Rising trend of asthma prevalence among Turkish schoolchildren (ISAAC phases I and III)

BACKGROUND: Asthma is a common chronic illness in childhood. The aim of the study was to examine time trends in the prevalence of asthma using the ISAAC questionnaire in 6- to 12-year-old schoolchildren in Istanbul and factors affecting asthma prevalence. METHODS: Two cross-sectional surveys were performed, 9 years apart (1995 and 2004) using the ISAAC protocol. The survey conducted in 1995 was repeated in 2004 using the same questionnaire in the same age group, in the same schools in the same season. The 2500 questionnaires were distributed to the children to be completed by their parents at home. RESULTS: A total of 2387 children (response rate 95.5%) in the 2004 study and 2216 children (response rate 94.3%) in 1995 were included in the final analysis. The overall lifetime prevalence of wheeze increased from 15.1% to 25.3%; prevalence odds ratio (POR) = 1.91, 95% confidence interval (95% CI) = 1.64-2.21, and P < 0.001. The overall 12-month prevalence of wheeze increased from 8.2% to 11.3%; POR = 1.43, 95% CI = 1.18-1.75, and P < 0.001. The prevalence of asthma increased significantly from 9.8% to 17.8%; POR = 1.99, 95% CI = 1.67-2.36, and P < 0.001. In both 1995 and 2004, family history of asthma, eczema diagnosed by a physician, food allergy diagnosed by a physician, frequent otitis, frequent sinusitis were associated significantly with high risk for asthma. CONCLUSIONS: In the 9-year period from 1995 to 2004, the prevalence of asthma symptoms has increased in 6- to 12-year-old schoolchildren in Istanbul. Risk factors affecting asthma prevalence remained unchanged during the 9-year period.     

The prevalence of asthma and allergic symptoms in Manisa, Turkey (A western city from a country bridging Asia and Europe)

The aim of this study was to determine the prevalence of asthma and allergic symptoms in Manisa city center, Turkey, to evaluate the determinants effective on those values, and to review the prevalence rates reported from different parts of the country. Data were collected from 610 households and complete interviews were conducted with 1,336 adults over 18 years of age by using European Community Respiratory Health Survey-ECRHS questionnaire. The prevalences of current asthma, cumulative asthma and asthma-like symptoms were found in 1.2, 1.0 and 25.0%, respectively, of the 20-44 years age group and the prevalences of allergic rhinitis, allergic dermatitis and family atopy were found in 14.5, 10.9, and 15.2%, respectively, in all age group. Wheezing with breathlessness, wheezing without cold, woken up with shortness of breath and woken up with cold were reported by 9.1%, 6.9%, 6% and 16.1% of the study population, respectively. Gender, age, active or passive smoking, family atopy and home condition effect on prevalence of asthma and allergic symptoms. In this study prevalence of asthma correlated with the studies reporting low prevalence rates of Turkey.     

The association between serum levels of neopterin and number of depressive episodes of major depression

Background

There is an interaction between the immune system and the central nervous system by means of hormones, peptides, and neurotransmitters. The aims of the present study were to determine whether the serum neopterin levels in patients with major depression (MD) differ from a healthy control group and to investigate the relationship between previous MD episodes and serum neopterin levels.

Methods

Thirty patients who were admitted to the GATA Psychiatry Outpatient Clinics and were diagnosed with MD according to DSM-IV, and who agreed to participate in the study, were included in the study. Twenty-six healthy volunteers matched for age, gender, and level of education who agreed to participate in the study were served as controls. Peripheral venous blood samples were obtained from the patients and the control group for complete blood count, routine biochemistry, and the detection of serum neopterin levels. The analyses were performed in the laboratory of the GATA Department of Biochemistry.

Results

There was no significant difference between the MD group and the healthy controls with respect to age, level of education, smoking, and gender. Serum neopterin levels of the MD group who had experienced two or more episodes were higher than the first-episode group and the control group. Age of onset and the number of previous episodes had an independent impact on serum neopterin levels in MD patients, while smoking did not show any effect.

