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WOS: 000455908800007, PubMed ID: 30745939, OBJECTIVE: The purpose of this study is to detect the prevalence and the factors associated with influenza and pneumococcal vaccination and outcomes of vaccination during 2013-2014 season in patients with chronic obstructive pulmonary disease (COPD) in Turkey. METHODS: This was a multicenter retrospective cohort study performed in 53 different centers in Turkey. RESULTS: During the study period, 4968 patients were included. COPD was staged as GOLD 1-2-3-4 in 9.0%, 42.8%, 35.0%, and 13.2% of the patients, respectively. Influenza vaccination rate in the previous year was 37.9%; and pneumococcus vaccination rate, at least once during in a life time, was 13.3%. Patients with older age, higher level of education, more severe COPD, and comorbidities, ex-smokers, and patients residing in urban areas had higher rates of influenza vaccination. Multivariate logistic regression analysis showed that advanced age, higher education levels, presence of comorbidities, higher COPD stages, and exacerbation rates were associated with both influenza and pneumococcal vaccination. The number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was 2.73 +/- 2.85 and 0.92 +/- 1.58 per year, respectively. Patients with older age, lower education levels, more severe COPD, comorbid diseases, and lower body mass index and patients who are male and are residing in rural areas and vaccinated for influenza had significantly higher rates of COPD exacerbation. CONCLUSIONS: The rates of influenza and pneumococcal vaccination in COPD patients were quite low, and the number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was high in Turkey. Advanced age, higher education levels, comorbidities, and higher COPD stages were associated with both influenza and pneumococcal vaccination.

There are only a few studies in the literature investigating the effects of gestational age on developmental dysplasia of the hip. The aim of this study was to investigate the effects of gestational age on hip ultrasound findings in the early neonatal period in preterm newborns born between 30th and 36th weeks of gestational age. Between January 2008 and December 2013, a total of 788 hips of 394 premature newborns with a gestational age of up to 36th weeks who underwent hip ultrasonography in the first week of their life were retrospectively examined. The distribution of roof angles and hip types in terms of sexes was compared between groups. Birth weight, birth height, a, and beta angles were analyzed in terms of the gestational age. The mean gestational age was 33.07 weeks (SD 2.09; between 30th and 36th). Six hundred and seven hips were classified as type I, 154 as type IIa, 21 as type IIc, and 6 as type III. In the 30th week, type IIc hips in females and type III hips in males were statistically significantly higher (P=0.001). In the 34th week, type IIc hips in males were statistically significantly higher than the females (P=0.013). In the 35th week, type IIa hips in females hips were statistically significantly higher than the males (P=0.008). Among all preterm infants, type IIc hips were more common in the 30th, 31st, 32nd, and 34th weeks, whereas type III hips were statistically significantly more common in the 30th week (P=0.0001). The 30th, 31st, 32nd, and 34th weeks of age are gestational ages that should be considered in terms of dysplastic and subluxed hips in premature newborns. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.

The purpose of this study was to compare the effect of fresh mineral trioxide aggregate (MTA) with set MTA on hard-tissue healing after periradicular surgery. The root canals of 24 mandibular premolars in four 2-yr-old beagle dogs were filled with MTA. Two weeks later the root ends of half of the samples were surgically exposed and resected to the set MTA within the canals. After exposing and resecting the other 12 root ends, they were prepared with ultrasonic instrumentation and preparations were filled with fresh MTA. After 4 months, the animals were killed. Hard-tissue healing was analyzed histomorphometrically. The results indicated that although freshly placed MTA resulted in a significantly higher incidence of cementum formation (12 of 12 versus 8 of 12, p = 0.028), there is no significant difference in the quantity of cementum or osseous healing associated with freshly placed or set MTA when used as root-end-filling material.

