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Copyright of Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study aimed to examine the overall and coronary mortality in the 2014 Turkish Adult Risk Factor Study survey, and the distribution of cumulative mortality and incident coronary heart disease (CHD) across 7 geographic regions., Methods: Information on mode of death was appropriately obtained. Information collected from survivors was based on history, examination of the cardiovascular system and the Minnesota coding of electrocardiograms. Cox regression analyses were performed., Results: Of the 1.323 participants to be surveyed, 87 were lost to follow-up, 753 examined, and 35 ascertained as deceased. In 448 subjects, verbal information alone was obtained regarding health status. Nineteen deaths were of coronary and cerebrovascular origin. Cumulative 24-year assessment of the entire cohort in the age bracket 45-74 years disclosed high coronary mortality, at 7.3 per 1000 person-years in men and 3.8 in women, and recorded a limited decline of 18% since the year 2000. Age-adjusted Cox regression analysis, comprising 614 deaths and 482 incident CHD over a follow-up of 9.6 years, revealed higher mortality rates in the Mediterranean region and in men in the Black Sea and Marmara regions. The age-adjusted CHD incidence was significantly higher in males of the Mediterranean and females of the Southeast regions. An estimated 400-420.000 incident CHD cases develop currently each year in Turkey., Conclusion: The generally high age-adjusted overall mortality in Turkey displays significant differences across geographic regions. Age-adjusted CHD incidence is not regressing sufficiently, and is especially high among men of the Mediterranean and women of the Southeast regions.

Objectives: To analyze (1) the sex-specific and age-bracket defined all-cause and coronary mortality in the 23-years' follow-up of the Turkish Adult Risk Factor Study, and (2) to determine the nation-wide prevalence of Type-2 diabetes and its recent trend., Study Design: Information on the mode of death was obtained from first-degree relatives and/or health personnel of local heath office. Information collected in survivors was based on history, physical examination of the cardiovascular system and Minnesota coding of resting electrocardiograms. Diabetes was defined by criteria of the American Diabetes Association without the use of glycated hemoglobin., Results: Of the 1370 participants to be surveyed, 768 were examined, in 452 subjects information was gathered, and 29 men, 18 women were ascertained to have died. Cumulative assessment of the entire cohort in the age bracket 45-74 years disclosed coronary mortality to be 7.5/1000 person-years in men and 3.74 in women, persisting to be high among the European countries. The recent decline observed in overall mortality seemed to halt as well. Of greatest concern was the finding in the past 12 years that the rate of rise in the age-controlled prevalence of Type-2 diabetes was as high as 5% annually., Conclusion: Overall and coronary mortality in Turkish adults continue to be high, while an elicited annual increase of 5% in the age-controlled prevalence of diabetes is virtually alarming and requires new public health policies.

Fungal keratitis, an eye infection with poor prognosis, is difficult to treat and can lead to loss of vision. Among filamentous fungi Scedosporium spp. rarely lead to fungal keratitis. Here we present a case of keratitis caused by Scedosporium apiospermum. A 61-year-old female patient was admitted to our hospital with the complaints of right eye pain and decreased vision after a foreign body trauma to the right eye. The patient was diagnosed as keratitis by biomicroscopic examination. Conjunctival swabs collected from both eyes were inoculated onto sheep blood agar, chocolate agar, eosin methylene blue agar and Sabouraud dextrose agar. Corneal scrapings from the right eye were inoculated onto the same solid media by "C-streak" method, and in brain-heart-infusion broth by immersion. While gram-stained smears of conjunctival swabs showed no significant finding, smears of corneal scrapings revealed abundant neutrophils and profuse septate hyphae. Fungal keratitis was diagnosed and topical enhanced amphotericin B (0.5 mg/ml) therapy was initiated with netilmicin sulfate and oxytetracycline HCl plus polymyxin B sulfate. At the 10th day of therapy a mold growth was detected in corneal scraping cultures and was identified microscopically as S.apiospermum. Based on the relevant literature, therapy was changed to enhanced topical voriconazole (2 mg/ml) applied hourly, plus systemic voriconazole administration. At the third day of treatment, reduction of epithelial defect and decline in the focus of keratitis were observed. In the following days, however, a progression occurred in the focus of keratitis and 5% natamycin ophthalmic suspension was added to the therapy. Since the patient did not respond to any of the medical treatments, therapeutic penetrating keratoplasty was planned; yet, the patient refused the operation and was discharged with her own request. As far as the local literature was concerned, this is the first report of keratitis caused by S.apiospermum in Turkey. Though a very rare causative agent of keratitis, S.apiospermum is generally resistant to antifungal therapy and often require surgical treatment. Especially in patients with predisposing factors, this organism should be kept in mind as a potential causative agent and relevant microbiological examinations should be performed.

