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https://hdl.handle.net/20.500.12684/6746

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Evaluation of false negativity of the Widal test among culture proven typhoid fever cases
(J Infection Developing Countries, 2008) Hoşoğlu, Salih; Boşnak, Vuslat; Akalın, Şerife; Geyik, Mehmet Faruk; Ayaz, Celal
Background: The Widal test is the most common, specific and quick diagnostic method available in the world for diagnosis of typhoid fever; however, false negativity is one of the obstructive features of the test. The aim of this study was to evaluate the associated factors with Widal test negativity in an endemic area. Methods: Widal test negativity was retrospectively analyzed among culture-proven typhoid fever cases. The potential features including age, gender, previous antibiotic usage, duration of symptoms, leucopoenia, hematocrit value, and erythrocyte sedimentation rate (ESR) were evaluated for association with Widal test negativity. Results: A total of 166 culture-proven typhoid fever cases (93 or 56.0% males) were included in the study. The mean age +/- SD was 23.3 +/- 10.6 years. Mean time of interval between first symptom and test performance time was 10.6 +/- 7.8 days. The Widal test (STO and/or STH) was found positive in 75 cases (45.2%). The statistical analyses revealed that none of these variables were significant for false negativity of the Widal test. Age was found to be a possible factor for a false negative Widal test (p=0.06). Conclusion: Of existing compatible clinical findings, age should be considered in cases of Widal test negativity.
Bir Üniversite Hastanesi Çocuk Ergen Ruh Sağlığı ve Hastalıkları Birimi’ne Başvuran Hastaların Sağlık Kurulu Raporlarının Değerlendirilmesi
(Duzce Univ, 2017) Yektaş, Çiğdem; Kaplan, Sümeyra Elif
Aim: In this study, we aimed to investigate sociodemographic and clinical characteristics of children and adolescents applied to a university of child and adolescent psychiatry unit and referred to the Disability Health Committee. This study results were also aimed to contribute to the previous studies about child and adolescent psychiatry disabilities. Methods: 352 children and adolescents applied to Duzce University Department of Child and Adolescent Psychiatry and referred to University Disability Health Committee between December 2016-2017 were analyzed retrospectively. Results: 58% (n=204) of patient group were female and 42% (n=148) were male. The mean age was 7.63 +/- 4.45. 38.1 % (134) of the cases were in the range of 0-6 years of age, 46 % (162) of the cases were in the range of 7-12 years of age and 15.6 % (55) of the cases were in the range of 13-28 years of age. The most common reasons for admission were special educational needs due to developmental delays and academic problems. (% 74,7 n=263) and health status report for homecare-payment and salary (% 25,3 n=89). The most common clinical diagnoses were mental retardation and developmental delay (% 36,1 n=127), learning disorder (% 20,2 n=71) and pervasive developmental disorders (% 11,1 n=39) respectively. Conclusion: In pediatric population early diagnoses of developmental delays, autism spectrum disorders and learning disorders and developing medical and educational strategies would help to reduce disability ratios and also enhance academic and social functionality of children.
Düzce Üniversitesi Tıp Fakültesi Öğrencilerinin Sigara İçme Sıklığı Ve Sigara İle İlgili Bilgi Tutum Ve Davranışları
(Duzce Univ, 2017) Sönmez, Cemil Işık; Başer, Duygu Ayhan; Aydoğan, Sevil
Objective: An active, faithful and continuous support of health providers plays essential role in reducing the smoking rates. Studies prove that smoking rates are most successfully reduced in countries where the smoking rates of physicians are the lowest. In this study, we aimed to investigate the smoking prevalence, the knowledge, attitude and associated risk factors of smoking among the term I and VI students of Duzce University School of Medicine. Methods: This study is a cross-sectional descriptive study that is composed of 198 medical students studying during the 2016-2017 academic year. The questionnaire determined students' smoking habits, knowledge on smoking cessation policies and questioned about the current status of smoking cessation education in medical faculties. Results: The rate of smokers was 18.26% in term I students and 21.27% in term VI. Most of the smokers (61.7% (n: 29)) were smoking before the faculty; the rest of them (36.2% (n: 17)) had started smoking at the medical faculty. A significant relationship was found between smoking and advanced class, smoking permission in the living environment, and smoking among friends. Conclusion: The most important finding of our study was that there is a certain percentage of smokers among the students of medical faculty, and these rates increase within time, from the class I to the class VI. The other important point that was noticed in our study was that medical students were not properly acknowledged during medical education about smoking and its harm, and also the students were not properly aware of mission of smoking cessation policlinics.
