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In this study, it was aimed to prospectively evaluate the efficacy, side effects and seroconversion data of inactive severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), CoronaVac® (Sinovac, China) vaccine in healthcare workers. A total of 1053 healthcare workers who were initially seronegative (COV2T® SARS-CoV-2 Total Siemens, USA) and vaccinated with inactivated SARS-CoV-2 were included in the study. Quantitative IgG antibodies (ADVIA Centaur® SARS-CoV-2 IgG, Siemens, USA) were investigated 28 days after the first vaccine (n= 939) and the second vaccine (n= 771). In addition, neutralizing antibodies were evaluated via "enzyme linked immunosorbent assay (ELISA)" test (ACE2-RBD Neutralization Assay, Dia-Pro, Italy) 28 days after the first vaccine. Antibody response of the vaccine was evaluated statistically by univariate (Chi-square, Fisher's exact test, Student's t test, Mann-Whitney U, one-way ANOVA and Kruskall Wallis ANOVA tests) analysis and linear regression models. The consistency between quantitative IgG test and neutralizing antibody test was also evaluated in blood samples taken 28 days after second vaccination. Statistical analysis was determined in logarithmically transformed data with statistical analysis with SPSS 23.0 and Stata, and type 1 error level was accepted as 0.05. At least one side effect was reported by 31.3% and 26.8% of the participants after the first and second vaccine, respectively. The most frequent side effect was pain at the injection site with a frequency of 20.4% vs 21.7%. The frequency of applying to a health center due to side effects was 1.0% after the first vaccine and 0.8% after the second vaccine. The percentage of those who produced sufficient quantitative IgG was found as 25.3% (95% CI= 22.5-28.1) 28 days after the first vaccine and 97.9% (95% CI= 96.91- 98.93) after the second vaccine. Neutralizing test antibody positivity was found as 97.7% 28 days after the second vaccine. In univariate analysis, the characteristics that significantly increased the quantitative IgG response against inactivated SARS-CoV-2 vaccine were young age (p

This study was conducted to determine the attitudes of men regarding violence against women. This was a cross-sectional descriptive study. Research data were collected using a Men’s Information Form and a Scale of Attitude towards Violence against Women. The mean age of the participating men was 39.54 ± 13.55 years. The men’s general mean score for attitude regarding violence was 52.02 ± 10.81, which showed that such attitudes had a patriarchal tendency. In the univariate analyses, there was a significant difference between age group, education status, place of residence, situations of domestic violence and violent behaviour against mothers or wives, years of marriage and wife’s education status and the scores of the Scale of Attitudes towards Violence against Women (p < 0.05). Based on our findings, it is suggested that socioeconomic factors such as witnessing and experiencing violence in childhood, female unemployment, low education level, unemployment and poverty, and place of residence affect and increase violence against women.

Amaç: Hasta güvenliği kültürü, hata bildirimlerinde şeffaflık ve tıbbi hataların önlenmesine sistemli yaklaşımdan sağlık çalışanlarının bu kültür içinde nasıl davranacağına, değer yargılarının nasıl olması gerektiğine, inançlarının ve kurallarının düzenlenmesine kadar geniş bir perspektifte değerlendirilmektedir. Bu çalışma, aile hekimliği birimindeki sağlık çalışanlarının hasta güvenliği kültürü ile ilgili algılarını ölçmeyi amaçlamıştır. Yöntem: Tanımlayıcı nitelikte olan bu araştırma Manisa iline bağlı iki ilçe merkezinde bulunan aile sağlığı merkezlerindeki aile hekimliği birimlerinde görev yapan 108 sağlık çalışanı ile yürütülmüştür. Araştırma verileri hasta güvenliği ile ilgili literatür eşliğinde hazırlanmış soru formu ile elde edildi ve SPSS 15 paket programı kullanılarak istatistiksel olarak değerlendirildi. Bulgular: Katılımcıların genel yaş ortalaması ise 41,19±9,27’dir. Katılımcıların 48’i (%44,4) aile hekimi, 60’ı (%55,6) da aile sağlığı elemanıdır. Katılımcıların hasta güvenliği kültürü ile ilgili sorulara verdiği yanıtlar değerlendirildiğinde olumlu puan ortalaması genel olarak %81,47’dir. Tıbbi ofis işleyişi değerlendirmesinde “Bu ofiste birisi gerçekten meşgul ise, diğerleri ona yardım eder” (%90,7), “Bu ofiste gelişen süreçlere paralel olarak personel eğitim alır” (%89,8) soruları en yüksek iki olumlu yüzdeyi, “Bu ofiste iş akışı ile ilgili sorunlar var” (%62,9) sorusu ise en düşük olumlu yüzdeyi alan seçeneklerdir. Ofis içi iletişim ve hasta takibi ile ilgili başlıkta “Bu ofis hastalara koruyucu ya da rutin bakım için randevuları hatırlatıyor.” %94,3 ile en yüksek olumlu yanıta sahip iken, “Bu ofiste anlaşmazlıkları dile getirmek zordur.” %69,9 ile en düşük olumlu yanıt verilen seçenek olmuştur. Sonuç: Bu çalışmada hasta güvenliği kültürü ile ilgili olumlu yanıt oranları önceki çalışmalara göre görece daha yüksek olarak bulunmuştur. Ancak ofis içi iş akışı ve anlaşmazlıkların dile getirilmesi ile ilgili sorulara verilen yanıtlar en düşük olumlu yüzdelere sahiptir. Aile hekimliği sisteminde hasta güvenliği kültürünü değerlendirecek çalışmaların bu sonuçlar ışığında planlama yapması önerilebilir.

Purpose To determine the variation in Anti-Mullerian Hormone (AMH) and Androstenedione (A4) concentrations in adolescent girls, with or without menstrual cycle disorder in relation to phenotypic features of PCOS. Methods Adolescent girls (n=129), age range 14-19 years, were recruited in the cohort study. All participants were in the 4th or 5th year after menarche. Sixty-eight had menstrual irregularities, usually oligomenorrhea (OM), and 61 had regular menstruation (RM). AMH and A4 concentrations were measured. Hirsutism was recorded. Polycystic ovarian morphology (PCOM) was evaluated by transabdominal pelvic ultrasonography. Polycystic ovary syndrome (PCOS) features were defined according to Rotterdam consensus criteria. Results AMH and A4 were significantly higher in adolescent girls with OM than in girls with RM (p

AimsA decrease in health-related quality of life (HRQOL) measures among obese (OB) and overweight (OW) children has been shown in several studies, but knowledge about the variables affecting HRQOL impairments is missing. The aim of this study was to evaluate the relationship between HRQOL and sociodemographic characteristics, anthropometric measurements, metabolic parameters, mental symptoms and parental attitudes in a sample of OB/OW children.MethodsEighty-six OB/OW children, aged between 9 and 17 years, participated in the study. We performed sociodemographic questioning, anthropometric examinations and laboratory evaluations of the participants. HRQOL was assessed using the Pediatric Quality-of-Life Inventory (PedsQL), and levels of anxiety and depressive symptoms were measured using the Screen for Child Anxiety-Related Disorders (SCARED) questionnaire and the Children’s Depression Inventory (CDI), respectively. Parental attitudes were assessed with the Parental Attitude Research Instrument (PARI) questionnaire.ResultsA statistically significant relationship was found between total scores of CDI and SCARED answered by children and the total and subscale scores of PedsQL. Scores of total quality of life subscale, physical functionality and emotional functionality subscales were significantly lower in children with a family history of mental illness. No relationship was found between PedsQL subscales, anthropometric and metabolic parameters.ConclusionsEmotional problems and parental psychological distress are important factors in models of HRQOL in the OB/OW pediatric population.

