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The novel coronavirus (COVID-19) outbreak has affected living standards around the world, and pandemic anxiety has changed social habits. In this context, this paper investigates the relationship between fear of COVID-19 and quality of life, and assesses the mediating effect of loneliness on this relationship among a sample of older adults in Turkey. The study considers data from approximately 400 people, all of whom completed the CASP-19 Quality of Life Scale in Older People, the Loneliness Scale for the Elderly and the Fear of COVID-19 Scale. Confirmatory factor analyses were performed to confirm a one-factor structure for each instrument. Subsequently, mediation analysis, correcting for age as a continuous covariate, was performed to assess the nature of the relationship between fear and quality of life, and the extent to which that relationship is mediated by loneliness. Our study showed that there is a negative and direct relationship between loneliness and quality of life. Another important finding of our research is that fear of COVID-19 has a significant effect on loneliness. Finally, loneliness mediates the relation between fear of COVID-19 and quality of life. This finding strongly suggests that fear of COVID-19 influences quality of life via loneliness. This result is noteworthy, as we could not find any similar finding in the literature. [ABSTRACT FROM AUTHOR]

Objective: Post-operative success and patient satisfaction were assessed following septoplasty for mild to severe anterior septal deviation. Methods: The study included patients with an anterior nasal septal deviation in the form of a 'C' shape and close to the nasal valve in the anterior septal area. Deviation severity was classified as severe (group 1), moderate (group 2) or mild (group 3). Open or closed septoplasty procedures were performed. All patients were surveyed twice using the Nasal Obstruction Symptom Evaluation scale and the 36-Item Short Form Health Survey. Results: The mean Nasal Obstruction Symptom Evaluation score for group 1 was 15.58 ± 2.34 prior to surgery and 6.61 ± 3.29 following surgery. The corresponding pre- and post-surgery scores in group 2 were 11.9 ± 2.82 and 6.3 ± 3.03, respectively. In group 3, these values were 8.28 ± 2.63 and 7.12 ± 3.18, respectively. The mean 36-Item Short Form Health Survey physical function value for groups 1 and 2 increased after surgery; in group 3, this value decreased after surgery, but the result was not statistically significant. Conclusion: Septoplasty is very successful for treating moderate or advanced deviations, but great care should be taken when employing septoplasty for mild deviations. [ABSTRACT FROM AUTHOR]

Objectives: Chronic maxillary atelectasis is an infrequent entity and data on its prevalence are lacking. This study investigated the prevalence of chronic maxillary atelectasis and aimed to determine the bilaterality of this entity. Methods: The data for 5835 patients who underwent paranasal sinus computed tomography from 2016 to 2020 were retrospectively analysed. Results: Fifty-four patients were diagnosed with chronic maxillary atelectasis; its prevalence was 0.92 per cent. The mean age of these 54 patients was 42.98 ± 18.89 years (range, 18–85 years); 17 of the patients were female and 37 were male. Chronic maxillary atelectasis was unilateral in 42 patients and bilateral in 12 patients (22.2 per cent). Eight patients were found to have enophthalmos with apparent facial asymmetry. Conclusion: The prevalence of bilateral chronic maxillary atelectasis may be higher than previously reported and bilaterality may increase as the number of diagnosed cases increases. A unified classification is also proposed, which describes the silent sinus syndrome as chronic maxillary atelectasis IIIS. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the effect of surgical incision on the auricle position in patients undergoing canal wall down mastoidectomy to treat chronic otitis media. Methods: Thirty-four patients who had undergone canal wall down mastoidectomy with a post-auricular incision approach were included in the study. Patients who had a previous auricle deformity, who underwent limited mastoidectomy surgery or mastoid obliteration, or who were younger than 18 years of age were excluded. The distances of the upper and middle parts of the auricle to the mastoid were measured. Results: Measurements in the first post-operative year were found to be 13.15 ± 3.59 mm in the upper region and 16.29 ± 5.00 mm in the middle region. It was observed that the auricle was approaching the mastoid area in both regions. Conclusion: In patients undergoing radical mastoidectomy, the distance between the auricle and the mastoid may decrease, leading to narrowing of the auriculo-cephalic angle. [ABSTRACT FROM AUTHOR]

The share of older migrants in Dutch cities is increasing. However, only limited knowledge has been gained about the urban conditions that older migrants live in and how these compare to those of their native Dutch counterparts. This paper contributes to filling this knowledge gap using detailed information on residential patterns, housing conditions and levels of neighbourhood deprivation in the city of Amsterdam in the Netherlands, and links this information to data about housing and neighbourhood satisfaction and perceived safety. Empirical evidence demonstrates that there is strong path dependence with regard to the places in which one finds different groups of older non-Western migrants. Older non-Western migrants in Amsterdam are highly concentrated in disadvantaged neighbourhoods. The number of concentrations has increased significantly over the past decade, as well as the concentration levels. Nevertheless, we did not find indications of social isolation. With regard to housing conditions, we found better conditions for socio-economically similar groups of native Dutch and Surinamese 55+ residents, compared to Turkish and Moroccan 55+ residents. These conditions correspond with levels of housing satisfaction. Surinamese older people are more positive about their neighbourhoods. We hypothesise that this is related to the restructuring of neighbourhoods where Surinamese 55+ residents are concentrated. Although the immediate environment of older non-Western people is characterised by high levels of social deprivation, this does not translate into dissatisfaction with social relations or feelings of lack of safety. This suggests that their residential concentration in particular urban neighbourhoods may also bring significant opportunities. [ABSTRACT FROM PUBLISHER]

