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Tastan S, Ciftci HD. Contraceptive use and sexual quality of life of patients with thalassemia in Northern Cyprus: a descriptive cross-sectional study. Afr Health Sci 2023; 23:70-78. [PMID: 38357181 PMCID: PMC10862598 DOI: 10.4314/ahs.v23i3.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Objective Although contraception methods are an important factor affecting sexual life, no literature has been recorded about the contraceptive methods used and the sexual life of thalassemia patients. The aim of this study is to document the effects of and preferences of contraception methods used in the sexual lives of patients with thalassemia. Methods The descriptive and cross-sectional study took place in Northern Cyprus at a Thalassemia Center in a State Hospital. The study sample consisted of 100 thalassemia major or intermedia patients. The data includes descriptive characteristics, the preference of contraception methods used by men and women and Sexual Quality of Life Questionnaires. Results Participants learned about contraception methods mostly from social media/internet, and 58.3% of the women and 46.2% of the men did not use any contraception method within the last year. Women's sexual quality of life score was 70.3±19.9 and men's Sexual Quality of Life score was 78.9±20.6. Women having knowledge of contraception methods had higher scores than man (p<0.05). Male patients not having physical exercise had sexual quality of life scores significantly lower than those who followed exercise programs (p<0.05). Conclusions Results indicate a significant need to include family planning and sexual health subjects that specifically address thalassemia patients.
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Affiliation(s)
- Sevinc Tastan
- Eastern Mediterranean University, Health Sciences Faculty, Nursing Department, Via Mersin 10, Famagusta, North Cyprus, Turkey
| | - Hafize Dogan Ciftci
- Dr. Burhan Nalbantoglu State Hospital, Nicosia, North Cyprus, Via Mersin 10-Turkey
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2
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Naz Şimdivar GH, Kurumoğlu Incekalan T, Tuncel DA. Ocular biometry, anterior chamber morphometry, and their relationship with serum ferritin levels in children with beta thalassemia major. Ther Adv Ophthalmol 2023; 15:25158414231165824. [PMID: 37113304 PMCID: PMC10126650 DOI: 10.1177/25158414231165824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/03/2023] [Indexed: 04/29/2023] Open
Abstract
Background Ocular biometry and anterior segment evaluations are important to determine ocular development and pathological changes, especially in thalassemia patients in Mediterranean countries such as Turkey. Objectives The objectives of this study were to compare ocular biometry and anterior segment parameters in children with thalassemia major and healthy controls and to examine the relationship between ferritin levels, anthropometric measurements, and ocular parameters. Design This is a prospective case-control study. Methods The height, weight, body mass index, and occipitofrontal circumference values of the participants were recorded. Anterior and vitreous chamber depth, lens thickness, axial length, central corneal thickness, anterior chamber volume, iridocorneal angle, pupil diameter, and mean keratometry were measured. Measurements were compared between patients and healthy children, and between patients with ferritin levels above and below 1000 ng/mL. Results This study included 40 patients and 45 controls. Height, weight, and body mass index were significantly lower while ferritin level and occipitofrontal circumference were significantly higher in patients compared with the controls (p < 0.001 for all). There were no statistically significant differences in the other ocular parameters (p > 0.05). In comparisons between patients with ferritin levels below (n = 15) and above 1000 ng/mL (n = 25), there were no significant differences in age, height, weight, body mass index, occipitofrontal circumference, or ocular parameters (p > 0.05). Occipitofrontal circumference and mean keratometry value were positively correlated in patients with ferritin levels below 1000 ng/mL (r = 0.573, p = 0.025), while body mass index was negatively correlated with pupil diameter in patients with ferritin levels above 1000 ng/mL (r = -0.469, p = 0.018). Conclusion Children with thalassemia showed significant growth retardation and large occipitofrontal circumference but did not differ from controls in terms of biometrics and anterior segment morphology. Our results demonstrated a positive correlation between the occipitofrontal circumference and mean keratometry value in children with ferritin levels below 1000 ng/mL and a negative correlation between body mass index and pupil diameter in children with ferritin levels above 1000 ng/mL.
