Syphilis and dentists: The data about knowledge and awareness of clinicians in Turkey.

Background: Syphilis may give pathognomonic signs in oral cavity. In order to emerge an awareness about dentists' role in syphilis management, it was aimed to obtain the data from them about their knowledge.Methods: This survey-based, cross-sectional study was conducted with 709 dentists practicing in Turkey. Participants answered 16 statements about syphilis "Transmission Routes," "Extra-oral Clinical Features," "Oral Findings," and "Diagnosis & Treatment" with options yes/no/I do not know. Moreover, they responded to two 5-point Likert type questions about their comfort level and frequency of taking sexual anamnesis. The statistical significance was set at p ≤ .05.Results: The mean age (years) and female/male ratio of the participants were 35.7 ± 10.2 and 449/260, respectively. The average of the correct answers in the survey was 10.38 ± 3.3. "Transmission Routes" had the highest ratio (50.6%) in terms of all questions in a single category that were answered correctly among groups. Dentists practicing at faculties had the highest number of correct answers (p = .003). The total number of correct answers and the number of correct answers in each category were positively related to both the level of comfort and the frequency of taking patient's sexual anamnesis (Oral Findings p = .002; others p ≤ .001).Conclusions: The results of this study indicate that dentists practicing in Turkey lack a significant level of knowledge about syphilis. This highlights the need for further training and education programs for dentists in Turkey.

Features of the Achilles tendon, paratenon, and enthesis in inflammatory rheumatic diseases : A clinical and ultrasonographic study.

AIM: We analyzed the ultrasonographic (US) features of the Achilles tendon (AT), paratenon (AP), and enthesis in patients with axial spondyloarthropathies (SpA) and rheumatoid arthritis (RA), and compared these to healthy subjects. Relationships between these findings and clinical and functional parameters were identified. METHODS: The study included 40 axial SpA and 27 RA patients, as well as 30 healthy subjects. Clinical evaluation relied on the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), AS Quality of Life Questionnaire (ASQoL), Disease Activity Score 28 (DAS28), and Health Assessment Questionnaire (HAQ), as well as on a visual analog scale (VAS) for entheseal pain and the Madrid Sonographic Enthesistis Index (MASEI). Separately, AT thickness, AP thickness, and echogenicity were examined bilaterally with US in 194 ankle regions. RESULTS: The fibrillar pattern of the AT was damaged in axial SpA patients compared to RA patients and healthy subjects (p < 0.001). The AT was thicker in axial SpA patients than in RA patients and healthy subjects (p < 0.05). The AP was thicker in axial SpA patients (p < 0.05). There were positive correlations of BASDAI and BASFI scores with the Achilles enthesitis total score (r = 0.523, p = 0.001 and r = 0.533, p = 0.001, respectively). In the multiple linear regression model, only age continued to show an effect on the Achilles enthesitis total scores in axial SpA patients (B = 0.091, ß = 0.417, p = 0.011). The AT thickness was consistently positively correlated with height in axial SpA patients (B = 0.059, ß = 0.482, p = 0.004). CONCLUSION: The AT thickness was affected much more by the height of patients with axial SpA in comparison to RA patients and healthy subjects. Age was an independent factor for high Achilles enthesitis scores only in axial SpA.

Periodontal treatment outcomes in post menopausal women receiving hormone replacement therapy.

PURPOSE: To evaluate the effect of hormone replacement therapy(HRT) on periodontal treatment outcomes in a group of postmenopausal women with periodontitis. MATERIALS AND METHODS: 23 post-menopausal chronic periodontitis patients were included in this study. The test group(n=11) consisted of women who started HRT with this study and received conjugated estrogen and medroxyprogesteron. The control group(n=12) was women not taking any HRT or supplement therapy. Study groups received the same periodontal treatment. All subjects examiend by recording the following: plaque index (PI), sulcus bleeding index (SBI), periodontal pocket depth (PD) and relative attachment level (RAL) from 6 sites in each tooth. Measurements were recorded at the baseline, 1 month, 3 months, and 6 months following periodontal treatment. Serum estrogene level and bone mineral density was recorded at baseline and 6 months following periodontal treatment. RESULTS: The GI change was greater in the control group. There wasn't significant difference by means of PD, the attachment gain was significantly greater in the HRT receiving group. CONCLUSION: HRT seems to have a positive effect on periodontal treatment outcomes.

The frequency of depression and menopause-related symptoms in postmenopausal women living in a province in Eastern Turkey, and the factors that affect depressive status.

BACKGROUND: This study was designed to determine depression in women in the postmenopausal stage in Elazig city, located in Eastern Turkey, and determine the factors affecting depressive status. MATERIAL/METHODS: The sample included 546 women and of these, 519 could be contacted. A questionnaire was conducted with the women who were included in the study. This included demographic properties, which are thought to affect depression. Subjects were given the Beck Depression Inventory (BDI). RESULTS: In total, 97.7% of women reported that they experienced a problem or had complaints during menopause, while 54.9% reported that they experienced problems in their sexual lives. The mean BDI score of women was 17.01+/-8.75. The ratio of women whose total scores were higher than the breakpoint of 17 was 42.2%. Single, widowed, and divorced women had higher ratios than married women; primary school or lower education women had higher ratios than high school or lower education graduate women; the women who reported that they had problems in their sexual lives had higher ratios than the other women within the survey; the women who were subject to violence at any time during their lives had higher ratios than the women who had not experienced violence (P<.05). CONCLUSIONS: The frequency of depression symptoms in women living in Elazig is high. The information and services that the local women receive about menopause are inadequate.