Objective:This paper reports the authors' technique of manubrio-stapedioplasty using glass ionomer cement for malleus and incus fixation due to tympanosclerosis.Methods:A retrospective case review was conducted of five patients with conductive hearing loss (mean pre-operative air–bone gap of 42.75 dB) treated in a tertiary referral centre. The hearing results of a manubrio-stapedial bone cement ossiculoplasty technique, utilised on the five patients, were analysed. All cases were Wielinga and Kerr tympanosclerosis classification type 2 (attic fixation of the malleus-incus complex with a mobile stapes). The incus and head of the malleus were removed in all patients, and the manubrium was directly connected to the head of the mobile stapes using glass ionomer cement. Patients were evaluated in terms of pre- and post-operative audiometric results; hearing gain and post-operative air–bone gap were the main outcome measures.Results:Mean post-operative air–bone gap was 5.25 dB. Four patients had an air–bone gap of less than 10 dB; the remaining patient had an air–bone of 12.50 dB.Conclusion:Manubrio-stapedioplasty is an effective method for ossicular reconstruction in cases of malleus and incus fixation due to tympanosclerosis. [ABSTRACT FROM PUBLISHER]

Objective: To determine the prevalence and distribution of inner-ear malformations in congenital single-sided deafness cases, as details of malformation type are crucial for disease prognosis and management. Methods: A retrospective study was conducted of 90 patients aged under 16 years with congenital single-sided deafness. Radiological findings were evaluated using computed tomography and magnetic resonance imaging. Inner-ear malformations were identified and cochlear nerve status was determined in affected ears. Results: Out of 90 ears, 42 (46.7 per cent) were found to have inner-ear malformation. Isolated cochlear aperture stenosis was the most common anomaly (n = 18, 20 per cent), followed by isolated cochlear aperture atresia (n = 11, 12.2 per cent) and cochlear hypoplasia (n = 7, 7.8 per cent). Cochlear nerve deficiency was encountered in 41 ears (45.6 per cent). The internal auditory canal was also stenotic in 49 ears (54.4 per cent). Conclusion: Inner-ear malformations, especially cochlear aperture anomalies, are involved in the aetiology of single-sided deafness more than expected. The cause of single-sided deafness differs greatly between congenital and adult-onset cases. All children with single-sided deafness should undergo radiological evaluation, as the prognosis and management, as well as the aetiology, may be significantly influenced by inner-ear malformation type. [ABSTRACT FROM AUTHOR]

Aim: This study aims to determine health-related quality of life (QoL) and the related factors from the perspective of social determinants of health among children. Background: Childhood is the most intense period of life, and environmental factors surrounding children, as well as individual lifestyle factors, are related to the child's physical and mental well-being. To our knowledge, there is a lack of studies evaluating the relationship between determinants of health and the QoL of healthy children in general. Methods: This cross-sectional study was executed in the Bayrakli district of Izmir city. Stratified clustered sampling was used including 24 schools and 3367 7th-grade children, and 1284 students were targeted (50% prevalence, 95% CI, %5 margins of error, 2.25 design effect, and 20% replacement). The response rate was 84.9% (n = 1090). The Turkish KID-KINDL Health-Related Quality of Life Questionnaire for Children was used to assess QoL. Independent variables were examined in four layers using Dahlgren's Determinants of Health Model: basic characteristics, lifestyle factors, family characteristics, and life conditions. Results: The mean QoL score was 71.3 ± 12.6. Our study explained 31.7% of the variance in QoL. Higher QoL scores were associated with better health status, perceived academic achievement, normal/thin body perception, physical activity (PA), and adequate sleep duration. Living with both parents and having fewer siblings positively influenced QoL. Moreover, the presence of structural problems in the household and poorer health perceptions were associated with lower QoL scores (P < 0.05) This study highlighted the multifaceted nature of QoL in Turkish children, revealing the importance of various determinants of health. The results show that in order to improve the general well-being of this population, interventions and policies are required that concentrate on elements including health status, academic accomplishment, body perception, physical activity, family structure, and living situations. [ABSTRACT FROM AUTHOR]

Background: Due to additional responsibilities and uncertainties during the COVID-19 pandemic, primary healthcare (PHC) workers are at increased risk of burnout. Aim: To determine and compare the burnout levels and related factors in PHC nurses and family physicians (FPs) during the COVID-19 pandemic. Methods: An online survey was delivered to PHC workers. Non-random sampling method was used. To evaluate burnout, the Maslach Burnout Inventory was used, which investigates burnout in three categories: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Multivariate linear regression was used to analyze factors associated with burnout for FPs and nurses separately. Findings: Among the participants, 55.7% were nurses, the mean age was 42.34. FPs and nurses experienced similar levels of burnout in terms of EE. Family physicians had higher levels of low PA and DP. Based on the results of the multivariate analysis, while higher EE levels were significantly associated with unequal distribution of workload and communication problems within the Family Health Center for physicians, the unequal distribution of PPE, lack of appreciation by patients or colleagues and restrictions on work-related rights were relevant factors for nurses. Lack of appreciation and restrictions of the rights were associated with increased DP scores in both groups. Unequal distribution of workload was also associated with reduced PA among FPs. Conclusion: PHC physicians and nurses are affected by burnout in different ways under the conditions of the COVID-19 pandemic based on gender, socioeconomic status and working conditions. To protect the mental health of PHC workers in the next public health emergency, clarification in the organization of services, empowering PHC workers in emergency risk communication and provision of timely, adequate and free PPE is essential. It is also crucial to ensure the rights of health workers through macro policy changes especially during emergencies. [ABSTRACT FROM AUTHOR]

