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Objective: Cardiovascular diseases still play an important role in public health and epidemiol- ogy as the leading cause of death worldwide. Ischemic heart disease is the most common reason in this group. This study aims to analyze the latest trends in ischemic heart disease mor- tality rates in Turkey by age, gender, and region using the Turkish Statistical Institute mortality data and evaluate the results., Methods: We have obtained ischemic heart disease mortality data (2009-2019, in 12 regions) for Turkey from the mortality database of the Turkish Statistical Institute. Joinpoint analysis was used to estimate the annual percentage change and average annual percentage change to identify significant changes in trends., Results: The mean mortality rate for ischemic heart disease in Turkey was in an increasing trend from 2009 to 2019 (annual percentage change=1.7 (-0.8; 4.3), P=.166). This increase was more pronounced in women (annual percentage change=2.2 (-0.7; 5.2), P=.121) compared to men (annual percentage change=1.4 (-1.1; 3.9), P=.235). When the period between 2015 and 2019 was evaluated, it was determined that ischemic heart disease mortality was in a decreasing trend in the groups over 65 years of age. The death rate due to ischemic heart disease is almost 2 times higher in men than in women in Turkey, and this rate ratio is highest in the Istanbul region., Conclusion: Although ischemic heart disease mortality trends have decreased globally, our country's average is still on an increasing trend. However, significant decreases have been observed in ischemic heart disease mortality rates, especially in the group over 65 years of age, in the last 5 years.

Background: It is important for public health to determine the awareness of cervical cancer, which is preventable and treatable when detected at an early stage., Aim: This study was conducted to determine female academicians' attitudes towards prevention and early diagnosis of cervical cancer and the factors affecting them., Methods: This descriptive study was conducted with 211 female academicians working in all departments of a university. In the study, the data were collected using questionnaire form, the attitude scale for early diagnosis of cervical cancer, and the attitudes towards prevention of cervical cancer scale., Results: It was determined that 68.2% of the female academicians had knowledge about the pap smear test; however, 41.0% of them did not have the test because they could not find time, and 56.4% had the knowledge about the pap smear test from a healthcare professional. It was determined that academicians had lower scores from the Attitude Scale for Early Diagnosis of Cervical Cancer (88.55 ± 9.75) and above-average scores from the Attitudes Towards Prevention of Cervical Cancer Scale (74.30 ± 15.92). It was found that area of expertise, income status, history of infectious disease, and vaginal douching affected both the early diagnosis of cervical cancer and the attitudes towards prevention of it., Conclusion: The female academicians inadequate attitudes towards early diagnosis of cervical cancer and better attitudes towards prevention. Nurses and administrators should encourage female academics and all women to screen for cervical cancer., (© 2022 Japan Society of Obstetrics and Gynecology.)

This study was conducted to examine the use of integrative treatment methods by individuals with COVID-19 using Pender's health promotion model. During the analysis of the themes, we observed that individuals' decisions to start integrative treatment were affected by uncertainty related to COVID-19, desire to recover and strengthen immunity, and thinking that there would be permanent damage due to the disease. Integrative treatment methods were frequently used by individuals who had COVID-19, and these methods were primarily based on non-evidence-based information sources and not disclosed to health care professionals., (© 2022 Elsevier Inc. All rights reserved.)

Objective: The primary purpose of the current study was to establish Turkish smoothed centile charts and Lambda, Mu, Sigma (LMS) tables for four-site skinfold thickness based on a population-based sample, and secondary purpose was to elaborate a reference for the percentage of body fat., Design: A cross-sectional and descriptive study was conducted between January and May 2017. Triceps, biceps and subscapular, suprailiac skinfold thicknesses were measured using Holtain skinfold caliper. Age- and gender-specific percentile values were determined with the LMS method, and body fat percentage was calculated using the Westrate and Deurenberg equation., Setting: Afyonkarahisar province in Turkey., Participants: The current study was conducted on 4565, 6-18-year-old students., Results: The triceps, biceps and subscapular skinfolds of the girls were higher than the boys. From the age of seven, the sum of four skinfold thicknesses of the girls was more than those of the boys. This difference became more evident after the age of 12. Although fat percentages of girls showed a fluctuating change, it decreased with the age in boys. Westrate and Deurenberg equation fat percentages of girls until adolescence were lower than boys, but increased after 12 years of age and exceeded that of boys., Conclusions: The current study has provided sex- and age-specific reference values for skinfold thickness and has shown that obesity in girls is higher than in boys in schoolchildren in Afyonkarahisar. The current study has also shown that skinfold thickness measurements are a valuable tool for screening obesity in children.

