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In overhead shooting athletes may have increased activity of the upper trapezius and inhibition of other shoulder muscles active during upper extremity elevation. In this study, we aimed to increase target retention and shoulder proprioception sense accuracy by taping in a way that would activate the lower trapezius muscle in elite adolescent archers. Our participants were 43 elite young athletes, aged 11–14 years, from the Archers Foundation Sports Club. We gathered athletes' sociodemographic information (age, height, weight, gender, the time they were engaged in archery, and other sports they were involved in), and we assessed their posture via the New York Posture Scale (NYPS) before taping. We evaluated them for the presence of scapular asymmetry using the Lateral Scapular Slide Test (LSST) and assessed their proprioception with the active displacement test and their target-reaching performances with the Archery Shooting Score (ASS). Since testing and scoring with the ASS is different for 11–12 and 13–14 age groups, we divided this sample into two different age groups for all analyses. There were significant changes in ASS and proprioception in both age groups, with medium to large effect sizes. There were between intragroup pre- and post-taping changes in classification according to the presence of scapular asymmetry, and there were significant changes in the archery shooting score and proprioception in both groups, with medium to large effect sizes (p < 0.05). Thus, taping applied to the lower part of the trapezius had a large to medium effect on proprioception and shooting accuracy improvement in these young archers. [ABSTRACT FROM AUTHOR]

The war that took place between 1683 and 1718 and the following developments led to a social and economic collapse in Anatolian cities as well as in the entire empire. Since the majority of the administrators in the rural went to the battle during the Second Siege of Vienna and following wars, bandits who belong to different people and groups attempted banditry events that disturbed the social order in many regions of Anatolia. In fact, this irregular environment that occurred in the rural areas of Ottoman Empire, caused population mobility in cities and rural areas. In the early modern period, the characteristics of the cities formed the central-rural relations. In this context, it is important to evaluate the events of 18th century which was expressed as the period of breaking and change for the Ottoman Empire and the events between 1683 and 1718 which affect this century, in terms of Anatolian cities. In this study, bandit movements caused by the events in administrative, military, economic and social fields between 1683 and 1718 were therefore examined in the example of Manisa District. [ABSTRACT FROM AUTHOR]

Aims: To determine the prevalence and predictors of victimization and perpetration of dating violence among nursing and midwifery students. Design: A cross‐sectional study design. Methods: The sample consisted of nursing and midwifery students (N = 603) at the largest state university in southeastern Turkey. Data were collected with a validated, investigator‐designed survey instrument between September 2015 and January 2016. Findings: Most participants had been exposed to dating violence. Jealousy, controlling behaviour, and restrictions on another's social life were not perceived as violent behaviour in dating relationships. There was no significant relationship of dating violence with gender, smoking, place of residence, or marijuana use. Exposure to parental violence and alcohol use were found to be the strongest predictors of being a perpetrator of violence in the dating violence perpetration model. Conclusion: The findings highlight the lack of recognition of dating violence among nursing and midwifery students. The perceptions of students should be enriched by adding content on violent behaviours in the curriculum of nursing and midwifery programmes. Impact: Efforts to reduce and stop dating violence have a crucial role in preventing future violence in established relationships. We acknowledge that the prevalence of dating violence among nursing and midwifery students is high. Psychological and verbal violence are extremely common and most are not recognized as violent behaviours by the students. This study contributes to the understanding of violent behaviours related to dating violence among nursing and midwifery students for establishing healthy relationship. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate levels of job satisfaction and burnout among Turkish physicians, and the relationships between demographic characteristics, job characteristics, and job satisfaction. A self-administered questionnaire was distributed to 351 physicians to determine factors contributing to stress and job satisfaction. The most important results of the study show that the participants were unhappy with their salary, did not have enough time to follow developments in medicine, and had a limited social life due to heavy workloads. The results of the study show that physicians who work in public facilities have low motivation due to the nature of their organizations. Public hospital working conditions and staff salaries must be improved to promote health professionals and healthy society. [ABSTRACT FROM AUTHOR]