Evaluation of Knowledge of Traditional and Complementary Medicine of Medical School Students
(Duzce Univ, 2018) Sönmez, Cemil Işık; Başer, Duygu Ayhan; Küçükdağ, Hüseyin N.; Kayar, Okan; Acar, İdris; Güner, Pınar Döner
Objective: Nowadays, many individuals in the community apply complementary and alternative medicine (CAM) for treatment purposes, protective purposes as well as culturally traditional purposes. It is necessary that the physicians who are primarily responsible for the prevention of human health, should be substantially practitioners of traditional and complementary medicine as well as modern medicine. We aimed to evaluate the knowledge, attitudes and behaviors of medical faculty students about CAM practices in this study. Therefore study is planned to contribute to the organising of CAM in the curriculum of medical education. Methods: This descriptive study was carried out between April 2018 and June 2018. Students of Term I, II, III, IV, V and VI of Diizce University Faculty of Medicine were included to the study. A questionnaire with 22 questions was administered to 276 volunteer students (183 female, 93 male) except unreacheable and non-volunteer students by internet. Results: The most commonly known CAM methods among the medical faculty students; acupuncture (77.5%), cup application (75.3%), phytotherapy (67.3%); the most commonly used methods are phytotherapy (33,3%) and cup method (11,5%). When questioned about the information source of CAM; 31.8% (n: 85) had learned information regarding CAM at the medical school education. And 94.2% (n = 242) of students thought that there was not enough education regarding practice of CAM at the medical faculties. 82.6% of the participants (n: 218) believed that CAM practice should be integrated into modern medicine and performed by physicians. Conclusion: In our study, medical faculty students' knowledge levels about CAM practices were not sufficient and they mostly had not been learned at the medical faculty. But it was determined that the students want this information to be included in medical education and to be used as integrated with modern medicine. Gap about this subjects will be filled with arrangements which will be made in the medical faculty curriculum and CAM trainings for both community and medical students.
Evaluation of left ventricular systolic asynchrony in patients with subclinical hypothyroidism
(Via Medica, 2012) Öztürk, Serkan; Alçelik, Aytekin; Özyaşar, Mehmet; Dikbaş, Oğuz; Ayhan, Selim; Özlü, Fatih; Yazıcı, Mehmet
Background: The heart was very sensitive to fluctuating thyroid hormone levels. To assess intra-left ventricular (LV) systolic asynchrony in patients with subclinical thyroid dysfunction. Methods: Fifty patients with subclinical hypothyroidism and 40 controls were included. A diagnosis of subclinical hypothyroidism was reached with increased TSH and normal free T4. All subjects were evaluated by echocardiography. Evaluation of intra-LV systolic asynchrony was performed by tissue synchronization imaging (TSI), and four TSI parameters of systolic asynchrony were calculated. LV asynchrony was defined by these parameters. Results: All of the groups were similar in terms of demographic findings and conventional and Doppler echocardiograpic parameters except peak systolic velocity and early diastolic velocity. LV systolic asynchrony parameters of TSI including; standard deviation of Ts of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any 2 of the 12 LV segments (Ts-12), standard deviation of TS of the 6 basal LV segments (Ts-SD-6), maximal difference in Ts between any of the 6 basal LV segments (Ts-6) were significantly lengthened in patients with subclinical hypothyroidism than controls (p < 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). The prevalence of LV asynchrony was significantly higher in patients with subclinical hypothyroidism than control. Conclusions: Patients with subclinical hypothyroidism present evidence of LV asynchrony by TSI. LV systolic asynchrony could be a warning sign of the early stage in cardiac systolic dysfunction in subclinical hypothyroid patients. (Cardiol J 2012; 19, 4: 374-380)
Evaluation of left atrial mechanical functions and atrial conduction abnormalities in patients with clinical hypothyroid
(Via Medica, 2012) Öztürk, Serkan; Dikbaş, Oğuz; Özyaşar, Mehmet; Ayhan, Selim; Özlü, Fatih; Baltacı, Davut; Yazıcı, Mehmet
