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A field survey has been conducted to define the impact of promotion activities on consumer behaviours in the area of highly competitive Turkish GSM sector. Within the context of the research, 400 volunteers who live in Ankara were surveyed through a questionnaire that consists of 38 questions and the data received was classified and analyzed by using the PASW v18.0 package programme. As a result of the "Chi-Square" analysis, the variables that have an impact on the participants in accordance with their demographic features were indicated and recommendations were made to the GSM operators. Subsequently, for "The Impact Level Dimension of the Promotion Activities Implemented in the GSM Sector on Consumers", a total dimension point has been calculated and the link which is anticipated to exist between this point variable and the demographic characteristics of the participants in the survey has been examined through the application of independent Samples t test, and One-Way Analysis of Variance test (Anova), and relevant hypothesis test. It has been observed that the results of the "Chi- Square" analysis and Samples t test and One-Way Analysis of Variance test (Anova) overlapped largely. [ABSTRACT FROM AUTHOR]

The aim of this survey is to evaluate the reasons behind the demand for postgraduate programs and the relationships between these reasons among disciplines. This survey was administered to 304 students randomly chosen from master with thesis and doctorate programs at the Institute of Sciences and Technology, Institute of Social Sciences and Institute of Educational Sciences of Gazi University in 2008-2009. The developed questionnaire was analyzed with SPSS 15 (The statistical packet for the social sciences) packaged software. The Chi-square statistical technique was used to determine whether there were meaningful relationships between the groups, and meaningful differences were found between disciplines. The results indicated that one of the important goals of students in graduate education is the self-development in scientific terms. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: This study aims at examining whether the social support sources of teachers differ depending on the variables of gender and seniority when they encounter violence at school and investigating their opinions on precautions against school violence. Methods: Data was collected via a questionnaire from a sample of 179 female and 166 male Turkish teachers. Chi-square and Mann-Whitney U tests were used for data analysis. Results: Male and female teachers preferred to share the experience of exposure to verbal (χ 2 (5) =22.81, p<.01), physical (χ 2 (5) =36.64, p<.01), emotional (χ 2 (5) =26.13, p<.01) and sexual violence (χ 2 (5) =37.43, p<.01) at school with different social support sources. Male teachers preferred their colleagues as social support sources whereas female teachers preferred their spouses/families. Social support sources which teachers prefer when they face any type of violence other than sexual violence differ due to the length of teaching experience. School administrators and counselors are not among the social support sources of teachers when they were exposed to violence. Conclusions: Turkish teachers'' preferences related to their victimization experiences indicate a need for prevention program encompassing teachers, school counselors and administrators. [Copyright &y& Elsevier]

The aim of this study was to examine the changes that occur in the oral health attitudes and behaviors of dental students in Istanbul, Turkey, during their dental education. The Turkish version of the Hiroshima University-Dental Behavioral Inventory (HU-DBI) was distributed among 757 dental students at the Dental Faculty, Istanbul University. The response rate was 72 percent. Chi-square and logistic regression models were used for statistical analysis. The mean HU-DBI score of the clinical students was significantly higher than that of the preclinical students. Preclinical students significantly more often believed that it was impossible to prevent gum disease with tooth-brushing alone and worried about the color of their teeth and bad breath. Most of them brushed their teeth with strong strokes, thought the condition of their teeth was getting worse despite daily tooth-brushing, and would seek dental care only when symptoms arise. Clinical students more often used disclosing solutions to see how clean their teeth were and complained of bleeding gums. The variation in favorable oral health attitudes/behaviors appeared to reflect the students' educational training experience. The findings of this study highlight the relatively poor oral health behaviors of Turkish dental students, which should be improved by means of comprehensive programs that aim to promote their own dental hygiene practices and preventive oral health knowledge from the start of dental training. [ABSTRACT FROM AUTHOR]

Objective: Taxi drivers carry significant risks related to occupational health and safety. Exposure to second-hand tobacco smoke is known to be one of those health risks. As legislations for smoke-free taxis become more widespread throughout the world, this study aimed to assess knowledge and attitude of taxi drivers on the new legislation for tobacco control introduced in Turkey recently. Methodology: The study population consisted of 135 taxi drivers from 22 different taxi stations in Ankara Turkey. Data of the descriptive study was collected in October, 2008 through face-to-face interviews with a standart questionnaire. Descriptive statistics were used to summarize data, whereas chi-square was used to compare groups. Results: All the study participants were male with a mean age of 47.2±11.8 years. More than half of the taxi drivers (59.3%) were found to be current smokers. Although level of knowledge and attitude of taxi drivers on the new legislation were favorable in general, some difficulties and barriers were found to be present in implementation of the ban. Most of the smoking drivers were found to continue smoking in their taxis. About 80.0% of the drivers stated their concern of losing out on clients' satisfaction if they restrict smoking in their taxis. Conclusion: Taxi drivers and clients' knowledge, attitudes and behaviors are important determinants in successful implementation of legislations for smoke-free taxis. [ABSTRACT FROM AUTHOR]

Aim: Whether to use the same ovarian stimulation protocol or change it after a failed in vitro fertilization cycle is still a controversial issue. In this study we aimed to investigate the effect of changing the stimulation protocol in the sequental cycle of the same patient population on intracytoplasmic sperm injection (ICSI) outcomes., Methods: This retrospective study included two sequental fresh ICSI cycles of 941 infertile women attended in a period of one year. Group A was composed of patients who failed to have clinical pregnancy with a GnRH agonist and group B was composed of patients who failed to have clinical pregnancy with a GnRH antagonist protocol cycle. In both groups the study group was composed of patients whose stimulation protocol was changed in the sequential cycle and the control group was composed of patients who proceeded with the same stimulation protocol. The clinical pregnancy and live birth rates were primary outcomes., Results: In group A, the clinical pregnancy rates were comparable between the study and the control groups, but the live birth rate was higher in the study group (p=0.03). In group B, there was no difference in terms of clinical pregnancy and live birth rates between the study and control groups (p=0.740 and p=0.842 respectively)., Conclusions: Changing the ovarian stimulation protocol after a failed ICSI cycle downregulated with a GnRH agonist increased the live birth rate. After a failed cycle stimulated with a GnRH antagonist protocol, protocol change did not have any impact on the clinical pregnancy and live birth rates., Competing Interests: Declerations of Competing Interest None. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Objective: The proto-oncogene Bax (Bcl-2-associated X protein) and related protein Bcl-2 (B-cell chronic lymphocytic leukemia/lymphoma-2) genes are triggers of apoptosis in Alzheimer's disease (AD). The balance of these proteins has an important role in the death or life of a neuronal cell, and the functional polymorphisms in genes expressing these proteins have been found to promote apoptosis. To investigate the role of Bax and Bcl-2 genes in AD, we examined the presence of the 2 polymorphisms in peripheral blood. To our knowledge, this is the first clinical association study of these 2 functional SNPs using the peripheral blood of patients with AD., Methods: Bax (rs4645878) and Bcl-2 (rs2279115) in Alzheimer's patients (N = 132) and healthy controls (N = 109), aged 65 to 85 years, were analyzed by qPCR (Quantitative Polymerase Chain Reaction) using TaqMan probe technology. Statistical analyses were done using SPSS, 11.5. The differences between groups were analyzed using an independent-samples t test. The relationships between genotypes and alleles were analyzed using chi-square or likelihood ratio test. The Hardy-Weinberg balance was checked for the patient and control groups. A p-value of less than 0.05 was taken as significant., Results: Sporadic AD patients and non-demented age matched control subjects were genotyped in this case-control study. No statistically significant relationship was found between the patients and controls for allele or genotype frequencies (p>0.05)., Conclusion: Our data suggest that these two polymorphisms do not contribute to AD in the population from the Mersin region of the Eastern Mediterranean. Further studies with larger sample sizes must be conducted to ascertain the association between the 2 polymorphisms.

Objective: The present study aimed to determine the types of monitor alarms and nurses' responses to them in an adult intensive care unit., Design and Methods: This was an observational descriptive research study conducted in the adult intensive care unit of a university hospital in the Mediterranean region of Turkey. The nonparticipant observation method was used. Data were collected by two observers using a semi-structured observation form developed according to literature., Results: Between August 2016 and January 2017, 13 registered nurses were observed for 328 hours. There were 1781 alarms, which included alarms for blood pressure (37.6%), respiration and oxygen saturation (35.3%) and heart rate and arrhythmia (27.1%). Nurses responded to approximately half (46.9%) of the alarms that required a response. Responses to alarms included silencing them, responding to the patient's clinical condition and solving contact and transmission problems., Conclusion: In the present study, according to response requirement, the division of the alarms was different. The number of alarms that do not reflect the clinical status of the patient was high. It was found that as the false alarm rate increased, the response rate of nurses to these alarms decreased., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: Eating disorders are one of the most prevalent psychiatric disorders and have become a growing problem nowadays. Research shows that eating disorders are mostly widespread in industrialized societies where beauty is associated with thinness. This study investigates the relationships between eating attitudes, body image and depression among Turkish university students aged 18 to 25., Materials and Methods: The sample comprised of 221 female and 80 male university students from four different universities located in Istanbul and Ankara. Demographic Information Form, Body Image Scale, Eating Attitude Test (EAT-40) and Beck Depression Inventory were used to collect data. Height and weight of the participants were also collected to measure Body Mass Index (BMI) of the individuals., Results: This study found that 55 (18.3%) students had abnormal eating attitudes, 115 (38.2%) students had negative body image and 102 (33.9%) students showed moderate and severe levels of depression. Body image was negatively correlated with eating attitude and depression in underweight individuals when grouped according to their BMI. Being underweight was significantly higher in females. Females also had more negative body image and higher depression levels. Individuals with abnormal eating attitudes had higher depression levels. BMI and gender did not lead to any significant difference in the eating attitudes of the students., Conclusion: This study has contributed to the literature on the relationships between eating attitudes, body image and depression among Turkish university students between the ages of 18 and 25. It has further drawn attention to the importance of eating disorders in Turkey and being aware of the relationships among eating attitudes, body image, depression, and BMI. Results of the study are discussed in detail and in consideration of cultural context.