Background: The symptoms of obsessive−compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques. Methods: A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (N = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive−Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the resulting dimensions were established using network analysis. Associations between dimensions and sociodemographic and clinical variables were explored using structural equation modeling (SEM). Results: Thirteen first-order symptom dimensions emerged that could be parsimoniously reduced to eight broad dimensions, which were valid across the lifespan: Disturbing Thoughts, Incompleteness, Contamination, Hoarding, Transformation, Body Focus, Superstition, and Loss/Separation. A general OCD factor could be included in the final factor model without a significant decline in model fit according to most fit indices. Network analysis showed that Incompleteness and Disturbing Thoughts were most central (i.e. had most unique interconnections with other dimensions). SEM showed that the eight broad dimensions were differentially related to sociodemographic and clinical variables. Conclusions: Future research will need to establish if this expanded hierarchical and multidimensional model can help improve our understanding of the etiology, neurobiology and treatment of OCD. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare serum macrophage migration inhibitory factor concentrations before and after oral steroid therapy in nasal polyps patients, and determine whether there is a difference between pre-treatment macrophage migration inhibitory factor concentrations and healthy individuals. Methods: The study included 24 patients with nasal polyps and 25 healthy individuals. The patient group received 1 mg/kg oral steroid. Results: The mean macrophage migration inhibitory factor concentration before oral steroid therapy was 3889.79 pg/ml in the patient group and 2334.52 pg/ml in the control group. Macrophage migration inhibitory factor concentrations were statistically significantly higher in the pre-oral steroid therapy patient group than in the control group (p = 0.017). The mean pre- and post-oral steroid therapy serum macrophage migration inhibitory factor concentrations were 3889.79 pg/ml and 2451.25 pg/ml, respectively. The reduction in macrophage migration inhibitory factor concentrations was statistically significant (p = 0.010). Conclusion: These findings suggest that concentrations of macrophage migration inhibitory factor may play a role in the pathogenesis of nasal polyps. [ABSTRACT FROM AUTHOR]

Objective:This study aimed to determine whether there was any relationship between tinnitus and mean platelet volume.Methods:This retrospective study was conducted between January 2013 and January 2014 in Ankara Atatürk Hospital and Ondokuz Mayıs University Hospital, Turkey, on a study group of 86 patients with tinnitus and a control group of 84 healthy subjects. Mean platelet volume was recorded and comparisons were made between the two groups.Results:Mean (± standard deviation) platelet volume was 7.67 ± 0.83 μm3 in the study group and 7.28 ± 0.56 μm3 in the control group. There was a statistically significant difference in mean platelet volume between the tinnitus patients and the healthy subjects (p < 0.05).Conclusion:The clinical findings indicated that tinnitus patients had a higher mean platelet volume than the healthy control subjects; however, the pathophysiological mechanism remains unclear. [ABSTRACT FROM PUBLISHER]

The perception of healthy growth and weight may differ between cultures, which could influence feeding practises and consequently affect the development of overweight. The present study examined ethnic variation in maternal perceptions of growth and their influence on feeding practises among Turkish and Dutch infants aged 0–6 months. Data were obtained from the mothers of 143 Turkish and 143 Dutch healthy, singleton, term infants with birth weights appropriate for gestational age, using structured interviews at 1, 4 and 6 months after birth. Compared with Dutch mothers, mothers of Turkish descent perceived a chubby infant more often as pretty (43 v. 22 %), and were more often worried about their infant's growth (13 v. 4 %). Turkish mothers were more likely to give full breast-feeding (BF) until at least 6 months (adjusted OR (aOR) 2·1, 95 % CI 1·0, 4·3) and to start introducing complementary feeding, including rice flour porridge, at the age of 6 months (aOR 2·4, 95 % CI 1·1, 4·9). Infants of Turkish descent were fed on average one milk feeding more during the day and, if introduced to complementary foods before 6 months, were more often given uncommon types of foods (e.g. yogurt and cookies) (aOR 2·1, 95 % CI 1·1, 4·3). The differences in perceptions affected differences in feeding practises only to a small extent. Preventive advice offered to Turkish mothers in Child Health Care should include discussing choices of complementary foods and frequency of feeding from an early age onwards. In Dutch mothers, support for the continuation of BF remains an important issue. [ABSTRACT FROM PUBLISHER]

This study addressed visual word recognition in deaf bilinguals who are proficient in German Sign Language (DGS) and German. The study specifically investigated whether DGS signs are activated during a monolingual German word recognition task despite the lack of similarity in German orthographic representations and DGS phonological representations. Deaf DGS–German bilinguals saw pairs of German words and decided whether the words were semantically related. Half of the experimental items had phonologically related translation equivalents in DGS. Participants were slower to reject semantically unrelated word pairs when the translation equivalents were phonologically related in DGS than when the DGS translations were phonologically unrelated. However, this was not the case in Turkish–German hearing bilinguals who do not have sign language knowledge. The results indicate that lexical representations are associated cross-linguistically in the bilingual lexicon irrespective of their orthographic or phonological form. Implications of these results for reading development in deaf German bilinguals are discussed. [ABSTRACT FROM PUBLISHER]

Background:This study aimed to evaluate the association of a disintegrin and metalloproteinase-33 protein (‘ADAM-33’) expression in vocal polyp formation and to determine its correlation with clinical characteristics.Methods:Medical charts and histological sections of 32 patients diagnosed with vocal polyps who underwent surgery were analysed. Controls were histopathologically normal vocal fold tissues obtained from 36 patients who underwent surgery for laryngeal squamous cell carcinoma. Immunohistochemical staining was performed to detect ADAM-33 expression in epithelial cells, stroma and vessels.Results:All epithelial, stromal and vascular staining scores were significantly greater in polyp tissue than in controls (p < 0.001). Stromal ADAM-33 staining scores were higher in vocal polyp patients with a symptom duration of less than six months (p < 0.05). Vocal overuse or the presence of reflux symptoms, sinonasal symptoms or allergy did not affect ADAM-33 immunostaining scores (p = 0.05).Conclusion:In this study, ADAM-33 immunostaining was significantly increased in vocal polyps. Therefore, over-expression of this protein may be associated with vocal polyp pathogenesis. [ABSTRACT FROM PUBLISHER]