Objectives: We aimed to analyze 1) overall and coronary mortality findings in the Turkish Adult Risk Factor (TARF) study survey 2012 and 2) the temporal trends in prevalence of metabolic syndrome (MetS) and its distribution across seven geographic regions., Study Design: Information on the mode of death was obtained from first-degree relatives and/or health personnel of a local health office. Information collected in survivors was based on history, physical examination of the cardiovascular system and Minnesota coding of resting electrocardiograms., Results: Of 1527 participants to be surveyed, 796 were examined; information was obtained on the health status in 502 subjects, and death was ascertained in 56 participants. Thirty deaths were attributed to coronary and cerebrovascular disease. Cumulative 22-year evaluation of participants in the age bracket 45-74 years revealed coronary mortality to be high, with 7.6 per 1000 person-years in men and 3.8 in women. Data used from 1754 identical subjects (median age 46 years initially), and examined in two periods 12 years apart, indicated an increase in the prevalence of MetS by 1.3% per aging of 1 year. Analysis across geographic regions showed a rise in the prevalence in the Mediterranean region, already having highest prevalence along with Southeast Anatolia, while the prevalence declined in the Marmara region and persisted to be lowest in the Aegean region., Conclusion: The prevalence of MetS in Turkish adults aged 40 years or over, currently standing at 53%, shows significant differences across geographic regions, being highest in the two southern regions and lowest in the Aegean region.

Objectives: We analyzed the distribution of cumulative all-cause and cardiovascular mortality and incident coronary heart disease (CHD) across the seven geographic regions of Turkey and presented overall and coronary mortality findings of the 2010 survey of the Turkish Adult Risk Factor Study., Study Design: A total of 1406 participants were surveyed. Information on the mode of death was obtained from first-degree relatives and/or health personnel of local heath offices. Information on survivors was obtained from history, physical examination, and 12-lead electrocardiography., Results: Of the surveyed participants, 686 were examined; information on health status was obtained in 577 subjects, and 32 participants (14 women, 18 men; mean age 72.3±15.6 years) were ascertained to have died. The total duration of follow-up was 2,520 person-years. Nineteen deaths were of coronary (n=16) or cerebrovascular (n=3) origin. Cumulative 20-year assessment of the entire cohort for the age bracket of 45-74 years disclosed a high coronary mortality rate, being 7.4 and 4.1 per 1000 person-years in men and women, respectively, and representing a limited decline after year 2000. Age-adjusted Cox regression analysis comprising 433 deaths and 506 incident CHD cases over a 7.3-year follow-up showed similar mortality rates across the regions, and a significantly high CHD incidence in males of the Black Sea and Marmara regions and in females of the Southeast Anatolia. Currently, 480,000 incident CHD cases are estimated yearly in Turkey., Conclusion: The high age-adjusted overall mortality in Turkey shows nonsignificant differences across geographic regions, whereas the age-adjusted CHD incidence is high in the Black Sea and Marmara regions.

