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It is difficult to evaluate ergonomic risk factors in occupations with unpredictable tasks, random demands, and variable settings such as emergency medical services (EMS). This study deals with the problem of selecting an ergonomic risk-evaluation method with Pythagorean Fuzzy Sets (PFSs) based Pythagorean Fuzzy AHP (PF-AHP) and Pythagorean Fuzzy WASPAS (PF-WASPAS) methodology. The method selection criteria were obtained by consulting five different anonymous experts on the candidate criteria obtained from the literature review. The final four main criteria and ten sub-criteria were then decided. After the determination of the decision criteria, five experts were asked to evaluate the criteria and to express their opinions on criteria-alternative scoring by means of a questionnaire for method selection. A two-step method is suggested for the selection of the ergonomic risk-evaluation method. In the first step, PF-AHP is utilized in order to identify the weight of criteria used in the method selection. In the second step, the PF-WASPAS method is proposed in order to OWAS, RULA, and REBA methods. The accuracy and validity of the suggested hybrid model is tested with real data in İstanbul Ambulance Service stations. A sensitivity analysis is carried out to test the reliability of the model. Moreover a comparative analysis is carried out with AHP and Fuzzy AHP methods to identify criteria weights. Study results show that REBA is the most appropriate ergonomic risk-evaluation method in EMS.

Objective To examine the immunoglobulin G-receptor-binding domain (IgG-RBD) response and changes in fibrinogen and D-dimer concentrations in individuals with a past coronavirus infection and followed by CoronaVac. Methods The study consisted of a total of 116 participants. Blood samples were drawn from subjects 21–25 days after they received first and second doses of CoronaVac as well as from individuals with a past infection. Fibrinogen, D-dimer, and IgG-RBD concentrations were measured. Results The IgG concentrations of the vaccinated subjects were significantly higher (P < .001), fibrinogen levels were lower (P < .001), and D-dimer levels increased following the second vaccination compared with the first vaccination (P = .083). No difference was obtained in IgG-RBD between vaccinated and previously infected individuals (P = .063). The differences in fibrinogen and D-dimer were statistically nonsignificant between both groups. Conclusion The CoronaVac vaccine appears to be safe and effective. It is essential for individuals to take personal protective measures, such as using masks and distancing.

Chronic lymphocytic leukemia (CLL) is a neoplasm characterized by excessive accumulation of B lymphocytes in the peripheral blood, bone marrow and lymph nodes. We assessed the expressions of 22 genes in the p53 pathway in 30 CLL patients and 15 healthy subjects by a RT2 Profiler PCR (polymerase chain reaction) Array technique and their relation to cytogenetic aberrations detected by fluorescent in situ hybridization (FISH). Our Student’s t-test results indicated that ATM, ATR, BAX, CASP9, CDK4, CDKN2A, CHEK1, CHEK2, E2F3, MCL1, MDM2, MDM4, PCNA, RB1, P53 and BCL2 genes were statistically significant (p (APAF1, CDKN1A, E2F1, GADD45A, PTEN and PTX3) were not statistically significant. The ATM, ATR, BAX, CASP9, CDK4, CDKN1A, CDKN2A, CHEK1, CHEK2, MDM2, MDM4, PCNA, RB1, P53, E2F1, GADD45A and BCL2 genes were found to be upregulated by the 2-ᐃᐃCt (relative fold change in gene expression) method. The highest up-regulation was detected in CDKN2A and BCL2 genes, 10.22- and 8.51-fold, respectively. On the other hand, the PTX3 gene with a fold regulation of 1.84 was found to the highest downregulation. Overall, the CDNK2A BCL2 and PTX3 genes are related to the mechanism of the disease in the p53 pathway and may be an important predictor of the prognosis of the disease. The BCL2 gene may be associated with increased risk of developing CLL. We suggest that the PTX3 gene may be considered as a marker associated with CLL disease. The CDKN2A gene expression seems to play a protective role in CLL.

Objective: The aim of this study was to compare the clinical and immunological results of nonsurgical periodontal treatment with or without the erbium, chromium:yttrium–scandium–gallium–garnet (Er,...

Aims Diabetes is a chronic disease that limits the quality and duration of life. We aimed to estimate the trends in prediabetes and diabetes between 2010-2020, and the projections to 2023 and 2045 in Turkey. Materials and methods Prediabetes and diabetes estimates were calculated by direct standardization using age/sex-specific data from the previous TURDEP-II survey as reference. The 2010-2020 population demographics were obtained from TurkStat. Comparative age-adjusted diabetes rates were estimated using standard population models of world and Europe. ResultsEstimates depicted that the population (20-84 years) of any degree of glucose intolerance in Turkey increased by approximately 5.3 million (diabetes: 2.2 million and prediabetes: 3.1 million) from 2010 to 2020. While the increase in prediabetes and diabetes rates was 22% and 31.6% in overall population, corresponding increase were 45.2% and 45.6% in the elderly. Notably, diabetes awareness was comparable (54% and 58%). Age-specific prediabetes and diabetes rates were significantly higher in women than in men (diabetes: 14.1% versus 17%; prediabetes: 38.6% versus 30.2%). The comparative age-adjusted prevalence of diabetes to the standard European but not the world population model, showed a higher rate of 19.4%. According to the projections the prevalence of diabetes will reach 15.9% in 2023 and 19.1% in 2045. Conclusion Diabetes has reached epidemic proportions in Turkey and will continue to grow in the coming decades. The fact suggests that there is an urgent need to developing and implementing the country-specific prevention program to halt this increase. Otherwise, the burden of diabetes on social, economic and health services will continue to increase.

