Reliability and Validity Study of Turkish Version of Pediatric Eosinophilic Esophagitis Symptom Scores® (Tr-PEESS v2.0) Led to Development of a New Pediatric Eosinophilic Esophagitis Scale: GaziESAS

BackgroundThere has been no valid and reliable Turkish scale that measures symptoms in children with eosinophilic esophagitis (EoE). The aim of the study is to test the validity and reliability of the Turkish version of Pediatric Eosinophilic Esophagitis Symptom Scores® (Tr-PEESS v2.0).Methods Relevant forms of Tr-PEESS v2.0 were applied to 2-18 years old children with EoE and to their parents. KINDL QoL patient and parent questionnaires and the GaziESAS scale developed in this study were used to test the convergent validity of Tr-PEESS v2.0. Discriminant validity was evaluated among 3 EoE treatment groups: under treatment, off treatment due to remission, and uncompliant with treatment. Reliability was evaluated by internal consistency, test–retest reliability, and item analysis.Results Fifty-two children/teens (mean age 130.2 ± 60.3 months) and 84 parents were interviewed twice one week apart. The mean duration of EoE was 47.2 ± 35.6 months. Tr-PEESS v2.0 reports correlated with GaziESAS (range 0.361-0.855) and KINDL QoL questionnaires (range −0.316 to 0.413). Parent report of Tr-PEESS v2.0 discriminated children uncompliant with treatment from the ones off treatment and undertreatment. Cronbach’s α values and intraclass correlation coefficients (ICC) values of Tr-PEESS v2.0 ranged from 0.614-0. 895 and 0.646-0.910, respectively.Conclusion Tr-PEESS v2.0 is a valid and reliable tool to use in Turkish children. GaziESAS is a new parent-proxy pediatric EoE scale with an additional adaptive behavior domain that passed scale developmental stages successfully for Turkish children with EoE.     

Evaluation of the effects of occlusal splint,trigger point injection and arthrocentesis in the treatment of internal derangement patients with myofascial pain disorders

Purpose

In temporomandibular disorders (TMDs), unless splints are effective, combined therapies are performed. The aim of this study is to show the effectiveness of the local anaesthethic injections (trigger point injections) to the masticatory muscles.

Adenosine deaminase activity in serum of patients with hepatitis -- a useful tool in monitoring clinical status.

BACKGROUND AND PURPOSE: The evaluation of adenosine deaminase (ADA) activity in sera of patients with hepatitis should be considered a useful tool in the monitoring of their clinical status. In this study, we aimed to determine the relationship between viral load, transaminase levels, and serum ADA levels in hepatitis B virus (HBV)- and hepatitis C virus (HCV)-infected patients. METHODS: Seventy three patients with hepatitis B, 71 patients with hepatitis C and 40 healthy individuals were included. Patients with HBV and HCV infections were classified into 3 groups according to viral load. Serum ADA levels were investigated by colorimetric assays. RESULTS: Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and ADA levels of HBV- and HCV-infected patients were higher than those of the control group. These differences were statistically significant for the levels of all enzymes in HCV-infected patients (p<0.05), and all except AST (p>0.05) in HBV-infected patients. ADA levels of HBV-infected patients with high viral loads were higher than those in HBV-infected patients with intermediate and low viral loads, and the difference was detectably significant between patients with high and intermediate viral loads. Evaluation of HCV-infected patients according to viral load showed no statistically significant relationship between viral load and serum ADA, ALT, and AST levels (p>0.05). HBV- and HCV-infected patients with high ALT and AST levels showed statistically significantly higher levels of ADA than patients with normal ALT and AST levels (p<0.001). CONCLUSIONS: We suggest that serum ADA levels are associated more with the level of serum transaminases than viral load in HBV- and HCV-infected patients. In the treatment of patients with hepatitis, serum ADA levels should be considered a useful tool for the monitoring of liver condition.     