Today, health care delivery systems worldwide are confronting rising costs, rapid changes in technology and increased demand for services. In Turkey, there has recently been a huge upsurge in health care expenses at the inpatient level due to poorly integrated delivery systems. This lack of integration has also increased the risk of conflicting treatments, duplication of diagnostic procedures, poor transferral between levels of care and inadequate discharge planning. In this setting, home health care offers a low-cost alternative to traditional inpatient care. It developed first in the United States and is now an appealing alternative for developing countries like Turkey. This study surveys the concerns of physicians in Turkey regarding home care and analyzes these in the context of the growing home health care market. In general, home health care is seen as an economically appealing but medically controversial area which shows promise for Turkey and other similar developing countries. [ABSTRACT FROM AUTHOR]

The article presents a comparative analysis on the public health status of the European Union (EU) and Turkey and how health care services might affect Turkey's accession to the EU. Reasons why health status is among the top pivotal issues in Turkey's accession into the EU are given. It provides information on the relations between Turkey and the EU. It notes that Turkey's health status has not yet reached a satisfactory level compared to EU members or applicant countries.

Pregnancy is an important period of a woman's life that can affect marital relationships because of decrease in the sexual function. This study aimed to examine the effect of sexual life on the marital adjustment of 607 healthy, pregnant women using the self-administered Sexual Quality of Life Questionnaire-Female and the Marital Adjustment Scale. Results showed that 30% of the pregnant women experienced problems during sexual intercourse and 50% had painful intercourse. The median total score of the Sexual Quality of Life Questionnaire-Female for pregnant women was 35.5, and the median total score of the Marital Adjustment Scale was 41.0. The authors found a positive moderate level correlation between the sexual quality of life for women and their marital adjustment for being pregnant (r = 0.468, p =.001). The results imply that the variance in the sexual activity during the childbearing period does occur and pregnant women need to be assessed regularly with regards to their sexuality by health care providers in a professional atmosphere. [ABSTRACT FROM AUTHOR]

Today, the aging of the population is a critical 'women's health issue'. The aging brings not only a high prevalence of chronic disease and disability, but also leads to an increased social and economic burden. Although notable progress has been made in understanding the various issues of elderly women in Turkey, the need for policy making and services planning are increasing. Thus, health needs of elderly women become a growing issue in Turkey. The purpose of this study is to analyze the Turkish health care policy related to elderly women and also to discuss health needs of elderly women in Turkey. Finally, strategies are provided for improving health and social conditions of elderly women in the context of recent trends in the world. [ABSTRACT FROM AUTHOR]

Aim: Unintended pregnancy rates are still high in Turkey and family planning services have been directed mostly at women. The aim of this study was to assess the influence of age on the usage of family planning methods by Turkish married men. Materials and methods: A cross-sectional survey research design was used, including 1352 men aged 20-52 years who lived in the southeast of Turkey and whose wives were fertile, not menopausal, and had at least 1 child. A questionnaire was used to collect data. Descriptive statistics and multidimensional cross-tabs were used. Results: Men 40 years old and over used family planning methods more often than men in the age group of 20-29 years. The rates of family planning methods being used by men in the age group of 20-29 years with 5 or more children and by men who were 40 years old and over with high income levels were found to be high. The use of modern methods increased as both age and duration of marriage increased. Conclusion: Age-specific family planning programs can make an important contribution to the overall efforts to improve contraceptive use among men. It is advisable for clinicians to design age-specific education programs for men and receive support from the opinions of their religious leaders. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Pneumococcal infection is an important and preventable cause of morbidity and mortality. The Turkish government introduced 7-valent pneumococcal conjugate vaccine (PCV) into the national immunization program in 2009. This suggests that replacing 7-valent PCV with a higher-valent version could at least maintain “standard of care” if not improve it, and that it could be affordable. Objectives and Methods: The aim of this analysis was to assess the potential direct cost-effectiveness of 13-valent PCV in Turkey, a country with a birth cohort of 1.4 million, against a “no vaccine” state, against the default 7-valent PCV state, and against a 10-valent PCV state, using a published cohort model with a 5-year horizon. Results and Conclusions: The cost per life-year gained is below the 1 × per-capita gross domestic product threshold across large changes in key input parameters, indicating that the model is stable and suggesting that any PCV would be very cost-effective in a Turkish national pediatric immunization schedule. [Copyright &y& Elsevier]