Purpose:In this article, we evaluate subfoveal choroidal thickness in celiac patients with respect to adherence to the gluten-free diet and nonadherence to the gluten-free diet, comparing with age and sex matched healthy controls using spectral-domain optical coherence tomography.Materials and Methods:A case-control study among 42 celiac patients and 42 healthy participants was conducted in the Department of Pediatric Gastroenterology. Celiac patients of our policlinics compliant with spectral-domain optical coherence tomography examination enrolled in the study. Celiac patients had been asked verbally about their adherence to gluten-free diet, were evaluated according to negative or positive EmA and anti-TG2 for defining adherence, and were divided into two groups (adherence to gluten-free diet and nonadherence to gluten-free diet).Results:Subfoveal choroidal thickness was thinner in EmA (+) or anti-TG2 (+) eyes than EmA(−) or anti-TG2 (−) eyes in celiac patients, but it was not statistically significant. The mean subfoveal choroidal thickness values in eyes with celiac disease, whose diagnosis time was longer than 60 months, were thinner than shorter group. Longer duration of gluten-free diet was associated with adherence difficulty and thinner choroidal thickness (r = −0.15, p = 0.34). Adherence to gluten-free diet was 88.2% for children below the age of 60 months and 57.1% for children older than 60 months.Conclusion:In conclusion, in addition to other extraintestinal manifestations of celiac disease, diagnosis time longer than 60 months in pediatric celiac patients, nonadherence to the gluten-free diet, and antibody positivity should be focused on during ophthalmologic examination and choroid measurement.

During the postmenopausal period, visceral fat tissue is responsible not only for increased cardiometabolic risk, but also for endocrine function leading to increased endometrial thickness (ET).

Aims: Peer bullying is a frequent problem among adolescents. The aim of this study is to evaluate the effectiveness of complementary prevention for peer bullying in 11-14-year-old adolescents with family, teacher, student collaboration and to assess the effect of peer bullying on the quality of life. Methods: Seven hundred sixty students registered in school between ages 11-14, and who accepted to participate in the study were included in our investigation. Olweus Bully/Victim Questionnaire and Pediatric Quality of Life Inventory were used as data collection tools in the study. After the pre-test, school teachers and two selected students from each class; a total of 48 students were trained in peer bullying in small group. Interactive awareness activities were organized for the students at the school with all trained students and teachers to raise awareness of peer bullying. Afterwards, information brochures were distributed to the children and parents. 3 weeks after the training post-test was applied. The statistical evaluation of the study was carried out by using Chi-square and Student’s t-tests. Results: The questions about bullying and victimization were analyzed. In the study, the rate of victim students reduced from 43.2% to 30.4%; the rate of bully students reduced from 23.4% to 21.7%. There was a significant reduction in the rate of people involved in peer bullying. Nevertheless, Pediatric Quality of Life Inventory assessment of health-related quality of life in our group showed that the quality of life of students who were not involved in peer bullying was significantly higher. After our training, quality of life significantly increased in students who were not involved in bullying, compared to the ones who are involved in bullying. Conclusion: In our study group, it was observed that the quality of life of students who were not involved in peer bullying was significantly higher. The number of people involved in peer bullying decreased significantly. The low number of invalid surveys revealed that our research was successful in attracting the attention of the target group.

HS is a chronic, recurrent, and debilitating skin disease. Recent studies showed that inflammatory biomarkers, such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and Lymphocyte/HDL ratio (LHR), Neutrophil/HDL ratio (NHR), Monocyte/HDL ratio (MHR) are an indicator of inflammatory diseases and may be associated with disease severity and disease activity. To investigate NLR, PLR, LHR, NHR and MHR in HS patients. In addition, to compare erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), complete blood count, leukocyte profile and biochemical parameters between the control and the patient group. Clinical and biochemical data of patients and healthy subjects were collected from medical records, retrospectively. In total, 166 patients with HS and 124 control subjects were included. We found no significant difference in NLR (P = 0.207) and PLR (P = 0.257). LHR (P < 0.001), NHR (P < 0.001) and, MHR (P < 0.001) were significantly higher in the patient group. No positive correlation was found between any of these markers and disease severity according to Hurley staging system. However, MCV (Mean corpuscular volume), RDW (Red cell distribution width) and CRP showed a significant positive correlation with disease severity. Among these markers, only MHR was positively correlated with disease duration. Our study shows that CRP still maintains its value for HS patients compared to new inflammation markers. Unlike the studies in other inflammatory diseases, no significant relationship was found with most of these inflammatory parameters. MHR may be more useful in patients with HS as an indicator of inflammation compared to other parameters. This article is protected by copyright. All rights reserved.

Skin cancers are the most common type of cancer. Nonmelanoma skin cancers (NMSCs) are more common than melanoma. Although the mortality rate is low, cancer word can be frightening for patients. Surgery is the main treatment. As skin cancers are most commonly located on the face, undesirable cosmetic results can occur as a result of treatments or due to primary disease. Therefore, the quality of life of patients could be affected. To determine the effect of surgical treatment on quality of life of the patients with facial NMSC using the Dermatology Life Quality Index (DLQI) at baseline and 3 months after surgery. We aimed to see if there was any improvement in quality of life scores after surgery, and to identify factors affecting quality of life. A total of 255 patients; 174 basal cell carcinoma (BCC) (68.2%) and 81 squamous cell carcinoma (SCC) (31.8%) were included in our study. All participants completed DLQI at baseline and 3 months after surgery. The mean total DLQI scores were 6.37 ± 6.28 in patients with BCC, and 6.35 ± 6.16 in patients with SCC. The mean total DLQI scores were 3.96 ± 5.14 in patients with BCC (P < .001), and 4.49 ± 5.24 in patients with SCC (P < .001) 3 months after surgery. In patients with primary skin cancer, all subscale scores and total DLQI scores were worse than the recurrent skin cancer group in both BCC and SCC at baseline. According to the treatment modalities, total DLQI scores and all subscales were worse in the graft group in BCC and SCC patients at baseline. Interestingly, the sex and the type of skin cancer did not affect quality of life, but tumor localization ([auricula OR: 6.45 [95% CI: 1.28-37.47] and eyelid OR:0.20 [95% CI: 0.04-0.96]) treatment procedure ([flap procedure OR: 7.90 [95% CI: 2.64-23.62] and graft procedure OR: 5.47 [95% CI: 1.60-18.71]) and, primary tumor OR:3.86 (95% CI: 1.01-14.78) were significant. The quality of life of skin cancer patients was affected by tumor localization, treatment procedure, primary, or recurrent tumor. The quality of life showed a significant improvement in patients with facial NMSC after surgical treatment. However, the type of NMSC seems to have no effect on the quality of life.

Amaç: Çalışmada, Sağlık Personelinin Bağımlı Bireylere Yönelik Bilgi ve Farkındalık Durumlarının incelenmesi amaçlanmıştır. Gereç ve Yöntem: Bu araştırma nicel bir çalışma olup, basit rastlantısal örnekleme yöntemiyle gerçekleştirilmiştir. Örneklemi, Aralık 2019- Şubat 2020 tarihleri arasında bir üniversite hastanesinde çalışan 217 profesyonel sağlık çalışanı oluşturmuştur. Veri toplama aracı olarak, literatür doğrultusunda hazırlanan soru formu, Web-tabanlı uygulamada google forms üzerinden tasarlanan forma kodlanmıştır ve online ortamda katılımcılara uygulanmıştır. Bulgular: Çalışmaya katılan 217 sağlık profesyonelinin %27,2’si erkek ve %72,8’i kadındır. Katılımcıların yaş ortalaması 36.78±10,2’dir. Eğitim durumları %47,0’sinin Üniversite mezunu olduğu, %88’inin her hangi bir bağımlılık merkezinde çalışmamış, olduğu %58,1’inin madde bağımlılığı ile ilgili herhangi bir eğitim programına (etkinlik, seminer vb. ) katılmadığı ve ortalama meslekte çalışma sürelerinin 14.11±10.50’yıl olduğu saptanmıştır. Sonuç: Sağlık profesyonellerinin büyük bir çoğunluğu, madde bağımlığını bir beyin hastalığı olarak kabul ederken, bu yöndeki hastalarla sosyal ortamı paylaşmaya dönük tutumlarının düşük olduğu saptanmıştır. Bu durum bağımlılıkla ilgili eğitim alan sağlık profesyonellerinde farklılaşmaktadır. Eğitim önemli bir değişken olarak tutumu belirlemektedir. Bu nedenle konuya dair eğitim programlarının düzenli bir şekilde yapılmasının sağlık hizmetinin sunum kalitesini etkileyeceği düşünülmektedir. Anahtar Kelimeler: Sağlık çalışanları, madde bağlılığı, bilgi, farkındalık

