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Aim: Healthcare professionals will set an example to society with their behaviors about Traditional and Complementary Medicine usage. We aimed to investigate and compare the knowledge and attitudes of society and physicians about Traditional and Complementary Medicine to create an infrastructure for medical training. Methods: In this cross-sectional descriptive study "Turkish Version of Complementary, Alternative and Conventional Medicine Attitude Scale" was used for data collection. Results: A total of 392 physicians and 438 citizens participated in the study. Among all participants, 36.9% had used a Traditional and Complementary Medicine method before and the most used method was phytotherapy. There was a significant difference between groups in terms of the level of knowledge. Surprisingly no significant difference was found between physicians and the public in the "Dissatisfaction with Modern Medicine" subgroup. Conclusion: Although there were differences in the level of knowledge between the public and physicians, it was seen that the behavioral patterns were similar to each other. This situation suggests that physicians are also influenced by the society they live in, rather than scientific data, in their decisions about Traditional and Complementary Medicine. Being as a role model to the public, physicians are responsible for providing evidence-based answers to questions about Traditional and Complementary Medicine and should receive adequate training about methods. Keywords: complementary medicine, therapeutic use, evidence-based practice, knowledge, physicians

Aim: This study aims to research the association of metabolic syndrome components with anthropometric measurements like arm circumference, neck circumference, hip circumference, waist-hip ratio, and waist-to-height ratio, which are applied rarely. Methods: This cross-sectional study was conducted with 292 patients in November-December 2019. The arm circumference, neck circumference, waist circumference, hip circumference, waist-hip ratio, waist-to-height ratio, and body mass index measurements of the patients were made. Glucose, high-density lipoprotein, low-density lipoprotein, systolic, and diastolic blood pressure measurements were also recorded. The association between metabolic syndrome components and anthropometric measurements was analyzed. Results: Metabolic syndrome is diagnosed in 32.8% of the participants. According to body mass index, 18.6% of the patients were normal, 34.2% were overweight, and 47.2% were obese. There was a significant difference between the patients with and without metabolic syndrome in terms of laboratory parameters, blood pressure values, and anthropometric measurements. In the diagnosis of metabolic syndrome, optimal cut-off values for arm circumference, neck circumference, hip circumference, waist-hip ratio, and waist-to-height ratio were determined as 31.75 (AUC=0.703), 34.85 (AUC=0.763), 113.75 (AUC=0.757), 0.90 (AUC=0.701), 0.61 (AUC=0.769) for females while they were 35.75 (AUC=0.573), 39.75 (AUC=0.795), 111.5 (AUC=0.607), 0.96 (AUC=0.888), 0.61 (AUC=0.888) for males respectively. Conclusion: A significant correlation was detected between arm circumference, neck circumference, hip circumference, waist-hip ratio, and waist-to-height ratio, and metabolic syndrome components. However, low-density lipoprotein was not correlated with neck circumference and high-density lipoprotein with waist-to-height ratio. Keywords: metabolic syndrome, anthropometric measurement, body mass index, obesity, lipid profile

Introduction. In this study we aimed to determine whether a difference in complications between smok­ers and non-smokers exists in type 2 diabetes mellitus (T2DM) and to evaluate if there is a correlation between microvascular complications and Fagerstrom test score. Material and methods. Patients with T2DM who at­tended the family medicine outpatient clinics were enrolled in the study. Smokers and non-smokers were compared according to their metabolic outcomes and presence of microvasculer complications. The level of smoking addiction was determined by Fagerstrom Test for Nicotine Dependence. Results. Fasting blood glucose (FBG), low-density lipoprotein, systolic and diastolic blood pressures were found to be higher in smokers. The presence of neuropathy was significantly higher in smokers. The presence of retinopathy rate increased with increasing level of smoking addiction. The nicotine dependence test score were found to be positively correlated with HbA1c and FBG levels whereas, negatively correlated with body mass index among smokers. Conclusions. Assessing the cigarette smoking status of diabetic patients at the initial clinic visit and indicating the importance of smoking cessation should be the essential part of diabetes follow up program.

Objective : Although cervical cancer is common, because of the presence of pre-invasive lesions and due to the fact that the cervix is an easily accessible organ, it is an appropriate disease for early diagnosis, prevention, treatment and even eradication. We aimed to evaluate the results of HPV-DNA screening program in women between the ages of 30-65 in a primary care setting and to make recommendations for preventable risk factors. Method: In this cross-sectional descriptive study we evaluated the records of 716 women 30-65 years old who scanned for HPV between 2014-2016 in a primary health care center. In the evaluation of data obtained, descriptive statistical methods and chi square test were used. Results: The average age of women included in the study was 44,11 ± 9,25, 97.1% were married; the age of first sexual intercourse was minimum 13 maximum 34 (mean 19,76 ± 3,67). Of women 20,81% smoked in various amounts, and 26,68% of them used hormonal contraceptives for varying periods of time. HPV-DNA (+) was found in 19 (2.65%) of the women. Of these, 7 (1%) were HPV-16. Conclusion: In our study, however the positive rate of HPV-DNA is lower than the studies done in Turkey and abroad, the high-risk HPV genotype-16 ratio was higher. We concluded that HPV vaccination, condom use and regular gynecological examination rates are inadequate in women which we included in our study and this may be due to economic reasons as well as socio-cultural factors.

