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Education is among the areas most affected by immigration. Addressing refugee children's schooling is an important contribution to the refugee crises, which span the world with far-reaching socio-economic effect. This study unpacks the challenges that refugee children, mainly from Syria, face in integrating into primary and secondary public schools in Turkey. It also proposes some tentative resolutions, drawing from the experiences of refugee parents, teachers, and headteachers. Within the current study, data were collected by means of fishbone analysis and semi-structured interviews with the participation of teachers, school headteachers, and refugee parents. The study draws from the theories of refugee education and confirms students' barriers in schooling with regard to psychosocial factors, cultural adaptation, language learning, systemic barriers, and family relations. Some further implications were elicited from the data and are discussed in line with the existing research.

In this study, milk yield from culture, cross-bred, and native cattle breeds in 7 geographical regions of Turkey were investigated by multivariate analysis of variance (MANOVA) in 2015. The values of Pillai's Trace, Wilks' Lambda, Hotelling's Trace and Roy's Largest Root statistics used for the MANOVA test were 0.522, 0.546, 0.711 and 0.490, respectively. The corresponding F values for these statistics were found to be 2.422, 2.518, 2.594 and 5.634, respectively. Mean annual milk yield of crossbred, culture, and native cattle breeds reached to be 3776.355, 2692.803 and 1311.513 kg, respectively. Therefore, the results of these statistics are very close to each other. As a result of the MANOVA test, the difference within milk yield between the regions was not significant for culture and native cattle breeds, whereas a significant difference was found in hybrid breed cattle (P < 0.001). As a result of the Bonferroni test, it was found that the milk yield difference in hybrid cattle was due to the difference in yield between Eastern Anatolia-Aegean, Eastern Anatolia-Marmara, Southeast Anatolia-Aegean and Southeast Anatolia-Marmara regions. [ABSTRACT FROM AUTHOR]

Objective Prehospital and hospital care during incidents of mass violence and civil conflict involve a number of aspects that distinguish it from care during times of peace. We aimed to analyze the dynamics and outcomes of prehospital and hospital care during ongoing conflicts. Study design Multicentric prospective observational study. Method Patients enrolled in the study, which was conducted in Turkey, were all injured in armed conflict and taken to level 1 trauma centers. On admittance, patients were requested to complete a semistructured questionnaire containing questions on patient demographics, transport type, weapons used, injury severity score (ISS), and other incident-related factors. We analyzed patient outcomes (mortality, morbidity, complications, and length of hospital stay) and transfers of patients between hospitals. The present study evaluated the cases of 390 victims enrolled over a 9-month period and followed up for 6 months. Results The majority of patients were transported by ambulances (n = 334, 85.6%); other transport modes were helicopters (n = 32, 8.2%) and private vehicles (n = 24, 6.2%). Nearly half of patients (48.7%) did not benefit by changing hospitals. During transport to hospitals, 4.1% of the vehicles in the study were involved in accidents. Using multiple regression analysis, only ISS (odds ratio [OR]: 1.098, 95% confidence interval [CI]: 1.044–1.156) and the Glasgow Coma Scale (OR: 0.744, 95% CI: 0.639–0.866) were found to affect mortality. In Receiver-operator characteristic analysis, a cutoff value of 22.5 for ISS had a sensitivity of 100% and a specificity of 89.6% for mortality. Conclusions Despite lower ISS values, patient outcomes were worse in terror incidents/civil conflicts. Transport modes did not significantly affect outcomes, whereas hospital transport was found to be inefficiently used. [ABSTRACT FROM AUTHOR]

The aim of the investigation was to forecast annual production of some oil seed crops (sesame, sunflower and soybean) in Turkey for the years 2016 through 2025 using annual production data for the period 1950-2015 and to give solid recommendation on production for producers, consumers and input providers. For this aim, three exponential smoothing methods, Holt, Brown and Damped Trend were executed to economically model the time series data. Goodness of fit criteria such as stationary R2, R2 and BIC criteria were adopted in the comparison of these exponential smoothing methods. Soybean, sunflower and sesame production amounts for the period 2016 -2025 were forecasted with high accuracy by using Holt exponential smoothing method with two parameters, which yielded the best result among exponential smoothing methods. Forecasted production amounts of soybean, sunflower and sesame from the period 2016- 2025 ranged from 162.878 to 179.784, 1.692.269 to 1.879.521 and 18.212 to 15.318 tons, respectively. We hope that the results from the time series data will provide baseline information for sustaining production and for guiding agricultural policy and exports of Turkey in terms of the above-mentioned plants in forthcoming years. [ABSTRACT FROM AUTHOR]

Objective:A disintegrin and metalloproteinase domain containing protein 33 (also known as ADAM-33) is a member of a matrix metalloproteinase family which mediates extracellular matrix remodelling and changes in cellular adhesion. This study aimed to evaluate expression of this protein in laryngeal squamous cell carcinoma, and to determine its correlation with patients' clinicopathological characteristics.Subjects and methods:Forty paraffin blocks of laryngeal carcinoma underwent immunohistochemical staining to detect “a disintegrin and metalloproteinase-33” expression. Case records were reviewed to determine patient characteristics.Results:All epithelial, vascular and stromal staining scores were significantly increased in tumour tissue compared with controls (p < 0.001). However, patients' clinical characteristics at the time of diagnosis, and their disease extent, did not correlate significantly with the immunohistochemical staining scores.Conclusion:This study suggests that increased expression of “a disintegrin and metalloproteinase-33” may play a role in the pathogenesis of laryngeal carcinoma. [ABSTRACT FROM PUBLISHER]

Objective:To determine prevalence of the metabolic syndrome (MS) in a sample representing Turkish population using United States Adult Treatment Panel-3 guidelines.Design:The study included random samples from both urban and rural populations in the seven geographical regions of Turkey. The population for this analysis were 2108 men (1372 in urban and 736 in rural areas) and 2151 women (1423 in urban and 728 in rural areas) with a mean age of 40.9±14.9 years (range 20–90).Results:The prevalence of the MS diagnosed using the Adult Treatment Panel III criteria was 33.9% (1442 of 4259) and differed significantly in men (28%) and women (39.6%). The prevalence of syndrome increased with age in men, from 10.7% in subjects aged 20–29 years to 49% in those aged over 70 years. The prevalence increased with age in women, from 9.6% in subjects aged 20–29 years to 74.6% in those aged 60–69 years, and decreased to 68.6% in those over 70 years of age. The prevalence of the syndrome was similar in urban (33.8%) and rural (33.9%) population. We found 26.8, 26.4, 19.3, 10.9 and 3.6% of the population had at least 1, 2, 3, 4 or 5 components, respectively. We found 57.2, 32.3 and 10.6% of the subjects with MS had 3, 4 and 5 components, respectively.Conclusions:The prevalence of the MS in the adult Turkish population is very high, especially in women. Our findings have important implications for public health in Turkey.European Journal of Clinical Nutrition (2007) 61, 548–553. doi:10.1038/sj.ejcn.1602554; published online 22 November 2006 [ABSTRACT FROM AUTHOR]