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Affiliation(s)
| | | | - Defne Ay Tuncel
- Department of Pediatric Hematology, Adana City
Training and Research Hospital, Adana, Turkey
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3
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Delatycki MB, Alkuraya F, Archibald A, Castellani C, Cornel M, Grody WW, Henneman L, Ioannides AS, Kirk E, Laing N, Lucassen A, Massie J, Schuurmans J, Thong M, Langen I, Zlotogora J. International perspectives on the implementation of reproductive carrier screening. Prenat Diagn 2019; 40:301-310. [DOI: 10.1002/pd.5611] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/22/2019] [Accepted: 11/07/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Martin B. Delatycki
- Victorian Clinical Genetics Services Parkville Victoria Australia
- Murdoch Children's Research Institute Parkville Victoria Australia
- Department of PaediatricsUniversity of Melbourne Parkville Victoria Australia
| | - Fowzan Alkuraya
- Department of GeneticsKing Faisal Specialist Hospital and Research Centre Riyadh Saudi Arabia
- Saudi Human Genome ProgramKing Abdulaziz City for Science and Technology Riyadh Saudi Arabia
- College of MedicineAlfaisal University Riyadh Saudi Arabia
| | - Alison Archibald
- Victorian Clinical Genetics Services Parkville Victoria Australia
- Murdoch Children's Research Institute Parkville Victoria Australia
- Department of PaediatricsUniversity of Melbourne Parkville Victoria Australia
| | - Carlo Castellani
- Cystic Fibrosis CentreIRCCS Istituto Giannina Gaslini Genoa Italy
| | - Martina Cornel
- Department of Clinical GeneticsAmsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Amsterdam Reproduction and Development Research Institute Amsterdam The Netherlands
| | - Wayne W. Grody
- Divisions of Medical Genetics and Molecular Diagnostics, Departments of Pathology and Laboratory Medicine, Pediatrics, and Human GeneticsUCLA School of Medicine Los Angeles California USA
- UCLA Institute for Society and Genetics, Molecular Diagnostic Laboratories and Clinical Genomics CenterUCLA Medical Center Los Angeles California USA
| | - Lidewij Henneman
- Department of Clinical GeneticsAmsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Amsterdam Reproduction and Development Research Institute Amsterdam The Netherlands
| | | | - Edwin Kirk
- Sydney Children's Hospital Randwick New South Wales Australia
- New South Wales Health Pathology Randwick New South Wales Australia
- School of Women's and Children's HealthUniversity of New South Wales Randwick New South Wales Australia
| | - Nigel Laing
- University of Western Australia Centre for Medical Research and Harry Perkins Institute of Medical ResearchQEII Medical Centre Nedlands Western Australia Australia
- Neurogenetic Unit, Department of Diagnostic Genomics, PathWest Laboratory MedicineQEII Medical Centre Nedlands Western Australia Australia
| | - Anneke Lucassen
- Faculty of Medicine, Southampton Medical SchoolUniversity of Southampton Southampton UK
| | - John Massie
- Murdoch Children's Research Institute Parkville Victoria Australia
- Department of PaediatricsUniversity of Melbourne Parkville Victoria Australia
- Department of Respiratory MedicineRoyal Children's Hospital Parkville Victoria Australia
| | - Juliette Schuurmans
- Faculty of Medicine, Southampton Medical SchoolUniversity of Southampton Southampton UK
- Department of Genetics, University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
| | - Meow‐Keong Thong
- Genetics and Metabolism Unit, Department of Paediatrics, Faculty of MedicineUniversity of Malaya Kuala Lumpur Malaysia
| | - Irene Langen
- Department of Genetics, University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
| | - Joël Zlotogora
- Hadassah‐Hebrew University Medical School Jerusalem Israel
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Tommasini A, Magnolato A, Bruno I. Innovation for rare diseases and bioethical concerns: A thin thread between medical progress and suffering. World J Clin Pediatr 2018; 7:75-82. [PMID: 30191136 PMCID: PMC6125142 DOI: 10.5409/wjcp.v7.i3.75] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/06/2018] [Accepted: 08/13/2018] [Indexed: 02/05/2023] Open
Abstract
With the development of precision medicines based on small molecules, antibodies, RNAs and gene therapy, technological innovation is providing some exciting possibilities to treat the most severe genetic diseases. However, these treatments do not always lead to a cure for the disease, and there are several factors that may hinder their overall success. Patients living during a period of great medical change and innovation may benefit from these technological advances but may also just face failures, both in terms of frustrated hopes as well as suffering. In this article, we are telling the stories of three children with rare and severe disorders, who live in an age of significant medical changes, bearing the burden of difficult scientific and ethical choices. The first two cases that are suffering respectively from severe immunodeficiency and beta thalassemia have already been described in scientific journals, as well as in popular magazines. Although similar when considering the medical challenges, the two cases had opposite outcomes, which resulted in distinct ethical implications. The third case is a baby with spinal muscular atrophy, living at a time of continued innovation in the treatment of the disease. With these cases, we discuss the challenges of providing correct information and proper counseling to families and patients that are making the bumpy journey on the road of medical innovation.
