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Biomedical subjects

Cüneyt Orhan Kara

Publications and source records attributed to Cüneyt Orhan Kara.

15 recordsLinked to original sources

Impact of multiple etiology on dizziness handicap.

OBJECTIVE: Our aim was to find the ratio of multiple diagnosis in dizziness patients and to evaluate the effect of multiple etiologies on handicap level of the patient. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. INTERVENTION: The data of 703 patients (178 men and 525 women) were included in the study. Diagnoses of the patients were made in a multiple-specialty environment including otolaryngology, neurology, cardiology, internal medicine, and rehabilitation medicine. MAIN OUTCOME MEASURES: All patients filled the dizziness handicap inventory and pointed the severity of dizziness on a 10-point visual analog scale. RESULTS: Four hundred thirty-three patients (61.6%) have only one diagnosis, whereas 183 (26%) had two. Three diseases have been found in 34 patients (4.8%), and four diseases were present in eight patients (1.1%). The mean number of diagnosis in one patient was 1.32 +/- 0.71. There was a significant difference between two sexes on the number of disease. There was no correlation between age and the number of diagnosis. There was no significant difference in functional scale, but the statistically significant increases are present in both physical (p < 0.05) and emotional (p < 0.01) scales. There was no correlation between age and handicap levels. CONCLUSION: Multiple diagnoses were important factors on physical and emotional handicaps. It was also found that this problem is not limited with older age group.

Adolescent↗

Variation in tonsil size in 4- to 17-year-old schoolchildren.

OBJECTIVE: The purpose of this study was to evaluate the variation in tonsil size and prevalence of asymmetric tonsils in 4- to 17-year-old schoolchildren and the relationships between tonsillar hypertrophy and frequent tonsillitis, frequent fever, and sleep-related symptoms observed by parents. DESIGN: Cross-sectional study. SETTING: Six daycare centres, four primary schools, and four high schools. METHODS: Questionnaire and physical examination. MAIN OUTCOME MEASURES: The size of the tonsils was evaluated and scored on a 4-point scale. The interrelationships between tonsillar hypertrophy and other studied symptoms were examined. RESULTS: In the study, the parents of 1784 children, consisting of 803 (45%) boys and 981 (55%) girls, completed the questionnaires. The prevalence rates of snoring, habitual snoring, observed apnea, and habitual observed apnea were 24.6%, 4.1%, 3.8%, and 0.9%, respectively. The results of tonsil scoring were grade 1, 62.7%; grade 2, 28.4%; grade 3, 3.3%; and grade 4, 0.1%. The prevalence rate of grade 1 tonsils was increasing, whereas the prevalence rates of grade 2 and 3 tonsils were decreasing with increasing age. Tonsil size peaked in 4- to 8-year-old children. The prevalence rates of tonsillar hypertrophy and asymmetric tonsils were 3.4% and 1.7%, respectively. Tonsillar hypertrophy was found to be significantly associated with male gender, a history of frequent tonsillitis, a history of frequent fever, often or always snoring, and often or always observed apnea. CONCLUSIONS: A tonsil size curve was developed in 4- to 17-year-old schoolchildren. Children aged 4- to 8 years with oropharyngeal symptoms and particularly male gender should undergo consultation with otorhinolaryngology and pediatric pulmonology physicians for the evalution of adenotonsillar tissue.

Adolescent↗

Does creating a subperiosteal tunnel influence the periorbital edema and ecchymosis in rhinoplasty?

PURPOSE: The study goal was to determine whether creating a subperiosteal tunnel before lateral osteotomy had an effect on postoperative periorbital edema, ecchymosis, and subconjunctival ecchymosis. PATIENTS AND METHODS: Eighteen consecutive patients who underwent septorhinoplasty were included in the study. In all patients lateral osteotomies were carried out bilaterally, after creating a subperiosteal tunnel on a randomly chosen side and without creating a subperiosteal tunnel on the other side. The patients were seen on the second postoperative day, and a different surgeon who was unaware of the side with the periosteal tunnel determined the side of the face with more edema and ecchymosis. Subconjunctival ecchymosis was evaluated and recorded, as well. RESULTS: Creating subperiosteal tunnels before lateral osteotomy statistically increased periorbital ecchymosis. Although there was no statistically significant difference, creating subperiosteal tunnels also increased development and severity of subconjunctival ecchymosis and edema. CONCLUSIONS: We suggest performing lateral osteotomy without creating subperiosteal tunnels.

Adolescent↗

Subjective visual vertical and subjective visual horizontal measures in patients with chronic dizziness.