Objectives: We analyzed 2009 survey of the Turkish Adult Risk Factor (TARF) Study to assess the distribution of all-cause and cardiovascular mortality in urban and rural areas and sex-specific coronary mortality in the age-bracket of 45 to 74 years., Study Design: The Marmara and Middle East regions have been surveyed every odd year in the TARF Study. In 2009, 1,655 participants were surveyed. Information on the mode of death was obtained from first-degree relatives and/or health personnel of local heath office; 960 participants underwent physical examination and ECG recording, and 572 subjects were evaluated on the basis of information obtained regarding health status., Results: In the survey, 23 men and 20 women were ascertained to have died. Twenty-one deaths were attributed to coronary disease and four deaths to cerebrovascular events. Assessment of the entire cohort in the age bracket of 45-74 years after a 19-year follow-up disclosed a high coronary mortality with 7.5 per 1000 person-years in men and 3.9 in women. In a Cox regression analysis comprising 405 deaths (235 cardiovascular) and over 24,000 person-year follow-up, age-adjusted cardiovascular mortality was similar in rural and urban participants. All-cause mortality was higher in females living in urban areas than those living in rural areas (HR 1.41; 95% CI 1.02-1.96)., Conclusion: Cardiovascular mortality both in absolute terms and as a share of overall mortality persists to be high among Turkish adults, with similar rates in urban and rural areas. Age-adjusted all-cause mortality rate is higher among urban versus rural women.

Knowledge obtained from the Turkish Adult Risk Factor (TARF) study on higher morbidity and mortality rates compared to other populations from coronary heart disease (CHD) among Turkish adults has been confirmed recently with greater power. This review provides insight that the dysfunctions of the protective serum proteins, attaining pro-inflammatory and atherogenic features, may be attributed to atherogenic dyslipidemia, oxidative stress, and systemic inflammation associated with the high prevalence of metabolic syndrome (MetS) among Turks. The mentioned protective protein dysfunctions, firstly described in a general population to date, are high-density lipoprotein (HDL), apolipoprotein (apo) A-I, A-II, and apoC-III, apart from adiponectin. Based on published findings of the TARF study, this review discusses the role of inflammatory mediators such as elevated C-reactive protein (CRP), apoB, apoC-III, fibrinogen, and low adiponectin serum levels in cardiometabolic risk comprising MetS, type 2 diabetes, and CHD, the degree of independence of these mediators from the ATP-III-defined MetS, and the influence of sex. Moreover, it is emphasized that dysfunctions of adiponectin and protective proteins related to HDL particles increase not only cardiometabolic risk significantly but also CHD risk among half of Turkish adults in a magnitude similar to or greater than that associated with traditional risk factors. Also underlined is the observation that cigarette smoking reduces the risk in Turkish women for the development of hypertension, MetS, and diabetes by mediation of positive effects on dysfunctional apoA-I, visceral fat accumulation and, above all, CRP levels. This knowledge is of utmost importance and sheds light to authorities and those concerned on the necessity of urgent and radical modifications regarding strategies in prevention and management of cardiovascular health of middle-aged Turks.

Objectives: We investigated the incidence, prevalence, and mortality of chronic atrial fibrillation (AF) in Turkish adults., Study Design: In a prospective and cross-sectional design, we analyzed 3,450 eligible participants (1707 men, 1743 women; mean age 52+/-13 years) of the Turkish Adult Risk Factor Study, who had been surveyed until 2006/07. Those who were dead and were found to have AF at baseline were excluded in the estimation of AF prevalence and incidence, respectively., Results: Atrial fibrillation was determined in 67 participants. The total follow-up was 34,100 person-years (mean 9.9 years). There were 43 prevalent and 46 incident cases, which corresponded to 1.25% and 1.35 per 1000 person-years, respectively. For age brackets of 32-59, 60-69, and > or =70 years, the prevalence rates were 0.46%, 2.09%, and 2.49%, and the incidence rates were 0.31, 1.98, and 3.50 per 1000 person-years, respectively. Both were higher in women of all age groups, with female-to-male ratios for overall prevalence and incidence being 1.69 and 1.19, respectively. Survival after onset of AF was 5 to 9 years and overall mortality was 6.8 per 100 person-years. Hypertension was the most common cause of AF, followed by advanced age. Contrary to expectations, waist circumference of men with AF was smaller by 1.9 cm than that of women. Serum C-reactive protein levels in men with AF (mean 1.21 mg/l) were significantly lower than women with AF (mean 2.62 mg/l) and than males without AF (mean 1.78 mg/l)., Conclusion: In Turkish adults, the current incidence and prevalence of chronic AF can be extrapolated to be 35,000 per year (22,000 in women) and 310,000 (200,000 in women), respectively. Considering the low incidence in males, it seems that inflammatory processes may play a minor role in the development of AF in Turkish men.