Background: In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice., Methods: Data from patients with chronic hepatitis C treated with SOF/LDV ± RBV or SOF/RBV in 31 centers across Turkey between April 1, 2017, and August 31, 2018, were recorded in a nationwide database among infectious disease specialists. Demographics, clinical, and virological outcomes were analyzed., Results: A total of 552 patients were included in the study. The mean age of the patients was 51.28 ± 14.2, and 293 (55.8%) were female. The majority had HCV genotype 1b infection (65%), 75.04% of the patients underwent treatment, and non-cirrhosis was present at baseline in 381 patients (72.6%). SOF/LDV ± RBV treatment was given to 477 patients and 48 patients received SOF/RBV according to HCV genotype. The total SVR12 rate was 99% in all patients. Five patients experienced disease relapse during the study and all of them were genotype 2. In patients infected with HCV GT2, SVR12 was 77.3%. SVR was 100% in all patients infected with other HCV genotypes. All treatments were well tolerated by patients without causing severe adverse events. Side effects and side effects-associated treatment discontinuation rates were 28.2% and 0.4%, respectively. Weakness (13.7%) was the common side effect., Conclusion: The present real-world data of 525 patients with HCV genotypes 1, 1a, 1b, 3, 4, and 5 who underwent SOF/LDV ± RBV treatment in Turkey demonstrated a high efficacy and safety profile. HCV GT2 patients should be treated with more efficacious treatment.

Competing Interests: Declaration of competing interest No competing financial interests exist.

Context: Dyspnea is the most common symptom of lung cancer. Acupressure is an important application in the management of dyspnea for lung cancer patients. High-powered, well-planned work is needed on the topic., Objectives: The study was conducted to determine the effects of acupressure on quality of life and dyspnea level for individuals with lung cancer., Design: The study was a randomized, controlled, single-blinded trial., Setting: The study took place in the Oncology Day Treatment Unit of a university hospital in Turkey., Participants: Participants were patients in the unit who were receiving chemotherapy and had experienced dyspnea., Intervention: Patients were divided into 2 groups: (1) an intervention group receiving acupressure, and (2) a control group receiving standard care. The P6-Lu1-Lu10 acupuncture points in the hand, forearm, and chest were used, with acupressure being applied 2 times per day for 4 wk, for a total of 56 sessions., Outcome Measures: Data were collected at baseline and postintervention. Sociodemographic and disease-related data were collected using the Patient Identification Form. Quantitative data were collected with the Modified Borg Dyspnea Scale (Borg scale) and the St George's Respiratory Questionnaire and through measurements of participants' heart rates, respiratory rates, oxygen saturation, and walking distance before and after the 6-mile walk test. Qualitative data were collected using the semistructured "Patients' Views Form on Acupressure Experience.", Results: The 4-wk acupressure intervention demonstrated a significant reduction in the participants' levels of dyspnea, and at the same time, significant increases in their quality of life. The quantitative findings of this study were supported with qualitative findings., Conclusions: Acupressure can be a helpful adjunct treatment that enhances the quality of life and reduces dyspnea in individuals with lung cancer. It is an easily applicable method without serious side effects.