BACKGROUND: Repeated cigarette use in individuals generally occurs due to the craving for smoking. Orexin-leptin hormones and temperament character traits are thought to be important factors affecting nicotine craving. OBJECTIVE: The aims of this study were to determine orexin-leptin blood levels, which appear in nicotine deprivation, in health professionals who were diagnosed as having tobacco use disorder in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) and to assess the temperament-character traits of the same group and to provide biologic and psychotherapeutic data for the treatment of tobacco abuse. METHODS: The study sample consisted of faculty of medicine students and resident physicians who were smokers (n = 40). The control group comprised medical students and resident physicians who were non-smokers (n = 40). The Sociodemographic and Clinical Information Form, DSM-IV SCID-I Clinical Version, and Temperament and Character Inventory (TCI) were applied to both groups. Substance Craving Scale (SCS) and Fagerstrom Test for Nicotine Dependence were applied only smoking group. Blood samples were taken for plasma orexin and serum leptin levels for both groups. RESULTS: The plasma orexin levels were lower in the smokers group (p

Introduction In this study it is aimed to evaluate the prevalence of smoking, factors affecting smoking status, and the attitudes of the elementary school students towards the smoking prohibition law which was approved in July 2009, in city. Materials and Methods The universe of this descriptive study was 6th-7th-8th class, 8236 urban and 4937 semi-urban, total 13.173 elementary schools students in city center. Study population was determined on the basis of a previous study in which the smoking trial prevalence was found 17.5%, 831 students in 6 urban 3 semi-urban, total 9 schools were chosen randomly. A questionnaire was prepared investigating smoking status, the effects of smoking and family history. Among the 9 chosen schools, the questionnaire was applied to 615 students. SPSS 14.0 statistical package was used. Result Forty-seven percentages of the students were female. Prevalence of smoking trial was found 23.5% (16% in urban, 35% in semi-urban schools) while the prevalence of smoking was 7.1% (1.7% in urban, 15.7% in semi-urban schools). Mean age of first smoking trial was 10.04 ± 2.3. The smoking prohibition law was supported by 86.6% of the students, the warnings on the cigarette package was thought to be effective by 43.3% students and 35.2% of the students were exposed to passive smoke. Male gender, social status, education level of the family, smoker family member or close friends were found to be important risk factors for smoking prevalence of the students. Conclusions The early onset of smoking should guide the smoking struggle be concentrated in elementary school especially in semi-urban areas where the smoking prevalence is high.

WOS: 000439157200006, PubMed ID: 28622915, Introduction: During clinical evaluations, in order to interpret patients' complaints caused by Eustachian tube dysfunction and to monitor the success of the treatment, standardized and disease-related scales are necessary. Objective: The aim of this study was to investigate the validity and reliability of the Turkish version of Eustachian tube dysfunction questionnaire-7. Methods: Forty patients diagnosed with Eustachian tube dysfunction and 40 healthy individuals were enrolled for the study. After language validation of the Eustachian tube dysfunction questionnaire-7 for Turkish, a scale was completed by the both Eustachian tube dysfunction and control groups. Two weeks after the first evaluation, 15 of the cases filled out the scale again without any treatment intervention. Known-groups method was used in validity analysis. Floor-ceiling effect, test-retest method, item-total score correlation and internal consistency analysis were used in reliability analyses. Results: Cronbach's alpha coefficient was 0.714 for the entire questionnaire. The test-retest reliability coefficient for the total scale was determined as 0.792, indicating correlation between the two questionnaires completed by the same patient over time. In the Eustachian tube dysfunction group, total and each item scores were found significantly higher than the control group (p

Objective: To determine the quantitative values of apparent diffusion coefficient (ADC), standardized uptake values (SUVmax, SUVmean), metabolic tumor volume (MTV), metabolic tumor volume indexes (MTImax, and MTImean) using diffusion weighted-MRI (DW-MRI) and positron emission tomography/computed tomography (PET/CT), and analyze the predictive and prognostic values of these biomarkers in a homogenous group of patients with advanced-stage laryngeal cancer. Methods: Patients with newly diagnosed advanced-stage laryngeal cancer who had both DW-MRI and 18F-FDG PET/CT before treatment, and who had curative cancer treatment (surgery ± adjuvant therapy or radio ± chemotherapy) between 2011 and 2015 were included in this study. All patients were followed up clinically and radiologically, if necessary every 3 months for the first 2 years, every 4-6 months for year 3, and then annually thereafter. Results: Thirty-eight patients were retrospectively analyzed. Our analysis demonstrated statistically significant differences when the pretreatment SUV and MTImean value were compared between patients with stages III and IV. Standardized uptake value was also a predictive factor for N-stage. Moreover, a statistically significant difference was determined when patients with and without perinodal involvement (PNI) were compared. Log rank analysis demonstrated that none of functional imaging-based biomarkers had a prognostic role for oncological outcomes. Conclusion: Our results demonstrated that pretreatment SUV and MTImean values were predictive factors for staging, N-stage and PNI. Indeed, functional imaging-based biomarkers are promising, novel, non-invasive techniques that may provide additional information about tumor characteristics, treatment selection and prognosis in the near future.

Objective: The aim of this study is to evaluate the breastfeeding habits of 0-24 month infants. Method: This study is descriptive and aims to reach the whole reference population without using any sampling methods. The study was conducted on 140 mothers with 0-24 month-old babies, all registered in a Family Health Center in a semi-urban region of Manisa. Results: It was found that 96.4% of the mothers breastfed at least once. The first nutrition given after birth was breast-milk in 87.9% of the cases, and 56.4% of infants were fed with only breast-milk for the first six months. The average breastfeeding duration was 8.5±6.2 months. 55.6% of infants were introduced to supplementary food after six months, where 72.3% of the supplementary food provided was milk or milk products. The likelihood of the infants only breastfeeding in the first six months had a statistically significant relationship with the parents’ education levels and the father’s employment status. The median duration of breastfeeding had a statistically significant relationship with the mother’s age, the age difference with a previous child, and with whether or not the infant experienced a lower respiratory tract infection in the first 6 months of life. Conclusions: The parents having at least a secondary school education, the father being employed in the upper social classes, the mother’s age being at or more than 30, and a greater than 2 year difference between children were all found to be positive factors for both the presence and duration of breastfeeding.Key words: Breast milk, Breastfeeding, 0-24 month infants

Background/aims Functional constipation (FC) is a common problem in childhood. In this study, we aimed to analyze the clinical and sociodemographic findings of patients with FC, parenting behaviors, and psychosocial states of children and parents. Materials and methods According to the Roma III diagnosis criteria, 32 patients with FC and 31 healthy controls were included. Patients' clinical and sociodemographic data set associated with constipation was determined. Strengths and Difficulties Questionnaire was used to screen the emotional and behavioral problems in children. To evaluate the parents and family, Beck Depression Inventory, State-Trait Anxiety Inventory, Parental Attitude Research Instrument were used. Results Emotional and peer problems subscale scores, parental concerns as well as over-parenting attitude were found higher in patients. Significant difference was also observed between the groups in terms of mean score of authoritarian attitude dimensions. Attitude of hostility and rejection and marital discordance was found to be significantly high in patient families. Our study revealed a decrease in the constipation rate with the increasing education level of parents, higher rate of constipation in families with less income than expenses, and lower rate of working mothers in patients with constipation. Parents' depressive symptoms and anxiety level were determined to be considerably higher. Conclusion A mother's low education level, low socioeconomic level, presence of psychological symptoms, and problems of parental attitude-primarily the authoritarian attitude-increase the risk of FC occurrence. Therefore, FC patients and their families should definitely undergo a psychosocial assessment.