Objectives: To investigate the relative values in the prediction of type 2 diabetes and coronary heart disease (CHD) by the metabolic syndrome (MS) as defined by the ATPIII and by its modification of the Turkish Adult Risk Factor Study (TEKHARF-def) and selection of most appropriate definition., Methods: Prospective evaluation of 1683 men and 1718 women, aged > or =28 years participating in the TEKHARF study surveys 1997/98 and 2002/03 with a mean follow-up of 5.9 years. The modification involved especially abdominal obesity (> or =95 cm in men, > or =91 cm in women)., Results: After exclusion of participants with diabetes at baseline and adjustment for sex and age, both MS definitions predicted the development of diabetes with virtually identical relative risks (RR) (ATPIII 2.85 [95%CI 2.14; 3.80]; TEKHARF 2.84 [95%CI 2.13; 3.81]. After similar exclusion and adjustments, both MS definitions predicted significantly the development of CHD with similar RRs (ATPIII 2.10 [95%CI 1.64; 2.68] in 36% of the cohort; TEKHARF-def 1.90 [95%CI 1.49; 2.43] in 39.6% of the cohort. For both outcomes, the TEKHARF-def provided higher predictive values in men, and (because of the high density lipoprotein (HDL)-cholesterol cutoff) the ATPIII definition in women. Absolute annual CHD risk in individuals with MS exceeded on average 2%, while age > or =50 years constituted the most appropriate indicator of further elevated risk in both genders. Most suitable modifications of the ATPIII definition are proved to be impaired fasting glucose (IFG) > or =100 mg/dl and in men > or =95 cm of waist circumference. Most CHD cases afflicting Turkish adults (namely 61% in men and 69% in women) originated from the latter definition of MS., Conclusions: In predicting diabetes and CHD risk, the TEKHARF-def MS is more valuable in men; the ATPIII definition modified for IFG (> or =100 mg/dl) should be adopted in women. In 2 out of every 3 cases, CHD originates from MS among Turks, and age > or =50 years is a good indicator of higher risk in both genders.

Symptoms of asthma can be intensified and/or mixed with depression since depression can cause asthmatic symptoms like complaints even in normal people. In the present study, depression index and its influencing parameters were examined in asthmatic patients. A questionnaire including sociodemografic features was applied to 120 patients, accepted as asthmatic according to the Thoracic Society Guidelines, who were following up in our asthma and allergy outpatient clinic. There were 98 female and 22 male patients and the mean age was 38.19 +/- 10.99. Physical examination, PEF and spirometric measures were made in all patients. Also daytime and nighttime symptom score, Q score, Beck depression score were applied to patients. Beck Depression Index (BDI) was in range of 0 and 37 and the mean was 11.26 +/- 8.54 (mild). According to the cut-off values, BDI scores were obtained as absent, mild, moderate and severe, 59%, 27%, 9%, 7% respectively. The mean BDI score was higher in female patients (12.32 +/- 8.77) than in male patients (6.55 +/- 5.41) and in married patients (11.91 +/- 8.77) than in unmarried ones (7.56 +/- 6.00). According to the results of FEV(1) values, PEF changes, there were no significant difference obtained between groups (p> 0.05). The mean value of BDI was found to be significantly high in patients with moderate and high daytime and nighttime score and Q score (p< 0.05). In conclusion, we think that, while evaluating the severity of asthma, if the spirometric results are not correlated with the symptoms then psychological conditions of the patients should be taken into consideration.