Background: The aim of this study was to investigate left atrial (LA) mechanical functions, atrial electromechanical delay and P wave dispersion in hypothyroid patients. Methods: Thirty-four patients with overt hypothyroid and thirty controls were included. A diagnosis of overt hypothyroid was reached with increased serum TSH and decreased free T4 (fT4) levels. LA volumes were measured using the biplane area length method and LA active and passive emptying volumes and fraction were calculated. Intra- and interatrial electromechanical delay (EMD) were measured by tissue Doppler imaging (TDI). P wave dispersion was calculated by 12 lead electrocardiograms. Results: LA diameter were significantly higher in patients with overt hypothyroid (p = 0.021). LA passive emptying volume and LA passive emptying fraction were significantly decreased with hypothyroid patients (p = 0.002 and p < 0.001). LA active emptying volume and LA active emptying fraction were significantly increased with hypothyroid patients (p < 0.001 and p < 0.001). Infra- and interatrial EMD, were measured significantly higher in hypothyroid patients (30.6 +/- 6.1 vs 18.0 +/- 2.7, p < 0.001; and 10.6 +/- 3.4 vs 6.9 +/- 1.4, p < 0.001, respectively). P wave dispersion were significantly higher in hypothyroid patients (48.8 +/- 6.2 vs 44.3 +/- 7.2, p = 0.022). In stepwise regression analysis demonstrated that, interatrial EMD and LA active emptying fraction related with TSH and fT4. Conclusions: This study showed that impaired LA mechanical and electromechanical function in hypothyroid patients. TSH and T4 were independent determinant of interatrial EMD and LA active emptying fraction. (Cardiol J 2012; 19, 3: 287-294)
Evaluation of Karyotype Composition of Our Turner Syndrome Patients with Their Application Complaints and Anthropometric
(Duzce Univ, 2018) Doğan, Mustafa; Eröz, Recep; Bolu, Semih; Yüce, Hüseyin
Objective: Turner syndrome (TS) is the result of partial or complete loss of the second X chromosome in women or structural anomalies of the X chromosome, and is characterized by clinical manifestations such as short stature, lymphedema, cardiac anomalies, primer over failure and neurocognitive problems. We have presented our patients with Turner syndrome together with the reasons for application complaints and anthropometric datas with karyotype compositions for contribution to the literature. Method: DNA was isolated from the peripheral blood samples and chromosome analysis were performed in the patients who were thoought to be Turner Syndrome at Duzce University Medical Faculty Medical Genetics Department. Twenty patients who were compatible with Turner's syndrome were included in the study. The complaints, height, weight, BMI (body mass index) values of each case included in the study were noted. Results: According to the results of cytogenetic analysis in our study, it was detected that 9 patients were 45, X (45%), 1 patient was 46, X, der(X), t(X,X)(p.11.2;q22)/45,X (%5), 1 patient was 45, X/46, X,del(X)(p.11.2) (%5), 1 patient was 45, X/47,XXX (%5), 4 patients were 45, X/46,XX (%20), 2 patients were 46,X,i(X)(q10)/45,X (%10), 1 patient was 46,X,i(X)(q10) (%5), 1 patient was 46, X, del(X)(p21) (% 5) chromosomal composition. Conclusion: Patients with TS show different karyotype compositions, which cause different clinical manifestations in patients. The "45, X" karyotype was found to be significantly higher than other chromosomal compositions, and the most common complaint in our patient group was short stature of 60%. Karyotype analysis is important for early diagnosis and early treatment in patients being followed up with short stature etiology. Patients should be followed up with a multidisciplinary team approach on a regular basis
Evaluation of serum Vitamin B12 level and related nutritional status among apparently healthy obese female individuals
(Medknow Publications & Media Pvt Ltd, 2017) Baltacı, Davut; Deler, Mehmet Harun; Türker, Yasin; Ermiş, Fatih; Iliev, Darko; Velioğlu, Usame
Objective: Obesity is a major public health problem and great risk for not only cardiovascular diseases but also cancer, musculoskeletal, and gynecological diseases. This study was aimed to investigate the association between serum Vitamin B12 (vitB12), body mass index (BMI), and nutritional status among obese women. Methods: This cross-sectional study enrolled consecutive female subjects. The consumptions of red meat, fish, bovine liver, egg, and mushroom were recorded. According to the Dietary Reference Intakes, the patients were categorized as insufficiency and sufficiency. Three cutoff points were defined for vitB12 status: (1) Deficiency if vitB12 is < 200 pg/mL; (2) insufficiency if vitB12 is 250-350 pg/mL, and (3) sufficient if vitB12 is >= 350 pg/mL. According to BMI, the patients were assigned to nonobese and obese groups. BMI, serum vitB12 level, consumptions of red meat, fish, bovine liver, egg, and mushroom were evaluated and compared between two groups. Results: Mean level of vitB12 was 247.8 +/- 10.4 pg/mL and significantly associated with consumption of egg (P = 0.031), bovine liver (P = 0.004), mushroom (P = 0.040), and red meat (P = 0.003). VitB12 was significantly higher in nonobese than obese group (282.5 +/- 106.8 vs. 242.5 +/- 107.5 pg/mL, P = 0.001). The ratio of vitB12 deficiency was significantly higher in obese than nonobese group (37.6% vs. 24.7%; P = 0.019). VitB12 level was negatively correlated with BMI (r = -0.155; P < 0.001), but not insulin resistance (r = -0.172; P = 0.062). Conclusion: Obesity was associated with low level of vitB12 in obese women, and more likely to be vitB12 deficient. Consumption of certain types of food contributes to increase vitB12 level.