Background: Investigation of genetic heterogeneity and spoligotype-defined lineages of drug-resistant Mycobacterium tuberculosis clinical isolates collected during a three-year period in two university hospitals and National Tuberculosis Reference and Research Laboratory in Ankara, Turkey. Methods and Findings: A total of 95 drug-resistant M. tuberculosis isolates collected from three different centers were included in this study. Susceptibility testing of the isolates to four major antituberculous drugs was performed using proportion method on Löwenstein-Jensen medium and BACTEC 460-TB system. All clinical isolates were typed by using spoligotyping and IS6110-restriction fragment length polymorphism (RFLP) methods. Seventy-three of the 95 (76.8%) drug resistant M. tuberculosis isolates were isoniazid-resistant, 45 (47.4%) were rifampicin-resistant, 32 (33.7%) were streptomycinresistant and 31 (32.6%) were ethambutol-resistant. The proportion of multidrug-resistant isolates (MDR) was 42.1%. By using spoligotyping, 35 distinct patterns were observed; 75 clinical isolates were grouped in 15 clusters (clustering rate of 79%) and 20 isolates displayed unique patterns. Five of these 20 unique patterns corresponded to orphan patterns in the SITVIT2 database, while 4 shared types containing 8 isolates were newly created. The most prevalent M. tuberculosis lineages were: Haarlem (23/95, 24.2%), ill-defined T superfamily (22/95, 23.2%), the Turkey family (19/95, 20%; previously designated as LAM7-TUR), Beijing (6/95, 6.3%), and Latin-America & Mediterranean (LAM, 5/95 or 5.3%), followed by Manu (3/95, 3.2%) and S (1/95, 1%) lineages. Four of the six Beijing family isolates (66.7%) were MDR. A combination of IS6110-RFLP and spoligotyping reduced the clustering rate from 79% to 11.5% among the drug resistant isolates. Conclusions: The results obtained showed that ill-defined T, Haarlem, the Turkey family (previously designated as LAM7- TUR family with high phylogeographical specifity for Turkey), Beijing and LAM were predominant lineages observed in almost 80% of the drug-Resistant M. tuberculosis complex clinical isolates in Ankara, Turkey. [ABSTRACT FROM AUTHOR]

Objective: Vaginal infections are common and when they are not treated, they can cause serious health problems such as getting infected with Human Immunodeficiency Virus (HIV). The aim of this study was to determine the behavioral risk factors for vaginal infections among women with and without vaginal infections. Methodology: This study was done in a large women's hospital. The sample consisted of 200 women between the ages of 15 and 49. A pelvic examination and clinical assessment were conducted on each woman. Risk factors were analyzed through the use of cross-tabs, t-test, odds ratio and percent analysis. Results: Behaviors such as washing from back to front after defecation (OR=3.79; 95% CI, 2.05-7.01), cleaning with bare hand in the toilet (OR=4.75; 95% CI, 1.71-13.23), bathing by sitting on a stool (OR=2.64; 95% CI, 1.44-4.84, p<0.001), infrequent change of underwear (OR=6.15; 95% CI, 2.43-15.55, p<0.001) and douching after intercourse (OR=1.84; 95% CI, 1.09-3.07, p <0.05) were risk factors associated with vaginal infections. Conclusion: The results can provide physicians with the evidence based data to be used when counseling, educating and treating women for vaginal infections. [ABSTRACT FROM AUTHOR]