The total phenolic contents and the essential oil compositions of the previously unknown Stachys taxa ( Labiatae), including Stachys pinardii Boiss, Stachys cretica L. subsp. mersinaea (Boiss.) Rech., and Stachys aleurites Boiss. & Heldr., all endemic to Turkey, were studied. Their essential oil compositions were investigated by GC-MS. It was found that the main constituents were α-curcumene (34.10%) for S. cretica, cedrandiol (25.26%) and caryophyllene dioxide (22.15%) for S. pinardii, and (Z)- β-caryophyllene (31.60%) for S. aleurites. The total phenolic contents, by the Folin-Ciocalteu colorimetric method, of the S. pinardii, S. cretica subsp. mersinaea, and S. aleurites methanolic extract were found to be 600.74±0.23, 1200.94±0.11, and 900.61±0.06 mg gallic acid equivalent (GAE)/100 g in dried herb, respectively. [ABSTRACT FROM AUTHOR]

Purpose: To compare the oncological outcomes of clear cell RCC (ccRCC), which is common in renal cell carcinomas (RCC), and chromophobic RCC (chRCC), which is less common, and to define the factors affecting survival in the Turkish patient population for both RCC subclassifications., Materials and Methods: Patients with a pathologically confirmed RCC diagnosis after radical or partial nephrectomy in the Turkish Urooncology Association (TUOA), Urological Cancers Database-Kidney (UroCaD-K), were retrospectively reviewed. Patients with ccRCC and chRCC were included in the study. Primary outcomes of this study are recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) for each histological subtype., Results: Data from 5300 patients in the TUOA UroCaD-K are reviewed and a total of 2560 patients (2225 in the ccRCC group and 335 in the chRCC group) are included in the final analysis. In the comparison of the groups, tumor size was greater both radiologically and pathologically in chRCC (p=0.019 vs 0.002 respectively). Recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) rates are worse in ccRCC subgroup. In the evaluation of risk factors; pathological stage, local invasion and Fuhrmann grade were found to be significant for recurrence in ccRCC. Age, body mass index and pathological stage were the risk factors affecting overall mortality (OM). Pathological tumor size was an independent risk factor for recurrence in chRCC, while age was analyzed as the only parameter affecting OM., Conclusion: chRCC oncological data and OS, CSS and RFS rates were found to be better than ccRCC in the Turkish patient population.

Metastatic castration-resistant prostate cancer (mCRPC) remains a challenging condition to treat despite recent advancements. This retrospective study aimed to assess the activity and tolerability of Lutetium-177 (Lu-177) PSMA-617 radioligand therapy (RLT) in mCRPC patients across multiple cancer centers in Turkey. The study included 165 patients who received at least one cycle of Lu-177 PSMA-617 RLT, with the majority having bone metastases and undergone prior treatments. Prostate-specific antigen (PSA) levels were assessed before each treatment cycle, and the biochemical response was evaluated in accordance with the Prostate Cancer Work Group 3 Criteria. The PSA decline of ≥50% was classified as a response, while an increase of ≥25% in PSA levels was indicative of progressive disease. Neither response nor progression was considered as stable disease. The Lu-177 PSMA-617 RLT led to a significant PSA response, with 50.6% of patients achieving a >50% decrease in PSA levels. Median overall survival (OS) and progression-free survival were 13.5 and 8.2 months, respectively. Patients receiving Lu-177 PSMA-617 RLT in combination with androgen receptor pathway inhibitors (ARPIs) had a higher OS compared to those receiving Lu-177 PSMA-617 RLT alone (18.2 vs 12.3 months, P = .265). The treatment was generally well-tolerated, with manageable side effects such as anemia and thrombocytopenia. This study provides real-world evidence supporting the effectiveness and safety of Lu-177 PSMA-617 RLT in mCRPC patients, particularly when used in combination with ARPIs. These findings contribute to the growing body of evidence on the potential benefits of PSMA-targeted therapies in advanced prostate cancer., (© 2023 UICC.)

Spiritual well-being is considered a significant factor in helping to manage chronic diseases and cope with the disease process. This descriptive-correlational study aimed to investigate the relationship between spiritual well-being, diabetes burden, self-management, and among 300 outpatients with type 2 diabetes in Turkey. A significant relationship was found between the diabetes burden and self-management levels and the spiritual well-being of patients with diabetes (p < 0.005). Multiple linear regression analyses found that a high diabetes burden (ß = -0.106) decreased well-being, and high self-management increased well-being (ß = 0.415). Additionally, the results revealed that marital status, household members, performing daily life activities alone, hospitalization due to complications, diabetes burden, self-management, glycemic control, and blood lipid parameters explained 29% of the total variance in the spiritual well-being level. Accordingly, the present study recommended that health professionals should consider spiritual well-being to support disease management with a holistic approach to diabetes patients., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The present study aimed to determine the pollution levels derived from polycyclic aromatic hydrocarbons (PAHs) in air, plant and soil samples and to reveal the PAH exchange at the soil-air, soil-plant and plant-air interfaces. In this context, air and soil samples were collected in approximately 10-day periods between June 2021 and February 2022 from a semi-urban area in Bursa, an industrial city with a dense population. Also, plant branch samples were collected for the last three months. Total PAH concentrations in the atmosphere (∑ 16 PAH) and soil (∑ 14 PAH) ranged from 4.03 to 64.6 ng/m 3 and 13-189.4 ng/g DM, respectively. PAH levels in the tree branches varied between 256.6 and 419.75 ng/g DM. In all air and soil samples, PAH levels were low in the summer and reached higher values in the winter. 3-ring PAHs were the dominant compounds, and their distribution in air and soil samples varied between 28.9%-71.9% and 22.8%-57.7%, respectively. According to the results of diagnostic ratios (DRs) and principal component analysis (PCA), both pyrolytic and petrogenic sources were found to be effective in PAH pollution in the sampling region. The fugacity fraction (ff) ratio and net flux (F net ) values indicated that the direction of movement of PAHs was from soil to air. In order to better understand the PAH movement in the environment, soil-plant exchange calculations were also achieved. The ratio of ∑ 14 PAH values measured to modeled concentrations (1.19net levels showed that branches were saturated with PAHs and the direction of PAH movement was from plant to soil. The plant-air exchange results indicated that the direction of movement of PAHs was from plant to air for low molecular weight PAHs and the opposite was true for compounds with high molecular weight ones., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Yucel Tasdemir reports a relationship with Scientific and Technological Research Council of Turkey that includes: funding grants., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: Pulmonary involvement is an important cause of mortality and morbidity in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV). In this study, we aimed to evaluate the type and frequency of pulmonary involvement and investigate the potential relationship between thorax computed tomography (CT) signs and other systemic clinical findings in AAV., Methods: A total of 63 patients over the age of 18 and diagnosed with AAV were included in this study. Thoracic CT imaging findings and clinical features of the patients at the time of diagnosis were retrospectively evaluated. The frequency and distribution of detected pathological findings on imaging according to disease types, in addition to the relationship of these findings with other systemic findings and disease severity, were analyzed., Results: Of 63 patients, 50 (79.4%) had pulmonary symptoms at the time of presentation. Most frequently observed pulmonary finding of thorax CT was nodular opacity. Consolidation, cavitary nodules, bronchiectasis, emphysema and fibrotic sequelae change were more common in the patients with diagnosis of granulomatosis with polyangiitis. Honeycomb, atelectasis, interstitial pneumonia, pulmonary venous congestion and pleural effusion were more common in the patients with diagnosis of microscopic polyangiitis. Ground-glass appearance, central airway disease, peribronchovascular nodules, pericardial effusion and lymphatic adenomegaly (>10 mm) were more common in the patients with diagnosis of eosinophilic granulomatosis with polyangiitis. Interstitial lung disease, pulmonary hemorrhage and severe lung involvement were found significantly increased in patients with myeloperoxidase antibody (MPO)-ANCA positivity (P < 0.05)., Conclusion: Lung involvement was detected in almost all of the patients with AAV. Both interstitial lung disease and severe lung involvement were more frequently found in patients with MPO-ANCA positivity compared to other patients. Pulmonary examination by an imaging technique in all patients with AAV may be useful to determine the vasculitis subtype and to determine the extent of the disease., Practitioner Points: Pulmonary involvement is quite common in AAV. Every patient with suspected AAV should be examined with imaging for lung involvement, even in the absence of respiratory symptoms. Severe pulmonary involvement is associated with the presence of severe disease and MPO-ANCA positivity., (© 2023 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Introduction: Telemedicine is a follow-up system that can improve the quality of management and cost-effectiveness of rapidly increasing diabetes patients. Methods: Two hundred adult patients with diabetes were enrolled in this prospective, randomized study. Consecutive patients were divided equally into two groups. Both groups received routine care visits quarterly. TeleDiab group also sent self-monitoring of blood glucose data and received short message service over the transmission system for 12 months. After the study was completed, all patients continued their routine care visits, and their data were evaluated for another 12 months. Six years after the initial study, patients were contacted by phone during the Covid-19 lockdown, and their status was assessed. Results: At the end of the study, glycemic control, kidney function, and lipid parameters of the TeleDiab group were statistically significantly better than the Usual Care group. There was no significant change in the weights of the patients. It was observed that this state of wellbeing continued both at the end of the second year and during the Covid-19 lockdown. Individuals with type 2 diabetes were found to benefit more from telemedicine. Discussion: It has been beneficial to guide patients with applications such as TeleDiab in diseases such as diabetes that require lifelong follow-up. On the other hand, the importance of telemedicine programs in the management of chronic diseases in the current pandemic conditions has come to the fore even more. Telemedicine is an effective motivational tool to ensure optimal control not only of glycemic but also of kidney and lipid parameters.

