The prevalence of asthma and allergic diseases among adults 30-49 years of age in Bolu, Western Black Sea Region of Turkey.

AIMS: To determine the prevalence of asthma, asthma-like symptoms and allergic diseases among adults 30-49 years of age in regions of Bolu. MATERIALS AND METHODS: A questionnaire was given to families of students in schools in different areas of Bolu, Turkey. The European Community Respiratory Health Survey (ECRHS) and a questionnaire, including questions about the socioeconomic status and demographic characteristics of the participants, were responded to by 1403 people. RESULTS: The prevalence of symptoms and diseases were as follows: wheezing in the last year 12.0% (n=168), asthma 8.7% (n=121), doctor-diagnosed asthma 3.6% (n=50), currently taking drugs for asthma 1.2% (n=17), allergic rhinitis 16.5% (n=230), and eczema 9.6% (n=134). The risk factors for each symptom or disease were as follows: for wheezing: smoking in the house (odds ratio [OR]=2.43 and 95% Confidence Limits [95%CL]=1.53-3.86), living in a non-concrete building (OR=2.17, 95%CL=1.27-3.69); for asthma: mold in the house (OR=1.70, 95% CL=1.05-2.76), living in a shanty (OR=2.76, 95%CL=1.30-5.85), smoking in the house (OR=1.51, 95%CL=1.02-2.22); for allergic rhinitis: being female (OR=1.55, 95%CL=1.08-2.24), living in a shanty (OR=5.81, 95%CL=2.06-16.39), a monthly income below $300 (OR = 1.74, 95%CL=1.13-2.69). CONCLUSIONS: A high rate of undiagnosed and untreated people with asthma among adults 30-49 years of age is present in Bolu. Especially, while a low socioeconomic level was observed to increase the risk of asthma and allergic rhinitis, risk of wheeze and asthma was found to be elevated by smoking in house.

Relationship between the IL-12B promoter polymorphism and allergic rhinitis, familial asthma, serum total IgE, and eosinophil level in asthma patients.

BACKGROUND: IL-12B is a strong candidate gene for asthma. OBJECTIVES: We investigated the relationship between IL-12B and asthma, allergic rhinitis, familial asthma, and levels of eosinophils and total immunoglobulin (Ig) E in the serum of asthma patients. METHODS: The study group consisted of 53 asthma patients and 60 control patients. Serum total IgE levels, eosinophil count, and the presence of allergic rhinitis and familial asthma were determined, and the IL-12B polymorphism was analyzed. Both patients and controls were divided into 3 groups based on their genotypes-homozygous for allele 1 (Al), homozygous for allele 2 (A2), and heterozygous patients, ie, alleles 1 and 2 (A1A2). Each genotype was compared with the other genotypes and the control genotypes. RESULTS: The rates for genotypes A1, A1A2, and A2 were 17%, 40%, and 43%, respectively. Male and female total IgE levels were not different between the groups (P>.05), but they were higher than in the controls (P > .05). The frequencies of allergic rhinitis and familial asthma were not different between the groups (P > .05), although allergic rhinitis in the A1A2 genotype and familial asthma in the A2 genotype were higher than in the controls (P < .05). CONCLUSIONS: Our comparison of asthma patients and controls showed that familial susceptibility to asthma may be related to the A2 genotype, whereas coexistence of asthma and allergic rhinitis may be related to the A1A2 genotype. In asthmatic patients, the effects of the IL-12B polymorphism on asthma, allergic rhinitis, familial asthma, eosinophilia and total IgE levels, are controversial. We think that there is a need to investigate this hypothesis in larger series.

Effects of supportive treatment such as antioxidant or leukotriene receptor antagonist drugs on inflammatory and respiratory parameters in asthma patients.

In this study, prospectively, we aimed to determine the effects of the different treatment alternatives on the oxidant system and inflammatory and clinic determinants during the stable period of 1 month following an asthmatic attack. Thirty-one patients (22 female, nine male) were randomly divided into three groups following the stabilization of an acute asthma attack. The control group that is an additional group to the three patient groups consisted of 10 healthy volunteers (five female, five male). The following protocols were used for 4 weeks: Group I: short-acting inhaler beta2 mimetic as required (treatment A)+800 mug inhaler budesonide (treatment B)+leukotriene receptor antagonist; Group II: treatment A and B; Group III: treatment A and B+vitamin E. The serum levels before and after treatment of eosinophilic cationic protein (ECP), leukotriene E4 (LTE(4)), and malondialdehyde (MDA) were determined. The values before and after treatment were statistically compared both with each other and control values. Pretreatment ECP, LTE(4), and MDA levels for the three groups were significantly higher compared with post-treatment levels (P<0.05 to P<0.001) and the control levels (P<0.01 to P<0.001). However, when post-treatment levels were compared with those of the control group, no significant differences were found (P>0.05). Lack of significant variation was observed when the pre- and post-treatment differences in the three groups were compared for each one of ECP, LTE(4), and MDA levels (P>0.05). Leukotriene receptor antagonist or antioxidant agents added to standard asthma treatment did not make a significant contribution on ECP, LTE(4), and MDA levels and respiratory parameters such as spirometric function tests. Etiologic factors and/or the possible changes in different pathogenetic ways of the inflammation process may have been responsible for nonsignificant intertreatment difference in the biomarker levels. The result confirms that suppressing the inflammation in asthma enables the entire inflammatory pathologic process to be controlled.