Evaluation of smoking cessation practice by physicians for hospitalized patients in a tertiary hospital
(Pakistan Medical Assoc, 2016) Baltacı, Davut; Aydın, Leyla Yılmaz; Alaşan, Fatih; Deler, Mehmet Harun; Karaçam, Mehmet Serkan; Türker, Yasemin; Sarıgüzel, Feyza
Objective: To investigate physicians' smoking cessation practice, consultation for smoking intervention for hospitalised patients and its determinants. Methods: The cross-sectional study was conducted at Duzce University Hospital, Duzce, Turkey, from January to April 2013, and comprised hospitalised patients. The survey, including smoking habits and 5As (Ask, Advise, Assess, Assist and Arrange) steps of smoking intervention practiced by physicians was applied to those patients discharged from the hospital. SPSS 20 was used for statistical analysis. Results: Of the 502(31.6%) participants, 264(52.6%) were women and 238(47.4%) were men. The overall mean age was 52.8 +/- 18.2 years. Besides, 269(53.6%) respondents were at the level of elementary school education; 289(57.6%) had chronic disease; 119(23.7%) were current and 106(21.1%) were former smokers. The frequency of current smokers among men with chronic disease was significantly lower compared to those who did not have chronic disease (p = 0.017). In women, the factor was insignificant (p = 0.642). The physicians practiced the steps of "Ask, Advise, Assess, Assist and Arrange" on 354(70.5%), 240(47.9%), 194(38.7%), 88(17.6%) and 29(5.8%) patients for active smoking. Consultation during hospitalization significantly increased patient's effort to quit smoking after discharge (p = 0.012). Conclusion: Smoking intervention by physicians for hospitalised patients was associated with the status of patient's gender, education level and chronic disease.
Evaluation of Psychometric Properties of the Internet Addiction Scale in a Sample of Turkish High School Students
(Mary Ann Liebert Inc, 2010) Canan, Fatih; Ataoğlu, Ahmet; Nichols, Laura A.; Yıldırım, Tuba; Öztürk, Önder
The Internet Addiction Scale (IAS) is a self-report instrument based on the seven substance dependence criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed., American Psychiatric Association, 1994) and two additional criteria recommended by Griffiths. The IAS was administered to 300 high school students along with the Beck Depression Inventory (BDI) and Submissive Acts Scale (SAS). For test-retest reliability, the IAS was administered a second time 7 days after the first administration. An interitem reliability reduced the initial scale from 31 to 27 items (with Cronbach's alpha of 0.94). The factor analysis suggests the existence mainly of one factor in the IAS. Correlation analyses indicated that BDI and SAS were significantly correlated positively with the IAS. One-week test-retest correlation for the IAS was highly significant. According to these results, the psychometric properties of the IAS are promising.
Evaluation of platelet parameters and neutrophil/lymphocyte ratio during omalizumab treatment in patients with severe chronic spontaneous urticaria
(Tubitak Scientific & Technical Research Council Turkey, 2018) Ertaş, Ragıp; Özyurt, Kemal; Karakükçü, Çiğdem; Akkuş, Muhammet Reşat; Özlü, Emin; Avcı, Atıl; Atasoy, Mustafa
Background/aim: Spontaneous wheals and/or angioedema lasting longer than six weeks are described as chronic spontaneous urticaria (CSU). Omalizumab is used for the treatment of antihistamine-resistant CSU. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) are considered important indicators of inflammation and platelet activation in chronic diseases. We aimed to determine the NLR, PLR, MPV, and PDW levels in patients with CSU compared with healthy controls. We also aimed to investigate the effects of omalizumab therapy on these parameters in CSU patients. Materials and methods: This hospital-based, retrospective study included 143 patients with CSU and 132 healthy controls with a mean age of 40.0 +/- 13.17 and 42.0 +/- 16.34, respectively. Patients with equal or higher-than-baseline UAS scores at week 12 of omalizumab treatment were considered nonresponders, others were considered responders. We analyzed the neutrophils, lymphocytes, platelet counts, NLR, PLR, MPV, and PDW before, during, and after omalizumab treatment and compared the results with those of healthy controls. Results: CSU patients presented higher baseline MPV (P = 0.035) and lower baseline PDW values (P < 0.001) than healthy controls. There were statistically significant increases in the MPV (P < 0.001), MPV/platelet count (P = 0.005), and PDW (P = 0.003) and there was a statistically significant decrease in the NLR (P = 0.018) during omalizumab treatment. The percent increase of MPV was low in nonresponders (P = 0.009). Nonresponders had lower PDW values than responders (P = 0.040). Conclusion: The increase in the MPV and PDW may be due to platelet activation during omalizumab treatment. The decrease in the NLR may be regarded as an antiinflammatory effect of omalizumab. The effect of omalizumab on platelet and inflammatory markers may be used to discriminate the responders from nonresponders.