Relationship between toll-like receptor 8 gene polymorphisms and pediatric pulmonary tuberculosis

Objectives: Genetic variants in Toll-like receptors (TLRs) are considered a potential indicator for host susceptibility to and outcome of several infectious diseases including tuberculosis. The aim of this study was to determine whether −129 C/G and Met1Val polymorphisms of TLR8 were associated with pediatric pulmonary tuberculosis in Turkish population. Methods: The −129 C/G and Met1Val polymorphisms were studied in 124 children with pulmonary tuberculosis compared to 150 age-matched healthy control subjects. Results: We did not identify any statistically significant differences between the patients with TB and control groups with regard to the frequency of genotypes GG or G/(−), CG, and CC or C/(−); and alleles G and C at rs3764879 (p > 0.05). We found a strong association with genotype A/(−) at rs3764880 with susceptibility to pulmonary TB in males (OR 2.87, 95%CI 1.38–5.98, p = 0.007). Conclusions: Our results provide evidence, for the first time, of a role for the TLR8 gene in susceptibility to pulmonary TB in male children. Additional research to verify our results are necessary. Tuberculosis in children presents particularly difficult challenges, but research priorities and advances in pediatric tuberculosis could provide wider insights and opportunities for tuberculosis control.     

Detection of Optic Disc Localization from Retinal Fundus Image Using Optimized Color Space

Optic disc localization offers an important clue in detecting other retinal components such as the macula, fovea, and retinal vessels. With the correct detection of this area, sudden vision loss caused by diseases such as age-related macular degeneration and diabetic retinopathy can be prevented. Therefore, there is an increase in computer-aided diagnosis systems in this field. In this paper, an automated method for detecting optic disc localization is proposed. In the proposed method, the fundus images are moved from RGB color space to a new color space by using an artificial bee colony algorithm. In the new color space, the localization of the optical disc is clearer than in the RGB color space. In this method, a matrix called the feature matrix is created. This matrix is obtained from the color pixel values of the image patches containing the optical disc and the image patches not containing the optical disc. Then, the conversion matrix is created. The initial values of this matrix are randomly determined. These two matrices are processed in the artificial bee colony algorithm. Ultimately, the conversion matrix becomes optimal and is applied over the original fundus images. Thus, the images are moved to the new color space. Thresholding is applied to these images, and the optic disc localization is obtained. The success rate of the proposed method has been tested on three general datasets. The accuracy success rate for the DRIVE, DRIONS, and MESSIDOR datasets, respectively, is 100%, 96.37%, and 94.42% for the proposed method.

     

Surgical treatment of acute arch dissection.

OBJECTIVES: Acute type A arch dissections are rare and no consensus has been reached on their surgical treatment. We studied perioperative risk factors for mortality in arch dissection patients. METHODS: Between October 1995 and October 2001, 108 patients with acute type A dissection were operated on, of whom 16 had acute arch dissections. Their mean age was 58 +/- 9 (44-77). Surgery involved total arch replacement in 4, hemiarch replacement in 10, and intimal tear repair with pledgeted sutures and ascending aortic replacement in 2. RESULTS: One patient who underwent total arch replacement died intraoperatively due to bleeding. Both patients who underwent ascending aortic replacement and primary repair of arch tears died 2 days postoperatively, 1 due to bleeding, and the other due to multiorgan failure. In-hospital mortality was thus 18.75%, or 3 of 16. All 3 had cardiac tamponade preoperatively. The 13 survivors were discharged after a mean hospital stay of 11 +/- 6 days. Mean follow-up was 38 +/- 25 months, from 3 months to 6 years. One patient died due to graft infection 3 months postoperatively, but the remaining 12 remain in good condition. Univariate predictors of in-hospital mortality were the type of surgery (primary intimal tear repair) (p = 0.027) and preoperative cardiac tamponade (p = 0.007). CONCLUSION: Surgical treatment of acute type A-arch dissections can be done with reasonable mortality and mid-term survival comparable with those of other subgroups with acute type A dissection. As with series of arch dissections, our patient population is too small to draw specific conclusions, but our experience leads us to conclude that the sites of intimal tears should be resected in acute type A arch dissection.     