In COVID-19-induced acute respiratory distress syndrome, the lungs are incapable of filling with sufficient air, leading to hypoxemia that results in high mortality among hospitalized patients. In clinical trials, low-molecular-weight heparin was administered via a specially designed soft-mist inhaler device in an investigator initiated, single-center, open-label, phase-IIb clinical trial. Patients with evidently worse clinical presentations were classed as the “Device Group”, 40 patients were given low-molecular-weight heparin via a soft mist inhaler at a dose of 4000 IU per administration, twice a day. The Control Group, also made up of 40 patients, received the standard therapy. The predetermined severity of hypoxemia and the peripheral oxygen saturation of patients were measured on the 1st and 10th days of treatment. The improvement was particularly striking in cases of severe hypoxemia. In the 10-day treatment, low-molecular-weight heparin was shown to significantly improve breathing capability when delivered via a soft-mist inhaler.

Noise-induced hearing loss (NIHL) is the most common occupational disease in the world and is the second most important cause of sensorineural hearing loss. Genetic and environmental factors are effective in the emergence of the disease. The World Health Organization (WHO) and the National Institute for Occupational Safety and Health (NIOSH) have classified NIHL as a research priority group. In this review, it is aimed to reveal the role of genetic variations and gene expression changes associated with susceptibility to noise-induced hearing loss in susceptibility to noise exposure. It can be said that genetic variations in heat shock protein 70 (Hsp70), 8-oxoG DNA glycosylase 1 (OGG1), Glutathione S-transferase M1 (GSTM1), catalase (CAT), Cadherin-23 (CDH23), Potassium Voltage Gated Channel Subfamily E Regulatory Subunit 1 (KCNE1) genes are associated with the risk of NIHL. Oxidative stress genes, inner ear potassium recycle pathway genes and monogenic hearing loss genes are accepted as candidate genes as genetic factors in NIHL. Individuals exposed to noise and at higher risk of developing NIHL are exposed to other environmental factors that interact with possible NIHL genes. More frequent use of high-throughput genotyping methods will allow the detection of multiple SNPs in a single sequence, making it possible to identify new NIHL susceptibility genes. This includes identifying individuals at high risk of developing NIHL and providing better hearing protection for susceptible individuals for noise-induced hearing loss. Thus, it could allow the development of genetic tests to help personalize treatment. Keywords: GBIK, occupational disease, genetic variations Special Issue of Health Sciences DOI: 10.7176/JSTR/7-08-07

Introduction Oral anticoagulants (OAs) are not in routine use during Coronavirus disease (COVID-19). Studies that compare the COVID-19 infection outcome of chronic OA users with their peers of non-OA users are available. To the best of our knowledge, none of these studies evaluated the effect of OA use on the COVID-19 related early admission laboratory parameters and/or length of the hospital stay. So, we will study these here. Methods This retrospective study was included 2 groups; group 1 (n=62) consisted of OA users, and group 2 (n=75) of age, and sex-matched of OA non-users at the time of COVID-19 diagnosis. Early admission laboratory measures, numbers of comorbidities, length of hospital stay, and outcomes of these patients were recorded and analyzed Results Despite higher numbers of comorbidities in group 1, their serum CRP and D-dimer levels were significantly lower than the group 2. (p0.05). Regression analysis showed that OA users (in comparison to non-OA users) had 0.980 and 0.520 times lower serum CRP and D-dimer levels, respectively. Conclusions This study showed a beneficial effect of OA use on early admission serum CRP, and D-dimer levels, which are important prognostic predictors in COVID-19. Additionally, OA use associated with lesser hospital stay days of COVID-19 patients. These beneficial effects of OA use might help in improving the management of this infection after further dedicated studies in this field.

Objective: To evaluate Turkey according to the number of work accidents, occupational diseases and related mortality rates, insured workers, establishments and cities, which are important issues in terms of showing countries’ situation.Material and Method: The data of 2010-2015 years according to the numbers of insured labourers and workplaces based upon cities were obtained, plotted and interpreted from Republic of Turkey Social Security Institution (RTSSI)’s statistical yearbooks. Indirect standardization technique was used to check the effects of mixed variables when interpreting. This study is an epidemiological, observational and descriptive research. The results were compared to national occupational health and safety targets. Results: Bilecik, Zonguldak and Manisa, which mining is the frontline, take the top in the standardization of work accidents and occupational diseases. In the standardization of occupational diseases, it has been evaluated that Kutahya has risen to the top in recent years, and in the standardization of mortality, Southeastern Anatolian Regions are at the top. Conclusion: The results of mining accidents in Soma / Manisa and Ermenek / Karaman affected the data of 2014 standardization of mortality. We investigated the standardization of work accidents, occupational diseases and their associated mortality rates in Turkey from 2010 to 2015 and it constitutes a benchmark for further studies on this issue. For better evaluation and analysis of notifications, it is important to keep records more systematically and comprehensively., Amaç: Ülkelerin durumunu göstermesi bakımından önemli konulardan olan iş kazaları, meslek hastalıkları ve buna bağlı ölüm hızları verilerini; Türkiye’de sigortalı işçiler ve işyerleri sayısına göre şehirler bazında değerlendirmeyi amaçladık.Gereç ve Yöntem: 2010-2015 yılları arasında, Türkiye Cumhuriyeti (T.C.) Sosyal Güvenlik Kurumu (SGK) istatistik yıllıklarından, şehirler bazında sigortalı işçi ve işyerleri verileri çizilmiş ve yorumlanmıştır. Karıştırıcı etkenlerin etkilerini yorumlarken kontrol edebilmek amaçlı dolaylı (indirekt) standardizasyon tekniği kullanılmıştır. Çalışma epidemiyolojik bir araştırma olup, gözlemsel-tanımlayıcı tiptedir. Sonuçlar Ulusal Mesleki Sağlık ve Güvenlik Hedefleri ile karşılaştırılmıştır.Bulgular: Madenciliğin ön planda olduğu Bilecik, Zonguldak ve Manisa illerinin iş kazaları ve meslek hastalıklarının standardizasyonunda ilk sırayı aldıkları görülmektedir. Meslek hastalıklarının standardizasyonunda özellikle son yıllarda Kütahya ve mortalitede de Güneydoğu Anadolu Bölgeleri en üst basamaklardadır.Sonuç: Soma / Manisa ve Ermenek / Karaman’daki madencilik iş kazası sonuçlarının, 2014’deki mortalite standardizasyon verilerine etki ettiği gözlenebilmektedir. Türkiye’de 2010 yılından 2015’e kadar gerçekleşen iş kazalarının, meslek hastalıklarının ve buna bağlı ölüm hızlarının standardize edilmesi işini yürütüyoruz ve bu konuda daha ileri çalışmalar yapılabilmesi için kriterler oluşturuyoruz. Daha iyi bir değerlendirme ve analiz için bildirimlerin daha sistematik ve kapsamlı tutulmasının önemli olduğu görülmektedir.