Background: Multi-drug resistant organisms, especially Vancomycin-Resistant Enterococcus (VRE) and Carbapenam Resistant Klebsiella pneumoniae (KPC), are serious health threat. Early detection of resistant bacteria colonization amongpatients in intensive care units (ICUs) not only enables effective treatment but more importantly prevents disease and limits transmission. Therefore, we aimed to to assess the frequency of VRE and KPC colonization via rectal swab sampling. Methods: The study was carried out in ICUs of a tertiary hospital. Two rectal swab samples were collected within the first 24 hours of admission and another one was taken every subsequent 15 days to test for for VRE and KPC carriage. Results: A total 316 rectal swab samples taken from 230 patients. Forty-seven patients were screened at least 2 times. 183 patients were not further screened due to discharge, exitus or transfer to other wards. Thirty-six patients (16%) were determinedto be VRE (+). The most frequently isolated strain was E. faecium (80.5%) and its most common genotype was VanA (87.5%). Seven patients (3%) were identified as KPC (+). OXA-48 type crbapenamase was confirmed in all KPC isolates. Conclusion: This study shows that VRE and KPC colonization continues to be a serious threat in ICUs. Keywords: Carbapenam resistant klebsiella pneumoniae; vancomycin-resistant enterococci; intensive care units.

Aim: The aim of this study is to reveal the knowledge, attitude and behaviors of the university students about Hepatitis A, Hepatitis B and Hepatitis C. Methods: This study was done among 1048 students from different faculties of five different universities in Ankara, was carried out between October 2012 and July 2013. A questionnaire was prepared by the authors by rewieving the literature and the participants were asked to fill this questionnaire. Knowledge level of participants was scored from 1 to 5 out of 100 according to the answers given about Hepatitis A, B and C. Results: When the average points of knowledge about hepatitis A, B and C is considered, it is seen that the knowledge points of males according to females and the knowledge points of the students who study in medical faculties according to the other faculties are higher. Participants were found to have a risky attitude with respect to the spread of Hepatitis A, B and C infections. While males had more risky behaviors, it was seen that there was no significant difference between the students of medical faculties according to other faculties. Conclusion: Despite advances in technology and health, Hepatitis A, B and C infections continue to be an important public health problem today. This study showed that even university students, whose education and intellectual levels are considered to be high according to society, have low level of knowledge about viral hepatitis and exhibit risky attitudes and behaviors, necessity of individual and social education. The most effective way to protect against these diseases is to increase the knowledge and awareness levels of the society and prevent the transmission of these diseases. Keywords: hepatitis, knowledge, attitude, behavior, vaccines

Aim: Night Eating Syndrome is thought to pose a risk for the development of cardiovascular system, endocrinological and psychiatric diseases. The aim of our study was to investigate the frequency of night-eating syndrome and risk factors related to night eating syndrome. Methods: This cross-sectional, descriptive study was carried out among 525 people who admitted to the Family Medicine Clinic of a tertiary hospital between 01 October and 30 November 2018. The night-eating questionnaire was applied to the partcipants using face-to-face interview. Persons with a psychiatric disorder, who have a history of chronic medication or disease, who have alcohol and drug addiction and who are working on the night shift were excluded from the study. p values < 0.05 were considered as statistically significant. Results: Fifty-one (9.7%) of the 525 patients admitted to our clinic met the criteria of Night Eating Syndrome. In our study, there were statistically significant difference between night eating syndrome and non-night eating syndrome groups with respect to smoking status and body mass index. Conclusion: Night eating syndrome is a hidden public health problem which is related to cardiovascular system diseases, diabetes mellitus and psychiatric disorders besides obesity. Because of the presence of serious health problems associated with night eating syndrome, it is very important to determine night eating syndrome in primary care.

