Oral melanin pigmentation related to smoking in a Turkish population

OBJECTIVE: Besides genetic factors, tobacco smoking has been found to be the major cause of oral melanin pigmentation. The purpose of the present study was to evaluate the frequency of oral melanin pigmentation in a Turkish population and to present its correlation with clinical parameters relevant to periodontal status in current smokers, non-smokers, former smokers. METHOD: A sample of 496 patients was randomly selected. The subjects were interviewed regarding their smoking habits. They were clinically examined by a single examiner for the presence of oral melanin pigmentation in different oral mucosal regions. The same examiner recorded the clinical parameters including GI (gingival index), PI (plaque index), BOP (bleeding on probing), PD (probing depth) and GR (gingival recession). Examiner 2 completed a questionnaire concerning skin color and smoking habits. RESULTS: In the study group, 41% were current smokers, 46% nonsmokers and 13% former smokers. The frequencies of pigmented areas were significantly higher in current smokers than in those without any smoking habits. The clinical parameters revealed similar findings for all groups. Low GI and BOP values were observed for current smokers when compared with non-smokers and former smokers, respectively. GI values were significantly associated with the pigmentations in gingiva. CONCLUSIONS: The results of our study show that smokers in a Turkish population had significantly more pigmented oral surfaces than nonsmokers.     

Situs inversus totalis with accompanying craniodiaphysial dysplasia: a new syndrome?

A 20-year-old man with craniofacial anomalies of craniodiaphysial dysplasia (CDD), facial paralysis, mental retardation, and situs inversus totalis is described. Similar features except situs inversus totalis are also present in two of his sisters. The authors believe this to be the first reported case of CDD with accompanying situs inversus totalis.     

The results of three different treatment modalities in patients with locally advanced nasopharyngeal carcinoma

The aim of the study was to evaluate the toxicity and efficacy of 62 patients with locally advanced nasopharyngeal carcinoma (NPC) (stage III, IVA, IVB) treated by three different modalities. Cisplatin was given weekly 35 mg/m²/day or every 3 weeks 100 mg/m²/day during radiotherapy (RT) in all patients. Patients were classified into following three groups: The patients in the group 1 (n = 23) were treated only with concurrent chemoradiotherapy (CCRT). In the group 2 (n = 15), before the CCRT, neoadjuvant chemotherapy, consisting of intravenous cisplatin and docetaxel on day 1, every 3 weeks treatment cycles was administered. In the group 3 (n = 24), adjuvant chemotherapy, consisting of cisplatin on day 1 and 5-flourouracil on day 1 to 5 every 3 weeks was used after CCRT. Three arms were treated with the same RT technique and dose. There was no difference for age, sex, and stage among the groups. Radiotherapy was administered in planned dose for all patients. A total of 82% patients completed planned chemotherapy concurrent with RT. The treatment related adverse effects were mild or moderate in intensity. There was no statistical difference between the groups regarding the treatment responses. Complete response rate of RT was 73.9%, 86.7%, and 87.5%, respectively. Median progression free survival (PFS) and overall survival (OS) were 13, 12, 9 months and 22, 20, 15 months for groups 1, 2, 3, respectively. No difference was observed in median OS and PFS among three groups. In our study, the efficacy and toxicity of neoadjuvant and/or adjuvant chemotherapy with CCRT and CCRT alone were found similar.     

Prevalence of depression,its correlates among students,and its effect on health-related quality of life in a Turkish university

Objective.The aims were to investigate the prevalence of depression among university students, and to determine some of the risk factors connected to depression, and also to evaluate its effect on health-related quality of life (HRQoL).

Methods.This cross-sectional survey was conducted between 1 December 2007 and 31 January 2008 at Osmangazi University, Eskisehir, in western Turkey. The study group consisted of 822 students. The questionnaire included the students’ socio-demographic characteristics, the Beck Depression Inventory, and the Medical Outcomes Study Short Form-36 (SF-36). The data were analyzed by using chi-square, Student's t test, percent (%) ratios, and backward logistic regression analysis with a significant value of P<0.05.

Results. Of the students, 377 (45.9%) were males and 445 (54.1%) females. Overall, the prevalence of depression was 21.8% (n=179/822). Family history of depression, acne on face, any physical defect on body, smoking, alcohol consumption, and future-related occupational preoccupation were all deemed important risk factors for depression (P <0.05, for each one). It was found that, in those with depression, all the mean domain scores of SF-36 scale were lower than those without depression (P <0.05, for each one).

Conclusions.The prevalence of depression among the university students in this region of Turkey was wide-spread, affecting negatively the HRQoL of the students. For prevention and control of depression, depression information and knowledge need to be addressed by health education programs.     

The Importance of Rockall Scoring System for Upper Gastrointestinal Bleeding in Long-Term Follow-Up

The aim of the study is to examine the importance of Rockall scoring system in long-term setting to estimate re-bleeding and mortality rate due to upper gastrointestinal bleeding. A total of 321 patients who had been treated for upper gastrointestinal bleeding were recruited to the study. Patients’ demographic and clinical data, the amount of blood transfusion, endoscopy results, and Rockall scores were retrieved from patients’ charts. The re-bleeding, morbidity, and mortality rates were noted after 3 years of follow-up with telephone. Re-bleeding rate was statistically significantly higher in Rockall 4 group compared to Rockall 0 group. Mortality rate was also statistically significantly higher in Rockall 4 group. Rockall risk scoring system is a valuable tool to predict re-bleeding and mortality rates for patients with upper gastrointestinal bleeding in long-term setting.     

Therapeutic plasma-exchange in hematologic disease: Results from a single center in Eastern Anatolia

Therapeutic plasma-exchange (TPE) is used as primary and adjunctive therapy in treatment of several hematologic diseases. We retrospectively evaluated the results of TPE in hematologic diseases during 2008–2012. A total of 301 TPE procedures were performed in 44 patients (19 male and 25 female, with mean age of 50.6 ± 15 years). Fifteen of 44 patients had thrombotic thrombocytopenic purpura (TTP), 14 patients had HELLP syndrome (Hemolysis Elevated Liver enzymes, Low Platelet count), 10 patients had multiple myeloma-hyperviscosity and the rest five patients had snake bite. Fresh frozen plasma (FFP) was used as replacement fluid. Complete response (CR) was achieved on 13 patients (87%) in primarily TTP. CR was achieved in all other three diseases. Total complications were detected in 8.1% of the TPE procedures. Adverse events (AEs), were seen in 5.4% of all procedures. None of the patients died from any complication. AE occurred in 4% (Grade-I), 1% (Grade-II), and 0.3% (Grade-III) of the procedures. The most common AE were nausea/vomiting, hypotension, pruritus and abdominal pain. TPE is effectively and safely carried out in our center in hematologic diseases.