Conclusion

In the present study, the neopterin levels of patients who had experienced two or more episodes were higher than the first-episode depressive group and healthy control group. It was also found that the number of previous depressive episodes and the ages of the MD cases had an independent effect on serum neopterin levels.     

Intussusception in adults： Clinical characteristics, diagnosis and operative strategies

AIM： To evaluate 20 adults with intussusception and to clarify the cause, clinical features, diagnosis, and management of this uncommon entity. METHODS： A retrospective review of patients aged 〉 18 years with a diagnosis of intestinal intussusception between 2000 and 2008. Patients with rectal prolapse, prolapse of or around an ostomy and gastroenterostomy intussusception were excluded. RESULTS： There were 20 rases of adult intussusception. Mean age was 47.7 years. Abdominal pain, nausea, and vomiting were the most common symptoms. The majority of intussusceptions were in the small intestine （85%）. There were three （15%） cases of colonic intussusception. Enteric intussusception consisted of five jejunojejunal cases, nine ileoileal, and four cases of ileocecal invagination. Among enteric intussusceptions, 14 were secondary to a benign process, and in one of these, the malignant cause was secondary to metastatic lung adenocarcinoma. All colonic lesions were malignant. All cases were treated surgically. CONCLUSION： Adult intussusception is an unusual and challenging condition and is a preoperative diagnostic problem. Treatment usually requires resection of the involved bowel segment. Reduction can be attempted in small-bowel intussusception if the segment involved is viable or malignancy is not suspected; however, a more careful approach is recommended in colonic intussusception because of a significantly higher coexistence of malignancy.     

Primary Intrathoracic Extrapulmonary Hydatid Cysts: Analysis of 14 Patients with a Rare Clinical Entity

Primary hydatid cysts very rarely form in intrathoracic yet extrapulmonary sites. Accurate preoperative diagnosis in such cases is difficult, and corrective surgical procedures necessarily differ from those that are used to treat the far more typical pulmonary or hepatic hydatid cysts. We retrospectively evaluated the diagnostic and operative characteristics of intrathoracic extrapulmonary hydatid cysts, and we examined the outcome of aggressive surgical interventions that went beyond conventional parenchymal-sparing procedures.From 2003 through 2007, 14 patients (mean age, 39.14 ± 16.8 yr) underwent surgical treatment in our hospital for primary intrathoracic extrapulmonary hydatid cysts. These cysts were variously in the diaphragm, chest wall, mediastinum, pleura, and pericardial cavity. All patients underwent cystectomy, decortication, resection, and repair of the adjacent structure. No complication, recurrence, or death occurred in the follow-up period of 15 ± 18.1 months (range, 2–52 mo).In order to achieve complete resection and to avoid recurrence of disease from intrathoracic extrapulmonary hydatid cysts, the thoracic surgeon should forgo cystotomy and capitonnage in favor of cystectomy with a wide resection and reconstruction of surrounding tissues. Postoperatively, patients should adhere to a regimen of anthelmintic therapy.Key words: Anthelmintics/therapeutic use, echinococcosis/complications/diagnosis/radiography/surgery, incidence, recurrence, retrospective studies, thoracic diseases/diagnosis/parasitology/surgery, thoracic surgical procedures, operative/methods, treatment outcome, Turkey/epidemiologyHydatid cyst disease, or echinococcosis, is a parasitic disease that has been known since the time of Hippocrates. It remains endemic in Turkey and other countries. Although the liver and the lungs are the usual sites of the disease, cysts can also form elsewhere in the body.^1,2 It is not difficult to diagnose typical pulmonary or hepatic hydatid cysts. Conversely, when cysts appear intrathoracically but in extrapulmonary locations, crucial diagnostic difficulties may occur, with atypical clinical and radiologic signs. Cysts in such sites can lead to fatal complications, such as bronchial rupture, fistulas to the pleural and pericardial cavities, and severe bleeding.^3,4 Difficulties in diagnosis notwithstanding, corrective surgical treatment differs from that of pulmonary or hepatic hydatid surgery.In this retrospective analysis, we evaluated the characteristics of intrathoracic extrapulmonary hydatid cysts and sought to confirm the most appropriate surgical interventions. This study was approved by our institution''s ethics committee.