Objective:To determine the relationship between severe tinnitus and inflammation using the neutrophil-to-lymphocyte ratio as a marker of stress.Methods:A total of 107 patients who had been suffering with severe tinnitus (tinnitus handicap inventory scale grades of 3–5) for at least 2 weeks were recruited. Patients underwent detailed ENT examinations and audiometric tests to exclude a relevant pathological cause of the tinnitus. Patients with systemic diseases, malignancy or inflammatory diseases that could alter neutrophil-to-lymphocyte ratio were excluded. A total of 107 age- and sex-matched healthy control participants were also recruited. Routine laboratory test results and neutrophil-to-lymphocyte ratio were compared between the patients and controls.Results:Lipid profile, liver function, white blood cell count, haemoglobin level, mean corpuscular volume, and vitamin B12 and folate levels were similar among the patients and controls. However, mean neutrophil-to-lymphocyte ratio was significantly higher among the patients than the controls (p < 0.05).Conclusion:The findings of this novel study suggest that neutrophil-to-lymphocyte ratio should be considered during the evaluation of tinnitus patients as a potential clinical marker of tinnitus. Further studies are required to verify the findings. [ABSTRACT FROM PUBLISHER]

Different front-of-pack (FOP) labelling systems have been developed in Europe by industry and organisations concerned with health promotion. A study (n 2068) was performed to establish the extent to which inclusion of the most prevalent FOP systems – guideline daily amounts (GDA), traffic lights (TL), GDA+TL hybrid (HYB) and health logos (HL) – impact consumer perceptions of healthiness over and above the provision of a FOP basic label (BL) containing numerical nutritional information alone. The design included within- and between-subjects factors. The within-subjects factors were: food (pizzas, yogurts and biscuits), healthiness of the food (high health, medium health and low health) and the repeated measurements under BL and test FOP label conditions. The between-subjects factors were: the system (GDA, TL, GDA+TL hybrid, HL), portion size (typical portion size and a 50 % reduction of a typical portion) and country (the UK, Germany, Poland and Turkey). Although the FOP systems tested did result in small improvements for objective understanding under some conditions, there was little difference between the provision of an FOP label containing basic numerical nutritional information alone or between the various systems. Thus, any structured and legible presentation of key nutrient and energy information on the FOP label is sufficient to enable consumers to detect a healthier alternative within a food category when provided with foods that have distinctly different levels of healthiness. Future research should focus on developing greater understanding of the psychological and contextual factors that impact motivation and the opportunity to use the various FOP systems in real-world shopping settings. [ABSTRACT FROM PUBLISHER]

Objectives:Adenoidectomy and tonsillectomy are the oldest surgical procedures. The neutrophil-to-lymphocyte ratio is an inflammatory marker. This study aimed to investigate neutrophil-to-lymphocyte ratios in chronic tonsillitis patients and to determine whether this ratio reflects the pre- and post-operative inflammatory status in these patients.Methods:Patients and healthy individuals were assigned to four groups: the adenoid hypertrophy, adenotonsillar hypertrophy, chronic tonsillitis and control groups. The neutrophil-to-lymphocyte ratio was calculated for each patient before surgery and one month post-surgery. Pre- and post-operative white blood cell, neutrophil and lymphocyte counts and neutrophil-to-lymphocyte ratios were compared both within and between groups.Results:Pre- and post-operative neutrophil-to-lymphocyte ratios were significantly higher in the chronic tonsillitis group than in the adenoid hypertrophy and adenotonsillar hypertrophy groups (p < 0.01 and p < 0.05, respectively). In the chronic tonsillitis group, post-operative neutrophil-to-lymphocyte ratios were significantly lower than pre-operative ratios (p = 0.045). The pre-operative neutrophil-to-lymphocyte ratio was significantly higher in the chronic tonsillitis group than in the adenoid hypertrophy, adenotonsillar hypertrophy and control groups (p = 0.000). In contrast, there was no significant difference in post-operative neutrophil-to-lymphocyte ratios among all groups (p = 0.584).Conclusion:The neutrophil-to-lymphocyte ratio measurement can be used in chronic tonsillitis patients as an effective auxiliary method for determining the necessity and timing of tonsillectomy and post-operative follow up, thereby helping prevent complications due to delayed or inadequate treatment. [ABSTRACT FROM PUBLISHER]

Expression of spatial motion shows wide variation as well as patterned regularities across the world's languages (Talmy, 2000), and events involving the traversal of a spatial boundary impose the tightest typological constraints in the lexicalization of motion, providing a true test of cross-linguistic differences. Speakers of verb-framed languages are required by their language not to use manner verbs in marking the change of location across boundaries (Aske, 1989). Here we test the strength of the boundary-crossing constraint and ask how speakers convey motion events when the constraints imposed by the experimental task are at odds with the constraints imposed by their native language. We address this question by comparing adult speakers’ description of motion scenes that involve the traversal of a spatial boundary in two typologically distinct languages: English and Turkish. Using an experimental paradigm that imposes competing demands with the semantic structure of Turkish, we compare Turkish speakers’ description of boundary-crossing scenes to that of English speakers. We find strong cross-linguistic differences in speakers’ verb choice (manner vs. path) and event segmentation (one vs. many), suggesting that boundary-crossing constraint can serve as a reliable test to detect the typological class of a language. [ABSTRACT FROM PUBLISHER]

On account of both their functional and their morphosyntactic characteristics, relative clauses are often viewed as indicators of complexity in child language. Morphosyntactic properties of Turkish make use of particularly arduous relative clauses in spontaneous early discourse. A matching sticker selection task was used to determine whether Turkish-learning 3- and 4-year-olds can be trained to use subject relative clauses and uniquely identifying constructions. Upon their selection of the accurate sticker, the children were exposed to relative clause constructions (relative clause condition), sentences with demonstrative pronouns (demonstrative noun phrase condition), or a general approval (positive feedback condition). The number of relative clauses increased from pretest to posttest only in the relative clause condition; the rate of using adequately discriminating forms increased in all the three conditions, albeit with a steeper increase in the relative clause condition. The results are discussed in the framework of both structural and pragmatic priming. [ABSTRACT FROM PUBLISHER]