The number of studies conducted on the subject of cigarette smoking habits in Turkish society in general is limited. This study presents data regarding the prevalence of cigarette smoking in the Eastern Black Sea Region of Turkey. This cross-sectional study was carried out between March 2003 and March 2005 in the provinces of Trabzon, Giresun, Rize, Artvin and Gümüşhane in the Eastern Black Sea Region. The research was conducted in the provincial capitals and districts. According to the 2000 general census, a total of 459.021 people live in these areas, and 6103 individuals were enrolled in the study, selected to be representative of gender, age groups and settlement locations. Data regarding cigarette smoking were obtained using questions employed by the World Health Organization and the British Health Protection Agency. Daily smoking prevalence (at least one cigarette smoked per day) of 18.3% was determined in women and 50.7% in men, while weekly smoking prevalence (less than one cigarette a day but at least one a week) was determined as 1.3% in men and women. It was also determined that 8.4% of women and 18% of men had quit smoking; 69.7% of women and 27.9% of men stated that they had never smoked in their lives. The difference between men and women in terms of smoking prevalence was statistically significant (p< 0.0005). The highest prevalence was in the 20-29 age group in women (23.3%) and in the 30-39 age-group in men (59.9%). In addition, significantly high levels were determined in high school graduates (46.3%, p< 0.0005), unmarried subjects (41%, p< 0.0005) and in the retired (53.7%, p< 0.0005). Cigarette smoking levels continue to represent a major public health problem in the Eastern Black Sea Region.

Objective: Serum lipoprotein(a) [Lp(a)] concentrations, determined in 665 persons in the 2003/04 survey of the Turkish Adult Risk Factor Study, were investigated in regard to distribution, determinants and relationship to cardiovascular risk factors, metabolic syndrome (MS) and coronary heart disease (CHD)., Methods: Diagnosis of MS was based on Adult Treatment Panel III criteria, that of CHD on the presence of clinical findings and Minnesota coding of resting electrocardiograms. Metabolic syndrome was observed in 44%, CHD in 14% of the study sample. Behring nephelometry was used for Lp(a) values measurements which were log-transformed for analyses because of skewing., Results: Geometric mean values of Lp(a) in 286 men and 379 women, aged 55.5 +/-12.0 years, were 9.46+/-2.90 mg/dL and 10.46+/-3.00 mg/dL (p>0.2), respectively. Apart from a slight correlation with age, Lp(a) exhibited significant positive correlations with apolipoproteins A-I and B, low density lipoprotein-cholesterol (LDL-C) (r =0.15), total cholesterol, high density lipoprotein-cholesterol (HDL-C), systolic blood pressure and log C-reactive protein, and inverse ones with thyroid stimulating hormone (r =-0.25) in men, and log gamma glutamyltransferase in women. Further 10 variables were not significantly correlated in either gender. In linear regression analyses for independent covariates of Lp(a), positive associations were noted with serum total cholesterol and systolic blood pressure, and inverse ones with waist circumference, triglycerides and (only in women) with gamma glutamyltransferase. Logistic regression analyses revealed in men no association with either MS or CHD likelihood. Among women, age-adjusted Lp(a) was associated inversely at a borderline significance with MS, as did levels of Lp(a) >30 mg/dl vs. the remaining sample, controlled for age and MS, display an odds ratio (OR) of 1.62 for prevalent CHD (p=0.20). An OR of 1.92 (p<0.19) was noted in all adults for the coexistence of Lp(a) >30 mg/dl and LDL-C >150 mg/dl, after controlling for age, MS, smoking status and LDL-C categories., Conclusion: Lipoprotein(a), the variance of which is known to be overwhelmingly due to the apo(a) isoforms, proved to have a significant inverse independent association with a measure of abdominal obesity. Lipoprotein(a) levels appeared not to be associated with risk for MS or CHD among men. In women, however, high Lp(a) levels were accompanied with an environment less prone to MS, and - without attaining significance -- tended to be associated with CHD likelihood, independent of age and MS. Further studies are warranted in this area.

