Saliva/serum ghrelin, obestatin and homocysteine levels in patients with ischaemic heart disease.

BACKGROUND: We aimed to compare ghrelin, obestatin, homocysteine (Hcy), vitamin B12 and folate levels in the serum and saliva of ischaemic heart disease patients. METHODS: Serum and saliva were collected from 33 ischaemic heart disease (IHD) patients and 28 age- and body mass index-matched healthy individuals. Levels of acylated and desacylated ghrelin, obestatin and Hcy were determined using the ELISA method. RESULTS: Acylated ghrelin, desacylated ghrelin and obestatin levels in the saliva were found to be higher than those in the serum of the control group, while acylated and desacylated ghrelin levels in the saliva were significantly lower than those in the serum. Obestatin levels were higher in IHD patients (p = 0.001). Saliva and serum vitamin B12 and folate levels in IHD patients were significantly lower than in the control group (p = 0.001). CONCLUSIONS: It was determined that serum ghrelin levels increased in ischaemic heart disease patients, while serum levels of obestatin decreased.

Maternal and neonatal outcomes in advanced maternal age: a retrospective cohort study.

OBJECTIVES: To describe the effect of extremely advanced maternal age (EAMA) on maternal/neonatal outcomes. METHODS: This was a case-control study in which 127 women ≥40 years at the time of delivery out of 2853 singleton hospital deliveries in Ondokuz Mayis University between 1 January 2008 and 31 August 2010 constituted the study group. One hundred and twenty-seven else were chosen randomly out of 2412, 21-35 years old women, via a computer system as controls. Demographic features of 254 mothers and infants as well as maternal and neonatal complications were recorded. RESULTS: Mean maternal age was 41.5 ± 1.9 (40-49) years in EAMA group and 28.9 ± 4.2 (21-35) years in controls. Primigravidity was 19.6% in the EAMA group, whereas 37.8% in controls (p = 0.003). No difference was found between groups according to route of delivery, stillbirth, preterm birth, congenital abnormalities, gender of babies, NICU admission and respiratory problems (for all p > 0.05). A 5th min Apgar score <7 was more frequent in babies born to EAMA mothers compared to controls (9.8% versus 4.9%, p = 0.004). CONCLUSION: The present study shows that EAMA mothers and their offsprings have similar peri and neonatal risks compared to younger mothers, except lower 5th minute Apgar scores. We conclude that with good perinatal care, EAMA women and their babies can pass through the perinatal period with similar risks of younger women.

Assessment of different folic acid supplementation doses for low-birth-weight infants.

AIM: The adequacy of 50 mcg folic acid supplementation given to low-birth-weight babies was investigated. The folate levels of the mothers and infants, and breastmilk, and the optimum dose for folic acid supplementation were also investigated. MATERIAL AND METHODS: After obtaining blood from 141 low-birth-weight infants on the 1st day of life for serum and red cell folate levels, the infants were randomly allocated into three groups according to the folic acid supplement dose. Forty-six infants were given 25 µg/d folic acid, 39 were given 50 µg/d folic acid, and 44 were given 75 µg/d folic acid. Folic acid could not be given to 12 infants. Follow-up blood samples were obtained at the end of folic acid supplementation. Maternal samples for red cell and serum folate levels and breast milk folate levels were obtained within the first 48 hours and the samples for measuring breastmilk folate level were obtained on the 3rd day postnatally. The feeding modes of the infants, maternal folic acid intake, and details of neonate intensive care unit course were recorded. RESULTS: The mean birth weight and gestational age of the infants were found as 1788.2±478.4 g and 33.5±2.9 weeks, respectively. The mean serum and red cell folate levels on admission were found as 21.2±12.2 ng/mL and 922.7±460.7 ng/mL, respectively. The mean maternal serum and red cell folate levels and the mean breast milk folate levels were found as 12.3±7.5 ng/mL, 845.5±301.4 ng/mL, and 30.6±33.0 ng/m, respectively. The breast milk folate levels of mothers who were supplemented with folic acid during pregnancy were significantly higher compared with mothers who were not supplemented with folic acid (p<0.001). Infants who were supplemented with folic acid had higher follow-up serum folate levels compared with the basal level in all groups, but there was no statistically significant difference between the groups. CONCLUSION: This study showed that the folic acid doses of 25, 50, and 75 µcg/d affected serum folate levels similarly. We can conclude that the dose of 25 µcg/d is adequate for low-birth-weight infants.

