techniques other than Mathieu's were used. Good cosmetic and functional results were achieved in all patients.There were no complications such as fistula or stricture formation. The MAVIS meatoplasty creates a natural-looking, slit-like glanular meatus in both distal and proximal hypospadias, even in complicated cases.     

Novel Mutation in <Emphasis Type="Italic">CECR1</Emphasis> Leads to Deficiency of ADA2 with Associated Neutropenia

Purpose

Adenosine deaminase 2 (ADA2) have been reported to cause vasculitic diseases and immunodeficiency recently. Patients present with stroke episodes and rashes mimicking polyarteritis nodosa (PAN). We report a patient who has been followed up with severe neutropenia and found an unexpectedly revealed novel mutation in CECR1 affecting ADA2.

Methods

We reviewed medical records and clinical history of the patient. No mutations in other known neutropenia genes such as ELA, G6PC3, HAX1, AP3B1, LAMTOR2, VPS13B, VPS45, GFI1, JAGN1, or WAS could be detected. Sanger sequencing was used to confirm the genetic variants in the patient and relatives.

Results

Genetic analysis by exome sequencing revealed a novel mutation in the gene CECR1 (c.G962A; p.G321E) which segregated perfectly in the relatives.

Conclusion

This is the first DADA2 patient presenting with severe neutropenia. We suggest that in patients with unexplained cytopenias combined with immunodeficiency, fevers of unknown origin and high inflammation markers, DADA2 should be considered.

     

EFI region 8 Balkan external proficiency testing for HLA typing: Results of 15 years

Istanbul Medical Faculty, Department of Medical Biology, as the first EFI‐accredited HLA laboratory in Turkey since 1999 has been organizing both national and international quality control tests for HLA typing under the banner of the “Balkan external proficiency testing (BEPT)” encompassing countries from EFI regions 8. The first round of BEPT in 2004 was organized for low‐resolution HLA‐A,‐B typing by molecular methods and 12 centres participated in the exercise. In 2005, low‐resolution HLA‐DR typing was added, and in 2007, low‐resolution HLA‐C and DQ typing were added to the exercise and 28 centres participated. In 2015, high‐resolution (four digits or higher typing) HLA‐A,‐B,‐C,‐DR and –DQ typing added to the exercise and 40 centres participated. In the last 2 years, 2017 and 2018, the number of participating centres increased to 48 and 52, respectively. When the distribution of low‐resolution typing methods applied in the exercises were investigated, it was found that 82% of the centres in the first round of BEPT in 2004 used PCR‐SSP, whereas in the last round in 2018, 26% of the centres preferred SSP, while the rest used SSO (50%) or SSP and SSO (24%) methods. Methods for high‐resolution typing were SBT (41%), NGS (18%), SSO (18%), SSP (6%), SBT + NGS (6%) and SBT + SSP (11%). In 15th trial for BEPT, nomenclature mistake rate was 12%, and erroneous result rate was 6% for HLA samples. The most common mistakes in the exercises were nomenclature mistakes. The EFI Standards Version 7.0 is stated "HLA type can be reported using a hyphen if homozygosity is not proven by family studies." In order to provide standard results among HLA laboratories and since accurate HLA typing leads to significant increase of graft and patient survival, quality control exercises should be performed in all HLA‐based tests periodically.     

Multicenter evaluation of AYC.2.2 agar for the isolation of mycobacteria from clinical samples

