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The natural radioactivity existed since creation of the universe due to the long life time of some radionuclides. This natural radioactivity is caused by γ-radiation originating from the uranium and thorium series and 40K. In this study, the gamma radiation has been measured to determine natural radioactivity of 238U, 232Th, and 40K in collected sedimentary rock samples in different places of Turkey. The measurements have been performed using γ-ray spectrometer containing NaI(Tl) detector and multichannel analyser (MCA). Absorbed dose rate (D), annual effective dose (AED), radium equivalent activities (Raeq), external hazard index (Hex), and internal hazard index (Hin) associated with the natural radionuclide were calculated to assess the radiation hazard of the natural radioactivity in the sedimentary rock samples. The average values of absorbed dose rate in air (D), annual effective dose (AED), radium equivalent activity (Raeq), external hazard index (Hex), and internal hazard index (Hin) were calculated and these were 45.425 nGy/h, 0.056mSv/y, 99.014 Bq/kg, 0.267, and 0.361, respectively. [ABSTRACT FROM AUTHOR]

Abstract: The activity concentrations of uranium, thorium and potassium can vary from material to material and it should be measured as the radiation is hazardous for human health. Thus first studies have been planned to obtain radioactivity of building material used in the Isparta region of Turkey. The radioactivity of some building materials used in this region has been measured using a γ-ray spectrometry, which contains a NaI(Tl) detector connected to MCA. The specific activity for 226Ra, 232Th and 40K, from the selected building materials, were in the range 17.91–58.88, 6.77–19.49 and 65.72–248.76Bq/kg, respectively. Absorbed dose rate in air (D), annual effective dose (AED), radium equivalent activities (Raeq), and external hazard index (H ex) associated with the natural radionuclide are calculated to assess the radiation hazard of the natural radioactivity in the building materials. It was found that none of the results exceeds the recommended limit value. [Copyright &y& Elsevier]

The solar radiation, as it comes through the atmosphere to the Earth's surface, can be used in a variety of fields, such as solar engineering, architecture, agriculture, and hydrology. It is important to investigate solar radiation, especially in a place such as Turkey, where solar-energy potential is high. Thus, in this study, the daily (during sunshine duration) and monthly average global, diffuse, and direct solar radiation in the Isparta (37° 18' and 38° 30' N latitude) region of Turkey has been obtained. In the comparison of calculated and meteorological data, a good agreement has been observed. [ABSTRACT FROM AUTHOR]

Radon, a naturally occurring radioactive noble gas, is the main source of the natural radiation that is received by the population. It derives from the traces of radium in rocks and can diffuse directly or as solution in water to the earth's surface. Measurements of radium and radon concentration in a total of ten different well waters sampled at about 100m depth in the Afyonkarahisar area of Turkey have been made. It was found that the concentration ranged from 0.42–28.82Bq·L-1 for radon and from 0.07–7.16Bq·L-1 for radium. A 99% correlation between radon and radium concentrations was found. From these data the average annual effective dose equivalent from radon and radium in the water have been estimated to about 73.8 and 778.96 μSv.y-1, respectively. [ABSTRACT FROM AUTHOR]

Purpose: The main goal of this retrospective study was to re-evaluate air available records of clinical and laboratory data of patients with tuberculosis (TB) in Sivas province, Middle Anatolia, Turkey. Methods: TB registration data held at health institutions in Sivas province were compared and matched with data obtained from the local official TB registries from January 2000 to December 2001. Results: Of the 536 TB cases found in 2000 and 2001, 255 (47.6%) were officially registered. Of the 127 cases with smear-positive pulmonary TB (PTB), only nine cases labelled as smear-positive were registered in local dispensaries. The incidence of unregistered cases with smear-positive PTB found by this study was approximately 40-fold and eightfold greater than the incidence of registered cases for 2000 and 2001, respectively. Conclusion: There were many more unofficially recorded TB patients compared with officially recorded cases in Sivas province between 2000 and 2001. The results of this study are disappointing and alarming for Turkey's national TB control programme, at least for its regional applications. [ABSTRACT FROM AUTHOR]