Are there any differences in the expression of hormonal receptors and proliferation markers between uterine and extrauterine leiomyomas?

The aim of this study is to determine the immunohistochemical expressions of estrogen receptor, progesterone receptor, and Ki-67 proliferation marker in 8 extrauterine leiomyomas and to compare these values with their uterine counterparts. In all, 8 patients with extrauterine leiomyomas and 20 patients with uterine leiomyomas as a control group were studied. Sections were immunohistochemically stained with estrogen receptor, progesterone receptor, and Ki-67 antibodies. Labeling indices for estrogen receptor, progesterone receptor, and Ki-67 were found to be 33.05%+/-31.70%, 14.18%+/-18.80%, and 0.52%+/-1.32% for extrauterine leiomyomas and 65.09%+/-26.65%, 32.53%+/-32.80%, and 0.37%+/-0.71% for uterine leiomyomas, respectively. The difference of labeling indices for progesterone receptor between uterine leiomyomas and extrauterine leiomyomas was statistically significant (P=.002). This study shows that increased expression of progesterone receptor is observed only in uterine leiomyomas during the reproductive period. However, it seems that additional factors to hormone receptors contribute to the development of extrauterine leiomyomas.

Bladder tumors: virtual MR cystoscopy.

Virtual cystoscopy is a promising new technique based on computer-simulated rendering of the inner surface of the urinary bladder using volumetric magnetic resonance (MR) imaging data, thus enabling maneuvers that normally are not possible with conventional cystoscopy. Due to several distinct advantages over conventional cystoscopy such as minimal invasiveness, evaluation of the urethral orifice from a cranial point of view and an opportunity to observe diverticula formations and the inner urethral space, gadolinium-enhanced MR cystoscopy has a great potential for competing with conventional cystoscopy under some clinical circumstances. The recent improvement in MR scanners has significantly facilitated virtual cystoscopic evaluation of the urinary bladder lumen by MR imaging. Volumetric data associated with powerful postprocessing procedures allow imaging of the inner urinary bladder surface with excellent detail. In this article, imaging techniques and clinical applications of gadolinium-enhanced virtual MR cystoscopy are presented.

Postmenopausal hormone replacement therapy use decreases oxidative protein damage.

OBJECTIVES: The aim of this study is to evaluate oxidative protein damage (OPD) by investigating protein carbonyl (PCO) and nitrotyrosine (NT) levels, oxidative stress by total thiol (T-SH), erythrocyte glutathione (GSH) and nitric oxide (NO) levels in women receiving hormone replacement therapy (HRT). MATERIALS AND METHODS: To examine the influence of oxidative stress on OPD, we studied 12 postmenopausal women who had received HRT for 6 months, and 13 postmenopausal women who did not receive HRT, as the control group. All subjects were non-smokers. Blood samples were drawn in the fasting state and processed within 1 h of collection. For NT and NO, serum samples were stored at -70 degrees C until analysis; all other parameters were determined on the same day of collection. RESULTS: After 6 months, plasma PCO and T-SH levels were decreased, GSH and NO levels were increased, and NT levels were not changed in 12 postmenopausal women receiving HRT. Except the NT levels, the rest of the parameters did not significantly change in the control group. Interestingly, mean NT levels in the control group increased significantly. CONCLUSIONS: A crucial part of the protective effect of HRT on the cardiovascular system arises secondary to the interaction between estrogen and vessel wall. Our results suggest that an important component of the mechanism underlying this interaction may depend on estrogen's antioxidant effect and its preventive role in OPD.

Effects of long-term oral hormone replacement therapy on plasma nitric oxide and beta-endorphin levels in postmenopausal women.

OBJECTIVES: The aim of this study is to evaluate the relationship between plasma nitric oxide (NO) and beta-endorphin levels in women using hormone replacement therapy (HRT) for 12 months. MATERIAL AND METHODS: Our study group was composed of 55 patients who were in at least their second postmenopausal year. Of the 55 patients, 25 were in the control group. All 30 women in the study group received 2 mg 17beta-estradiol + 1 mg norethisterone acetate tablets daily for 12 months. Plasma NO and beta-endorphin levels were measured both before and after the study period and possible relationships were analyzed. RESULTS: There was a significant increase in both beta-endorphin (p = 0.0001, 10.93 +/- 2.25 vs. 14.85 +/- 2.49) and NO (p = 0.0001, 19.79 +/- 4.01 vs. 27.83 +/- 10.27) levels measured after the study in the HRT group. A correlation was seen between the increments in beta-endorphin and NO levels in the HRT group. CONCLUSION: Continuous combined HRT raises both plasma NO and beta-endorphin levels and a close relationship was found between the two molecules after therapy. We postulate that the increment in these molecules may explain some of the beneficial effects of HRT on cognitive function and mood.