Tüberkülozlu hastalar, yakın temaslıları, sağlık çalışanları ve tüberküloz laboratuvarı personelinde Quantıferon-TB gold ve tüberkülin cilt testinin değerlendirilmesi
(Ankara Microbiology Soc, 2010) Cesur, Salih; Hoca, Nevin Taci; Tarhan, Gülnur; Çimen, Filiz; Ceyhan, İsmail; Annakkaya, Ali Nihat; Birengel, Serhat
Tüberkülin cilt testi (TCT), uzun bir süredir duyarlılık ve özgüllük değerlerindeki sınırlamalara rağmen etkin bir şekilde kullanılmaktadır. Aktif tüberkülozu olmaksızın TCT pozitif olan hastalar, latent tüberküloz enfeksiyonu (LTBE) olarak tanımlanır. LTBE olan hastaların TCT ile tanımlanması, hastalığın kontrolünde önemli bir aşamadır. Plazma interferon gamma (IFN-γ) düzeyini belirleyen Quantiferon-TB Gold Testi (QTG, Cellestis, Austuralya) latent tüberküloz (TB) enfeksiyonu tanısında TCT’ye göre avantajları olan in vitro tanısal bir testtir. Bu test Mycobacterium tuberculosis’e özgül ESAT-6 ve CFP-10 antijenlerini içerir. Bu çalışmanın amacı, TB’li hastalar, yakın temaslıları, sağlık çalışanları ve TB laboratuvarı personelinde QTG ve TCT testi sonuçlarının karşılaştırılmasıdır. Çalışmaya, 26 aktif akciğer TB’li hasta, 6 hasta yakını, 11 hasta teması olan sağlık çalışanı ve 8 TB laboratuvarı personeli dahil edilmiştir. TCT uygulanmadan önce QTG testi için kan örnekleri alınmıştır. Tüm bireyler BCG aşılaması yönünden sorgulanmış ve BCG skarı yönünden incelenmiştir. Çalışmaya katılanların tümünde BCG aşılaması öyküsü ve muayenede BCG skarı tespit edilmiştir. QTG testi plazma örneklerinde üretici firmanın önerileri doğrultusunda çalışılmıştır. TCT ile QTG testi arasındaki uyum kappa istatistiği ile ölçülmüştür. Aktif TB’li hastalarda (gerçek enfekte bireyler) TCT (PPD) pozitifliği %34.6 (9/26), QTG pozitifliği %65.3 (17/26) olarak belirlenmiş; pozitiflik oranı QTG testinde daha yüksek tespit edilmiş olmasına rağmen aradaki fark istatistiksel olarak anlamlı bulunmamıştır (p> 0.001). Diğer çalışma gruplarına bakıldığında; sağlık çalışanları, TB’li hastanın yakın temaslıları ve TB laboratuvarı çalışanlarında TCT ve QTG pozitiflik oranları sırasıyla; %36 (4/11) ve %27 (3/11); %16.6 (1/6) ve %83 (5/6); %37.5 (3/8) ve %75 (6/8) olarak tespit edilmiştir. PPD testi sonucu, QTG negatif grupta ortalama 11 mm iken, QTG pozitif grupta ortalama 14 mm olarak saptanmış ve aradaki fark istatistiksel olarak anlamlı bulunmuştur (p< 0.001). QTG pozitif ve negatif gruplar arasında yaş (p≥ 0.05) ve cinsiyet (p< 0.001) yönünden istatistiksel olarak anlamlı farklılık saptanmamıştır. QTG testi, latent ve aktif TB enfeksiyonunu saptamada BCG aşısından etkilenmemesi, TB dışı (atipik) mikobakterilere bağlı yanıtları ayırt etmesi ve TCT’nin uygulanması ve değerlendirilmesiyle ilişkili değişkenlik ve birey- sel farklılıklardan etkilenmemesi nedeniyle TCT’den üstündür. Ayrıca, QTG testinin değerlendirilmesi için hastanın sağlık merkezine tekrar gelme zorunluluğu olmaması ve sonuçların daha erken alınabilmesi de avantajları arasındadır. Buna karşın TCT’den daha pahalı olması, test için özel ekipmanlara ve iyi yetişmiş laboratuvar personeline gereksinim duyulması, QTG testinin dezavantajları arasında sayılabilir.