Psychological health problems such as depression, anxiety and feelings of distress are often seen in patients with acute coronary syndrome (ACS). Religious coping in dealing with psychological health problems is one of the methods commonly used by cardiac patients. This study was conducted to determine the depression levels and religious coping methods of individuals diagnosed with ACS and identify the relationship between their positive or negative religious coping methods and their depression levels. The descriptive and correlational study was conducted with 253 ACS patients. In the study, the depression levels of most patients were low, but 19.8% showed moderate-severe depressive symptoms. It was found that the patients adopted positive religious coping styles on a high level, but there was no significant relationship between positive religious coping and depression levels (p > 0.05). It is recommended that health professionals also closely monitor ACS patients for depressive symptoms after their diagnosis, encouraging patients to use positive religious coping styles to support their well-being and recovery against this life-threatening disease., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Religious coping is considered an important factor for assisting with the management of chronic diseases. This study was conducted to determine the relationship between religious coping and disease acceptance and management among patients with diabetes. A total of 504 individuals with type 2 diabetes were included in this descriptive-correlational study. In this study, individuals who did not use their medications regularly, those who did not pay attention to their diet and those who did not exercise regularly had higher levels of positive religious coping. No significant relationship was found between the level of acceptance of illness and religious coping styles among participants with diabetes. However, it was found out that there was a positive relationship between HbA 1 C levels and the mean score of positive religious coping and positive religious coping accounted for 7% of the total variance in the glycemic control parameter., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Backgrounds: SARS-CoV-2 is known to be a neurotrophic virus. However, the effect of this virus on the hearing system is still uncertain., Objectives: We aimed to investigate the possible effect of COVID-19 on hearing., Materials and Methods: Thirty healthcare workers who had COVID-19 after hearing evaluation with pure tone audiometry (PTA) for any reason in the last 1 year were included in the study. PTA and transient evoked otoacoustic emissions (TEOAE) tests were performed in 15 of 30 patients during the active infection period. For all 30 patients, otoscopic examination plus PTA and TEOAE tests were performed at the end of the first month after their treatment., Results: When the PTA results of 30 patients (60 ears) before and after COVID-19 were compared, a significant decrease in hearing level was found only at 1000 Hz ( p  < .05). There were no significant differences at other frequencies. When the PTA and TEAOE test results of 15 patients (30 ears) that were performed during and after COVID-19 were compared, no significant differences were found., Conclusion and Significance: We conclude that COVID-19 may cause hearing loss. However, this result needs to be confirmed with comprehensive studies to be conducted in larger patient groups.

Aim: This study was conducted to determine the impact of tailored training provided to nurses for preventing pressure injuries (PIs) on nurses' knowledge levels and the PI point prevalence (PP)., Materials and Methods: This interventional study was carried out in a university hospital with a bed capacity of 1114 in an urban center in Turkey. Ethics committee approval (28.06.2018/31) and institutional permission were obtained for the study, in addition to the nurses' written, informed consent. The study was completed in three stages. In the first stage an initial PP study was conducted in the clinics with the participation of the nurses and the members of the research team (n = 422 patients). In the second stage the knowledge levels of 194 nurses were measured before training was given on following-up and preventing PIs. The nurses then participated in the tailored training and their knowledge levels were re-measured afterwards. All the nurses were given individual advice related to the prevention of PIs for 30 days after they had completed the training. In the third stage a second PP study was conducted four months after the first PP study (n = 454 patients). The data were collected using the Pressure Injury Prevalence Form, the Braden Pressure Ulcer Risk Assessment Tool and the Knowledge Level Measurement Form. Descriptive values, the paired samples t-test, Pearson's chi-squared test and Fisher's Exact test were used to evaluate the data., Results: The nurses' pretest mean knowledge score was 55.36% ± 14.40 and their posttest mean score was 69.92% ± 9.73. The difference between these scores was statistically significant (p < 0.05). The study found no significant difference between the first PP ratio and the second PP ratio (p > 0.05), and the nurses were better able to evaluate skin and PIs after the training., Conclusion: The study determined that the tailored training given to the nurses increased their knowledge; however, it had no impact on the PP after four months. It is recommended that any training programs using this model be continued and that PP studies of institutions be conducted annually., (Copyright © 2021 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.)

Aim: The aim of this study was to investigate relapse rates in azathioprine (AZA) maintenance therapy at different doses in Behçet's disease (BD) with venous involvement., Method: Clinical records of patients who met the diagnostic criteria of International Study Group (ISG) for BD, were diagnosed with venous involvement of BD for at least 6 months and sustained clinical remission with AZA for at least 3 months were analyzed retrospectively. The analysis cohort was divided into 2 groups based on AZA dose (Group A: ≥ 2 mg/kg/d and Group B: <2 mg/kg/d). Relapse was defined as requiring another antirheumatic/immunosuppressive drug or more than dose of 10 mg/d of prednisolone., Results: Of 78 patients who were included into the study, there was no significant difference between the 2 groups in terms of age, gender and clinical characteristics. Mean relapse-free survival time was found to be higher in group A compared to group B (111.6 ± 11.2, 95% CI 89.5 ± 133.8 versus 51.5 ± 6.1, 95% CI 39.5 ± 63.4 months)., Conclusion: Relapse-free survival rate was less in the group receiving low-dose AZA and shows the importance of effective dose of AZA in maintenance therapy., (© 2021 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Introduction: Accurate localisation of the abnormal hyperfunctioning gland with preoperative imaging has a critical role in parathyroid surgery to obtain a successful outcome. This study aimed to evaluate the diagnostic performance of second-line imaging and their contribution to the treatment success in primary hyperparathyroidism when the first-line methods were negative or discordant., Methods: Among the patients who underwent parathyroidectomy due to primary hyperparathyroidism, 33 who underwent four-dimensional computed tomography and/or four-dimensional magnetic resonance imaging because of negative or discordant first-line imaging results were included. Persistent and recurrent cases were excluded., Results: The majority of the patients were female (84.8%) and the mean age was 59.2 years. Seventeen patients had four-dimensional computed tomography and 25 had four-dimensional magnetic resonance imaging, respectively. Four-dimensional computed tomography and four-dimensional magnetic resonance imaging localised the culprit gland successfully in 52.9% and 84%, respectively. Twenty-five patients in whom single adenoma was detected underwent focused parathyroidectomy. The culprit gland was solitary in 32 cases and one patient had double adenoma. Normocalcaemia was achieved in all cases. Among the 29 patients who completed their postoperative sixth month success rate was 100%., Conclusion: Four-dimensional magnetic resonance imaging had high accuracy with fast dynamic imaging in detecting parathyroid adenomas. When the first-line imaging methods were negative or inconclusive, four-dimensional magnetic resonance imaging should be considered primarily since it is cost effective in Turkey and emits no radiation.