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Affiliation(s)
- Alberto Tommasini
- Department of Pediatrics, Institute of Maternal and Child Health, IRCCS Burlo Garofolo, Trieste 34137, Italy
| | - Andrea Magnolato
- Department of Pediatrics, Institute of Maternal and Child Health, IRCCS Burlo Garofolo, Trieste 34137, Italy
| | - Irene Bruno
- Department of Pediatrics, Institute of Maternal and Child Health, IRCCS Burlo Garofolo, Trieste 34137, Italy
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ŞANLIDAĞ B, ÇAĞIN B, ÖZENLİ Ö, ŞAHALOĞLU Ö, DALKAN C, GALİP N, BABAYİĞİT HOCAOĞLU A, BAHÇECİLER N. Prevalence of Thalassemia Trait & Iron Deficiency Anemia during Infancy in 2011-2013 in a Thalassemia Prevalent Region: North Cyprus. IRANIAN JOURNAL OF PUBLIC HEALTH 2016; 45:1038-1043. [PMID: 27928530 PMCID: PMC5139961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Iron Deficiency Anemia (IDA) is an important health problem all around the world especially in developing countries. In the Mediterranean countries another prevelant reason of anemia is Thalassemia. Certain strategies had been established as a government policy to reduce prevalence in North Cyprus, such as pre-marital screening of Thalassemia. The prevalence of thalassemia trait has not been evaluated since then. The aim of this study was to detect the prevalence of IDA, thalassemia trait in infants under regular follow-up and to evaluate the compliance to prophylactic iron supplementation (PIS) and its effect on IDA. METHODS Healthy children admitted to Department of Pediatrics, Near East University Hospital, in 2011-2013 were included. Data of anthropometric measurements, parental thalassemia trait status, duration of PIS usage, complete blood count, ferritin levels and hemoglobin electrophoresis were collected from hospital database program. Anemic children were grouped as IDA, thalassemia trait, both IDA and thalassemia trait and others. RESULTS Eıghty-nine infants with a mean age 13.52±2.09 mo were included. Compliance with PIS recommendation was 85.3% and, the mean duration of iron usage was 6.44±3.18 mo. IDA and thalassemia trait were found to be 11.2% and 4.5% respectively, while 3.4% of the infants had both IDA and thalassemia trait. CONCLUSION Prevalence of thalassemia trait was 7.9% demonstrating approximately a 50% decline within 5 decades. This result confirms the success of premarital screening policy in North Cyprus. In addition, prevalence of IDA was relatively low being 14.6% supporting the beneficial effect of PIS on prevention of IDA.
