Translation,cultural adaptation,cross-validation of the Turkish diabetes quality-of-life (DQOL) measure

Objective The aim of this study was to test the validity and reliability of the Turkish version of the diabetes quality of life (DQOL) questionnaire for use with patients with diabetes. Methods Turkish version of the generic quality of life (QoL) scale 15D and DQOL, socio-demographics and clinical parameter characteristics were administered to 150 patients with type 2 diabetes. Study participants were randomly sampled from the Endocrinology and Diabetes Outpatient Department of Dr. Lutfi Kirdar Kartal Education and Research Hospital in Istanbul, Turkey. Results The Cronbach alpha coefficient of the overall DQOL scale was 0.89; the Cronbach alpha coefficient ranged from 0.80 to 0.94 for subscales. Distress, discomfort and its symptoms, depression, mobility, usual activities, and vitality on the 15 D scale had statistically significant correlations with social/vocational worry and diabetes-related worry on the DQOL scale indicating good convergent validity. Factor analysis identified four subscales: satisfaction”, impact”, “diabetes-related worry”, and “social/vocational worry”. Conclusion Statistical analyses showed that the Turkish version of the DQOL is a valid and reliable instrument to measure disease related QoL in patients with diabetes. It is a simple and quick screening tool with about 15 ± 5.8 min administration time for measuring QoL in this population.     

Therapeutic plasma exchange for the treatment of thrombotic thrombocytopenic purpura: a retrospective multicenter study.

BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a rare disease that is fatal if it is not treated. Therapeutic plasma exchange (TPE) has resulted in excellent remission and survival rates in TTP patients. MATERIAL AND METHODS: We describe our experience with 52 TTP patients treated with TPE during the past eight years (65% of the patients were females; patient median age=34 years, range: 17-73). TPE was carried out 1-1.5 times plasma volume. Fresh frozen plasma (FFP) or cryosupernatant plasma (CSP) was used as the replacement fluid. TPE was performed daily until normalization of serum LDH and recovery of the platelet count to >150 x 10(9)/dL; TPE was then slowly tapered. Clinical, laboratory data, the number of TPE, other given therapy modalities, treatment outcomes and survival rate were evaluated retrospectively. RESULTS: Overall response (OR) and complete response (CR) rates were 77% and 60%, respectively. Response was excellent in 82.8% of the patients with primary TTP among whom 74.2% were CR. Additionally, there were statistical differences in terms of CR rate between patients with primary TTP and secondary TTP (74.2% vs. 29.4%; p=0.005). OR and CR rates were 79% and 57.9% in patients on TPE alone and 75.8% and 60.6% in patients on TPE+prednisolone, respectively (p=1 and p=0.8). Additionally, there were no statistical differences in terms of OR and CR rates between patients on TPE with FFP and CSP (p=0.25 and p=0.16, respectively). The presence of fever and the number of TPE were statistically important factors influencing the probability of response in multivariate logistic regression analysis (p<0.01 and p<0.01, respectively). Additionally, in multivariate Cox's regression analysis, the probability of survival was higher in patients who were responsive to treatment compared to patients who were unresponsive (p<0.001). CONCLUSION: TPE is an effective treatment for primary TTP; however, it may be used as adjunctive therapy for secondary TTP until it is under control. The addition of steroids to TPE had no advantage compared to TPE alone. CSP as replacement fluid is not superior compared to FFP. Fever appears to be a bad prognostic indicator. Therefore, prolonged treatment with TPE may be needed in patients with fever.     

Transient hypogammaglobulinemia of infancy: Clinical and immunologic features of 40 new cases

BACKGROUND: Transient hypogammaglobulinemia of infancy (THI) results from a delay in the maturation of immunoglobulin production. METHODS: The clinical and immunologic data of 40 patients with THI are presented. Clinically, the majority of patients presented with recurrent respiratory infections and otitis media, bronchitis and/or bronchial asthma and recurrent gastroenteritis. RESULTS: Ten of 40 children had isolated low IgG; isolated low IgA and isolated low IgM were detected in one and three patients, respectively. At initial evaluation, levels of all three immunoglobluins were low in nine patients. Ten patients had diminished IgG and IgA levels, six had diminished IgA and IgM levels and one had low IgG and IgM levels. Two patients were given intravenous immunoglobulin replacement therapy for 1 year. None of the patients has experienced serious infections during their follow-up period. CONCLUSIONS: Prospective evaluation of patients (age range 5-60 months) revealed that immunoglobulin levels in 33 patients recovered before 36 months of age. Seven patients still had low immunoglobluin levels at 40-57 months of age. Three of these patients had low levels of both IgG and IgA, while two patients had low IgM levels and a further two patients had low IgA levels.     

Metabolic predictors for early identification of fatty liver using doppler and B-mode ultrasonography in overweight and obese adolescents

The aims of our study were: (1) to evaluate the frequency of asymptomatic fatty liver disease (FLD) using both Doppler and B-mode ultrasound (US) in overweight and obese adolescents; (2) to compare metabolic findings of fatty liver (FL) assessed by two methods; and (3) to evaluate metabolic predictors of FL shown by these methods. Fifty-nine overweight and obese adolescents aged between 9.0 and 17.0 years and 41 non-obese healthy adolescents were included in this study. B-mode and right hepatic vein Doppler ultrasonography (US) were performed and anthropometric indices, lipid profiles, and adiponectin levels were evaluated in all adolescents. HDL-C levels were significantly lower in patients with FL detected by Doppler US compared to patients without FL (p < 0.05). HDL-C levels were inversely correlated with presence of FL assessed by two methods (r = −0.285, p = 0.004; r = −0.328, p = 0.001, respectively) and adiponectin levels were correlated with presence of FL only detected by B-mode US (r = −0.263, p = 0.008). Adiponectin levels were significantly lower in patients with FL than those without FL assessed by B-Mode US (p = 0.049). Multiple regression analysis revealed that HDL-C levels was the most important predictor of FL assessed by Doppler US (p = 0.027), while body mass index was the determinant of FL assessed by two methods (p < 0.001) in asymptomatic overweight and obese adolescents. It was found that FLD, identified by both B-mode and Doppler US, is seen frequently in asymptomatic overweight and obese adolescents. Elevated BMI is associated with increased risk of FL assessed by two ultrasonographic methods. When using Doppler US, low HDL-C levels can be used as a good predictor for presence of FLD in overweight and obese adolescents.     