PurposeThe aim of this multicenter study is to evaluate AYC.2.2 agar for the isolation of mycobacteria from clinical samples.MethodsTotally 5559 media were tested in 7 centers. AYC.2.2 agar media for the study were prepared by C1 and sent to other centers under appropriate conditions. Other media except AYC.2.2 agar were purchased commercially.The media were subjected to routine laboratory operations in the center where they were sent. After the samples received for routine processing (in all centers, samples were processed with the same method (NALC-NaOH)), they were cultivated on routine media and AYC.2.2 agar afterward.ResultsC1: Average growth time was determined as 12.74±3.74 days with MGIT 960 system; 24.42±4.75 days with LJ and 24.37±4.96 days with AYC.2.2 agar. C2: Average growth time was determined as 18.25±9.32 days with TK-Medium, 28.73±7.44 days with LJ, and 31.72±6.35 days with AYC.2.2 agar. C3: Average growth time was determined as 20.48±7.24 days with Ogawa medium, 20.74±7.12 days with LJ, and 20.26±7.43 days with AYC.2.2 agar. C4: Average growth time was determined as 15.27±6.37 days with MGIT 960 system, 22.14±9.1 days with LJ, and 22±8.45 days with AYC.2.2 agar. C5: Average growth time was determined as 13±4.24 days with MGIT 960 system, 32.16±6.23 days with LJ, and 33±5.73 days with AYC.2.2 agar. C6: Average growth time was determined as 9±3.11 days with MGIT 960 system, 18.68±5.32 days with LJ, and 18.34±4.63 days AYC.2.2 agar. C7: Average growth time was determined as 14.74±7.65 with MGIT 960 system, 26.01±8.21 days with LJ, and 26.24±7.88 days with AYC.2.2 agar.ConclusionsIn conclusion, similar results were obtained with LJ and Ogawa media and AYC.2.2 agar. Furthermore, more studies should be conducted for isolation of M. tuberculosis and performing antibiotic susceptibility tests using AYC.2.2 agar before it can be used as a routine media in the laboratories.     

The effect of cyclosporin A on alveolar bone in rats subjected to experimental periodontal disease

Cyclosporine A (CsA), broadly used in organ transplantation, may contribute to pathogenesis of osteoporosis. The aim of this study was to investigate the effects of CsA on alveolar bone in rats subjected or not to experimental periodontal disease using biochemical, radiographic, and histometric analysis. Forty Wistar rats were divided into 4 equal groups: Group I (Control), Group II (CsA was injected subcutaneously in a daily dose of 10 mg/kg), Group III (Ligature was placed around the mandibular molars), Group IV (Ligature+CsA). After 60 days, rats were decapitated, serum alkaline phosphatase and calcium levels were measured. Radiographic-alveolar bone loss (ABL), histometric-ABL, and percentage of new alveolar bone formation (NABF%) were determined on mandibular molars. Significant increase in serum alkaline phosphatase levels (p < 0.001), no significant difference in calcium levels were observed (p > 0.05) in Group IV compared to Group III. Radiographic and histometric-ABL were significantly less (p < 0.001), NABF% was significantly greater (p < 0.05) in Group IV than in Group III. No significant difference in any of the parameters between Group II and Group I was found. It can be concluded that in the presence of periodontal disease, CsA treatment may bring out an imbalance in the alveolar bone homeostasis by decreasing resorption and stimulating formation of alveolar bone in rats.     

Prevalence of stress urinary incontinence in both sexes at or after age 15 years: a cross-sectional study

PURPOSE: We determine the prevalence of stress urinary incontinence among males and females at or after age 15 years in an education and research health district. MATERIALS AND METHODS: During a personal interview questionnaires were given to a total of 2,053 people at or after age 15 years in an education and research health district near Ankara, Turkey. In addition to the particular questions about stress incontinence, the medical history, including congenital or acquired diseases of clinical significance, operations and details relevant to positive findings were obtained. Groups with or without stress incontinence were compared in regard to age and sex, and parity in women. Subgroups that emerged as to the presence of nocturia and/or urgency incontinence were examined in regard to systemic diseases, operations, congenital anomalies and regular medications. RESULTS: A total of 229 people (11.1%) had stress incontinence, with a female predominance of 20.8% versus 1.0% (p <0.05). People 65 years old or older experienced stress incontinence 6.24 times more than those in the 15 to 24-year age group. In contrast, females had increasing stress incontinence prevalence by age as noted by relevant odds ratios. Stress incontinence prevalences among women in the 35 to 44 and 45 to 54-year age groups were about 39 and 35 times higher than those of men in the corresponding age groups. As expected the incontinence prevalences increased with the number of births in women. Nocturia was absent in 50.2% of all subjects, whereas 26.7% reported nocturia at all times and 23.0% had nocturia sometimes. Persistent nocturia was present in 21.1% of males and 32.1% of females. Persistent nocturia and urgency were apparently greater in patients with systemic diseases and/or those who had undergone surgery. Urgency incontinence was present in 9.7% of the entire population with a distinct female predominance of 16.3% versus 2.7%. CONCLUSIONS: Stress incontinence occurred in both sexes at or after age 15 years with a female predominance. The prevalence of stress incontinence increases with age and parity in women. Urgency and nocturia are more prevalent in people with systemic diseases and those who have undergone previous pelvic or neurosurgical operations.