To Compare Time-Weighted Graphs to Evaluate the Inclination of the Acetabular Component of Patients Who Had Total Hip Replacement Surgery.

Time-weighted graphs are used to detect small shifts in statistical process control. The aim of this study is to evaluate the inclination of the acetabular component with CUmulative SUM (CUSUM) chart, Moving Average (MA) chart, and Exponentially Weighted Moving Average (EWMA) chart. The data were obtained directly from thirty patients who had undergone total hip replacement surgery at Ondokuz Mayis University, Faculty of Medicine. The inclination of the acetabular component of these people, after total hip replacement, was evaluated. CUSUM chart, Moving Average chart, and Exponentially Weighted Moving Average were used to evaluate the quality control process of acetabular component inclination. MINITAB Statistical Software 15.0 was used to generate these control charts. The assessment done with time-weighted charts revealed that the acetabular inclination angles were settled within control limits and the process was under control. It was determined that the change within the control limits had a random pattern. As a result of this study it has been obtained that time-weighted quality control charts which are used mostly in the field of industry can also be used in the field of medicine. It has provided us with a faster visual decision.

The relationship of T helper-2 pathway components interleukin-4, interleukin-10, immunoglobulin e, and eosinophils with prognostic markers in non-hodgkin lymphoma: a case-control study.

OBJECTIVE: Increased risk for non-Hodgkin lymphoma (NHL) is associated with infections and environmental agents. We hypothesized that these factors chronically trigger the T helper-2 (Th2) pathway and result in lymphoma. We investigated the role of the Th2 pathway by exploring the relationships between components of the Th2 pathway, interleukin (IL)-10, IL-4, immunoglobulin E (IgE), and eosinophils, and prognostic markers of NHL. MATERIALS AND METHODS: Thirty-one NHL patients and 27 healthy controls were enrolled. IL-10, IL-4, IgE, and eosinophils were measured. IL-4 and IL-10 were analyzed with the enzyme amplified sensitivity immunoassay method. RESULTS: High IL-10 levels were correlated with several poor prognostic features, short early survival, and lymphopenia. There was a positive correlation between albumin and IL-4 levels and a negative correlation between IL-10 and albumin. There was no relationship related with eosinophils and IgE. We found remnant increased IL-4, which could be a clue for the triggering of the Th2 pathway in the background. CONCLUSION: There is a need for differently designed studies to detect the place of the Th2 pathway in NHL.

A breast cancer nomogram for prediction of non-sentinel node metastasis - validation of fourteen existing models.

BACKGROUND: To avoid performing axillary lymph node dissection (ALND) for non-sentinel lymph node (SLN)-negative patients with-SLN positive axilla, nomograms for predicting the status have been developed in many centers. We created a new nomogram predicting non-SLN metastasis in SLN-positive patients with invasive breast cancer and evaluated 14 existing breast cancer models in our patient group. MATERIALS AND METHODS: Two hundred and thirty seven invasive breast cancer patients with SLN metastases who underwent ALND were included in the study. Based on independent predictive factors for non-SLN metastasis identified by logistic regression analysis, we developed a new nomogram. Receiver operating characteristics (ROC) curves for the models were created and the areas under the curves (AUC) were computed. RESULTS: In a multivariate analysis, tumor size, presence of lymphovascular invasion, extranodal extension of SLN, large size of metastatic SLN, the number of negative SLNs, and multifocality were found to be independent predictive factors for non-SLN metastasis. The AUC was found to be 0.87, and calibration was good for the present Ondokuz Mayis nomogram. Among the 14 validated models, the MSKCC, Stanford, Turkish, MD Anderson, MOU (Masaryk), Ljubljana, and DEU models yielded excellent AUC values of > 0.80. CONCLUSIONS: We present a new model to predict the likelihood of non-SLN metastasis. Each clinic should determine and use the most suitable nomogram or should create their own nomograms for the prediction of non- SLN metastasis.

