Prevalence and risk factors of allergies in Turkey: Results of a multicentric cross-sectional study in children

The Prevalence And Risk Factors of Allergies in Turkey (PARFAIT) study was planned to evaluate prevalence and risk factors of asthma and allergic diseases and also to find out which geographical variables and/or climatic conditions play a role determining the prevalence of allergic diseases in Turkish school children. Study was planned as cross-sectional questionnaire-based. About 25,843 questionnaires from 14 centers were appropriate for analysis. Parental history of allergy, having an atopic sibling and other atopic disease in index case was significant risk factors for all allergic diseases. Breast feeding decreased the risk of current asthma (OR: 0.92, CI: 0.86-0.99) and wheezing (OR: 0.93, CI: 0.87-0.99) but not allergic rhinitis and eczema. Respiratory infection in the past was an important risk factor for the occurrence of allergic diseases especially for asthma which was increased 4.53-fold. Children exposed to household smoke were significantly at higher risk of asthma, wheezing, and allergic rhinitis (OR: 1.20, CI: 1.08-1.33; OR: 1.21, CI: 1.09-1.34; and OR: 1.32, CI: 1.21-1.43, respectively). All allergic diseases were increased in those children living in areas which have altitude of below 1000 m and mean yearly atmospheric pressure above 1000 mb. The study has suggested that household and country-specific environmental factors are associated with asthma, wheezing, allergic rhinitis, and eczema risk during childhood in Turkey.     

Frey's syndrome following fracture of the mandibular condyle - a case report

Frey's syndrome (preauricular gustatory sweating) following multiple fractures of maxillofacial structures, including both mandibular condyles, is presented. Condylar fracture is an uncommon cause of this syndrome. The physiology of this syndrome is reviewed. Successful relief of symptoms and technique for objective documentation are presented.     

Diagnosis of anterior commissure invasion in laryngeal cancer

The objective of the study is the invasion of anterior commissure (AC) by a laryngeal carcinoma has an oncological importance for the outcome. Detection of invasion is difficult due to particular anatomical features of this region. Therefore, we aimed to investigate the value of different diagnostic modalities for the detection of AC involvement at the patients with laryngeal carcinoma. Retrospective analysis of medical charts in a tertiary referral center. Records of preoperative clinical examination, computerized tomography (CT), peroperative examination and postoperative histopathological examination of 47 patients with laryngeal carcinoma were analyzed. The results of postoperative histopathological examination were accepted as true. Sensitivity, specificity, negative-predictive value, positive-predictive value and accuracy ratios were calculated for each modality. AC involvement was found to be positive in 23 patients according to the postoperative histopathological examination. Peroperative clinical examination was found to be superior to preoperative clinical examination and CT. In conclusion, classical multi-slice CT only on axial planes is not a reliable method to detect the invasion of AC. Preoperative clinical examination by suspension laryngoscopy under general anesthesia has an approximately 30% failure rate. Peroperative examination must not be neglected if possible.     

Results of artificial inflammation in scarless foetal wound healing: an experimental study in foetal lambs.

Recent experimental and clinical evidence suggests that the foetus responds to injury in a fashion fundamentally different from the adult. Foetal wound healing occurs without scar formation. The mechanisms causing this difference are still not well defined but absence of inflammation may play a significant role. The aim of this study was to investigate the effects of artificially induced inflammation on scarless foetal wound healing. Twelve time-dated pregnant ewes underwent hysterotomies at 70 and 90 days' gestation. A potent chemoattractant agent (N-formyl-methionyl-leucyl-phenylalanine) was injected into the upper lip of the foetus in the first operation. In the second operation, a full-thickness incisional wound on the right side and a 3-mm excisional wound on the left side of the upper lip were created and closed primarily. A control wound was created on the lower lip. Macroscopic and histologic examinations of the wounds after birth revealed visible scar lines on the upper-lip wounds but no scar line on the lower lip, and an increase in fibrous tissue and collagen content in the upper-lip wounds. We have shown that injecting a chemotactic agent can stimulate inflammation in a period of gestation when tissue injury can not. Although lack of inflammation due to tissue injury in the early period of foetal life may be an important cause of scarless healing, further experimental studies should be carried out to investigate the pathways that are not activated by tissue injury, the immune status of the foetus and the growth factors involved in the inflammatory response.     