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Affiliation(s)
- Burçin ŞANLIDAĞ
- Dept. of Pediatrics, School of Medicine, Near East University, Nicosia, Cyprus,Corresponding Author:
| | - Buse ÇAĞIN
- School of Medicine, Near East University, Nicosia, Cyprus
| | - Övgü ÖZENLİ
- School of Medicine, Near East University, Nicosia, Cyprus
| | - Özlem ŞAHALOĞLU
- Dept. of Pediatrics, School of Medicine, Near East University, Nicosia, Cyprus
| | - Ceyhun DALKAN
- Dept. of Pediatrics, School of Medicine, Near East University, Nicosia, Cyprus
| | - Nilüfer GALİP
- Dept. of Pediatrics, School of Medicine, Near East University, Nicosia, Cyprus
| | | | - Nerin BAHÇECİLER
- Dept. of Pediatrics, School of Medicine, Near East University, Nicosia, Cyprus
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6
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The molecular spectrum and distribution of haemoglobinopathies in Cyprus: a 20-year retrospective study. Sci Rep 2016; 6:26371. [PMID: 27199182 PMCID: PMC4873807 DOI: 10.1038/srep26371] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 04/28/2016] [Indexed: 12/14/2022] Open
Abstract
Haemoglobinopathies are the most common monogenic diseases, posing a major public health challenge worldwide. Cyprus has one the highest prevalences of thalassaemia in the world and has been the first country to introduce a successful population-wide prevention programme, based on premarital screening. In this study, we report the most significant and comprehensive update on the status of haemoglobinopathies in Cyprus for at least two decades. First, we identified and analysed all known 592 β-thalassaemia patients and 595 Hb H disease patients in Cyprus. Moreover, we report the molecular spectrum of α-, β- and δ-globin gene mutations in the population and their geographic distribution, using a set of 13824 carriers genotyped from 1995 to 2015, and estimate relative allele frequencies in carriers of β- and δ-globin gene mutations. Notably, several mutations are reported for the first time in the Cypriot population, whereas important differences are observed in the distribution of mutations across different districts of the island.
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7
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Srivastava A, Kay MA, Athanasopoulos T, Angastiniotis M, Anagnostopoulos A, Karponi G, Yannaki E, Zon LI, Lederer CW, Phylactides MS, Kleanthous M. A Tribute to George Stamatoyannopoulos. Hum Gene Ther 2016; 27:280-6. [DOI: 10.1089/hum.2016.29025.gst] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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8
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Ergoren MC, Pirzada RH, Arici M, Serakinci N. Near East University Genetic Mutation Database (NEU-GD): The first mutation database of Northern Cyprus. Gene 2015; 571:145-8. [PMID: 26183225 DOI: 10.1016/j.gene.2015.07.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 05/18/2015] [Accepted: 07/11/2015] [Indexed: 10/23/2022]
Abstract
The health care system is negatively affected by the genetic disorders that lead to an increasing rate of morbidity and neonatal deaths and affect adults as well. These create a substantial government's psychosocial and economic burden on clinicians, patients and their families with the advancement in the field of genetics. There has been a tremendous increase in the rate in which diseases associated with variant DNA sequences are being sought and identified. The goal behind the creation of Near East University Genetic Mutation Database (NEU-GD) is to map and apprehend the patterns of common genetic diversity in the human genetic makeup in order to accelerate the search for the genetic causes of human disease. NEU-GD will allow scientists to generate extraordinarily useful information such as allelic variations among population, and description of the genetic blueprint of mutations occurring in human beings. In this communication we report the construction of the first genetic mutation database for the people belonging to different ethnic groups living in North Cyprus (http://genetics-db.neu.edu.tr/). Therefore NEU-GD can serve as an important tool available online for molecular genetic testing of inherited disorder and persuade for further investigation of novel genetic disorders in North Cyprus population.
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Affiliation(s)
- Mahmut Cerkez Ergoren
- Department of Medical Genetics, Faculty of Medicine, Near East University, Near East Avenue, 99138, Nicosia, Mersin 10, Turkey.
| | - Rameez Hassan Pirzada
- Department of Medical Genetics, Faculty of Medicine, Near East University, Near East Avenue, 99138, Nicosia, Mersin 10, Turkey.
| | - Mustafa Arici
- EU-IBM Advanced Research Centre, Near East University, Near East Avenue, 99138, Nicosia, Mersin 10, Turkey.
| | - Nedime Serakinci
- Department of Medical Genetics, Faculty of Medicine, Near East University, Near East Avenue, 99138, Nicosia, Mersin 10, Turkey.