[Infectivity-resistotype-genotype clustering of methicillin-resistant Staphylococcus aureus strains in the Central Blacksea Region of Turkey]. / Türkiye'nin Orta Karadeniz Bölgesinde metisiline dirençli Staphylococcus aureus kökenlerinin enfeksiyözite-rezistotip-genotip kümelenmesi.

The increase in the prevalence of epidemic strains of methicillin resistant Staphylococcus aureus (MRSA) in hospitals and community requires special attention of infection control. The aim of this study was to determine the pathogenic phenotype (i.e. infectivity and resistotype) and genotypic characteristics (i.e. PFGE-pulsotyping, SLST-spa typing, MLST-sequence typing, eBURST-clonal complex detection algorithm) of clinical MRSA isolates in the Central Blacksea region of Turkey, in order to understand their short- and long-term epidemiological and evolutionary dynamics, and to investigate any probable presence of a significant clustering. This prospective study included consecutive but non-repetitive 48 MRSA isolates (of them 18 were colonized strains and 30 were causes of nosocomial infection) and seven methicillin-susceptible S.aureus (MSSA, all were isolated from nosocomial infection), collected between December 2006-February 2007 period from hospitalized patients. Identification of the isolates were performed by Vitek-2 automated system (BioMérieux, USA), and in vitro antimicrobial susceptibility testing by broth microdilution method and Vitek-2 automated system. The MRSA isolates found susceptible to erythromycin (n= 10) were further investigated for the presence of ermA gene by the PCR method. All the strains were typed by spa-typing and PFGE-pulsotyping methods. Among the isolates with different spa-types, representatives were selected (3 MRSA, 7 MSSA) and typed with MLST typing method. Among the isolates with different spa-types, representatives with different antimicrobial susceptibility patterns were selected (n= 8), and SCCmec types were determined by the multiplex PCR method. Antimicrobial resistance patterns of the isolates were digitized to get standardized antimicrobial resistance phenotypes. Clustering of MRSA isolates in pattern groups on the basis of discriminatory characteristics, namely infectivity, phenotype and genotype were statistically analyzed with specific inclusion and exclusion criteria. As a result, three different antimicrobial resistance phenotypes were found in MSSA isolates, whereas 13 were identified in MRSA isolates. In MSSA isolates, seven different PFGE-pulsotypes were detected, as compared to 14 pulsotypes in MRSA isolates. Among MRSA isolates, 10 sporadic strains with single PFGE-pulsotypes were detected. All MRSA isolates, with two exceptions (t459, t632), were of t030 spa-type; in the MLST analysis of the representatives of different spa-types (n= 3), a single type of MLST-clonal complex (CC8) and single MLST-sequence type (ST239) were identified. Each of the seven MSSA isolates yielded different spa-types, MLST-clonal complex types and MLST-sequence types (t777-ST5-CC5; t660-ST25-CC5; t153-ST34-CC30; t015-ST45-CC45; t267-ST97-CC97; t377-ST360-CC8; t084-ST15-C15). In the statistical analysis of 38 non-sporadic MRSA isolates, the isolates in Group-13 (n= 16; infectious, resistotype 14, pulsotype 4; antimicrobial resistance score= 24) displayed significant infectivity-phenotype-genotype clustering (p< 0.001). In 27 of the MRSA isolates, decreased susceptibility to teicoplanin (MIC= 4 µg/mL) was detected. Although, global MRSA isolates belonging to MLST-CC8, MLST-ST239, t030 spa-type were usually expected to be resistant to erythromycin, 10 such strains were erythromycin susceptible. However, ermA gene was found in six of these 10 strains, leading to a conclusion that the ermA gene of these isolates might be dysfunctional due to a point mutation or deletion. Selected representatives of MRSA isolates with different antimicrobial susceptibility patterns (n= 8) were detected to be SCCmec type III. In conclusion, S.aureus isolates in the patient population of our hospital representing the Central Blacksea region showed statistically significant clustering in infectivity, antimicrobial resistance phenotype and clonal genotype (p< 0.001). The dominant MRSA clone was ST239 which was one of the five major pandemic MRSA clones. Nosocomial MSSA isolates displayed long-term clonal diversity. This study produced regional evolutionary-epidemiological data that may support further regional, national and international long-term surveillance studies of S.aureus strains.

