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Heart failure (HF) is a complex clinical condition associated with significant morbidity and mortality. Early diagnosis and effective management at the primary care level are essential for improving patient outcomes and reducing the burden on the healthcare systems. The Eurasian Society of HF and the Turkish Association of Family Medicine developed a guideline that underscores the critical role of natriuretic peptides (NPs) in the early detection, diagnosis, and management of HF. NPs, particularly the N-terminal pro-B-type NP, are a reliable biomarker for identifying HF, guiding treatment decisions, and monitoring disease progression. This guideline emphasizes the importance of measuring the levels of these peptides in primary care so as to detect individuals at risk, confirm the diagnosis of HF in symptomatic patients, and evaluate the treatment response. The recommended thresholds for NP levels account for variations arising from factors such as age, gender, and the presence of other health conditions. B-type natriuretic peptides (BNP) levels ≥ 35 pg/ml or N-terminus-proBNP levels ≥ 125 pg/ml are used to confirm the likelihood of HF in symptomatic patients, enabling timely diagnosis and appropriate intervention. Incorporating NP testing into routine clinical practice enables timely referrals and ensures appropriate management at all stages of HF. Beyond diagnosis, the measurement of NPs provides valuable information about treatment effectiveness and prognosis, allowing clinicians to individualize the treatment. By integrating NP testing into primary care, healthcare providers can facilitate early detection, optimize treatment strategies, and improve the quality of life for patients with or at risk of HF. Thus, this guideline highlights the essential role of primary care physicians in addressing the growing challenges of HF through the effective and evidence-based use of NPs.

INTRODUCTION: Premature newborns are defined as babies born before 37 weeks of pregnancy and after 22 weeks of pregnancy as a viability limit. Aim of this study was to analyze growth characteristics at the age of second and third age and prevention of metabolic diseases that may occur in adult age at an early phase. METHODS: This study was conducted as a retrospective cohort study between May 2018 and October 2018 in 18 different Family Medicine Outpatient Clinics in Rize, Central district. All participants were at least 3 years old and their follow-up visits made by the same family physicians for 3 years. RESULTS: It was found that 54.66% of babies were males(n=123), 45.33% of them were females(n=102). According to BMI (Body Mass İndex) evaluations, 19.11% of babies were overweight(n=43), 16% of them were obese(n=36) at the age of two and 20% of them were overweight (n=45), 13.33% of them were obese(n=30) at the age of three. The mean Hb levels of the mothers whom children were obese at the age of two were statistically lower than the others (p

Amaç: Bu çalışmanın amacı, maternal obezite, doğum ağırlığı, cinsiyet, gebelikte kazanılan kilo dikkate alındığında, yaşamın ilk yılında antibiyotik kullanımının 3 yıllık obezite veya fazla kilo durumu üzerindeki etkisini araştırmaktır. Materyal ve Metot: Bu retrospektif kohort çalışması, Rize (Türkiye) ilinde doğan ve 3 yaşına kadar düzenli olarak takip edilen 182 sağlıklı çocuğa uygulandı. Çocukların yaşamlarının ilk 12 ayı içerisinde kullandıkları antibiyotikler elektronik sağlık kartları ile belirlendi ve antibiyotik kullanımı ile 3 yıllık obezite veya fazla kilo durumu arasındaki ilişki tespit edildi. Bulgular: Potansiyel karışıklıkları ayarlamak için lojistik regresyon analizi kullanıldı. Ham analizde, yaşamdan sonraki ilk 12 ay içerisinde antibiyotik kullanımına maruz kalan çocuklarda kullanılmamış olanlara kıyasla aşırı kilo alma ve şişmanlık riski değerlendirildi. (oran oranı((OR)): 1.40;% 95 CI: [1.23-1.57]). Çok değişkenli ayarlama sonrasında, artan risk kaldı (düzeltilmiş oran oranı((AOR)): 1.22;% 95 CI: [1.04-1.40]). Sonuç: Elde edilen sonuçlar, obezite riskinin, yaşamın ilk 12 ayında antibiyotik uygulanan 3 yaşındaki çocuklarda anlamlı derecede yüksek olduğunu göstermiştir. Gelecekteki çalışmalar, antibiyotik kullanımı nedeniyle çocuklarda obezitenin önlenmesine odaklanabilir.

Background and Objective: Diabetes Mellitus is a long-term, multifaceted metabolic condition that necessitates ongoing medical management. Hypogonadism is a syndrome that is a clinical and/or biochemical indicator of testosterone deficiency. Cross-sectional studies have reported that 20–80.4% of all men with Type 2 diabetes have hypogonadism, and Type 2 diabetes is related to low testosterone. This study presents an analysis of the use of ML and EL classifiers in predicting testosterone deficiency. In our study, we compared optimized traditional ML classifiers and three EL classifiers using grid search and stratified k-fold cross-validation. We used the SMOTE method for the class imbalance problem. Methods: This database contains 3397 patients for the assessment of testosterone deficiency. Among these patients, 1886 patients with Type 2 diabetes were included in the study. In the data preprocessing stage, firstly, outlier/excessive observation analyses were performed with LOF and missing value analyses were performed with random forest. The SMOTE is a method for generating synthetic samples of the minority class. Four basic classifiers, namely MLP, RF, ELM and LR, were used as first-level classifiers. Tree ensemble classifiers, namely ADA, XGBoost and SGB, were used as second-level classifiers. Results: After the SMOTE, while the diagnostic accuracy decreased in all base classifiers except ELM, sensitivity values increased in all classifiers. Similarly, while the specificity values decreased in all classifiers, F1 score increased. The RF classifier gave more successful results on the base-training dataset. The most successful ensemble classifier in the training dataset was the ADA classifier in the original data and in the SMOTE data. In terms of the testing data, XGBoost is the most suitable model for your intended use in evaluating model performance. XGBoost, which exhibits a balanced performance especially when the SMOTE is used, can be preferred to correct class imbalance. Conclusions: The SMOTE is used to correct the class imbalance in the original data. However, as seen in this study, when the SMOTE was applied, the diagnostic accuracy decreased in some models but the sensitivity increased significantly. This shows the positive effects of the SMOTE in terms of better predicting the minority class.

