Turkish Adaptation of Dentine Hypersensitivity Experience Questionnaire (DHEQ)

OBJECTIVE

The Dentine Hypersensitivity Experience Questionnaire (DHEQ) is a valid and reliable instrument for oral health-related quality of life (OHRQoL) studies. This study aimed to assess the Turkish version of the DHEQ and determine the effects of degree of DH, sex, and age on OHRQoL.

MATERIALS

The study participants were 251 DH patients (age 18-78 years; 68.5% female) who completed the Turkish version of the DHEQ. The reliability of the instrument was assessed in terms of internal consistency, using item-total correlations and Cronbach's alpha and test-retest reliability using intra-class correlation coefficients (ICCs) among 51 patients who repeated the DHEQ following a 2-week interval. Construct validity was determined based on exploratory factor analysis (EFA). Convergent validity was tested through correlating DHEQ total and subscale scores with the global rating of oral health and effect on life overall. Discriminative validity was tested by comparing the total and subscale scores against the degree of sensitivity.

RESULTS

Patients with more severe hypersensitivity showed higher DHEQ scores and greater OHRQoL impairment. Female and older (⟩40 years) patients had significantly greater OHRQoL impairment. Cronbach's alpha exceeded 0.70, indicating good internal consistency reliability. The ICC values measured were ⟩0.60 for the overall scale and each subscale of the DHEQ, signifying good to excellent test-retest reliability.

CONCLUSION

The results suggested that the Turkish version of the DHEQ is appropriate for assessing the OHRQoL among people with dentine hypersensitivity.

Rapid emergence of colistin resistance and its impact on fatality among healthcare-associated infections

This article describes the emergence of resistance and predictors of fatality for 1556 cases of healthcare-associated Gram-negative bloodstream infection in 2014 and 2015. The colistin resistance rate in Klebsiella pneumoniae was 16.1%, compared with 6% in 2013. In total, 660 (42.4%) cases were fatal. The highest fatality rate was among patients with Acinetobacter baumannii bacteraemia (58%), followed by Pseudomonas aeruginosa (45%), Klebsiella pneumoniae (41%), Enterobacter cloacae (32%) and Escherichia coli (28%). On multi-variate analysis, the minimum inhibitory concentrations for carbapenems [odds ratio (OR) 1.02, 95% confidence interval (CI) 1.01-1.04; P = 0.002] and colistin (OR 1.1, 95% CI 1.03-1.17; P = 0.001) were found to be significantly associated with fatality.

Healthcare-associated Gram-negative bloodstream infections: antibiotic resistance and predictors of mortality

This article describes the prevalence of antibiotic resistance and predictors of mortality for healthcare-associated (HA) Gram-negative bloodstream infections (GN-BSI). In total, 831 cases of HA GN-BSI from 17 intensive care units in different centres in Turkey were included; the all-cause mortality rate was 44%. Carbapenem resistance in Klebsiella pneumoniae was 38%, and the colistin resistance rate was 6%. Multi-variate analysis showed that age >70 years [odds ratio (OR) 2, 95% confidence interval (CI) 1.22-3.51], central venous catheter use (OR 2.1, 95% CI 1.09-4.07), ventilator-associated pneumonia (OR 1.9, 95% CI 1.1-3.16), carbapenem resistance (OR 1.8, 95% CI 1.11-2.95) and APACHE II score (OR 1.1, 95% CI 1.07-1.13) were significantly associated with mortality.

A hereditary bisatellite-dicentric supernumerary chromosome in a case of cat-eye syndrome

We studied the clinical and cytogenetic features of a case of Cat-eye Syndrome. The chromosomal analysis showed 47 chromosomes. The supernumerary small, metacentric, bisatellited marker chromosome was probably derived from a No. 22 and occurred as well in the proband's sister and mother.

A new locus for autosomal recessive non-syndromic mental retardation maps to 1p21.1-p13.3

Autosomal recessive inheritance of non-syndromic mental retardation (ARNSMR) may account for approximately 25% of all patients with non-specific mental retardation (NSMR). Although many X-linked genes have been identified as a cause of NSMR, only three autosomal genes are known to cause ARNSMR. We present here a large consanguineous Turkish family with four mentally retarded individuals from different branches of the family. Clinical tests showed cognitive impairment but no neurological, skeletal, and biochemical involvements. Genome-wide mapping using Human Mapping 10K Array showed a single positive locus with a parametric LOD score of 4.92 in a region on chromosome 1p21.1-p13.3. Further analyses using polymorphic microsatellite markers defined a 6.6-Mb critical region containing approximately 130 known genes. This locus is the fourth one linked to ARNSMR.

A familial Xp+ chromosome detected during fetal karyotyping, which is associated with short stature in four generations of a Turkish family

The short-stature homeobox-containing gene (SHOX) on chromosome Xp22.3 was recently identified as an important determinant of the stature phenotype. Deletions of the SHOX gene, some of them due to structural chromosome abnormalities, have been described in patients with idiopathic short stature and Leri-Weill syndrome. Additionally, haploinsufficiency of SHOX is a main cause for short stature seen in patients with Turner syndrome. Here we report an unusual X-chromosome abnormality, which was detected during a fetal karyotyping performed because of a previous child with Down syndrome. GTG banding demonstrated an extra chromosome segment on the terminal part of the short arm of chromosome X in the index case (karyotype: 46,X,Xp+). The same chromosomal abnormality was found in the mother and the maternal grandmother. All carriers of this chromosomal abnormality presented with short stature but no other associated symptoms. Whole chromosome painting of X revealed a homogeneous painting of the abnormal X chromosome indicating that no other chromosome was involved. Additional FISH studies with probe DXS1140 (Kallmann probe at Xp22.3), Quint-Essential X-Specific DNA (DMD probe at Xp21.2), XIST (at Xq13.2), and Tel Xq/Yq were performed, and no abnormality was observed in the intensities or the localizations of the probes signals. However, applying a specific SHOX gene probe (derived from cosmid LLNONO3M34F5) showed a loss of signal on the derivative X chromosome. Our results show that the Xp+ generation led to a deletion of the complete SHOX gene and caused short stature in the presented family.