Comparison of oversized artery and vein grafts for interpositional pedicle lengthening in rat femoral artery.

Vessel grafting is commonly used for revascularization or pedicle lengthening. Although veins are more commonly used, they can form aneurysms when bridging an arterial gap. This can lead to thrombosis, and the risk is increased when there is a size discrepancy. This study reports the long-term results of arterial lengthening via size discrepant carotid artery and femoral vein grafts in a rat femoral artery model (1:1.5 ratio). A total of 28 rats were used in this study, divided into two groups of 14. By the 21st day, one anastomosis in each group has been found to be thrombosed. Long-term patency rates were the same for both groups (93.3%). Radiologic imaging showed that size match in the carotid artery grafts was excellent despite of slightly fusiform dilatation, but in the vein groups, pronounced aneurismal deformation and distortion in the anastomosis was seen. Histologic analysis revealed that in the arterial grafts, endothelial continuity was smooth and mural inflammation was less than that of the vein grafts. Organized or recanalized mural thrombi were seen in 38.5% in the vein grafts, whereas in arterial grafts there were none.

The optimal dose of remifentanil for acceptable intubating conditions during propofol induction without neuromuscular blockade.

STUDY OBJECTIVE: To determine the optimal remifentanil dose required to provide acceptable intubating conditions following induction of anesthesia with propofol without using neuromuscular blockade. DESIGN: Dose-response study. SETTING: Operating room of a university hospital. PATIENTS: 50 ASA physical status 1 men, aged between 20 and 40 years, who were scheduled for general anesthesia. INTERVENTIONS: Intubating conditions were evaluated according to the scoring system described by Viby-Mogensen et al. Successful intubation was defined as excellent or good. MEASUREMENTS: For induction of anesthesia, an intravenous (IV) bolus dose of propofol 2.0 mg/kg was given over 30 seconds followed by the administration of predetermined IV remifentanil over 30 seconds; intubation was performed 90 seconds after completion of the remifentanil administration. The dose of remifentanil used for each patient was determined by the response of the previously tested patients, using the modified Dixon's up-and-down method (using 0.2 µg/kg as a step size). The first patient was tested with remifentanil 1.0 µg/kg. If intubation failed, the remifentanil dose was increased by 0.2 µg/kg; if intubation was successful, the dose was decreased by 0.2 µg/kg. Mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation were recorded during the study period. MAIN RESULTS: According to probit analysis, the effective dose of remifentanil in 50% (ED(50)) and 95% (ED(95)) of patients were 1.40 µg/kg and 2.40 µg/kg, respectively. Preintubation and postinduction HR and MAP values were lower than preinduction values (P < 0.001). CONCLUSION: The optimal bolus dose of remifentanil for acceptable intubating conditions was 2.40 µg/kg (95% confidence interval, 1.90-9.0 µg/kg) in 95% of patients during induction of anesthesia with propofol 2.0 mg/kg without neuromuscular blocking agents.

Hsp 70, hsCRP and oxidative stress in patients with acute coronary syndromes.

