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Yeni Koronavirüs Hastalığı (COVID-19) ile ilgili toplumda zihinlerde karışıklığa neden olan ve sağlık davranışlarını olumsuz yönde etkileyen bazı yanlış bilgiler mevcuttur. Bu yazı kapsamında COVID-19 ile ilgili toplumda var olan yanlış bilgilerin yayılmasının önlenmesi için önerilerin sunulması amaçlanmıştır. Çalışma sürecinde COVID-19 ile ilgili yazılı ve görsel medya, gündem izlenmiştir. Yanlış bilginin yayılmasında sağlığın belirleyicileri de dâhil olmak üzere birden çok faktör bulunmaktadır. Yanlış bilgi, bireylerde yanlış davranışın oluşmasına neden olmaktadır. Dolayısıyla, sistematik bir şekilde önleme yaklaşımları gerekmektedir.

Prof John M. Last halk sağlığı bilimi ve öğretimine önemli katkılar yapmış bir bilim insanıdır. Halk sağlığı alanında çalışanlarda eleştirel düşünce biçiminin yerleşmesine çok büyük katkı sağlamıştır. Hazırladığı yazılı kaynaklar dünyanın birçok üniversitesinde ders kitabı ve temel başvuru kaynağı olarak kullanılmıştır. Zaman içinde halk sağlığı öğretmenliği niteliği aynı zamanda önemli bir halk sağlığı düşünürlüğüne evrimleşmiştir. Prof. Last, gerçek bir halk sağlığı eylemcisi ve kadın hakları savunucusuydu., Prof John M. Last is a scientist who has made significant contributions to public health science and teaching. He has greatly contributed to the establishment of critical thinking among those working in the field of public health. The written sources he prepared have been used as textbooks and fundemental reference sources in many universities around the world. Over time, his qualification of public health teacher has also evolved into an important public health thinker. Prof. Last was a true public health activist and women's rights advocate.

WOS: 000468613100013 PubMed ID: 30238284 Purpose Obesity is among the known risk factors for obstructive sleep apnea syndrome (OSAS). In this study, our aim was to investigate the correlation of waist-to-height ratio, an indicator of central obesity, with presence and severity of OSAS; to compare the use of this ratio with the use of waist circumference and body mass index (BMI); and to determine OSAS-related cutoff values. Methods The patient records were retrospectively analyzed for whom a polysomnography was conducted at our sleep. Sex, age, Apnea-Hypopnea Index (AHI), waist circumference, height, and BMI values of those patients were recorded. AHI scores were used to classify severity of OSAS. Results The study included 437 OSAS patients and 72 control cases. Out of the patient group, OSAS was severe in 208 (47%) patients, moderate in 124 (28%), and mild in 105 (24%) of them. In the group of OSAS patients, waist-to-height ratio, waist circumference, and BMI were higher compared to the control group with a further difference of all three parameters among severe, moderate, mild OSAS, and controls both in males and females. Cutoff values for OSAS of females were 95.5cm for waist circumference, 0.595 for waist-to-height ratio, and 27.75 for BMI whereas the cutoff values of males were 100.5cm, 0.575, and 27.75, respectively. Conclusions A high value of waist circumference, waist-to-height ratio, and BMI is associated with the presence and severity of OSAS. We have determined the cutoff values of the studied anthropometric measurements in both sexes for OSAS and severe OSAS.

WOS: 000435398900004 Objective: Restless Legs syndrome (RLS) is a frequent neurological disease. Levetiracetam (LEV) is an effective and broad-spectrum anticonvulsant drug. The aim of this study is to investigate the frequency of RLS in patients diagnosed with epilepsy who took LEV monotherapy. Materials and Methods: Two neurologists were reviewed the files of 1680 patients, who were followed in epilepsy outpatient clinic. One hundred seven patients under LEV monotherapy for at least six months and 120 healthy controls were included in the study. The criteria for the International Restless Legs Syndrome Study Group were taken into consideration for the assessment of RLS. Results: The mean age of patient group was 38.26 +/- 17.39 years, while the mean age of healthy controls was 39.17 +/- 16.12 years. There were no statistically significant differences in terms of age and sex between each two groups. The mean duration of LEV usage was 28.34 months. The LEV usage dose was between 500-3000 mg/day. RLS was seen in 7 (5.83%) healthy controls, whereas 4 patients (3.73%) had RLS in patient group before LEV treatment. The symptom of RLS in two patients disappeared after LEV treatment started and this rate decreased to 1.87%. The biochemical parameters were normal in all patient groups, after LEV treatment, peripheral neuropathy was detected in one patient whose symptoms were not relieved. Conclusion: LEV may have therapeutic effect on RLS. It may be preferred especially in comorbid situations where epilepsy and RLS are seen together. Longitudinal and prospective studies are needed to manifest better the therapeutic effects of LEV on RLS.

18th National Sleep Medicine Congress - OCT 26-29, 2017 - Bodrum, TURKEY Saruhan, Ercan/0000-0001-6416-1442 WOS: 000495454200003 Objective: Although the presence of a systemic inflammatory response is known in obstructive sleep apnea syndrome (OSAS), there have not been adequate investigations on the association of such a response with the predominance of apneas either in rapid eye movement (REM) or in the non-REM (NREM) phase. In this study, we compared interleukin-23 (IL-23) concentrations, a marker of systemic inflammatory process, in individuals with sleep apnea syndrome, whose apneas where predominant in the REM or NREM phase. Methods: Fifty-four patients aged over 18 years who were diagnosed as having OSAS based on polysomnography were included in the study. The apnea-hypopnea index (AHI) was used to divide patients into groups of AHI(REM)>AHI(NREM) and AHI(NREM)>AHI(REM). In the blood samples drawn from the patients, IL-23 concentrations were measured using enzyme-linked immunosorbent assay. Results:The study included patients with OSAS aged 28-65 years, of whom 29 were AHI(REM)>AHI(NREM) and 25 were AHI(NREM)> N-REM. The AHI(REM) >AHI(NREM) OSAS group had no sex-based variance (14 males, 15 females), but the AHI(NREM) >AHI(REM) group was substantially composed of males (21 males, 4 females). The average AHI( )of the AHI(NREM) >AHI(REM) group (43.34 +/- 21.40) was significantly higher than in the AHI(REM) >AHI(NREM) Nifm group (26.79 +/- 17.32). IL-23 concentrations were higher in patients with AHI(REM) >AHI(NREM) sleep apnea (225.38 +/- 77.29) compared patients with AHI(NREM) >AHI(REM), sleep apnea (183.68 +/- 78.49). Conclusion: In AHI(REM) >AHI(NREM )sleep apnea, the systemic inflammatory response may be more dramatic. Taking the AHI(REM) value into consideration along with the average AHI value seems to be important for treatment modalities.