Objectives: The aim of this study was to determine the knowledge, attitudes, and prejudices of nursing students regarding the provision of transcultural nursing care to refugees., Methods: The sample of this comparative descriptive study was composed of 317 volunteering nursing students living in Ankara, Turkey. Descriptive statistics were presented as number, percentage, and mean ± standard deviation. The relationships among dependent and independent variables were analyzed with Pearson chi-square test. p ≤ 0.05 was accepted as statistically significant., Results: The mean age of the students was 21.19 ± 1.66 years; 88.6% were female. Only 30.0% (n = 95) of students (predominantly seniors) were educated on transcultural nursing. Statistically significant differences were found among grades of nursing students on the answers to the items, "Refugees are under coverage of general medical insurance system," "The concept of 'Health' differs from culture to culture," "Cultural features of the patient are important for caring nurse," "In order to provide care to only refugees and foreign patients, nurses from other cultures should be employed in hospitals," "Interpreters should be employed in hospitals 24 hours for services for refugees," and "According to my observations, refugees and their relatives admitted to the hospital are not respecting the healthcare workers and hospital rules." In addition, there was a statistically significant difference in students' comfort level with nursing care activities between those students who were literate in a foreign language and those who were not literate in a foreign language., Conclusions: Our findings show that attending lectures on transcultural nursing in a curriculum of seniors and being literate in a foreign language had a positive impact on the attitudes of students in terms of the provision of medical care to refugees. It is recommended that nursing programs integrate lectures on transcultural nursing into the curricula of all four grades of nursing education and encourage students in language learning to better serve our disadvantageous guests., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: To investigate the effect of challenging factors on laparoscopic hysterectomy trends within twenty-four years., Population and Method: This was a trend analysis study of 7558 women who underwent hysterectomy for benign indications between 1995-2018 in Bursa Uludag University Hospital, Turkey. A trend analysis of obesity, previous laparotomy (≥3) and uterine specimen weight (≥500g) was applied for abdominal hysterectomy (TAH), vaginal hysterectomy (VH), and laparoscopic hysterectomy (TLH) rates in this period. The primary outcome was laparoscopic hysterectomy trends throughout the years. We measured the effect of obesity, previous laparotomies and large uterus on TLH trends as secondary outcomes., Results: The ratio of TLHs to all hysterectomies was 2.4% in 1995 and 44.7% in 2018 which increased 33 times higher over 24 years. The percentage of obese patients in TLH cases increased from 1% to 37%, the rate of patients who had three or more previous laparotomy in TLH cases increased from 0% to 32.2%, and the percentage of patients who had more than 500g uterus specimen in laparoscopic hysterectomy cases increased from 0% to 32.8%., Conclusion: Laparoscopic hysterectomy trends are increasing in challenging cases. Obesity, previous surgeries, and large uteruses are no longer a limiting factor for laparoscopic hysterectomy., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Evaluating the healing status of pressure injuries is important to planning medical and nursing care., Purpose: A descriptive, retrospective study was conducted to determine the healing status of pressure injuries among critically ill immobile patients., Methods: Data were obtained via medical record review of all patients admitted to a Turkish university hospital's anesthesiology intensive care unit (ICU) between January 2008 and December 2015. Demographic (age, gender), medical (comorbidities, diagnosis, length of ICU stay), and pressure injury characteristics (number, location, stage, healing status, length, width, exudate amount, tissue type) were evaluated along with Pressure Ulcer Scale for Healing (PUSH) Tool scores. Data from all patients >18 years of age with an ICU stay >24 hours who had a pressure injury and whose records were complete were included in the study. Data were expressed as number, percentage, and mean and median values. Wilcoxon test, Spearman's correlation analysis, and chi-square test were performed as appropriate. Pressure injuries were considered healed when the PUSH score equaled zero., Results: The study sample comprised 359 patients (60.97 ± 19.31 [range 19-95] years, 217 men, median length of stay 25 [range 1-363] days) with 672 pressure injuries. Most pressure injuries were located on the coccyx (278 [41.4%]), and 153 (22.8%) healed during ICU stay. Older age (r = 0.167; P = .002) and length of ICU stay (r = 0.238; P = .0001) were significantly correlated with having multiple pressure injuries. There was a statistically significant relationship between pressure injury location and stage and healing status (χ2 = 28.993, P = .0001; and χ2 = 60.200, P = .001, respectively). The lowest percentage of injuries healed were on the coccyx and were stage 4 and unstageable. Overall, the mean first PUSH score was significantly higher than the last assessment score (8.99 ± 3.82 to 7.28 ± 5.22, respectively; z = -10.807; P = .0001)., Conclusion: Many immobile ICU patients had multiple pressure injuries, especially patients who were older and who had a longer length of stay. Healing scores for pressure injuries were better at discharge or transfer and 22% of injuries were healed. Prospective studies comparing all factors that may contribute to pressure injury healing are warranted. .

Transmission of infections through blood and blood product transfusion is a serious healthcare problem. There are insufficient up-to-date data about seroprevalence of HBsAg, anti-HCV and anti-HIV ½ among healthy blood donors in Turkey. We aimed to investigate the seroprevalence of HBsAg, anti-HCV and anti-HIV ½ in Southeastern Anatolia, Turkey. HBsAg, anti-HCV, and anti-HIV ½ analysis results among blood donors who applied to Dicle University Faculty of Medicine, Diyarbakir District Blood Centre, between January 1, 2011 and December 31, 2015 were retrospectively evaluated. HBsAg, anti-HCV, and anti-HIV 1/2 screenings were performed using a fully automated device with the microparticle enzyme immunoassay method (MEIA). The chi-square (χ2) test was applied to variables. Among the donors, 1607 (1.73%) were HBsAg-positive, 255 (0.27%) were anti-HCV-positive and two (0.0021%) were positive for anti-HIV 1/2. HBsAg positivity rates by years were 2.50% in 2011, 1.92% in 2012, 1.74% in 2013, 1.53% in 2014 and 1.27% in 2015 (p<0.001). HBsAg-positivity was 0.78% for the donors between 18-24 years of age, 1.90% for those between 25-49 years of age and 3.92% for donors over the age of 49 (p<0.001). Anti-HCV positivity rates were as follows: 0.35% in 2011, 0.34% in 2012, 0.29% in 2013, 0.23% in 2014 and 0.16% in 2015 (p<0.001). Verified anti-HIV 1/2 positivity was observed for only two donors (0.0021%) within five years. HBsAg and anti-HCV positivity were observed to decrease significantly over the years and were significantly lower among younger donors.

Objective: This study aimed to determine the effectiveness of an intratympanic (IT) injection of a mixture of gentamicin and dexamethasone compared with intratympanic dexamethasone (ITD) for controlling vertigo and protecting the hearing level of Meniere's disease patients who have persistent vertigo attacks, despite medical treatment., Methods: Thirty eight patients with intractable Meniere's disease were included in this study. Twenty-one patients were treated with IT mixture gentamicin and dexamethasone injection; seventeen patients were treated with ITD. Pre- and post-treatment audiograms were compared with pure-tone averages. Control of vertigo was classified according to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) vertigo control index., Results: In the mixture group single IT injection was administered in 18 patients (85.7%), 2 injections were administered in 2 patients (9.5%) and 3 injections were administered in one patient (4.8%). In the ITD group IT injection was performed 3 times (days 1,3,5) at intervals. The mean number of intervals per patient was 3,41 (range 1-6). Two years after IT treatment there was better control of vertigo in mixture group than in ITD group; 81% of mixture group and 70,6% of the ITD group achieved satisfactory control of vertigo (p = 0,0286). Audiology results of mixture group showed 20 patients (95,24%) with unchanged hearing and 1 patient (4,76%) with only 10-decibel deteriorated hearing. There was no worsening of hearing in the ITD group., Conclusion: The results of this study showed that an IT injection of a mixture of gentamicin and dexamethasone in intractable Meniere's disease cases is more effective than ITD for vertigo control., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Nurses play an important role in identifying, evaluating, monitoring, and managing patients with urinary incontinence (UI)., Purpose: This study was conducted to determine nurses' knowledge, attitudes, practices, and obstacles to managing patients' UI., Methods: A descriptive study was conducted between September 2017 and February 2018 at 2 university hospitals, 2 private hospitals, and 4 state hospitals in a metropolitan city in Turkey. All registered nurses present at the times of data collection were eligible to participate. After providing informed consent, they were asked to complete a 25-item demographic characteristic questionnaire, a 7-item UI assessment and care implementation form, a 12-item form assessing obstacles faced during UI care provision, a 24-item UI knowledge questionnaire (higher scores indicated more knowledge; a score of 70% correct was considered adequate), and the Urinary Incontinence Attitude Scale. The latter comprised 15 Likert-type questions that measures attitudes toward UI symptoms, treatment, and prevention (maximum score of 60; higher scores infer positive attitude). Data were collected and entered into a software program for statistical analysis including Mann Whitney U, chi-square, and correlation tests. Incomplete forms were excluded., Results: Of the 475 potential participants, 254 nurses completed all forms; 228 (89.8%) were women, 177 (69.7%) had a bachelor's degree, 146 (57.5%) worked in a state hospital, and 105 (41.3%) worked for 2 to 3 years. The mean score for UI knowledge was 15.22 ± 3.43 (range 0-24), and the mean attitude score was 46.40 ± 5.50 (range 15-60). The major nurse- or hospital-related obstacles to providing UI care were a lack of systems for patient follow-up (67.7%) and lack of patient education materials (60.2%). A weak positive correlation was noted between UI knowledge level and attitude (r = 0.263; P = .000)., Conclusion: Although nurses had a positive attitude toward UI, UI knowledge scores were low. Lack of patient follow-up systems and patient education materials were important obstacles to nurses providing UI care. In addition to addressing these obstacles, postgraduation evidence-based UI education for nurses is needed to optimize care.