Objective:To study the biomechanical properties of glass ionomer cement used for incudostapedial rebridging.Methods:Two groups were established based on the size of the gap between the incus and stapes (1.0 mm in group 1 and 2.0 mm in group 2). Glass ionomer cement was applied to the gaps, and compression tests were performed. Maximum force was measured at the fracture point, and was divided by the cross-sectional area to obtain the maximum compressive strength.Results:No significant difference was found in the maximum force for the two groups (p = 0.312). The glass ionomer cement diameter was significantly higher in group 2 than in group 1 (p = 0.006). The maximum compressive strength was significantly higher in group 1 than in group 2 (p = 0.042).Conclusion:The fragility of bone cement used in this study was 25.5 per cent higher for a 2 mm gap than for a 1 mm gap. We speculate that the use of bone cement may be safer for the repair of smaller incudostapedial defects. [ABSTRACT FROM PUBLISHER]

Objective:Obstructive sleep apnoea syndrome can lead to unhealthy open-mouth breathing. We investigated the possible relationship between obstructive sleep apnoea syndrome and dental health. We also evaluated other clinical factors that may affect oral health.Methods:We measured sleep using polysomnography and determined the apnoea–hypopnoea index for a total of 291 patients. We also recorded the demographic data, duration of snoring complaints, educational status and income levels for our patient cohort; finally, we calculated the decayed, missing and filled teeth index.Results:Forty-one patients presented with primary snoring (control group) and 250 patients (study group) presented with mild, moderate and severe obstructive sleep apnoea syndrome. We found no correlation between obstructive sleep apnoea syndrome severity and the decayed, missing and filled teeth index (p = 0.057). We also found no correlation between the apnoea–hypopnoea and decayed, missing and filled teeth indexes. Age and the duration of snoring complaints were positively correlated with the decayed, missing and filled teeth index while educational status and income levels were negatively correlated (p < 0.001).Conclusion:Obstructive sleep apnoea syndrome does not negatively affect oral and dental health. [ABSTRACT FROM PUBLISHER]

Objective:This study aimed to compare the effects of topical and systemic lignocaine on the circulatory response to direct laryngoscopy performed under general anaesthesia.Methods:Ninety-nine patients over 20 years of age, with a physical status of I–II (classified according to the American Society of Anesthesiologists), were randomly allocated to 3 groups. One group received 5 ml of 0.9 per cent physiological saline intravenously, one group received 1.5 mg/kg lignocaine intravenously, and another group received seven puffs of 10 per cent lignocaine aerosol applied topically to the airway. Mean arterial pressures, heart rates and peripheral oxygen saturations were recorded, and changes in mean arterial pressure and heart rate ratios were calculated.Results:Changes in the ratios of mean arterial pressure and heart rate were greater in the saline physiological group than the other groups at 1 minute after intubation. Changes in the ratios of mean arterial pressure (at the same time point) were greater in the topical lignocaine group than in the intravenous lignocaine group, but this finding was not statistically significant.Conclusion:Lignocaine limited the haemodynamic responses to laryngoscopy and endotracheal intubation during general anaesthesia in rigid suspension laryngoscopy. [ABSTRACT FROM PUBLISHER]

Deixis is a linguistic bridge between spoken language and communicative context, and its use is intrinsically dependent on the context as well as the language system itself. This cross-linguistic study examined the impact of two distinct language systems, English and Turkish, on the uses of nouns, spatial deixis, and person deixis in 26 Turkish versus 26 Anglo Australian healthy older adults. The study revealed a predilection for spatial deictic use in Turkish versus person deictic use in English speakers at task-specific levels, and the pattern of relationships between language use forms were partially distinct between the two languages. The study provided empirical evidence to deictic theories regarding the role of language structure in discourse production, with implications on brain–language relationships. [ABSTRACT FROM PUBLISHER]

Objective:This study aimed to present the histopathological and audiological effects of mechanical trauma associated with the placement of a model electrode in the scala tympani in rats, and the effects of continuous topical corticosteroid application.Method:The study comprised three groups of rats. The round window membrane was perforated in all three groups and a model electrode was inserted in the round window. Group one received no further treatments. Groups two and three also had an intrathecal microcatheter compatible with a mini-osmotic pump inserted; in group two this was used to release normal saline and in group three the pump released 400 µg/ml dexamethasone.Results:Dexamethasone infusion given after implantation of the intracochlear model electrode was more effective for preventing hearing loss than the administration of just one dose of dexamethasone.Conclusion:The findings suggest that continuous dexamethasone infusion is beneficial for preventing the loss of hair cells and neurons associated with early and late periods of intracochlear electrode trauma. [ABSTRACT FROM PUBLISHER]

Objective:To investigate the frequency of demodex species in the external acoustic meatus in patients with an itchy ear canal.Methods:Patients were assigned to one of three groups. Group one consisted of 54 patients with an itchy ear canal who were using a local agent, while group two was composed of 51 patients with an itchy ear canal who were not using a local agent. Group three consisted of 50 healthy individuals without an itchy ear canal.Results:Demodex species test results were positive in nine (5.8 per cent) of the cases. Six of these positive cases were in group one, two in group two and one in group three. The frequency of demodex species in the external acoustic meatus was similar between those patients with an itchy ear canal who did not use a local agent and the healthy individuals (p = 0.571), but it was significantly higher in those using a local steroid compared with those not using a local agent (p = 0.046).Conclusion:Although demodex species was not significantly higher in patients with an itchy ear canal compared with the control group, use of a local steroid increased the parasite frequency in the external ear canal of affected patients. [ABSTRACT FROM PUBLISHER]

