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Background: Acromegaly is a disease with high morbidity and mortality rates. The role of primary care physicians is very important in the early diagnosis of acromegaly. The present study aims to determine the knowledge and attitudes of primary care physicians about acromegaly in different countries worldwide., Methods: The survey consisted of 33 questions prepared in English and Turkish and was administered to a total of 396 primary care physicians, 280 of whom were from Turkey, 84 from European countries, 28 from Asian countries, and 4 from Nigeria. Mostly, the survey was administered via Google Forms sent to social media groups of primary care physicians. Some of the surveys were administered in person. The survey included 12 questions about the clinical manifestations, six questions about the diagnosis, 12 questions about the comorbidities, one question about the treatment, and two questions about the prognosis of acromegaly. Data of acromegaly knowledge and the attitudes of physicians were evaluated using the chi-square test., Results: The presence of acral findings in acromegaly was better known by Turkish physicians (96.8%) compared to Asian/African (84.4%) and European (84.5%) physicians (p < 0.001). The presence of generalized visceromegaly and excessive sweating was better known by Asian/African physicians (p = 0.01 and p = 0.009, respectively). The rate of correct answers to the question "Old photographs can be informative in patients suspected to have acromegaly" was higher in the Turkish and Asian/African groups (p < 0.001). Only 36.1% of the Turkish physicians, 29.8% of the European physicians, and 31.3% of the Asian/African physicians knew that serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels were diagnostic indicators for acromegaly. Colon cancer and goitre incidences were increased in acromegaly patients. These comorbidities were better known by Asian/African primary care physicians than by Turkish and European primary care physicians (p < 0.001 and p = 0.032, respectively). Only 18.6% of Turkish and 13% of European physicians knew that surgery was the treatment of choice for acromegaly patients. The rate of correct answers to this question was higher for Asian/African physicians (59.4%) (p = 0.003)., Conclusion: Knowledge of primary care physicians regarding acromegaly should be increased through workshops, seminars, and subject-focused courses., Competing Interests: Declarations. Ethics approval and consent to participate: We conducted this study in compliance with the Declaration of Helsinki. All physicians who participated in the study in person signed a written informed consent before participating. Physicians who participated via a Google form approved the informed consent section, which was added to the questionnaire. The Clinical Research Ethics Committee of Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty (approval date and number 21.10.2020–139312), approved the study. Consent for publication: All of the authors have read and agreed to the published version of the manuscript. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Vitamin D receptors (VDRs) are present in almost all cells of the immune system, including B cells, T cells, NK (Natural Killer) cells, dendritic cells, and monocytes, as well as the epithelial cells of many organs such as the intestine, pancreas, prostate, lungs, and cardiomyocytes. In addition, some immune cells, including dendritic cells, macrophages, and B and T cells, can synthesize calcitriol by expressing 1α-hydroxylase. Upon binding to VDRs, vitamin D (Vit D) regulates the expression of genes involved in immune responses, including those encoding for cytokines. It modulates the production of pro-inflammatory cytokines while promoting the synthesis of anti-inflammatory cytokines. Vit D also affects the differentiation and maturation of cells of the immune system. By inhibiting the nuclear factor kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) pathways, Vit D reduces the expression of pro-inflammatory genes. These effects highlight the potential of Vit D as a therapeutic agent in the management of inflammatory diseases, including autoimmune disorders, cardiovascular diseases, diabetes, metabolic syndrome, cancer, neurological diseases, depression, and inflammatory bowel disease.

In this study, we aimed to reveal the pro-inflammatory effects of serum 25-hydroxyvitamin D3 (Vit D) deficiency and insufficiency in new-onset type 2 diabetes mellitus (T2DM) and prediabetes. We recruited 84 prediabetes patients, 94 new-onset T2DM patients and 113 healthy participants. We measured the levels of C-reactive protein (CRP), fibrinogen, ferritin, interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), nuclear factor kappa-B (NF-κB) and mitogen-activated protein kinase (MAPK) in the serum of the participants. ANOVA Bonferroni and Kruskal-Wallis Dunn tests were used to compare the inflammation markers and vitamin D levels between the groups. Based on covariance analysis with age, gender and BMI, the Vit D levels of the T2DM group were significantly lower ( p < 0.003). Pro-inflammatory markers and CRP were significantly higher in prediabetic and diabetic subjects. In the prediabetes group, IL-1β, IL-6, IL-8, TNF-α and MAPK were significantly higher in those with Vit D insufficiency and deficiency groups. In the T2DM group, IL-1β, IL-6, IL-8, TNF-α, NF-κB, MAPK and CRP were significantly higher in those with Vit D insufficiency and deficiency. Our study emphasizes the pro-inflammatory effects of Vit D deficiency and insufficiency in new-onset type 2 diabetes mellitus and prediabetes.