Acute coronary syndromes (ACS) like unstable angina (UA) and acute myocardial infarction (AMI) can lead to the morbidity and mortality. The diagnosis and management of patients with ACS in the earliest times after symptom onset are considerably important in the emergency service. Study aimed to investigate the serum levels of heat shock protein 70 (Hsp 70), high sensitivity C-reactive protein (hsCRP), total creatine kinase (CK) activity, creatine kinase MB (CK-MB), cardiac troponin I (cTnI), leukocyte count (WBCs) and markers of oxidative stress in the first hours of ACS and to view their diagnostic values. 70 patients with ACS after admission and 20 sex-matched healthy controls were included in this study. Serum Hsp 70, hsCRP, CK, CK-MB, cTnI, protein carbonyls, malondialdehyde as well as whole blood WBCs were measured. The level of hsCRP was statistically higher in patients with AMI and UA than that of control group (p<0.001). WBCs and oxidized protein levels were higher in AMI than in UA and control groups. cTnI was related to CK-MB in AMI and UA groups (r=0.731, r=0.806, p<0.001, respectively) and also related with hsCRP in UA group (r=0.824, p<0.001). The mean Hsp 70 level was higher by 32.2% in AMI and 12.7% in UA patients compared to control subjects. hsCRP may have a role in the inflammatory response after ACS. In addition to cTnI and CK-MB, WBCs and hsCRP may be useful as a marker for the identification of ACS patients with chest pain in early diagnosing.

Effectiveness of microwave diathermy on pain, functional capacity, muscle strength, quality of life, and depression in patients with subacromial impingement syndrome: a randomized placebo-controlled clinical study.

The aim of this clinical trial was to evaluate the effectiveness of therapeutic MD on pain, functional capacity, muscle strength, quality of life, and depression in patients with subacromial impingement syndrome (SIS). A total of 40 inpatient subjects with definite SIS were included in this study. These patients were sequentially randomized into 2 groups. Group 1 (n = 20) received therapeutic MD. Group 2 (n = 20) was served as control group and received sham MD. Superficial heat and exercise program were given to both groups. Both of the programs were performed 5 times weekly for 3 weeks. Patients were assessed before treatment (BT), after treatment (AT), and at a 1-month follow-up (F). Outcome measures included visual analogue scale, goniometry, Shoulder Pain and Disability Index, Shoulder Disability Questionnaire, shoulder isokinetic muscle testing, handgrip strength, Short Form 36, and Beck Depression Index. The patients with SIS in each group had significant improvements in pain, shoulder ROM, disability, shoulder muscles and grip strength, quality of life, and depression AT and F when compared with their initial status (P < 0.05). There was no statistically significant difference between the groups according to all the parameters regarding the change scores between AT-BT test and F-BT test (P > 0.05). A 2,450-MHz MD regimen showed no beneficial effects in patients with SIS, so the superficial heat and exercise program, as it is efficient, may be preferable for the treatment of SIS, alone.

[Performance evaluation of VITEK 2 system in meropenem susceptibility testing of clinical Pseudomonas aeruginosa isolates]. / Pseudomonas aeruginosa klinik izolatlarinda VITEK 2 sistemiyle yapilan meropenem duyarlilik testinin performans degerlendirmesi.