Introduction: Enuresis nocturna (EN) is very common worldwide, and psychiatric disorders are 1.3-4.5 times higher in children with EN. When the authors focus on symptoms of individuals with EN, they figured out that the individuals were impaired in social and emotional skills because of the dramatic consequences of EN. The authors presume that, despite a lack of psychiatric comorbidity, primary enuresis nocturna (PEN) itself and its consequences may increase adolescents' social anxiety (SA), leading to adulthood mental diseases., Objective: In this study, the authors aimed to investigate the presence of SA of adolescents with monosymptomatic PEN without any psychiatric comorbidity by comparing them with their healthy peers., Methods: The study was composed of 56 children who applied to pediatric nephrology outpatient clinic and were diagnosed with monosymptomatic PEN and 42 healthy controls. The psychiatric diagnoses were made by a child psychiatrist, with the help of a semistructured interview (Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, K-SADS-PL), and patients were required to fill out the Screen for Child Anxiety and Related Disorders, Social Anxiety Scale for Adolescents (SAS-A), and Children's Depression Inventory (CDI) scales with the help of a clinical psychologist. The physical examination made by a pediatric nephrologist and dysfunctional voiding and incontinence scoring system questionnaire were used to evaluate the voiding dysfunction in children., Results: There was no significant difference in the total depression and anxiety scores between the groups (p > 0.05). There was a significant difference between the two groups in the subscale of SA (t = 2.67 p = 0.009) (Table). Social Anxiety Scale for Adolescents (p < 0.001) and subscales of SAS-A (Fear of Negative Evaluation [p < 0.001], General Social Avoidance and Distress [p = 0.003], Social Avoidance and Distress in New Situations [p < 0.001]) scores were significantly higher in the patient group., Discussion: The authors want to emphasize the comorbid SA of adolescents diagnosed with PEN. This anxiety may disturb adolescents' health in two ways: first, with the help of direct consequences of the SA and second, being late for seeking help for the EN and possible delay in EN treatments. The main limitation of this study is the assessments of the prior mental status of subjects were made by K-SADS-PL, thus remaining a recall bias. A follow-up study may be more objective., Conclusion: So all adolescents diagnosed with PEN should require a detailed mental examination to prevent further negative consequences and provide more comprehensive treatment. Also, the study needed to be repeated in larger samples, and prospective studies should be designed to enhance authors' understanding., (Copyright © 2019 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Objective: The aim of this cross-sectional study was to assess the prevalence of apical periodontitis in root canal treated teeth in Turkish subpopulation and to evaluate the effects of both coronal restoration quality and root canal treatment (RCT) quality on apical periodontitis., Materials and Methods: Panoramic images of individuals who applied to our department for different diagnostic reasons were randomly and retrospectively scanned. Total RCT number, RCT quality, type of coronal restoration, restoration quality, periapical status, and total number of teeth were recorded. The criteria used for coronal restorations quality and RCT quality were defined by De Moor et al. and slightly modified by Gunduz et al. Periapical status was assessed by the periapical index developed by Orstavik et al. Pearson's Chi-square test was used for statistical analysis, and the intraobserver agreements were assessed by Kappa coefficients. Values of P < 0.05 were accepted to be meaningful., Results: The total examined teeth number was 6064, of which had 541 (8.9%) RCT. The prevelance of apical periodontitis was 40.5%. The number of adequate RCT was 178 (32.9%), and 138 (77.5%) of them were healthy. The number of adequate coronal restoration was 334, and 62.3% of them were healthy. For the cases that have adequate coronal restorations, there was statistically significant relationship between adequate RCT and periapical status (P < 0.001)., Conclusion: The prevelance of apical periodontitis was 40.5% and there was statistically significant relationship between adequate RCT and periapical status., Competing Interests: None

Background: Little is known about sperm health in male patients with familial Mediterranean fever (FMF). In this study, the authors aimed to search the frequency of sperm abnormalities of adolescent boys with FMF and also to investigate whether disease activity or colchicine treatment have negative effects on sperm parameters., Method: The male adolescents older than 14 years with a diagnosis of FMF were investigated retrospectively. Tel Hashomer and pediatric FMF clinical criteria were used for diagnosis of FMF. Patients who had semen analysis were included in the study., Result: Mean age at the diagnosis was 11.13 ± 3.82 years, and mean age at the study was 14.50 ± 0.70 years. The mean sperm concentration was found as 66.26 ± 41.02 million/ml (N > 15 million/ml), the mean total sperm count 113.42 ± 132.39 million (N > 39 million), and the mean sperm motility 51.78 ± 23.70% (N > 40%). Only 8 of 19 (42.1%) patients had normal sperm parameters. Sperm concentration was reduced in two cases, total sperm count was reduced in four patients, and motility was reduced in nine cases. The presence of FMF attacks under treatment was found to be a risk factor for decreased motility in the study group by multivariate regression analysis (odds ratio 0.076, [95% confidence interval 0.005-0.648], P = 0.031). Erythrocyte sedimentation rate at the time of diagnosis was high in patients with low sperm counts compared with those with normal sperm counts (56.00 ± 8.51 vs 24.35 ± 6.32, P: 0.03). Mean colchicine dose at the time of sperm analysis was higher in patients with low sperm motility than that with normal sperm motility (1.72 ± 0.18 vs 1.25 ± 0.08, P: 0.02)., Conclusion: Sperm abnormalities of male patients with FMF is not infrequent, and it is linked to both inflammation due to uncontrolled disease and colchicine therapy., (Copyright © 2019 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Purpose: This study evaluated students' perceptions of their self-confidence regarding aspects of their undergraduate oral and maxillofacial surgical training. It further aimed to develop a reliable Turkish version of the questionnaire originally developed by the Association of British Academic Oral Maxillofacial Surgeons (ABAOMS) Education Committee., Methods: A cross-sectional survey of 40 fourth-year and 47 fifth-year dentistry students of Yeditepe University Faculty of Dentistry in Turkey with a mean age of 23.30 ± 1.50 was conducted in January and February 2018. The ABAOMS questionnaire was adapted to the Turkish language and culture. The items were organized in five domains (general information, self-confidence in oral surgery, role of outreach, anatomy knowledge in relation to oral surgery, and career aspirations) with most response options on a five-point Likert-type scale. Reliability was assessed through an internal consistency analysis and a test-retest approach. Descriptive statistics, independent samples t-tests, and Chi-squared for contingency tests were used to examine the data., Results: Cronbach's alpha coefficient on the questionnaire was 0.89. The responses reflected general agreement among the respondents. Females were significantly more self-confident than males. Although the fifth-year respondents were more self-confident than the fourth-year respondents on items regarding anatomy knowledge, fourth-year respondents were more self confident in forceps extractions. Other than that no major differences in self-confidence were found between the two groups., Conclusion: Though self-confidence was high regarding extraction of teeth and retained roots, the participants of this study lacked self-confidence in performing surgical extractions and its related procedures, recognition of malignancies, and ability to differentiate between pain of odontogenic or non-odontogenic origin. Female students were relatively more self-confident. Teaching should focus on practical applications that support students' sense of self-confidence in their abilities. The Turkish version of the questionnaire was a reliable instrument.

Objective: School-aged children are a risk group in terms of accidents and injuries, and these factors may be the primary causes of death in children. Teachers have important roles in preventing accidents and injuries and giving first aid. The purpose of this research was to identify situations in which teachers most frequently encounter the need to administer first aid to children and whether the teachers performed the correct application in these events., Methods: This descriptive study was conducted with 331 teachers in a city in the Central Anatolia Region. The study was approved by the local ethics committee and the participants., Results: Of the 45.3% teachers educating children ages 6 to 15 years, 81.0% of the teachers were familiar with first aid, but only 23.0% claimed to have an adequate knowledge. In the previous year, situations that had required first aid included epistaxis (75.2%), abdominal pain (49.2%), and vomiting (39.2%). The study also investigated any accidents and injuries occurring, their causes, and the teachers' interventions following the accidents and injuries. It was found that teachers had information about first aid, but they did not trust themselves enough to practice it., Conclusion: Understanding the causes of accidents and injuries, finding preventive measures, and updating teachers' knowledge about this subject are important to provide a safe educational environment. (Disaster Med Public Health Preparedness. 2019;13:456-462).