The refugee problem has become a global concern with multidimensional characteristics. Monitoring migration flows over time and comparing the situation with a number of indicators can give clues on how to manage the problem.In this study, the global refugee issue was discussed by focusing on such data including the potential factors causing crises in the most affected countries.In this ecological study, the analysis was completed for the countries that either "host" or "source" refugees between 2005 and 2015. Excel-dataset was formed for United Nations Development Programme (UNDP), World Bank and United Nations High Commissioner for Refugees (UNHCR) datasets and were converted to SPSS-23.0. Mapping was done via pixelmap.In 2005, Pakistan, Islamic Republic of Iran, and the United States of America were the first three on the hosting country list, while Germany ranked 8th and China 9th. In 2015, Turkey ranked first as hosting country while previously it was not even in the top 10 countries. Geographical proximity plays a crucial role during displacement. Countries differ from each other according to the values of selected indices.Global solutions integrated with local precautions to reduce the worldwide burden of migration are required.نظرة عامة عالمية حول اللاجئين: مقارنة بين بيانات عامي 2005 و 2015 في البلدان العشرة الأكثر تضررًا.رنا كافوزوجلو، غمزة أكتونا، إكين كوتش، ديلك أصلان، مروة عثمان.أصبحت مشكلة اللاجئين مصدر قلق عالمي ذي خصائص متعددة الأبعاد. ويساعد رصد تدفق المهاجرين على مدار الزمن ومقارنة الوضع باستخدام عدد من المؤشرات على معرفة الطريقة (الطرق) المناسبة لكيفية إدارة المشكلة.تمت مناقشة مشكلة اللاجئين العالمية في هذه الدراسة من خلال التركيز على هذه البيانات، بما في ذلك العوامل المحتملة المُسببة للأزمات في البلدان الأكثر تضررًا.في هذه الدراسة الإيكولوجية، تم استكمال التحليل للبلدان «المستضيفة» أو «المصدرة» للاجئين بين عامي 2005 و 2015. وتم إنشاء مجموعة بيانات باستخدام برنامج (إكسل) تضم مجموعات بيانات برنامج الأمم المتحدة الإنمائي والبنك الدولي ومفوضية الأمم المتحدة السامية لشؤون اللاجئين، وتم تحويلها إلى برنامج 23.0 – SPSS. وجرى رسم الخرائط باستخدام برنامج pixelmap.في عام 2005 ، تصدرت باكستان وجمهورية إيران الإسلامية والولايات المتحدة الأمريكية المراكز الثلاثة الأولى في قائمة البلدان المستضيفة، بينما أتت ألمانيا في المركز الثامن والصين في المركز التاسع. وفي عام 2015 ، صُنفت تركيا في المركز الأول للبلدان المستضيفة، بينما لم تكن ضمن البلدان العشرة الأوائل فيما مضى. ويؤدي القرب الجغرافي دورًا بالغ الأهمية عند النزوح. وتختلف البلدان عن بعضها البعض من حيث قيم المؤشرات المحددة.يجب وضع حلول عالمية وإدماجها في التدابير الاحتياطية المحلية بهدف تخفيض العبء العالمي من المهاجرين.Aperçu mondial sur la situation des réfugiés : comparaison des données de 2005 et 2015 pour les dix pays les plus touchés.Le problème des réfugiés est devenu une préoccupation mondiale aux caractéristiques multidimensionnelles. Le suivi des flux migratoires dans le temps et la comparaison de la situation avec un certain nombre d’indicateurs peuvent donner des indices sur la manière de gérer le problème.Dans la présente étude, la question mondiale des réfugiés a été examinée en se concentrant sur ces données, y compris les facteurs potentiels à l’origine des crises dans les pays les plus touchés.Dans cette étude holistique, l’analyse a été complétée pour les pays qui « accueillaient » des réfugiés ou « étaient source » de réfugiés entre 2005 et 2015. Un fichier Excel a été créé pour les jeux de données du Programme des Nations Unies pour le développement (PNUD), de la Banque mondiale et du Haut-Commissariat des Nations Unies pour les réfugiés (HCR) et a été converti au format SPSS-23.0. La cartographie a été réalisée via pixelmap.En 2005, le Pakistan, la République islamique d’Iran et les États-Unis d’Amérique étaient les trois premiers sur la liste des pays hôtes, tandis que l’Allemagne et la Chine venaient en huitième et neuvième positions respectivement. En 2015, la Turquie occupait le premier rang en tant que pays hôte, alors qu’elle ne figurait même pas parmi les 10 premiers pays auparavant. La proximité géographique joue un rôle crucial lors des déplacements. Les pays diffèrent les uns des autres en fonctions des valeurs des indices sélectionnés.Des solutions mondiales intégrées comprenant des précautions locales pour réduire le fardeau mondial des migrations sont nécessaires.

Amaç: Adolesan dönemi sağlık sorunları, ihmal edilen ve sıklıkla önlem alınmayan durumlardır. Bu sorunlar bireylerin şu anki sağlık düzeylerini etkilediği gibi yetişkinlik döneminde meydana gelebilecek hastalıkların da temelini oluşturmaktadır. Bu çalışmada adolesan dönemde 2009 ve 2016 yılları arasında meydana gelen ölüm nedenleri incelenmiş, ölümlerin yıllar içindeki değişimleri değerlendirilmiştir. Gereç ve Yöntem: Türkiye’de 2009-2016 yıllarına ait adolesan ölüm nedenlerini inceleyen tanımlayıcı tipteki bu araştırma için gerekli veriler Türkiye İstatistik Kurumu’ndan yazılı başvuru ile elde edilmiştir. Adolesan dönem ölüm nedenlerinin boyutunu değerlendirmek amacıyla; yaşa-özel ve yaşa-nedene-özel ölüm hızları ile ölüm nedenlerinin tüm ölümler içerisindeki yüzdeleri ölçüt olarak kullanılmıştır. Bulgular: Adolesan yaş grubunda 2009 yılında yüz binde 22.4 olan yaşa-özel ölüm hızı 2016’da yüz binde 29.2’ye çıkmıştır. 2016 yılında adolesan yaş grubunda birinci ölüm nedeni “dışsal yaralanma nedenleri ve zehirlenme kaynaklı ölümler”’dir. Bu nedene bağlı ölüm hızı adolesan yaş grubunda 2009’dan (yüz binde 6.8) 2016 yılına (yüz binde 12.7) artış göstermiştir. Dışsal yaralanma nedenleri ve zehirlenme kaynaklı ölümler içerisinde en büyük paya sahip olan taşıma kazalarına bağlı ölümler de 2009’dan (yüz binde 3.0) 2016 yılına (yüz binde 5.1) artış göstermiştir. Sonuç: Ölüm nedenlerinde meydana gelen değişimlerin düzenli olarak değerlendirilmesi önemlidir. Bu değerlendirmeler alınacak olan önlemleri etkileyebilmektedir. Bu nedenle benzer değerlendirmelerin yapıldığı bilimsel zeminli çalışmaların sürdürülmesi önerilmektedir.

Novel Coronavirus Disease (COVID-19) raised many questions needing answers in order to overcome the disease burden globally. Uncertainty about COVID-19 contributes to the complexity of the burden on the health, social, economic, and cultural influences of COVID-19. In this context, all related disciplines are working together to mitigate the negative influences of the disease. In particular, health promotion, a discipline of public health, matters to the pandemic as it may address the threats at different levels. Health promotion strategies mostly use solution-oriented efforts with inter- and multidisciplinary approaches. Nevertheless, as the COVID-19 burden has many time-critical determinants, these approaches cannot be sufficient to overcome the problem. A transdisciplinary approach in its broader sense using almost all inputs to synthesize and produce an integrative solution may be extremely helpful. In this paper, the importance of transdisciplinary approaches in health promotion to combat COVID-19 has been discussed.