Aims: This study aimed to determine risk factors for type 2 diabetes among adults who were not diagnosed with diabetes., Methods: Adults were included in this study within the public activities performed on World Diabetes Day (n=1872). Data were collected using the FINDRISC questionnaire and a short questionnaire., Results: Participants' mean age was 39.35±10.40. The mean FINDRISC score was 7.46±4.62, women's mean score was higher than that for men. The FINDRISC score indicates that 7.4% of the participants were in the highrisk group. Among participants, BMI value of 65.1% was 25kg/m 2 and higher, waist circumference of 58% was over the threshold value; and 50.7% did not engage in sufficient physical activity. Of the participants, 9.5% had a history of high blood glucose, families of 38.9% had a history of diabetes. The mean FINDRISC score was in the slightly high category, 121 participants were found likely to be diagnosed with diabetes within ten years if no action was taken., Conclusions: It is recommended the risk screening studies to be conducted and the FINDRISC tool to be used in Turkey, where diabetes prevalence is increasing rapidly, to determine diabetes risks in the early period and to raise social awareness for diabetes., (Copyright © 2018 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

This study aims to identify precipitation, throughfall, stemflow, precipitation, and interception processes in pure black pine, pure Scots pine, and mixed black pine-Scots pine forest ecosystems and present the precipitation partitioning according to different stand types. Throughfall and stemflow measurements were performed using five standard precipitation gauges in a pilot area established to represent pure black pine, pure Scots pine, and mixed black pine-Scots pine stands in the Bezirgan Basin. The total precipitation was measured in an open field close to the study area. Throughfall values were calculated as the percentage of precipitation measured in an open field. According to the results of the study, the throughfall values were 69.8% in black pine, 73.9% in Scots pine, and 77.7% in the mixed black pine-Scots pine stands; the stemflow values were 2.6% in black pine, 5.9% in Scots pine, and 3.1% in the mixed black pine-Scots pine stands; the amounts of precipitation reaching the forest floor were 72.3% in black pine, 79.8% in Scots pine, and 80.7% in the mixed black pine-Scots pine stands; and the interception values were found to be 27.7% in black pine, 20.2% in Scots pine, and 19.2% in the mixed black pine-Scots pine stands.

Hashimoto's thyroiditis (HT) is thought to result from decreased T helper type 2 (Th2) responses, leading to the progressive destruction of thyrocytes. IFN-λ1, -λ2, and -λ3 (also known as IL-29, IL-28A, and IL-28B, respectively) are recently described members of the IFN-λ family and have been shown to decrease the production of Th2 cytokines in vitro. However, the role and mechanism of IFN-λ1 in HT remain unknown. The purpose of this study was to examine whether IL29 and IL28B gene polymorphisms are susceptibility genes for the development of HT. Also, we investigated the effects of IL-29 and IL-28 serum levels in the pathogenesis of HT. Using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, single-nucleotide polymorphisms (SNPs) of IL28B rs8099917 (IL28 G/T) and IL29 rs30461 (IL29 T/C) were studied in 99 patients with HT and 100 healthy controls. Considering the allelic distribution of the IL28 G/T polymorphism, a higher frequency of the G allele was observed in the control group versus the HT group. Thus, it was suggested that the G allele may be protective against HT pathogenesis (OR = 0.388, 95% CI = 0.217-0.693; p = 0.001). Our findings also demonstrated that there was a statistically significant difference in serum IL-28 and IL-29 levels between case and control groups (p < 0.001). Increased serum levels of IL-28 and IL-29 were found in patients with HT. However, we did not find a relationship between the IL29 gene polymorphism and HT. In conclusion, the IL28B gene polymorphism and serum IL-28 and IL-29 levels seem to play a role in the pathogenesis of HT.

Purpose: To examine the psychometric properties of a Turkish version of the Diabetes Fear of Injecting and Self-testing Questionnaire (D-FISQ)., Methods: Forward-backward translation of the D-FISQ from English into Turkish was conducted. Original English and translated forms were examined by a panel group. Validity was investigated using content, confirmatory factor analysis, and divergent validity. Reliability was assessed using Cronbach α values, item-total correlations, and intraclass correlations. The sample comprised 350 patients with diabetes. Data were analyzed using SPSS 15.0 for Windows and LISREL 8., Results: The content validity index for the panel members was .90, which indicated perfect content validity; items in D-FISQ were clear, concise, readable, and distinct. Confirmatory factor analysis confirmed the original construct of the D-FISQ. All items had factor loadings higher than the recommended level of .40. The D-FISQ scores were discriminated by the level of anxiety. Reliability results were also satisfactory. Cronbach α values were within ideal limits. Item-total correlation coefficient ranged from .72 to .86. In terms of test-retest reliability, intraclass correlation coefficient was found to be over .90., Conclusions: D-FISQ is a valid and reliable questionnaire in assessing needle-prick fear among Turkish patients with diabetes. We recommend performing the Turkish D-FISQ in determining and screening patients with diabetes who have fear related to self-insulin injection and finger-prick test. Thus, health care professionals should be aware of the potential consequences of injection fear such as insulin misuse and poor self-monitoring of blood glucose, which may have unfavorable effects on optimal diabetes management., (Copyright © 2016. Published by Elsevier B.V.)

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

The Stroke and Aphasia Quality Of Life Scale (SAQOL-39) is a widely used instrument in assessing the quality of life in aphasic patients. Our purpose was to translate the SAQOL-39 into the Turkish language (SAQOL-39/TR) and assess its reliability and validity in patients who had aphasia. SAQOL-39/TR was obtained using the 'translation-backward translation' method and administered to 40 patients with aphasia. The reliability studies were performed by means of internal consistency and test-retest reliability. The validation studies were carried out by means of construct validity using within-scale analyses and analyses against the external criteria. Correlation analysis was performed between scales and the Ege Aphasia Test, the Barthel index, the 12-item General Health Questionnaire and the Brunnstrom recovery stages (BRS) of the arm, hand, and lower extremity. In the results, the scores of the SAQOL-39 were not different between groups. Cronbach's α variables were good for all domains (0.80, 0.88, 0.89, 0.82, and 0.83). Test-retest reliability was also high (0.96, 0.97, 0.91, 0.70, and 0.96). There were significant correlations with coefficients ranging from 0.36 to 0.60 among the domains of scale and other measures. Moderate-high correlations were also seen with BRS-arm, BRS-hand, and BRS-lower extremity (r, 0.27-0.58). It was found that all domains were highly related with all domains of Ege aphasia test, except praxia (P<0.001). This study showed that the SAQOL-39/TR has acceptable validity and reliability in assessing the quality of life. However, similar results of the scale in patients with dysarthria suggest that the SAQOL-39 may not be specific to only aphasic patients.