Pseudomonas aeruginosa is an important opportunistic pathogen associated with various community-acquired or nosocomial infections. Multi-drug resistant P.aeruginosa strains increasingly cause epidemics and spread in various hospital wards and geographic regions. Carbapenems are among the most effective antimicrobials in the treatment of multi-drug resistant P.aeruginosa infections, and meropenem is the most successful among alternatives in initial therapy. Particularly in severe infections, inappropriate or inadequate initial antimicrobial therapy is independently associated with adverse clinical and economic outcomes. Availability of accurate and rapid susceptibility testing is a priority. Most of the automated microbiology systems can provide rapid results within 8 to 12 hours. In comparison to standard methods, problems in the antimicrobial susceptibility testing of particular microorganisms and antimicrobial agents have been reported for automated microbiology systems. Failures have been reported previously especially in the susceptibility testing of P.aeruginosa versus carbapenem. Most of these studies are designed according to the Food and Drug Administration (FDA, USA) performance analysis scheme (Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test Systems) in a simplified form. However, there are many lacking issues in the design of most of these studies. Among these, insufficient sample size, use of inappropriate reference method, lack of reproducibility testing, and inadequate distribution of study isolates in interpretative categories are of notice. There are only few studies in the literature that evaluate the performance of automated systems in antimicrobial susceptibility testing of carbapenems in clinical P.aeruginosa isolates with a sufficient sample size (n ? 100). However, most of these studies still have one or more major deficiencies in the study design. Furthermore, none of these studies evaluate the performance of VITEK 2 system without a major deficiency in study design. Therefore, we aimed to evaluate the performance of VITEK 2 system (bioMérieux, France) in antimicrobial susceptibility testing of carbapenems in clinical P.aeruginosa isolates in a well-designed study. The study was conducted on nonrepetitive P.aeruginosa isolates (n= 142) of clinical origin. Isolates were selected from the isolate collections of Culture Collection Unit of the Medical Laboratories at Ondokuz Mayis University Hospital. The study collection was characterized with conventional tests and the VITEK 2 automated microbiology system. Broth microdilution method standardized by Clinical and Laboratory Standards Institute was used as the reference method. P.aeruginosa ATCC 27853 was used as the quality control strain in all experimental steps. Twofold dilutions of meropenem (AstraZeneca, USA) concentrations between 64 mg/L and 0.125 mg/L were tested. In compliance with FDA recommendations, minimum inhibitory concentrations of study isolates were shown to be on-scale and distributed within the range of five sequential dilutions in both methods. In reproducibility testing, 15 organisms were tested with VITEK 2 system in triplicate. Results of the reproducibility tests were evaluated in comparison to the test mode (the most frequent test result for the isolate) as a reference. Overall reproducibility was 100%. Essential and categorical agreements of the VITEK 2 system in comparison to the reference method were 83.8% and 96.5%, respectively. Very major and minor discrepancy rates were 1.4% and 2.8%, respectively. There was no major discrepancy. While the results of the essential agreement was not acceptable, categorical agreement was acceptable according to the FDA performance criteria. There was very good agreement between methods as shown by the kappa value (?= 0.938). In conclusion, VITEK 2 system exhibited acceptable performance in the meropenem susceptibility testing of clinical P.aeruginosa isolates. As pre-market approval may not guarantee proper validation, performance of the automated microbiology systems in antimicrobial susceptibility testing should at least be verified and the literature that reports performance evaluation results should be read critically before implementation for routine use in laboratory.

Treatment of melasma with a depigmentation cream determined with colorimetry.

BACKGROUND: Melasma is a pigmentary disorder often recalcitrant to treatment. Few studies have objectively evaluated the efficacy of treatment colorimetrically. AIM: To evaluate the safety and efficacy of a depigmentation cream, including mainly glycolic acid and Rumex occidentalis. METHOD: Twenty-seven patients applied the cream twice daily for the first 3 months and twice weekly for the following 3 months. L*, C* and h* values of the target lesions and the perilesional area were analyzed at baseline, 12 and 24 weeks colorimetrically. The physician and patient evaluated the clinical response rate. These results were compared statistically between the lesional and perilesional area. RESULTS: There was a significant difference between 0-12, 0-24 (L*, C* and h* values) and 12-24 weeks (L* value) (p <0.001). For C* and h* values, the difference was not significant between 12 and 24 weeks (p = 0.464 and 0.151, respectively). Statistical significance was detected only between 3 and 6 months for C* value (p < 0.05) for the lesional and the perilesional areas. Clinical response rate was significant (p < 0.05). CONCLUSION: Our depigmentation cream is a moderate effective agent, well tolerated and can be considered as an alternative treatment of melasma. Twice-daily application may enhance the efficacy of treatment instead of twice-weekly application in the maintenance period.

Comparison of the 532-nm KTP and 1064-nm Nd:YAG lasers for the treatment of cherry angiomas.