Background Intensive care units (ICUs) are noisy environments, which may have negative psychological effects on nurses. Aims and objectives To investigate the effects of the noise level of ICUs on nurses' burnout, job satisfaction, anxiety, psychological symptoms and general psychopathology level. Design A descriptive and correlational study. Methods The study was conducted with 150 intensive care nurses. A Type 2250-L Bruel & Kjaer hand-held sound level meter was used for noise measurement. A Nurse Information Form, the Maslach Burnout Inventory, Minnesora Satisfaction Questionnaire, Self-Report Inventory and Symptom Checklist-90 Revised were used for data collection. Results The highest levels of noise (71 dB(A) and above) were measured in the neonatal, neurology and cardiovascular surgery ICUs. It was observed that noise level affected extrinsic satisfaction (F = 3·704; p = 0·027) and trait anxiety (F = 3·868; p = 0·023) of nurses. Conclusions Noise levels in ICUs are well above the recommended levels, and this affects nurses' job satisfaction and anxiety levels. Relevance to clinical practice More studies on the effects of noise levels on the physical and mental states of nurses working in ICUs are needed. Increased quality of patient care can be achieved by providing healthy working conditions for nurses working in special units such as ICUs.

The study was conducted to examine the relationship between problem solving skills and personality traits of university security guards. The research was carried out with 190 security personnel working at universities in 2019. In the study, the Problem- Solving Skills Scale for Adults and the Big Five Personality Questionnaire-50 Turkish Form were used. 83.7% of the participants in the study were male, 73.2% were married, 68.4% were high school graduates, and 95.8% had in-service training. According to the logistic regression model, the results of our study were as follows: the problem solving skill ‘Considering the Effects of the Solution of the Problem’ was OR= 2.33 times (95% CI: 1.028-5.29) higher in female security guards than in males; ‘Problem- Solving Through Modeling’ was OR=0.48 times (95% CI : 0.237-0.987) higher in single security guards than married ones; and OR=2.18 times (95%CI: 1.181- 4.047) higher in ones whose ‘responsibility’ personality trait was above the median value. The problem- solving skills of the security personnel were found to be related to their personality traits, gender, marital status, working time and education level.

Background: This cross-sectional study evaluated the utility of the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classifications of epidemiological studies in terms of periodontitis severity, prevalence and associated risk factors and the 2012 American Academy of Periodontology/Centers for Disease Control and Prevention (AAP/CDC) case definitions. Methods: We included 488 participants aged 35–74 years. Measurements were recorded at six sites per tooth by two qualified examiners. The evaluated parameters included pocket depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP). Periodontitis prevalence and severity were reported using the 2018 EFP/AAP classification and the AAP/CDC case definitions. The data were stratified by recognized risk factors (age, diabetes and smoking status). Results: The 2018 EFP/AAP classification indicated that all patients suffered from periodontitis. When CAL served as the main criterion, the frequency of patients with severe (Stages III–IV) periodontitis was 54%. When the AAP/CDC case definitions were applied, the prevalence of periodontitis was 61.9% and that of severe periodontitis 16.8%. Age was the most significant risk factor, regardless of the chosen case definition. Conclusion: It is essential to employ a globalized standard case definition when monitoring periodontitis and associated risk factors.

BACKGROUND To see the relationship of early admission parameters with the type of stroke and/or with the 30-days mortality from this disease. METHODS Stroke patients at their early hyperacute phase (n = 180) were enrolled in this study (156 ischemic strokes and 24 hemorrhagic strokes). Blood levels of C-reactive protein (CRP), testosterone, and estradiol were determined at admission, before any specific intervention. Patients' clinical data, including the above-mentioned laboratory parameters, were compared between the above two stroke types (in total and between sexes). RESULTS The mean age of the patients was 69.55 ± 12.03 years old (69.92 ± 11.94 years old in ischemic stroke and 67.12 ± 12.54 years old in hemorrhagic stroke). Serum estradiol levels of both males of ischemic stroke and females of hemorrhagic stroke patients were significantly higher than the females of the ischemic stroke. Serum CRP levels of both females and males of the hemorrhagic group were higher than their peers of the opposite group. Early admission serum CRP level ≥ 0.74 mg/dL in males helped predict hemorrhagic stroke while a serum estradiol level ≥ 14.07 ng/mL helped predict the same type of stroke in females. CONCLUSIONS Our study results show that simple early laboratory measures (such as CRP and estradiol) may help in the early phase management of stroke. Further studies are needed to confirm our findings.