Evaluation of patient satisfaction with family physicians after implementation of family medicine in Turkey
(Drunpp-Sarajevo, 2012) Baltacı, Davut; Celesun, Tahsin; Eröz, Recep; Sarıtaş, Ayhan; Çeler, Ahmet; Muşlu, Cemil; Kara, İsmail Hamdi
Patient's satisfaction is a desired out-come measure of quality of health care. It is direct feedback measurement and easy method. We aimed to evaluate level of patient's satisfaction with family physician after family medicine implementation at primary care settings in Turkey. This cross-sectional study was conducted in Turkey between January and May 2011 in 45 family medicine offices. The self-administered study survey including EURO-PEP tool was delivered with hand-out by researchers who were not family physicians to patients admitted to family health center. They were collected in closed-box. 1500 surveys were distributed. 1112 surveys were returned. Response rate was 74.13%. Of them, 54% (601) was female and 46% (511) was male. Mean age was 36.1+/-13.9 years-old. Overall rate of patient satisfaction was 70.9%. Rate for high satisfaction level (good-excellent) ranked between 53.5% and 82.4%. Item of" listening to patients" was rated by patients as highest satisfaction (82.4%). Item related with accessibility to physicians on phone was rated as lowest satisfaction (53.5%) by patients. Level of patient satisfaction with clinical behavior was considerably better than health care organization. In conclusion, the study showed that level of patient satisfaction was relatively high, especially with clinical behavior. The patients were less satisfied with health care organization, particularly with accessibility to physicians via phone and waiting time. We observed that patient satisfaction was improved, compared to before implementation of family medicine, and additionally lower than north European countries, but similar with some of the south European ones.
Evaluation of post-graduate training effect on smoking cessation practice and attitudes of family physicians towards tobacco control
(E-Century Publishing Corp, 2014) Türker, Yasemin; Aydın, Leyla Yılmaz; Baltacı, Davut; Erdem, Özgür; Tanrıverdi, Mehmet Halis; Sarıgüzel, Yunus Cem; Alaşan, Fatih
Objective: Family physicians (FPs) are cornerstone for tobacco control. It was aimed to compare the effect of training on their smoking cessation practice, knowledge level and attitudes towards smoking and tobacco control. Methods and materials: The cross-sectional and multi-centered study was carried out using structured survey modified WHO based questionnaire. It was delivered to 1500 FPs randomly selected among approximately 23000 family physicians across the country. The study survey was self-reported by FPs, assessing their knowledge, attitudes, status of post-graduate training, and practice about tobacco control. Participants were assigned into two groups as non-trainee groups (Group 1) and post-graduate trainee (Group 2). Results: The mean age was 38.4 +/- 7.1 years-old. The percentage of male and female FPs in the study was 53.1% and 46.9%. The ratio of family physicians who participated in training program Group 2) was 26.5% (n = 327). The ratio of female FPs who participated the SCP training course was significantly higher than that of male FPs (27.3% versus 22.5%, p = 0.035). There was no significant difference for smoking status between groups (p = 0.686). When the number FPs whose consulted by the smokers over = 5 a week was compared, the ratio of FPs was significantly higher in group 2 than group 1 (p < 0.001), but overall ratio of FPs (2.8%) who consulted within a week smokers was considerably lower Statements of Competence and confidence items stated by all FPs were 24.2% and 32.2%, respectively. Physicians who had attended post-graduate training on SCP were more competent and confident, compared to non-trained FPs (p = 0.002 and p = 0.001). Conclusion: Post-graduate training on tobacco control improved self-confidence and competence of FPs. With post-graduate training, significant improvement was seen in practical skills of physicians. A continuing training program should be introduced to FPs, to engage them for smoking cessation practice.
Evaluation of outer hair cell function and medial olivocochlear efferent system in patients with type II diabetes mellitus
(Tubitak Scientific & Technical Research Council Turkey, 2014) Karabulut, Hayriye; Karabulut, İsmail; Dağlı, Muharrem; Bayazıt, Yıldırım Ahmet; Bilen, Şule; Aydın, Yusuf; Bayramoğlu, İsmet
Aim: This study was designed to investigate the function of outer hair cells and medial olivocochlear efferents in type II diabetes mellitus (DM). Materials and methods: There were 50 patients with type II DM and 51 age-and sex-matched healthy controls included in the study. Both groups were compared in terms of transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), and contralateral suppression of TEOAE. Results: Pure tone thresholds of the patients with type II DM were significantly higher than in the controls (P < 0.05). The TEOAE amplitudes at 1 kHz and at 1.5, 2, 3, 4, and 6 kHz signal-to-noise ratio amplitudes on DPOAE testing were significantly lower in the patients than controls (P < 0.05). There was no significant difference between the type II DM and control groups regarding contralateral suppression test results of TEOAEs. Conclusion: Type II DM seems to impact the auditory system at the cochlear level by affecting the functions of outer hair cells, and it results in elevation of the thresholds on audiometry and a decrease in the amplitudes of otoacoustic emissions.
