Common tongue conditions affect quality of life: an issue to be recognized.

INTRODUCTION: There is an increasing recognition that oral disorders might cause significant impact on life of patients. To date, there has been less focus on oral health-related quality of life (OHR-QoL) measures in outpatient clinics for oral diseases. AIM: This study was carried out to test the assumption that patients with common tongue conditions would report a worse OHR-QoL than controls. METHOD: A total of 59 oral subjects with various tongue conditions and 44 controls were enrolled in this prospective study. Demographic, clinic, and laboratory findings of oral subjects were recorded, and an OHR-QoL questionnaire, named 14-item oral health impact profile (OHIP-14), was completed by oral subjects and controls at the outpatient clinics of four centers. RESULTS: Median of OHIP-14 total scores of the oral subjects with common tongue conditions was 11 and that of controls was 4 (P = 0.00) indicating that OHR-QoL was worse in oral subjects than in controls. Most (n = 39, 66%) of the oral subjects had mild to distressing pain. Eating was the most commonly affected function. Oral subjects were arbitrarily divided into two groups. Group 1 (n = 22) included patients with tongue conditions which were associated with candidal infections and the other patients formed Group 2 (n = 34). A significant difference between Group 1 and Group 2 was observed only with respect to functional limitation (P = 0.027), indicating that oral subjects of Group 1 had more functional limitation. CONCLUSION: Common tongue disorders were believed to be innocuous by most. When the influence of one of the most common form of oral disease (tongue conditions) on OHR-QoL was taken into consideration, OHR-QoL will provide an additional dimension and may help to improve the impact of a disease on an individual's life. Moreover, we also encourage more extensive use of these OHR-QoL instruments for oral diseases at outpatient clinics.

Pre-Conditioning Serum Uric Acid as a Risk Factor for Sinusoidal Obstruction Syndrome of the Liver in Children Undergoing Hematopoietic Stem Cell Transplantation

Objective: Uric acid (UA), a known danger signal released from injured cells, is a valuable sign of inflammation. We aimed to evaluate the association of serum UA levels before the start of conditioning regimens with the risk of hepatic sinusoidal obstruction syndrome (SOS) development after hematopoietic stem cell transplantation (HSCT). Materials and Methods: Two hundred and twenty-two children who underwent allogeneic HSCT at the Pediatric BMT Unit of Hacettepe University between 2000 and 2014 were included in this retrospective study. Serum UA levels were measured before conditioning as an indicator of the pre-transplant inflammatory status of the patients. Patients with and without a diagnosis of SOS were compared regarding primary diagnosis, previously described risk factors for SOS, and pre-conditioning serum UA. Results: SOS was diagnosed in 42 patients who had higher pre-conditioning serum UA levels compared to those who did not. Pre-transplant serum creatinine, gamma-glutamyl transferase, bilirubin, ferritin, and C-reactive protein levels did not differ significantly among patients with and without SOS; however, serum albumin was lower in the patients who developed SOS. Receiver operating characteristic analysis revealed that a pre-conditioning UA level higher than 3.32 mg/dL was predictive of SOS. When applied to a multivariate model, only pre-conditioning UA and albumin levels remained significant risk factors for SOS (UA: odds ratio [OR], 2.54; 95% confidence interval [CI], 1.26-5.12, p=0.009; albumin: OR, 0.45, 95% CI, 0.22-0.95, p=0.037). Conclusion: Our results suggest that pre-conditioning serum UA is an independent risk factor for SOS, and it might be used as an early predictor of hepatic SOS together with previously described clinical and laboratory parameters.

Effect of glycemic control on refractive changes in diabetic patients with hyperglycemia.

PURPOSE: To investigate the effect of intensive glycemic control on hyperglycemia- induced changes in refraction, corneal topography, lenticular and corneal thickness in diabetic patients. METHODS: Eighteen diabetic patients with plasma glucose >300 mg/dl were enrolled in the study consecutively. Autorefraction, C-Scan corneal topography, Javal keratometry, corneal pachymetry and ultrasonic biometric measurements were carried out at presentation and after metabolic control of blood sugar (plasma glucose profile <200 mg/dl). One eye of each patient was selected randomly for statistical analysis. RESULTS: Mean plasma glucose levels were 356.00 mg/dl before and 133.78 mg/dl after treatment. The median values of the autorefractometric measurements were - 0.125 D on admission and + 0.375 D at the second examination. The difference in the refraction was statistically significant (P = 0.022). Nine of 18 patients became hyperopic, 2 became myopic and 7 showed no change after treatment. There was a significant change in the corneal topographic keratometric measurements at the flattest corneal meridian after treatment (P = 0.037). After treatment no statistically significant changes were observed in the pachymetric corneal thickness, anterior chamber depth, biometric dioptric lens calculations and Javal keratometric data. CONCLUSIONS: Hyperglycemia is the major cause of the transient refractive changes in diabetic patients. Following intensive medical treatment, a considerable number of patients tend to become more hyperopic compared with the hyperglycemic state. During the treatment period, changes in the corneal topographic parameters might be a potential source of error for keratorefractive and cataract surgery.

Does recurrent aphthous stomatitis affect quality of life? A prospective study with 128 patients evaluating different treatment modalities.

INTRODUCTION: Quality of life measures are increasingly being used in the evaluation of oral disease outcome. To date, there has been less focus on oral health-related quality of life (OHR-QoL) measures for oral diseases in dermatologic literature. OBJECTIVE: To test whether patients with recurrent aphthous stomatitis (RAS) report a lower OHR-QoL than the general population and to evaluate therapeutic regimens for RAS by using OHR-QoL measures. METHOD: A total of 128 patients and 40 controls were enrolled. A questionnaire entitled the 14-item oral health impact profile (OHIP-14) was completed. Forty-three (33%) of the patients were followed-up and completed the OHIP-14 following treatment. RESULTS: The median total score of patients on colchicine before treatment was 21. Following use of colchicine, the total score was 10. There was a significant difference concerning the impact of oral health following use of oral colchicine. However, no reduction of OHIP-14 scores was observed in the topical treatment group. CONCLUSION: When the influence of one of the most common oral diseases such as RAS on OHR-QoL was taken into consideration, OHR-QoL provides an additional dimension that may help to improve the impact of a disease on an individual's life. In relation to this, colchicine seems to be one of the most effective management strategies used in RAS.