Subacute reconstruction of lower leg and foot defects due to high velocity-high energy injuries caused by gunshots, missiles, and land mines

The present study reviews 215 male patients suffering high velocity-high energy injuries of the lower leg or foot caused by war weapons such as missiles, gunshots, and land mines. They were treated in the Department of Plastic and Reconstructive Surgery at Gulhane Military Medical Academy (Ankara, Turkey) between November 1993-January 2001. Severe soft-tissue defects requiring flap coverage and associated open bone fractures that were treated 7-21 days (mean, 9.6 days) after the injury were included in the study. Twenty-three of 226 extremities (10.2%) underwent primary below-knee amputation. The number of debridements prior to definitive treatment was between 1-3 (mean, 1.9). Gustilo type III open tibia fractures accompanied 104 of 126 soft-tissue defects of the lower leg. Sixty-four bone defects accompanied 83 soft-tissue defects of the feet. Eighteen local pedicled muscle flaps and 208 free muscle flaps (latissimus dorsi, rectus abdominis, and gracilis) were used in soft-tissue coverage of 209 defects. Overall, the free muscle flap success rate was 91.3%. Bone defects were restored with 106 bone grafts, 25 free fibula flaps, and 14 distraction osteogenesis procedures. Osseous and soft-tissue defects were reconstructed simultaneously at the first definitive treatment in 94% of cases. The mean follow-up after definitive treatment was 25 (range, 9-47) months. The average full weight-bearing times for lower leg and feet injuries were 8.4 months and 4 months, respectively. Early, aggressive, and serial debridement of osseous and soft tissue, early restoration of bone and soft-tissue defects at the same stage, intensive rehabilitation, and patient education were the key points in the management of high velocity-high energy injuries of the lower leg and foot.     

Efficacy of 5-aminolevulinic acid-based photodynamic therapy in different subtypes of canine mammary gland cancer cells

Lasers in Medical Science - Canine mammary gland tumors (CMGTs) are heterogeneous disease and subclassified [sarcomas (S), carcinomas (C), and carcinosarcomas (CS)] according to histopathological...     

An unusual cause of stroke in a patient with permanent transvenous pacemaker

We report the case of a 61-year-old man with a stroke secondary to cerebral embolism resulting from inadvertent malposition of a permanent transvenous pacemaker lead in the left ventricle. An electrocardiogram and chest X-ray were suggestive of a left-sided positioned lead which was confirmed by transthoracic echocardiography. Because this malposition was complicated with a cerebrovascular event, transcatheter lead extraction was planned, however, the patient chose lifelong anticoagulation therapy.     

How does parental smoking affect nasal mucociliary clearance in children?

European Archives of Oto-Rhino-Laryngology - Correlation between passive smoking and nasal mucociliary clearance (MCC) in pediatric population has not been reported before. Therefore, in this...     

The prevalence of occupational asthma in auto and furniture dye workers in downtown Elazig

Occupational asthma (OA) is characterized by reversible airway obstruction and/or bronchial hyperresponsiveness occurred after exposition to dust, vapor, gas or smoke which are present in the workplace. We aimed to determine the frequency of OA in auto and furniture dye workers in our city center. One-hundred-forty-two workers in Elazig Central Industrial Centre (86 auto, 56 furniture dyes) were included in the study. The workers were questioned with "Turkish Thorax Association Occupational and Environmental Pulmonary Diseases Evaluation Form", and physical examination and pulmonary function tests (PFT) were performed. Follow of peak expiratory flow rate (PEFR) and reversibility tests were performed to patients who had complaints or abnormality in PFT. The workers who had reversibility and positive daily PEFR variability were taken away from work and PEFR variables were followed. The workers had no symptoms when they were taken away from work and daily PEFR were below than 20%, accepted as OA. Twenty-one workers of 22 workers who have abnormal questionnaire, symptoms and abnormality in PFT, accepted daily PEFR measurements. Daily PEFR variability and reversibility test were positive in 5 (3.52%) workers who were accepted as OA. We detected the prevalence of OA, an important worker health problem, was 3.52% in auto and furniture dyes in industrial centre of our city. We think that the prevalence of OA can be determined with detailed history, serial PEFR follow and using PFT, in the absence of specific bronchial provocative tests. Thus, it is important to be become conscious about OA the groups who are under risk.