Purpose: The older population has reached to 8.5%, and the prevalence of frailty is reported as 39.2% in Turkey. The purpose of the study was to assess caregiver burden in families who care for frail older adults in Turkish culture., Method: This descriptive study was conducted in Turkey between June and October 2017. Frail older adults who had no severe cognitive impairment were included. Data were measured using the Older Adult Information Form, Edmonton Frailty Scale, Caregiver Information Form, and Zarit Burden Interview., Results: In total, 131 older person/caregiver dyads were analyzed; the Zarit Burden Interview mean score was 37.59 ± 18.20. Caregivers with less education and providing care more than 8 hours experienced a higher burden ( p < .05). The severity of frailty significantly correlated with the caregiver scores ( R = .36, p < .01)., Conclusion: The caregiver burden in Turkish family caregivers was found mild to moderate and correlated with the degree of frailty. Policymakers should focus on culture-specific formal caregiver services.

Objectives:  To determine the prevalence of sarcopenia and related factors in individuals aged ≥65 years living in the Bornova district of Izmir, Turkey. Sarcopenia is one of the most serious health problems among elderly individuals., Methods:  This cross-sectional study was conducted in the Bornova district of Izmir, Turkey, between February-July 2015. This study participants were comprised of 909 individuals aged ≥65 years. The dependent variable was the presence of sarcopenia and the European Working Group on Sarcopenia in Older People (EWGSOP) approach was used for determining sarcopenia. The independent variables were socio-demographic and economic characteristics, healthy life behaviors and health status/condition. Data were collected at home through face-to-face interviews and measurements, analysed using chi-square test, t-test and logistic regression analysis., Results:  The participants' mean age was 72.8±6.2 (range: 65-100) years, and 60.2% were female (n=582). The prevalence of sarcopenia was 5.2% and that of low gait speed was 41.0%, low grip strength was 57.0%, low calf circumference was 6.1% and the combination of low gait speed and low grip strength was 14.3%. Risk factors of sarcopenia included increasing age, physical inactivity, low body mass index and the presence or risk of malnutritionConclusion: The prevalence of sarcopenia was 5.2% in this population and increased with age, physical inactivity, low body mass index and the presence or risk of malnutrition.

Background: At present, more than 90% of adolescents with chronic conditions survive into adulthood as health care users and move pediatric to adult care with their chronic illness. Therefore, the need satisfaction scale focuses specifically on transitional care and reflect the increasing expectations among youth and their parents., Aims: To examine the validity and reliability of the Turkish version of Mind the Gap scale., Study Design: Methodological study., Methods: The Turkish versions of Mind the Gap scale and Patient Assessment of Choronic Illness Care scale were applied to the participants in two tertiary hospitals in Ankara. The validity was evaluated with factor analyses and content-scope validity; the reliability was evaluated with item-total score correlation, internal consistency, and continuity methods., Results: A total of 109 adolescents and 157 parents completed the questionaire. The content validity was confirmed. Exploratory factor analysis was used to determine the factor structure of the scale. Both adolescent and parent scales formed three sub-dimensions and explained 71% and 73% of the variation, respectively. The Cronbach’s alpha reliability coefficient of Mind the Gap scale 1 and Mind the Gap scale 2 were 0.89 and 0.87, respectively, with internal consistencies of the parent’s scales reaching 0.92 and 0.90. The test-retest reliability coefficients totalled 0.88 and 0.85 for the adolescents and parents, respectively. The suitability of the model was examined with confirmatory factor analysis. Conformity indices and x2/df value of the model were in good fit to data., Conclusion: The Turkish version of the Mind the Gap scale is a valid and reliable scale for evaluating the needs, expectations, and satisfaction of adolescents and their parents in terms of health care.

Pressure ulcers (PUs) are a common problem with serious health care implications., Purpose: This study was conducted to assess PU prevalence, incidence, clinical features, nursing care measures, and patient variables and outcomes among inpatients admitted to 13 internal medicine departments at a university hospital in Turkey between 2010 and 2014., Methods: Using a cross-sectional, retrospective design, records of all hospitalized patients were reviewed and records from patients with a PU abstracted. Patient demographics, diagnosis, Braden Scale score, and PU information were abstracted from patient files/electronic records. Data were collected to an electronic data collection form between January and December 2015 and analyzed using descriptive statistics, chi-squared, one-way analysis of variance, and Student's t test., Results: From a population of 20 175 patients, the records of 664 patients showed the presence of a PU; the total PU prevalence rate was 3.3% and the overall PU incidence rate for 5 years was 1.8%. Ulcers were most often Stage 1 (326. 49.1%), located at the sacrum (364, 54.8%), and hospital-acquired (370, 55.7%; 175 (56%) of PU patients were oncology patients, followed by dementia/Alzheimer's patients (31, 9.2%). A significant relationship between Braden scores and general diagnoses was found (P <.01)., Conclusion: PU incidence was highest in patients with cancer and patients >65 years old, and patients with a diagnosis of dementia/Alzheimer's were at highest risk. Many patients outside of acute care settings have a PU. Risk assessments should be conducted and appropriate nursing interventions should be provided during facility admission and follow-up care. Prospective studies on the prevention of PU development in patients at risk are warranted.

Research related to the design and development of new incontinence containment products for women is scarce., Purpose: The purpose of this 2-part study was to 1) develop a new incontinence containment product for fecal incontinence and 2) examine the effect of this new product on the occurrence of incontinence-associated dermatitis (IAD)., Methods: In part 1, a new incontinence containment product was designed, developed, and trialed among 10 healthy female volunteers. The product was comprised of a double layer of polypropylene nonwoven fabric and 100% cotton interlock fabric with a 3-ply 100% cotton interlock fabric added into the perianal section. Participants wore the product for 8 hours and were asked to defecate into the product and evaluate its comfort, ability to contain liquids and protect privacy, any personal allergic reaction, and air permeability. In part 2, after any product modifications, 12 bedridden women treated in the neurology unit of a hospital in western Turkey who had an indwelling urinary catheter and fecal incontinence and who did not have diabetes mellitus, a darkly pigmented area in the perianal area, pressure injury, or erythema were randomized to 2 groups (study product and control, a premium adult diaper) and monitored for 8 days for the development and severity of perineal dermatitis (scored from 0 [no erythema] to 4 [broken, abraded skin]) using a skin assessment tool. Any type of erythema was considered IAD. Skin care (cleansing with a washcloth and water) was provided daily and after each defecation to all study participants. Data were collected via paper-and-pencil completion of the perineal skin integrity assessment and patient observation forms and entered into and analyzed by a computerized statistical program. Fisher's exact test and the chi-squared test were used to analyze the difference in IAD incidence and severity between the 2 groups, and the Mann Whitney U test was used to detect differences in the number and consistency of defecations., Results: No statistically significant differences were noted among the characteristics of the 12 participants (6 in each group) except for age; patients in the study product group were significantly older (70.66 ± 10.36 vs 52.20 ± 16.78 years; P <.05. Four (4) patients in the study group exhibited 13 areas of perineal dermatitis (degree 1 = 6 areas; degree 2 = 6 areas; degree 3 = 1 area; and degree 4 = 0); 1 patient in the control group had 4 areas with degree 1., Conclusion: This prototype product is not sufficient to be used in clinical practice in patients with fecal incontinence, but further study in a larger population is warranted..