A primary goal of modern health systems is to protect citizens from catastrophic health expenditures. Today, health care spending is a significant cause of poverty and the poor are more vulnerable to catastrophic payments. Similar to other countries, Turkey is facing problems of poverty due recent economic crises and it has developed poverty alleviation programs with the support of international organizations such as the World Bank. In the literature, no studies have identified and measured catastrophic health expenditures among poor people in Turkey. This study included 92 households in the Etimesgut region of Ankara, with these households being in the priority group for assistance identified by the Social Risk Mitigation Project of the Social Solidarity Fund (SYDTF). In the study, households' socio-demographic characteristics, living standards, health status and situations regarding catastrophic health expenditures were examined via face-to-face interviews. The results of the study indicate that poverty, households' socio-demographic characteristics and living standards are strongly related. The poverty rate of female-headed households (61.33%) was greater than that of male-headed households (32.8%). Moreover, 125 household members (34.3%) had at least one chronic illness and/or disability, and 14 households (15.2%) were facing catastrophic health expenditures that constituted an average of 62.3% of their non-food expenditures. One conclusion of the study is that particularly in poor households, people can be protected from catastrophic health expenditures by reducing the health system's reliance on out-of-pocket payments and by providing more financial risk protection. If the poor are not protected, their increased health risks will create further financial and social burdens at both the community and government levels. [ABSTRACT FROM AUTHOR]

Aims and objectives. To examine the validity and effectiveness of a symptomatic approach based on symptoms, administered by a nurse working in women's health area, in identifying vaginal infections in women with or without vaginal discharge. Design. Survey. Methods. Between November 2005-August 2006, 300 married women were included. A questionnaire and vaginal discharge assessment form were used for data collection. The modified algorithm of a symptomatic approach without speculum examination was used to manage participants. Three diagnoses were made for each participant. The first diagnosis was made by the research nurse using the vaginal discharge assessment form; the second diagnosis is the clinical diagnosis which was made after the gynaecological examination by a physician; and the third diagnosis is the microscopic diagnosis made by the physician when assessing the collected specimens. Results. In the methodological part of this study, the sensitivity, specificity, positive predictive value and negative predictive value of the symptomatic approach were 91·5, 69·7, 87·7 and 77·5%, respectively. The symptomatic approach had 27·7% sensitivity for bacterial vaginosis, 16·6% for trichomonas vaginalis and 62·8% for candida albicans, compared to the microscopic results. The sensitivity of the approach was higher for the identification of candidiasis compared to bacterial vaginosis and trichomonas vaginalis. Conclusion. From the results, it is suggested that the symptomatic approach model can be used by nurses who work in women's health area to diagnose vaginal infections. Relevance to clinical practice. This study showed that trained clinician nurses will be able to diagnose and manage vaginal infections - especially candidiasis - by using the symptomatic approach. Moreover, the symptomatic approach will encourage women not to delay or fail to seek treatment for their health problems, especially for vaginal infections in conservative societies. [ABSTRACT FROM AUTHOR]

Abstract: Genotyping of Mycobacterium tuberculosis isolates from infected individuals can play an important role in tracking the source of infection and unraveling the epidemiology of a tuberculosis pandemic. A total of 114 M. tuberculosis isolates were genotyped by spoligotyping and results were compared with an international spoligotype database (SpoIDB4). Twenty-one spoligotyping-defined clusters including 97 patients were established, and an additional 17 unique patterns were found. Ninety-eight (85.9%) isolates belonged to previously defined shared types (STs). The ST53 (ill-defined T1 superfamily, n =31), ST41 (LAM7-TUR family, n =9), ST118 (T undefined, n =8) and ST50 (Haarlem 3, n =6) were four major clusters of our isolates. After comparison with the international SpoIDB4 database, two new intrafile clusters, ST2136 and ST2139, were created and two new interfile clusters, ST2135 and ST2140, were defined. Eight (7%) of the 17 isolates with unique patterns were found to be orphans, whereas the STs of 9 isolates had previously been deposited in the international SpoIDB4 database. In addition, two isolates with an ST pattern characteristic of the Beijing family of M. tuberculosis were found. This study shows that, although ubiquitous spoligotypes are common, several spoligotypes specific to Turkey also exist. Thus, our study may help us to better understand the spread of M. tuberculosis genotypes to Turkey. [Copyright &y& Elsevier]