Assumed mutual antagonism of T-helper cell (Th)1 and Th2 diseases suggests that the prevalence of atopy should be decreased in rheumatoid arthritis (RA). We tried to determine that prevalence. Sixty-two patients with RA and 61 with osteoarthritis (control group) were included in the study. A questionnaire was used concerning mainly the symptoms of atopy. Skin prick tests, pulmonary function tests, chest X-rays, immunoglobulin E levels, and eosinophil counts were obtained. The prevalences of asthma, hay fever, and eczema in the RA group were 3.2%, 14.5%, and 1.6%, respectively. In the control group, they were 6.5%, 22%, and 6.5%, respectively. There was no significant difference between groups. There was also no significant difference between immunoglobulin E levels. Eosinophil counts were higher in the control group, however these values were within the normal range. Skin prick tests were obtained in seven RA patients, and eight controls revealed increased positivity. The prevalence of atopy in rheumatoid arthritis was not different from that in the general population. Our study results cannot support the concept of Th1/Th2 mutual antagonism. [ABSTRACT FROM AUTHOR]

Objectives: To explore the rate of pneumoconiosis in dental technicians (DTP) and to evaluate the risk factors., Material and Methods: Data of 893 dental technicians, who were admitted to our hospital in the period January 2007-May 2012, from 170 dental laboratories were retrospectively examined. Demographic data, respiratory symptoms, smoking status, work duration, working fields, exposure to sandblasting, physical examination findings, chest radiographs, pulmonary function tests and high-resolution computed tomography results were evaluated., Results: Dental technicians' pneumoconiosis rate was 10.1% among 893 cases. The disease was more common among males and in those exposed to sandblasting who had 77-fold higher risk of DTP. The highest profusion subcategory was 3/+ (according to the International Labour Organization (ILO) 2011 standards) and the large opacity rate was 13.3%., Conclusions: To the best of our knowledge, it was the largest DTP case series (N = 893/90) in the literature in English. Health screenings should be performed regularly for the early diagnosis of pneumoconiosis, which is an important occupational disease for dental technicians.

One of the most significant diseases related to environmental asbestos exposure is malignant mesothelioma (MM). Sivas province is located in the Central Anatolia where asbestos exposure is common. We aimed to study clinical, demographical and epidemiologic features of the patients with MM in Sivas, along with the history of asbestos exposure. In total, 219 patients with MM who were diagnosed in our hospital between 1993 and 2010 were retrospectively analyzed in terms of demographical and clinical features. Rock, soil and house plaster samples were taken from the habitats of those patients and were evaluated with optical microscopy and X-ray diffraction methods. The age of the patients ranged between 18 and 85 years. The male-to-female ratio was 1.4:1. Most of the patients confirmed an asbestos exposure history. The most frequent symptoms of the patients were chest pain (60 %) and dyspnea (50 %). The gap between the start of first symptoms and the diagnosis date was approximately 4 months in average. The plaster materials used in most of the houses were made up of mainly carbonate and silicate minerals and some chrysotile. Ophiolitic units contained fibrous minerals such as serpentine (clino + orthochrysotile) chiefly and pectolite, brucite, hydrotalcite and tremolite/actinolite in smaller amounts. MM is not primarily related to occupational asbestos exposure in our region, and hence, environmental asbestos exposure may be indicted. Yet, single or combined roles and/or interactions of other fibrous and non-fibrous minerals in the etiology of MM are not yet fully understood and remain to be investigated.