BACKGROUND: Laser therapy is the treatment of choice for cherry angiomas since it is more effective and has better cosmetic results. There is no comparative study about the treatment efficacies with KTP and Nd:YAG lasers for cherry angiomas. OBJECTIVE: To compare the efficacy and side effects of 532-nm KTP and 1064-nm Nd:YAG lasers for the treatment of cherry angiomas. METHODS: Two comparable lesions of the same patient were chosen. One of them was treated with the KTP laser while the other was treated with the Nd:YAG laser. Sessions were repeated every 4 weeks until complete clearance was achieved. Side effects were evaluated using a severity scale (0 to 4). RESULTS: The number of sessions was significantly higher with the KTP than with the Nd:YAG laser (p = 0.002). Erythema, edema, pain and scar formation were higher in the Nd:YAG laser group (erythema: p = 0.001; edema: p < 0.001; pain: p < 0.001; scar: p < 0.001). The hyperpigmentation rate was statistically higher with the KTP laser (p = 0.01). CONCLUSION: Both KTP and Nd:YAG lasers were found to be effective methods. The Nd:YAG laser offered fewer treatment sessions, but a higher risk of scar formation. The KTP laser seems more advantageous, but in dark-skinned patients the Nd:YAG laser may be preferable.

Environmental risk factors in pediatric psoriasis: a multicenter case-control study.

To analyze the effect of possible risk factors, including breastfeeding, on the development of childhood-onset psoriasis, a multicenter case-control study with prospective collection of data was performed. Using a standard questionnaire, personal and specific variables including family history of psoriasis, maternal and environmental tobacco smoke exposure, body mass index (BMI), exclusive and partial breastfeeding for at least 3 and 12 months, cow's milk intake before 1 year, birth delivery method, and stressful life events were collected during 2009 from 537 patients with psoriasis and 511 controls younger than 18. Overall, patients more frequently reported exposure to environmental tobacco smoke at home and stressful life events in the year preceding the diagnosis than controls. The odds ratios (OR) for smoking and stressful life events were 2.90 (95% confidence interval [CI]=2.27-3.78) and 2.94 (95% CI=2.28-3.79), respectively. In addition, children with psoriasis were more likely to have a higher BMI (>26) than controls (OR=2.52; 95% CI=1.42-4.49). High BMI, environmental tobacco smoke exposure at home, and stressful life events may influence the development of pediatric psoriasis.

Tumor necrosis factor alpha and beta and interferon gamma gene polymorphisms in Turkish breast cancer patients.

Cytokine genes are important for researching cancer predisposition to cancers that elicit anti-tumor immune response. In this study, we investigated the association between breast cancer and tumor necrosis factor alpha (TNF-α) -308 (G>A), TNF-ß +252 (A>G), and interferon gamma (IFN-γ) +874 (T>A) gene polymorphisms in a Turkish population. This study involved 204 female breast cancer patients and 204 healthy female controls. Genomic DNA was extracted from EDTA-preserved peripheral venous blood of patients and controls by a salting-out method and analyzed by polymerase chain reaction, allele-specific oligonucleotide polymerase chain reaction, and restriction fragment length polymorphism. TNF-α -308 genotype was found to have no effect on breast cancer susceptibility. However, there were statistically significant differences between the genotype frequencies of patients and controls for TNF-ß polymorphism (p = 0.016) and the allele and genotype frequencies for the IFN-γ polymorphism (p = 0.0312 and p = 0.001, respectively). In the composite genotype analysis, the TNF-α/ß GAAG composite genotype (p = 0.0424), the TNF-α/IFN-γ GGTT and GATT composite genotypes (p = 0.0296 and p = 0.0129, respectively), the TNF-ß/IFN-γ AGTT composite genotype (p = 0.0003), and the TNF-α/ß/IFN-γ GGAGTT and GAAGTT composite genotypes (p = 0.0437 and p = 0.0038, respectively) were estimated to have a protective effect against breast cancer. However, the TNF-α/IFN-γ GGTA composite genotype is a risk factor for breast cancer (p = 0.0156). In conclusion, TNF-ß +252GG genotype was found more frequent in Turkish breast cancer patients than controls and IFN-γ TA+AA genotypes were estimated to increase breast cancer risk significantly in Turkish population.

Colorimetric-plate method for rapid disk diffusion susceptibility testing of Escherichia coli.