Objective. Quantitative sensorial tests (QST) are used for evaluating specific sensorial nerve function. In this study, QST and magnetic resonance imaging (MRI) findings are compared in lumbar disc herniation patients, and the accuracy of QST data was investigated. Material and Methods. Sixty-four patients between 18 and 70 years of age suffering from radicular pain with positive Lasegue's test were included in this study. Specific criteria included complaints due to L5 discopathy. MRI findings were classified according to the Pfirmann grading system, and QST was applied to the L5 dermatoma of both symptomatic and nonsymptomatic legs of all patients. Vibration detection threshold, heat detection threshold, cold detection threshold, and heat pain detection threshold values were obtained, and MRI findings were classified according to the Pfirmann grading system. Results. When we compared the symptomatic and nonsymptomatic legs of participants, there were significant differences by means of all QST parameters (0 5 0.00). In a comparison of the QST and MRI Pfirmann grading systems, there is also a strong parallel statistical correlation between the Pfirmann grade and QST parameters (P < 0.05). Conclusions. According to the results of our study, QST has an additive effect to MRI for nerve root compression evaluation in the clinical basis, which might enable more sensitive diagnosis and treatment protocol. QST can also be an alternative method for evaluation of nerve root compression in patients who have contraindications for MRI. © 2017 American Academy of Pain Medicine. All rights reserved.

Amaç: Acil servisten istenen troponin I testi sonuç verme süresini kısaltmak amacıyla laboratuvarımız iş akışında serum yerine plazma örnek tipi değişikliği ve acil test istem panelinin yenilenmesi gibi süreç iyileştirme düzenlemeleri yapılmıştır. Çalışmamızda yapılan değişikliklerin; düzenleme öncesi ile düzenleme sonrası kısa ve uzun dönemler arasında troponin I sonuç verme süresi üzerine etkisinin karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmamızda düzenleme öncesi üç ay (n=1852) ve düzenleme sonrası üç aylık kısa dönem (n=1278) ve üç aylık uzun dönemde (n=2786) laboratuvarımıza gelen acil servis troponin I testi sonuç verme süreleri karşılaştırılmıştır. Veriler Laboratuvar Bilgi Sistemi'nden geriye dönük olarak elde edilmiştir. Bulgular: Troponin I sonuç verme süreleri karşılaştırıldığında; düzenleme öncesi ile düzenleme sonrası kısa dönem (48±20 vs 43± 16 dakika, p=0,0007) ve düzenleme öncesi ile düzenleme sonrası uzun dönem (48±20 vs 35±12 dakika, p=0,0002) arasında istatistiksel olarak anlamlı azalma bulunmuştur. Düzenleme sonrası kısa dönem ile düzenleme sonrası uzun dönem TAT süreleri arasında da (43± 16 vs 35±12 dakika, p=0,0004) istatistiksel olarak anlamlı kısalma tespit edilmiştir. Hedef süreyi aşan örnek yüzdesinde; düzenleme öncesi ile düzenleme sonrası kısa dönem (p=0,001) ve düzenleme öncesi ile düzenleme sonrası uzun dönem (p

Çevik, Celalettin (Balikesir Author), Background: This study aims to determine the psychometric properties of the World Health Organization Well-Being Index (WHO-5) Turkish version in Turkish adults and older adults. Methods: This is a multicenter cultural adaptation study carried out with 1752 participants. Internal consistency (by Cronbach's alpha); Construct validity (by known groups and confirmatory factor analysis-CFI) and discriminant validity are evaluated stratified by adults and older adults. Cohen's Effect Size is used in known groups and discriminant validity analyses. Results: Distribution properties of the WHO-5 Turkish version are in acceptable limits. Alpha values are 0.81 for adults and 0.86 for older adults. The variances of the 58.5% of the adults sample and 63.9% of the older adults sample are explained in Exploratory FA. Model fits (CFI) are satisfactory ( > 0.95) in both samples; but RMSEA is poor in the older adults sample (0.166) whereas it is acceptable (0.073) in the adults sample. Known groups validity and discriminant analyses are satisfactory in both adults and older adults. Conclusion: The WHO-5 Turkish version has a good measurement capacity, internal consistency and good model fits in both samples. The error values in the older adults group suggest that the results when testing older adults should be interpreted with caution.

INTRODUCTION: Serum to plasma sample type change and renewal of the emergency test request panel were carried out in our laboratory workflow to decrease the turnaround time (TAT) of the troponin I test requested from the emergency department. The aim of the present study was to compare the TATs of the troponin I test between the short and long term periods before and after the workflow arrangements.METHODS: In our study, TAT times of the emergency service troponin I test were compared in the study groups as; three months before the organization (n=1852), short-term post organization (n=1278) and long-term post organization (n=2786) at three months intervals. The data were obtained retrospectively from the Laboratory Information System.RESULTS: Troponin I TAT times were compared between the study groups and statistically significant decreases were observed; before and after short-term workflow organization (48±20 vs 43±16 minutes, p=0.0007) before and after long-term workflow organization (48±20 vs 35±12 minutes, p=0.0002). The percentages of the troponin I values exceeding the target TAT emergency periods were also found to be significantly decreased between the study groups; before and after short-term workflow organization (p=0.001) before and after long-term workflow organization (p, GİRİŞ ve AMAÇ: Acil servisten istenen troponin I testi sonuç verme süresini (TAT) kısaltmak amacıyla laboratuvarımız iş akışında serum yerine plazma örnek tipi değişikliği ve acil test istem panelinin yenilenmesi gibi süreç iyileştirme düzenlemeleri yapılmıştır. Çalışmamızda yapılan değişikliklerin; düzenleme öncesi ile düzenleme sonrası kısa ve uzun dönemler arasında troponin I TAT üzerine etkisinin karşılaştırılması amaçlanmıştır.YÖNTEM ve GEREÇLER: Çalışmamızda düzenleme öncesi üç ay (n=1852) ve düzenleme sonrası üç aylık kısa dönem (n=1278) ve üç aylık uzun dönemde (n=2786) laboratuvarımıza gelen acil servis troponin I testi TAT süreleri karşılaştırılmıştır. Veriler Laboratuvar Bilgi Sistemi'nden geriye dönük olarak elde edilmiştir. BULGULAR: Troponin I TAT süreleri karşılaştırıldığında; düzenleme öncesi ile düzenleme sonrası kısa dönem (48±20 vs 43± 16 dakika, p=0.0007) ve düzenleme öncesi ile düzenleme sonrası uzun dönem (48±20 vs 35±12 dakika, p=0.0002) arasında istatistiksel olarak anlamlı azalma bulunmuştur. Düzenleme sonrası kısa dönem ile düzenleme sonrası uzun dönem TAT süreleri arasında da (43± 16 vs 35±12 dakika, p=0.0004) istatistiksel olarak anlamlı kısalma tespit edilmiştir. Hedef süreyi aşan örnek yüzdesinde; düzenleme öncesi ile düzenleme sonrası kısa dönem (p=0.001) ve düzenleme öncesi ile düzenleme sonrası uzun dönem (p

In this study it is aimed to evaluate the prevalence of smoking, factors affecting smoking status, and the attitudes of the elementary school students towards the smoking prohibition law which was approved in July 2009, in city.The universe of this descriptive study was 6th-7th-8th class, 8236 urban and 4937 semi-urban, total 13.173 elementary schools students in city center. Study population was determined on the basis of a previous study in which the smoking trial prevalence was found 17.5%, 831 students in 6 urban 3 semi-urban, total 9 schools were chosen randomly. A questionnaire was prepared investigating smoking status, the effects of smoking and family history. Among the 9 chosen schools, the questionnaire was applied to 615 students. SPSS 14.0 statistical package was used.Forty-seven percentages of the students were female. Prevalence of smoking trial was found 23.5% (16% in urban, 35% in semi-urban schools) while the prevalence of smoking was 7.1% (1.7% in urban, 15.7% in semi-urban schools). Mean age of first smoking trial was 10.04 ± 2.3. The smoking prohibition law was supported by 86.6% of the students, the warnings on the cigarette package was thought to be effective by 43.3% students and 35.2% of the students were exposed to passive smoke. Male gender, social status, education level of the family, smoker family member or close friends were found to be important risk factors for smoking prevalence of the students.The early onset of smoking should guide the smoking struggle be concentrated in elementary school especially in semi-urban areas where the smoking prevalence is high.