Background: Malignant mesothelioma (MM) is an insidious tumor with poor prognosis, arising from mesothelial surfaces such as pleura, peritoneum and pericardium. We here aimed to evaluate the demographic, clinical, and radiological features of patients with MM followed in our center as well as their survival., Methods: The study included 228 patients (131 male, 97 female) who were followed up in our institution between 1993 and 2010 with the diagnosis of MM., Results: The mean age was 59.1 years in men and 58.7 years in women and the sex ratio was 1.4:1 in favor of males. Environmental asbestos exposure was present in 86% of the patients for a mean duration of 40±20 years (range: 3-70). Pleural effusion and thoracic/abdominal pain were the most common presenting signs and symptoms (70.2% and 57.8%, respectively). One hundred-thirteen (66%) patients were treated with platinum-based combination chemotherapy (PBCT) plus supportive care (SC) and 67 (34%) patients received SC alone. The median follow-up time was 10.0 months. The median overall survival was significantly improved with PBCT plus SC compared to SC alone (11.4 vs. 5.1 months; p=0.005). The 6, 12, 18, and 24-month survival rates were significantly improved with PBCT plus SC compared to SC alone (72%, 43%, 19%, and 2% vs. 49%, 31%, 11%, and 1%)., Conclusion: The survival of patients with MM improved in patients treated with PBCT. The survival advantage continued 12- and 24-month after the initial time of combination chemotherapy.

In order to prevent and control non-communicable diseases (NCDs), the 61st World Health Assembly has endorsed an NCD action plan (WHA resolution 61.14). A package for essential NCDs including chronic respiratory diseases (CRDs) has also been developed. The Global Alliance against Chronic Respiratory Diseases (GARD) is a new but rapidly developing voluntary alliance that is assisting World Health Organization (WHO) in the task of addressing NCDs at country level. The GARD approach was initiated in 2006. GARD Turkey is the first comprehensive programme developed by a government with all stakeholders of the country. This paper provides a summary of indicators of the prevalence and severity of chronic respiratory diseases in Turkey and the formation of GARD Turkey.

Aim: We investigated specific aetiology and different therapeutic approaches in patients with empyema in a General Thoracic Surgery Clinic., Material and Methods: Charts of 139 patients admitted with empyema, between January 1998 and March 2005 were retrospectively reviewed. Although not completely comparable, patients were divided into two groups; Paediatric (n = 71) and adult (n = 68) cases. In addition to demographic characteristics, treatment options, complications and clinical outcomes were investigated according to the specific group., Results: The mean age was 5.6 years (4 mo - 17 y) for paediatric patients and 49.6 years (20-81 y) for adult patients. Overall, 65% of the patients (n = 91) were male. All paediatric cases had parapneumonic empyema, while 63% of the adult cases had parapneumonic and 23.5% had postoperative empyema. Of the paediatric cases, 50% received fibrinolytic treatment in addition to tube thoracostomy and 35% had decortication. In adults, 42% had tube thoracostomy and fibrinolytic treatment, and decortication was required in 9% only. Thoracomyoplasty was performed in 12% of the patients (n = 8). We had no mortality in paediatric patients, however mortality rate was 8% in the adult group. Morbidity, consisted mostly of prolonged air leakage and impaired lung expansion., Conclusion: Early decortication and fibrinolytic treatment are sufficient for paediatric patients, while a variety of techniques including open drainage, rib resection and thoracomyoplasty are required in adult patients with empyema.