Objective:To compare the effect of right- or left-sided cochlear implantation on listening skills in a paediatric population.Methods:A retrospective analysis was conducted on the listening skills performance data of children who were operated on and followed up at the Çukurova University Department of Otorhinolaryngology between 2007 and 2011. Sixty-three patients were included in the study. Patients were evaluated using the Listening Progress Profile, the Meaningful Auditory Integration Scale and the littlEARS test.Results:The mean age of the children was two years (range of one to five years). Twenty-nine patients were male and 34 were female. Twenty-eight patients were implanted in the right ear and 35 in the left ear. There were no statistically significant differences between right and left ear implantees in terms of listening skills performance.Conclusion:This study indicates that the choice of cochlear implant side is not crucial for the development of listening skills. [ABSTRACT FROM PUBLISHER]

Objective:We aimed to evaluate the relationship between swimming pool pollutants and allergic rhinitis in swimming pool workers.Materials and methods:Twenty-seven indoor pool workers (group 1) and 49 control subjects (group 2) were enrolled in the study. A skin prick test was performed and a nasal smear was obtained from each subject to evaluate rhinitis.Results:When the groups were compared in terms of epithelial cells, group 1 had significantly more epithelial cells than group 2. When the groups were compared with regard to eosinophils, group 1 had significantly more eosinophils than group 2. The skin prick test results for both groups were not significantly different.Conclusion:Indoor pool workers showed severe symptoms of rhinitis and eosinophilic nasal cytology, likely due to chlorine. Nasal cytology is an easy-to-administer diagnostic test and can be used to follow up rhinitis in indoor pool workers, along with nasal endoscopy, a detailed clinical history and a skin prick test. [ABSTRACT FROM PUBLISHER]

Objectives:To determine the patterns of lymph node metastases in oral tongue carcinomas, and examine the implications for elective and therapeutic neck dissection.Method:The study entailed a retrospective analysis of 67 patients with previously untreated oral tongue squamous cell carcinoma who had undergone simultaneous glossectomy and neck dissection.Results:Of the 40 clinically node-negative patients, 7 patients had metastatic lymph nodes on pathological examination. No occult metastasis was found at level IV. Of the 27 clinically node-positive patients, the incidence rate of level IV metastasis was 11.1 per cent (3 out of 27 patients). No ‘skip metastases’ were found at level IV. Level IV metastases were significantly related to clinically staged nodes categorised as over 2a (p = 0.03) and metastasis to level III (p = 0.01).Conclusion:Routine inclusion of level IV in elective neck dissection is not necessary for clinically node-negative patients with oral tongue squamous cell carcinoma. Furthermore, extended supraomohyoid neck dissection with adjuvant radiotherapy can be sufficient in the treatment of selected patients with clinically node-positive necks. [ABSTRACT FROM PUBLISHER]

Background:Serum paraoxonase 1 is involved in mechanisms that protect cells from oxidative stress damage. This study aimed to investigate the correlation between serum paraoxonase 1 activity and polymorphisms in patients with oral squamous cell carcinoma.Methods and materials:Fifty-seven patients with oral squamous cell carcinoma and 59 matched healthy controls participated in the study. Serum paraoxonase 1 activity and polymorphisms in blood samples were compared with results for polymerase chain reaction and restriction fragment length polymorphism tests.Results:Mean serum paraoxonase 1 activity levels were lower in patients than controls (mean ± standard deviation, 21.9 ± 5 units/l and 120.4 ± 2 units/l, respectively) (p = 0.001). The serum paraoxonase 1 192 glutamine polymorphism was more common in patients than controls.Conclusion:Patients with oral squamous cell carcinoma had significantly lower serum paraoxonase 1 activity levels and a greater prevalence of the serum paraoxonase 1 192 glutamine allele, compared with controls. Serum paraoxonase 1 may play a role in the aetiology of oral squamous cell carcinoma. [ABSTRACT FROM PUBLISHER]

Objective:To investigate the relationship between development of laryngeal cancer and the presence of polymorphisms of the MnSOD Val16Ala, CAT-262 C < T and GPx1 Pro198Leu genes in a smoking population.Patients and methods:Single nucleotide polymorphisms were determined in DNA from the peripheral blood erythrocytes of 48 heavy smokers (25 patients with laryngeal cancer and 23 cancer-free controls), using polymerase chain reaction.Results:There were no significant differences in age, smoking duration or smoking intensity, comparing the two groups. The homozygous AA genotype of MnSOD Val16Ala was significantly more prevalent in the cancer group than the control group (92 vs 13 per cent, respectively), while the heterozygous AV genotype of MnSOD Val16Ala was more prevalent in the control group than the cancer group (87 vs 8 per cent, respectively) (p < 0.001). There were no significant differences between the cancer and control groups regarding GPx1 Pro198Leu or CAT-262 C < T polymorphisms.Conclusion:Polymorphism of the MnSOD Val16Ala gene may contribute to susceptibility to laryngeal cancer among smokers. [ABSTRACT FROM PUBLISHER]

Objective:To investigate perceptual, acoustic and aerodynamic voice parameters in obese individuals.Methods:Twenty obese and 20 normal-weight volunteers underwent voice evaluation by laryngoscopy, acoustic analysis, aerodynamic measurement and perceptual analysis (using the grade-roughness-breathiness-asthenia-strain (‘GRBAS') scale and the Voice Handicap Index 10 scale). Data from both subject groups were compared.Results:No difference was found in acoustic analysis parameters between the two groups (p > 0.05). Maximum phonation time in the obese group (mean ± standard deviation, 19.6 ± 4.9 seconds) was significantly shorter than in controls (26.4 ± 4.1 seconds) (p < 0.001), although the s/z ratio was very similar between the two groups. In the obese and control groups, the mean ± standard deviation grade-roughness-breathiness-asthenia-strain scores were 1 ± 1.3 and 0.2 ± 0.6 (p = 0.002) and the mean ± standard deviation Voice Handicap Index 10 scores were 0.5 ± 1.2 and 1.2 ± 1.7 (p = 0.27), respectively.Conclusion:Obese individuals had poorer vocal quality as judged by the grade-roughness-breathiness-asthenia-strain scale, and reduced maximum phonation time. However, there was no change in voice quality as assessed by acoustic analysis and Vocal Handicap Index 10 score, compared with controls. [ABSTRACT FROM PUBLISHER]