Amac: Meme kanseri kadinlarda en sik gorulen kanser olmasi nedeniyle onemlidir. Literaturde meme kanserinin ailenin hastaligi olarak degerlendirilmesi gerektigi vurgulanmaktadir. Bu calismada, meme kanserli hasta yakinlarinin sosyodemografik ozellikleri ile bakim yukleri ve yasam kaliteleri arasindaki iliskinin incelenmesi amaclanmistir. Materyal ve Metot: Calismamiza Manisa Celal Bayar Universitesi Hafsa Sultan Hastanesi Tibbi Onkoloji ve Radyasyon Onkolojisi polikliniklerine Kasim 2016-Mart 2017 tarihleri arasinda basvuran 100 meme kanserli hastanin oncelikli yakini dâhil edilmistir. Veri toplama araci olarak sosyodemografik form, Zarit Bakici Yuku Olcegi, WHOQOL BREF-TR (Dunya Saglik Orgutu Yasam Kalitesi Olcegi – Turkce Ulusal Kisa Surumu) kullanilmistir. Anketler yuz yuze gorusme teknigi ile arastirmaci tarafindan uygulanmistir. Bulgular: Meme kanserli hasta yakinlarinin %68,00 oraninda erkek ve %54,00 oraninda hastanin esi oldugu, %56,00 oraninda ilkogretim egitim seviyesinde, %53,00 oraninda gelir duzeylerinin orta duzeyde oldugu sonucuna ulasilmistir. Yasam kalitesi sosyal alan puaninin erkek cinsiyette ve hastaya yakinliga gore eslerde daha dusuk oldugu; bakim verenin yas ortalamasi arttikca sosyal alanda yasam kalitesinin azaldigi; gelir seviyesi arttikca cevresel, ulusal cevresel ve sosyal alanda yasam kalitesinin arttigi; egitim seviyesi arttikca cevresel ve ulusal cevresel alanda yasam kalitesinin arttigi; bakim verme suresi acisindan ilk 6 ay sosyal alan yasam kalitesi puanlarinin en yuksek duzeyde oldugu ve bakim yuku arttikca cevresel, ulusal cevresel ve sosyal alanda yasam kalitesinin azaldigi, bakim yukunun ise gelir seviyesi azaldikca arttigi, cerrahi, kemoterapi, radyoterapi sureclerini tamamladiktan sonraki surecte daha fazla oldugu sonucuna ulasilmistir. Sonuc: Meme kanserli hasta yakinlarinin bakim yukleri ve yasam kaliteleri periyodik araliklarla degerlendirilmeli, meme kanserli hastalar kadar onlara bakim veren hasta yakinlari; sosyoekonomik durumlari goz onunde bulundurularak sosyal acidan, ozellikle hastanin esi egitim acisindan desteklenmelidir. Bakim verenlerin egitim alaninda, sosyal ve ekonomik alanda gereksinimlerinin belirlenmesi ve karsilanmasi, sorunlarinin goz ardi edilmemesi gerekmektedir. Boylece bakim verenlerin bakim yuklerinin azaltilmasi ve yasam kalitelerinin iyilesmesi, meme kanseri tedavisi alan hastalarin tedavi sureclerini ve hastalikla basa cikabilme cabalarini da olumlu etkileyecektir.

Amaç: Meme kanseri kadınlarda en sıkgörülen kanser olması nedeniyle önemlidir. Literatürde meme kanserinin aileninhastalığı olarak değerlendirilmesi gerektiği vurgulanmaktadır. Bu çalışmada,meme kanserli hasta yakınlarının sosyodemografik özellikleri ile bakım yüklerive yaşam kaliteleri arasındaki ilişkinin incelenmesi amaçlanmıştır.Materyalve Metot: ÇalışmamızaManisa Celal Bayar Üniversitesi Hafsa Sultan Hastanesi Tıbbi Onkoloji veRadyasyon Onkolojisi polikliniklerine Kasım 2016-Mart 2017 tarihleri arasındabaşvuran 100 meme kanserli hastanın öncelikli yakını dâhil edilmiştir. Veritoplama aracı olarak sosyodemografik form, Zarit Bakıcı Yükü Ölçeği, WHOQOLBREF-TR (Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği – Türkçe Ulusal Kısa Sürümü)kullanılmıştır. Anketler yüz yüze görüşme tekniği ile araştırmacı tarafındanuygulanmıştır.Bulgular: Meme kanserli hasta yakınlarının %68,00 oranında erkek ve %54,00oranında hastanın eşi olduğu, %56,00 oranında ilköğretim eğitim seviyesinde,%53,00 oranında gelir düzeylerinin orta düzeyde olduğu sonucuna ulaşılmıştır.Yaşam kalitesi sosyal alan puanının erkek cinsiyette ve hastaya yakınlığa göreeşlerde daha düşük olduğu; bakım verenin yaş ortalaması arttıkça sosyal alandayaşam kalitesinin azaldığı; gelir seviyesi arttıkça çevresel, ulusal çevreselve sosyal alanda yaşam kalitesinin arttığı; eğitim seviyesi arttıkça çevreselve ulusal çevresel alanda yaşam kalitesinin arttığı; bakım verme süresiaçısından ilk 6 ay sosyal alan yaşam kalitesi puanlarının en yüksek düzeydeolduğu ve bakım yükü arttıkça çevresel, ulusal çevresel ve sosyal alanda yaşamkalitesinin azaldığı, bakım yükünün ise gelir seviyesi azaldıkça arttığı,cerrahi, kemoterapi, radyoterapi süreçlerini tamamladıktan sonraki süreçte dahafazla olduğu sonucuna ulaşılmıştır.Sonuç: Meme kanserli hastayakınlarının bakım yükleri ve yaşam kaliteleri periyodik aralıklarladeğerlendirilmeli, meme kanserli hastalar kadar onlara bakım veren hastayakınları; sosyoekonomik durumları göz önünde bulundurularak sosyal açıdan,özellikle hastanın eşi eğitim açısından desteklenmelidir. Bakım verenlerineğitim alanında, sosyal ve ekonomik alanda gereksinimlerinin belirlenmesi vekarşılanması, sorunlarının göz ardı edilmemesi gerekmektedir. Böylece bakımverenlerin bakım yüklerinin azaltılması ve yaşam kalitelerinin iyileşmesi, memekanseri tedavisi alan hastaların tedavi süreçlerini ve hastalıkla başa çıkabilmeçabalarını da olumlu etkileyecektir., Objectives: Breast cancer is vital because it’s the most frequent type of cancer observed in women. It’s stressed in the literature that breast cancer needs to be considered as a family disease. In this study, the aim is to examine the relationship between the sociodemographic characteristics as well as the burden of caregiving on the patient’s relatives and their life quality. Materials and Methods: The close relatives of 100 patients with breast cancer admitted to the Medical Oncology and Radiation Oncology Polyclinics of Hafsa Sultan Hospital in Manisa Celal Bayar University between November 2016 and March 2017, are included in our study. As data collection tool, sociodemographic form, the Zarit caregiver burden scale, WHOQOL BREF-TR (World Health Organization Quality of Life Scale – Turkish national short version) were used. Surveys were implemented by the researcher with face-to-face interview technique.Results: The results show that 68.00% and 54.00% of patient relatives with breast cancer are male and are the patient's spouses, and 56.00% and 53.00% are at the primary education level and at the middle-income level, respectively. The results are as follows: Life quality score in social domain is lower in males and spouses when considered in terms of kinship. As age average of caregivers increases, their life quality decreases in social domain. As income level goes up, life quality in environmental, national environmental and social domain increases. When education level arises, life quality increases in environmental and national environmental domain. In terms of caregiving period, the first six months have the highest scores of life quality in social domain and as caregiving burden rises, life quality in environmental, national environmental and social domain reduces. Moreover, when income level decreases, caregiving burden increases and it rises dramatically in the period after surgical, chemotherapy, radiotherapy processes are completed. Conclusion: Caregiving burdens and life quality of patient’s relatives should be evaluated at periodic intervals. Both patients with breast cancer and patient relatives, especially spouses, should be supported in terms of education by their socio-economic conditions being taken into consideration. The educational, social and economic needs of caregivers should be determined and fulfilled and their problems should not be ignored. In that way, burdens of the caregivers would be reduced and their life quality would improve and this would have a positive impact on the treatment process of the patients and on their efforts to cope with the cancer.