Objective: The work accidents are one of the biggest issues of today’s occupational lives regarding the human losts and economical losts. The humanity lost of this daily issue is pretty huge. Material and Method: At this study, it is aimed to compare the EU’s work accidents resulted with death and SSI Statistical Yearbook datas standardized number of the workers with insurances according to their work accidents, occupational diseases, and death rates from different occupational branches. Results: At the data which are achieved by indirect standardization method of SSI 2008-2017 Statistical Yearbook, it is seen that the mining industry is leading regarding work accidents, occupational diseases and death rates. Although the highest standardization rate belonged to “Activities of Domestic Employees’’ in 2008, between 2009-2017 years, the “Mining coal and lignite’’ placed always at the first place. Regarding the occupatinal disease standardization between 2008-2017 the “Mining coal and lignite’’ and “Metal mining’’ industries are placed at the top. Conclusion: It is expected to increase the feed back quantity by applying 6331th Occupational Health and Security law in the future. Hence, with the state occupational accidental feedbacks, rates would change and corrective considerations would be more efficient., Amaç: İş kazaları, günümüz mesleki yaşamlarının insan kayıpları ve ekonomik kayıplarla ilgili en büyük sorunlarından biridir. Bu sorundan kaynaklı insan kaybı oldukça yüksek sayıdadır. Gereç ve Yöntem: Bu çalışmada, Ülkemizde SGK İstatistik Yıllığı standardize edilmiş iş kazaları, meslek hastalıkları verilerinin, AB ülkelerinin ölümlü olan ve olmayan iş kazası sonuçlarının karşılaştırılması amaçlanmıştır. Bulgular: SGK 2008-2017 İstatistik Yıllığı’ndan dolaylı standardizasyon yöntemi ile elde edilen veriler değerlendirildiğinde, maden endüstrisinin iş kazaları, iş kazası ölüm oranları ve meslek hastalıkları yönünden ilk sıralarda yer aldığı görülmektedir. En yüksek standardize oran 2008 yılında “ Ev içi çalışanların faaliyetleri” ne ait olsa da, 2009-2017 yılları arasında “Kömür ve Linyit Çıkartılması” her zaman ilk sırada yer almaktadır. 2008-2017 yılları standardize edilmiş meslek hastalıkları hızlarında “Kömür ve Linyit Çıkartılması” ve “Metal Cevheri Madenciliği” endüstrileri en üst sıradadır. Tartışma: 6331’inci İş Sağlığı ve Güvenliği yasasını uygulanması ile geri bildirim miktarının artırılması beklenmektedir. Bu nedenle, devletin iş kazasıyla ilgili geri bildirimleriyle oranlar değişecek ve düzeltici hususlar daha etkili olacaktır.

Objectives: We aimed to study the effect of seasonal influenza (flu) vaccination on the susceptibility to coronavirus disease 2019 (COVID-19). Methods: A total of 203 healthcare workers of a pandemic centre of Istanbul, Turkey, were included in this retrospective study. According to the presence or absence of flu vaccination, participants were divided into group 1 and group 2. A comparison of the rate of COVID-19 was done between these two groups. Also, the mean age and the sex ratio of females/males were evaluated and compared between these two groups. Results: Group 1 participants (n = 65) were older than participants in group 2 (n = 138) (p < 0.05). Despite of this, interestingly, the COVID-19 infection rate was lower in the 1st group (in comparison to the 2nd group) (p < 0.05). Conclusion: Our study results showed that, even if low, the flu vaccination may have a protective effect on the susceptibility to COVID-19 infection. Using this beneficial adjuvant effect of the vaccine may help us in this unpredictable battle with the COVID-19 pandemic. Further studies are needed to confirm this assumption.

SARS-CoV-2, transmitted from person to person and associated with the outbreak of atypical pneumonia, first emerged in Wuhan, China. Although bats, SARS-CoV and MERS-CoV are the primary reservoirs for COVID-19, it turns out that SARS-CoV may have been transmitted from the civet in China, MERS-CoV from camels in the Middle East, and COVID-19 from the bat to humans via the pangolin (scaly anteater). SARS-CoV, MERS-CoV and SARS-CoV-2 are coronaviruses belonging to the Coronaviridae family and Betacoronavirus genus, which cause epidemiological outbreaks, are enveloped viruses with approximately 32 Kb long positive sense, ssRNA, and play a role in the pathogenesis of proinflammatory responses with high mortality rates associated with infection. The 2019-nCoV genome has 89% nucleotide identity with bat SARS-like CoVZXC21 and 82% with human SARS-CoV. ACE2 is the receptor of this severe acute respiratory syndrome coronavirus. The aim of this review is to reveal the molecular structure and genetic features of the SARS-CoV-2 virus and the clinical effects of the disease, which causes COVID-19 acute respiratory disease, and to compare it to SARS and MERS. Clarifying the specific molecular details of COVID-19 will guide researchers to the discovery of its treatment. Thus, the development of the molecular genetic methods for COVID-19 will increase our control measures against the virus in the future., İnsandan insana bulaşan ve atipik pnömoni salgınıyla ilişkili yeni bir şiddetli akut solunum sendromu koronavirüs 2 (SARS-CoV-2), Çin'in Wuhan şehrinde ortaya çıkmıştır. Yarasalar, SARS-CoV, MERS-CoV ve COVID-19 için birincil rezervuar olsa da, SARS-CoV’nin, Çin'deki misk kedilerinden, MERS-CoV’nin, Orta Doğu'daki develerden, COVID-19’un yarasadan insana pangolin (pullu karıncayiyen) aracılığıyla bulaşmış olabileceği ortaya çıkmıştır. Epidemiyolojik salgınlara yol açan koronavirüs ailesine ve betakoronavirüs cinsine ait üç insan koronavirüsü (SARS-CoV, MERS-CoV ve SARS-CoV-2) yaklaşık 32 Kb uzunluğunda pozitif anlamlı tek iplikli RNA'sı olan zarflı virüslerden olup enfeksiyonla ilişkili yüksek mortalite oranlarıyla proenflamatuar yanıtların patogenezinde rol oynamaktadırlar. 2019-nCoV genomu, yarasa SARS benzeri CoVZXC21 ile % 89 ve insan SARS-CoV'siyle % 82 nükleotid benzerliğine sahiptir. Orf1a/b, spike, zarf, membran ve nükleoproteinlerinin filogenetik ağaçları yarasa, misk kedisi ve insan SARS koronavirüslerininkiyle yakından ilişkilidir. Anjiyotensin-I dönüştürücü enzim 2 (ACE2), şiddetli akut solunum sendromu koronavirüsünün reseptörüdür. Viral protein ve ACE2 reseptörü arasındaki etkileşim, replikasyon döngüsünde önemli bir adımdır. Bu derlemenin amacı SARS ve MERS ile karşılaştırıldığında COVID-19 akut solunum yolu hastalığına neden olan SARS-CoV-2 virüsünün moleküler yapısı ve genetik özellikleriyle hastalığın klinik etkilerini ortaya koymaktır. COVID-19’un spesifik moleküler detaylarının açıklığa kavuşturulması, tedavi hedeflerine ulaşılmasında yol gösterici olacaktır. Böylelikle COVID-19 için moleküler genetik yöntemlerin geliştirilmesi gelecekte virüse karşı kontrol önlemlerimizi arttıracaktır.

