The role of temperament in evaluating the relationship between symptoms and signs in dry eye disease

OBJECTIVES

In this study, we aimed to evaluate the relationship between symptoms and objective findings and dry eye (DE) patients' personalities and levels of depression and anxiety.

METHODS

The study group consisted of 67 DE patients who presented to the ophthalmology clinic with symptoms of dry eye disease (DED) and were first diagnosed. Patients underwent a complete ophthalmologic examination, including tear-film break-up time (TBUT), Schirmer 1 and Ocular Surface Disease Index (OSDI). All subjects also completed the Temperament and Character Inventory (TCI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI).

RESULTS

No relationship was found for the Schirmer 1 Test and TBUT with psychological parameters or OSDI scores. When compared with the normal values for the Turkish population, sub-dimensions of temperament in DED; novelty seeking (NS) was significantly lower (P<0.001); harm avoidance (HA) (P=0.014), and persistence (P<0.001) were significantly higher. Significant positive correlation with HA and significant negative correlation with NS were found for the OSDI results. Furthermore, our mediation model revealed that anxiety mediated the effect of NS and HA on OSDI.

CONCLUSION

The significant association of temperament sub-dimensions with OSDI scores in the DED group may play a role in explaining the inconsistency between symptoms and signs. Professionals who care for DED should consider temperament sub-dimensions when they detect discordance between symptoms and signs.

INFLUENCE OF PREGNANCY ON NEUROMYELITIS OPTICA FROM AN OPHTHALMOLOGICAL POINT OF VIEW. A CASE REPORT

Neuromyelitis Optica (NMO, Devics disease) is a rare demyelinating disease of the central nervous system, leading to optic neuritis and transverse myelitis. The clinical course of the disease and ocular changes in pregnancy are still not well known. Here we present the subclinical ophthalmological changes which were evaluated by spectral domain optical coherence tomography (SD-OCT) during the 39 weeks gestation and postpartum period in a pregnant woman with a diagnosis of NMO. In addition, we present the obstetric and neurological course of our patient and review the literature. A 30-year-old female with a history of NMO was ophthalmologically examined and SD-OCT was performed periodically every trimester to observe the effects of pregnancy on the disease course. No ophthalmological changes were observed during the pregnancy and postpartum period. Caesarean delivery was preferred due to obstetric indication. The patient was discharged on the second day of the postpartum period.

Nodule and cancer assessment following thyroid surgery: a cohort of 460 patients

OBJECTIVE

Thyroid nodule formation and the cancer risk of these nodules have recently become widely researched topics. Developments in diagnosis and treatment options have correlated with an increased number of diagnosed patients. However, such a high number of malignant patients in a single center is rare, and this advantage is able to assess the patients in reverse by reviewing nodularity in the malignant patient population. In this study, we retrospectively reviewed nodularity and malignancy following thyroid surgery in a high-risk population with high thyroid cancer rates.

PATIENTS AND METHODS

Out of 1,007 thyroid patients either referred to or operated on at Ankara Oncology Training and Research Hospital between January 1995 and December 2003, 460 patients with readily available data were included in the study.

RESULTS

Of the 460 patients, 74.9% were female and 25.1% were male. The mean age of female patients operated on due to thyroid nodules was 43.7 years (SD: 14.7; range: 12-81) and 47.1 years for males (SD: 14.6; range: 14-80) (p = 0.02). The mean age of patients with a solitary thyroid nodule (STN) was 40.57 years (SD: 13.65) and 45 years (SD: 14.49) for multinodular cases, with the number of nodules increasing with age (p = 0.0008). Malignancy was seen in 78% of STN cases and 73% of multinodular goiter (MNG) cases (p = 0.554). Comparing genders, 74.2% of female patients and 79.6% of male patients with an STN showed malignancy (p = 0.556). Similarly, 73.4% of females and 75.7% of males with MNG showed malignancy (p = 0.694). Multicentric malignancy was detected in 65.2% of MNG cases and 26.6% of STN cases (p < 0.001). This was especially prominent in papillary carcinomas, which had multicentric malignancy rates of 66.6% for MNG and 22.4% for STN (p < 0.001).

CONCLUSIONS

The females tended to develop nodules at an earlier age than the males, the MNG risk increased with age, and multicentric malignancy was prominent in MNG in papillary carcinomas.

Does adjuvant intracameral triamcinolone acetonide increase the effectiveness of phacotrabeculectomy? A Case-Control Study

AIMS

To investigate the effect of intracameral triamcinolone acetonide (TA) on surgical success in 5-fluorouracil (5-FU) supported primary phacotrabeculectomy (PT) cases.

MATERIAL AND METHODS

This retrospective study included 23 eyes (study group) of 23 patients who underwent TA during PT and 26 eyes (control group) of 26 patients without TA. PT patients in the study group received 1 mg TA intraoperatively at the end of surgery. Pre- and postoperative visual acuity, intraocular pressure (IOP), and number of antiglaucoma drugs used were compared. Postoperative complications and need for 5-FU injection were evaluated for both groups.