Aim: This study aimed to determine the effect of application of superficial local heat and a home exercise program on pain and function levels to patients with bilateral knee osteoarthritis., Methods: This study was conducted in Turkey between January 2014 and February 2015. The sample group of the study consisted of 62 patients with osteoarthritis; 15 assigned to heat application, 15 to exercise, 15 to exercise after heat application, and 17 for the control group. While the patients in the control group received routine treatment only, the patients in the intervention group were treated with heat application, exercise, or exercise after heat application, suggested for 5 days a week for 4 weeks in addition to routine treatment., Results: In this study, all of the intervention groups had decreases in Visual Analogue Scale Pain and Western Ontario and McMaster Universities Osteoarthritis Index pain, stiffness, and function scores when compared with the control group. It was found that this decrease in Visual Analogue Scale Pain and Western Ontario and McMaster Universities Osteoarthritis Index scores was mostly in the exercise group, but this condition was not statistically significant., Conclusions: As a result, it is recommended that nurses train patients with osteoarthritis on heat application and home exercises and encourage them to apply these practices., (© 2019 John Wiley & Sons Australia, Ltd.)

Objective: This study is designed to evaluate the potential effects of age, period and cohort (APC) on trends in suicide between 1983 and 2013 in Turkey., Methods: Mortality data were obtained from the Turkish Statistical Institute. The data were grouped into seven age groups, four periods and ten birth cohorts. A nonlinear regression model was estimated for both sexes. The effects of age, period and cohort were parameterized using natural spline smoothing functions., Results: There were 61,795 deaths recorded as suicides during the investigated time period, where 64.5% occurred in males (n = 39,862) and 35.5% in females (n = 21,933). There is an upward trend in mortality by age until the end of the study period for males and females. Age effect is decreased until the forties, kept decreasing during the middle ages, and sharply increased after the sixties. The death rates for females declined from 1999 until the end of the study period. For males, the death rates increased until the end of the study period., Conclusion: If the current trends continue, it can be expected that these effects will continue to reduce female mortality and increase male mortality. Future studies on suicide, strongly focused on specific factors attributed to period effects, are needed in Turkey.

The prediction of the consequences of disease is important to determine the therapy approaches and prevention of the chronical state in patients infected with hepatitis B virus (HBV). In recent years various studies are carried on to investigate the effect of IL-28B gene polymorphisms on the clinical course or therapy response in patients with chronic hepatitis B infection. The aim of the study was to evaluate the influence of IL-28B rs12979860 polymorphisms on the natural course of HBV infection. The study was designed prospectively, and the subjects were randomly selected among patients admitted to infectious disease outpatient clinics of Kocatepe University Medical School Hospital and Yunus Emre State Hospital located at provinces in Central Anatolia, Turkey. A total of 99 cases were included in the study and evaluated into three groups, namely, chronic hepatitis B patients (group 1, n= 43); inactive HBV carriers (group 2, n= 34) and subjects with acquired immunity after native infection (group 3, n= 22). There were no significant differences regarding the age and gender distribution between the groups (p> 0.05). All subjects were investigated for the IL-28B promoter single nucleotide polymorphism rs12979860 at position 3176 C/T, by real-time polymerase chain reaction (RT-PCR). Evaluation of the range of IL-28B rs12979860 C/T polymorphisms observed in the study groups showed that, the frequency of CC, CT and TT allels were as follows; 34.9%, 48.8% and 16.3 % in group 1; 47.1%, 35.3% and 17.6% in group 2; 63.6%, 27.7% and 13.6% in group 3, respectively. No significant differences were observed between the groups in terms of C/T allel distriubution (p> 0.05). However, in spite of statistical insignificance, the rate of CC allel in IL-28B rs12979860 gene was the highest in immune subjects (63.6%), while it was the lowest in chronic hepatitis B patients (34.9%). According to our data, IL-28B rs12979860 gene polymorphisms were not effective on the clinical course of HBV infection. In conclusion, further studies with large numbers of patients are needed to support these data.

Objectives: This descriptive study was conducted to determine pain and self-efficacy levels of individuals with osteoarthritis., Methods: 83 patients, who were hospitalized in and admitted to physical therapy or rehabilitation outpatient clinic and had a primary diagnosis of osteoarthritis, were included in the study. The data of the study were collected by using patient information form, visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and arthritis self-efficacy scale. Pearson correlation analysis, t-test, and one-way analysis of variance were used to assess the data. A p value less than 0.05 was considered as statistically significant., Results: The most frequent complaints of 78.5% of the individuals with osteoarthritis were pain and limitation of movement. The pain experienced by 69.9% affected their daily life activities so much. VAS mean score of the participants was 5.7±2.3, their WOMAC mean score was 56.3±14.8, and their self-efficacy score was 103.7±29.5. Self-efficacy levels of those, who were men, had a higher educational level, were not housewives, were independent in daily life activities and did not have an additional chronic disease, were higher compared to the other groups (p<0.05). In this study, a negative correlation between self-efficacy scores and VAS and WOMAC scores and a positive correlation between VAS and WOMAC scores were found (p<0.05)., Conclusion: It was determined that self-efficacy of the individuals with osteoarthritis was moderate and gender, educational level, status of independence, pain, and functional level affected self-efficacy.