Aim: Benign and malignant pleural and lung diseases due to environmental asbestos exposure constitute an important health problem in Turkey. The country has widespread natural deposits of asbestos in rural parts of central and eastern regions. Few data exists about the respiratory health effects of occupational asbestos exposure in Turkey. A cross-sectional study was conducted to investigate respiratory health effects of occupational asbestos exposure and the contribution of environmental asbestos exposure., Methods: Investigations included asbestos dust measurements in the workplace and application of an interviewer-administered questionnaire, a standard posteroanterior chest X-ray and spirometry. Information on birthplace of the workers was obtained in 406 workers and used to identify environmental exposure to asbestos, through a map of geographic locations with known asbestos exposure., Results: Asbestos dust concentration in the ambient air of the work sites (fiber/ml) ranged between 0.2 and 0.76 (mean: 0.25, median: 0.22). Environmental exposure to asbestos was determined in 24.4% of the workers. After the adjustment for age, smoking, occupational asbestos exposure, and potential risk factors environmental asbestos exposure was associated with small irregular opacities grade > or = 1/0 (44.2% vs. 26.6%, P < 0.01), FVC% (97.8 vs. 104.5, P < 0.0001), and FEV1% (92.4 vs. 99.9, P < .0001). Occupational exposure to asbestos was associated with small irregular opacities grade > or = 1/0 (OR: 2.0, 95% CI: 1.3-3.1, per 1 unit increase in the natural logarithm of fiber/ml) and FEV1/FVC% (beta: 1.1, SEM: 0.54; P < 0.05, per 1 unit increase in the natural logarithm of fiber/ml)., Conclusions: Environmental exposure to asbestos could increase the risk of asbestosis and lung function impairment in workers occupationally exposed to asbestos, independent from occupational exposure and smoking., (Copyright 2006 Wiley-Liss, Inc.)

Studies consistently show that patients with sleep related diseases (SRD) have higher accident rates. Polysomnography (PSG) is the gold standard for the diagnosis of SRD. Sleep habits questionnaires are also useful tool for research of the prevalence of SRD on large populations. The aim of this study is to investigate the prevalence of SRD and SRD related traffic accidents on the whole population of professional drivers in Sivas city. A questionnaire that includes questions about drivers' background such as how long they have been driving, if they had any accidents, and if they drive just in Sivas city or inter state. This questionnaire composed of 50 questions about SRD and was asked to drivers answer them face to face. Three hundred forty male drivers participated for this study. Their mean age was 39.5+/-9.3 (21-68) years. The mean driving duration was 13.3+/-7.9 years. The percentage of drivers who drove in Sivas was 52.1% and 47.9% of the drivers drove inter state. The percentage of drivers who had at least one accident was 36.3%. The prevalence of habitual snoring, insomnia, sleep apnea, nocturnal myoklonus were 41.2%, 39.1%, 32.9%, and 33.6% respectively. The traffic accident Odds ratio was 1.619 for drivers with habitual snoring (95% CI, 1.034 to 2.536, p=0.02). In conclusion, this study found out that drivers with habituel snoring seems to have tendency (approximately 2-folds) of involving in traffic accidents than drivers who do not have habituel snoring. Polysomnography of candidate drivers with sleep disordered symptoms has to be logical before giving to driving license.

Purpose: The purpose of this study was to examine the effect of exposure to different substances on the development of chronic obstructive pulmonary disease (COPD)., Methods: The case group consisted of 74 housewives. These were female patients who never smoked who had a diagnosis of COPD and were seen at the Cumhuriyet University Hospital in Sivas, Turkey, between January 1, 2001, and March 31, 2002. The control group consisted of 74 housewives; this group consisted of healthy women who never smoked who came to the hospital as visitors and who did not have the diagnosis of COPD. The control group was chosen by group matching of the age distribution of the women in the case group and the regions and the neighborhoods where they lived. All of the women in the case and control groups were evaluated with a questionnaire for exposure to wood ashes, biomass, and cigarette smoke in closed areas., Results: No difference was found in the groups for exposure to wood ashes (p > 0.05). Logistic regression analysis resulted in the following odds ratio of COPD estimate for women with > or = 30 years biomass exposure, 6.61 (95% Confidence interval [CI]: 2.17-20.18); for women with > or = 30 years cigarette smoke exposure, 4.96 (95% CI: 1.65-14.86)., Conclusion: A statistically significant correlation was found between the effect of > or = 30 years of exposure to biomass and cigarette smoke exposure and the development of COPD.