The purpose of this study was to determine the effect of calcium sulfate (CS) on cementum deposition and osseous healing after periradicular surgery. The root canals of 24 mandibular premolars in four 2-yr-old beagle dogs were endodontically treated, followed 2 weeks later by periradicular surgery. Mineral trioxide aggregate (MTA) was used as root-end-filling material. The right or left side was assigned at random to receive CS alpha-hemihydrate or no material in the osteotomy sites before closure. The animals were killed after 4 months. Hard-tissue healing was analyzed histomorphometrically. All samples displayed evidence of cementum deposition adjacent to the root-end fillings and bone regeneration in the osteotomy sites. The data was analyzed using the Mann-Whitney U test, comparing the scores for cementum and osseous healing of the two groups at significance level of alpha = 0.05. The results indicated that placement of CS in osteotomy sites after periradicular surgery does not significantly affect periradicular healing.

WOS: 000391457100008, PubMed ID: 27780164, Objective: To investigate the symptoms of lung cancer in Turkey and to evaluate approaches to alleviate these symptoms. Subjects and Methods: This study included 1,245 lung cancer patients from 26 centers in Turkey. Demographic characteristics as well as information regarding the disease and treatments were obtained from medical records and patient interviews. Symptoms were evaluated using the Edmonton Symptom Assessment Scale (ESAS) and were graded on a scale between 0 and 10 points. Data were compared using the. 2, Student t, and Mann-Whitney U tests. Potential predictors of symptoms were analyzed using logistic regression analysis. Results: The most common symptom was tiredness (n = 1,002; 82.1%), followed by dyspnea (n = 845; 69.3%), appetite loss (n = 801; 65.7%), pain (n = 798; 65.4%), drowsiness (n = 742; 60.8%), anxiety (n = 704; 57.7%), depression (n = 623; 51.1%), and nausea (n = 557; 45.5%). Of the 1,245 patients, 590 (48.4%) had difficulty in initiating or maintaining sleep. The symptoms were more severe in stages III and IV. Logistic regression analysis indicated a clear association between demographic characteristics and symptom distress, as well as between symptom distress (except nausea) and well-being. Overall, 804 (65.4%) patients used analgesics, 630 (51.5%) received treatment for dyspnea, 242 (19.8%) used enteral/parenteral nutrition, 132 (10.8%) used appetite stimulants, and 129 (10.6%) used anxiolytics/antidepressants. Of the 799 patients who received analgesics, 173 (21.7%) reported that their symptoms were under control, and also those on other various treatment modalities (dyspnea: 78/627 [12.4%], appetite stimulant: 25/132 [18.9%], and anxiolytics/antidepressants: 25/129 [19.4%]) reported that their symptoms were controlled. Conclusion: In this study, the symptoms progressed and became more severe in the advanced stages of lung cancer, and palliative treatment was insufficient in most of the patients in Turkey. (C) 2016 S. Karger AG, Basel

Aims: To assess diabetic patients’ knowledge and practices regarding foot care. Methods: This study was conducted as a cross-sectional study in 1030 patients between November 2017 and February 2018.The descriptive survey instrument was developed by the investigators. Survey content and format were based on prior surveys and guidelines. The survey sought socio-demographic characteristics of the patients and the level of knowledge about diabetic foot care practice. Results: 29.5% of patients had bad foot care, 49.6% of patients had moderate foot care and 20.8% of patients had good foot care. There were no significant differences between patient groups in regard to age, gender, foot infection history and having undergone amputation surgery. We found that patients who good at foot care had higher education status (p < 0.001), were more likely live in a city (p < 0.001), had higher income (p < 0.001), had been trained about foot care (p < 0.001) and were more likely to have type I DM (p = 0.015). Disease duration was longer in those who had good foot care compared to the other groups (p = 0.010). Conclusions: The mean knowledge and practice scores of our patients were moderate, indicating that much is to be done for the education of patients on this matter. We also found that knowledge about the importance of this practice, education status and disease duration had significant influence on the practice of foot-care in patients with DM. © 2019 Primary Care Diabetes Europe

Conclusions: The physical and mental HRQOL of PLWH can be increased by educating the population about HIV/AIDS and providing adequate social support for PLWH in our country.