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9
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Kyrri AR, Kalogerou E, Loizidou D, Ioannou C, Makariou C, Kythreotis L, Phylactides M, Kountouris P, Angastiniotis M, Modell B, Kleanthous M. The Changing Epidemiology of β-Thalassemia in the Greek-Cypriot Population. Hemoglobin 2013; 37:435-43. [DOI: 10.3109/03630269.2013.801851] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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10
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Denic S, Aden B, Nagelkerke N, Essa AA. β-Thalassemia in Abu Dhabi: consanguinity and tribal stratification are major factors explaining the high prevalence of the disease. Hemoglobin 2013; 37:351-8. [PMID: 23600619 DOI: 10.3109/03630269.2013.790827] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Tribalism and consanguineous marriages are common in parts of the world with a high prevalence of the β-thalassemia (β-thal) mutations, and increase the risks of homozygosity for this and other recessive disorders. We explored the frequency of β-thal genes and β-thal carriers in 5672 subjects screened before marriage, of whom 2262 were couples. The mean coefficient of inbreeding (F) in the population was estimated from self-reported relationships to prospective spouses in 383 subjects. Overall frequency of β-thal mutations and β-thal carriers in the population were 1.16 and 2.3%, respectively. Among the 14 largest tribes, β-thal carrier frequencies varied from 0 to 13.6%. The estimated F in the population was 0.022. The expected number of couples needed to be screened to detect one couple who were both β-thal carriers in the non inbreeding (F = 0) and inbreeding (F = 0.022) population was 1858 and 646, respectively. However, among 2262 couples, 10 were both β-thal carriers, i.e., 1 in 226 couples, significantly (p = 0.02) more than expected by taking only inbreeding into account. Although β-thal mutations are relatively rare, the burden of β-thal disease is increased eight-fold by tribalism and consanguinity.
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Affiliation(s)
- Srdjan Denic
- Department of Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
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11
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Cowan RS. Moving up the slippery slope: Mandated genetic screening on Cyprus. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2009; 151C:95-103. [DOI: 10.1002/ajmg.c.30202] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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12
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13
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Wainscoat JS, Kanavakis E, Wood WG, Letsky EA, Huehns ER, Marsh GW, Higgs DR, Clegg JB, Weatherall DJ. Thalassaemia intermedia in Cyprus: the interaction of α and β thalassaemia. Br J Haematol 2008. [DOI: 10.1111/j.1365-2141.1983.00353.x-i1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Affiliation(s)
- L Varesi
- Faculty of Sciences and Techniques, University of Corsica, Corte, France
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15
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Kyriacou K, Kyrri A, Kalogirou E, Vasiliades P, Angastiniotis M, Ioannou PA, Kleanthous M. Hb Bart's levels in cord blood and alpha-thalassemia mutations in Cyprus. Hemoglobin 2000; 24:171-80. [PMID: 10975437 DOI: 10.3109/03630260008997525] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this study was to examine the frequency of alpha-thalassemia in the population of Cyprus using cord blood samples. The levels of Hb Bart's were compared with the hematological indices and the results correlated with the presence of alpha-thalassemia mutations. The protocols for the polymerase chain reaction detection of the six most common alpha-globin mutations encountered in Cyprus were optimized, and the frequency of each mutation was determined through the screening of 495 random cord blood samples. The total allele frequency for the mutations examined was 10.6%, of which 1% is due to the triplication of the alpha-globin genes. The -alpha(3.7 kb) deletion accounts for 72.8% of all detectable mutations, while the--MED-I and -(alpha)-20.5 kb mutations account for 7.8%. The level of Hb Bart's and the MCV and MCH values in cord blood samples were found to correlate closely with the severity of alpha-thalassemia, although the -alpha(3.7 kb) deletion and perhaps other mild alpha-thalassemia mutations may not give detectable Hb Bart's levels. A reasonably accurate estimate of the alpha-thalassemia carrier frequency may be obtained from cord blood studies if Hb Bart's estimates are combined with hematological indices. When molecular methods are added, these give the best way to use cord bloods to survey populations for alpha-thalassemia.