Purpose: This study was designed to evaluate errors in inhaler technique in COPD vs asthma patients and to investigate the association of poor inhaler technique with patient demographics and clinical variables., Patients and Methods: A total of 509 adult patients with COPD (n=328) or asthma (n=181) who were currently using an inhaler device were included in this study. Data on patient demographics, duration of disease, type and duration of inhaler therapy, and assessment of inhaler technique were recorded., Results: Metered dose inhaler (MDI) was the most common type of inhaler used by a similarly high percentage of patients in both COPD (83.2%) and asthma (77.3%) groups. Failure to exhale before inhaling through device (75.8% and 68.5% for MDIs; 73.2% and 71.8% for Aerolizer ® /Handihaler ® ; 53.1% and 66.7% for Turbuhaler ® ) was the most common error in inhaler technique, in both COPD and asthma groups. Device-specific errors in inhaler techniques were more common in asthma patients as compared with COPD patients, particularly for MDIs ( P -values ranged from 0.046 to 0.0005), as associated with female gender (failure to press the buttons on both sides of Aerolizer ® /Handihaler ® , P =0.006), shorter duration of disease (failure to hold MDI or head in a vertical position, P <0.001, and to keep Turbuhaler ® upright, P =0.005), and shorter duration of inhaler usage (failure to hold head in a vertical position during MDI usage, P =0.006, and to keep Turbuhaler ® upright, P =0.012)., Conclusion: In conclusion, our findings revealed that errors in inhaler technique in terms of inhalation maneuvers and device handling were similarly common in COPD and asthma patients. Errors in certain device handling maneuvers, particularly with MDIs, were more common among asthma patients than among COPD patients and associated with female gender and shorter durations of disease and inhaler therapy., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Background: To evaluate the accuracy of the FARP 2 (female gender [F], bypass after a previous angioplasty [A], Redo bypass [R], and Pedal bypass [P 2 ]) scoring system in predicting early graft failure (EGF) after infrainguinal bypass surgery (IBS)., Methods: Charts of patients who underwent IBS between January 2014 and January 2017 in 2 tertiary academic centers were evaluated retrospectively. In follow-ups, 1 week after operation, detailed physical examination was done, Doppler ultrasonography was performed 1 month after operation, and integrity of the graft was evaluated. Calculation of FARP 2 score was performed by a single surgeon (M.S.) who was well informed regarding FARP 2 scoring system. The FARP 2 scoring system was evaluated as following: female gender 1 point, bypass after a previous angioplasty 1 point, redo bypass 1 point, and pedal bypass 2 points., Results: Totally, 231 patients (180 men and 51 women) were enrolled in the study. The mean FARP 2 score was 0.52 ± 0.73. The graft occlusion occurred in 23 patients (10%). Presence of critical leg ischemia was lower in patients who faced early graft occlusion (P = 0.002). On the other hand, Rutherford classification score was significantly higher in patients who did not face graft occlusion (4.1 vs. 3.4, P = 0.007). Moreover, unsuccessful angioplasty history and history of previous surgery were more common in that group (P < 0.001 and P < 0.001, respectively). None of the patients faced acute pulse loss, numbness loss, or ulcerative lesion after unsuccessful angioplasty. The mean interval between unsuccessful angioplasty and bypass was 1 ± 1.2 days in our study, which may have a role to prevent undesirable clinical consequences. The FARP 2 score was 1.5 ± 1.2 and 0.4 ± 0.6 in patients who faced graft occlusion and in patients without occlusion (P < 0.001). Multivariate regression analysis identified that critical leg scheme, presence of unsuccessful angioplasty history, and history of previous bypass operation were found as a predictive factor for EGF (P = 0.044, P < 0.001, and P = 0.003, respectively). Finally, our study demonstrated that patients with FARP 2 score 3-4 have 2.88-fold increased graft occlusion risk when compared with patients with FARP 2 score 1-2., Conclusions: Our study externally validates that the FARP 2 scoring system is related with EGF after IBS. The FARP 2 score may be an effective practice in prediction of EGF in patients with peripheral arterial bypass surgery., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Despite the high prevalence of infantile colic, the pathogenesis remains incompletely understood. Cortisol and melatonin hormones affect gastrointestinal system development in several ways, and interestingly, both cortisol and melatonin's circadian rhythms begin around the 3rd month in which infantile colic symptoms start to decrease. We hypothesized that infantile colic might associate with desynchronization of normal circadian rhythms of these hormones. In this study, we aimed to investigate the role of melatonin and cortisol in the pathogenesis of infantile colic., Methods: Patients who were diagnosed as infantile colic according to Wessel's "rule of three" were enrolled in the colic group. We measured the saliva melatonin and cortisol levels of colic group and control group infants. In both groups, the saliva samples were taken in mornings and at evenings, at the time of diagnosis and 6th month., Results: Fifty-five infants finished the study. Melatonin circadian rhythm developed earlier in the control group than the infantile colic group in our study. We found no significant difference between the daily mean cortisol levels. However, infants with colic had flatter daily cortisol slope than controls which pointed out the probability that they had a less clearly defined cortisol rhythm than infants without colic., Conclusions: We found an association between melatonin levels and infantile colic. However, more research is needed to fully understand the role of hypothalamic-pituitary-adrenal axis and hormone's role on infantile colic physiopathology.

Introduction: Upper pole access in percutaneous nephrolithotomy (PCNL) provides a straight tract to the ureter, resulting in easier placement of a guidewire to the ureter, good exposure of the pelvis, calices, and upper ureter, and comfortable manipulations. However, despite these benefits, upper pole access is usually avoided because of the risk of chest complications in both pediatric and adult patients., Objective: We aimed to evaluate the safety and morbidity of single upper pole access in pediatric patients undergoing PCNL., Study Design: We retrospectively reviewed patients aged ≤17 years with renal stones who underwent PCNL with a single access between August 2004 and February 2016. The patients were separated into two groups: the single upper pole access group (SUPAG) and the single other pole access group (SOPAG). We compared the SUPAG and SOPAG in terms of the demographic features of the patients, stone burden and location, operative data, and postoperative outcomes. Complications were classified according to the modified Clavien system., Results: During the study period, 101 PCNL procedures were performed, 77 of which were managed with only one access. The median age of the 77 patients managed with a single access was 12 years (range 3-17 years). The number of cases in the SUPAG and SOPAG was 10 and 67, respectively. There were no statistically significant differences between the SUPAG and SOPAG in terms of age, sex, stone location, hydronephrosis status, stone area, side of kidney, and previous stone treatment or renal surgery. Furthermoret, there were no significant differences between the groups in terms of the operative parameters. Although the difference was insignificant, the median operation times in the SUPAG and SOPAG were 37 and 45 min, respectively. There was no chest complication or bleeding that required transfusion in the SUPAG. Two cases required transfusion, and one case was managed with a double pigtail catheter (double-J) placement because of prolonged extravasation in the SOPAG. The stone-free ratios were 100% and 82.1% in the SUPAG and SOPAG, respectively., Conclusion: Upper pole access provides similar outcomes to other (middle and lower) pole accesses, and may be performed without serious complications. These results indicate that this is a safe and effective approach of PCNL, and it presents a good alternative for removal of renal stones in pediatric patients., (Copyright © 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Purpose: To determine changes in antimicrobial resistance and demographics of UTIs in pediatric patients in a single institution over a 6-year period., Materials and Methods: The current study examined outpatient urinary isolates from patients aged <18 years. A retrospective cross-sectional analysis of bacteria isolated from children with UTI was performed between 2009 and 2014. The most common bacterial pathogens were determined in the following four age groups: <2 years; 2-5 years; 6-12 years; and 13-17 years. The study analyzed the prevalence and antibiotic resistance patterns for the six most common uropathogens: Escherichia coli, Proteus, Klebsiella, Enterobacter, Pseudomonas and Enterococcus (Summary table). The antibiotic resistance pattern for UTI during 2009-2014 was also examined., Results: A total of 6515 urinary cultures was examined. The majority of these isolates were from female patients (66.8%). E. coli was the most common uropathogen overall, but the prevalence of E. coli was higher among females (79.5%) than males (54.9%). The biggest percentage of isolates in males was from children aged <2 years (46.1%). Conversely, the majority of isolates in females were from children aged >6 years (46.8%). Results of antimicrobial resistance for E. coli were the highest for ampicillin (70%) and lowest for meropenem (0.19%). Comparing the hospital network data from 2009 to 2014, E. coli resistance increased for ampicillin (from 47.1% to 89%), trimethoprim-sulfamethoxazole (TMP-SMX) (from 44.8% to 56%) and nitrofurantoin (from 5.3% to 15.1%). In contrast, cephalosporins have maintained low antibiotic resistance., Conclusion: UTI in females was nearly twice as common than in males. E. coli remained the most common pediatric uropathogen. Although widely used in other tract infections, ampicillin was a poor empiric choice for pediatric UTIs. Cephalosporins were appropriate alternatives given their low resistance rates. A successful empirical treatment protocol should be based on local epidemiology and susceptibility rates., (Copyright © 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Background: The advances in science and technology increasingly lead to the appearance of ethical issues and to the complexity of care. Therefore, it is important to define the ethics position of students studying in health departments so that high quality patient care can be achieved., Objectives: The aim of this study was to examine the ethics position of the students at Shool of Health of an University in western Turkey., Methods: The study design was descriptive and cross-sectional. The study population included 540 first, second, third, and fourth year students from the Departments of Nursing, Midwifery, and Rescue and Disaster Management in the 2013-2014 academic year. Data were collected with a Personal Identification Form and The Ethics Position Questionnaire. Obtained data were analyzed with Chi-square test, Confirmatory Factor Analysis, and Nested Analysis of Variance. Ethical considerations: Before conducting the research, approval was obtained from Ege University Clinical Research Ethics Committee in İzmir and written informed consent was taken from all the participants., Findings: There was no significant difference in the mean scores for the Ethics Position Questionnaire between the students in terms of years and fields of study. Although the mean scores for the subscale idealism did not differ between fields of study, the mean scores significantly differed between years of study. However, the mean scores for the subscale relativism did not differ in terms of years and fields of study., Discussion: Whether students are idealistic or relativistic in terms of ethical judgment will be effective in ethical decision-making skills during patient care. Therefore, we need to define the factors that influence students' ethics position in the future., Conclusion: It is suggested that the courses and practices that teach students to be aware of their ethics position to create an ethical outlook can be placed in the curriculum in health schools.

Aim: The purpose of this study was to analyze the presence of Aggregatibacter actinomycetemcomitans in saliva and cardiac tissue samples of children requiring cardiac surgery in Istanbul, Turkey., Subjects and Methods: Twenty-five patients (mean age: 6.24 ± 2.93) undergoing surgery for congenital heart defects (CHDs) and an age/gender-matched control group of 25 healthy children were enrolled in the study. Saliva samples were collected from all children; plaque index (PI) and gingival index (GI) were also determined. In CHD group, cardiac tissue samples were received during surgery. All samples were evaluated for the presence of A. actinomycetemcomitans and its highly leukotoxic JP2 clonal strains using polymerase chain reaction. The findings were analyzed by Mann-Whitney U, Chi-square, and Fisher's exact tests., Results: No significant differences were found in PI and GI values between the groups. A. actinomycetemcomitans was not detected in cardiac tissue samples. A. actinomycetemcomitans in saliva was detected in 2 (8%) of the CHD and 5 (20%) of the control children (p > 0.05). A. actinomycetemcomitans JP2 clonal strains were determined from 1 (4%) of the control group while it was not determined from the samples of the CHD group., Conclusions: Early colonization of A. actinomycetemcomitans in oral cavities could be assessed as a risk marker for periodontal disease. Periodontal pathogens may enter bloodstream through bacteremia; thus, the presence of periodontal pathogens in the oral cavity of children should be assessed as a risk marker for cardiac diseases in older ages.