Appropriate prescribing implies the maximizing of effectiveness and the minimizing of risks and costs, while respecting patients' choices. Physicians' experiences in medical school and residency are formative in establishing patterns of prescribing. Today, pharmaceutical representatives also exert influence in the drug selection process among practicing physicians. Although physicians often state that peer-reviewed publications of clinical trials are their main source of information about drugs, the research literature has shown that this is actually one of the least important sources. The purpose of this study is to identify factors that influence prescribing decisions among physicians in Turkey. This study is important because the factors that influence physicians' prescribing behaviors are difficult to quantify and have rarely been acknowledged here. For the purpose of the study, 156 physicians in a Ministry of Health Hospital in Ankara were surveyed. The majority of the participants reported that pharmaceutical representatives were their main source of information about new drugs on the market. Regarding peer influence on drug selection, 75% of the physicians reported being affected by department heads and colleagues in the same specialty. As for monotherapy and combined therapy, 68% of participants reported using both methods when prescribing drugs to patients. Generic drug issues were also important, with 74% of the participants agreeing that for drugs having the same active ingredients, local versus foreign distinctions should be made to protect national interests, and 88% completely agreeing/agreeing that the patient's economic level and social security must be considered in drug selection. In addition, important concerns were gathered regarding ethical issues and patient drug use. At the end of study, policy suggestions are provided for both physicians and health policy makers regarding the factors that influence patterns of drug prescribing. [ABSTRACT FROM AUTHOR]

In many developing countries, healthcare administrators are currently facing challenges that are representative of those in the United States. Most healthcare administrators here are physicians with no formal training in healthcare administration, and this is perhaps most apparent in their difficulties with time management. The authors' purpose in this study was to characterize the time management difficulties of administrators working in primary healthcare facilities of the Ministry of Healthcare. In the study, 67 healthcare administrators each completed a 31-item time management questionnaire. Of the participants, 79.1% reported that they have never attended time management courses or workshops. Although 76.1% said they were free to choose the priority of their daily tasks, only 44.8% felt they knew how much time they should allow for each activity in their daily life. These and other findings in the study suggest that the need for time management education is a well-defined target for intervention, both in university-based programs for future healthcare administrators and in workplace-based programs, such as in-service training for healthcare administrators who are already working. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the extent of inappropriate days of stay in a Turkish military hospital, and to explore the variables correlated with these. A review was made of the medical records of surgery patients admitted to the hospital of Gülhane Military Medical Academy. To determine the appropriateness of lengths of hospitalization, a Turkish version of the Appropriateness Evaluation Protocol (AEP) was applied retrospectively. A total of 375 patients' files were reviewed; and 21.3% of the hospital admissions were evaluated as inappropriate. Multiple logistic regression analysis showed that inappropriate length of stay was significantly increased with relation to age, emergency status, military rank, and distance from the hospital to the patient's home. The results of the study suggest that changes in physicians' behavior and in the organization of hospital activities may be effective in improving the quality and efficiency of hospital care. [ABSTRACT FROM AUTHOR]

The article focuses on sex workers and the issues surrounding registration in Turkey. Awareness of the activities of commercial sex workers can be an important step toward understanding the transmission of sexually transmitted infections (STIs) in developing countries. This study discusses how sex workers are viewed in Turkey and the process of mandatory registration. To support the information provided and the conclusions drawn, a sample of 150 sex workers who made regular visits to a STI hospital was interviewed. Information on socio-demographic characteristics, family and support information and certain risk behaviors were solicited. Recommendations for increasing preventive education are made, with considerations for increased attention and support for this group of individuals. In many countries attention is being focused toward understanding the activities of prostitutes, often referred to as commercial sex workers. Awareness of this information may provide valuable insight into the increasing numbers of STIs.