Introduction Public health practices of medical training should be modifiable according to the needs of the population. Turkey has been facing with the refugee problem since 2011. In this regard, new requirements are arising for medical professionals starting from the medical faculties. In this paper, a new elective course introduced for medical students on migration and health will be defined. Materials and Methods ”Migration and Health” in Public Health Perspective Course was proposed for the first phase medical students at Hacettepe University, Faculty of Medicine. The proposal was approved by the official mechanisms of the medical faculty after a detailed assessment. The aim of the approved Course was to gain information and increase awareness on health aspect of migration based on good medical practices. Results The Couse was held between October 2019 and January 2020 once a week for two hours. Fifteen Turkish and other international students completed the Course. Interactive training techniques were used during the Course. Feedbacks of the students were regularly taken after each class once a week. Reflections of the students were also recorded both at the beginning and at the end of the Course. The students were successful in achieving the aims of the Course. Additionally, another achievement was gained which was not proposed at the beginning of the Course. The “positive” attitude of the medical students refusing discrimination against refugees was the secondary and may be a more worthy outcome of the Course. All students were able to look at the refugee problem with good medical values and based on the basic rights of the humanity. Conclusions The students reported their satisfaction about the Course. As the Course was applied for the first time, it is open for revision according to the feedbacks received during of the Program. The Content, the methods will be overviewed before the next year. Key messages Medical students’ curricula could have been updated due to the new and the dynamic developments in the population. Refugee issue needs a global perspective which the medical students need to learn.

Bu çalışmada yaş ayrımcılığı kavramının tanımlanması, belirleyicilerinin ve sonuçlarının değerlendirilmesi amaçlanmıştır. Çalışma kapsamında dünyadaki ve Türkiye’deki güncel durum incelenmiş olup yaş ayrımcılığına bağlı olarak ortaya çıkan toplumsal ve bireysel problemler ele alınmıştır. Bu değerlendirmelerin sonucunda ise küresel ve ulusal seviyede uygulanmaya çalışılan güncel çözüm yolları ve bunlara ilişkin öneriler incelenmiştir. Yaşlı bireyler, 65 yaş ve üzerindeki bireyler olarak tanımlanmaktadır. Bu popülasyonun tüm dünyada göstermekte olduğu sürekli artış; bir sorun olarak toplumsal yaşamı ve bireylerin sağlık düzeylerini olumsuz etkilemektedir. Bu demografik değişime hazır olmayan toplumlarda zaman içerisinde daha fazla sayıda yaşlı bireyin savunmasız duruma düşmesi beklenmektedir. Bu süreçte yaş ayrımcılığının anlaşılması ve yaş ayrımcılığına yönelik farkındalığın arttırılması büyük önem göstermektedir. Yaşlı ayrımcılığına yönelik uluslararası mücadelenin desteklenmesi; hükümetler düzeyinde ise üretilen politikaların bu bireylerin toplumsal yaşama katılımını arttıracak şekilde düzenlenmesi gerekmektedir. Bireylerin yaşlanmaya ve yaşlı bireylere yönelik gerçek olmayan olumsuz düşüncelerinin önüne geçilmesi; nesiller arasında iletişimin arttırılarak yaşlanmaya ve yaşlı bireylere yönelik olumlu tutumların geliştirilmesi sağlanmalıdır., This study aims to define age discrimination concept and to assess the determinants and consequences. Within the extent of the study, current situation in the world and social and individual problems arising due to age discrimination in Turkey have been discussed. Suggestions for the problems are proposed. Aged individuals are defined as 65 and older people. Continuously increasing trend in the numbers of the aged population all over the world affects the social life and the health conditions of individuals negatively. The societies are not ready for this demographic change. Therefore, more older individuals are expected to become vulnerable over time. In this regard, understanding ageism and improving awareness on age discrimination is becoming more important. The international struggle to prevent ageism should be supported and policies produced at state level should be arranged in a way to increase the participation of older age in social life. Interaction among generations and positive attitudes towards old age should be improved in order to prevent the negative thoughts towards aging and older individuals.

The aim of this article is to discuss what the prominent tactics of the food industry which could have influenced “health” and “wellbeing” negatively and how to address the preventive strategies in this regard in public health approach. Food industry is resorting to a variety of "tactics" to increase its activities on the market. The similarity of the combination of food and beverage and tobacco industry and the "tactics" they use is remarkable. The ethical violations used within these "tactics" may have the risk to affect certain groups including children and young people. Industrial tactics in the scientific literature include introduction of harmful products, misleading marketing campaigns, targeting of children and other vulnerable groups, corporate lobbying, material contributions, and negative approaches to informatics/scientists.Prevention or elimination of the activities of the food industry which could have a negative impact on the individual/community health is crucial. Based on public regulations, all responsible components should act in accordance with the precautionary principle of public health. Bu yazinin amaci gida endustrisindeki “saglik” ve “iyilik” halini olumsuz etkileyebilecek one cikan taktiklerin neler olabilecegini tartismak ve bu olumsuz etkilere yonelik olarak alinabilecek onlemleri halk sagligi yaklasimi ile ele almaktir. Gida endustrisi, piyasadaki etkinliklerini arttirmak icin cesitli “taktiklere” basvurmaktadir. Yiyecek, icecek ve tutun endustrisinin birlikteligi ve kullandiklari ‘’taktiklerin/oyunlarin’’ benzerligi dikkat cekmektedir. Kullanilan bu “taktikler” de etik ihlaller cocuklarin ve genclerin icinde oldugu bazi ozel gruplari etkilemektedir. Bilimsel literaturde yer alan endustri taktikleri arasinda; zararli urunlerin tanitimi, yaniltici pazarlama kampanyalari, cocuklarin ve diger hassas gruplarin hedef alinmasi, sirket lobiciligi, maddi katkilar ve bilime/bilim insanlarina yonelik olumsuz yaklasimlar yer almaktadir. Gida endustrisinin sagligi olumsuz yonde etkileyecek faaliyetlerinin onlenmesi ya da ortadan kaldirilmasi birey ve toplum icin son derece onemlidir. Kamusal duzenlemeler zemininde sorumlulugu olan tum bilesenler, halk sagliginda ihtiyatlilik ilkesi geregince hareket etmelidirler.

Background Evidence suggests that advice from motivated physicians to their smoking patients is effective in promoting smoking cessation. Yet, detection rate of smokers is often low and, the proportion of smokers receiving special advice to quit varies. This study aimed to detect how frequently European physicians enquire about their patients' smoking status, and to compare and contrast how (if any) smokers benefit from physicians' enquiry and/or advice about smoking cessation. Methods The study was based on secondary analysis of data from six European countries that conducted Global Adult Tobacco Survey, namely, Greece, Poland, Romania, Russia, Turkey and Ukraine. Results Out of Global Adult Tobacco Survey participants who were smoking 12 months preceding the survey and had 'at least one visit to a physician' before the survey, half were asked by their physicians about their smoking status and only 37.7% got a brief advice from their physicians to quit smoking. Remarkably, 25% of current smokers did not get any advice from their physicians to quit even when the smoking status was enquired. The adjusted odds ratio was found as 1.55 (95% confidence interval=1.29-1.87) for the association between physician's enquiry about smoking status of a patient and his/her attempt to quit smoking. Conclusion Even a simple enquiry of the physician about smoking status of a patient could be effective in smoking cessation, yet, enquiry and advice rates are still far below expected. Regardless of the reason for admission, each contact with a patient should be used as an opportunity to combat smoking-related health risks.