Aim: Whether a specialization training program achieves its objectives or not is decided by showing that the graduates of the program have gained the expected knowledge, skills and behaviors. The measurement tools used in this decision require some specific knowledge and skills. The aim of this study was to analyze the questions asked in an examination and to investigate the suitability of the assistants and the education program in terms of educational sciences. Methods: Responses of Family Medicine residents to a multiple-choice test that consists of 50 items, conducted throughout the country. The questions were analyzed in terms of the connection with the educational objectives, the degree of difficulty, separation and distraction power. Results: Of the 150 questions asked, 20 were not found in the learning objectives. In the analysis of difficulties, 105 of the questions were easy and very easy questions; on the other hand, in the analysis of distraction, 27 out of 150 questions are sufficient for discriminating; in terms of distractors, all the distractors of the 19 problems were found to be functional. Conclusion: The examination is not suitable for the evaluation of both the residents and the program, because it is based on knowledge measurement by multiple choice quiz method, not being competency based, the questions are not included in the learning objectives, the disaggregation of the questions are weak, and the distractors are not working in a large majority. In order to avoid these situations, it would be appropriate for the family medicine trainers to undergo a training including the role and importance of measurement and assessment in education before taking the authority of assistant and program evaluation.

The aim of this study was to evaluate the prevalence of anemia and other vitamin deficiencies among elderly home care patients and to evaluate the causes of anemia and effect of malnutrition as a contributing factor. Anemia was defined according to the World Health Organization. Hemogram, serum iron, iron binding capacity, ferritin and transferrin saturation values, serum vitamin B12, folic acid and vitamin D levels were evaluated. It was tried to differentiate as absolute iron deficiency anemia, anemia of chronic disease, anemia of unknown cause and vitamin B12 deficiency anemia. Malnutrition was evaluated by Mini Nutritional Assessment test. Total of 472 patients (mean age 81,4±7,4 years) were included in the study. Anemia was detected in 179 (%37,9) patients, 22,7% of males and 45,5 % of female. Prevalence of iron deficiency anemia, vitamin B12, folic acid and vitamin D deficiencies were found 43%, 46%, 19% and 91% respectively. 22,8% of all patients were malnourished, 17,5% were under malnutrition risk. In patients with anemia 16,2% chronic disease anemia and 37,4% unknown anemia were detected. With or without malnutrition, iron deficiency anemia, vitamin B12 deficiency and vitamin D deficiency were common in the home care elderly patients.

Background Hypertension is an early finding of autosomal dominant polycystic kidney disease (ADPKD) and is related to different mechanisms. Cyst expansion related renin secretion or early endothelial dysfunctions are some of these hypotheses. Different course of hypertension in ADPKD preoccupies that relatives of ADPKD patients may also be under risk for this underlying mechanisms. In this study, we aimed to find blood pressure response problems to exercise as an initial vascular problem in unaffected relatives of hypertensive ADPKD patients. Methods The cross-sectional study included 24 unaffected relatives (siblings and children) of ADPKD patients and 30 healthy controls that performed a cycle ergometer test. Additionally, as a marker for endothelial function, nitric oxide (NO) and asymmetric dimethylarginine (ADMA) levels at baseline and post exercise were measured. Results Systolic blood pressure (SBP) and diastolic blood pressure (DBP) increases were similar in both groups during the 1st, 3rd, and 6th min of exercise. During the exercise recovery phase SBP decreased in both groups; however, in the relatives of ADPKD patients DBP remained high at the end of the 6th min, suggesting impaired capacity for exercise-induced vasodilatation. Baseline NO and ADMA, and 1-min NO and ADMA were similar in both groups. Conclusion Abnormal blood pressure response to exercise stress was observed in unaffected normotensive relatives. The observed abnormal DBP response pattern to exercise suggests that arterial vascular responses might be already altered in unaffected relatives of hypertensive ADPKD patients; however, long-term clinical trials are needed to clarify the significance of these findings.

Susceptibility of the homecare patient to vaccine preventable infections and their complications is high. Hospitalization of this patient group increases costs to the healthcare system. Therefore vaccination services are of great importance for protecting these patients from complications and hospitalization. We aimed to determine vaccination status of the patients receiving home care services from a tertiary hospital in Turkey and to reveal their vaccination needs. This cross sectional study was carried out in the Division of Home Care Services of Dışkapı Yıldırım Beyazıt Training and Research Hospital in Ankara Turkey. A questionnaire Comprised of 15 questions were administered through face to face with 336 patients and their care givers. The data obtained was analyzed with descriptive statistical methods and chi-squared test was used for comparison of proportions. A total of 86.3% of the patients and 22.6% of the caregivers were older than age 65. Approximately 45% of the patients were receiving home care due to primary neurological diagnosis such as Dementia, Parkinson's disease and Cerebrovascular Accident. In addition, 78% of the patients had at least 1 additional diagnosis other than their primary diagnosis. Although immunization indications were present among all patients included in the study and at least 22% of the care providers, only 15.2% of patients and 11.3% of care providers had been recommended to receive vaccination. Among those who had been recommended to get vaccinated, 74% of patients and 77% of care givers had been administered the recommended vaccine. This finding implied that both groups were responsive to the advice for vaccination. Moreover, since the patients receiving home care are already followed-up by a healthcare team, thus these patients can be vaccinated with very little additional logistic support.