Cigarette smoking is an intractable public health problem and health care providers play a important role in the effort to reduce the prevalence of smoking. Our outpatient smoking cessation clinic started working in April 2000. Since then it has been servicing once a week by appointment. After smoking habits and sociodemographic features of the people were asked all individuals attended a suitable smoking cessation program. The results were analyzed with Chi-square test and Kaplan Meier survival analysis. It was observed that 226 people, 97 (42.9%) women and 129 (57.1%) men, visited the polyclinic during this period. The average age was 37.8 +/- 11.8 years. The rate of the smoking cessation was 43.4% at the end of the year. There were no relations between smoking cessation and initial age (p= 0.677), duration of smoking (p= 0.367), number of daily cigarette (p= 0.712), and nicotine addiction level (p= 0.673) and education level (p= 0.131). We think that our results are important to show the importance of professional support in stopping smoking.

Plastic teeth are preferred as functional portions with acrylic denture base material. The resin teeth have become the integral part of the denture by their chemical bonding with the base. But several factors effect the bonding: faulty boil-out procedures, residual wax on ridge-laps of the teeth, careless application of tin-foil substitutes to the teeth. On the other hand, grinding the glossy ridge-lap surface, painting the teeth with monomer or a solvent, preparing retention grooves on the ridge-lap portion of the teeth effectively lock the teeth to the denture base. The purpose of this research was to evaluate the bond strengths of the acrylic resin teeth and denture base material with retention grooves on the ridge-lap portion of the teeth. As a result of this study, bond strength between resin teeth and the denture base material is increased by the mechanical retention applied on the ridge-lap portion of the teeth.

The dentist himself is responsible for the design of the removable partial denture, because he must know and apply the biomechanical principles also. Two mandibular removable partial dentures, one with a lingual bar and the other with a lingual plate as the major connector were constructed for 7 men and 9 women patients who had mandibular Kennedy class I edentulous area. Patients used each type of prothesis for one month. At the end of this period, speeching, chewing and comford of partial dentures were evaluated according to the patients subjective impression. In general, patients adapted best to major connectors that covered soft tissues least was better. As a result, generally patients preferred lingual bar type denture.

Given the potential for transfer of pathogenic microorganisms from dental impressions, a method for surface disinfection of impressions is needed to prevent spread of infection by way of impressions and casts made from them. The effects of disinfectant solutions on the impression materials linear and dimensional stability to prevent viral infections are investigated in this article. For this purpose, irreversible hydrokolloid and silicon rubber base impression materials and five disinfectant solutions were used. No apparent linear and dimensional change could be detected after 30 minute immersion in any of the disinfectants tested.

The occlusal plane is an important factor in stability and esthetic of dentures. The location of the occlusal plane in complete dentures is a controversial subject. The occlusal plane in complete denture has often been oriented anteriorly to fulfill esthetic and posteriorly to Camper's line. However, recently the methods used for locating the occlusal plane appear to be less limiting. The purpose of this investigation was to compare the different concepts of occlusal plane. A roentgenographic cephalometric investigation was conducted to compare the position of the occlusal plane of the artifical teeth with that of the natural teeth which existed before the remaining teeth were extracted.

In our study, cases where teeth with excessive crown loss served as abutments, where examined in Kennedy Class II modification 1, that have tooth and tissue support on removable partial dentures which were constructed with the same design. Our study aims to examine, how vertically directed forces are transmitted to the supporting tissues by using photoelastic method. Teeth with case post and core appliances were used as abutments for removable partial dentures. Vertical loading procedure following the construction of removable partial dentures with the same design, revealed distribution of force over dentulous and edentulous ridge areas. When a comparison between endodontically treated and sound abutment teeth, was made, we had the conclusion that teeth with excessive crown loss can successfully serve as abutments for partial dentures, because the results of our finding exhibited no significant difference.