Here, we report a laboratory-developed colorimetric-plate method for rapid disk diffusion susceptibility testing of Escherichia coli. One hundred isolates were evaluated. Categorical agreement between the colorimetric plate and the standard disk diffusion method was 99%. Mean time to results was 7.07 h (95% confidence interval, 5.96 to 8.19).

Clinical comparison of potassium-titanyl-phosphate (KTP) versus neodymium:YAG (Nd:YAG) laser treatment for lower extremity telangiectases.

BACKGROUND: The Nd:YAG laser has been considered the gold standard of treatment for leg veins, but pain and side effects have fueled physicians to use treatment alternatives. OBJECTIVE: To compare the clinical efficacy of the long-pulsed 1064-nm Nd:YAG laser with KTP laser irradiation in the treatment of leg telangiectasia. METHODS: A series of 16 patients with size-matched superficial telangiectases of the lower extremities were randomly assigned to receive three consecutive monthly treatments with the long-pulsed 1064-nm Nd:YAG on one leg and 532-nm KTP laser irradiation on the other. RESULTS: For the 16 patients who completed the study, 64 leg vein sites were treated. Average clinical improvement scores were 1.94 and 1.25 for the KTP laser-treated leg and 3.38 and 3.50 for the Nd:YAG laser-treated leg with thin (≤ 1 mm) and large (1-3 mm) vessels, respectively. After the third treatment session, average improvement scores of 2.44, 1.31 and 3.75, 3.23 were given for the KTP and Nd:YAG laser-treated sides, respectively. CONCLUSION: Both the 1064-nm Nd:YAG and KTP lasers are effective in the treatment of lower extremity telangiectases. However, the KTP laser has very low efficacy with vessels larger than 1 mm and should not be elected when treating such vessels.

Narrow-band ultraviolet B as a potential alternative treatment for resistant psychogenic excoriation: an open-label study.

Narrow-band ultraviolet therapy has been used successfully for the treatment of inflammatory skin disorders and generalized pruritus. We have prospectively evaluated seven consecutive patients with resistant psychogenic excoriation (PE) treated with narrow-band ultraviolet B (NB-UVB). Approximately 70% of all patients showed improvement in their condition. NB-UVB therapy was well tolerated, with no serious side effects. We may conclude that, when treating a patient with PE, NB-UVB in combination with other approaches may provide extra benefit in resistant cases.

Evaluation of the relationship between passive smoking and salivary electrolytes, protein, secretory IgA, sialic acid and amylase in young children.

OBJECTIVE: To evaluate the relationship between passive smoking as determined by salivary cotinine levels and salivary electrolytes, protein, secretory IgA, sialic acid and amylase in children. DESIGN: Saliva was collected from 90 passive smoker (PS) subjects (the study group) and 90 healthy age-matched children (the control group). The study group was divided into three subgroups according the number of cigarettes smoked. Socio-economic status, dental and dietary habits were recorded by questionnaire. Stimulated salivary calcium (Ca), phosphate (P), sodium (Na), potassium (P), total protein, amylase activity, sialic acid level, secretory IgA concentration and cotinine level were analysed. All data were analysed using SPSS, version 13.0. RESULTS: Socio-economic status, dental and dietary habits were similar between the two groups. The salivary electrolytes concentrations did not reveal significant difference between the two groups (p>0.05). The mean cotinine levels of PS children were 1.58+/-4.3 ng/mL. The salivary concentrations of protein were similar between the two groups (p>0.05). The salivary secretory IgA concentration was significantly lower in the PS group than controls. The sialic acid level and amylase activity in PS group were found significantly higher compared with the controls (p<0.05). No difference was observed for all these parameters with sex (p>0.05). When saliva samples were analysed for output, the sialic acid level and amylase activity increased significantly in PS subjects (p<0.05). Further, the output of secretory IgA concentration was found significantly lower compared with the controls (p<0.05). CONCLUSION: In conclusion, we show that passive smoking was associated with a decrease in secretory IgA concentration, whereas with increase in amylase activity and sialic acid level of stimulated whole saliva in young children.