A retrospective study was carried out on 4549 which is the total number of hanging cases autopsied at Forensic Medicine Institute in Istanbul, Turkey. 4502 hanging cases of suicidal origin were detected and evaluated in terms of demographic features, the type of hanging material used for ligature, internal findings in neck organs, toxicological findings and microscopic findings. Of these suicides, 3295 (73.2%) were males and 1207 (26.8%) were females. The average age of the victims was 37.8 (SD 1.6). Crude suicidal hanging rate is approximately two-fold increase in women, while it is about five-to six-fold increase in men during 33 years. 1424 of the victims committed suicide by hanging themselves at home, and 441 of them in prison and indoor areas. The alcohol in the blood of all autopsy victims was tested and results were positive for 687 people. A drug active agent was detected in 108 (2.4%) victims: 70 (1.5%) of them were antidepressants, 20 (0.5%) of them were analgesic/anti-inflammatory/anti-histaminic and 18 (0.4%) of them were antipsychotic. In the examination of the psychoactive substances in blood and urine, any of such substances was not detected in 4146 of the victims. However, victims' blood and urine contained a sedative-hypnotic-anxiolytic with 74 (1.6%), a cannabinoid with 16 (0.4%) and an opioid with 12 (0.3%). Psychoactive substance examination was not carried out for 243 victims. Of these cases, 4060 (90.2%), ecchymosis in soft tissues and 2800 (62.1%) fracture in neck organs was found., (Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Aim and Objectives: To improve the knowledge and skills of diabetic patients on insulin injections using mobile phone short message services and to evaluate the association of this intervention with metabolic outcomes., Background: Mobile communication technologies are widely used in Turkey, which maintains a diabetic population of more than 6·5 million. However, there are a limited number of studies using mobile technologies in the challenging and complicated management of diabetes., Design: A one group pretest-posttest design was used in this study., Methods: The study sample consisted of 221 people with type 1 and type 2 Diabetes Mellitus from eight outpatient clinics in six cities in Turkey. The 'Demographic and diabetes-related information Form' and 'Insulin Injection Technique and Knowledge Form' were used in the initial interview. Subsequently, 12 short messages related to insulin administration were sent to patients twice a week for six months. Each patient's level of knowledge and skills regarding both the insulin injection technique and glycaemic control (glycated haemoglobin A1c) levels were measured at three months and six months during the text messaging period and six months later (12 months total) when text messaging was stopped., Results: The mean age of the patients with diabetes was 39·8 ± 16·2 years (min: 18; max: 75). More than half of the patients were females with a mean duration of diabetes of 11·01 ± 7·22 years (min 1; max: 32). Following the text message reminders, the patients' level of knowledge and skills regarding the insulin injection technique improved at month 3 and 6 (p < 0·05). The patients' A1c levels statistically significantly decreased at the end of month 3, 6 and 12 compared to the baseline values (p < 0·05). The number of insulin injection sites and the frequency of rotation of skin sites for insulin injections also increased., Conclusion: This study demonstrated that a short message services-based information and reminder system on insulin injection administration provided to insulin-dependent patients with diabetes by nurses resulted in improved self-administration of insulin and metabolic control., Relevance to Clinical Practice: Today, with the increased use of mobile communication technologies, it is possible for nurses to facilitate diabetes management by using these technologies. We believe that mobile technologies, which are not only easy to use and to follow-up with by healthcare providers, are associated with positive clinical outcomes for patients and should be more commonly used in the daily practice of diabetes management., (© 2014 John Wiley & Sons Ltd.)

Objective: To determine whether there is a relationship between genetic polymorphisms of glutathione S-transferase zeta 1 (GSTZ1) and gastric cancer. The contribution of GSTZ1 genotypes to susceptibility to the risk of gastric cancer (GC) is still unclear., Methods: Using a polymerase chain reaction (PCR)-based restriction fragment length polymorphism (RFLP) method in an ethnic Turkish population, we examined the frequency of the GSTZ1 gene polymorphism in patients with GC patients (n = 73) and control individuals (n = 80)., Results: For GSTZ1 A94G polymorphism, in the group of patients with the GC, the frequency of the GG genotype was quite a bit higher in comparison with that of the control group; however, this increase was not statistically significant. For the GSTZ1 A124G polymorphism, the GSTZ1 heterozygous genotype (AG) occurred more frequently in GC patients than in controls; however, it was not associated with risk of developing GC. We found no significant association between the A94G or A124G variants of the GSTZ1 gene and risk of gastric cancer., Conclusions: Our data indicate no association between GSTZ1 genotypes and risk of gastric cancer. Despite its marked decline in many industrialized countries, gastric cancer remains the most common cause of death by cancer in areas such as Japan, Turkey, and South America. Gastric cancer (GC) is a disease of complex etiology that involves intimately interconnected infectious, dietary, environmental, and genetic factors. Although it has been estimated that 67% of GCs could be prevented by implementing lifestyle changes, the fact that some individuals develop GC but others do not, despite exposure to similar potentially carcinogenic factors, suggests that genetic predisposition may also play an important role in the etiology of GC.

Age-related legal problems are especially common in underdeveloped parts of Turkey. In terms of civil and criminal law, the ages from 13 years to 18 years are critical in our country. Estimation of age is a very significant in aspect of accordance with laws. The aims of this study were to evaluate the applicability and accuracy of the Demirjian technique for assessing southern Turkish children; to analyze the sexual dimorphism of dental age in the studied groups; and to define the relationship between the dental age and the degree of mineralization in mandibular permanent tooth in southern Turkish children. This study was performed using panoramic radiographs from 932 healthy southern Turkish children, 444 girls and 488 boys aged between 4 and 18 years. Statistical evaluations were performed using SPSS (Statistical Package for Social Sciences) for Windows 13.0 software. The mean difference between dental and chronological age was calculated for each age and sex group. The paired t-test was used to compare all data. The chi-square test was used for between-group comparisons of categorical variables. Continuous variables were tested for normality using the Kolmogorov-Smirnov test. Relationships between continuous variables were examined using Pearson's correlation coefficient. The same observer re-examined 700 teeth three months after the first examination. The results were evaluated with the intraclass correlation test and both measurements were statistically significantly similar with each other(R = 0.982, p = 0.0001). .Dental age (DA) and chronological age (CA) were consistent for boys in the 16-16.9 age group and for girls in the 9-9.9 and 15-15.9 age groups. From this study, we can conclude that dental age varies across ethnic populations. Additionally, dental maturation varies across different regions of the same country. Because Demirjian's standards are not suitable for all age groups of southern Turkish children, a new table is necessary for evaluating this population. Future studies using multi-ethnic population data are needed to establish the international applicability of Demirjian's method., (Copyright © 2014. Published by Elsevier Ltd.)