Introduction: Systemic inflammatory biomarkers are promising predictive and prognostic factors for solid cancers. The neutrophil–lymphocyte ratio and derived neutrophil–lymphocyte ratio are used to predict inflammation and used as biomarker in several malignancies. Objective: The purpose of this study was to demonstrate the diagnostic, predictive and prognostic role of neutrophil–lymphocyte ratio and derived neutrophil–lymphocyte ratio in patients with laryngeal neoplasms. Methods: A retrospective study was conducted on medical records involving 229 patients with benign, premalignant and malignant laryngeal neoplasms between 2002 and 2015. The diagnostic, predictive and prognostic role of neutrophil–lymphocyte ratio and derived neutrophil–lymphocyte ratio were evaluated using uni– and multivariate analysis. Results: The neutrophil–lymphocyte ratio and derived neutrophil–lymphocyte ratio were not statistically different between patients with benign, premalignant and malignant laryngeal neoplasms. Both neutrophil–lymphocyte ratio and derived neutrophil–lymphocyte ratio were predictive factors for stage, lymph node metastasis, and distant metastasis. Patients with high neutrophil–lymphocyte ratio value (≥4) had a poor prognosis when compared with patients with low neutrophil–lymphocyte ratio value (5 year, Overall Survival: 69.0% vs. 31.1%, p

Objective: Tobacco use is the most important public health concern worldwide, particularly in developing countries. It is estimated that 1.7 billion people worldwide will be smokers by 2025 if any intervention do not made. Turkey took an important step in the fight against smoking with the introduction of the project ‘smokeless airspace’ in May 2009. The aim of this study is to evaluate the prevalence of smoking and characteristics of smokers among undergraduates attending Celal Bayar University, Manisa, Turkey. Methods: This cross-sectional study was realized among Manisa Celal Bayar University students between March 2015 and June 2015. A self-administered questionnaire was used to obtain sociodemographic data and determine smoking behaviour and nicotine dependence among university students. Descriptive statistical analyses were used to measure the prevalence of smoking and determine correlations between dependent and independent variables. Chi-square test was used to compare categorical variables Results: Of the 2170 respondents, 518 (23.9%) were current smokers, comprising 312 (60.2%) males and 206 (39.8%) females. Cigarette smoking was significantly associated with having friends who smoked, male gender, and parental smoking. Based on the Fagerstrom Tolerance Test, 8.9% of the students were identified as being addicts. According to Fagerström Tolerance of Nicotine Dependence. 193 out of 518 (37.2%) students were reported as nicotine dependent. Conclusion: Deleterious effects of smoking on human health should be incessantly emphasized in the university curriculum, policies of ‘smokeless airspace, should be supported by stronger, and more effective programs in order to encourage university students to quit smoking. Amaç: Tütün kullanımı, özellikle gelişmekte olan ülkelerde dünyadaki en önemli halk sağlığı olarak kabul edilmektedir. Herhangi bir müdahale yapılmazsa, 2025 yılına kadar dünyadaki 1,7 milyar insanın sigara içeceği sanılmaktadır. Türkiye, Mayıs 2009’da “dumansız hava sahası” projesinin başlatılmasıyla sigara içilmesine karşı mücadelede önemli bir adım attı. Bu çalışmanın amacı, Celal Bayar Üniversitesi, Manisa, Türkiye’ye gelen lisans öğrencileri arasında sigara içme prevalansını ve sigara içenlerin özelliklerini değerlendirmektir. Yöntem: Kesitsel tipteki bu araştırma Mart 2015 - Haziran 2015 tarihleri arasında Manisa, Celal Bayar Üniversitesi öğrencileri arasında gerçekleştirildi. Sosyodemografik veriler ile üniversite öğrencileri arasında sigara içme davranışını ve nikotin bağımlılığını belirlemek için anket kullanıldı. Bağımlı ve bağımsız değişkenler arasındaki ilişkileri belirlemek için tanımlayıcı istatistikler kullanıldı. Kategorik değişkenleri karşılaştırmak için ki-kare testi uygulandı. Bulgular: Ankete katılan 2170 katılımcının 518’i (%23,9) [312 (%60,2) erkek, 206 (%39,8) kadın] mevcut sigara içiciydi. Sigara içimi erkek cinsiyet, anne-babanın ve arkadaşların sigara içme durumları ile anlamlı şekilde ilişkiliydi. Fagerstrom Tolerans Testine dayanarak, öğrencilerin %8,9’u bağımlı olarak tanımlandı. Fagerström Nikotin Bağımlılığı Toleransına göre sigara içen 518 öğrencinin 193’ü (%37,2) nikotin bağımlısı olarak rapor edilmiştir. Sonuç: Yasal düzenlemelerin yanı sıra üniversite öğrencileri arasında sigarayı önlemeyi teşvik etmek için sigaranın insan sağlığı üzerindeki olumsuz etkilerinin eğitim müfredatında sürekli olarak işlenmesi ve “dumansız hava sahası” gibi sigara içiciliğini azaltmaya yönelik politikaların daha güçlü ve etkili programlar ile desteklenmesi gerekmektedir.

Giriş: Bu çalışmada ilimizdeki ilköğretim öğrencilerinde sigara içme prevalansının, içimi etkileyen faktörlerin belirlenmesi ve Temmuz 2009’da yürürlüğe giren sigara yasağına karşı öğrencilerin tutumlarının değerlendirilmesi amaçlanmıştır. Materyal ve Metod: Tanımlayıcı nitelikteki araştırmanın evrenini ilimiz merkez ilköğretim okulları 6-7-8. sınıflarında bulunan 8236’sı kent ve 4937’si gecekondu olmak üzere 13.173 öğrenci oluşturdu. Örneklem sayısı, ilimizde daha önce bulunan sigarayı ilk kez deneme prevalansı %17.5 baz alınarak 831 kişi, rastgele seçim yöntemi kullanılarak 6 kent ve 3 gecekondu olmak üzere 9 okul olarak belirlendi. Sigara içme, etkileyen faktörler, sigara içmenin etkileri ve ailelerinin sigara içme durumları gibi soruları içeren anket formu hazırlandı. Belirlenen 9 okuldan toplam 615 öğrenciye anket uygulandı. Araştırmanın verileri SPSS 14.0 bilgisayar istatistik paket programı kullanılarak değerlendirildi. İstatistiksel analizlerde tanımlayıcı istatistikler (yüzde dağılımı, ortalama, standart sapma), ki-kare ve bağımsız gruplarda t-testi kullanıldı. Bulgular: Öğrencilerin %47’si kızdı. Sigara deneme prevalansı %23.5 (kent okullarında %16, gecekondu okullarında %35), sigara içme prevalansı ise %7.1 (kent okullarında %1.7, gecekondu okullarında %15.7) olarak saptandı. Sigara deneme yaşı 10.04 ± 2.3’tü. Öğrencilerin %86.6’sının sigara yasağını desteklediği, %43.3’ünün sigara paketleri üzerindeki uyarı yazılarının etkili olduğunu düşündüğü ve %35.2’sinin sigara dumanına maruz kaldıkları saptandı. Erkek cinsiyet, yaş, sosyoekonomik durum, ailenin eğitim durumu, aile bireyi ve en yakın arkadaşın sigara içmesinin öğrencinin sigara içmesinde önemli risk faktörleri olduğu görüldü. Sonuç: Sigara içmeye başlama yaşının erken olması sigarayla mücadele çalışmalarının ilköğretim okullarına ve özellikle sigara içme prevalansının yüksek olduğu gecekondu bölgelerine yoğunlaştırılmalıdır. Introduction: In this study it is aimed to evaluate the prevalence of smoking, factors affecting smoking status, and the attitudes of the elementary school students towards the smoking prohibition law which was approved in July 2009, in city. Materials and Methods: The universe of this descriptive study was 6th-7th-8th class, 8236 urban and 4937 semi-urban, total 13.173 elementary schools students in city center. Study population was determined on the basis of a previous study in which the smoking trial prevalence was found 17.5%, 831 students in 6 urban 3 semi-urban, total 9 schools were chosen randomly. A questionnaire was prepared investigating smoking status, the effects of smoking and family history. Among the 9 chosen schools, the questionnaire was applied to 615 students. SPSS 14.0 statistical package was used. Results: Forty-seven percentages of the students were female. Prevalence of smoking trial was found 23.5% (16% in urban, 35% in semi-urban schools) while the prevalence of smoking was 7.1% (1.7% in urban, 15.7% in semi-urban schools). Mean age of first smoking trial was 10.04 ± 2.3. The smoking prohibition law was supported by 86.6% of the students, the warnings on the cigarette package was thought to be effective by 43.3% students and 35.2% of the students were exposed to passive smoke. Male gender, social status, education level of the family, smoker family member or close friends were found to be important risk factors for smoking prevalence of the students. Conclusion: The early onset of smoking should guide the smoking struggle be concentrated in elementary school especially in semiurban areas where the smoking prevalence is high.