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Affiliation(s)
- K Kyriacou
- The Cyprus Institute of Neurology and Genetics, Nicosia
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16
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Baysal E, Kleanthous M, Bozkurt G, Kyrri A, Kalogirou E, Angastiniotis M, Ioannou P, Huisman TH. alpha-Thalassaemia in the population of Cyprus. Br J Haematol 1995; 89:496-9. [PMID: 7734346 DOI: 10.1111/j.1365-2141.1995.tb08354.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We have determined the alpha-thalassaemia (alpha-thal) determinants in 78 patients with Hb H disease from Cyprus; 25 were Turkish Cypriots and 53 were Greek Cypriots. Four deletional and three non-deletional alpha-thal alleles were present; the -alpha(3.7 kb) alpha-thal-2 and the --MED-I alpha-thal-1 were most frequently seen; --MED-II and -(alpha)20.5 deletions occurred at considerably lower frequencies. About 15% of all chromosomes carried a non-deletional alpha-thal-2 allele; of these the 5 nucleotide (nt) deletion at the first intervening sequence (IVS-I) donor splice site was present in approximately 8% of all chromosomes. Two types of polyadenylation signal (poly A) mutations were observed. No striking frequency differences were seen between Greek and Turkish Cypriot patients. Combinations of the various types of alpha-thal resulted in eight different forms of Hb H disease. The phenotypes were comparable except for great variations in the level of Hb H which was highest (average approximately 22%) in the 12 patients with the alpha 5nt alpha/--MED-I combination. One patient with the same form of Hb H disease but with an additional beta-thal (IVS-I-110,G-->A) heterozygosity had a most severe microcytosis and hypochromia with < 1% Hb H. Variations in the level of Hb H might correlate with the severity of the disease, although this was not evident from the haematological data.
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Affiliation(s)
- E Baysal
- Laboratory of Protein Chemistry, Medical College of Georgia, Augusta 30912-2100
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Baysal E, Indrak K, Bozkurt G, Berkalp A, Aritkan E, Old JM, Ioannou P, Angastiniotis M, Droushiotou A, Yüregir GT. The beta-thalassaemia mutations in the population of Cyprus. Br J Haematol 1992; 81:607-9. [PMID: 1390250 DOI: 10.1111/j.1365-2141.1992.tb03000.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We have identified the beta-thalassaemia alleles in nearly all known Turkish Cypriot beta-thalassaemia homozygotes and in over 700 Greek Cypriot beta-thalassaemia heterozygotes living on the island of Cyprus. The data confirmed earlier observations that the IVS-I-100 (G-->A) mutation is present for about 74-80%, while three other alleles [IVS-II-745 (C-->G), IVS-I-6 (T-->C), IVS-I-1 (G-->A)] occur at frequencies of 5-8%. Nearly identical percentages were observed for the two Cypriot groups, quite different from those for beta-thalassaemia patients from Greece and Turkey. This suggests close contacts between the two Cypriot communities during many centuries without a major recent influence from Greek or Turkish beta-thalassaemia carriers.
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Affiliation(s)
- E Baysal
- Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta 30912-2100
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18
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Affiliation(s)
- R R Crichton
- Unité de Biochimie, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
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19
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Sozuoz A, Berkalp A, Figus A, Loi A, Pirastu M, Cao A. Beta thalassaemia mutations in Turkish Cypriots. J Med Genet 1988; 25:766-8. [PMID: 3236356 PMCID: PMC1051582 DOI: 10.1136/jmg.25.11.766] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Using oligonucleotide hybridisation or restriction endonuclease analysis, we have characterised the molecular defect in 94 patients with thalassaemia major and four with thalassaemia intermedia of Turkish Cypriot descent. We found that four mutations, namely beta+ IVS-1 nt 110, beta zero IVS-1 nt, beta+ IVS-1 nt 6, and beta+ IVS-2 nt 745 were prevalent, accounting for 69.9%, 11.7%, 8.7%, and 5.6% respectively of the beta thalassaemia chromosomes. This information may help in the organisation of a large scale prevention programme based on fetal diagnosis of beta thalassaemia by DNA analysis in the Turkish population.