Background : Primary health care is the first point of entrance into the health care system for individuals and families who are seeking health care and a holistic approach to their health problems. The systematic evaluations of care is a mean to improve quality of primary health care. Patient satisfaction scales are one of these evaluation methods. The aim of this study was to translate and adapt the SPOSPCP to Turkish and examine its validity and reliability. Materials and Methods: This study was conducted among 920 patients, who applied to a family health center in Ankara, Turkey in 2015. The scale was translated to Turkish by a panel of reviewers. Confirmatory factor analysis was used in the study. The validity of the scale was determined by the validity coefficient and the reliability by alpha internal consistency coefficient. Results: The Cronbach’s alpha of the scale was 0.96. There was a high correlation between the scores of the scale and EUROPEP. The scale was considered to be reliable and valid. Conclusion: The Turkish version of SPOSPCP can be applied to healthy Turkish population and is a proper questionnaire to evaluate satisfaction levels of patients about the primary health care physicians. Giris: Birincil saglik bakimi, saglik problemlerine holistik bir yaklasim ve cozum arayan kisi ve ailelerin saglik sistemine ilk giris noktasidir. Bu bakimin kalitesinin arttirilmasinin bir yolu sistematik bir sekilde arastirilmasidir. Bu arastirmayi yapmanin bir yolu ise hasta memnuniyeti olcekleridir. Bu calismanin amaci Scale of Patient Overall Satisfaction with Primary Care Physicians isimli olcegin Turkce’ye tercume edilmesi ve gecerlik ve guvenilirliginin test edilmesidir. Gerec ve Yontem: Bu calisma 2015 yilinda Ankara’da bir aile sagligi merkezine basvuran 920 kiside yapilistir. Olcek olusturulan bir juri tarafindan Turkceye cevrilmistir. Calismada dogrulayici faktor analizi kullanilmistir. Olcegin gecerliligi “gecerlilik katsayisi” ve guvenilirligi de “Cronbach alfa guvenilirlik katsayisi” ile degerlendirilmistir. Bulgular : Calismamizda Cronbach alfa guvenilirlik katsayisini 0,96 olarak bulduk. Gecerlilik ve guvenilirligi test edilen olcekle benzer bir olcek olan EUROPEP olcegi sonuclari arasinda yuksek duzeyde korelasyon saptanmistir. Bu nedenle SPOSPCP olceginin Turkce cevirisinin gecerli ve guvenilir oldugu kabul edilmistir. Sonuc: “Hastalarin Birinci Basamak Hekimlerinde Genel Memnuniyet Olcegi” 18-75 yas arasi Turk populasyonunun Aile Hekimlerinden memnuniyetini degerlendirmek icin uygun bir ankettir.

Proton pump inhibitors are the commonly prescribed drugs for acid-related disorders. However, many of those prescriptions are inappropriate in inpatient and outpatient settings according to the recommended guidelines. Many studies have been conducted in inpatient clinics, but data about the appropriateness of proton pump inhibitor prescribing in outpatient clinics are scarce. Therefore, the aim of this study was to determine inappropriate proton pump inhibitor prescribing rates among patients admitted to a tertiary hospital family medicine outpatient clinic. A total of 259 patients (median age = 59 years; 72.6% women) were enrolled into the study and 35.9% of them had no proper indications to utilize proton pump inhibitors. Inappropriate proton pump inhibitor usage rate was significantly higher in patients older than 60 years compared with their younger counterparts (62.4% vs. 37.6%; p = .001). The most frequent reason to use a proton pump inhibitor with nonapproved indications was polypharmacy (41.9%). Despite endoscopic evaluation, 41.9% of the patients received a proton pump inhibitor without an approved indication. A significant proportion of nonindicated prescriptions were a consequence of continued prescribing without re-evaluating patients in outpatient clinics. Consideration of proton pump inhibitor indications according to the guidelines in every admission may prevent inappropriate prescriptions.

Objective: Osteoporosis (OP) which is a global health problem can be prevented or the development of the disease can be delayed. To educate individuals at risk and to intervene in a timely manner will provide significant reduction in morbidity and mortality caused by OP. Possible interventions in the age group of developed OP are important to determine. Therefore, in this study, it was aimed to determine information, attitudes and behaviors levels on osteoporosis at young women. Materials and Methods: This study was carried out among 18-35 years old females who attended to outpatient clinics of Dışkapı Yıldırım Beyazıt Training and Research Hospital Family Medicine Clinic. A questionnaire was used to assess knowledge, beliefs, and practices towards OP. The questionnaire to assess practices related to OP included questions on positive and negative behaviors towards OP. The positive behaviors assessed were dietary calcium intake, physical activity and exposure to sun. The negative behavior assessed was on smoking status. Results: A total of 218 women (mean age= 26.2±5.6 years) were enrolled in the study. The median score of knowledge about OP was 40, out of a total score of 100. Knowledge scores were lower than the median in 138 (63.3%) and were higher than the median in 80 (36.7%) of the participants. In the group who had high knowledge score than median (n=80); 24 (30%) were smokers, 8 (10%) were not exposed to the sun for at least 10 minutes a day and 45 (56.2%) of the participants did not achieve the recommended daily allowances for calcium and 64 (80%) were not engaged in the recommended exercises in type and duration. Conclusion: Awareness for OP is low in young women and practices towards preventing OP are inadequate. Thus, preventive measures are required in order to encourage OP-preventive life style especially before reaching peak bone mass.