RESULTS

Mean age was 64.1 2 ± 1.91 (48-86) years in the control group and 66.52 ± 2.02 (52-86) years in the study group (p = 0.824). Comparison of pre- and postoperative IOP values showed significant decreases in postoperative IOP levels at all-time points in both the control and study groups (p &lt; 0.001). The only significant difference between groups was on postoperative first day (study group: 9.22 ± 1.41 mmHg; control group: 6.35 ± 2.17 mmHg, p &lt; 0.001). Need for postoperative 5-FU injection was significantly more common in the control group (p = 0.023).

CONCLUSION

Intracameral injection of 1 mg TA at the end of PT surgery did not yield superior results in postoperative IOP compared to PT alone, and the two groups showed similar IOP reduction. When given as an adjunct to PT, 1 mg TA suppresses anterior segment inflammation and reduces the need for 5-FU injection.

Turkish health field periodical editors' Views on publication process and ethical problems

Objective

We aimed in this study to investigate views and suggestions of health field editors about the publication process and ethical problems.

Materials and Methods

The study involved 42 journal editors who accepted to participate in the study. The data were collected through 70-item "Editor Views Questionnaire" which was developed by the researchers in line with the related literature.

Results

The editors who participated in the study were asked about their views about the most common problems they encountered related to publication ethics; the top three problems indicated by the editors included unjustified authorship (40.5%), duplicate publication (33.3%), and falsification (26.2%). An analysis of the problems encountered in the initial evaluation stage revealed the top three issues as articles that did not follow the writing rules of the journal (33.3%), unqualified articles (30.1%), and negligence of the author(s) (14.3%). Views in relation to the problems about the referee evaluation stage included evaluations that were not completed within the time given (28.6%), insufficient importance attached to the evaluation (23.9%), and inability to find sufficient number of referees (16.7%).

Conclusion

some editors were found to encounter violation of publication ethics, to experience problems in the revision stage, and not to feel fully independent in their contribution to article publication and thus the improvement of the journal quality. Identification of journal editors' views and problems is an important step for the solution to these problems; it could thus contribute to improving the quality of publication process and journal quality.

The relationship of insulin resistance and metabolic syndrome with known breast cancer prognostic factors in postmenopausal breast cancer patients

PURPOSE

The aim of this study was to investigate the effect of metabolic syndrome and insulin resistance at the time of diagnosis on the known prognostic factors of breast cancer in postmenopausal breast cancer patients.

METHODS

The study included 71 patients with a recent diagnosis of postmenopausal breast cancer, admitted at the Medical Oncology outpatient clinic of the Izmir Ataturk Training and Research Hospital between June 2010 and June 2011. We determined whether the patients had metabolic syndrome and insulin resistance at diagnosis, and recorded known prognostic factors, such as tumor size, axillary lymph node involvement, presence of distant metastasis, tumor grade, estrogen receptor (ER), progesterone receptor (PR), and CerbB-2 status.

RESULTS

Among 71 patients, 25 (35%) had metabolic syndrome at the time of diagnosis, and 33 (46%) had insulin resistance with Homeostasis Model of Assessment-Insulin Resistance (HOMA-IR)>2.7. No statistically significant difference was found in the prognostic values of breast cancer, i.e. tumor size, axillary lymph node involvement, distant metastasis, tumor grade, ER, PR, and CerbB-2 status between the patients with and without metabolic syndrome. There was no statistically significant difference in the prognostic factors of breast cancer at the time of diagnosis between 33 patients with insulin resistance and 38 patients without insulin resistance.

CONCLUSION

Several previous studies showed a negative relationship between metabolic syndrome and insulin resistance and prognostic factors of breast cancer in postmenopausal breast cancer patients. However, our study failed to show such a relationship. The relationship between metabolic syndrome and insulin resistance and postmenopausal breast cancer was not well demonstrated due to the small number of patients, unknown duration of the metabolic syndrome and insulin resistance, and shorter follow-up period. Further studies are required to demonstrate the effect of metabolic syndrome and insulin resistance on the prognosis of breast cancer, including larger number of patients and longer follow-up periods.

Evaluation of flow and structure abnormalities of splanchnic system veins in cirrhotic patients without portal hypertension

AIM

The aim of this study was to evaluate hemodynamic and anatomic alterations of the splanchnic venous system and the efficiency and safety of color Doppler radial endosonography in the assessment of cirrhotic patients by comparing Child A cirrhotic patients without portal hypertension findings versus a non-cirrhotic group.

METHODS

The study was carried out between January 2009 and February 2010; the study population was 38 cirrhotic patients without portal hypertension and 140 control patients.

RESULTS

Hepatopedal flow was monophasic in all the control patients; the flow pattern was chaotic and irregular in 8% of the cirrhotic patients; in the cirrhotic patients the portal vein diameter was increased and the flow velocity reduced; no differences in flow volume were observed between the two groups. Splenic vein diameter and flow velocity were normal. In the majority of the Child A cirrhotic patients without portal hypertension, no changes were seen in portal vein diameter or flow volume; in some patients no significant increase portal vein diameter was observed and showed the flow volumes were unchanged.

CONCLUSION

Radial Doppler endosonography may be efficient and safe for assessing the splanchnic system.