Issue/background Public health values transdisciplinary, multidisciplinary, and interdisciplinary perspectives. This background always advocates solidarity which usually finds its positive reflections in the society with the support of many institutional bodies including Non-governmental organization (NGO) movements. which move up solidarity. Globally, NGOs are represented by societies and associations. Turkey is one of the countries which NGO movement is frequent. Turkish NGOs in (public) health may vary on their vision(s) and mission(s). Such variety seems to be “good”; thus, complexity and duplications may occur when a strong systematic ground is not provided. In this paper, a systematic on the functionality of NGOs will be proposed to make the NGO movement more inclusive, accessible, transparent, and auditable in order to support solidarity using the experience of a local case. Results The number of the societies is high in Turkey and they have a wide range of working area including health. Officially they are recorded in the Turkish Ministry of Internal Affairs (MoIA) and can be accessed via the website of the MoIA. There are about 300 000 societies which 116 000 of them are active. The majority of them are founded in big cities. Societies working on health focuses on different areas including professionalism, prevention, rehabilitation, etc. Such varieties may have the potential to create difficulty to follow up their work in a systematic manner. Lessons As NGO/civil society movement is crucial for public health, the proposed steps may contribute to improve/support solidarity on any advocative work on health: To maintain transparency, and auditabilityTo develop methods to prevent duplicative workTo develop accessible “common” platforms to share experiencesTo improve adaptation capacity in the face of new requirementsTo improve networking among NGOsTo improve the global perspective as well as the local one Key messages Solidarity in public health can be achieved with the help of systematic and powerful NGO/civil society movement. Global needs and changes influence civil society dynamics and NGOs should be open to be updated in the face of new requirements.

Methylation is a key epigenetic modification of DNA and regarding its impact on epilepsy, it is argued that "DNA methylation may play an important role in seizure susceptibility and maintenance of the disorder". DNA methylation status of KCC2 (SCL12A5) and NKCC1 (SCL12A2) associated with refractory temporal lobe epilepsy was investigated in our study.Thirty-eight patients with temporal lobe epilepsy (TLE) who were diagnosed by video EEG monitoring and 32 healthy control subjects were included in the study. Twenty-three patients in TLE group were men and the remaining 15 were women. Among them, 27 had unilateral temporal focus (9 with right; 18 with left) and 11 patients had bilateral TLE. We analyzed promoter region methylation status of the KCC2 (SCL12A5) and NKCC1 (SCL12A2) genes in the case and control groups. Gene regions of interest were amplified through PCR and sequencing was accomplished with pyro-sequencing.We found a significant relationship between TLE and methylation on the NKCC1. However, there was no association between TLE and methylation on the KCC2 gene. Also, we found no association between right or left and unilateral or bilateral foci of TLE. There was no relationship between TLE and methylation on the NKCC1and KCC2 genes in terms of mesial temporal sclerosis in cranial MRI, head trauma or febrile convulsions.The methylation of NKCC1 can be a mecha-nism of refractory temporal lobe epilepsy. There are limited findings about DNA methylation in TLE. Therefore, further studies with large sample sizes are necessary.A metiláció kulcsfontosságú a DNS epigenetikai módosítása során. Az epilepsziában fontos a metiláció szerepe, olyannyira, hogy az is felmerül: a DNS-metiláció közreműködik a rohamokra való fogékonyság kialakulásában, továbbá a betegség fenntartásában is. Vizsgálatunkban elemeztük a refrakter temporalis epilepsziával asszociált KCC2 (SCL12A5) és NKCC1 (SCL12A2) gének metilációs státuszát.38, video-EEG-monitorral diagnosztizált temporalis epilepsziában szenvedő beteget és 32 egészséges kontrollszemélyt vontunk be a vizsgálatba. A 38 betegből 23 volt férfi, 15 nő; 27-en unilaterális temporalis epilepsziában (9 jobb oldali, 18 bal oldali), 11-en kétoldali temporalis epilepsziában szenvedtek. A vizsgálati és a kontrollcsoportban egyaránt elemeztük a KCC2 (SCL12A5) és NKCC1 (SCL12A2) gének promoter régióinak metilációs státuszát. A kérdéses régiókat PCR-rel amplifikáltuk és piroszekvenálással elemeztük.Szignifikáns kapcsolat mutatkozott a temporalis epilepszia és az NKCC1 metilációja között. Mind­azonáltal, nem volt kapcsolat a temporalis epilepszia és a KCC2 gén metilációja között, továbbá nem találtunk össze­függést az epilepto­gén fókusz elhelyezkedése (jobb vagy bal oldali unilaterális, il­let­ve kétoldali temporalis epilepszia), valamint a metilációs státusz között sem. Nem mutatkozott kapcsolat a temporalis epi­lep­szia, a KCC2, NKCC1 gének metilációs státusza, valamint a koponya-MRI-n ábrázolódó mesialis halántéki sclerosis, a fejet ért trauma vagy a lázgörcs között sem.A refrakter temporalis epilepszia hátterében az NKCC1 metilációja állhat. További nagy esetszámú vizsgálatokra van szükség, mivel korlátozott adattal rendelkezünk a DNS metilációjával kapcsolatosan refrakter temporalis epilepszia esetében.

MATERIAL AND METHODS: The study was conducted at the smoke-free zones around Hacettepe University Sihhiye Campus Hospi- tals with 182 participants over 18 years-old. Data was collected through a questionnaire using face to face interview technique in this descriptive study. The official permission was obtained prior to the data collection. SPSS 15.0 predictive analytics software was used to analyze the data. RESULTS: Among 182 participants, 58.8% stated that they continue smoking in public areas during the presence of non-smokers. Eighty three point six percent of the participants who were aware of the health problems associated with smoking found the smoke-free zones in the hospital garden useful. The survey indicated that the awareness of the health problems associated with smoking and the usefulness of the establishment of smoke-free zones in a hospital garden was strongly correlated (p

In this study, we aimed to assess the knowledge and opinions of the public health residents recorded in the Society of Public Health Specialists’ inventory by August 2013 on mentoring related concepts, as well as to determine whether their training period is compatible with the requirements of mentoring idea. Materials and Methods: Two hundred and eighty three research assistants who were in the list of the Society of Public Health Specialists’ working at the 43 universities’ Public Health Departments was the universe of the study. Nevertheless, 160 residents participated in this study (participation rate=55.9%). Data was collected via electronic data collection method. Results: Mean age of the participants was 28.9±2.9. 60.8% of the research assistants started their thesis process and 69.2% of the research assistants had an advisor. The average time of determining the thesis content was9.4±10.5 months (median=2.0). 50.3% of the residents’ definition on academic advisor was found as “sufficient”. 72.0% of the residents declared that their academic plan had been completed at the beginning of their training period whereas 18.6% of them mentioned their un-satisfaction on that their expectations. 91.1% of the participants attended the internship education, 97.5% of them attended seminars, 91.1% of them attended literature classes, and 56.6% of them attended to the post graduate Public Health classes. Conclusion: In both under and post graduate medical education, the term of mentoring is need to be known accurately and to be practiced more effectively in resident training. It is recommended that the administrative bodies of Public Health departments with their academic members and the society of Public Health Specialists’ should collaboratively work to improve the current curricula and programs in this regard.