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Affiliation(s)
- A Sozuoz
- Turkish Cypriot Thalassaemia Control Program, Nicosia, Cyprus
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20
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Affiliation(s)
- S Cin
- Pediatric Hematology and Oncology Research Center, Ankara University, Turkey
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21
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22
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Abstract
Seven hundred and ninety-five people, (96% of whom were of Greek origin) were screened for thalassaemia trait. A prevalence rate of 7.1% for beta-thalassaemia carriers was found. The red cells of individuals with the alpha-1-thalassaemia, beta-thalassaemia, and haemoglobin Lepore traits all had a mean corpuscular volume (MCV) of less than 76 fL and a mean corpuscular haemoglobin (MCH) of less than 25 pg, thus confirming the usefulness of these indices as a preliminary thalassaemia screening test. However, in three of the six people provisionally diagnosed as having delta-beta-thalassaemia trait, an overlap of MCV and MCH values with the normal range occurred. Community attitudes to the survey and its implications are discussed.
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Wainscoat JS, Kanavakis E, Wood WG, Letsky EA, Huehns ER, Marsh GW, Higgs DR, Clegg JB, Weatherall DJ. Thalassaemia intermedia in Cyprus: the interaction of alpha and beta thalassaemia. Br J Haematol 1983; 53:411-6. [PMID: 6297530 DOI: 10.1111/j.1365-2141.1983.tb02041.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Restriction endonuclease analysis has been performed on the alpha and beta globin gene clusters of 57 Cypriots homozygous for beta thalassaemia, 30 with the transfusion dependent form of the condition (thalassaemia major) and 27 who are less severely affected (thalassaemia intermedia). There was a significant difference in the incidence of alpha thalassaemia between the two groups: 14/27 of the patients with thalassaemia intermedia also had deletion forms of alpha thalassaemia, while only 4/30 of the patients with thalassaemia major were similarly affected. Thus in Cypriot patients who are homozygous for beta thalassaemia the co-inheritance of alpha thalassaemia is an important factor in determining the clinical course.
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24
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Abstract
A programme for the prevention of beta-homozygous thalassaemia has been operating in Cyprus from 1973. From 1976 there has been an increasing gap between the number of homozygotes born and the number expected, calculated as 1 in 135 of the total births. In 1978 23 homozygotes are known to have been born compared with 71 expected, and in 1979, 18 compared with 77 expected. All cases may not have yet to come to notice. the programme consists of public education, population screening, genetic counseling, and antenatal diagnosis.
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25
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Sophocleous T, Higgs DR, Aldridge B, Trent RJ, Pressley L, Clegg JB, Weatherall DJ. The molecular basis for the haemoglobin Bart's hydrops fetalis syndrome in Cyprus. Br J Haematol 1981; 47:153-6. [PMID: 6159913 DOI: 10.1111/j.1365-2141.1981.tb02770.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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26
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Matsakis M, Berdoukas VA, Angastiniotis M, Mouzouras M, Ioannou P, Ferrari M, Modell B, Fairweather DV, Ward RH, Loukopoulos D, Sakarellou N. Haematological aspects of antenatal diagnosis for thalassaemia in Britain. Br J Haematol 1980; 46:185-97. [PMID: 7426453 DOI: 10.1111/j.1365-2141.1980.tb05957.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The results are described of 200 antenatal diagnostic tests for haemoglobinopathies performed on samples of fetal blood obtained during the second trimester of pregnancy. Haemoglobin A synthesis in the fetus was measured by incorporation of tritiated leucine in vitro and separation of the globin chains on CM23 columns. The range of HbA synthesis detected was 3.5-8.0% in normal fetuses, 2.0-5.0% in fetuses with thalassaemia trait, and less than 1.6% in fetuses with thalassaemia major. There were eight cases in which other haemoglobinopathies were diagnosed. 29% of the pregnancies were terminated because thalassaemia major was diagnosed, and 9.5% of the remaining healthy fetuses were lost for obstetric reasons. Follow up has been possible for 96% of the 124 surviving babies and three misdiagnoses have come to light; one false positive (0.5%) and two false negatives (1%). These figures represent a first effort at antenatal diagnosis for haemoglobinopathies and it is likely that they will improve with the passage of time.