This study aimed to reveal the perceptions and conspiracy theories surrounding the new coronavirus infection. We aimed to explore associations between COVID-19 conspiracy beliefs with recommended health protective attitudes and sociodemographic features among the Turkish population. A questionnaire consisting of seven items about COVID-19 conspiracy theories and perceptions and ten items about attitudes was given to patients and their relatives in five different centres during the second national lockdown in Istanbul. A chi-square test was used to evaluate the associations of disease perceptions and conspiracy beliefs with sociodemographic features and with health protective attitudes. Logistic regression analysis was performed for significant results. Of 483 participants, 242 (50.1%) were found to have a conspiracy belief. Conspiracy theories were more frequent in the participants who were older than 50 years of age ( p = 0.009) (OR: 1.83) and less frequent in higher education levels ( p = 0.005) (OR: 0.499). In addition, 6.6% of the participants were infected with COVID-19, but having the infection was found to have no effect on disease perceptions or conspiracy beliefs. Wearing a mask in crowds, avoiding shaking hands and kissing, and washing hands were less frequent among conspiracy believers and participants with impaired perceptions. These results indicate that misconceptions and conspiracy beliefs are driving the adoption of disinformation about the prevention of COVID-19 infection.

Aim: Oral and dental heath are important aspects of general health and impact the quality of life and well-being. In this study, we aimed to assess the level of knowledge and attitudes towards oral and dental health and to examine the relative effect of social-behavioural risk factors on caries and other teeth problems among seventh and eighth grade students., Methods: Study Design: The study population consisted of all seventh and eighth graders who started the 2011 school year in Sarigol village of the Manisa city, Turkey (n = 377). Data were gathered by questionnaires which were carried out before tooth examination. Associations between sociodemographic characteristics, knowledge items, attitudinal factors and number of dental caries, dental fillings and teeth loss were studied., Results: Oral health was worse among females (p=0.002). As the number of children under care increased in the house, the number of dental filling and teeth loss increased in the students (p= 0.001 and p=0.021). Education of mothers of students who had worse dental health was significantly lower compared to the others (p=0.029). Among students who had four and more dental caries and dental fillings, frequency of dentist visit was lower (p= 0.034 and p= 0.005). Among students who had more dental caries, the knowledge that consumption of acidic beverages is not good for oral health was less prevalent (p=0.011)., Statistics: Associations between sociodemographic characteristics, knowledge items, attitudinal factors and number of dental caries, dental fillings and teeth loss were studied using chi-square test., Conclusions: Health authorities should strengthen the implementation of oral disease prevention and oral health promotion programs rather than traditional curative care. Community-oriented education programs for students and their families are crucial for this purpose.

Background: The hyperglycemia-induced oxidative stress in diabetes mellitus (DM) is the major factor in the pathogenesis of cardiovascular complications. The phenolic compounds are potent antioxidants that can reverse the factors leading to cardiovascular complications in DM. The aim of this study was to determine the antagonizing effects of a polyphenol-rich antioxidant supplement containing pomegranate extract, green tea extract, and ascorbic acid, on oxidative stress in Type 2 diabetic patients., Materials and Methods: A total of 114 male and female non-smokers (56 study, 58 placebo) with Type 2 DM and without any complications were recruited. The blood levels of fasting blood glucose, glycated hemoglobin, LDL, HDL, triglycerides, plasma malondialdehyde (MDA), total glutathione (GSH), hydrogen peroxide, and antioxidant capacity (AOC) were determined at the beginning and at the end of the 3-month trial. The differences of the data changes between the groups were statistically analyzed by Mann-Whitney U test., Results: The study group showed a decrease in LDL and an increase in HDL and the comparison with the difference in placebo group was statistically significant (p<0.001 for LDL and p<0.001 for HDL). Accordingly, as a by-product of lipid peroxidation, plasma MDA was decreased in the study group compared to the placebo group (p<0.001). As an indicator of increased antioxidant defense, total plasma GSH and AOC increased more in the study group compared to control group (p<0.001)., Conclusions: These observations indicated that the polyphenol-rich antioxidant supplement containing pomegranate extract, green tea extract, and ascorbic acid has important antagonizing effects on oxidative stress and lipid peroxidation in patients with Type 2 DM and might be beneficial in preventing cardiovascular complications.

Most of the previous studies have shown a significant inverse relationship between smoking during pregnancy and weight, height and head circumference of infants at birth, but there is limited literature that assesses the head circumference measures of infants of smoker mothers in postnatal follow-up. The aim of this study was to assess the effects of maternal smoking and passive smoking during pregnancy on postnatal anthropometric measures of infants. Infants were divided into 3 groups: infants of smokers (n = 48), passive smokers (n = 57) and nonsmokers (n = 54), and were evaluated for their weight, height and head circumference at birth, 3 months and 6 months of age. Infants of smokers showed significant weight and head circumference deficits at birth compared to nonsmokers' infants (p < 0.05 and p < 0.001, respectively). At 6 months of age, infants of smokers continued to show significant deficits in all 3 measures compared to nonsmokers' infants (p < 0.001 for each), and infants of passive smokers showed only marginal decreases. Moreover, the weight and height growth velocities of the smokers' infants remained deficient, whereas their growth velocity of the head circumferences increased from birth up to 6 months and reached the growth velocity of the nonsmokers' infants. Infants of passive smokers showed a complete catch-up growth at 6 months. This study indicates that smoking during pregnancy results in serious deficits in infants' growth even after birth. Therefore, it is essential to inform smoker women before pregnancy the possible growth retardation of infants.