Background: Extra genetic material in patients with Down syndrome (DS) may affect the function of any organ system. We evaluated cardiac functions using conventional tissue Doppler and two-dimensional speckle tracking echocardiography in patients with DS in the absence of congenital and acquired heart disease in patients., Methods: A total of 115 patients with DS between 6 and 13 years of age with clinically and anatomically normal heart and 55 healthy children were included in this cross-sectional study. DS was diagnosed by a karyotype test. Patients with mosaic type were not included in this study. Systolic and diastolic functions were evaluated by echocardiography., Results: Pulsed waved Doppler transmitral early/late inflow velocity (E/A), tissue Doppler mitral annular early/late diastolic peak velocity (Ea/Aa), transtricuspid E/A and tricuspid valve annulus Ea/Aa, pulmonary venous Doppler systolic/diastolic (S/D) wave ratio were lower in patients with Down syndrome than in the control group (P=0.04, P=0.001, P<0.05, P<0.001, P<0.001, respectively). Mitral and tricuspid annular Ea were lower in patients with DS (P<0.001). The right and left ventricular myocardial performance indexes were higher in patients with DS than in the controls (P<0.01). They had significantly higher left ventricular mass, ejection fraction, the mitral annular plane systolic excursion values. However, the Down syndrome group compared with the controls had a lower strain values examined by two-dimensional longitudinal speckle-tracking strain echocardiography., Conclusion: These findings suggest conventional tissue Doppler and two-dimensional longitudinal speckletracking strain echocardiography were useful methods of investigating ventricular function and identifying a higher incidence of biventricular dysfunction in patients with Down syndrome compared with the healthy controls.

Aim: We aimed to assess the utility of DN4 questionnaire (Douleur Neuropathique en 4 questions) to define the frequency and severity of neuropathic pain (NP) and also its clinical correlation to daily clinical practice., Methods: We included 1357 patients with diabetes (56.5% women, 90.4% type 2 diabetes) who were followed up in our diabetes outpatient clinic. Presence of NP was evaluated by performing simultaneous DN4 questionnaires and physical examination. Those who had a DN4 score ≥4 were considered to have NP., Results: The mean age was 58.2±12.1 years, mean duration was 12.5±7.5; (min-max: 1-45) years, mean HbA1c level was 7.8±1.6% (min-max: 5-16.2%), (61.7±6.0mmol/mol; min-max: 31.1-153.6mmol/mol). Three hundred thirteen patients (23%) were diagnosed with NP using the DN4 tool. Male gender (p=0.01), receiving antihypertensive treatment (p=0.01), presence of retinopathy (p<0.001), cardiovascular disease (CVD) (p=0.01) and previously diagnosed neuropathy (p<0.001) were significantly associated with higher NP scores. Those who had increased DN4 scores were more likely to be on oral hypoglycemic agents (OHA)+insulin combinations (p<0.001), had longer diabetes duration (p<0.001) and higher HbA1c levels (p=0.001). Logistic regression model revealed that diabetes duration (OR: 1.02, 95% CI: 1.00-1.04, p=0.007), elevated HbA1c levels (1.11, 1.02-1.21, 0.015), presence of retinopathy (1.41, 1.20-1.64, <0.001), management with at least one OHA (1.47; 1.12-1.92; 0.004) or any insulin regimen (1.62; 1.16-2.27; 0.005) (compared with diet only-regimens) were significantly associated with NP., Conclusion: Utilization of DN4 questionnaire in daily clinical practice is an effective tool in the identification of pain related with peripheral diabetic polyneuropathy., (Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Our native tongue influences the way we perceive other languages. But does it also determine the way we perceive nonlinguistic sounds? The authors investigated how speakers of Italian, Turkish, and Persian group sequences of syllables, tones, or visual shapes alternating in either frequency or duration. We found strong native listening effects with linguistic stimuli. Speakers of Italian grouped the linguistic stimuli differently from speakers of Turkish and Persian. However, speakers of all languages showed the same perceptual biases when grouping the nonlinguistic auditory and the visual stimuli. The shared perceptual biases appear to be determined by universal grouping principles, and the linguistic differences caused by prosodic differences between the languages. Although previous findings suggest that acquired linguistic knowledge can either enhance or diminish the perception of both linguistic and nonlinguistic auditory stimuli, we found no transfer of native listening effects across auditory domains or perceptual modalities. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

Background: Despite all of the studies conducted on cardiopulmonary resuscitation (CPR), the mortality rate of cardiac arrest patients is still high. This has led to a search for alternative methods. One of these methods is active compression-decompression CPR (ACD-CPR) performed with the CardioPump., Objective: The differences in the restoration of spontaneous circulation; the 1-, 7-, and 30-day survival rates; and hospital discharge rates between conventional CPR and ACD-CPR performed with CardioPump were investigated. In addition, the differences between the 2 methods with respect to complications were also investigated., Methods: Our study was a prospective, randomized medical device study with a case-control group. Cardiac arrest cases brought to our emergency medicine clinic by the 112 emergency ambulances from out of hospital and patients who had developed cardiac arrest inhospital clinics between April 2015 and September 2015 were included in our study. For randomization, standard CPR was performed on odd days of each month, and CPR using CardioPump was performed on the even days of each month., Results: A total of 181 patients were included in our study. The number of patients who received conventional CPR was determined as 86 (47.5%), and the number of patients who received CPR using the CardioPump was determined as 95 (52.5%). We did not identify any difference between conventional CPR and CardioPump ACD-CPR with respect to restoration of spontaneous circulation, discharge rates, and the 1-, 7-, and 30-day survival rates. (P=.384, P=.601, P=.997, P=.483, and P=.803, respectively) The complication rate was higher in the patient group that received conventional CPR (P<.001)., Conclusion: As a result of our study, we did not obtain any evidence supporting the replacement of conventional CPR with ACD-CPR performed using CardioPump., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Pilonidal sinus is a chronic inflammatory disorder of the intergluteal sulcus. The disorder often negatively affects patients' quality of life, and there are numerous possible methods of operative treatment for pilonidal sinus. The aim of our study was to compare the results of 3 different operative procedures (tension-free primary closure, Limberg flap, and Karydakis technique) used in the treatment of pilonidal disease., Methods: The study was conducted via a prospective randomized design. The patients were randomized into 3 groups via a closed envelope method. Patients were included in the study after admission to our clinic with pilonidal sinus disease and operative treatment already were planned. The 2 main outcomes of the study were early complications from the methods used and later recurrences of the disease., Results: A total of 150 patients were included in the study, and the groups were similar in terms of age, sex, and American Society of Anesthesiologists scores. The median follow-up time of the study was 24.2 months (range, 18.5-34.27) postsurgery. The recurrence rates were 6% for both the Limberg and Karydakis groups and 4% for the tension-free primary closure group. Therefore, there was no substantial difference in the recurrence rates., Conclusion: The search for an ideal treatment modality for pilonidal sinus disease is still ongoing. The main conclusion of our study is that a tension-free healing side is much more important than a midline suture line. Also, tension-free primary closure is as effective as a flap procedure, and it is also easier to perform., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: We changed our surgical approach to malignant pleural mesothelioma (MPM) in August 2011 and adopted pleurectomy and decortication (PD) instead of extrapleural pneumonectomy (EPP). In this study, we analyzed our perioperative and survival results during the 2 periods., Methods: All patients who underwent surgical intervention for MPM during 2003-2014 were included. Data were retrospectively analyzed from a prospective database. Before August 2011, patients underwent evaluation for EPP and adjuvant chemoradiation (group 1). After August 2011, patients were evaluated for PD and adjuvant chemotherapy and/or radiation (group 2). Demographic characteristics, surgical technique, histology, side, completeness of resection, and types of treatments were recorded. Statistics was performed using Student t test, χ(2) tests, uni- and multivariate regression, and Kaplan-Meier survival analysis., Results: The same surgical team operated on 130 patients. Median age was 55.7 years (range, 26-80 years) and 76 were men. EPP and extended PD was performed in 72 patients. Ninety-day mortality was 10%. Median survival was 17.8 months with a 5-year survival rate of 14%. Uni- and multivariate analyses showed that epithelioid histology, stage N0, and trimodality treatment were associated with better survival (P = .039, P = .012, and P < .001, respectively). Demographic variables and overall survival (15.6 vs 19.6 months, respectively) were similar between the groups, whereas nonepithelioid histology, use of preoperative chemotherapy, and incomplete resections were more frequent in group 2 (P < .001, P < .001, and P = .006, respectively). Follow-up was shorter in group 2 (22.5 ± 20.6 vs 16.4 ± 10.9 months; P < .001)., Conclusions: Adoption of PD as the main surgical approach is not associated with survival disadvantage in the surgical treatment of MPM., (Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)