BackgroundThere is a strong association between chronic kidney disease (CKD) and cardiovascular events. Increased arrhythmia risk in kidney disease is one of the main predominant factors in increased mortality and sudden cardiac death. To estimate this risk, noninvasive measurement of repolarization abnormalities including QT interval and its heart rate-corrected value (QTc) with surface ECG, are commonly used parameters in clinical practice. The aim of this study is to examine the effect of CKD-related problems – mainly acidosis – on QT intervals.Methods30 patients with stage 3–5 CKD whose serum bicarbonate concentrations below 20 mmol/L were included in the study. Alkali therapy with oral sodium bicarbonate was used to maintain the serum bicarbonate concentration in the normal range. At the beginning all patients had sinus rhythm on surface ECG records. Kidney function tests including serum urea, serum creatinine, uric acid, blood gas analysis, and electrolytes were analyzed at the beginning and at the end of alkali treatment. All patients underwent 12 lead-ECGs, recorded simultaneously. One cardiologist examined the ECGs manually in terms of QT intervals, corrected for heart rate (QTc), QT dispersion (QTd) and corrected QT dispersion (QTcd).ResultsThere were statistically significant differences in QT intervals, QTc, QTd and QTcd before and after sodium bicarbonate treatment. The correlation analyses revealed that there were significant negative correlations in pretreatment ECGs of patients between QTd and QTcd with blood pH level. Multivariate analyses between biochemical parameters and QTd-QTcd intervals have revealed that pH was related to QTd and QTc.ConclusionsThis study demonstrated that QT intervals on surface ECG are decreased after treatment of acidosis in CKD. Further studies are needed to show whether increased QT intervals cause ventricular arrhythmias in CKD.

Background Brucellosis produces a variety of non-specific hematological abnormalities. The aim of the present study was to evaluate the hematological findings in childhood brucellosis. Methods Medical records of children with brucellosis admitted to a tertiary hospital in a 1 year period, were analyzed retrospectively. Results Sixty-nine patients (mean age, 14.5 ± 3.3 years) were diagnosed with brucellosis. The most common hematological finding was thrombocytopenia (n = 11, 15.9%). Thrombocytosis was detected in five patients (7.3%), leukopenia in four (5.8%), anemia in three (4.3%), and bicytopenia in three (4.3%). None of the patients had pancytopenia. Blood culture was positive for Brucella spp. in 41 patients (59.4%). Among those patients with positive blood culture, six (14.6%) had serum agglutination test titer ≤1/80. Platelet (PLT) count was significantly lower in the bacteremia-positive group. The OR (95%CI) of bacteremia for PLT cut-off 200 000/mm3 was 0.148 (95%CI: 0.031–0.718) and relative risk was 1.718 (95%CI: 1.244–2.372; P = 0.010). Conclusions Brucellosis should be kept in mind in the differential diagnosis of isolated thrombocytopenia in pediatric patients from endemic areas.

Aim: Complementary and alternative medicine (CAM) is commonly used all over the world and herbal medicines are the most preferred ways of CAM. The aim of this study is to determine the frequency of herbal medicine use among patients with chronic diseases. Methods: A cross-sectional descriptive study was conducted from April 2014 to December 2014 among patients who had been diagnosed with diabetes mellitus (DM), hypertension (HT) and hyperlipidemia (HL) in Family Medicine Department of Diskapi Yildirim Beyazit Training and Research Hospital, in Ankara. A questionnaire about herbal drug use was applied by face to face interview to the participants. Results: A total of 217 patients were included in this study. The mean age of the participants was 56.6+/-9.7 years (55 male and 162 female). The rate of herbal medicine use was 29%. Herbal medicine use among female gender was significantly higher (p=0.040). Conventional medication use was found to be lower among herbal medicine consumers. There was no relationship between herbal medicine use and type of chronic disease, living area, occupation or education level. Most frequently used herbs were lemon (39.6%) and garlic (11.1%) for HT, cinnamon (12.7%) for DM and walnut (6.3%) for HL. Conclusions: In this study herbal medicine use was found to be higher among patients who had been diagnosed with chronic diseases. Therefore physicians should be aware of herbal medicine usage of their patients and inform them about the effectivity and side effects of herbal medicines. [J Intercult Ethnopharmacol 2015; 4(3.000): 217-220]