Özet İnternet, birçok alanda olduğu gibi sağlık alanında da farklı amaçlarla yaygın olarak kullanılmaktadır. Bu amaçlar arasında, bilgi sistemleri oluşturulması, değerlendirme sistemleri yapılandırılması, epidemiyolojik veri toplanması, sağlıkla ilgili müdahalelerin planlanması ve davranışla ilgili verilerin toplanması sıralanmaktadır. Bu denli yaygın olarak kullanılan İnternet kullanımının bir yansıması olarak, web tabanlı araştırmalar son dönemlerde toplumun sağlığını korumayı ve geliştirmeyi öncelikli hedefleri arasında alan halk sağlığı uygulamalarının çalışma alanları arasına girmiştir. Bununla birlikte, web tabanlı araştırmaların kullanımının katılım sınırlılığı, araştırma metodolojisinde sorunlar, etik açısından sınırlılıklar gibi kimi önemli kısıtlılıkları da bulunmaktadır. Halk Sağlığı araştırmacılarının web tabanlı araştırmaları yürütürken bu kısıtlılıklara dikkat edebilmeleri önemlidir. Bu yazıda web tabanlı araştırmaların halk sağlığı alanında kullanımının gerekçesi, kullanıma ilişkin yöntem ve kısıtlılıkların tartışılması amaçlanmıştır. Anahtar Kelimeler: İnternet, halk sağlığı, araştırma Use of Web Based Research in Public Health Abstract The internet is frequently used for health issues and for many other related purposes: creating information systems, structuring evaluation systems, gathering epidemiological data, planning intervention methods are examples. As a reflection of such wide use of the internet, web based research has been one of the working areas of the public health discipline, which basically aims to prevent and promote health and wellbeing of the community. Nevertheless, there are a number of limitations of web based research and these include limitations in participation, methodological issues, ethical limitations, and others. It is important for public health researchers to take all these limitations into consideration during their research. In this paper, the rationale of web based research in Public Health, its methods and basic limitations in use were discussed. Key Words: Internet, public health, research

Background/aims Functional bowel disorders (FBDs) impair the quality of life in patients with end-stage renal disease (ESRD). The aim of our study was to determine the prevalence and distribution of the subtypes of FBDs in hemodialysis (HD) patients. Materials and methods This prospective, cross-sectional study included 80 patients who received HD for more than 3 months (patient group) and 80 healthy controls (control group). FBDs were diagnosed according to the Rome II diagnostic criteria by excluding organic pathologies. Results Forty-six (57.5%) patients were males, and their average age was 62.13±12.92 (23-90) years. The mean duration of dialysis was 57.48±59.23 (3-312) months, and the mean Kt/V (K: dialyzer clearance of urea, t: dialysis time, V: volume of distrubition of urea) value was 1.53±0.31. The rate of FBDs was significantly higher in the patient group than in the control group (p=0.01). In total, 7.5% of the patients had irritable bowel syndrome, 3.8% had functional bloating, and 16.3% had functional constipation. FBDs were significantly higher in women (p=0.004). While there was no statistically significant difference between patients with and those without FBDs in terms of the presence of additional diseases, smoking, alcohol use, educational level, marital status, and resi- dential areas (p>0.05), serum phosphorus (P) levels were significantly higher in the patients with FBDs (p=0.03). Conclusion FBDs and their functional constipation subtype are more common in HD patients than in the healthy population in Turkey. FBDs are most frequently observed in females and housewives with high serum P levels.

WOS: 000438303700008 Sudden unexpected death in epilepsy (SUDEP) is a serious problem, and its importance has increased in recent years. It is responsible for the death of 17% of epilepsy patients. As the age of onset rises, the risk increases. Patients with refractory epilepsy are particularly at risk. Likewise, male gender, early age of onset, polytherapy, nocturnal seizures, generalized tonic-clonic seizures (GTCS) are also among the risk factors. Respiratory, cardiac, autonomic and brain stem related pathologies are held to be responsible for its pathophysiology.

There are two types of malnutrition in patients with chronic renal failure (CRF); type 1 and type 2. The aim of this study was to investigate the relationship between malnutrition and inflammation and also the relationship between malnutrition and volume status. Ninety-four pre-dialysis CRF patients were included in the study. Nutritional status of the patients was calculated using the subjective global assessment. Scores of 1-5 were given according to the severity of the symptoms and physical examination findings. Serum inflammation markers [high-sensitive C-reactive protein (hs-CRP), interleukin-1β, interleukin-6 and tumor necrosis factor-alfa] and nutrition parameters (albumin, pre-albumin, transferrin, fetuin-A, insulin like growth factor-1 and insulin-like growth factor-binding protein-3)] were measured in all the patients. Serum N-terminal pro-brain natriuretic peptide levels and echocardiography were performed to evaluate the volume status of the patients. The mean age of the patients was 59.6 ± 13.3 years, the mean malnutrition score was 17.2 ± 6.01, the mean and the median of hs-CRP levels were 18.5 ± 40.7 and 5.6 mg/L, respectively, the mean albumin level was 3.46 ± 0.48 and the mean creatinine clearance was 23.7 ± 13.5 mL/min. A positive correlation between malnutrition scores with inflammation and volume parameters was found in the bivariate and multivariate analysis. In the multiple regression analysis, volume parameters proved to be the most important factors influencing malnutrition scores. Thus, the elimination of volume excess would ameliorate both inflammation and malnutrition. This hypothesis needs to be supported or proved with prospective studies.

Objective A student-oriented basic life support and first-aid training is practical to enlarge the number of qualified people in the field. In this study, we aimed to describe and discuss the training process of a group of medical students at Hacettepe University, School of Medicine and their assessment as basic life support and first-aid trainers. Methods A ‘6-hour’ ‘Training the Trainers’ course was conducted and participants’ demonstration and coaching skills were evaluated by using a 3-point scale (1 – needs improvement; 2 – competently performed; 3 – proficiently performed). In total, 31 students out of 45 volunteers were certified as trainers. Results All of the students proficiently performed ‘explain the aim of the demonstration’, ‘motivate participants to use checklists’, and ‘motivate the participants to ask questions’ for demonstraton skills. Similarly, they all got the maximum grade for ‘answer the questions of the participant’, ‘discuss the coach role of the participant’, ‘apply the skills’, and ‘follow up with the participant by using the checklist’ as steps of coaching skills. None of the skills within the checklists needed improvement for any of the candidates. Conclusion Although there are limitations, we hope that our experience of the Training the Trainers course will be useful for readers to highlight the importance of skill-based peer education on a very important public health concern, especially for the developing countries.