Background: Apolipoprotein E (ApoE) is a potential inhibitor of cell proliferation, immune regulation and modulation of cell growth and differentiation; it also has a substantial role in antioxidant activity. ApoE has a potential role in prostate cancer progression., Materials and Methods: ApoE genotyping was performed using real-time polymerase chain reaction (RT-PCR) for blood samples from a group of patients with prostate cancer (n=68) and a control group (n=78)., Results: The frequency of the E3/E3 genotype was significantly higher in patients compared to controls (p=0.004). E3/E3 genotype carriers were 3.6-fold more likely to be patients than controls (odds ratio=3.67, 95% confidence interval=1.451-9.155; p=0.004). Additionally, the patients with E3/E3 genotype had significantly higher Gleason score (p=0.017), and more patients with this genotype had a Gleason score higher than 7 (p=0.007). Individuals carrying the E4 allele were significantly more common in the control group (p=0.006). The frequency of the E3/E4 genotype was found to be significantly higher in controls compared to patients (p=0.007), and patients were significantly less likely to have this genotype than controls (odds ratio=0.89, 95% confidence interval=0.833-0.967, p=0.007). Individuals carrying the E2/E3 genotype had a significantly lower Gleason score (p=0.049)-all of the patients with this genotype had a Gleason score lower than 7 (p=0.024)., Conclusion: E3/E3 genotype may be a potential risk factor for prostate cancer and high Gleason scoring. The E4 allele maybe a risk-reducing factor for prostate cancer., (Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)

Familial hypercholesterolemia (FH) is a genetic disorder of lipoprotein metabolism and increases the risk of premature cardiovascular diseases. In patients with FH, platelet function may be activated; however, the extent of this activation and its etiology are unclear. We aimed to evaluate the mean platelet volume (MPV), a marker of platelet activation, in patients with FH. The study group consisted of 164 patients with FH and 160 control patients. Controls were matched for age, gender, hypertension, and smoking. The MPV was significantly higher in patients with FH than in controls (9.2 ± 0.4 vs 7.9 ± 0.6 fL, respectively; P < .001). Platelet count was significantly lower among patients with FH when compared to control patients (259 ± 51 vs 272 ± 56 × 10(3)/L, respectively; P = .03). In linear regression analysis, MPV was independently associated only with total cholesterol (β = .6, 95% confidence interval: 0.004-0.008, P < .001). We have shown that MPV was increased in patients with FH and that it was independently associated with total cholesterol level., (© The Author(s) 2015.)

Background: We estimated the prevalence and incidence, clinical features, treatment, and prognosis of systemic lupus erythematosus (SLE) patients in the Thrace region of Turkey., Methods: We retrospectively evaluated 331 patients (307 female, 24 male, mean age 38.5 years) diagnosed with SLE between 2003 and 2014. Clinical features, treatments, and response to various treatment modalities were recorded. Our hospital has been the only tertiary referral center for rheumatological diseases for a mixed rural and urban population of 620,477 people (306,036 females, 314,411 males) for more than 16 years., Results: The mean annual incidence of SLE was 4.44/100,000 (females, 8.4/100,000; males, 0.6/100,000). The overall prevalence of SLE was 51.7/100,000 (females, 97.7/100,000; males, 7/100,000). Major organ involvement was present in the following percentages: neurologic involvement: 20.1%; renal involvement: 28.2%; autoimmune hemolytic anemia: 9.6%; thrombocytopenia: 14.7%. Seventeen SLE patients (13 females, four males) died at a median follow-up of 48 months. The five-year survival was 94.5%, and the ten-year survival was 89.9%. According to Kaplan-Meier survival analysis, poor prognostic factors were: male gender (p = 0.015); smoking (p = 0.02); pleural involvement (p = 0.011); thrombocytopenia (p = 0.021); myocarditis (p = 0.028); renal involvement (p = 0.037); treatment with cyclophosphamide (p = 0.011); and an initial high SLEDAI score (>4) (p = 0.02). Lymphopenia at the time of diagnosis appeared as a favorable prognostic factor (p = 0.008). Cox regression analysis revealed myocarditis (OR: 20.4, p = 0.018) and age at diagnosis (OR: 1.11, p = 0.035) to be poor, and lymphopenia at the time of diagnosis to be good prognostic factors (OR:0.13, p = 0.031)., Conclusions: The annual incidence and prevalence of SLE in the Thrace region of Turkey is lower than those reported in North America, however they are similar to those reported for European countries. Clinical manifestations appear to be milder, whereas survival was similar to those recorded in Western countries., (© The Author(s) 2015.)

Background: COPD exacerbations requiring hospitalization increase morbidity and mortality. Although most COPD exacerbations are neutrophilic, approximately 10%-25% of exacerbations are eosinophilic., Aim: We aimed to evaluate mortality and outcomes of eosinophilic and non-eosinophilic COPD exacerbations and identify new biomarkers that predict survival., Methods: A retrospective observational cohort study was carried out in a tertiary teaching hospital from January 1, 2014 to November 1, 2014. All COPD patients hospitalized with exacerbations were enrolled in the study at their initial hospitalization and followed-up for 6 months after discharge. Electronic data were collected from the hospital database. Subjects' characteristics, hemogram parameters, CRP levels, neutrophil-to-lymphocyte ratio (NLR), platelet-to-mean platelet volume ratio on admission and discharge, length of hospital stay (days), readmissions, and mortality were recorded. Patients were grouped according to peripheral blood eosinophil (PBE) levels: Group 1, >2% PBE, eosinophilic; Group 2, non-eosinophilic ≤2%. Patient survival after hospital discharge was evaluated by Kaplan-Meier survival analysis., Results: A total of 1,704 patients hospitalized with COPD exacerbation were included. Approximately 20% were classified as eosinophilic. Six-month mortality was similar in eosinophilic and non-eosinophilic groups (14.2% and 15.2%, respectively); however, the hospital stay length and readmission rate were longer and higher in the non-eosinophilic group (P<0.001 and P<0.01, respectively). CRP and NLR were significantly higher in the non-eosinophilic group (both P<0.01). The platelet-to-mean platelet volume ratio was not different between the two groups. Cox regression analysis showed that survival was negatively influenced by elevated CRP (P<0.035) and NLR (P<0.001) in the non-eosinophilic group., Conclusion: Non-eosinophilic patients with COPD exacerbations with high CRP and NLR values had worse outcomes than eosinophilic patients. PBE and NLR can be helpful markers to guide treatment decisions.

We assessed the relation between platelet-to-lymphocyte ratio (PLR) on admission and contrast-induced nephropathy (CIN) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). A total of 488 patients with NSTE-ACS who underwent urgent coronary angiography were enrolled. Levels of PLR and creatinine were measured before angiography and at 72 hours after angiography. Patients were divided into 2 groups, namely, the CIN group, 80 patients (16.3%; age 65.3 ± 12.5years; 66.7% men) and the non-CIN group, 408 patients (83.7%; age 61.2 ± 12.3 years; 72.5% men). Patients in the CIN group had significantly higher PLR than those in the non-CIN group (152.9 ± 99.6 vs 120.4 ± 66.1, P < .001). In logistic regression analysis, PLR (odds ratio [OR] 1.004, 95% confidence interval [CI] 1.001-1.007, P = .02), diabetes mellitus (OR 1.75, 95% CI 1.02-2.98, P = .03), and ST-segment depression on admission electrocardiogram (OR 1.68, 95% CI 1.00-2.81, P = .04) were independent predictors of CIN. The PLR was an independent predictor of CIN after angiography in patients with NSTE-ACS., (© The Author(s) 2015.)

Objective: The relationship between sleep bruxism and antidepressant drugs in patients remains unclear. In this study, we aimed to investigate the incidence rate of antidepressant-related bruxism and to examine whether antidepressant use is associated with this adverse effect in the patients., Methods: The study sample was gathered from 2 hospitals. A total of 807 patients who met the inclusion criteria were included in the study. The sample was divided into 2 groups: the antidepressant group (n = 506) and the control group (n = 301). Sleep bruxism was established with reports from the study participants on the basis of the International Classification of Sleep Disorders: Diagnosis and Coding Manual Second Edition., Results: The prevalence of bruxism was significantly higher in the antidepressant group (24.3%) than in the control group (15.3%). The incidence of antidepressant-induced bruxism was 14.0%. The antidepressants most associated with bruxism were paroxetine, venlafaxine, and duloxetine. The patients experiencing antidepressant-induced bruxism had higher age compared with those who did not experience this adverse effect., Conclusions: The results of the present study suggest that bruxism is frequently observed in women taking antidepressants and that it seems to be associated with antidepressant use at least in some patients.

Objectives: To evaluate the frequency of suicidal ideation among Behçet's syndrome (BS) patients compared to healthy and diseased controls and to delineate possible factors predicting an increase in suicidal ideation., Methods: We included consecutive BS patients attending our outpatient clinic, patients with ankylosing spondylitis (AS) and healthy hospital staff as controls. Suicidal ideation was assessed by a standard questionnaire. Linear regression was used to identify the factors associated with suicidal ideation, such as demographic and clinical features, drugs, disease activity assessed using the Behçet's disease current activity form (BDCAF) for BS patients and BASDAI for AS patients, Behçet's disease quality of life (BDQoL) and Beck depression inventory (BDI) score., Results: We surveyed 303 BS patients, 52 AS patients and 106 healthy controls. Suicidal thoughts, as reflected by a positive response to the first three items of the questionnaire, were higher among BS patients with major organ involvement (42%) than those with mucocutaneous involvement (35%) and the control groups. There were significantly more BS patients with active major organ involvement who had thought to terminate their lives without plans within the last year (25.5%) compared to those with active mucocutaneous involvement (8.7%) and active AS patients (10%) (p=0.012). Patient-reported joint pain (β=-0.155, p=0.046), BDQoL (β=0.176, p=0.032), and BDI (β=0.017, p<0.0001) scores, suicidal thoughts before the onset of BS (β=-0.124, p=0.043), neurologic involvement (β=0.119, p=0.047) and past prednisone use (β=0.212, p=0.005) were independent predictors of suicidal thoughts., Conclusions: BS patients with major organ involvement have increased thoughts of suicide during the active stages of their disease. A number of risk factors could help physicians to identify patients with increased suicidal thoughts.