Following an extensive overview of the subject, this study explores the relationships between second-language (L2) explicit/implicit knowledge sources, embedded in the declarative/procedural memory systems, and L2 working memory (WM) capacity. It further examines the relationships between L2 reading comprehension and L2 WM capacity as well as those between L2 reading comprehension and L2 explicit/implicit knowledge sources. Participants were late adult learners of English as an L2, with a relatively advanced level of English proficiency. They completed tests measuring their WM capacity, explicit knowledge, implicit knowledge, and L2 reading comprehension. Correlation analysis revealed significant relationships between L2 WM capacity and both explicit and implicit L2 knowledge. Exploratory factor analysis showed that explicit knowledge, WM capacity, and L2 reading comprehension loaded on a single factor whereas implicit L2 knowledge formed an independent factor with no relationship to L2 reading. The results suggest that L2 WM is able to manipulate and store both explicit and implicit L2 input through controlled and automatic processes. They also suggest that L2 explicit knowledge, connected with the control processes of the declarative system's lexical/semantic features, and L2 WM, reflecting attentional resource capacity/allocation associated with control processes, play an important role in L2 reading comprehension. [ABSTRACT FROM AUTHOR]

Objective:To investigate endoscopic staging, and nitric oxide levels in the polyp tissue, in patients with nasal polyposis undergoing glucocorticoid therapy.Methods:Nasal polyposis was evaluated using endoscopic staging and measurement of polyp tissue nitric oxide levels (chemiluminescence method). Forty-five nasal polyposis patients received either nasal therapy (n = 15), oral therapy (n = 15) or combined therapy (n = 15). Pre-treatment and post-treatment staging and nitric oxide levels were evaluated.Results:Endoscopic grading indicated significant post-treatment staging improvements in the oral (p = 0.016) and combined (p = 0.016) groups. Post-treatment staging differed significantly between the three groups (p = 0.041), with greater improvements in the oral and combined groups. All groups showed significantly lower post-treatment nitric oxide levels, compared with baseline, but post-treatment levels did not differ significantly between groups. A significant association was found between treatment response and nitric oxide level alteration.Conclusion:This study demonstrates the favourable effects of glucocorticoids on nasal polyposis, and alteration in nitric oxide tissue levels post-treatment. Nitric oxide level in nasal polyp tissue could be an indicator of treatment response, and may aid surgical decision-making by detecting cases that probably will not respond to medical treatment. [ABSTRACT FROM PUBLISHER]

Objective:To investigate the role of Langerhans cells in the pathogenesis and clinical picture of middle-ear cholesteatoma.Subjects and methods:The study included 40 patients operated upon for a diagnosis of chronic otitis due to acquired cholesteatoma.Results and analysis:A closed surgical technique was used in 20 per cent of patients and an open technique in 80 per cent. Langerhans cells were more densely accumulated in cholesteatoma epithelium, compared with external ear canal skin (p < 0.001). Staining for Ki-67 protein was greater in cholesteatoma epithelium (p < 0.001) and Apo2.7 protein staining (indicating apoptosis) was more prominent (p < 0.001), compared with ear canal skin. Regarding significant relationships between clinical and pathological findings, staining for Ki-67 (p = 0.046) and Apo2.7 (p = 0.037) was more prominent in patients undergoing open versus closed surgery.Conclusion:Using cell proliferation and apoptosis markers, a dense Langerhans cell infiltration was found to occur as a host response to middle-ear cholesteatoma. [ABSTRACT FROM AUTHOR]

Objective:Proteases of the disintegrin and metalloproteinase family (also known as ADAM proteins) are involved in various physiological and pathological processes. This study assessed the expression of disintegrin and metalloproteinase family proteins 10, 12 and 17 in cholesteatoma.Materials and methods:The study evaluated cholesteatoma specimens from 19 patients, and external ear canal skin samples from 7 of the same patients (as controls), for the expression of disintegrin and metalloproteinase family proteins 10, 12 and 17, using immunohistochemical methods.Results and analysis:The study observed over-expression of proteins 10 and 17 in blood vessels, and over-expression of proteins 12 and 17 in cholesteatoma stroma. Immunostaining scores for proteins 10, 12 and 17 in epithelial and inflammatory cells from cholesteatoma specimens versus control specimens showed no statistically significant differences.Conclusion:Over-expression of disintegrin and metalloproteinase family proteins 10, 12 and 17 in cholesteatoma may be related to cholesteatoma pathogenesis. These proteins deserve further study as they may represent potential targets for cholesteatoma treatment. [ABSTRACT FROM AUTHOR]

Objective:Deafness may be one of the factors that leads to a change in sexual function. This study aimed to assess sexual function, in particular erectile dysfunction, in male patients with hearing loss.Materials and methods:We studied two groups: (1) adult men with acquired, bilateral, sensorineural hearing loss, and (2) healthy, adult, married men demonstrated to have normal hearing levels, as the control group. Sexual function was assessed using the International Index of Erectile Functions questionnaire, and quality of life using the 36-Item Short-Form Health Survey.Results:There was a statistically significant difference between the groups regarding the International Index of Erectile Functions questionnaire results (p <0.001), both for each of the five questionnaire domain scores and for the total score.Conclusion:Our results indicate that men with mild or moderate sensorineural hearing loss have poorer sexual health. [ABSTRACT FROM AUTHOR]