Meslek hastalıkları, iş yerinde fiziksel, kimyasal, biyolojik ve psikolojik etkenlerle karşılaşan çalışanın kişisel özelliklerine bağlı olarak gelişen geçici veya sürekli hastalıklardır. Tamamen önlenebilir hastalıklardan olan meslek hastalıkları, beslenme alışkanlığı, genetik varyasyonlar, sigara ve alkol kullanımı, obezite gibi bir çok faktöre bağlı olarak ortaya çıkmaktadır. Meslek hastalıklara karşı duyarlılıkta popülasyondaki kişisel farklılıkların belirlenmesini sağlayan hastalığa yatkınlık nedeni olan genetik polimorfizmlerin bir kısmı hastalık riskini arttırırken, bir kısmı da azaltabilmektedir. Bu derlemenin amacı; meslek hastalıklarına yatkınlıkla ilgili genetik polimorfizm profilleri kullanılarak genlerin ve polimorfizmlerin belirlenmesiyle hastalıklara yatkınlık taraması yapılmasının ve hastaların genotipine uygun bireysel tedavi seçeneklerinin geliştirilmesinin olası yararlarını araştırmaktır. Genel popülasyondaki yüksek prevalansları nedeniyle, çevresel risklere duyarlılığı belirleyen genetik polimorfizmler, işyerinde ortaya çıkan spesifik risklerin belirlenmesiyle mesleki hastalıkların tespitine büyük katkı sağlayabilirler. Korunma önlemleri yeterince alınmayan iş yerlerinde, genetik olarak yatkınlık taşıyan kişilerde, duyarlılaştırıcı özellik taşıyan etkenlerle yoğun ve uzun süreli temasta riskin artacağı açıktır. İşyerinde genetik duyarlılıkları araştıran çalışmalar, hastalığın etiyolojisinin, özellikle de çevreye duyarlı genlerin belirlenmesini; maruz kalma açısından hassas alt popülasyonların tanımlanmasını; genetik duyarlılığı göz önünde bulundurarak mesleki maruz kalma sınırlarının belirlenmesinde faydalı veriler sağlamaktadır. Genetik duyarlılık polimorfizmlerinin hastalık riskini belirlemede açık bir rolü olsa bile, çalışma ortamlarındaki geniş ölçekli genetik taramanın değeri, etik ve sosyal kaygılar nedeniyle sınırlı kalmaktadır. Bu nedenle, işyerlerinde büyük ölçekli genetik tarama yapılması şu anda önerilmemektedir.&nbsp, Occupational diseases are transient or permanent and completely preventable diseases that occur due to many factors (feeding habits, genetic variations, obesity etc) that develop depending on the personal characteristics of the employees who encounter physical, chemical, biological and psychological factors at work. Some of the genetic polymorphisms may increase the risk of disease while others may reduce it. The aim of this review is to investigate the possible benefits of susceptibility screening for diseases by identifying genes and polymorphisms, using genetic polymorphism profiles related to occupational disease susceptibility, and developing individual treatment options appropriate to the genotype of the patients. Genetic polymorphisms that determine susceptibility to environmental risks can contribute greatly to the identification of occupational diseases by identifying specific risks in the workplace. It is evident that the risk of intense and prolonged contact with sensitizing agents will increase in genetically susceptible individuals. Studies investigating genetic susceptibilities in the workplace determine the etiology of the disease, environmentally sensitive genes and identify sensitive subpopulations; providing beneficial data for determining occupational exposure limits considering genetic sensitivity. The value of large-scale genetic screenings in work environments remains limited due to ethical and social concerns. Therefore, large-scale genetic screening in workplaces is not currently recommended.

DOI : 10.26650/IUITFD.391782 Amac: Bu calisma, isleri geregi pestisitleri kullanan ilaclama calisanlarinda hipertansiyon sikligini tespit etmek ve hipertansiyonu etkileyebilecek diger faktorleri incelemek amaciyla yapilmistir. Gerec ve Yontem: Calismamiz Ocak-Haziran 2014 tarihleri arasinda Istanbul Buyuksehir Belediyesi’ne bagli bulunan bir ilaclama merkezinde yapilmistir. Katilmayi kabul eden tum ilaclama calisanlari, calismaya dahil edilmistir. Calisma kapsamina alinan kisilerin tumunde fizik muayene ve tansiyon olcumleri yapilmistir. Calisanlarin yaslari, egitim duzeyleri, sigara icme aliskanliklari ve hipertansiyon oykuleri hakkinda bilgiler yuz yuze gorusme yoluyla elde edilmistir. Yas, calisma suresi, vucut Kitle Indeksi (VKI) ve bel cevresinin hipertansiyon ile analizinde normal dagilim gosteren degiskenler icin bagimsiz gruplarda t testi, normal dagilim gostermeyenler icin de Mann-Whitney U testi kullanildi. Bulgular: Calisma kapsamina 370 erkek ilaclama calisani alindi. Calisanlarin yas ortalamasi 37,8±8,1 (min 20,0 , max 64,0), calisma suresi ortalamasi ise 4,4±2,4 (min 0,1, max 14,0) iken VKI’leri 30,9±4,3 (min 20,3, max 45,2) dir. Calisma kapsamina alinan kisilerin 134‘unde (%36.2); (%95 GA: %31,5-%41,2) hipertansiyon tespit edildi. Hipertansiyon tespit edilen calisanlardan 12’si (%9) daha once bir hekim tarafindan hipertansiyon tanisi almisti. 122 katilimci (%32,9):(%95 GA:%28,4-%37,9) ise hipertansiyonu oldugunun farkinda degildi. Calisma grubunda hipertansiyonu tespit edilenlerin yas, VKI ve bel cevresi ortalamalari hipertansiyonu olmayanlara gore istatistiksel olarak anlamli derecede yuksek bulundu (tum degiskenlerde p