Purpose: The aim of this study was to identify the knowledge and awareness about human papilloma virus (HPV) and human papilloma virus (HPV) vaccine of women in reproductive age. Material and Methods: The study covered 294 women aged between 15 and 49. A questionnaire was prepared by the researchers based on the literature review. Results: The mean age of the participants was 30.5±8.9 years. Only 24.5% had heard about HPV infection and 28.2% had heard HPV vaccine. Of the participants, 188 (63.9%) got zero point from the knowledge questions. Conclusion: This study indicates that the women who apply primary care units have low knowledge levels; it is apperent that personal and social education is needed. Paying importance to patient education on HPV and cervical cancer in primary care health politics will increase knowledge and awareness for HPV infection and HPV vaccination., Amaç: Bu çalışmanın amacı doğurganlık çağındaki kadınların HPV ve HPV aşısı hakkındaki farkındalık ve bilgi düzeylerini ortaya çıkarmaktır. Materyal ve Metod: Çalışmaya 15-49 yaş aralığındaki 294 kadın dahil edildi. Yazarlar tarafından literatür taranarak hazırlanan anket formunun doldurulması istendi. Bulgular: Katılımcıların ortalama yaşı 30.5±8.9 idi. Yalnızca %24.5'i HPV enfeksiyonundan, %28.2'si ise HPV aşısından haberdardı. Katılımcılardan 188'i bilgi sorularından sıfır puan aldı. Sonuç: Bu çalışma birinci basamağa başvuran kadınların düşük bilgi düzeyinde olduklarını , bireysel ve toplumsal eğitimin gerekliliğini göstermiştir. Birinci basamak sağlık politikalarında hasta eğitimine önem verilmesi toplumun bilgi ve farkındalık düzeylerini artıracak ve kanser insidansının düşmesini sağlayacaktır.

Objectives:Epidemiological studies have revealed an association between higher totalperipheral white blood cells (WBC) count and Type 2 Diabetes Mellitus (T2DM).However, the association has not been systematically investigated. The aim ofthis study was to compare peripheral leukocyte count and biochemical testresults in diabetic and non–diabetic patients.Materials and Methods: The study wasconducted among the patients had been followed by Family Medicine OutpatientClinics of Dışkapı Yıldırım Beyazıt Training and Research Hospital between02.02.2015-30.09.2015. Patients anthropometric measurements, complete bloodcell count and biochemical tests’ results were recorded and these values werecompared between two groups (T2DM(+) and T2DM(-)).Results: A total of 286 patients(mean age: 58.7±10.5 years) were enrolled. There were no differences in age andsex distribution between T2DM(+) (n=108) and T2DM (-) (n=178) groups. InT2DM(+) group, leukocyte count was found to be higher than T2DM(-) group (7.73× 103/ml; 7.17 × 103/ml; p=0.001). Waist circumference, body mass index,fasting blood glucose, alanine amino transferase and triglycerides levels werealso found to significantly higher in T2DM(+) group. Conversly, high densitylipoprotein and low-density lipoprotein levels were found to be significantlylower in T2DM(+) group. Conclusion: Leukocyte count, evenwithin normal range, was higher in T2DM patients compared to non-diabeticindividuals. Our results support the role of chronic inflammation in T2DM.There is a need for comprehensive studies to explain the role of inflammationin diabetes., Amaç: Epidemiyolojikaraştırmalar periferik kandaki lökosit sayısı ile Tip 2 Diyabetes Mellitus(T2DM) arasında ilişki bulunduğunu göstermesine rağmen bu ilişki sistematikolarak incelenmemiştir. Bu çalışmada, T2DM tanısı olan hastaların (T2DM(+))lökosit sayımı ve biyokimya tetkik sonuçlarının diyabeti olmayan hastaların(T2DM(-)) sonuçlarıyla karşılaştırılması amaçlanmıştır.Materyal ve Metot: Çalışmaya;02.02.2015-30.09.2015 tarihleri arasında Dışkapı Yıldırım Beyazıt Eğitim veAraştırma Hastanesi Aile Hekimliği Poliklinikleri’ne başvuran hastalaralınmıştır. Hastaların antropometrik ölçümleri, tam kan sayımı ve biyokimyasaltestlerinin sonuçları kaydedilmiştir ve bu değerler T2DM(+) ile T2DM(-)grupları arasında karşılaştırılmıştır.Bulgular: Çalışmaya dâhiledilen 286 hastanın yaş ortalaması 58,7±10,5 yıl olarak saptandı. T2DM(+)(n=108) ve T2DM(-) (n=178) gruplarının yaş ve cinsiyet dağılımları arasındafark yoktu. T2DM(+) grubun ortalama lökosit sayısının T2DM(-) grubundan yüksekolduğu saptandı (7,73 × 103/ml; 7,17 × 103/ml; p=0,001). T2DM(+) grubun belçevresi, vücut kitle indeksi (VKİ), açlık kan şekeri (AKŞ), alaninaminotransferaz (ALT) ve trigliserid değerleri T2DM(-) grubuna göre anlamlıolarak yüksek olduğu, düşük yoğunluklu kolesterol (LDL) ve yüksek yoğunluklukolesterol (HDL) değerlerinin ise anlamlı olarak daha düşük olduğubulundu. Sonuç: Lökosit sayısı normalsınırlar içerisinde dahi T2DM hastalarında diyabeti olmayan bireylerden dahayüksektir. Bizim sonuçlarımız kronik inflamasyonun Tip 2 diyabetteki rolünüdesteklemektedir. İnflamasyonun diyabetteki rolünü açıklayacak daha kapsamlıçalışmalara ihtiyaç vardır.