Early effects of fibrin sealant on colonic anastomosis in rats: an experimental and case-control study.

BACKGROUND: Leakage from colonic anastomoses leads to mortality and morbidity. Fibrin adhesives can be used to increase the strength of the anastomosis. In this study, we evaluated the early effects of fibrin sealant and hyaluronic acid-carboxymethylcellulose on colonic anastomosis in rats. METHODS: Anastomoses were made in the descending colon of 38 female Wistar-Albino rats, in three groups: control group (n = 12), group 1 treated with hyaluronic acid-carboxymethylcellulose (n = 16), and group 2 treated with fibrin sealant (n = 10). After 72 hours, adhesion scores, bursting pressure, rupture strength and histopathologic healing scores were evaluated. RESULTS: Due to postoperative mortality, we evaluated 10, 10 and 9 rats in the control group and in groups 1 and 2, respectively. Of these, we excluded 4, 5 and 4 rats that had macroperforations at autopsy. In the remaining rats, bursting pressure (123.2 +/- 14.8 mmHg) and rupture strength (400 +/- 16 mg) in the fibrin sealant group were significantly greater than in the two other groups ( CONTROL: 68.0 +/- 10.6 p = 0.006 and 325 +/- 52 p = 0.009; Group 1: 74.0 +/- 9.8 p = 0.03, 330 +/- 27 p = 0.016). However, we did not observe any significant difference between adhesion scores (2.5 +/- 0.6, 2.0 +/- 0.7, 2.0 +/- 0.7, p = 0.343). CONCLUSIONS: In this experimental study, fibrin sealant increased bursting pressure and rupture strength of colonic anastomoses while hyaluronic acid-carboxymethylcellulose had no effects in rats, but both of them showed no effect on adhesion scores. In order to use fibrin sealant to decrease the rate of early leakages from colonic anastomoses, further studies have to be performed.

Relationship between the frequency of autonomic dysfunction and the severity of chronic obstructive pulmonary disease.

OBJECTIVE: The relationship between the frequency of autonomic dysfunction (AD) and the severity of chronic obstructive pulmonary disease (COPD) has not been exactly known, despite its importance in the pathogenesis of COPD. Therefore, we aimed to evaluate the relationship between the clinical stage severity of the disease and the frequency of AD in COPD patients. METHODS: The frequency and type of AD were determined according to the clinical severity of 35 stable COPD patients. The results were compared between the mild and moderate-severe COPD groups. Sympathetic system (SS) was evaluated with sympathetic skin response (SSR), QT and QTc intervals (ms) analyses. Parasympathetic system was evaluated with the heart rate interval variations (RRIV). RESULTS: For the total group, an AD was detected in 20 patients (57%), a parasympathetic dysfunction (PD) in 14 (40%), a mixed-type dysfunction in five (14%) and a sympathetic dysfunction (SD) in only one patient (3%). For the 12 mildly affected patients, there were cases of isolated SD in only one patient (8.5%), isolated PD in five (42%) and AD in six patients (50%). For the 23 moderate-severe COPD patients, mixed AD was detected in five patients (22%), isolated PD in nine (39%) and AD in 14 patients (61%). There were no significant differences between the two patient groups, neither for isolated parasympathetic and sympathetic, mixed form nor for total AD (P>0.05). CONCLUSIONS: The results suggested that PD was dominant in patients with COPD. However, the frequencies of autonomic parasympathetic and sympathetic dysfunction did not increase significantly with the severity of COPD. The severity of hypoxemia and/or airflow limitation may not be the only unique or definite reason for AD in COPD, as there was not an exact correlation between the presence of AD and the severity of airflow limitation and hypoxemia.

Investigation of antioxidant vitamins (A, E, C) and lipid peroxidation levels in rats injected N-(1,3-benzothiazol-2-yl)-N-(4,5-dihydro-1H-imidazol-2-yl) amine.

The present study examined the influence of synthetic N-(1,3-benzothiazol-2-yl)-N-(4,5-dihydro-1H-imidazol-2-yl) amine (2-Amdz) on levels of vitamins A, E and C and malondialdehyde (MDA) in rats. A total of 30 rats, divided into two groups, were used in the study. The control group was given only a subcutaneous injection of 250 microL 75% ethanol, every other day. The other group of rats was administered a subcutaneous injection of 2-Amdz (25 mg kg-1, dissolved in 250 microL of 75% ethanol). Injections were continued for 16 days. After the application of 2-Amdz for 16 days, the serum levels of vitamins A, E and C and malondialdehyde (MDA) were determined by HPLC. The serum vitamin A, E, and C levels decreased significantly compared to controls (p<0.05) whereas serum MDA levels were higher than control levels (p<0.005). As a result, it can be suggested that 2-Amdz induced a severe stress and more importantly, increased the amount of free radicals and significantly decreased the levels of serum antioxidant vitamins.