OBJECTIVES: We aimed to find the frequency of otolith organ pathologies in the clinical picture of common dizziness etiologies in the chronic stage. METHOD: Subjective visual vertical and subjective visual horizontal measures were assessed in patients who had persistent or recurrent dizziness at least 2 months after the acute period. Every patient was tested in three head positions: neutral, right, or left deviation in the roll plane. Test results were compared with those of the control group. RESULTS: Seventy-three patients and 18 controls were examined. Fifty-eight of the patients had peripheral vestibular disease; 15 of them had central vestibular disease. Left subjective visual horizontal (SVH) and right SVH measures of the peripheral group were significantly different from those of the control group (p < .01). There was no difference in any test between the peripheral and central groups. When we put a cut off point for abnormality (0, 1) according to mean +/- 2 SD of the control group, the peripheral and central groups had very high significant differences from the control group. Approximately 25 to 50% of our patients had pathologic subjective visual vertical or SVH measures according to test type. CONCLUSION: These results showed that the otolith system must be evaluated in the chronic period of dizziness, especially in patients who frequently visit their physician, and modifications in treatment programs must be conducted.

Adult↗

[The prevalence of snoring in adult population].

OBJECTIVES: This study aimed to investigate the prevalence of habitual snoring in adult population and the relationship between habitual snoring and accompanying factors. PATIENTS AND METHODS: A cross-sectional, epidemiological study was conducted to evaluate snoring and accompanying factors. Data of 1245 persons (629 females, 616 males; mean age 45.0+/-12.2) were evaluated. A questionnaire was administered to draw information on their sociodemographic data, the incidence of snoring, the presence of witnessed apnea during sleep, the severity of snoring and its changes depending on the body position, their willingness to receive treatment for snoring, the presence of alcohol or cigarette consumption, and hypertension and coronary disease. Height and weight measurements were performed to calculate body mass index. The results were evaluated using the chi-square test and a multiple regression analysis. RESULTS: The prevalence of habitual snoring was 8.9% in females and 29.5% in males. Multivariate analyses showed that male sex, age over 40 years, obesity, smoking, and the use of alcohol were significant risk factors for habitual snoring. Hypertension and coronary heart disease were statistically more common in individuals with habitual snoring. The severity of snoring was high enough in 2.1% of females and in 9.4% of males to force their roommates to leave the room, making 1.1% of females and 3.4% of males to show willingness to receive medical attention. CONCLUSION: Habitual snoring is a frequent complaint in our country. Inquiry into the presence of habitual snoring is necessary in adults and patients should be subjected to a detailed examination for respiratory disorders during sleep.

Adult↗

[The prevalence of allergic rhinitis in the adult urban population of Denizli].

OBJECTIVES: We investigated the prevalence of allergic rhinitis in the adult urban population of Denizli. STUDY DESIGN: A survey study was conducted to cover 1010 adults above 19 years of age, representing the urban population of Denizli district, Turkey. A questionnaire was designed to collect data on sociodemographic features, symptoms of allergic rhinitis, duration of symptoms, and any prior diagnosis of allergic rhinitis made by a physician. Interviews were made with randomly chosen adults from three socioeconomically different urban areas. RESULTS: Interviews were completed for 951 adults with ages ranging from 19 to 65 years (414 males, mean age 36.3+/-12 years; 537 females, mean age 35.2+/-12 years). The frequency of self-reported allergic rhinitis was 10.8%, and 5.2% had allergic rhinitis diagnosed by a physician. Two or more symptoms of allergic rhinitis were found in 7.2%. The prevalence of allergic rhinitis was higher in females. There was no relationship between the frequency of allergic rhinitis and age. CONCLUSION: The prevalence of allergic rhinitis in the adult urban population of Denizli is between 5% to 10%, with a higher frequency in females.

Adult↗

Are tonsils a reservoir for Helicobacter pylori infection in children?

OBJECTIVE: Helicobacter pylori (H. Pylori) has been associated with the development of gastritis, peptic ulcer and gastric cancer. Although H. pylori infects up to more than half of the world's population, to date the precise modes of transmission has not been fully understood yet. Therefore a study was planned to investigate whether the tonsils and the adenoid tissue were the reservoir or the gate for the entrance of H. pylori. METHODS: The adenotonsillectomy specimens obtained from 50 children, between two and 10 years of age were examined for H. Pylori colonization by the CLO-test method. Before tonsillectomy, anti-H. pylori IgG antibody titers were detected by commercial enzyme immunoassay method in venous blood and H. pylori antigen enzyme immunoassay for detection of H. pylori in stool was used to define current infection status. RESULTS: The stool antigen was positive in 25 (50%) of 50 children. Serum IgG antibody was positive in 28 (56%) patients and both tests were positive in 21 (42%) patients. H. pylori positivity was not detected in any one of the adenotonsillectomy specimens with the CLO-test method. CONCLUSION: In this study although H. pylori was detected in stools of children, it was not detected in adenotonsillectomy specimens with CLO-test method. The results may indicate that H. pylori does not colonize in either adenoid or tonsils and that these tissues do not constitute a reservoir for H. pylori infection.