Breast-cancer-related lymphedema (BCRL) is a common complication of breast cancer treatment. Informing patients about BCRL can contribute to decrease their risk of developing the condition or prevent it from progressing further. In order to educate patients about BCRL effectively, clinical knowledge of clinicians must be adequate. In study, we aimed to reflect BCRL knowledge and attitude of Turkish primary care physicians (PCPs). This questionnaire-based study was conducted by face-to-face interview method. The participants included actively working PCPs from all parts of Turkey. The questionnaire elicited data on physicians’ demographics, the BCRL knowledge, self-reported BCRL knowledge, referral patterns, and education. A total of 314 PCPs with a mean age of 36.9 % ± 8.1 years (mean ± standard deviation) were included in the study. Median BCRL knowledge score of all study group was 15 (11–18) [median (25–75 % range)]. PCPs who received education about BCRL during their medical faculty and/or residency periods had significantly higher knowledge scores (p = 0.005). Of PCPs, 94.9 % indicated to make a BCRL referral for a breast cancer patient. Among them, 55 % preferred to make a referral to a general surgeon, 28.2 % to an oncologist, and 16.8 % to a physical medicine and rehabilitation specialist. Assessment of factors related with BCRL should be part of routine evaluation of patients with breast cancer in primary care. Education of PCPs about BCRL is warranted in order to improve the BCRL care.

WOS: 000379331000004, PubMed: 28360781, Introduction: We aimed to determine the level of bereavement and depression symptoms among elderly patients who experience the loss of a significant other and the relationship between depressive symptoms and bereavement symptoms. Methods: The study sample consisted of elderly adults who lost a significant other at least 6 months prior to the submission time. Participants were recruited from patients who presented to either the psychiatry or family medicine outpatient unit of a Training and Research Hospital. Cognitive functions were assessed using Standardized Mini Mental Examinations for Educated and Uneducated People (SMME/SMME-U). Participants were excluded from the study if their SMME or SMME-U scores were lower than 23 points. To assess the severity of depressive and bereavement symptoms, the Geriatric Depression Scale (GDS) and Core Bereavement Items (CBI) scales were used, respectively. Results: Overall, 33 out of 67 individuals (49.2%) who presented to the psychiatry unit and 7 out of the 43 individuals (16.3%) who presented to the family medicine unit were diagnosed with major depressive disorder (MDD). CBI scale score means were higher in the MDD groups than in the non-depressive groups (p=0.012 and p=0.001, respectively). CBI scores were significantly correlated to acute (p=0.047) and chronic stress (p=0.007) in the psychiatry group and to chronic stress in the family medicine group (p=0.001). Conclusion: Probing loss experiences and reactions to them can be important to understand depression, to evaluate its symptoms, and to help manage the relevant symptoms. Considering the significant contributions of bereavement to depressive symptom severity in elders, interventions specific to bereavement symptoms should not be ignored.

[Purpose] Osteoporosis is an inflammatory disease, and platelets play a critical role in bone remodeling. Mean platelet volume has been shown to be influenced by inflammation. Our aim was to evaluate the relationship between mean platelet volume and bone mineral density in postmenopausal women. [Subjects and Methods] The records of female patients who had been referred to a tertiary hospital for bone mineral density analysis were retrospectively reviewed. [Results] A total of 175 patients (mean age: 61.3 ± 9.0 years) were enrolled. Overall, 72% (126/175) of patients met the criteria for osteoporosis. Mean platelet volume was found to be inversely correlated with body mass index. There was a significant positive correlation between mean platelet volume and femoral neck bone mineral density in our normal weight osteoporotic group, whereas there was a significant negative correlation in our overweight-obese osteoporotic group. The negative correlation between mean platelet volume and femoral neck bone mineral density in the overweight-obese osteoporotic group persisted after adjustment for confounding factors. Multivariate analyses revealed that mean platelet volume was significantly associated with femoral neck bone mineral density in osteoporotic patients in both our normal weight and overweight-obese groups. [Conclusion] Regardless of mechanisms, mean platelet volume might be used as a biomarker for osteoporosis in clinical settings.