Effects of long-term inhaled steroid use on bone mineral density in asthma patients.

UNLABELLED: Asthma is a chronic inflammatory disease of the airways. Inhaled corticosteroids are the most effective and most frequently used antiinflammatory drugs in the treatment of asthma. It is well known that long-term systemic steroid therapy causes osteoporosis, whereas it is thought that inhaled forms do not cause this side effect. Despite the recent disagreeing reports, it has been suggested that the use of inhaled steroids are associated with findings of biochemical bone changes. Therefore, we measured the bone mineral densities (BMD) of 18 patients (15 female, 3 male) with bronchial asthma receiving long-term inhaled steroids by X-ray absorptiometry technique and compared the results with those of 14 healthy control subjects (12 female, 2 male) who had been matched according to age, sex, menopausal state, and body mass index (BMI). RESULTS: There were no detectable significant difference between the BMD levels of left hip (trochanter major, neck of femur, Ward's triangle) and lumbar area of the spine (L2-L4) (p > 0.05).

Antioxidant enzyme activities and trace element concentrations in ischemia-reperfusion.

In this study, we investigated the impact of ischemia-reperfusion on antioxidant enzyme activities and trace element concentrations. For this purpose, ischemia was initiated by clamping superior mesenteric artery of Wistar (albino) rats for 30 min, followed by reperfusion for 20 min. Immediately after reperfusion, blood samples were taken and examined for red cell copper-zinc superoxide dismutase (Cu-Zn-SOD), catalase (CAT), and glutathione peroxidase (GPx) activities spectrophotometrically and plasma zinc, copper, and magnesium concentrations by atomic absorption spectrophotometer. In the ischemia-reperfusion group, red cell Cu-Zn-SOD activity and plasma zinc and copper concentrations were increased significantly (p < 0.001) when compared to the control group; however, the increases in GPx activity and plasma magnesium concentration were not significant (p > 0.05). We also found a significant (p < 0.01) decrease in catalase activity. Free radicals released as a consequence of ischemia-reperfusion caused significant alterations in antioxidant enzymes and in the concentrations of trace elements.

Does pneumoperitoneum cause bacterial translocation?

Although extensive research has been carried out on the respiratory and renal effects of intra-abdominal pressure increase, there is limited research with regard to its effects on bacterial translocation. The objective of this study was to discuss whether the high intra-abdominal pressure due to carbon dioxide (CO2) insufflation during laparoscopy leads to bacterial translocation. Eighteen male dogs, 7 of which constituted the control group, were used in the study. Two study groups, in which the intra-abdominal pressure was raised to 15 mm Hg and kept at that level for 30 and 120 minutes, respectively, were set. Blood gases and blood pressure values were observed throughout the experiments. Samples of peritoneal smear, portal vein blood, mesenteric lymph node, liver, spleen, and cecum were examined to detect bacterial translocation. Histopathological examinations of all samples were also carried out. No translocation was detected in the samples of peritoneal smear, portal blood, mesenteric lymph node, liver, or spleen, but in the samples of cecum, bacterial colonization for the second group (p<0.05) and for the third group (p<0.05) was significantly higher compared with the control group. There was a considerable difference between the second and third groups (p<0.05). The changes in the mesenteric lymph nodes were interpreted to be a result of bacterial drainage. Histopathological examination disclosed active changes in the mesenteric lymph nodes in all groups, but there was considerable sinus histiocytosis only in the third group. We conclude that the intraabdominal pressure of 15 mm Hg created by carbon dioxide insufflation does not lead to bacterial translocation but causes intraluminal bacterial colonization in the cecum after 30 minutes and after 2 hours.

Intra-arterial infusion chemotherapy in the treatment of locally advanced breast cancer.

The efficacy of intra-arterial infusion chemotherapy (IACT) as the first step in a combined modality therapy in the treatment of locally advanced breast cancer was evaluated in a prospective clinical study consisting of 18 patients, 15 with stage IIIB, and three with stage IV breast cancer. A combined chemotherapy using adriamycin, mitomycin C and 5-Fluorouracil were administered at 3-week intervals until sufficient regression was achieved. Objective response rate was 66.6%. Among the 14 patients who received IACT for induction, plus surgery, simultaneous adjuvant chemotherapy and radiotherapy, 7 were disease-free at a mean of 19.5 (range 4-42) months. Six patients developed various relapses at a mean of 20.6 (range 12-28) months. IACT was found to be quite effective in local control. The early systemic relapse continues to be a serious problem that needs further intervention.