Proinflammatory cytokines with immunosuppressive properties play an important role in the pathogenesis of multiple sclerosis (MS). Interleukin 18 (IL-18) is one of the most important innate cytokines produced from macrophages in the early stages of the inflammatory immune response. The purpose of this study was to determine whether there was any relationship between IL18 gene polymorphisms and MS. IL18 genotyping were performed in 101 MS patients and 164 control subjects by using the PCR-restriction fragment length polymorphism (PCR-RFLP) method. The frequency of MS patients with the CC genotype of the IL18 gene at position -137 was significantly higher than with the GG genotype [p = 0.01, odds ratio (OR) 3.17]. In haplotype analysis of two SNPs in the IL18 gene, frequency of the CC haplotype was significantly higher in MS patients (p = 0.002, OR 3.0). However, the genotype distribution of the IL18 -607 C/A polymorphism in the MS patient group was not significantly different from that of the control group. These data suggest that IL18 gene polymorphisms at position -137 might be a genetic risk factor for MS in the Turkish population.

Objective: To determine the prognostic importance of admission time, admission day, admission source, and route of admission, attached devices before admission, diagnosis of patients, and total Simplified Acute Physiology Score (SAPS) II score during admission on intensive care unit mortality rates., Methods: This retrospective study was carried out with 545 patients admitted to adult intensive care units between January 2006 and January 2011 at Zonguldak, Turkey. Computerised database and patient records were used for data collection. Data from the patient records was collected by a constructed survey form and SAPS II scale. The data was evaluated by numeric values and percentages, Pearson correlation analysis, logistic regression analysis, Chi-square, and student t-tests., Results: The mortality rate was 60.4%. The patients who died had a higher SAPS II score. The mortality rate was higher in admissions from the emergency department (p=0.000), admissions of patients on a stretcher (p=0.000), the existence of an intubation tube (p=0.000) and monitor (p=0.001), and in patients with respiratory tract illness (p=0.000), and infection (p=0.000). A significant difference was not found between the admission day (p=0.761), and time (p=0.063)., Conclusion: The SAPS II scores of the patients, the route of admission and admission source, being intubated and connected to a monitor, admission diagnosis, and length of stay in intensive care units was increased to mortality rate. However, the days and hours of admission did not significantly affect mortality.

Background: One of the most important reasons for the high mortality rates of cancer is the low level of awareness, which can lead to a late diagnosis and treatments starting too late. Therefore, it is necessary for individuals, especially at younger age, to gain awareness and integrate taking the necessary precautions into their lifestyle in order to prevent cancer and ensure early diagnosis. The aim of this study was to assess the levels of awareness of factors for major cancers among students studying in two different campuses of a university in the Western Black Sea Region., Materials and Methods: This descriptive/cross-sectional study was performed between January-March 2014. Students studying in the 2013-2014 academic year in a university in the Western Black Sea Region in two separate campuses were the subjects., Results: The mean age was 21.01 ± 3.63. While female students (51.2%) were the majority in the health sciences campus (74.8%), male students (48.8% ) were the majority in the social sciences campus (76.5%). Some 9.6% of the students from the health sciences campus and 12.4% of the students from the social sciences campus thought that cancer was communicable, while most of the students from both campuses knew that smoking caused cancer. It can also be seen that the rate of answering questions regarding cancer correctly was higher among students studying in the health sciences campus., Conclusions: It was determined that students who do not study at the health sciences campus have insufficient information on cancer, cancer symptoms, and the possibility of breast cancer in males and approximately half of them regarded obesity as a risk factor for cancer.

Purpose: Behçet's disease is a multisystem disease characterized by recurrent oral and genital ulcers, relapsing uveitis, mucocutaneous, articular, gastrointestinal, neurologic, and vascular manifestations. Paraoxonase is believed to play an important role in protection of LDL and HDL particles from oxidation, in antioxidant effect against lipid peroxidation on cellular membranes, and in anti-inflammatory process. Lipid peroxidation and free oxygen radicals have been thought to play a role in pathogenesis of BD. The association of paraoxonase gene polymorphisms with Behçet's Disease in a group of Turkish patients with clinical manifestations and healthy controls has been investigated., Patients and Methods: Paraoxonase (PON-1-L55M) gene polymorphism was investigated in 50 Behcet patients and 50 healthy individuals with a PCR/RFLP method., Results: There were significant differences between patients and the control group in allele frequencies of the PON1 L55M polymorphism (p=0.04). Also, when patients were compared with the control group according to clinical manifestations, this statistical significance was getting sharper. Compared with the PON55 L allele, the M allele was associated with greater than 3.5 fold (OR 3.5, 95% CI 1.3-8.9) increased risk of ocular (OR 2.4, 95% CI 1.1-5.3), 2.4 fold joint and 3.1 fold (OR 3.1, 95% CI 1.1-8.4) central nervous system manifestations of BD., Conclusion: The PON L55M gene polymorphism seemed to play a role in the pathogenesis of BD.

Background: Emergence of high-level aminoglycoside and glycopeptide resistance causes more severe prognosis, higher mortality, and recurrence in enterococcal infections. The present study was conducted to investigate the antimicrobial resistance patterns, prevalence of AMEs, erm and van genes of enterococci isolated from various clinical samples at Istanbul University, Cerrahpasa Medical School hospital., Methods: During the period of 2012-2013, a total of 128 enterococcal isolates collected from various clinical samples were typed with the API 20 strep test, and antibiotic sensibilities were analysed with the disc diffusion and E-test methods. The detection of resistant genes was determined by a multiplex PCR method., Results: Forty-nine percent E. faecalis, 46% E. faecium, 4 E. avium and 2 E. durans were detected. E. faecium resistance rates were significantly higher than E. faecalis (p < 0.001). The resistant genes were analysed in 50 enterococcus strains. The vanA gene was found in 29 of the 30 VRE strains. The most prevalent AMEs genes were aac (6')-Ie-aph (2")-Ia gene (72%), followed by aph (3')-IIIa gene (30%). The ermB gene was found in 49 of a total of 50 strains., Conclusions: This study shows that aac (6')-Ie-aph (2")-Ia, ermB, and vanA genes are common among enterococci isolates in our hospital and spread of VRE along with acquisition of resistance to most of the antibiotics used in therapy.

Methyl and ethyl alcohol poisoning are still responsible for high morbidity and mortality rates. The purpose of this retrospective study was to examine ethyl and methyl alcohol poisoning related deaths in Ankara and surrounding cities between 2001 and 2011 and compare them with previous studied conducted in Turkey and other countries. For this purpose, 10,720 medico-legal autopsy cases performed in Ankara Branch of the Council of Forensic Medicine were reviewed in terms of alcohol poisonings. The deaths due to methanol and ethanol poisoning were 74 (0.69% of all medico-legal autopsies performed) and the distribution among them was 35 (47.3%) for methanol poisoning and 39 (52.7%) for ethanol poisoning. Overwhelming majority of the cases were male (n = 67, 90.5%). The mean age of the victims was 44.9 ± 10.9 years and ranging from 21 to 92 years. The age group of 35-49 years was the mostly affected. Most of the cases were seen in 2004 (n = 12, 16.2%). The levels of postmortem blood alcohol levels were available for all cases and the mean alcohol levels were 322.8 ± 155.5 mg/dL ranging from 74 to 602 mg/dL for methanol and 396.8 ± 87.1 mg/dL and ranging from 136 to 608 mg/dL for ethanol. Early diagnosis is essential for successful treatment in methanol and ethanol poisoning. Besides increased awareness, more sensitive/specific diagnostic tools, and the prompt approach to the poisoned individual should be implemented in the hospitals., (Copyright © 2012. Published by Elsevier Ltd.)