Aim: Psoriatic arthritis (PsA) is a chronic, inflammatory disease. The purpose of this study was to examine the association between PsA and comorbid conditions. This is the first study to investigate comorbid diseases in PsA in Turkey., Methods: This study was performed under the auspices of the Anatolian Group for the Assessment in Rheumatic Diseases (ANGARD) and involved participation by six university research hospitals. Patients diagnosed with and treated for PsA on the basis of clinical, radiological and laboratory findings and expert opinion were monitored using standardized examination methods and jointly prepared forms. Clinical status, accompanying systemic diseases and surgical history were recorded., Results: One hundred and seventy-three patients with PsA (75 male, 98 female, mean age 41.8) and 138 patients with rheumatoid arthritis (RA) (17 male, 121 female, mean age 48.6) and 67 with psoriasis (PsO) (43 male, 24 female, mean age 36.1) were included in the study. No accompanying disease was determined in 72.8% of PsA, 50.0% of RA and 80.6% of PsO groups. In regression analysis, patients with PsA had higher risk for cataract/glaucoma surgery (odds ratio [OR] = 11.99; 95% CI 1.36-105.4, P = 0.025) compared to patients with RA, and higher risk for hypertension (HT) (OR = 4.26; 95% CI 1.27-14.23, P = 0.018) compared to the patients with PsO., Conclusion: Patients with PsA have relatively lower frequency of comorbidities like diabetes mellitus, HT and cataract/glaucoma surgery compared to the patients with RA. The increased risk for having cataract/glaucoma surgery in RA compared to PsA may be particularly attributed to the more prevalent glucocorticoid use in RA., (© 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.)

Background: Leukoaraiosis (LA) is closely associated with cognitive deficits. The association between LA and cognitive disorders, such as mild cognitive impairment (MCI) and dementia, after initial stroke has not been systematically studied. In this study, we sought to identify whether LA contributes to the occurrence of certain type of cognitive disorders after initial stroke., Methods: Data from our Stroke Registry were examined, and 5-year follow-up data for LA and cognitive disorders were analyzed. We performed Kaplan-Meier analysis and log-rank test to assess the predictive value of LA for risk of cognitive decline and the Cox proportional hazards model to test the risk factors studied as independent determinants of cognitive impairment., Results: The frequency of patients with normal cognitive function decreased significantly at 5 years compared with initial stroke (78% vs 70%; odds ratio, 1.51; 95% confidence interval, 1.41-1.62). Of 8784 patients, 1659 (19%) had dementia and 964 (11%) had MCI at the final analysis. After 5 years of follow-up, survival analysis showed that all patients with LA had an increased probability of MCI compared with those without LA (P < .0001). Patients with LA had an increased chance of dementia compared with those without LA (P < .0001) at the end of follow-up. Cognitive decline probability was significantly higher in patients with severe LA compared with those with mild/moderate LA (P < .0001). Cox regression analyses showed that recurrence of stroke (hazard ratio [HR], 3.92 [95% CI, 3.26-4.72]), hypertension (HR, 1.11 [95% CI, 1.0-1.22]), LA (HR, 1.15 [95% CI, 1.05-1.25]), age (HR, 1.05 [95% CI, 1.04-1.06]), hypercholesterolemia (HR, .86 [95% CI, .77-.95]), higher LDL cholesterol (HR, 1.21 [95% CI, 1.11-1.32]), lower HDL cholesterol (HR, .90 [95% CI, .83-.98]), coronary heart disease (HR, .85 [95% CI, .77-.94]), and National Institutes of Health Stroke Scale score at admission (HR, .77 [95% CI, .72-.82]) were also significantly associated with cognitive impairments., Conclusions: Our findings suggest that patients with LA may be at risk of developing new cognitive impairments at long-term period after initial stroke. The evaluation of the concomitant risk factors, besides providing insights about the possible mechanisms behind the cognitive dysfunction present in LA, may be of help for the prevention of cognitive impairments., (Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.)

Alveolar echinococcosis (AE) is a chronic disease caused by ingestion of the eggs of the parasitic cestode Echinococcosis multilocularis (EM). In severe cases, liver transplantation (LT) may represent the only possibility of survival and cure. Patients undergoing LT associated with hepatic AE at our institution between April 2011 and October 2014 were investigated retrospectively. The clinical findings of the 27 patients who participated in the study were noted. Kaplan-Meier and chi-square tests were used to investigate the effect of these characteristics on survival and mortality. Living donor LT was performed on 20 patients (74.1%), and deceased donor LT was performed on 7 patients (25.9%). Hilar invasion was the most common indication (14 patients, 51.9%) for transplantation. The patient follow-up was 16.1 ± 11.4 months, and the overall survival rate was 77.8%. Primary nonfunction developed only in 2 patients in the posttransplantation period. Six patients died during monitoring, the most common cause of death being sepsis (3 patients). The relationship between the mortality rate of the patients and the invasion of the bile duct and/or portal vein by alveolar lesions was found to be statistically significant (P = 0.024 and P = 0.043, respectively). According to PNM staging, when the AE disease exceeds the resectability limits, the only alternative for the treatment of the disease is LT. However, different from LT due to cirrhosis, it is extremely difficult to perform a transplantation for AE disease because of the invasive characteristics of it. In order to decrease the difficulty of the operation and the postoperative mortality, the intracystic abscess and cholangitis which occur because of AE must be treated via medical and percutaneous methods before transplantation., (© 2015 American Association for the Study of Liver Diseases.)

Background: The clinical importance of complete blood count (CBC) parameters such as the neutrophil-to-lymphocyte ratio (NLR) has been shown in cardiovascular diseases. Stent restenosis (SR) is a major adverse event after stent implantation. In this study, we aimed to investigate the correlation of CBC parameters with SR rates after primary percutaneous coronary intervention (PCI)., Methods: Patients who had undergone primary PCI for ST-segment elevation myocardial infarction (STEMI) and control angiography during follow-up were retrospectively recruited. Patients were categorized according to admission NLR tertiles, and clinical, hematological, and angiographic data were compared., Results: A total of 404 patients (207 patients with SR and 197 patients without SR) were included in the study. Patients were categorized into three groups according to the tertiles of admission NLRs; the NLR was less than 3.38 in tertile 1 (n=134), between 3.38 and 6.26 in tertile 2 (n=135), and greater than 6.26 in tertile 3 (n=135). During a follow-up period of a median of 14 months (minimum 6 months, maximum 60 months) SR developed in 80 patients of tertile 3 (59%), 74 patients of tertile 2 (55%), and 53 patients of tertile 1 (40%), which were significantly different (P=0.01). According to multivariate Cox regression analysis, male sex, stent length (odds ratio 1.04, 95% confidence interval 1.01-1.06, P=0.01), admission NLRs (odds ratio 1.13, 95% confidence interval 1.08-1.19, P=0.01), and white blood cell and neutrophil counts remained the independent predictors of SR in the study population. Other CBC parameters and admission C-reactive protein, creatinine, and fasting glucose levels were not independently correlated with SR. On receiver operating curve analysis, admission NLRs higher than 3.84 were found to predict SR with a sensitivity of 73.4% and a specificity of 50.8% (area under the curve 0.604, P=0.01)., Conclusion: High NLR levels, white blood cell counts, and neutrophil counts at admission are independently correlated with SR after primary PCI.

Aim: Continuous ambulatory peritoneal dialysis (PD) has become a treatment modality for end stage renal disease with a peak of its use in 1990 s. The aim of this study was to examine the peritonitis rates, causative organisms and the risk factors of peritonitis in a large group of patients in our center., Methods: The study was conducted in the Nephrology Department of a University Hospital in Turkey. Patients in the PD programme between January 2000 and January 2006 were included. Cohort-specific and subject specific peritonitis incidence, and peritonitis-free survival were calculated. Causative organisms and risk factors were evaluated., Results: Totally 620 episodes of peritonitis occurred in 440 patients over the six years period. Peritonitis rates showed a decreasing trend through the years (0.79 episodes/patient-year 2000-2003 and 0.46 episodes/patient-year 2003-2006). Cohort-specific peritonitis incidence was 0.62 episodes/patient-years and median subject-specific peritonitis incidence was 0.44 episodes/patient-years. The median peritonitis-free survival was 15.25 months (%95 CI, 9.45-21.06 months). The proportion of gram-negative organisms has increased from 9.8% to 17.3%. There was a significant difference in the percentage of culture negative peritonitis between the first three and the last three years (53.1% vs. 43.2%, respectively). Peritonitis incidence was higher in patients who had been transferred from HD, who had catheter related infection and who had HCV infection without cirrhosis., Conclusions: Our study showed significant trends in the peritonitis rates, causative organisms and antibiotic resistance. Prior HD therapy, catheter related infections and HCV infection were found to be risk factors for peritonitis.