Background Autoimmune thyroid diseases are the most common of all autoimmune diseases. In the literature, Hashimoto thyroiditis (HT) is considered to be a T-helper (Th) type 1 dominant condition, and Graves disease is considered a Th2-dominant condition. Objective The aim of this study was to highlight a new aspect of the relationships among Th cell subgroups by determining the incidence of autoimmune thyroid disease in patients with allergic rhinitis (AR). Methods Patients were diagnosed with AR based on their medical histories, physical examinations, and skin-prick test results in an outpatient clinic. The levels of free triiodothyronine, free thyroxine, thyroid-stimulating hormone, thyroid peroxidase antibodies, and thyroglobulin antibodies were measured in peripheral blood samples from all study subjects. Results A total of 1239 patients with AR and 700 consecutive, age- and sex-matched healthy subjects were included in the study. Thyroid function tests showed that 1037 patients with AR (83.7%) had normal thyroid function, 171 (13.8%) had euthyroid HT, and 31 (2.5%) had hypothyroid HT. Among the control subjects, thyroid function test results showed that 688 subjects (98.2%) had normal thyroid function, 10 subjects (1.4%) had euthyroid HT, and 2 subjects(0.4%) had hypothyroid HT. Conclusion The incidence of HT in the general population is 1.5%; in contrast, it was observed in 16.3% of our patients with AR, which represented a much higher rate than that in the overall population. Graves disease was not detected in our study subjects. A high incidence of HT in patients with AR, in which Th2 responses are dominant, indicates that further studies of the relationships among atopy, autoimmune diseases, and Th cell subgroups are needed.

This study aims to evaluate Helicobacter pylori with clarithromycin resistant genotypes in Manisa region, Turkey. Two hundred patients, who received diagnosis of Helicobacter pylori infection histopathologically, were included. The sex, age and endoscopy indications of the patients were recorded. Polymerase chain reaction method was applied to determine the clarithromycin resistance rate and resistance genotypes at the histologic sections prepared from gastric biopsies that had been embedded in paraffin after fixation by formalin. Helicobacter pylori resistance to clarithromycin was found in 19/200 (9.5%) patients. 10/19 (52.6%) of these clarithromycin-resistant patients had A2143G mutation and 9/19 (47.4%) had A2142G mutation. A2142C mutation on 23S rRNA gene was not detected for any of the patients. Clarithromycin can be used as a first step treatment in the eradication of Helicobacter pylori for the children in our region; if the treatment fails for some patients, clarithromycin resistance, especially A2143G and A2142G mutations should be considered.

Purpose: To determine the clinical characteristics and seasonal distribution of patients admitted to the ocular emergency department of a tertiary ophthalmology care center. Methods: The study cohort includes 27,120 patients who were admitted to ocular emergency room between November 2013 and November 2014. The age, sex, reason for admission, diagnosis, and complete ocular examination reports were recorded for each patient. X-ray and ultrasonographic examinations were performed if necessary. Results: The mean patient age was 32.83 ± 17.62 years (range, 0-95). The number of males was nearly two times the number of females, with 18,808 (69.4%) males and 8312 (30.6%) females. The diagnoses included viral conjunctivitis (7,859 patients; 29.0%), corneal foreign body (5,286 patients; 19.5%), bacterial conjunctivitis (3,892 patients; 14.4%), corneal abrasions (2,306 patients; 8.5%), and allergic conjunctivitis (1,433 patients; 5.3%) (Table 1). Other frequent diagnoses included subconjunctival hemorrhage, photo keratopathy, chemical eye injury, and penetrating and blunt eye injuries. Allergic conjunctivitis, ocular trauma, and corneal foreign body were more frequent in spring, whereas keratitis and chemical eye injury were more common in winter (chi-square test). The most common reasons for emergency room admission, in order of frequency, were viral conjunctivitis, corneal foreign body, bacterial conjunctivitis, and corneal abrasions. Conclusion: This study is the first long-term prospective study to evaluate the seasonal distribution and diagnosis of all adult and pediatric patients admitted to the emergency room for ocular conditions. The frequency of ophthalmological conditions seen in the emergency room may vary according to the season. RESUMO Objetivo: Determinar as características clínicas e a distribuição sazonal dos pacientes admitidos no departamento de emergências oculares de um centro terciário de cuidados oftalmológicos. Métodos: Um total de 27.120 pacientes, admitidos no pronto atendimento ocular entre novembro de 2013 e novembro de 2014, foram incluídos neste estudo prospectivo. Idade, gênero, causa da admissão, diagnóstico e relatórios completos dos exames oculares dos pacientes foram registrados e exames de raios X e de ultrassonografia foram realizados quando necessários. Resultados: A idade média do paciente foi de 32,83 ± 17,62 anos (intervalo, 0-95). O número de homens era quase duas vezes maior que o número de mulheres, com 18.808 (69,4%) do sexo masculino e 8.312 (30,6%) do sexo feminino. Os diagnósticos incluíram conjuntivite viral (7.859 pacientes, 29,0%), corpo estranho corneano (5.286 pacientes, 19,5%), conjuntivite bacteriana (3.892 pacientes, 14,4%), abrasões corneanas (2.306 pacientes, 8,5%) e conjuntivite alérgica (1.433 pacientes, 5,3%) (Tabela 1). Outros diagnósticos freqüentes incluíram hemorragia subconjuntival, queratopatia fotográfica, lesões oculares químicas e lesões oculares penetrantes e contundentes. A conjuntivite alérgica, o trauma ocular e o corpo estranho da córnea foram mais frequentes na primavera, enquanto que a queratite e lesões oculares químicas foram mais comuns no inverno (teste qui-quadrado). Os motivos mais comuns para a admissão na sala de emergência, em ordem de frequência, foram conjuntivite viral, corpo estranho da córnea, conjuntivite bacteriana e abrasões da córnea. Conclusão: Este é o primeiro estudo prospectivo de longa duração avaliando as causas e a distribuição sazonal de todos os casos de admissão em um pronto atendimento oftalmológico para pacientes em idade adulta ou pediátrica. A frequência das causas de encaminhamento ao pronto atendimento pode variar em função da estação do ano.

Background & objectives: Rapidly progressive glomerulonephritis (RPGN) is a clinical syndrome manifested by features of nephritic syndrome and progressive loss of renal function over a short time. The objective of this study was to investigate the relationship between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and prognostic factors and pathological findings of renal biopsy in RPGN. Methods: Consecutive newly diagnosed RPGN patients who had follow up for at least six months were retrospectively analyzed. The estimated glomerular filtration rate (EGFR) was calculated. Albumin, C-reactive protein (CRP) levels and CRP/albumin ratio were also calculated. Results: Fifty four patients were included in the study. The mean age was 48.92±20.12 years. Clinicopathological diagnosis was pauci-immune glomerulonephritis (GN) in 40 while two had postinfectious GN, six systemic lupus erythematosus, three IgA nephropathy, two Henoch-Schönlein purpura and one membranoproliferative GN. The mean NLR was 7.02±6.34 and mean PLR was 273.90±39.15. Positive correlations between NLR and CRP levels (P=0.009, r=0.511) and CRP/albumin ratios (P=0.005, r=0.542) were observed. PLR and CRP/albumin ratios (P=0.041, r=0.412) were correlated positively. The per cent of fibrocellular crescents was negatively correlated with NLR (P=0.019, r=-0.291), and positively correlated with the lymphocyte count (P=0.05, r=0.256). In secondary crescentic subgroup, the per cent of fibrinoid necrosis had a positive correlation with PLR (P=0.013, r=0.642). Both NLR (P=0.036) and PLR (P=0.051) detected at the first month of the treatment period, were observed to be significantly correlated with mortality. Interpretation & conclusions: This study showed that NLR could predict mortality in patients with RPGN; correlated with systemic inflammation; showed a negative correlation with the per cent of fibrocellular crescents and could be regarded as a measure of glomerular inflammatory state. Moreover, PLR may be considered to be an indicator of disease severity in acute phase of crescentic GN. © 2019 Indian Journal of Medical Research.

