Prevalence and comorbidity of allergic eczema, rhinitis, and asthma in a city in western Turkey.

BACKGROUND: Allergic diseases co-occur in many patients. There is no published population-based epidemiologic study about allergic diseases in Turkey. OBJECTIVE: The aim of this population-based study was to investigate the prevalence of allergic eczema, allergic rhinitis, and asthma and their co-occurence in Manisa. METHODS: The sample size was calculated using an estimated prevalence of ever wheezing for the analyzed age group. Interviews were conducted with 725 children. The survey instrument consisted of a set of sociodemographic questions plus the questionnaire of the International Study of Asthma and Allergies in Childhood. RESULTS: The mean (SD) age of the children studied was 8.94 (5.16) years. The prevalence of ever having allergic eczema was 4.7% whereas that of current allergic eczema was 3.2%. Current allergic rhinitis and allergic conjunctivitis were present in 14.5% and 13%, respectively. Asthma was reported in 14.7% of the children older than 3 years of age while the prevalence of physician-diagnosed asthma was 7.9%. The burden of allergy was 27.1%. The prevalence of concomitant eczema and rhinitis was 1.9%. Among children aged between 3 and 17 years, 1.5% and 4.7% had asthma along with eczema and rhinitis respectively. Asthma was significantly more common in children with rhinitis (31.5% vs 11.8%; P < .01; odds ratio [OR], 3.45). Asthma was diagnosed in 28.1% of children with eczema and 14% of children without eczema (P = .03; OR, 2.41). CONCLUSIONS: Atopic diseases seem to significantly increase the risk of developing another atopic disease with ORs that range from 2.4 to 3.4.

Pulmonary hypertension in patients with chronic renal failure.

BACKGROUND: Many etiologies causing pulmonary hypertension (PH) have been reported, and one of the background disease seen with patients with PH is chronic renal failure (CRF); however, the pathogenesis of PH in this group of patients is not explained satisfactorily. OBJECTIVES: The aims of this study were to evaluate the incidence of unexplained PH among patients with CRF and to suggest possible etiologic factors. METHODS: Two hundred and eleven patients with CRF were evaluated and the ones who have comorbid conditions that cause PH were excluded. Pulmonary arterial pressure (PAP) and cardiac functions were evaluated by Doppler echocardiography. Arteriovenous fistula (AVF) flow was measured by Doppler sonography. The patients were followed for at least 6 months. RESULTS: Forty-eight CRF patients (20 males, 28 females) were included: 23 were predialysis patients, and 25 patients received hemodialysis via AVF. Patients were followed for 7.5 +/- 1.01 months. Systolic PAP >35 mm Hg was found in 56% (14/25) of patients receiving hemodialysis (36.8 +/- 10.7 mm Hg) and in 39.1% (9/23) of predialysis patients (29.5 +/- 9.5 mm Hg). The parathyroid hormone level, cardiac output values and CRF duration were found to be increased in patients with elevated systolic PAP (p < 0.05). AVF flow and AVF duration were positively correlated with systolic PAP in patients receiving hemodialysis (p < 0.05). There was a negative correlation between systolic PAP and residual urine volume (p < 0.05). AVF compression in hemodialysis patients decreased systolic PAP from 36.8 +/- 10.7 to 32.8 +/- 10.5 mm Hg. Systolic PAP values were increased at the end of the study in the predialysis group, whereas they were decreased at the end of the follow-up in the hemodialysis group (36.9 +/- 10.5 and 32.04 +/- 10.5 mm Hg, respectively). CONCLUSIONS: This study demonstrates a high incidence of PH among patients with CRF. CRF duration, AVF flow, parathyroid hormone level and cardiac output may be involved in the pathogenesis of PH. The effective hemodialysis and dry weight reduction decreased systolic PAP values.

Lumbar stiffness but not thoracic radiographic changes relate to alteration of lung function tests in ankylosing spondylitis.

Involvement of the costovertebral (CV) and costotransverse (CT) as well as the sacroiliac (SI) joints is known to occur in patients with ankylosing spondylitis (AS). The functional significance of these changes is not clear. We have performed clinical and radiological evaluations and assessed the effect of joint involvement on pulmonary function. We detected radiologic evidence of involvement of the CV joint in 80% of patients and of the CT joint in 60 %. We found a direct relation between the severity of CV, CT and SI joint affliction, and the severity of CV and SI joints were related to time of evolution of the disease. Pulmonary function tests revealed neither restrictive nor obstructive defects. No relation was found between pulmonary function and CV and CT joint affliction. Patients with stiffer spines had a tendency to have pulmonary function tests within the lower limit of the normal range. In patients with AS diaphragmatic breathing might compensate the chest respiration to some extent.

Tuberculous tonsillitis.

The epidemiology of tuberculosis has changed recently with an increasing incidence of unusual presentations. A case of tuberculous tonsillitis, which is a rare condition, is presented in this report. The manifestations of this entity are tonsillar hypertrophy and painful ulceration. Final diagnosis of tuberculous tonsillitis is usually made after histopathologic examination of tonsillectomy material. Cultures should be obtained from the tissue specimens, and acid-fast bacilli must be investigated to confirm the diagnosis. Systemic signs of tuberculosis may not be seen in this clinical form. These features may confuse tuberculous tonsillitis with malignancies. In this article, general information and literature about tuberculous tonsillitis are reviewed, and a case of tuberculous tonsillitis is reported to draw attention to this rare clinical form of tuberculosis.