This article investigates the prevalence of sexual harassment among nurses in the hospitals in Turkey. For this study, subjects were recruited from two hospitals in Turkey where one was considered a public university hospital with a 150-bed capacity and the other was a state hospital with a 400-bed capacity. The hospitals had a combined total of 353 nurses when the survey research was conducted. Questionnaires were distributed to all 353 nurses within a plain envelope. Participation was voluntary and no penalty was considered for anyone that did not participate. During implementation many of the nurses told the researchers that this study was the first project they ever participated in where issues of this nature were discussed and more studies of this nature should be conducted. Prior to completion of the surveys respondents were assured that confidentiality and the anonymity of their responses would be maintained and no concrete incidents would be described. To protect confidentiality of the respondents data was collected and displayed in a group format only. Participants all agreed that these assurances were particularly important because of the sensitive nature of the survey information. Of the 353 nurses actually surveyed, 215 nurses responded; this left a response rate of 61%.

Today, the social, economic, cultural, ethical, and political climate has given rise to an international movement which is re-evaluating the importance of patients' rights. In Turkey, as competition continues to increase between public and private hospitals, the emphasis on presenting health care services in the most advantageous way has become a focal point of debate. As a result, patients' rights issues are being actively discussed in both the private and public health care sectors in the country. In this study, the development of patients' rights issues in Turkey is reviewed and the results of some selected descriptive studies are summarized. Suggestions are made toward policies for effective and efficient health care provision in terms of both broad and specific issues which have arisen in the field of patients' rights. [ABSTRACT FROM AUTHOR]

Patients' rights issues are currently being discussed in health care at both the private and public levels in Turkey. In this study, 317 patients were interviewed upon hospital discharge and asked what they knew about their "rights" as patients. According to the collected data, 63% of the patients were not aware that they had any fights in receiving health care services at all. Since this is the first study of its type in Turkey, further research in this area is needed. In closing, it is recommended that hospitals in Turkey adapt routine policies similar to those in the United States for informing customers about their fights for safe, effective and efficient health care provision. [ABSTRACT FROM AUTHOR]

Alkaptonuria (AKU) is an inborn error of metabolism caused by the deficiency of homogentisate 1,2-dioxygenase (HGD) as a result of a defect in the HGD gene. HGD enzyme deficiency results in accumulation of homogentisic acid (HGA) in the body, which in turn leads to multisystemic clinical symptoms. The present study aimed to investigate the presenting symptoms, age at diagnosis, and clinical and genetic characteristics of AKU patients followed-up in different centers in Turkey. In this cross-sectional, multicenter, descriptive study, medical records of 66 AKU patients were retrospectively evaluated. Patients' data regarding demographic, clinical and genetic characteristics were recorded. HGD database (http://hgddatabase.cvtisr.sk/) was used to identify HGD gene variants. Of the patients, 37 (56.1%) presented with isolated dark urine and 29 (43.9%) were diagnosed based on the clinical symptoms or family screening. One of these patients was on follow-up for 2 years due to Parkinsonism and was diagnosed with AKU on further analyses. Signs of ochronosis such as joint pain, low back pain and renal stones developed in childhood in 7 patients. Eight patients were diagnosed with depression via psychiatric evaluation. There were 14 (21.2%) patients operated on for ochronosis. The most frequent mutation observed in the patients was c.175delA, which was followed by c.674G > A and c.1007-2A > T mutations. Four novel mutations (c.189G > A, c.549+1G > T, c.1188+1G > A, and c.334 T > G) were identified in the patients included in the study. In addition to the known signs such as dark urine and skin pigmentation, symptoms involving different systems such as neurological findings and depression can also be encountered in AKU patients. The presence of a change in urine color needs to be questioned in patients presenting with different symptoms such as arthralgia/arthritis, renal stones or low-back pain, particularly in childhood, when skin ochronosis is not pronounced, and further examination should be performed. • Signs of ochronosis may initiate in childhood in AKU patients. • Black urine should be questioned in the presence of arthralgia, kidney stones, and lumbar pain in childhood. • As black urine may be misdiagnosed as hematuria, AKU should be kept in mind in children admitting with black urine. • Adult AKU patients may be presented with neurological symptoms like Parkinsonism. • Depression is one of the psychiatric findings seen in in AKU patients in all ages. [ABSTRACT FROM AUTHOR]