Adenoidectomy↗

Experimental sinusitis in a rhinogenic model.

OBJECTIVES/HYPOTHESIS: The objectives were to determine the optimal sinusitis induction period and to examine microbiological and histopathological changes of sinusitis recovery stage in a rhinogenic sinusitis model. METHODS: A synthetic sponge was inserted into the right-side nasal cavities of rabbits. The sponge was impregnated with a Streptococcus pneumoniae strain in group 1 and with sterile saline solution in groups 2 and 3. After the fourth day of sponge insertion, sinuses were examined by coronal computed tomography scans at two-day intervals until any radiological evidence of sinusitis was observed. When sinusitis was detected radiologically, five rabbits each from groups 1 and 2 were killed for histological examination. To determine the recovery period of sinusitis, sponges were removed from the rest of the rabbits in groups 1 and 2. Rabbits were selected randomly and killed on the 15th and the 30th days of the recovery period, immediately after radiological examinations. Group 3 was considered a sham group. RESULTS: Sinusitis induction was performed in all rabbits in groups 1 and 2 until the 8th day. After the sponges were removed, inflammation persisted until the 30th day of the study. CONCLUSION: In a rhinogenic sinusitis model, although histological features of sinusitis were demonstrated, further studies are required to standardize this model and to examine whether or not the studied bacterial strain spreads from nasal cavity into sinus.

Animals↗

Migraine patients with or without vertigo: comparison of clinical and electronystagmographic findings.

OBJECTIVE: To find the differences between patients with migraine with and without vertigo. STUDY DESIGN: A prospective study. SETTING: Ambulatory dizziness centre of a tertiary referral hospital. METHODS: Eighty-four patients with migraine (31 with headache, 53 with headache and vertigo) according to the diagnostic criteria of migraine published by the International Headache Society in 1988 were included in the study. Patient history, vestibular tests, electronystagmography (ENG), and imaging studies were performed for differential diagnosis. MAIN OUTCOME MEASURES: Clinical findings and ENG parameters. RESULTS: Fifty-three of 84 patients (63%) had episodic vertigo attacks. Vertigo was independent from headache in 24 patients (45%). Vertigo symptoms always appeared later in the history of migraine headache. Headache started at age 27 +/- 8.3 years and vertigo symptoms began 7.7 +/- 8.7 years later. The beginning age of the migraine and female-to-male ratio were significantly greater in the vertigo group. Fifty-eight of the 84 patients had ENG testing. Fifty-eight percent of the patients with migraine and 55% of the patients with migraine + vertigo had abnormal ENG findings. None of the tests except the Dix-Hallpike manoeuvre had a statistically significant difference between the two groups. CONCLUSION: The presence of the same ENG abnormalities in patients with pure headache shows that the vestibular pathways are also affected in these patients, even when there are no vestibular symptoms.

Adult↗

[A review on experimental sinusitis models in rabbits].

Experimental animal models are instrumental to study the pathogenesis of diseases and to examine the results of treatment. The great size and ease of accessibility have made rabbit sinuses popular in the investigation of experimental sinusitis. Microbiologic, histopathologic, and radiologic aspects of this model have been well-described and the effects of medical and surgical treatments on sinusitis have been examined. Ongoing research may provide further data to find more simple and non-invasive methods to induce sinusitis in rabbits that may more closely simulate sinusitis pathogenesis in humans. This article reviews the most recent data on technical, surgical, microbiologic, histopathologic, and radiologic aspects, and complications of sinusitis models in rabbits.

Animals↗

Prevalence of tonsillar hypertrophy and associated oropharyngeal symptoms in primary school children in Denizli, Turkey.