Prevalence of antiphospholipid antibodies in patients with neurological symptoms

OBJECTIVE AND PURPOSE: Neurological involvement is a common feature of the antiphospholipid syndrome (APS). A variety of thrombotic and non-thrombotic manifestations may accompany the presence of antiphospholipid antibodies (aPL). PATIENTS AND METHODS: We retrospectively reviewed the prevalence of aPL in a cohort of over 350 unselected patients from a neurological clinic and studied the neurological manifestations of APS. RESULTS: We found that within this cohort the prevalence of aPL was about 15%. Most of the patients with aPL suffered from strokes and transient ischemic attacks (TIA). One patient died from spinal infarction. Non-thrombotic manifestations also occurred in 40% of these patients, such as multiple sclerosis, chorea, seizures or cerebral malignancies. No significant correlations of the titres or different types of aPL and the type of the neurological symptoms could be found. In comparison to age and sex matched patients of the cohort where the presence of aPL could be excluded, the occurrence of non-thrombotic manifestations was significantly more frequent and varied in the group of patients with aPL. The higher incidence of stroke in the non-APS group could be explained by the significantly higher presence of other laboratory risk factors, mainly hypercholesterinemia. CONCLUSION: This investigation indicates that aPL may play an important role in the etiology of various neurological syndromes.     

Increased ratios of homocysteine/vitamin B12, homocysteine/folate and methionine/vitamin B12 in schizophrenic patients

Homocysteine (HCY) and other mediators of one-carbon metabolism have been blamed for the etiology of schizophrenia for a long time. The present study aimed to analyze the serum levels of HCY, methionine (MTY), vitamin-B12 (V-B12), folate (FLT), and glutathione (GSH) in schizophrenic patients and to search for new clues about the etiopathogenesis of this disease. The study included 62 schizophrenic patients (26 females and 36 males with a mean age of 33.79 ± 8.23 years) and 57 healthy control subjects (23 females and 34 males with a mean age of 33.66 ± 8.67 years). The serum levels of HCY and MTY were established using the LC/MS-MS method and the serum levels of V-B12, FLT and GSH were established using the ELISA method. The serum levels of HCY and MTY were significantly higher in the schizophrenia group compared to the control group. Again, the serum ratios of HCY/V-B12, HCY/FLT and MTY/V-B12 were significantly higher in the schizophrenia group than the control group. On the other hand, the serum levels of GSH and V-B12 were significantly lower in schizophrenic patients. The correlation analysis between V-B12 and HCY revealed a stronger negative correlation between HCY and V-B12 in schizophrenic patients than control group (r =–0.491, p < 0.001 for schizophrenic patients; r =–0.286, p = 0.03 for the control group). The present study is the first to evaluate the ratios of HCY/V-B12, HCY/FLT and MTY/V-B12 in schizophrenic patients. A defect in the V-B12 metabolism may increase the serum levels of HCY and MTY in schizophrenic patients.     

Renin–angiotensin gene polymorphisms in relation to severe chronic periodontitis

Aim: Evidence suggests that the ultimate product of the renin–angiotensin system (RAS), angiotensin II, exerts inflammatory actions. The present study aimed to evaluate the inter‐relation between gene polymorphisms of the RAS components; angiotensin converting enzyme (ACE), angiotensinogen (AGT) and angiotensin II type‐I receptor (AT1R), and severe chronic periodontitis (CP). Material and Methods: DNA was obtained from peripheral blood of 90 CP patients and 126 periodontally healthy subjects, and the clinical parameters were recorded. ACE I/D, AGT M235T and AT1R A1166C polymorphisms were genotyped by the PCR–RFLP method. Chi‐square, anova and logistic regression methods were used in statistical analyses. Results: The frequency of the ACE D allele was significantly lower in the CP group than the healthy group (p_corr=0.015). CP subjects exhibited increased C allele carriage and C allele frequency of the AT1R gene (p_corr=0.03 and p_corr=0.03, respectively). All clinical parameters of CP patients were found to be similar in variant allele‐carrying and non‐carrying subjects (p>0.05). Conclusions: The present findings suggest that ACE I/D and AT1R polymorphisms might be associated with susceptibility to CP but not with disease severity. The D allele of ACE I/D might be associated with decreased, whereas the C variant of AT1R A1166C might be associated with an elevated risk for CP in Turkish population.