BACKGROUND Studies on real-life adherence to subcutaneous allergen immunotherapy (SCIT) for respiratory allergy are scarce. The aim of this study was to evaluate adherence to SCIT. METHODS The patients prescribed SCIT for allergic rhinitis and/or asthma in 2009-2011 were contacted in 2014 and asked whether they completed at least the 3 years of SCIT and/or whether they suspended the treatment for at least 2 months. The Total Symptom Score-6, visual analog scale (VAS), asthma control test (ACT), medication scores, quality of life (QoL) scores, and immunotherapy satisfaction scores with VAS obtained before the initiation of SCIT in the first year and at the end of SCIT were compared. RESULTS A total of 204 patients (136 female [66.7%]; mean age, 38.83 ± 12.02 years) were included; 73% (149/204) were both compliant and persistent; 14% (29/204) were only persistent; and, overall, 87.3% (178/204) were considered adherent. Adherence was more frequent in female patients (95% CI, 62.3-76.3%; p = 0.018). Medication, symptom, ACT, and QoL scores in the first year and at the end of the treatment were significantly lower than the initial scores, and the immunotherapy satisfaction scores at the end of treatment were higher than the scores in the first year in the patients who were adherent (p < 0.001 for each score). CONCLUSION The adherence rate to SCIT in our study was relatively high, in contrast to previous real-life data. Results of our study indicated that a close relationship between allergists and their patients during SCIT and the follow-up period in the same center improved the outcome of SCIT.

Amaç: Blastocystis spp. neden olduğu klinik semptomlar nedeniyle günümüzde önem kazanan enterik bir protozoondur. Prevalansı dünyanın farklı bölgelerinde değişmekle birlikte gelişmekte olan ülkelerde daha sık görüldüğü bildirilmektedir. Bugüne kadar insanlarda 9 Blastocystis spp. alt tipi saptanmıştır ve bu örneklerin farklı klinik semptomlar ile ilişkili olabileceği öne sürülmüştür.Yöntem: Bu çalışmada formol-etil asetat yöntemi ile Blastocystis spp. varlığı saptanan 50 semptomatik hastadan elde edilen izolatlarının iki farklı besiyerinde kültürleri yapılmış, bu izolatların alt tip dağılımı sekanslama yöntemi ile belirlenmiş, alt tipler ile klinik bulgular arasındaki ilişkiler incelenmiştir.Bulgular: Örneklerden 40 (%80)’ı her iki besiyerinde de üremiş, 5 (%10)’i iki besiyerinde de ürememiş, 5 (%10) örnek ise iki besiyerinden sadece birinde üremiştir. 39 (%78) örnekte tek bir alt tip saptanırken, 11 (%22) örnekte birden fazla alt tip varlığı saptanmıştır. Örnekler arasında en sık ST3 saptanırken bunu sırasıyla ST1, ST5, ST2 ve ST4 takip etmiştir. Karın ağrısı 23 (%46) hastada olmak üzere en sık rastlanan klinik semptom olup, allerjik semptomlar ise 17 (%34) hastada gözlenmiştir. Bunun dışında hastalarda çeşitli gastrointestinal semptomlar ve eklem ağrısı varlığı da gözlenmiştir. Klinik semptomlar ile alt tipler arasında anlamlı bir ilişki saptanamamıştır.Sonuç: Çalışmamızda, gastrointestinal ve allerjik semptomları olan hastalarda ST3 alt tipi en sık saptanmıştır. Ayrıca her ne kadar az sayıda olgu bildirilmiş olsa da bir hastada eklem ağrısı saptanmış olması Blastocystis spp.’nin artrit ile ilişkisi olabileceğini ve klinisyenler tarafından göz önünde bulundurulması gerektiğini düşündürmektedir. Her ne kadar çalışmamızda klinik bulgular ile alt tipler arasında anlamlı bir ilişki bulunamamış olsa da Blastocystis spp. alt tiplerinin, klinik bulgularla ilişkilerinin anlaşılması için daha fazla araştırmaya ihtiyaç vardır.

To compare the efficacy of intermittent and consecutive balneological outpatient treatment (hydrotherapy and peloidotherapy) in fibromyalgia syndrome (FMS). A parallel 1:1, single-blind, pilot study was performed. Patients were recruited from musculoskeletal disorders outpatient clinic. Eligible participants were patients aged 18–60, diagnosed as FMS according to ACR 2010 criteria. They were randomly assigned to either consecutive or intermittent treatment groups. Both groups received 20 min of full body immersion in a tap water pool at 38–39 °C and 30 min of mud pack application on the back region at 45 °C. Delivery of the treatment was five times weekly during 2 weeks in consecutive group and two times weekly during 5 weeks in intermittent group. The primary outcomes were pain intensity and the number of patients achieving a minimal clinically important difference (MCID) on Fibromyalgia Impact Questionnaire (FIQ) at the 1st month after the completion of the treatment. Statistical analyses were based on intention to treat method. The assessing physician was blinded. Pain intensity significantly decreased in all post-treatment evaluations of both groups (except after treatment in the intermittent group). There was no significant difference between the groups. MCID for FIQ was achieved in 6 (24%) patients in the consecutive group and 12 (48%) in the intermittent group at the 1st month. There was no statistical difference in the secondary judgment criteria. The consecutive and intermittent deliveries of balneological outpatient treatment (hydrotherapy and peloidotherapy) seem to have similar effects on the clinical status of patients with FMS.