In this study, our aim was to investigate the association of methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism on the vitamin B12 therapy response in 95 patients with vitamin B12 deficiency and 92 healthy control subjects using vitamin B12, plasma total homocysteine (tHcy), and folate as the main measure of outcome. MTHFR C677T genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism techniques. There were no differences in the distribution of MTHFR genotypes in the cases versus the controls. Mean concentrations of plasma tHcy and B12 vitamin were 18.84 μM and 142.47 pg/mL in patients with TT (10.5%) genotypes. Furthermore, mean concentrations of B12 vitamin after cobalamin therapy were 697.62, 656.64, and 488.76 pg/mL in patients with the CC, CT, and TT genotypes, respectively. The MTHFR 677 TT genotype has decreasing effect in B12 vitamin and increasing effect in tHcy. In comparison with the patients having CC and CT genotypes, patients with the TT genotype had a lower response to vitamin B12 therapy.

Objective: Hypertension is a major public health problem worldwide with increasing prevalence. The purpose of this study was to examine the prevalence of hypertension and related risk factors among adult population in Afyonkarahisar region., Methods: In this cross-sectional research, regarding the population distribution totally 2035 subjects, randomly selected from 75 different parts of our city, both the urban and the rural areas, were included in this epidemiologic research. After the administration of a questionnaire to the subjects, blood samples were taken and physical examinations were performed. Socio-demographic features, diabetes mellitus (DM), hypertension, family history of hypertension, coronary heart disease (CHD), smoking, and number of births were evaluated as possible risk factors for hypertension. Statistical analysis was performed using Student's t-test, Chi-square test and binary logistic regression analysis., Results: The overall prevalence of hypertension was 24.2% (31.3% in women, 14.1% in men, p<0.001). Its prevalence increased with age (from 2.2% to 50.4%, p<0.001). Age, gender, DM, family history of hypertension, body mass index (BMI), CHD and income levels were significant risk factors. Diabetic patients had 2.35 times (95%CI 1.70-3.25: p<0.0001) more risk, people who had positive family history 2.23 times (95%CI 1.62-3.07: p<0.0001) more risk and those with high BMI 2.15 times (95%CI 1.66-2.78: p<0.0001) more risk to develop HT than who did not have these factors. In addition, women have 2.74 times (95%CI 2.08-3.62: p<0.0001), more risk than men for HT. We determined CHD and low income as other risk factors for HT (OR=2.32, 95%CI 1.48-3.64: p<0.0001) and OR=1.47, 95%CI 1.08-2.02: p=0.016 respectively)., Conclusion: Hypertension is an important health problem in our region. We think that it is possible to reduce the hypertension prevalence with lifestyle changes and educating people, regarding the risk factors.

Experimental and field studies have proven that the bovine herpesvirus type-4 (BHV-4) infection leads to various reproductive system problems. In this study, the role of BHV-4 infection in repeat breeding was investigated serologically. Eighty-four samples were obtained from repeat-breeding diagnosed cows in two organized dairy herds; an equal number of healthy cows were sampled from the same farms. The rest of the samples (105) were obtained from reproductively normal cows that were breeding in 18 small enterprises as a control group. The seropositivity proportion in repeat-breeding diagnosed cows was found to be significantly higher (69% (58/84)) than other cows (44% (37/84)) on the same farms. The lowest antibody positivity value for BHV-4 was detected as 24.7% (26/105) in the samples from family-type small farms. The odds ratio (OR) value was calculated as 2.834 in repeat-breeding diagnosed and healthy cows on the same farms, while 6.778 was determined in cows with and without reproductive problems on organized farms compared to small farms. As a result, the BHV-4 infection can be considered one of the reasons for repeat breeding besides other reproductive disorders.

