Mean platelet volume in familial Mediterranean fever related AA amyloidosis and comparison with common primary glomerular diseases

Background/aim: Compared to healthy controls, mean platelet volume (MPV) is frequently higher in patients with Familial Mediterranean fever (FMF) but lower in AA amyloidosis patients. The reason for the difference in MPV levels in FMF patients with and without AA amyloidosis is unclear. The aim of the study was to determine whether low MPV is unique to AA amyloidosis or MPV is similarly low in all glomerular diseases as a result of proteinuria and/or renal dysfunction. Materials and methods: We compared pre-biopsy MPV levels of patients with AA amyloidosis secondary to FMF, to MPV levels of patients with membranous glomerulonephritis, focal segmental glomerulosclerosis (FSGS) and IgA nephropathy that all present with proteinuria and renal dysfunction. Results: 703 patients (411 male, 292 female) were included in the study. Mean age was 42.6  14.3 years. There were 124 patients with AA amyloidosis, 224 patients with IgA nephropathy, 188 patients with membranous glomerulonephritis, and 167 patients wit h FSGS. Patients with AA amyloidosis had lower MPV levels compared to patients without AA amyloidosis (7.9  1.2 fL vs. 8.2  0.9 fL respectively, p = 0.008). Patients with AA amyloidosis had significantly lower MPV compared to patients with each of the othe r diagnoses. Independent predictors of MPV were platelet count (ß = ­0.321, p < 0.001) and CRP (ß = ­ 0.134, p < 0.03). Conclusion: This study is the largest study of MPV in patients with biopsy proven AA amyloidosis and confirms previous studies reporting low MPV in AA amyloidosis. This study indicates that low MPV in AA amyloidosis cannot be explained with proteinuria and renal dysfunction.

The clinical features and outcomes of Turkish patients with IgG4-related disease:a single-center experience

Background/aim: Since the majority of the IgG4-related disease (IgG4-RD) patients in the literature are from the Far East and the United States, there is a lack of large series from other parts of the world. We aimed to identify the clinical characteristics and outcome of Turkish IgG4-RD patients from a tertiary center. Materials and methods: Fifty-two patients classified as having definite IgG4-RD according to comprehensive diagnostic criteria were included in the study. Patients not fulfilling the definite criteria due to lack of pathologic specimen and/or serum IgG4 levels were excluded (n = 47). Clinical, laboratory, and histopathological features and treatment approaches were analyzed. Results: Median age at diagnosis was 51.1 years and sex predominance was not observed (male/female: 26/26). Median follow-up duration was 18 (IQR 25­75: 8­35) months. Retroperitoneal fibrosis was the most frequent presentation. Twenty-four (46.1%) patients had localized involvement. Corticosteroids were the mainstay of treatment (92.5%). Rituximab had been used for cases resistant to previous treatment or with relapses in 19 (47.5%) patients. A complete response was achieved in 52.5% and partial response (<50% regression) in 40%. Conclusion: This large and first cohort of IgG4-RD patients from Turkey showed similar clinical features to European cohorts, except for the male predominance in previous cohorts. Corticosteroids and rituximab are effective in IgG4-RD but there is still uncertainty about the usage of corticosteroid-sparing agents.

Evaluation of reproductive health criteria in seasonal agricultural workers: a sample from Eskisehir, Turkey.

INTRODUCTION: The aim of the present study was to determine reproductive health outcomes of seasonal agricultural female workers in rural areas of Eskisehir, Turkey, and to compare such identified outcomes with the country-wide data. METHODS: Data in respect of this cross-sectional study were collected during a field visit in July 2012. The study group was formed by all of the distribution camps located in rural areas of Eskisehir. Each tent was considered as a domestic dwelling and the census method was used. First, a household questionnaire about sociodemographic characteristics was administered. The '15-49 year old married women questionnaire' was applied only if there was a married woman in the household in the age range of 15-49 years. The said questionnaire comprised information on marriage, childbirth and family planning. The 2008 Turkey Demographic and Health Survey was utilized for the comparison between the data attained from the rural sample and those of the general population. RESULTS: A total of 192 married women aged 15-49 years, inhabiting the 133 tents, were included in the study group. The mean age at first marriage and at first pregnancy were significantly lower in the female seasonal agricultural workers compared to the general Turkish population. Compared with the overall Turkish population, the crude birth rate and general fertility rate of the female seasonal agricultural workers were 2.5 times higher whereas the total fertility rate was 3.9 times higher and the completed fertility rate 2.3 times higher. With the exception of the 45-49 year age group, the age-specific fertility rates were 2-24 times higher. Female seasonal agricultural workers have higher fertility rates than the general population. CONCLUSIONS: According to the results of the present study, reproductive and maternal health status is significantly lower in female seasonal agricultural workers compared to the general Turkish population. There is a need towards multidisciplinary approaches in order for the provision of improved maternal and reproductive health status and outcomes for this group of disadvantaged women in terms of educational level, residence, fertility rights and access to healthcare services. Reducing the fertility rate should be the principal starting point.

Participation of people living in rural areas of Eskisehir province in field researches, and factors affecting their rates of participation.

OBJECTIVE: The aim of the study was to determine participation rates of people living in the rural area of Eskisehir in field researches, and the factors influencing this. METHODS: This descriptive study was performed with 1,482 people aged 18 and above in two districts of Eskisehir. Data were collected with a 16 question questionnaire using the face-to-face interview technique. Data were analysed with descriptive statistics, chi- square test, logistic regression analysis, and factors affecting rates of participation in field researches. RESULTS: The most important reason (46.9%) given by participating for participant in field researches was the intention of "helping the interviewer". The other reasons were; believing in the usefulness of the researches (35.0%), contribution to public improvement (14.9%) and taking pleasure in talking with various people (3.2%). The most important reason (34.6%) for not participating in field researches was "considering field researches a waste of time". The other important reasons for non-participation were unnecessarily long questions in the research questionnaire forms (32.7%) and being uninformed of the research results (31.9%). In logistic regression analysis, age was found to be an influential factor in participation rates. CONCLUSION: Lower rates of participation in field researches cause bias. As far as possible high participation in field researches is important. For the achievement of higher participation rates in field researches, training courses must be provided to both research workers and the public.