A 2 1/2-year-old girl with reflex sympathetic dystrophy syndrome (CRPS type I): case report

An unusual case of a 2 1/2-year-old girl with reflex sympathetic dystrophy (RSD) of the left arm is described. She is the youngest RSD case ever presented in the literature. Upper extremity involvement is also rare in childhood RSD. She had both physical and psychological trauma in an earthquake preceding the disease. The association of RSD with a psychological disorder is stressed and awareness of the condition to the general paediatrician is recommended for early diagnosis and successful treatment.

An unusual translocation between 12tel and 14q11 in a large kindred

In one couple investigated because of recurrent abortions, the female was found to have an unusual translocation between the long arm of the telomeric region of chromosome 12 and the long arm of the chromosome 14 at band q11. We studied ten additional members of the family who were under the risk of the same chromosomal rearrangement, and four of them were found to be carriers. The diagnosis of this translocation was determined using different banding techniques and FISH. The karyotype was found to be 45,XX,t(12;14)(qtel;q11).

Identification of the parental origin of polysomy in two 49,XXXXY cases

The parental origin and mechanism of formation of polysomy X were studied in two polysomic cases, using four X-linked restriction fragment length polymorphisms, three (CA)n dinucleotide repeat sequences and one variable number tandem repeat (VNTR) locus as genetic markers. A nonradioactive technique based on the hybridization of the polymerase chain reaction (PCR) product was developed for the analysis of dinucleotide repeats. Segregation analysis using different nonradioactive approaches based on the PCR, revealed that all four X chromosomes were of maternal origin. These data provide additional evidence of an identical mechanism of successive nondisjunctions in maternal meiosis I and II.

Clinical and cytogenetic studies of two cases of Klinefelter syndrome with hereditary retinoblastoma and rhabdomyosarcoma

Two children with Klinefelter syndrome (KS), one associated with bilateral hereditary retinoblastoma (RB) and the other with rhabdomyosarcoma (RMS) are reported. Both were boys and chromosomally mosaic for KS. The hereditary retinoblastoma case yielded 46,XY,del(13)(q12q14.2)/47, XXY(c),del(13)(q12q14.2) in PHA-stimulated lymphocytes. The rhabdomyosarcoma case yielded 46,XY/ 47,XXY(c) in peripheral blood cells whereas tumor revealed trisomy 8, trisomy 7, and t(7;13)(q33;q32) in addition to 46,XY/47,XXyc mosaicism.

Prenatal diagnosis of beta-thalassaemia and sickle cell anaemia in Turkey

This paper reports our experience of molecular analysis and diagnosis of beta-thalassaemia and sickle cell anaemia (HbS) in 70 prospective parents of Turkish descent and their fetuses. Molecular screening was carried out by allele-specific oligonucleotide (ASO) hybridization of amplified DNA to the 12 most common mutations in the Turkish population. By using this approach, we were able to define the mutation in 95 per cent of chromosomes investigated. Genomic sequencing led to the additional detection of three rare mutations: Cd 44 (-C), IVS-I-5 (G-C), and IVS-I-116 (T-G). All diagnoses were successfully accomplished and no misdiagnosis occurred. Consanguineous marriage appears to contribute significantly to the frequency of affected births in Turkey. Out of the 14 homozygous fetuses, six were the result of close consanguinity. This study indicates that fetal diagnosis of beta-thalassaemia and HbS may be obtained in practically all cases, even in a heterogeneous population like the Turkish population, when early methods of fetal sampling are combined with polymerase chain reaction (PCR)-based techniques. Until gene therapy becomes a reality, the only approaches to the control of haemoglobinopathies are prevention and avoidance. The most relevant and common aspects of the programmes, which have been very effective in reducing the birth rate of beta-thalassaemia major in several at-risk areas of the Mediterranean basin, are the continuous educational campaigns directed at the population at large, the voluntary basis, and non-directive counselling. The most important challenge for the eradication of the haemoglobinopathies in Turkey is the organization of a nation-wide and comprehensive genetic preventive programme based on DNA technology.

Tetra-amelia, lung hypo-/aplasia, cleft lip-palate, and heart defect: a new syndrome?

We report on a family with two sons affected with tetra-amelia, cleft lip-palate, bilateral agenesis of lungs, and heart defects. These two cases support the previous suggestions that this complex entity may indeed represent a new syndrome. However, the mode of inheritance is still not clarified.

Cellular and humoral immunity in prostitutes in Istanbul

Acquired immunodeficiency syndrome (AIDS) can be transmitted through heterosexual intercourse and prostitutes may be responsible for this form of transmission. Thirty-four prostitutes were included in this study and their humoral and cellular immunological parameters were compared with control group. Prostitutes were divided in two subgroups according to their sexual practice and the use of illicit drugs and compared with each other. The only immunological parameter that is significantly different from the control group was the serum IgM level. In prostitutes who have more than 11 partners in a week, the mean number of E rosettes, EAC rosette forming cells and cells expressing surface immunoglobulins were significantly higher than prostitutes who have 0-10 sexual partner in a week.