Amaç: Tanımlayıcı ve ilişki arayıcı tipteki bu araştırma hemşirelerde iş güvenliğini bazı değişkenler yönünden incelemek amacı ile yapıldı. Materyal-Metot: Araştırmanın örneklemini bir üniversitenin farklı iki hastanesinde çalışan ve araştırmaya istekli ve gönüllü olan toplam 1072 hemşire oluşturdu. Araştırmanın verileri “Hemşire Bilgi Formu ve İş Güvenliği Ölçeği” ile toplandı. Bulgular: Araştırmaya katılan hemşirelerin yaş ortalaması 35,43±8,85 yıl olup çoğunluğunu (%94,6) kadın hemşireler oluşturdu. Hemşirelerin %61,8’inin evli, %65,1’inin lisans mezunu olduğu belirlendi. Hemşirelerin “Mesleki hastalıklar ve şikâyetler” alt boyutu toplam puan ortalamasının 1,65±0,65; “Sağlık taraması ve kayıt sistemleri” alt boyutu toplam puan ortalamasının 2,43±1,08; “Kazalar ve zehirlenmeler” alt boyutu toplam puan ortalamasının 2,53±1,18; “Yönetsel destek ve yaklaşımlar” alt boyutu toplam puan ortalamasının 1,95±0,88; “Malzeme, araç ve gereç denetimi” alt boyutu toplam puan ortalamasının 2,63±1,22; “Koruyucu önlemler ve kurallar” alt boyutu toplam puan ortalamasının 3,09±1,34; “Fiziksel ortam uygunluğu” alt boyutu toplam puan ortalamasının 2,34±1,26; İş Güvenliği Ölçeği toplam puan ortalamasının ise 2,23±0,72 (Min.=1-Mak.=5) olduğu belirlendi. Hemşirelerin iş kazası geçirme durumu ile iş güvenliğinin tüm alt boyutları ve toplam iş güvenliği puan ortalamaları arasında istatistiksel anlamlılıkla farklılıklar saptandı (p

INTRODUCTION Patients with pulmonary hypertension (PH) show no symptoms at rest, but symptoms are triggered by physical activities. OBJECTIVES The primary aim of our study was to assess physical activity of patients with PH by using an activity monitor. The secondary aim was to evaluate the correlation between the activity monitor parameters and 6-min walk distance (6MWD), activity of daily living (ADL), quality of life, WHO functional class and PH classification. METHODS Thirty-eight patients with pulmonary arterial hypertension (PAH) and seven patients with chronic thromboembolic PH were included in the study. Physical activity was assessed using a SenseWear arm band. A 6-min walk test was performed. Daily living activities were assessed using the 'nottingham extended activity of daily living index' (NEADL). For quality of life assessments, 'Minnesota living with heart failure' (MLHF) and 'Short form-36' (SF-36) surveys were used. RESULTS Physical activity, exercise capacity, quality of life and contribution to ADL were lower in patients with PH. These data were associated with the 6MWD, quality of life and ADL index scores. We also found weak and moderate correlations between activity monitor data and SF-36 sub-group scores, MLHF and NEADL scores (P

Introduction Conflicting results has been achieved in a small number of clinical studies evaluating the efficiency of magnesium sulphate (MS) in COPD exacerbations. We aimed to investigate the efficiency of nebulised MS in COPD exacerbations. Patients and methods Twenty patients who met the study criteria were randomized into two groups. All patients were treated with O2, antibiotics and oral corticosteroids. Additionally one group received ipratropium bromide (IB) 500 µg together with MS 151 mg/dose, while the other group received IB together with placebo. The patients were followed-up with forced expiratory volume in 1 second (FEV1) and visual analogue scale dyspnea scores for 48 hours. Peak expiratory flow rates (PEFRs) were measured before and 10, 30, 60 and 120 minutes after each nebule treatment. Result The baseline characteristics of the patients in both groups were similar. The FEV1 values measured at 24 and 48 hours did not show significant changes compared to baseline in both groups. Dyspnea scores in both groups decreased significantly in the first day, and in only MS group in the second day. The % change in the dyspnea score at the end of first day was significantly more in the MS group [-23.8% (13.6)] compared with the placebo group [-9.4% (12.9)] (p= 0.002). The % changes in PEFRs at 10 minutes [4.7 (7.5) and -3.5 (6.0), p= 0.005] and 30 minutes [8.2 (6.7) and 1.3 (5.5), p= 0.03] were significantly greater in the MS group compared with the placebo group on the first day. No side effects developed due to MS. Conclusion Nebulised MS is a cheap, feasible and safe drug that can be added to the standart bronchodilator treatment since it provides additional relief of dyspnea in patients with COPD exacerbations. This needs to be evaluated in future clinical studies including greater number of patients.

Objective: Analyzing mortality rates and the reasons for these in Turkey's urban allocations using geographic information systems (GISs) is a new research area. While planning health services, knowing the mortality rates and reasons according to age and residential area are a big source of information for health planners and people who provide health services. The aim of this research is to analyze the deaths of children under the age of 5 years in big cities depending on a socioeconomic range using GIS. Further, this should make it possible to determine geographically risky places. Materials and Methods: The deaths of children under the age of 5 years that occurred between 2005 and 2009 were analyzed. Date from the Turkish Statistical Institute (Turk Stat) concerning population and age-specified deaths, İstanbul Metropolitan Municipality (IMM) cemetery directorate death records, and the Ministry of Finance land unit prices (to determine the socioeconomic level of the districts) were used as data resources. The Z value of each year's death rate, depending on the districts age ranges and average of all years' Z values, was calculated and is shown on the map.Results: While the under-5 mortality rate was 19.37 per 1000 in 2005, it was 14.31 per 1000 in 2009. Deaths of children under the age of 5 years took place particularly in Istanbul on the European side (in districts where the land value is low).Conclusion: Priority should be given to health promotion programs in areas with a low socioeconomic level in particular where premature death rates are observed to be more common. Objective: Analyzing mortality rates and the reasons for these in Turkey's urban allocations using geographic information systems (GISs) is a new research area. While planning health services, knowing the mortality rates and reasons according to age and residential area are a big source of information for health planners and people who provide health services. The aim of this research is to analyze the deaths of children under the age of 5 years in big cities depending on a socioeconomic range using GIS. Further, this should make it possible to determine geographically risky places. Materials and Methods: The deaths of children under the age of 5 years that occurred between 2005 and 2009 were analyzed. Date from the Turkish Statistical Institute (Turk Stat) concerning population and age-specified deaths, İstanbul Metropolitan Municipality (IMM) cemetery directorate death records, and the Ministry of Finance land unit prices (to determine the socioeconomic level of the districts) were used as data resources. The Z value of each year's death rate, depending on the districts age ranges and average of all years' Z values, was calculated and is shown on the map.Results: While the under-5 mortality rate was 19.37 per 1000 in 2005, it was 14.31 per 1000 in 2009. Deaths of children under the age of 5 years took place particularly in Istanbul on the European side (in districts where the land value is low).Conclusion: Priority should be given to health promotion programs in areas with a low socioeconomic level in particular where premature death rates are observed to be more common.