OBJECTIVE: The purpose of this study is to investigate the prevalence of tonsillar hypertrophy and associated oropharyngeal symptoms in primary school children. METHODS: The study was performed in two primary schools which were chosen randomly in Denizli. Size of the tonsils was evaluated and scored on a five-point scale and weights of children were measured. The mothers or primary caregivers of children were asked to fill a questionnaire that included questions concerning the associated symptoms of tonsillar hypertrophy. The interrelations between tonsillar hypertrophy and other studied items were examined by chi(2) tests. RESULTS: The study population consisted of 1211 (636 boys, 575 girls) primary school children between 6 and 13 years old (mean 9.3+/-2 years). Prevalence of tonsillar hypertrophy in school children was found as (133) 11% in the school children. There were a statistically significant association between tonsillar hypertrophy and history of frequently having tonsillitis, habitual snoring, observed apnea, oral breathing during sleep and difficulty eating. CONCLUSION: The prevalence of tonsillar hypertrophy was found to be 11% in school children in Denizli, Turkey. Primary school children with tonsillar hypertrophy have signs and symptoms of frequent upper airway infections and upper airway obstruction so they need further evaluation for associated oropharyngeal symptoms of tonsillar hypertrophy.

Child↗

Experimental sinusitis in nasally catheterised rabbits.

AIM: The aim of the study was to create an experimental rabbit model for investigating the effects of nasal catheterization on rhinosinus mucosa, bacterial flora and observing the development of bacterial sinusitis. METHODS: Healthy adult white rabbits of either sex and with body weights of 2.5-3 kg were used. Rabbits were randomly separated into two groups; the first group was catheterized by 12 French and the second group was catheterized by 8 French catheters blindly and the non-catheterized left sides were accepted as control. Three randomly chosen rabbits from each group were examined by computerized tomography scans (CT) and sacrified in the first, second and the fourth week of the study. Microbiological and histopathological examinations were performed. RESULTS: In both study groups after the first week of nasal catheterization, opacity or air-fluid level was detected in maxillary sinuses by CT scans, which was significant in group 1. Inflammation spread by the prolongation of nasal catheterization and rapidly development of sinusitis was observed by thicker catheters' usage. CONCLUSION: In this study, the role of nasal catheterization as a predisposing factor in the development of sinusitis and the increase of sinusitis development risk in relation with the catheterization period and the catheters' thickness was shown.

Animals↗

Experimentally induced rhinosinusitis in rabbits.

OBJECTIVE: The purpose of this study was to develop an experimental rhinosinusitis model by using bacteria-added absorbable material for temporary ostial obstruction. METHOD: Absorbable gelatin sponge was inserted between the endoturbinals and the ostium of the sinus. In the first group, the effects of surgical procedure and Gelfoam on ostial mucosa were examined macroscopically. In the second group Gelfoam was moistened with Staphylococcus aureus (ATCC 25923). The sinuses of rabbits were examined by coronal com puted tomography before each surgical procedure and sacrifice. The animals were sacrificed at the first, second, fourth eighth, and tenth weeks. Histologic and microbiologic examinations were performed. RESULTS: In the first group, fibrotic bands and adhesions were observed between the ostium of the maxillary sinus and the endoturbinals in the first and second week. In the second group, a thick purulent discharge that invariably filled the sinuses of the inoculated side was seen after the first week of induction, and opacity, which was determined radiologically, did not disappear until the end of the study. CONCLUSION: In this study, an experimental rhinosinusitis model was accomplished. It is currently believed that obstruction of the ostium with mucosal edema, polyps, or tumour leads to maxillary sinusitis. In this model, the pathogenesis of human sinusitis was imitated by temporary occlusion of the ostium with bacteria-added Gelfoam. This model can be used in further studies to explore the role of the ostium in the pathogenesis of sinusitis.

Animals↗

Childhood asthma and its relationship with tonsillar tissue.

The aim of this study was to evaluate the prevalence of asthma among 4-17 years old school children and to determine the relationship between frequent tonsillitis, tonsillar hypertrophy and asthma-related symptoms. A total of 2,000 school children, aged 4-17 years, in Denizli were surveyed using the ISAAC questionnaire; the size of the tonsils was evaluated by physical examination. A total of 1,784 questionnaires were completed giving an overall response rate of 89.2%. The prevalence of lifetime wheezing, 12-month wheezing and lifetime doctor-diagnosed asthma were 16.4%, 6.2% and 1.7%, respectively. The prevalence of frequent tonsillitis and tonsillar hypertrophy were 19.9% and 3.4%, respectively. Tonsillar hypertrophy was positively correlated with a history of frequent tonsillitis. Frequent tonsillitis and tonsillar hypertrophy could be evaluated as risk factors for asthma due to their significant association with asthma-related symptoms.

Adolescent↗