The total linear attenuation coefficients micro (cm(-1)) have been obtained using the XCOM program at photon energies of 1 keV to 1 GeV for six different natural marbles produced in different places in Turkey. The individual contribution of photon interaction processes to the total linear attenuation coefficients for marble has been investigated. The calculated results were also compared with the measurements. The results obtained for marble were also compared with concrete.

The prevalence of sleep-related disorders (SRD) in adults in Turkey is unknown. The main objective of our study was to assess the prevalence of SRD in Sivas, Turkey. Adults living in Sivas, a city of Turkey from the central region of Anatolia at 20-107 years of age, in both genders, of the 5339 persons, who attended the survey 2638 (49.4%) were male and 2701 (50.6%) were female. The prevalence of insomnia, habitual snoring, obstructive sleep apnea (OSA) and day time hyper somnolence was 40.3%, 37.0%, 6.4%, 24.0% respectively. The prevalence rates of narcolepsy and nocturnal myoclonus was 30.6%, 40.1% respectively. There was a statistical significance between the persons of above 60 years old and another age groups (p< 0.05). But we did not find any significant difference between smokers and non-smokers, also between males and females about SRD prevalence (p> 0.05). However, sleep apnea prevalence was about 9 times higher in the persons suffering from hypertension than without hypertension. Also sleep apnea prevalence was 12 times higher in the persons suffering from overweight. This study has shown that sleep-disordered breathing (SDB) prevalence in Turkey is as high as in other countries and may be more common.

Background: Gram-negative bacteria cause most nosocomial respiratory infections. At the University of Cumhuriyet, we examined 328 respiratory isolates of Enterobacteriaceae and Acinetobacter baumanii organisms in Sivas, Turkey over 3 years. We used disk diffusion or standardized microdilution to test the isolates against 18 antibiotics., Results: We cultured organisms from sputum (54%), tracheal aspirate (25%), and bronchial lavage fluid (21%). The most common organisms were Klebsiella spp (35%), A. baumanii (27%), and Escherichia coli (15%). Imipenem was the most active agent, inhibiting 90% of Enterobacteriaceae and A. baumanii organisms. We considered approximately 12% of Klebsiella pneumoniae and 21% of E. coli isolates to be possible producers of extended-spectrum beta-lactamase. K. pneumoniae isolates of the extended-spectrum beta-lactamase phenotype were more resistant to imipenem, ciprofloxacin, and tetracycline in our study than they are in other regions of the world., Conclusions: Our results suggest that imipenem resistance in our region is growing.

Background: In our clinical experience, asthma is an important health problem in our region, but we did not know its prevalence., Objective: The main objective of our study was to assess the prevalence of asthma in Sivas, a city in Central Anatolia., Methods: A cross-sectional study was performed using a screening questionnaire adopted from European Community Respiratory Health Survey (ECRHS). A total of 5448 adults of both genders between 20 and 107 yr of age living in Sivas, a city in the central region of Anatolia in Turkey, participated in the survey. Of the cohort, 2691 were men (49.4%) and 2757 (50.6%) were women., Results: The mean age was 38.2 yr (SD = 12.7 yr), almost half of the study population was at or younger than 40 yr of age. The prevalence of wheezing in the last 12 months, diagnosis of asthma, asthma attack in the last 12 months, and use of asthma medicine were 20.9%, 4.5%, 4.9%, and 3.4%, respectively. Awakening with chest tightness, with shortness of breath, or with cough were reported as 14.2%, 14.8%, and 22.7%, respectively. The prevalence of respiratory symptoms related to asthma was statistically higher in women than that of men (p = 0.000, OR 1.346, 95% CI: 1.228-1.475). Those who had asthma/allergic symptoms in their family members were significantly younger than others (p: 0.001)., Conclusions: The results of this study demonstrate that symptoms suggestive of asthma are quite common and constitute a major health problem in Sivas, Turkey. This study also showed that, despite a high rate of reported symptoms exists, the rate of diagnosis and treatment of asthma is low among the adult population in Sivas.