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27
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Smith MB, Cauchi MN. Quantitative studies of Hb Bart's levels and red cell indices in alpha thalassaemia trait in Mediterraneans. Pathology 1979; 11:621-7. [PMID: 530752 DOI: 10.3109/00313027909059042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Haemoglobin Bart's was detected and quantitated in 42 babies during a survey of cord blood from neonates of Mediterranean origin. The distribution of Hb Bart's levels for the group appeared to be bi-modal, with modes at 2.0% and 5.5%. Haematological data obtained from 21 babies during the first week of life showed a highly significant reduction in average MCV (86.3 +/- 7.7 fl) and MCH (27.8 +/- 6.0 pg) in comparison with a control group of babies. However, there was no significant correlation between these parameters and Hb Bart's levels. Haematological data were available on 57 parents of the Hb Bart's babies and HbH preparations were positive in 28 cases (49%). Examination of red cell indices showed a highly significant reduction in the average MCV and MCH of parents with positive HbH preparations, and a diagnosis of alpha-thalassaemia (based on the presence of HbH inclusion bodies and reductions in MCV and/or MCH) was made in at least one parent in the majority of couples with both partners tested, suggesting that alpha-thalassaemia trait in people of Mediterranean origin is generally associated with detectable haematological changes.
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28
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Bartsocas CS, Karayanni C, Tsipouras P, Baibas E, Bouloukos A, Papadatos C. Genetic structure of the Greek gypsies. Clin Genet 1979; 15:5-10. [PMID: 103665 DOI: 10.1111/j.1399-0004.1979.tb02022.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Data are presented on several polymorphic genetic markers in 200 Greek gypsies. Polymorphic loci studied were: the ABO, MN, Rhesus, Kell and Duffy blood groups, hemoglobin, and ceruloplasmin. A survey for congenital malformations and hereditary diseases was also carried out on this group. The ABO, Rhesus, MN and Duffy system frequencies varied significantly from the figures obtained for the Greek population. However, there is a characteristic similarity between various gypsy groups studied in other nations and the distribution of polymorphic traits in the Punjab region of India. Cystic fibrosis, renal tubular acidosis, 21-hydroxylase deficiency, Hoty-Oram syndrome and homozygous beta-thalassemia were diagnosed within the gypsy group studied.
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29
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Loukopoulos D, Loutradi A, Fessas P. A unique thalassaemic syndrome: homozygous alpha-thalassaemia + homozygous beta-thalassaemia. Br J Haematol 1978; 39:377-89. [PMID: 698115 DOI: 10.1111/j.1365-2141.1978.tb01109.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The disturbed balance of globin chain synthesis is a major factor in the pathophysiology of the thalassaemic disorders; this concept is strongly supported by the study of a patient displaying an extreme but symmetrical deficit of both major types of chains alpha and beta. The patient had a mild clinical picture but presented a striking hypochromia (MCH 10 pg) with compensatory erythrocytosis (RBC 10(12)/l.). Study of the propositus and his family by haematological, biochemical and biosynthetic techniques indicates that the patient carries two alpha- and two beta-thalassaemia genes resulting in balanced globin chain synthesis; in addition, several members of the family carry two or three abnormal genes. During observation a change in the haematological pattern occurred with a shift towards more intensive beta-chain and away from gamma-chaim synthesis; this appeared with be associated with improvement of his anaemia through more effective erythropoiesis.
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31
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Abstract
Structural analysis documented the presence of haemoglobin LeporeWashington (=LeporeBoston) in a Greek Cypriot family and provided further evidence that, of the various types of Lepore mutants, only one is common in the Mediterranean area. Two individuals in this family were heterozygous for both Hb Lepore and beta thalassaemia, but they exhibited striking differences in the clinical severity and course of the disease. The data illustrate that additional environmental or genetic factors play roles in determining or modifying the pathophysiological consequences of highly specific molecular defects and, thus, their ultimate clinical phenotypes.
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