Küresel olarak nüfus yaşlanmakta ve kadın/erkek oranı artmaktadır. Tüm dünyada yaşlı kadınlar erkeklerden daha uzun yaşamaktadırlar. Uzun yaşamalarının bir sonucu olarak kırılganlıkları artmakta ve yaşam kalitesi olumsuz yönde etkilenmektedir. Yaşlılık dönemi, sağlık, eş, ekonomik, rol, statü, yakın ilişki, sosyal destek gibi birçok kayıpların yaşandığı dönemi olarak kabul edilmektedir. Bu dönemde yaşlı kadınlar, bir yandan kronik hastalıklar, kanserler, mental ve ruhsal hastalıklar ile bir yan dan da ekonomik yetersizlikler, bakım verici ve sosyal destek eksikliği ile baş etmeye çalışmaktadırlar. Bu sorunlar dikkate alınarak yaşlı kadınların sayısına, ihtiyaçlarına ve kültürüne uygun sağlık, ekonomik, politik çevresel düzenlemeler yapılmalı, sağlık ve refahlarının arttırılması hedeflenmelidir. Bu amaçla sağlık çalışanlarının gerontoloji ve geriatri alanında bilgi içeriklerinin genişletilmesine ihtiyaç vardır. Hemşirelerin gerontoloji hemşireliği alanında bilgi birikimleri, yetkinlikleri ve güçleri arttırılarak, yaşlıya evde bakım veren aile üyeleri, kurumdaki bakım ve destek personeli ile birlikte daha kaliteli bir hizmet sunması sağlanmalıdır. Globally the population is aging and the female / male ratio is increasing. All over the world, older women live longer than men. As a result of their long life, their fragility increases and their quality of life is adversely affected. Old age is accepted as the period in which many losses such as health, spouse, economic, role, status, close relationship, social support are experienced. In this period, elderly women are trying to cope with chronic diseases, cancers, mental and mental illnesses on the one hand, and economic deficiencies, lack of caregivers and social support on the other. Considering these problems, health, economic and political environmental regulations should be made in accordance with the number, needs and culture of elderly women, and it should be aimed to increase their health and well-being. For this purpose, there is a need to expand the knowledge content of healthcare professionals in gerontology and geriatrics. Nurses’ knowledge, competencies and strengths in the field of gerentology nursing should be increased and it should be ensured that they provide a higher quality service together with family members who care for the elderly at home, and care and support personnel in the institution.

To investigate the distribution of viral genotypes, the extrahepatic manifestations, and the relationship between genotypes and extrahepatic manifestations in patients with chronic hepatitis C. Materials and methods: The study included 62 treatment-naive patients with chronic hepatitis C infection. Genotype determination was performed by DNA sequencing analysis. To investigate extrahepatic manifestations, the patients' data, recorded prospectively during the pretreatment period, were analyzed. Results: Genotype determination was successful in 74.2% of the cases. All patients were infected with hepatitis C virus (HCV) genotype 1b. At least 1 extrahepatic manifestation was identified in 37.1% of the patients. The most frequent clinical manifestations were type II diabetes mellitus (8.1%) and arthralgia or arthritis (8.0%). There was no relationship between extrahepatic manifestations and fibrosis or transaminase levels, but female sex and advanced age were risk factors. Because all patients were infected with the same genotype, the relationship between extrahepatic manifestations and genotype could not be examined. Conclusion: HCV genotype 1b is predominant in patients with chronic hepatitis C in the Eastern Anatolian Region of Turkey. In total, 37.1% of the patients had at least 1 extrahepatic manifestation. Female sex and advanced age were risk factors for having extrahepatic manifestations.