Evaluation of ocular findings in patients with lichen planus
(Termedia Publishing House Ltd, 2019) Özlü, Emin; Teberik, Kuddusi
Introduction: Lichen planus (LP) is a chronic, inflammatory disease of unknown etiology. Aim: To evaluate the tear functions and the retinal and choroidal thickness (CT) in patients with LP. Material and methods: In total, 33 patients and 30 healthy controls were enrolled. All participants were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer 1 test (with anesthesia), tear break-up time (TBUT) test, intraocular pressure (IOP), axial length (AL), and central corneal thickness (CCT). The measurements of retinal thickness (RT) and CT were obtained by spectral domain optical coherence tomography. Results: No significant difference was observed between the groups in IOP, AL, CCT, or RT (p > 0.05 in each group). There was a significant difference in the Schirmer 1 test, TBUT, and OSDI questionnaire (p < 0.05 in each group). Choroidal thickness in LP patients was thinner than that in the controls (p = 0.001 in each location). There was a moderate negative correlation between the disease duration and Schirmer 1 test, TBUT, and subfoveal CT (r = -0.426, r = -0.555, r = -0.637; p = 0.001, p = 0.001, p = 0.001, respectively). There was a moderate negative correlation between the oral mucosal involvement and Schirmer 1 test, TBUT, and subfoveal CT (r = -0.345, r = -0.392, r = -0.467; p = 0.006, p = 0.001, p = 0.001, respectively). There was a positive correlation between disease duration, oral mucosal involvement and OSDI score (r = 0.717, r = 0.345; p = 0.001, p = 0.006, respectively). Conclusions: Lichen planus may influence tear function tests and may cause dry eye. Patients with LP had lower CT values than healthy controls. Further studies are needed to clarify the effect of LP on the eyes.
Evaulation of atrial conduction abnormalities and left atrial mechanical functions in patients with subclinical thyroid disorders
(Via Medica, 2012) Öztürk, Serkan; Dikbaş, Oğuz; Baltacı, Davut; Özyaşar, Mehmet; Erdem, Alim; Ayhan, Selim Suzi; Yazıcı, Mehmet
Introduction: Changes of thyroid hormones levels may lead to effects, not only in ventricular function, but also atrial function. The aim of this study was to investigate left atrial (LA) mechanical functions, atrial electromechanical coupling and P wave dispersion in patients with subclinical thyroid disorders. Material and methods: Eighty patients with subclinical thyroid disorders and forty controls were included. A diagnosis of subclinical thyroid disorders were reached with increased or decreased serum TSH and normal free T4 (fT4) levels. LA volumes were measured using the biplane area length method and LA active and passive emptying volumes and fraction were calculated. Intra- and interatrial electromechanical delay were measured by tissue Doppler imaging (TDI). Results: All groups had similar demographic findings. LA mechanical functions significantly impaired in subclinical thyroid disorders than control group. Intra- and Interatrial delay, were measured significantly higher in patients with subclinical thyroid disorders than control group. PA lateral and interatrial delay were positively correlated with TSH (r = 0.507, p = 0.006 and r = 0.455, p = 0.015, respectively) in subclinical hypothyroid patients. There was negative correlation between TSH and interatrial delay (r = -0.492,p = 0.006) in subclinical hyperthyroid patients. Linear multivariate regression analysis demonstrated that, TSH was the only an independent factor of interatrial delay in patients with subclinical thyroid disorders. Conclusions: This study showed that impaired LA mechanical and electromechanical function in subclinical thyroid disorders. TSH was an independent determinant of interatrial delay. Prolonged atrial electromechanical coupling time and impaired mechanical atrial functions may be related to the increased incidence of arrhythmias. (Endokrynol Pol 2012; 63 (4): 286-293)
Evidence for a complex risk profile in obese postmenopausal Turkish women with hypertriglyceridaemia and elevated apolipoprotein B
(Portland Press Ltd, 2004) Onat, Altan; Yazıcı, Mehmet; Can, Günay; Sniderman, Allan
The aim of the present study was to examine possible pathophysiological relationships among a wide array of proatherogenic risk factors in postmenopausal women. Fasting lipids, apoB (apolipoprotein B), BMI (body mass index) and waist circumference were measured in 178 women (59.4 +/- 7.2 years) from the Turkish Adult Risk Factor Study. Fasting levels of complement C3, insulin, SHBG (sex hormone-binding globulin), cortisol, oestradiol, testosterone and DHEA-S (dehydroepiandrosterone sulphate) were also determined. This is the first study to examine the relationships of all these variables with apoB. In the first of two different approaches, three groups of obese women were compared. Group 1 comprised women who were normolipidaemic with normal apoB; group 2, women who were hypertriglyceridaemic, but with normal apoB; and group 3, women who were hypertriglyceridaemic with elevated apoB. Complement C3, fasting insulin and glucose were significantly higher and HDL-C (high-density lipoprotein-cholesterol) and SHBG levels were significantly lower in group 3 than in group 1. In the former group, the testosterone/SHBG ratio tended to be higher, indicating more free testosterone, than in group 1. The mean risk score in group 3 and the odds ratio for coronary disease by logistic regression analysis were significantly higher, 2.56 (confidence intervals, 1.12-5.85; P = 0.026), compared with the two other groups combined. In examining the whole group, apoB levels correlated significantly with a wider array of pro-atherogenic risk factors than did LDL-C (low-density lipoprotein-cholesterol), particularly being linked to complement C3 and glucose, as well as the risk score. Complement C3 demonstrated the widest associations and was significantly linked with BMI, waist circumference, insulin, glucose, fibrinogen, triacylglycerols (triglycerides) and apoB and was inversely correlated with HDL-C and SHBG. SHBG was also correlated inversely with a wide spectrum of risk variables. In summary, in Turkish women, apoB was linked with a complex array of proatherogenic risk factors, and hypertriglyceridaemia with elevated apoB was associated with a higher risk of coronary disease.
