Systemic associations and prevalence of exfoliation syndrome in patients scheduled for cataract surgery.

PURPOSE: To study the frequency of exfoliation syndrome (XFS) and its association with intraocular pressure (IOP) and systemic diseases in patients with age-related cataract scheduled for surgery. METHODS: All 1480 cataract patients had a comprehensive systemic and eye examination, including slit-lamp biomicroscopy before and after mydriasis, IOP measurement, gonioscopy, and fundus examination. RESULTS: The percentage of XFS among patients scheduled for cataract surgery was 16.4, with no gender difference (p=0.833). The mean age of XFS patients (74.3+/-7.0 years) was significantly higher when compared to the ones without XFS (66.5+/-10.9 years) (p<0.001). XFS was unilateral in 41.3% of the subjects and bilateral in 58.7%. The number of subjects with XFS increased significantly with aging (p<0.001) (OR=1.093, 95% CI=1.073-1.14) (p<0.001). The most common type of cataract was nuclear in the XFS group (33.5%) and 24.6% of patients with mature cataract had XFS. In the XFS group, 11.2% of the subjects had glaucoma, which was statistically higher than the non-XFS group (4.6%) (p<0.001) (OR=2.67, 95% CI=1.65-4.32). Eighty-four patients had glaucoma and 27 of them (32.1%) had exfoliative glaucoma. The only systemic disease that was found to be associated with XFS was coronary heart disease with an OR of 1.49 (95% CI=1.068-2.072) (p=0.019). CONCLUSIONS: XFS is a common problem in the aging cataract population of Turkey and increased IOP, glaucomatous optic neuropathy, and coronary heart disease occur more frequently in patients with XFS compared with subjects without XFS.

Factors influencing the distribution of metastases and survival in metastatic breast carcinoma.

A total of 370 patients with metastatic breast, carcinoma who had been followed at Hacettepe Oncology Department between 1980 and 1991 were retrospectively analyzed for the factors influencing the distribution of metastases and survival. Median age was 47 years. Radical or modified radical mastectomies were performed in 199 (53.8%). Infiltrative ductal carcinoma was the most common pathologic subtype (69.4%). In 191 patients who were evaluated for estrogen receptor (ER) status, 101 (52.9%) were positive and 90 (47.1%) were negative. The distribution of first metastases did not differ between the soft tissue, bone, and visceral sites. The second, third, and fourth metastases were more common in visceral sites (p < 0.05). ER and menopausal status did not affect distribution. Mortality rate was significantly lower in the group having the first metastasis to the bone (p < 0.05). Of interest, first metastases were predominantly found in visceral sites in patients having radical or modified radical mastectomies (p < 0.05). Response to therapy, presence of initial metastases, axillary status, and age were the important factors influencing the overall survival in univariate analysis, whereas response to therapy, ER status, age, and presence of initial metastases were the important factors according to the multivariate analysis.

Validation and reliability of the Turkish version of the fear avoidance beliefs questionnaire in patients with low back pain.

AIM: The aim of this study was to translate the questionnaire into Turkish and to investigate the test-retest reliability, construct validity and its sensitivity to change following physical therapy. METHODS: The questionnaire was translated into Turkish using the forward and backward translation technique. Test-retest reliability was assessed with the correlation coefficients. Scale analysis for internal validity, the Cronbach's alpha score was calculated. Construct validity was tested with principal components analysis and was also tested with divergent validity. Following three weeks of treatment, sensitivity to change and responsiveness of the questionnaire was assessed. RESULTS: The questionnaire was applied on 55 patients and high correlations were found on the repeated items 48 hours later. In the scale analysis, the Cronbach's alpha score was found as 0.911 for the total questionnaire. Two factors were found compatible with the original questionnaire with principal components analysis. These two factors explain 61.647% of the total variance in the questionnaire performed on 150 patients. In divergent validity, the fear avoidance beliefs were found in low correlation with the clinical variables. Sensitivity to change and responsiveness of the FABQ was found to be low. CONCLUSIONS: FABQ has sufficient psychometric features for its applicability in the Turkish population with subacute and chronic low back pain.