Brucellosis produces a variety of non-specific hematological abnormalities. The aim of the present study was to evaluate the hematological findings in childhood brucellosis.Medical records of children with brucellosis admitted to a tertiary hospital in a 1 year period, were analyzed retrospectively.Sixty-nine patients (mean age, 14.5 ± 3.3 years) were diagnosed with brucellosis. The most common hematological finding was thrombocytopenia (n = 11, 15.9%). Thrombocytosis was detected in five patients (7.3%), leukopenia in four (5.8%), anemia in three (4.3%), and bicytopenia in three (4.3%). None of the patients had pancytopenia. Blood culture was positive for Brucella spp. in 41 patients (59.4%). Among those patients with positive blood culture, six (14.6%) had serum agglutination test titer ≤1/80. Platelet (PLT) count was significantly lower in the bacteremia-positive group. The OR (95%CI) of bacteremia for PLT cut-off 200,000/mm(3) was 0.148 (95%CI: 0.031-0.718) and relative risk was 1.718 (95%CI: 1.244-2.372; P = 0.010).Brucellosis should be kept in mind in the differential diagnosis of isolated thrombocytopenia in pediatric patients from endemic areas.

Amaç: Bu çalışmada; Van depremi öncesi ve sonrası dönemlerde pediatrik hastalarda, su kaynaklı salgın hastalık oluşturabilen bazı mikroorganizmaların izolasyon sıklığını belirleyerek, bulaşıcı hastalıklar üzerine depremin olası etkilerinin tespit edilmesi amaçlanmıştır. Yöntemler: Çalışmada 23 Ekim 2011 tarihinde Van\'da yaşanan deprem öncesi ve sonrası altı aylık dönemde, 0-14 yaş grubu çocuklara ait Adenovirüs, Rotavirüs, Hepatit A Virüsü (HAV), Giardia intestinalis ve E.histolytica/dispar test sonuçları retrospektif olarak incelenmiştir. Bulgular: Deprem sonrası, Adenovirüs, Rotavirüs, Anti HAV IgM ve E.histolytica/dispar saptama oranında bir önceki döneme göre azalma olduğu görülmüştür. Rotavirüs ve E.histolytica/dispar sıklığındaki azalma istatistiksel olarak anlamlı bulunmuştur (, Objective: In this study, it was aimed to compare the isolation frequency of some water-borne disease causing microorganisms in pediatric patients before and after Van earthquake in order to determine the potential impact of earthquake on those selected infectious diseases. Methods: The laboratory test results of Adenovirus, Rotavirus, Hepatitis A virus (HAV), Giardia intestinalis and E.histolytica/dispar which were requested from 0-14 years old children, during six months before and six months after Van earthquake which took place on 23 October 2011, were retrospectively reviewed. Results: Adenovirus, Rotavirus, Anti HAV IgM and E.histolytica/dispar showed reduction in the isolation frequency rate during the six months period after the earthquake compared with the same period of previous year. The reduction rates in the isolation frequencies of Rotavirus and E.histolytica/dispar were found to be statistically significant (p

Turkiye’de Aile hekimligi uygulamasi Saglik Bakanligi tarafindan yenilenmistir. Yeni uygulama ilk defa 15.09.2005’de Duzce’de baslamis ve 2010 yili sonunda tum Turkiye’de yayginlasmistir. Bu sure icinde, sozlesmeli olarak aile hekimligi yapmak isteyen uzman ya da pratisyen hekimler, standardize edilmis kisa bir egitimden gecerek calismaya baslamislardir. Turkiye Halk Sagligi Kurumu (THSK), sahada calismaya devam eden aile hekimlerinin uzmanlik egitimi almalarina yonelik bir calisma yaparak, 2014 yili ilkbaharda yapilan Tipta Uzmanlik Sinavi ile ilk defa Sozlesmeli Aile Hekimligi Uzmanligi (SAHU) icin asistan almaya baslamistir. Bu makale, sozu edilen surecte ortaya cikan degisimleri tanimlamayi, gelisim surecini degerlendirmeyi ve ileriye donuk olasi problemleri gozden gecirmeyi amaclamaktadir. The official organization of family practice was renewed by Ministry of Health in Turkey and practicaly started in Duzce at 09.15 th . 2005. It become widespread across Turkey by the end of 2010. In the mean time, specialists and practitioners who wanted to work as contracted family physicians were trained by a standardized training module and started working. First in 2014, as a part of the project aiming to train contracted family physicians to grow up as specialists (SAHU), Turkish Community Health Institution (THSK) started to recruit family medicine residents by an elective examination in 2014. This article targets to define the changes appeared in the process, evaluate the progress and revise the problems that might be a concerne in the future.