This study was designed to determine the acute effects of a single-dose of orally administered doramectin, eprinomectin and selamectin on Syphacia muris infection in rats. Rats, naturally infected with S. muris, were divided into four groups: three different treatment groups (n=7) and one positive control (n=7). Cellophane tape preparations were obtained from the treated rats on day 0 pre-treatment and on days 2, 4 and 6 post-treatment. Syphacia sp. eggs were counted. Eprinomectin was found to be 100% effective in eliminating eggs on two post-treatment. However when egg counts on day 6 post-treatment were compared with pre-treatment egg counts, doramectin and selamectin were found to be 99.32 and 98.77% effective in eliminating eggs, respectively. On day 7 post-treatment, blood samples were obtained from all groups, and then the rats were necropsied. Doramectin, eprinomectin and selamectin were found to be 100% effective in eliminating adult S. muris, when compared with the positive control group.

Objectives: This study was designed to determine the prevalence of and risk factors for low back pain (LBP) in a sample of Turkish population among adults living in the Afyon region, Turkey., Methods: A field screening investigation was performed in a total of 75 areas including the city center, 18 districts, and 57 associated small municipalities. Adequate sample size was determined as 1,990 and a total of 2,035 individuals (1,194 females, 841 males) were enrolled. Participants were inquired about age, occupation, sex, height, weight, history of LBP, hypertension, diabetes, and smoking. Depression symptoms were evaluated using the Symptom Checklist-90-Revised., Results: The prevalence of lifetime LBP was 51%, and the prevalence of chronic LBP was 13.1%. Overall, 63.2% of women and 33.8% of men had LBP at least once in their lives (p=0.001). With regard to occupation, the highest incidence of LBP was seen in housewives (64.2%; p=0.0001), whose age and body mass index (BMI) were also higher compared to employed women. Depression (p=0.016) and increased BMI (p=0.000) were found to increase the risk for LBP, whereas smoking, hypertension, or diabetes were not correlated with the prevalence of LBP. Poverty was found to be the leading cause (39.7%) for not presenting to a physician., Conclusion: Among risk factors reported for LBP, many are also effective in Turkish population. Special attention should be given to the education of housewives in terms of low back protection, healthy nutrition, and family planning. Poverty seems to be a significant barrier to patient presentation to physicians, requiring extended social security coverage.

A total of 504 bovine faecal samples collected from intensively managed beef farms in Afyon province of Turkey were examined to determine the types and prevalence of coccidian parasites present. Coccidian oocysts were found in 20.04% of all the samples examined by sucrose-flotation. The species detected and their prevalence were Eimeria bovis (34.55%), E. auburnensis (23.03%), E. canadensis (14.55%), E. brasiliensis (10.91%), E. zuernii (6.67%), E. bukidnonensis (3.03%), E. cylindrica (2.42%), E. ellipsoidalis (1.21%), E. illinoisensis (1.21%), E. alabamensis (1.21%) and Isospora sp. (1.21%). Mixed infections of two to four species were found in 43.6% of the animals. The overall prevalence of coccidial oocysts in faecal samples was 27.23% for calves, 15.65% for cows. Linear regression analysis showed that there is a significant reduction in the OPG (the number of oocysts per gram of feces) levels (P<0.05) in cows infected with Eimeria. No cases of clinical coccidiosis were observed in this survey.

In this study, livers, gall bladders, rumens and reticulums from 746 males and 255 females, making a total of 1001 slaughtered cattle, were examined in order to determine the prevalence of paramphistomiasis and distomatosis during the period of June 2003-November 2003 in the Afyon province. The infection rate of parasites was 13.6% (136 cattle) for Paramphistomidae spp., 4.6% (46 cattle) for Fasciola spp., 15.3% (153 cattle) for Dicrocoelium dendriticum and 1.4% (14 cattle) for either Fasciola spp. or D. dendriticum. The infection of males with paramphistomiasis and distomatosis was 3.05 times more than that in the females.