Objective:Mutations in the genes for connexin 26 (GJB2) and connexin 30 (GJB6) play an important role in autosomal recessive, non-syndromic hearing loss. This study aimed to detect the 35delG and 167delT mutations of the GJB2 gene and the del(GJB6-D13S1830) mutation of the GJB6 gene in paediatric patients diagnosed with congenital, non-syndromic hearing loss and treated with cochlear implantation in Mediterranean Turkey.Materials and method:We included 94 children diagnosed with congenital, non-syndromic hearing loss and treated with cochlear implantation. Blood samples were collected, DNA extracted and an enzyme-linked immunosorbent assay performed to enable molecular diagnosis of mutations.Results:Of the 94 children analysed, the 35delG mutation was detected in 12 (12.7 per cent): 10 (83.3 per cent) were homozygous and 2 (16.7 per cent) heterozygous mutant. The 167delT and del(GJB6-D13S1830) mutations were not detected.Conclusion:The GJB2-35delG mutation is a major cause of congenital, non-syndromic hearing loss in this study population. [ABSTRACT FROM PUBLISHER]

Background. Familial liability to both severe and common mental disorder predicts psychotic disorder and psychotic symptoms, and may be used as a proxy in models examining interaction between genetic risk and the environment at individual and contextual levels. Method. In a representative general population sample (n = 4011) in Izmir, Turkey, the full spectrum of expression of psychosis representing (0) no symptoms, (1) subclinical psychotic experiences, (2) low-impact psychotic symptoms, (3) high-impact psychotic symptoms and (4) full-blown clinical psychotic disorder was assessed in relation to mental health problems in the family (proxy for familial liability) and the wider social environment. Quality of the wider social environment was assessed in an independent sample using contextual measures of informal social control, social disorganization, unemployment and low income, aggregated to the neighbourhood level. Results. The association between familial liability to severe mental illness and expression of psychosis spectrum was stronger in more deprived neighbourhoods [e.g. this association increased from β=0.33 (p=0.01) in low-unemployment neighbourhoods to β=0.92 (p<0.001) in high-unemployment neighbourhoods] and in neighbourhoods high in social control, while neighbourhood variables did not modify the association between familial liability to common mental disorder and the psychosis outcome. Neighbourhood variables mediated urbanicity effects. Conclusions. Contextual effects may be important in moderating the expression of psychosis liability in populations, representing a specific pathway independent of the link between common mental disorder and psychosis. [ABSTRACT FROM AUTHOR]

Background:The pathogenesis of cholesteatoma remains unclear, despite several theories. Alterations in the density of mast cells positive for cluster of differentiation 117 protein (also known as CD117) can be critical to cholesteatoma formation, due to the effect on keratinocyte growth factor production. This study aimed to investigate the potential role of these mast cells in cholesteatoma pathogenesis.Methods:The number and density of mast cells positive for cluster of differentiation 117 protein were immunohistochemically analysed in 52 patients: 22 with chronic otitis media alone (group one), 25 with chronic otitis media with cholesteatoma (group two) and five controls.Results:The number of these mast cells was much higher in group two (in cholesteatoma matrix tissue) than in group one (in chronic otitis media granulation tissue) or the controls (in normal post-auricular skin). The density of these mast cells was significantly greater in group two than in group one or the controls (p < 0.05). The number and density of these mast cells was much greater in group one than in controls (p < 0.01).Conclusion:Mast cells positive for cluster of differentiation 117 protein could play a role in cholesteatoma formation. Further investigation of the role of these mast cells in cholesteatoma may suggest new ways of addressing this disorder, and may enable the development of targeted treatments. [ABSTRACT FROM PUBLISHER]

Objective:To investigate the possible clinical relationship between gastroesophageal reflux disease and the type one tympanoplasty surgical outcomes of adults with chronic otitis media, by using a simple, cost-effective, reliable questionnaire and physical findings.Methods:Fifty-two of 147 patients undergoing type one tympanoplasty were studied. Gastroesophageal reflux disease symptoms were evaluated using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease questionnaire. Laryngoscopic physical findings of laryngopharyngeal reflux were evaluated using the Reflux Finding Score. A successful outcome was defined as an intact tympanic membrane. Correlations between the two assessment tool results and the patient's surgical success were calculated.Results:The gastroesophageal reflux disease questionnaire score was significantly higher in patients with unsuccessful tympanic membrane closure (group one) than in patients with successful closure (group two) (p < 0.05). The Reflux Finding Score was also significantly higher in group one than group two (p < 0.05). There was a significant positive relationship between the gastroesophageal reflux disease questionnaire score and the Reflux Finding Score (p < 0.01).Conclusion:Gastroesophageal reflux disease may be a significant prognostic factor for tympanoplasty failure. Therefore, reflux investigation may be important during the treatment of chronic otitis media, and positive cases may need reflux treatment as well as ear disease treatment. [ABSTRACT FROM PUBLISHER]

Objective:A disintegrin and metalloproteinase domain containing protein 33 (also known as ADAM-33) is a member of a matrix metalloproteinase family which mediates extracellular matrix remodelling and changes in cellular adhesion. This study aimed to evaluate expression of this protein in laryngeal squamous cell carcinoma, and to determine its correlation with patients' clinicopathological characteristics.Subjects and methods:Forty paraffin blocks of laryngeal carcinoma underwent immunohistochemical staining to detect “a disintegrin and metalloproteinase-33” expression. Case records were reviewed to determine patient characteristics.Results:All epithelial, vascular and stromal staining scores were significantly increased in tumour tissue compared with controls (p < 0.001). However, patients' clinical characteristics at the time of diagnosis, and their disease extent, did not correlate significantly with the immunohistochemical staining scores.Conclusion:This study suggests that increased expression of “a disintegrin and metalloproteinase-33” may play a role in the pathogenesis of laryngeal carcinoma. [ABSTRACT FROM PUBLISHER]