Reports on the results of a patient-satisfaction survey administered by interview of adults discharged from several major public and private hospitals in Turkey. Comparison of services provided by public and private hospitals; Need to take into account the public's perception of hospitals and enhancing customer satisfaction as a means of increasing service utilization.

Public relations activities for all organizations can have an important effect on consumer decision-making when buying goods or services. This study examines the effect that public relations activities can have regarding consumer decisions and choice. To explore exemplify this relationship a questionnaire was given to 971 patients within public, university and private hospitals in Ankara, Turkey. Study results show that public relations activities were a crucial factor in determining consumer hospital choice. The majority of respondents reported that the behaviors and attitude of personnel as public relations activities that support the hospital's reputation within the public were the primary variables in hospital choice. Health care managers can use these findings to further understand how patients make informed choices related to usage of a health care facility and to develop and/or improve public relations activities. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare three alternative surgical therapies for Benign prostatic hyperplasia (BPH) in terms of their cost and effectiveness in a general hospital setting in Turkey. BPH is an important potential burden on health care resources in developing countries like Turkey, not only because of the increasing incidence of the disease, but also because of the differences in cost and effectiveness that exist among the various available treatment technologies. In this study, three alternative surgical treatments for BPH, namely open prostatectomy, transurethral resection of the prostate (TURP), and laser prostatectomy were compared in terms of their cost and effectiveness. Effectiveness was measured through the use of the International Prostate Symptom Score (IPSS) before the operation and at 3 months after. Laser prostatectomy was found to be the most costly and least effective way of treating BPH. This conclusion was valid both in terms of cost per prostate symptom score and cost per improvement of quality of life index. This study shows how a rough estimate can be made of the potential burdens that alternative treatment methods would impose on a country’s health budget. [ABSTRACT FROM AUTHOR]

The incidence and subsequent rise of sexually transmitted infec- tions (STIs) is an important public health problem in Turkey, as it is in other parts of the world. Since the mid-1980s, the incidence of STIs among the Turkish population has increased dramatically, particularly in the major urban areas. One hundred and fifty registered sex trade workers were interviewed to examine their current perceptions, knowledge, and behaviors. Socio-demographic information and other responses were tabulated as well as discussion of current behaviors and practices. Future recommendations are made to assist social workers, nurses, and other professionals in the area of public health. Suggestions include: (a) helping to increase awareness of problems within the sex trade among decision makers and opinion leaders by educating members of parliament, the mass media and the general population; (b) provision of additional resources and problem solving strategy for women who test positive or need treatment for STIs; and, (c) emphasizing and supporting formalized programs to help educate commercial sex trade workers, consumers and public health workers in the assessment and prevention of communicable diseases. [ABSTRACT FROM AUTHOR]

In this report we describe the upper gastrointestinal tractus involvement in a rare genetic disease of lipid metabolism. A 12-year-old boy presented with sore throat and fever. On physical examination, orange-yellow tonsils and adenoid tissue were noted. Mild hepatosplenomegaly was present. Lipid profile was compatible with Tangier disease ( TD). Endoscopy of the upper gastrointestinal tract showed white-yellowish fatty deposits on the gastric mucosa. Microscopically, biopsy specimens contained numerous histiocytes with a foamy cytoplasm packed in the lamina propria of the gastric mucosa and at the crypt basement of the duodenum. His sister, 8 years old, was also diagnosed with TD based on abnormal lipid profile and orange-yellow tonsils. TD is a rare familial disorder of lipid metabolism, characterized by deposition of cholesteryl esters, probably involving the entirety of the gastrointestinal tract from the mouth to the anus. [ABSTRACT FROM AUTHOR]