Objective: The aim of the present study was to describe the epidemiology of unintentional carbon monoxide (CO) poisonings (between 2001 and 2011) in Ankara, Turkey., Methods: Data were collected from the records of Ankara Branch of Council of Forensic Medicine and the licensed official institutes and hospitals for medico-legal autopsies. A total of 10,720 medico-legal autopsy reports were obtained and reviewed by the authors., Results: Among 622 fatal poisoning cases during the period, 380 deaths were due to unintentional CO poisoning. The mean CO saturation of the groups was 55.4 ± 13.4 (% saturation). The minimum and maximum levels of CO in blood was 3.6 and 86.5 (% saturation), respectively. Of all the fatal poisonings determined by Ankara Branch of Council of Forensic Medicine, CO poisoning was the most common mortality cause (61.1%). Among the cases, 301 (79.2%) were found to be death in their houses, 43 (11.3%) in hospitals, 15 (3.9%) in their workplaces and 11 (2.9%) in some public places such as park and garden. Most of the cases were from the capital city of Turkey, Ankara (n = 203, 53.4%). When we compared the cities according to their population, it was realized that the highest death rate due to CO poisoning was in Kirikkale (12.3/100,000), followed by Karabuk (8.3/100,000), Cankiri (7.8/100,000) and Kirsehir (5.0/100,000)., Discussion and Conclusion: These findings add new data to the pool of knowledge in terms of the need of safety, proper heating system instructions and more education on CO poisoning in Turkey.

Background: Testicular germ cell tumors (TGCTs) are a relatively common malignancy in young men. The aim of this study was to investigate the clinicopathological features and survival of young Turkish patients with TGCT., Materials and Methods: In this retrospective study, the clinical and pathological characteristics of young Turkish patients with TGCT who were monitored by the Department of Medical Oncology of a military hospital between 2008 and 2013 were investigated. Overall survival data were analyzed., Results: Ninety-six patients were included in the study. The mean age was 26.4 years. Among the patients, 17.7% had seminoma and 43.8% had mixed non-seminomatous germ cell tumors. Some 46.9% were Stage I, 30.2% were Stage II, and 22.9 were Stage III. Of the patients, 83.3% received chemotherapy, 25% underwent retroperitoneal lymph node dissection (RPLND), 3.1% received radiotherapy, and 12.5% were followed-up without treatment. In addition, 18.8% of the patients were administered salvage chemotherapy due to relapse or progression. The 5-year overall survival rate was 90.2% for all patients. The 2-year overall survival rate was 100% for Stage I patients, 94% for Stage II patients, and 70.2% for Stage III patients. The difference between the survival curves of stages was statistically significant (p=0.029)., Conclusions: In young Turkish patients with TGCT, good results were obtained with appropriate treatment, most receiving chemotherapy. The prognosis of the disease was good even in the advanced stage.

Purpose: To evaluate long-term results of decortications in patients with symptomatic restrictive pleurisy and trapped lung after coronary bypass grafting., Methods: Twenty consecutive patients undergoing lung decortications for trapped lung after coronary bypass grafting were prospectively evaluated. Pulmonary function tests were used as objective criteria, and quality of life was assessed by the Medical Research Council dyspnea scale. A p value <0.05 was considered significant., Results: Twenty patients, 3 women and 17 men, with a median age of 59 years were evaluated. The median time interval between coronary bypass grafting and decortications was 9.3 months. The mean preoperative forced expiratory volume in one second and forced vital capacity were 63.8% ± 7.4% and 50.5% ± 6.6% of the predicted value, respectively, and the improvement rates after decortications were 14.97% ± 6.3% and 17.62% ± 6.38%, respectively. Dyspnea scores improved after decortications (p <0.05). The median follow-up was 25 months. After surgery, 3 patients developed superficial wound infections, and out of 7 patients with prolonged air leaks, 2 underwent re-operation. After surgery, one patient died on day 34 and another, after 3 years., Conclusion: Lung decortications, re-expanding the affected lung, ensures symptom remission and improves quality of life of patients with trapped lung after coronary bypass grafting in the long-term.

Background and Aims: An association of homozygous MTHFR 677T genotypes with elevated plasma homocysteine level has been documented, but results are still controversial. We aimed to investigate prevalence of the C677T polymorphism in patients with acute myocardial infarction (MI) in the Eastern Black Sea region of Turkey., Methods: We studied genomic DNA of 231 unrelated patients (aged 59 ± 13 years; 175 male, 56 female) with first anterior acute MI and 242 healthy controls (aged 54 ± 19 years; 182 male, 60 female) using real-time polymerase chain reaction kits for the MTHFR C677T mutation., Results: Prevalence of MTHFR C677T mutant genotype was 49.1% (CT: 45.8%, TT: 3.3%) in controls and 48.45% (CT: 38.5%, TT: 9.95%) in patients with acute MI. The TT mutation was more frequent in patients with acute MI than in controls (9.95 vs. 3.3%) (OR; 3.23, 95% CI; [1.34-8.05], p = 0.003)., Conclusions: The MTHFR gene homozygote TT mutation is a risk factor for patients with MI in the eastern Black Sea Turkish Population., (Copyright © 2011 IMSS. Published by Elsevier Inc. All rights reserved.)

Children are at increased risk for various causes of injury from accidents. Accidents are, by far, the leading cause of death among children and adolescents. The aim of this study is to evaluate the lethal childhood accidents in İstanbul by age groups. Reports of autopsies performed between 2001 and 2005 in the Morgue Department of the Council of Forensic. Medicine in Istanbul (n :16853) are examined retrospectively. 833 deaths from accidents in children aged 0-18 years are investigated into the study. The parameters of age, gender, types of accidents and causes of death are evaluated. The accidents account for 47.3% of the deaths among children aged 0-18 years. Of 833 cases, 601 (73%) are male and 232 (27%) are female. The female to male ratio is 1/2.6. The highest rate of death from accidents is at the group of 15-18 years. The primary causes of accidental childhood deaths are motor vehicle accidents (23.1%), followed by drowning (20,1%), poisoning (15.7%), and fall from height (15.5%). The incidence and types of trauma vary with socio-economic status and culture. İstanbul, where this study is conducted in, has approximately 3000 autopsy number annually. Therefore, it provides an important database., (Copyright © 2011 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

The foramen magnum (FM) has a vital importance to have a direct view of the vertebral artery, lower cranial nerves, and the brainstem. The morphologic analysis of the FM was studied in 352 occipital bones of adult human skulls by 3D-Doctor V 3.5.050402 Demo version. The perimeter and area of the FM were calculated as 115.6 (SD, 9.9) mm and 829 (SD, 137.7) mm(2), respectively. The FM index was found as 84.02%, and the majority (38.4%) of holes were observed to have a narrow index.The FM was observed to 8 different types. The most frequently observed types were the tetragonal type in 25.66%, and the one formed by the combination of 2 semicircles in 23.28%. The large anterior margin of the FM type, such as types 1, 4, 5, and 6, can be easily performed partially. In the cases of types 2, 3, and 8, the anterior margin was determined as narrow, the resection procedure is completed with more difficulty. In Pearson correlation analysis, it is significant that a statistically strong relation was found between the area and perimeter, and the area and length of FM. This findings suggest that the resection should be started at the anterior margin, just lateral and then extended superolaterally.