This study, performed in two phases, compared the smoking status of first- and last-year pharmacy students and identified underlying factors of smoking using both "quantitative" and "qualitative" research techniques. The quantitative phase was a cross-sectional study with 207 students (of these, 102 were first-year and 105 were last-year students). The mean age at which first-year students tried tobacco/tobacco products was 14.1 +/- 3.2 and for last-year students, 16.0 +/- 2.4. The students completed an 18-item questionnaire at the end of the spring semester in May 2004. Chi-square and t-test analyses were used for statistical comparisons. Furthermore, focus group discussion techniques were used to find out the underlying factors of smoking in the second phase.

Objective: This study was designed to evaluate the role of zygote intrafallopian transfer (ZIFT) procedure in patients with repeated failure of implantation. Study Design: A total of 141 ZIFT cycles of 132 women and 145 embryo transfer (ET) cycles of 97 women in whom five or more embryos were transferred were included in this study. Transcervical uterine embryo transfer and ZIFT cycle outcome in patients with five or more previous implantation failure were compared. Embryos were transferred by laparoscopy into the fallopian tube 24–27 h following oocytes retrieval in the ZIFT group. In the ET group, embryos were transferred transcervically on the third day following oocytes retrieval. Results: The mean age was 34 ± 4.9 and 34.9 ± 5.0 years in ZIFT and ET group, respectively. No difference was determined between the two groups regarding the basal FSH, E2 value on the day of HCG injection and the number of oocytes retrieved or fertilized. The implantation rate was 6.5% versus 7.2%, clinical pregnancy rate was 22.7% versus 24.8% and live birth rate was 21.2% versus 16.5% in ZIFT and ET groups, respectively. Conclusions: Implementation of ZIFT procedure in patients with repeated implantation failure is not superior to transcervical uterine embryo transfer.

Background Asthma, which is a chronic inflammatory disorder of the airways characterized by the infiltration of inflammatory cells, is a common cause of morbidity in adults. It is almost the third leading cause of preventable hospitalization in the developed countries and accounts for approximately millions of visits to emergency departments. Methods In this study, we aimed to determine asthma prevalence in five urban centers in Turkey. Three of the cities were located in the middle-west region of the Anatolia one of them as located across the Mediterranean cost and the last one was in the north part of the country. Data of totally 2353 participants was collected by the trained interviewers, who visited the households and administered the questionnaire to the household members at or over the age of 15 years. Results The prevalence of asthma was found to be 6.6 % and the difference of asthma prevalence between the urban centers was statistically non-significant (p = 0.059).

Objective: The aim of the study was to evaluate the voiding symptoms of pregnant women and to compare the symptoms amongst trimesters and controls by means of the International Prostate Symptom Score (IPSS). Materials and Methods: Voiding symptoms of 256 pregnant and 230 non-pregnant healthy women hospitalized for other reasons were evaluated. Subjects who had a history of urological and neurological problems or previous pelvic surgery associated with urinary symptoms and those who had urinary tract infection were excluded from the study. The pregnant group was then subdivided into subgroups as to the trimesters of pregnancy. The IPSS assesses seven symptoms on a scale of 0 (no symptoms) to 5 (symptom always present) and was administered as a self-administered questionnaire with the assistance of a trained nurse. Symptom scores of each group and subgroup and the distribution of scores were assessed. Results: The mean scores for all questions in the pregnant group were significantly higher than controls. The comparison of mean scores according to trimesters showed a significant difference for the questions of frequency, intermittency, urgency, weak stream, nocturia, quality of life and for the total scores. The distribution of the scores for each question showed that frequency and nocturia were the most prominent symptoms in pregnancy. The percentage of the respondents with an IPSS score of >7 was 47.6% and the percentage of a quality of life score of ≧4 (mostly dissatisfied) was 48.4%. Conclusions: Voiding symptoms during pregnancy are highly prevalent. These symptoms worsen as the pregnancy progresses.