WOS: 000396680900004 PubMed ID: 27238248 This multi-centre study aimed to determine the antibiotic consumption in Turkish hospitals by point prevalence. Antibiotic consumption of 14 centres was determined using the DDD method. Among hospitalized patients, 44.8% were using antibiotics and the total antibiotic consumption was 674.5 DDD/1000 patient-days (DPD). 189.6 (28%) DPD of the antibiotic consumption was restricted while 484.9 (72%) DPD was unrestricted. Carbapenems (24%) and beta lactam/beta lactamase inhibitors (ampicillin-sulbactam or amoxicillin-clavulanate; 22%) were the most commonly used restricted and unrestricted antibiotics. Antibiotics were most commonly used in intensive care units (1307.7 DPD). Almost half of the hospitalized patients in our hospitals were using at least one antibiotic. Moreover, among these antibiotics, the most commonly used ones were carbapenems, quinolones and cephalosporins, which are known to cause collateral damage. We think that antibiotic resistance, which is seen at considerably high rates in our hospitals, is associated with this level of consumption.

Background/aim: Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics., Materials and methods: A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician., Results: A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had 5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05)., Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did.

WOS: 000386954300001, PubMed: 27809934, Background: The aim of this study was to assess health-related quality of life (HRQOL) among chronic hepatitis B (CHB) patients in Turkey and to study related factors. Methods: This multicenter study was carried out between January 01 and April 15, 2015 in Turkey in 57 centers. Adults were enrolled and studied in three groups. Group 1: Inactive HBsAg carriers, Group 2: CHB patients receiving antiviral therapy, Group 3: CHB patients who were neither receiving antiviral therapy nor were inactive HBsAg carriers. Study data was collected by face-to-face interviews using a standardized questionnaire, Short Form-36 (SF-36) and Hepatitis B Quality of Life (HBQOL). Values equivalent to p < 0.05 in analyses were accepted as statistically significant. Results: Four thousand two hundred fifty-seven patients with CHB were included in the study. Two thousand five hundred fifty-nine (60.1 %) of the patients were males. Groups 1, 2 and 3, consisted of 1529 (35.9 %), 1721 (40.4 %) and 1007 (23.7 %) patients, respectively. The highest value of HRQOL was found in inactive HBsAg carriers. We found that total HBQOL score increased when antiviral treatment was used. However, HRQOL of CHB patients varied according to their socio-demographic properties. Regarding total HBQOL score, a higher significant level of HRQOL was determined in inactive HBV patients when matched controls with the associated factors were provided. Conclusions: The HRQOL score of CHB patients was higher than expected and it can be worsen when the disease becomes active. Use of an antiviral therapy can contribute to increasing HRQOL of patients.

Geyik, Mehmet Faruk/0000-0002-0906-0902; demirdal, tuna/0000-0002-9046-5666; KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X; Gunduz, Alper/0000-0001-9154-844X WOS: 000352106600012 PubMed: 25500658 Introduction: Although pegylated interferons (pegIFNs) alpha-2a and alpha-2b have been used in chronic hepatitis B (CHB) treatment for many years, there are few studies concerning predictors of sustained virologic response (SVR) to pegIFN therapy. In this study, we aimed to investigate the predictors of response to pegIFN treatment in cases with HBeAg-negative CHB infection. Methodology: Seventeen tertiary care hospitals in Turkey were included in this study. Data from consecutively treated HBeAg-negative CHB patients, who received either pegIFN alpha-2a or alpha-2b, were collected retrospectively. SVR is defined as an HBV DNA concentration of less than 2,000 IU/mL six months after the completion of therapy Results: SVR was achieved in 40 (25%) of the 160 HBeAg-negative CHB patients. Viral loads in patients with SVR were lower compared to those with no SVR, beginning in the third month of treatment (p < 0.05). The number of cases with a decline of 1 log(10) IU/mL in viral load after the first month of treatment and with a serum HBV DNA level under 2,000 IU/mL after the third month of treatment was higher in cases with SVR (p < 0.05). The number of patients who had undetectable HBV DNA levels at week 48 among responders was significantly greater than among post-treatment virological relapsers (p < 0.05). Conclusions: Detection of a 1 log(10) decline in serum HBV DNA level at the first month of treatment and a serum HBV DNA level < 2000 IU/mL at the third month of therapy may be predictors of SVR.