Nursing has been a dynamic process since the existence of humanity on Earth. As a part of this process, whether nursing is an occupation or a profession has been a long-lasting question. There exist different sets of criteria and schemes of classification that are used to define professions. In this article the authors inquire into the professionalism of nursing in Turkey in view of the criteria for nursing professionalism first set by B. K. Miller et al. (1993).

Objectives: The concordance of patient reported outcomes in rheumatoid arthritis (RA) among different countries has not been studied in detail. We tried to determine the differences in pain and fatigue perception among a group of RA patients in the US and in Turkey who had similar disease activity and functional score in multidimensional health assessment questionnaire (MDHAQ FN)., Methods: One hundred and thirty seven RA patients from Turkey and 129 from the US were studied. An MDHAQ was obtained and a DAS28 was calculated for each patient. Pain and fatigue perception was compared between the two groups after adjusting for age, sex, MDHAQ FN and DAS 28., Results: Turkish patients had less pain than their US counterparts when adjusted for MDHAQ FN, DAS 28, age and sex (3.56 (2.24) vs. 4.35 (2.23), p=0.005) whereas there was no difference in fatigue between the two groups (3.85 (2.44) vs. 4.25 (2.45), p=0.194). When the patients with a DAS28 score of above 5.1 and below 2.6 were compared in both groups, Turkish patients had again less pain albeit less in the high disease activity group., Conclusions: This study suggests that Turkish patients have less pain than the US patients when controlled for age, gender and MDHAQFN and DAS28 scores. This is at odds to the conventional wisdom that pain perception is increased among the non-Western cultures.

This study explores the major issues facing collective response operations after destructive earthquakes. The small-n case study design employs qualitative and quantitative methods to investigate the decision-making process in a context of seismic risk to exemplify how public managers can utilise information and communication systems to ensure collaborative actions in managing an extreme event. Fifty-eight semi-structured interviews with 39 key decision-makers and researchers and content analyses of daily reports from Cumhuriyet comprise the main data sources. The study compares and contrasts the Turkish disaster management system following the Marmara and Duzce earthquakes of 1999. It addresses whether the use of information and communication technologies significantly affected its performance. The study's findings reveal that difficulties in accessing and exchanging timely and accurate disaster-relevant information inhibited coordination during the Marmara response while increased communication functions improved coordination and search-and-rescue activities during the Duzce response.

The purpose of this study was to determine nursing care for deceased patients among intensive care unit nurses. This prospective, observational study was conducted in Istanbul, Turkey. The sample consisted of 20 intensive care nurses caring for 39 deceased patients during the study period. Researchers observed the care activities of the nurses and these were recorded. All the nurses closed the curtains or placed screens to separate the deceased patient from others and to allow some privacy for the family. Two nurses allowed the family to participate in the care. There was no difference in care activities according to the religious affiliation of the patients.

Introduction: There are three facets over upper side of talocalcaneal joint: anterior talar facet, middle and posterior. Three types of calcaneus that have distinct talar facets were defined as types A, B and C., Materials and Methods: A total of 221 calcanei (98 right, 123 left), with unknown gender, were dried and evaluated., Results: In our study type B calcaneus (58%) was defined as the most common type, and type A calcaneus (39.3%) as the second most common type. By using facet joint differences and bone measurement, we tried to define calcaneus bone., Discussion: In many diseases of foot, such as the talocalcaneal artritis and coalition, intraarticular fractures and congenital dysmorphology, flatfood, valgus deformities, the size and shape of the bones, the relationships of the talus and calcaneus with each other and other bones of the foot must be considered for the internal and external fixation and surgical procedures. Type B calcaneus was defined as the most comman type in Turkish race and these results correlate with the ones which were performed on bones of American, Indian and African people, and it was uncorrelated with the results of the researches performed in Europe.

The purpose of this study was to determine the application status of hand-washing information given within the context of infection control measures in practice areas among nursing students. This descriptive study was conducted with 430 students. A questionnaire was filled out by the students. In the statistical analysis, frequency, percentage, and chi(2) values were measured for all the questions in the hand-washing questionnaire. We determined that students wash their hands before and after each clinical procedure at a rate of 80.2%. Most of the students (71.9%) reported that they wash their hands for 1 minute or longer. The students' answers showed that the nursing education program, including hand-washing applications within the context of infection control measures, is updated but that the students neither practice what they have learned nor give adequate attention to the subject.

The volatile constituents of the aerial parts of Centaurea amanicola Hub.-Mor., Centaurea consanguinea DC. and Centaurea ptosimopappa Hayek were extracted by hydrodistillation and analysed by GC and GC-MS. Altogether 94 components were identified. Sesquiterpenoids, fatty acids and carbonylic compounds were the most abundant components in the oils. Hexadecanoic acid and (Z,Z )-9,12-octadecadienoic acid were the main fatty acids in all the examined samples, that showed different patterns of composition. The study on the biological activity of the oils showed an action mainly against the Gram-positive pathogens.

Aim: This study of verbal and physical abuse against nurses in Turkey aimed to describe prevalence, sources, important effects on work, family and social life of the nurses, coping methods and factors., Methods: A sample of 622 nurses working in eight hospitals located in the capital city of Turkey was surveyed using verbal and physical abuse questionnaires., Results: The prevalence of verbal and physical abuse against nurses in the sample of this study were found to be as 91.1% and 33.0% respectively. Colleagues were found to be the most important source of verbally abusive behaviours while patients and patients' relatives were the important sources of physically abusive behaviours. Disturbed mental health, decreased job performance and headache were the more frequently reported negative effects of verbal and physical abuses on nurses. The most common reactions against abusive behaviours were anger, helplessness, humiliation and depression. It is interesting to find that 'did nothing' was the most reported coping method with verbal abuse. The findings also suggested that working in inpatient units and increasing work experience in the nursing profession were statistically significant variables increasing the likelihood of being abused physically., Discussion: All the results on sources, negative effects, feelings and coping methods on verbally and physically abusive behaviours lead us to discuss that lower working status and power of the nurses at the work, poor working conditions in healthcare settings and insufficient administrative mechanisms as well as law and regulations against the abusers are the important factors forcing the nurses to work in an inappropriate work environment in Turkey.

Objective: Characteristics of legal autopsy cases with cardiac rupture following myocardial infarction are investigated in this retrospective observational study and the results are compared with a control group consisting of acute myocardial infarction cases without rupture., Methods: Legal autopsy reports of 50 cases with heart tamponade resulting from heart muscle rupture following myocardial infarction, autopsied at the Morgue Department of the Council of Forensic Medicine between the years 1998-2005 were retrospectively reviewed. Findings were compared to control group consisting of 30 myocardial infarction cases without rupture., Results: The rupture was located in the left ventricle in 48 of 50 cases. At microscopic examination, infarction date was consistent with first three days, 4-7 days and 1-2 weeks for 30, 12 and 8 cases, respectively. The average volume of fluid leading to tamponade was 467 ml in males and 352.3 ml in females. There were no statistical differences between rupture and control groups for existence of hypertrophy and scar tissue in myocardium and advanced atheromatous lesions in coronaries (p>0.05). Considering the manner of death of the cases died due to heart wall rupture and tamponade formation, 28 of the cases were found dead at home, 6 died suddenly by falling to the ground at home or on the street, and 5 were delivered dead to the hospital., Conclusion: The rupture was located in the left ventricle in almost all cases. Ruptures in the left ventricle were found most frequently in the anterior wall. There was no relationship between development of rupture and existence of hypertrophy and scar tissue in myocardium, and advanced atheromatous lesions in coronaries.