INTRODUCTION: On 31 December 2019, the China Country Office of the World Health Organization (WHO) reported on cases of pneumonia with unknown etiology in the Wuhan city of the province of Hubei. On 7 January 2020, the factor was defined as a new Coronavirus (2019-nCoV) that had not been detected in humans before. The aim of this study is to analyze the pandemic in 8 different countries. METHODS: In the study, we included the countries with the highest numbers of cases by the date 04.05.2020 (USA, China, Italy, Germany, Iran, France, Turkey), as well as South Korea. We comparatively analyzed the countries' total case and mortality numbers, mortality rates, over-65 years old population rates and dates of precautions that were taken. RESULTS: The number of COVID cases in the entire world exceeded 3.6 million, and approximately 75.2% of these cases were seen in 7 countries (USA, Italy, China, Germany, France, Iran, Turkey), whereas the number of related deaths worldwide exceeded 250 thousand by the same date (02.04.2020). DISCUSSION AND CONCLUSION: We are facing the greatest pandemic of the last century, or even the history of humanity, which has affected the society in all aspects from the field of medicine to economics. The greatest weapon for the history of humanity in the fight against the pandemic would be countries' transfer of their knowledge to each other.

Objective:The aim of the present study was to evaluate healthy lifestyle behaviors of medical school students attending Recep Tayyip Erdoğan University during academic year 2016-2017.Methods:Among 510 students attending Recep Tayyip Erdoğan University during academic year 2016-2017, 285 were enrolled as volunteers in this study. A questionnaire form that was developed through literature information including sociodemographic characteristics as well as Healthy Lifestyle Behaviors Scale (HLBS) was used for data collection. Data analysis was performed through t-test, variance analysis, Mann-Whitney U, Kruskal-Wallis variance analysis.Results:Average age of the participants was 21-23 years. Mean scale score of the students was at moderate level with 127.38±19.28. The title of the subtopic with the highest score was “Self-realization” (25.19±4.89), whereas the lowest score was detected on “Physical Activity” (18.88±4.49). Female sex and improved awareness on health status were found to be associated with a healthy lifestyle attitude.Conclusion:The improvement of health developing attitudes of medical school students who are future healthcare professionals as well as role models for the community is important for public health. In line with these outcomes, planning and implementation of training programs regarding the topics that the students found unsatisfying in terms of health behaviors are essential.

Introduction:Cesareansection rate (CS) has increased to 15.5% in 2012 while it was 12% in 2000s, ingeneral. Information during these follow-ups is very important for pregnantwomen to decide on delivery method. Another aspect that affects women’sdelivery method is the education level. The objective of this study is toinvestigate the effect of education level on delivery method for pregnantwomen.Method: Thisdescriptive study was carried out by the participation of 500 pregnant womenwho were regularly followed in Family Physician Polyclinic in Rize betweenJanuary 2016 and December 2017. Each pregnant woman was followed up in FamilyHealth Center at least 4 times during pregnancy. Methodsof delivery of pregnants participating in the study were determined, and thefactors affecting them were investigated with appropriate statistical methods.Results: Of 500pregnant women included in the study, 254 (50.8%) women were between the agesof 20-35 and the majority (n=282; 56.4%) were primary and secondary schoolgraduates. 52 (10.4%) of the mothers were smoking while 104 (20.8%) motherswere working at any job. The mean age of the mothers participating to study is28.8±9.8. No correlation was found between the delivery method and age groups.(p=0.651) Patients were divided into three groups as primary and secondaryschool graduates, high school graduates and university graduates according tothe education level. University and higher education group was significantlychoosing cesarean section more than primary school graduates groups. (p=0.021)Conclusion: In thisstudy carried out in Turkey, where cesarean section is performed in the worldat most, we have figured out that there is a relation between high educationlevel and socio-economic status of pregnant women and cesarean deliverypreference.

Introduction: Theobjective of the present study was to determine educational level of theworkers of a tea factory on occupational health and safety and to reveal thefactors affecting a healthy lifestyle.Methods: The presentdescriptive research was carried out in a tea factory where 352 workers areemployed between December 2016 and January 2017. 303 volunteer workers wereenrolled into the study and a questionnaire form including topics ofsociodemographic characteristics, occupational health and safety (OHS)implementations, health state and working conditions that was developed throughliterature information as well as Healthy Lifestyle Behaviors Scale (HLBS) wereused for data analysis. Results: Ageaverage of the workers who were all male was 39.88±5.53. Among the workers,70.29% were elementary school graduate and more than half of the participants(62.70%) have a middle income (500-1,000 USD). Mean score of HLBS scale was118.00±20.28 points. Average score of the sub-topics was the highest in healthresponsibility item with 22.06 points whereas the lowest score was detected inphysical activity sub-topic. It wasdetected that 64.69% of the workers had an occupational health and safetytraining at least once during their lifetime and 21.78% use a protectiveequipment. Rate of exposure to work-related accidents was detected as 10.57%.