Could prolactin receptor gene polymorphism play a role in pathogenesis of breast carcinoma?

OBJECTIVE: Constitutive activation of various hormone and growth factor receptors is newly recognised as a common cause of tumour development. This study investigated the presence of any mutation or polymorphism of prolactin receptor (PRLR) in 38 patients with breast cancer. RESEARCH METHODS: Genomic DNA was extracted and PCR amplification was carried out for exon 1-10 of PRLR from tumoral and adjacent non-cancerous breast tissue of tumour specimens from 38 breast cancer patients. PCR products were analysed by SSCP and automatic sequencing for mutations. RESULTS: For the first time, A150C (Leu-->Ile) transversion at exon 6 of PRLR in tumour tissues, in adjacent non-cancerous breast tissues, and in blood samples of two (5.3%) out of 38 patients with breast cancer were detected. In contrast to this finding, no polymorphism of PRLR in blood samples of 100 normal individuals were found. CONCLUSION: Polymorphism of prolactin receptors might play a role in mammary carcinogenesis as a consequence of intracellular changes of PRLR signalling.     

Determination of the food dye carmine in milk and candy products by differential pulse polarography

As a basis for the development of a sensitive analytical method for the determination of carmine food dye, a study of the differential pulse polarographic reduction of carminic acid (CA) on a dropping mercury electrode was performed. For the analytical differential pulse polarographic method running at pH 2.0 Britton–Robinson (B–R) buffer solution (peak at −489 mV), the relationship between the peak current and CA concentration was linear in the range of 1 μM to 90 μM with a detection limit of 0.16 μM. The proposed electrochemical procedure was successfully applied to the determination of carmine food dye in spiked commercially available strawberry flavored milk. The method was extended to the determination of CA in candy and results were in agreement with that obtained by a spectrophotometric comparison method. A cyclic voltammogram of CA in 2.0 B–R buffer electrolyte was obtained on the dropping mercury electrode at pH 2.0 during potential scans from 0.00 mV to 1000 mV versus Ag/AgCl. From repetitive cyclic voltammograms, one cathodic peak at −500 mV and three anodic peaks on the reverse scan between approximately −340 mV and −460 mV were recorded. The influences of some other commonly found inorganic and organic salts on the determination of CA were also examined. The sufficiently good recoveries and low standard deviations for the data reflect the high accuracy and precision of the proposed differential pulse polarographic method.     

Prospective neurobiological effects of the aerial and root extracts and some pure compounds of randomly selected Scorzonera species

Context: Scorzonera L. species (Asteraceae) are edible and as medicinal plants are used for various purposed in folk medicine.

Objective: The methanol extracts of the aerial parts and roots from 27 Scorzonera taxa were investigated for their possible neurobiological effects.

Materials and methods: Inhibitory potential of the Scorzonera species was tested against acetylcholinesterase (AChE), butyrylcholinesterase (BChE), and tyrosinase (TYRO) at 100?µg?mL^?1 using ELISA microtiter assay. Antioxidant activity of the extracts was tested with radical scavenging activity, metal-chelation capacity, ferric- (FRAP), and phosphomolibdenum-reducing antioxidant power (PRAP) assays. Chlorogenic acid, hyperoside, rutin, and scorzotomentosin-4-O-β-glucoside were also screened in the same manner. Total phenol and flavonoid quantification in the extracts were determined spectrophotometrically.

Results: The aerial parts of Scorzonera pisidica (40.25?±?0.74%) and chlorogenic acid (46.97?±?0.82%) displayed the highest TYRO inhibition, while the remaining samples showed only trivial inhibition against cholinesterases (2.08?±?1.35%–25.32?±?1.37%). The same extract of S. pisidica was revealed to be the most potent in scavenging of all three radicals and FRAP assay.

Discussion and conclusion: Out of 27 taxa, S. pisidica, in particular, may deserve further investigation for its neuroprotective potential.     

Heavy metals in soil, vegetables and fruits in the endemic upper gastrointestinal cancer region of Turkey

The environmental exposure to heavy metals is a well-known risk factor for cancer. We investigated levels of seven different heavy metals, (Co, Cd, Pb, Zn, Mn, Ni and Cu) in soil, fruit and vegetable samples of Van region in Eastern Turkey where upper gastrointestinal (GI) cancers are endemic. Heavy metal contents of the samples were determined by flame atomic absorption spectrometer. Four heavy metals (Cd, Pb, Cu and Co) were present in 2- to 50-fold higher concentrations whereas zinc levels were present in 40-fold lower concentrations in soil. The fruit and vegetable samples were found to contain 3.5- to 340-fold higher amounts of the six heavy metals (Co, Cd, Pb, Mn, Ni and Cu) tested. The volcanic soil, fruit and vegetable samples contain potentially carcinogenic heavy metals in such a high levels that these elements could be related to the high prevalence of upper GI cancer rates in Van region.