Aim. In this study, “active” web sites related to health which were selected due to determined criteria have been evaluated in terms of formal, contextual and institutional characteristics. Methods. In this descriptive study, web sites which have been accessed when selected key words on the most frequently seen symptoms of the diseases were entered into the most frequently used search engine in Turkey. Four key words for each symptom were determined like “symptom alone”, symptom and prevention”, “symptom and diagnosis”, “symptom and treatment”. Researchers determined the most frequently seen symptoms of the neural, gastro intestinal, cardiovascular, respiratory, musculo-skeletal, endocrine, urinary, male genital, female genital, skin and lymphatic systems due to the answers of chief residents’ working at a university hospital to the question “Would you kindly say the most frequently seen five symptoms in your daily practice?”. All stated symptoms were listed by the researchers and three of five for each system were selected by random. For each key word, four searches were completed (the key word itself as well as three more searches using; “key word, prevention”, “key word, diagnosis”, “keyword, treatment”. Four different searches were done for each symptom which equals to 12 searches for one system. The first five web sites excluding the web sites used advertisements were investigated for one search. In the end, 60 web sites for each system and 600 web sites for all systems were assessed in the first run of the study. After exclusion of the duplicated sites, 475 web sites were included in the study. SPSS program was used for data entry and analysis. Results. Ninety two percent of the web sites did not include evidence based information. Besides, 40.6% of the current sites did not direct their users to either physicians or health professionals. Sixty five percent nine of the accessed web sites included advertisements. Only 9.7% of the researchers stated their possibility to recommend the web sites to their patients. The advertisement and sponsor relationships influenced their recommendation status. Conclusion. Web sites’ related to health/diseases need improvement (s) in order to be useful for their users in the community independently from commercial expectations, ÖzetAmaç. Bu çalışmada, sağlığı ilgilendiren konularda kullanımda olan ve belirlenmiş kriterlere göre seçilmiş bazı web sitelerinin şekil, içerik ve kurumsallık gibi özelliklerinin araştırılması amaçlanmıştır. Yöntem. Tanımlayıcı tipte olan bu araştırmada, Türkiye’de en sık kullanılan arama motoruna vücut sistemleri ile ilgili semptomlara ilişkin seçilmiş anahtar sözcükler verildiğinde ulaşılan web siteleri değerlendirilmiştir. Anahtar sözcükler, her bir semptom için dört adet olmak üzere “semptomun kendisi”, “semptom ve koruma”, “semptom ve tanı”, “semptom ve tedavi” şeklinde belirlenmiştir. Anahtar sözcükler, araştırmacılar tarafından belirlenen vücut sistemleri (sinir, sindirim, kardiyovasküler, solunum, kas-iskelet, endokrin, üriner, erkek genital, kadın genital, deri ve lenfatik sistemleri) ile ilgili araştırmacıların çalıştıkları hastanenin ilgili bölümlerinin baş asistanlarına ilgilendikleri sistemle ilgili “En sık gördüğünüz beş semptomu söyler misiniz?” sorusuna verilen yanıtlara göre belirlenmiştir. Baş asistanlar tarafından ifade edilen anahtar sözcükler listelenmiş, araştırmacılar tarafından kura çekilerek beş semptom içinden üç semptom seçilmiştir. Her bir anahtar sözcük için anahtar sözcük yanında virgül kullanılarak üç farklı ek sözcük kullanılmıştır (“anahtar sözcüğün kendisi”, “anahtar sözcük, korunma”, “anahtar sözcük, tanı”, “anahtar sözcük, tedavi”). Bir semptom için toplam dört farklı arama yapılmıştır. Toplamda, her bir sistem için 12 anahtar sözcük incelenmiştir. Her bir anahtar sözcük için reklam kullanarak üst sırada olan siteler hariç ilk 5 site değerlendirilmiştir. Sonuç olarak, ilk aşamada her bir sistem için toplam 60, on sistem için ise 600 web sitesi incelenmiştir. Sitelerde çakışmalar dışarıda bırakıldığında toplamda 475 web sayfası incelenmiştir. Veri girişi ve analizi için SPSS programı kullanılmıştır. Bulgular. Araştırmaya dahil edilmiş sitelerin %92’sinde kanıta dayalı hiçbir bilgi olmadığı bulunmuştur. Bununla beraber sağlıkla ilgili bilgi veren mevcut sitelerin %40,6’sında hekime veya sağlık çalışanına yönlendirme olmaması dikkat çekmiştir. Ayrıca sitelerin %65,9’u reklam içermektedir. Araştırmacıların sadece %9,7’si web sayfalarını hastalarına önereceklerini belirtmişlerdir. Reklam içerme ve sponsor olması araştırmacıların öneri seçeneklerini etkilemiştir. Sonuç. Sonuç olarak sağlık/hastalıkla ilgili web sitelerinin kullanıcıları için ticari kaygılardan bağımsız olarak yararlı olabilmeleri için gelişmeye/iyileşmeye gereksinimi bulunmaktadır.Anahtar sözcükler: Semptom, sağlık arama davranışı, internet AbstractAim. In this study, “active” web sites related to health which were selected due to determined criteria have been evaluated in terms of formal, contextual and institutional characteristics. Methods. In this descriptive study, web sites which have been accessed when selected key words on the most frequently seen symptoms of the diseases were entered into the most frequently used search engine in Turkey. Four key words for each symptom were determined like “symptom alone”, symptom and prevention”, “symptom and diagnosis”, “symptom and treatment”. Researchers determined the most frequently seen symptoms of the neural, gastro intestinal, cardiovascular, respiratory, musculo-skeletal, endocrine, urinary, male genital, female genital, skin and lymphatic systems due to the answers of chief residents’ working at a university hospital to the question “Would you kindly say the most frequently seen five symptoms in your daily practice?”. All stated symptoms were listed by the researchers and three of five for each system were selected by random. For each key word, four searches were completed (the key word itself as well as three more searches using; “key word, prevention”, “key word, diagnosis”, “key word, treatment”. Four different searches were done for each symptom which equals to 12 searches for one system. The first five web sites excluding the web sites used advertisements were investigated for one search. In the end, 60 web sites for each system and 600 web sites for all systems were assessed in the first run of the study. After exclusion of the duplicated sites, 475 web sites were included in the study. SPSS program was used for data entry and analysis. Results. Ninety two percent of the web sites did not include evidence based information. Besides, 40.6% of the current sites did not direct their users to either physicians or health professionals. Sixty five percent nine of the accessed web sites included advertisements. Only 9.7% of the researchers stated their possibility to recommend the web sites to their patients. The advertisement and sponsor relationships influenced their recommendation status. Conclusion. Web sites’ related to health/diseases need improvement(s) in order to be useful for their users in the community independently from commercial expectations.Keywords: Symptom, health seeking behavior, internet

OBJECTIVES The present study aimed to investigate smoking status of households having children under 5 years of age and any changes in their smoking habits after the enforcement of the anti-tobacco Law Nb. 4207 and after the birth of the child based on the records of two Family Health Centres in Ankara. MATERIAL AND METHODS Within the scope of this cross-sectional study, 192 houses, in which 228 children under five years of age were living, were evaluated. Data were collected via face-to-face interview. Data collection form included information regarding socio-demographic characteristics, health status, smoking habits, status of exposure to second-hand smoke. Data transfer to the computer and data analyses were performed using the SPSS 15.0 statistical package program. RESULTS According to the statements of the study participants, the rate of smoking in the balcony, kitchen, toilet-bathroom, and rooms of the house decreased after the enforcement of the anti-tobacco Law Nb. 4207. Similar decrease was valid also for working environment. The decrease in the rate of smoking was the least in "Balconies" at both home and working environments. Birth of a child was also a factor that decreased the rate of smoking. A decrease was observed in almost all parts (bedroom, kitchen, balcony, and toilet-bathroom) of the houses after birth of a child. CONCLUSION Exposure to second-hand smoke at homes, where children under the age of five years were living, could not be completely (100%) prevented. Health care workers' persistent study on this issue may contribute to the awareness of parents in preventing exposure to second-hand smoke.

WOS: 000410870800004 PubMed ID: 29042878 Objective Stroke is the second most common cause of death and the leading cause of adult disability. Both stroke patients and their family can therefore experience increased traumatic stress level. Methods The participants are close relatives of patients (n=65) who had a first time stroke (CRPWS) hospitalized. A control group (CG) (n=61), who had no history of chronic illness in their family and had at least one traumatic life event experience. The National Institutes of Health Stroke Scale, Modified Rankin Scale, Personal Information Form, Life Events Checklist, Traumatic Stress Symptom Scale, and Multidimensional Scale of Perceived Social Support, were used in the study. Results We found no significant association between NIHSS and MRS of patients and traumatic stress level of the family member. The traumatic stress level was significantly higher in the CRPWS group than in the CG group. Traumatic stress level was higher in women than men and was not associated with perceived social support in the CRPWS group. Conclusion The traumatic stress level of the relatives was not associated with the clinical features of the stroke patients. In the early phase, after the diagnosis of stroke, psychological support may be important to prevent CRPWS from PTSD.

Objective To determine community pharmacists’ burnout levels and prevalences as well as factors associated with burnout. Setting Study was conducted in Ankara, the capital of Turkey. Method In this cross-sectional study, 251 pharmacists were randomly selected from 1,504 community pharmacists registered in Ankara Chamber of Pharmacists. A questionnaire including questions related to pharmacists’ individual and professional characteristics and Maslach Burnout Inventory was administered. The data was collected between February 27 and May 25, 2007. Main outcome measure Three Maslach Burnout Inventory subscales (emotional exhaustion-EE, depersonalization-D, and personal accomplishment-PA) scores. Results Pharmacists’ mean emotional exhaustion score was found to be 16.84 (SD: 6.25), depersonalization score was 4 (Range: 0–14), and personal accomplishment score was 22 (Range: 9–32). Of the pharmacists, 1.2% had high level of EE, .8% had high level of D, and 71.3% had high level of inefficacy. Age, marital status, work experience, work contentment, workload, time pressure, stress, and satisfaction with customers were found to be related with pharmacists’ burnout levels. Conclusion It can be useful to monitor pharmacists’ burnout levels and prevalences periodically. Interventions on individual and organizational basis were needed to cope with burnout, respond to job demands, minimize the level of chronic stress, and increase work contentment and satisfaction.