Evaluation of Thyroid Ultrasound and Thyroid Hormone Levels in Obese Patients who applied to the Outpatient Clinic of Family Medicine
(Duzce Univ, 2016) Yılmaz, Aylin; Kara, İsmail Hamdi; Baltacı, Davut; Çeler, Hesna; Hakan, Leziz; Güçlü, Derya; Memişoğulları, Ramazan
Objective: In the present study, we aimed to evaluate obesity in terms of its effect on thyroid function and morphology. Methods: We included 327 consecutive obese patients (mean age 41.0 +/- 11.6) who applied to the Department of Family Medicine Obesity and Check-up Polyclinic of Dzce University School of Medicine and had an ultrasound scan (USG) between the months January to July 2012. Cases were classified as patients with obesity (n=130), patients with Type 2 Diabetes mellitus (DM) (n=27) and patients with Metabolic Syndrome (METS) (n=170). USG findings, as well as hematological, biochemical and hormonal parameters, were compared among these groups Results: When body mass index (BMI) values were compared between the groups, the highest results were found in DM group, and these results were statistically significant. In USG examinations of patients, 108 (29.2%) patients had nodules. There was no difference between the groups in terms nodule prevalence. When thyroid volumes were compared between the groups, the largest volumes were found in the DM group; however, this was statistically not significant. When thyroid stimulating hormone (TSH) levels were compared, the highest levels were in the obesity group; however, these results were again statistically insignificant. We observed that obese women and women with METS had higher TSH levels. Thyroid disorders were found less frequent in the DM group than the other groups, and these results were statistically significant. Conclusion: Although no significant difference was found between the groups in our study in terms of thyroid pathology, in the light of other studies, the prevalence of thyroid dysfunction in diabetic patients and patients with METS is 2-3 times higher than the normal population. Therefore the measurement of TSH should be made for all obese patients.
Exercise capacity in sarcoidosis. Study of 29 patients
(Elsevier Espana Slu, 2005) Akkoca, Öznur; Çelik, Gökhan; Ülger, Füsun; Arbak, Peri; Saryal, Sevgi; Karabıyıkoğlu, Gülseren; Alper, Doğanay
BACKGROUND AND OBJECTIVE: Sarcoidosis is a systemic granulomatous disease of unknown etiology. Aims of this prospective study are to evaluate degree of impairment in pulmonary function tests (PFT), arterial blood gas analysis (ABG), respiratory muscle strength, exercise capacity and correlation of these parameters with radiological stages; to further evaluate the use of cardiopulmonary exercise testing in assessment of extent of pulmonary disease; and to discuss the pathophysiologic mechanisms of limitation in exercise capacity in patients with sarcoidosis. PATIENTS AND METHOD: 29 patients with sarcoidosis were grouped according to their radiological stages (stage I: group 1; stage II, group 2; stage III, group 3). Group 1, 2 and 3 included 11, 13 and 5 patients, respectively. PFT, cardiopulmonary exercise testing and ABG were performed for each patient. RESULTS: Evaluation of all patients showed a significant decrement in exercise capacity. Patients in stage III had decreased diffusing capacity and exercise capacity. There was limitation in exercise capacity in stage I patients who had completely normal spirometry and diffusing capacity. We also found a correlation between radiological stages of the disease and exercise capacity, diffusing capacity and ABG. CONCLUSIONS: Exercise capacity is impaired also in early stages of sarcoidosis and it was found to be the earliest impaired physiological parameter in sarcoid patients. Exercise intolerance, having mutifactorial basis, is correlated with radiological stages. Circulatory impairment and impaired heart rate response to exercise have effects on limitation in exercise capacity. Especially in advanced radiological stages of disease, ventilatory and gas exchange impairment also seems to be effective on limiting exercise in patients with sarcoidosis.