Arginine, glutamine, and Beta-hydroxy-beta-methylbutyrate were combined in a dietary supplement. This specialized amino acid mixture enhances wound collagen accumulation and increases wound healing. We aimed to investigate the effects of this special amino acid mixture on the healing process of experimental left colonic anastomosis. Material and Methods: The study included 20 adult male Wistar-Albino rats. The study group (n=10) received 685 mg/kg/day specialized amino acid mixture for 7 days until 12 h before surgery and was maintained throughout the study. Following midline laparatomy a 1-cm segment of the left colon was resected. Bowel continuity was restored with an end-to-end anastomosis. The animals were re-anesthetized on day 7 after the operation and anastomotic bursting pressure was measured by passing a catheter per anum up to the area of anastomosis. Anastomotic segments were removed en bloc and were vertically divided into two. One was used for hydroxyproline measurement and the other for histopathological examination. Abramov's histologic scoring system was used in this study. Results: The hydroxyproline levels and bursting pressures in the study group were superior compared to the control group. Collagen deposition and reepithelization scores of the study group were higher than that of the control group. Conclusion: Results of the present study indicates that significantly enhancing the anastomotic bursting pressure, hydroxyproline level and collagen deposition may improve anastomosis healing., Arjinin, glutamin ve beta-hidroksi-beta-metilbütirat, diyet desteği olarak kombine edilmiştir. Bu özel amino asit karışımı, yara yerinde kollajen birikimini artırır ve yara iyileşmesini geliştirir. Bu çalışmanın amacı, deneysel sol kolon anastomozunun iyileşmesinde özel amino asit karışımının etkilerini araştırmaktır. Gereç ve Yöntemler: Çalışmada 20 adet yetişkin Wistar-Albino sıçan kullanıldı. Çalışma grubu (n=10) ameliyattan 7 gün öncesinden başlayarak tüm çalışma süresince 685 mg/kg/gün özel amino asit karışımı aldı. Orta hattan karın açıldı ve 1 cm’lik sol kolon segmenti rezeke edildi. Uç-uca anastomoz yapılarak barsak lümeninin devamlılığı sağlandı. Sıçanlara bu ameliyattan 7 gün sonra tekrar anestezi verildi. Anastomoz patlama basıncı, anüsten yerleştirilip anastomozun üzerine çıkan bir kateter ile ölçüldü. Anastomoz sahaları sağlam sınırlarla çıkarıldı ve dikey olarak iki parçaya bölündü. Bir parça hidroksiprolin ölçümünde, diğer parça histolojik değerlendirmede kullanıldı. Histolojik değerlendirme için Abramov’un skorlama sistemi kullanıldı. Bulgular: Hiroksiprolin düzeyleri ve patlama basınçları çalışma grubunda, kontrol grubuna göre daha yüksekti. Kollajen birikimi ve reepitelizasyon skorları çalışma grubunda daha belirgindi. Sonuç: Bu çalışmanın sonuçları, özel amino asit karışımının, anastomoz patlama basıncı, hidroksiprolin düzeyi ve kollajen birikimini arttırarak anastomoz iyileşmesinde yararlı olabileceğini göstermiştir.

OBJECTIVE Results of 17.711 patien admitted to the Department of Parasitology in Celal Bayar University Hospital for parasitological stool examination between January 2006 and December 2010 were evaluated. METHODS All stool samples were examined with wet mounts, formalin ethyl acetate concentration and trichrome staining methods. In addition, cellophane tape preparations from 5952 patients were evaluated. RESULTS Intestinal parasites were detected in 2337 (13.12%) of 17.711 patients who were admitted during a five year period. The highest parasite infected individual ratio (16.69%) was found in 2008. The most frequently identified intestinal parasites were Blastocystis spp. 1353 (7.64%) and Giardia intestinalis 348 (1.96%) in stool samples, with Enterobius vermicularis 253 (4.25%) in cellophane tape preparations. Two or more parasites were detected in 158 (6.76%) of the positive cases. The mean age of persons identified as having a parasite was 21.9. Parasite incidence was 10.7% in females, and 13.6% in males (p < 0.001). The highest ratio was 23.8% in patients who lived in rural areas when all positive cases were evaluated in terms of settlement areas. CONCLUSION While Blastocystis spp., E. vermicularis and G. intestinalis were the most frequently detected intestinal parasites in our province, intestinal parasites still remain important despite advances in infrastructure in recent years.

OBJECTIVE The aim of this study is to determine the serological results of patients with suspected toxoplasmosis who were admitted to the Medical Parasitology Laboratory of Celal Bayar University Hospital in Manisa between 2006 and 2010. METHODS Anti-Toxoplasma gondii IgG and IgM antibodies were investigated by IFAT, IgG ELISA, and IgM Capture ELISA in 2815 patients. IgG avidity tests were also performed in cases with both IgG and IgM seropositivity. RESULTS Only IgG, only IgM and both IgG and IgM seropositivity were detected in 657 (23.3%), 4 (0.1%) and 6 (0.2%) cases respectively among 2815 patients. Anti-T. gondii IgG seropositivity was mostly found in patients [21.2% (n=139)] who consume raw meat. IgG seroprevalence was found to be statistically higher in the 15-49 age group than the 0-14 age group (p < 0.05). Decrease in the prevalence of anti- T. gondii IgG seropositivity in 2010 was found to be statistically significant considering the five years period (p < 0.001). CONCLUSION Raw meat consumption was detected as the most important risk factor in Toxoplasma infection. A decrease in anti-T. gondii IgG antibodies was detected in recent years considering the five years' serologic data, but toxoplasmosis remains important as a public health problem in Manisa.

WOS: 000371952700008, PubMed ID: 27306288, Aim: The aim of this study was to investigate the relationship between ultrasonographic carotid intima-media thickness (C-IMT) and visceral fat thickness (VFT) and an endometrial thickness (ET) of more than 5 mm in postmenopausal women. Methods: C-IMT, VFT, and ET measurements were performed in 63 postmenopausal women using ultrasonography. The relationships between ultrasonographic data and demographic data, anthropometric measurements, such as waist circumference, metabolic syndrome parameters, and insulin resistance were examined. Moreover, the role of VFT and C-IMT in predicting an ET of more than 5mm was investigated. Results: Only the C-IMT was higher in the ultrasonographic measurements of women with an ET >5 mm (p = 0.03). Insulin resistance was also significantly higher in these women (p = 0.03). ET showed a positive correlation with VFT and body mass index (BMI) (r = 0.286, p = 0.02 and r = 0.249, p = 0.04), and C-IMT showed a positive correlation with age, pregnancy, parity, and time since menopause (p5 mm (p = 0.04). Conclusions: There was a positive correlation between the ultrasonographic measures of VFT and ET, and high-C-IMT levels were independently associated with an ET>5 mm. Thus, C-IMT may be a predictor of pathologic ET in the postmenopausal period.

Background/aim: In this study, we investigated the effectiveness of antibiotic prophylaxis (ABP) with respect to the incidence of symptomatic urinary tract infections (UTIs) and evaluated the development of renal scarring in patients treated with clean intermittent catheterization (CIC). Materials and methods: A total of 22 patients were included in the study. The patients were administered ABP in the first year (the ABP-received period) but not in the second year (the ABP-discontinued period). Results: Twenty-eight of all cultures taken in the ABP-received period (18.2%) and 25 (16.2%) of the ABP-discontinued cultures were considered to be indicative of symptomatic UTIs (P = 0.65). The multiple antibiotic resistance rate of microorganisms in cultures taken during the ABP-discontinued period (47; 30.5%) was lower than that in those taken in the ABP-received period (62; 40.3%), (P = 0.07). There was no difference between the ABP-received and ABP-discontinued periods with respect to the development of new lesions according to dimercaptosuccinic acid results (P = 0.14). Conclusion: Routine ABP usage is not protective against the development of symptomatic UTIs and new lesions in neurogenic bladder patients receiving CIC. Furthermore, the growth of resistant microorganisms increased in the ABP-received period