The objective of this study was to find all the existing Web sites of Turkish community pharmacies and evaluate their "quality" in terms of Health on the Net (HON) Code of conduct principles. Multiple Internet search engines were used (google.com, yahoo.com, altavista.com, msn.com). While searching on the Internet, "eczane (pharmacy)" and "eczanesi (pharmacy of)" key words were used. The Internet search lasted for 2 months starting from March 1, 2007 until May 1, 2007. SPSS ver. 11.5 statistical program (SPSS, Inc., Chicago, IL) was used for data entry and analysis. At the end of the Internet search via all the indicated search engines, a total of 203 (all different from each other) community pharmacy Web sites were determined; of these, 14 were under construction and 6 were not accessible. As a result, 183 community pharmacy Web sites were included in the study. All of the Web sites could be accessed (100%). However, the availability of some characteristics of the pharmacies were quite poor. None of the pharmacies met all of the HON principles. Only 11 Web sites were appropriate in terms of complementarity (6.0%). Confidentiality criteria was met by only 14 pharmacies (7.7%). Nine pharmacies (4.9%) completed the "attribution" criteria. Among 183 pharmacy Web sites, the most met HON principle was the "transparency of authorship" (69 pharmacy Web sites; 37.7%). Because of the results of our study, the Turkish Pharmacists Association can take a pioneer role to apply some principles such as HON code of conduct in order to increase the quality of Turkish community pharmacists' Web sites.

Obesity and its associated metabolic complications can impair the physiologic regulation of fibrinolysis, leading to a hyper coagulable state. We aimed to assess circulating thrombin activatable fibrinolysis inhibitor (TAFI) levels in obese female patients and to test the effects of orlistat-induced weight loss on basal TAFI concentrations. Obese female outpatients age 18 and older, with a body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) of at least 30, were included into the study. Thirteen nonobese (median BMI, 22.60 kg/m2) age-matched females were taken as controls. Plasma TAFI levels were measured before orlistat administration and after 6 months of orlistat treatment in the obese group and only one measurement was done in the control group. Twenty-seven obese patients were recruited into the study. The median TAFI level of the control group was 124.00; this value was significantly lower than the basal TAFI level of the obese group (p < 0.001). TAFI levels after orlistat therapy were statistically significantly lower than basal TAFI levels (p < 0.001) in the obese group. Hemostatic abnormalities including TAFI alterations represent a link between obesity and vascular thrombosis. Effective interventions should be considered in improving the obesity-associated prothrombotic risk profile.

To investigate the efficacy of gonadotrophin-releasing hormone (GnRH) antagonist supplementation during natural cycles in poor responders undergoing IVF-ET treatment.We retrospectively evaluated 540 cycles of 433 suitable patients who were divided by treatment protocol into modified natural, antagonist, and long agonist groups. There were 52 modified natural cycles with GnRH antagonist supplementation, 200 stimulated cycles with GnRH antagonist, and 288 long GnRH agonist cycles. Cycle characteristics and treatment outcomes were compared between the groups.The mean number of oocytes retrieved in the modified natural group was significantly lower than in the stimulated antagonist and long agonist groups (1.4 +/- 0.5 vs. 2.3 +/- 1.1 and 2.5 +/- 1.1, respectively, p0.05). The respective implantation and pregnancy rates were 10% and 14.3%, 6.75% and 10.2%, and 7.4% and 10.6%. Cycle outcome and cycle properties were similar.Modified natural IVF cycle with GnRH antagonist supplementation is a feasible alternative to ovarian stimulation protocols in poor responders.

Tuberculosis (TB) is one of the leading causes of morbidity and mortality and almost one-third of the world is infected with this disease. In Turkey, it remains an important public health concern. In many of the studies, social aspects of TB are underestimated. In this study, self-evatuations of TB inpatients between the ages of 18 and 65 were assessed between July 29 and August 01, 2002 at Ankara Ataturk Sanatorium Training and Research Hospital, which is one of the major reference hospitals for TB in Turkey. This was a cross-sectional epidemiological study in which the participation rate was 88.2%. Mean age of the total 97 participants was 41.3 (SD = 13.6) and 80.4% of patients were mate. Patients expressed "unhappiness and stress (23.7%)" to be the major cause of their illness. From the patients' point of view, the three major difficulties incorporated in their lives due to TB were "financial problems (27.9%)", "loneliness (9.3%)", and "hospitalization (9.3%)". Relationships between the patients and their social environments were also assessed in five categories: "closest friend at work, closest friend in life, parents, children, and spouse". (C) 2004 Elsevier Ltd. All rights reserved.

Background: Malnutrition is very common in chronic kidney disease patients and it starts from predialytic stage. The purpose of our project is to investigate the relationship between volume and

The objective of this study was to compare sexually transmitted disease (STD) occurrence and STD complaints in women using intrauterine device (IUD) with women who are not using any modern contraceptive method in a family planning setting in Trabzon, Turkey. A great majority of all women in both groups were housewives and all indicated their husbands as the first and only lifetime sexual partner. The IUD user group (n = 211) did not differ significantly from the nonuser group (n = 155) in terms of mean age, years of schooling, first age at intercourse, frequency of sexual intercourse or practice of vaginal douching (p >0.05). STD signs and symptoms were not found to be significantly different among both groups, with the exception of vaginal discharge. IUD users complained more of abnormal vaginal discharge than nonusers (RR = 2.09, CI = 1.17-3.75, p = 0.007). Bacterial vaginosis was diagnosed with the Gram-staining of the vaginal smear and current IUD users were found to be 2.78 times more likely to be diagnosed with bacterial vaginosis as compared to nonusers (p

Introduction The tobacco control effort in Turkey has made significant progress in recent years. Turkey initiated its tobacco control effort with the passing of Law 4207 (The Prevention of Harmful Effects of Tobacco Products) in 1996 and ratified the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in 2004. It is important to base policy decisions on valid and reliable evidence from population-based, representative studies that are periodically repeated to enable policy makers to monitor the results of their interventions and to appropriately tailor anti-tobacco activities towards future needs. Methods The Global Youth Tobacco Survey (GYTS) was developed to track tobacco use among young people and enhance the capacity of countries to design, implement, and evaluate tobacco control and prevention programs. Turkey conducted the GYTS in 2003 and data from this survey can be used as baseline measures for evaluation of the tobacco control programs implemented by the Ministry of Health (MOH) of the Turkish government. Results The GYTS was conducted in 2003 on a representative sample of students aged 13 to 15 years. It indicated that almost 3 in 10 students in Turkey had ever smoked cigarettes, with significantly higher rates among boys. Current cigarette smoking rates were lower, at 9% for boys and 4% for girls. The prevalence of current use of other tobacco products was about half these figures for each gender. About 80% were exposed to secondhand smoke. Exposure to pro-smoking media messages was not rare. Almost half of the smokers 'usually' bought their tobacco from a store, despite the law prohibiting this. Exposure to teaching against smoking in schools was not universal. Conclusion Findings from the GYTS, with periodic repeats of the survey, can be used to monitor the impact of enforcing various provisions of the present law (No: 4207), the progress made in achieving the goals of the WHO FCTC, and the effectiveness of various preventive interventions against smoking. Such data would inform and help in the development of public health strategy.