Objective: We aimed to investigate the role of autoimmunity in the etiopathogenesis of alopecia areata (AA) and the effects of the coexisting autoimmune diseases on the prognosis of AA. Methods: The records of 134 AA patients diagnosed in the dermatology and venereology outpatient clinic were retrospectively analyzed for the history of concomitant autoimmune disease and the family history for autoimmune diseases. Results: Of the 134 patients, 79 were males, 55 were females. The rate of autoimmune disease was 16.4%. The rate of autoimmune disease was found significantly higher in the females (p=0.034) and in the patients with a positive family history of autoimmune disease (p=0.011). No significant relationship was found between the coexistence of an autoimmune disease and the duration, type, severity of the disease, age at disease onset, nail involvement, atopy, nevus flammeus and family history of AA. The rate of the family history of autoimmune disease within the AA patients was 16.4%. Conclusion: The high rate of autoimmune disease in AA, prominent high rate of autoimmune disease in females, high rate of family history of autoimmune disease might prove the role of the autoimmunity in the etiopathogenesis of AA and suggested AA as an autoimmune disease. The coexistence of the autoimmune disease in AA has no relationship with poor prognosis.

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) have been used to diagnose new-onset diabetes mellitus (DM) in order to simplify the diagnostic tests compared with the 2-hour oral glucose tolerance test (OGTT; 2-hPG). We aimed to identify optimal cut-off points of high sensitive C-reactive protein (hs-CRP) in new-onset DM people based on FPG, 2-hPG, or HbA1c methods. Data derived from recent population-based survey in Turkey (TURDEP-II). The study included 26,499 adult people (63% women, response rate 85%). The mean serum concentration of hs-CRP in women was higher than in men (p<0.001). The people with new-onset DM based on HbA1c had higher mean hs-CRP level than FPG based and 2-hPG based DM cases. In HbA1c, 2-hPG, and FPG based new-onset DM people, cut-off levels of hs-CRP in women were 2.9, 2.1, and 2.5 mg/L [27.5, 19.7, and 23.5 nmol/L] and corresponding values in men were 2.0, 1.8, and 1.8 mg/L (19.0, 16.9, and 16.9 nmol/L), respectively (sensitivity 60–65% and specificity 54–64%). Our results revealed that hs-CRP may not further strengthen the diagnosis of new-onset DM. Nevertheless, the highest hs-CRP level observed in new-onset DM people diagnosed with HbA1c criterion supports the general assumption that this method might recognize people in more advanced diabetic stage compared with other diagnostic methods.

Temporomandibular eklemin (TME); internal düzensizlikleri; diskin mandibular kondil ve temporal kemikteki artikuler fossa ile olan normal konumundan uzaklaşması ile meydana gelir. İnternal düzensizlik basit eklem seslerinden kilitlenmeye ve ağrıya kadar giden semptomlar gösterir. Bu yazının amacı; Gow Gates anestezi tekniği ile birlikte intrakapsüler lokal anestezi enjeksiyonun artrosentez esnasında hasta konforu üzerine etkisini incelemektir. Artrosentez işlemi konservatif yöntemlere yanıt vermeyen 24 hastada uygulanmıştır. Sonuç olarak; artrosentez esnasında hasta konforunu arttırmak için kontrollü randomize klinik çalışmalara ihtiyaç olduğunu düşünmekteyiz. İnternal düzensizlikler; TME'nin en yaygın rahatsızlıklarındandır. Hastanın günlük hayatını, ağrı, disfonksiyon, eklem sesi ve hatta aural semptomları değiştirerek etkiler Internal derangement of the temporomandibular joint (TMJ) can be defined as a disorder of the intracapsular components of the joint, which is originated by displacement of the disc from its normal functional relationship with the condyle of the mandible and the temporal bones articular fossa. The most common symptoms of temporomandibular joint internal derangement vary from simple joint sounds to locking and pain. The aim of this case series is to evaluate the effects of GowGates anaesthesia technique, which blocks the auriculotemporal nerve, in combination with an intracapsular local anaesthetic injection, on patient comfort during artrocenthesis. 24 patients had arthrocentesis due to temporomandibular disorder complaints. We suggest that further studies might give more information about the patient comfort during artrocenthesis. Internal derangement of the temporomandibular joint (TMJ) the most common form of temporomandibular disorders. It affects patient's daily life with pain, dysfunction, joint sounds, and even aural symptoms

43rd Annual VEITH Symposium / Meeting of the International-Society-for-Vascular-Surgery (ISVS) -- NOV 15-19, 2016 -- New York, NY Karpuzoglu, Eren/0000-0003-0113-7589; WOS:000456077800004 PubMed: 29963797 BACKGROUND: Endovascular treatment of symptomatic peripheral artery disease has gained widespread acceptance. The efficacy and safety of drug-coated balloon (DCB) angioplasty in the setting of critical limb ischemia in comparison to conventional surgery has not been demonstrated. We have compared our results with DCB angioplasty to conventional bypass surgery in patients with critical limb ischemia (CLI). METHODS: A total of 187 patients with CLI treated over a 6-year period between 2006 and 2012 by a single operative team constituted the study population. Between 2006 and 2009, all patients underwent conventional surgery. Between 2009 and 2012, the investigators adopted endovascular approach with the use of IN. PACT Admiral (Medtronic Inc., Santa Rosa, CA, USA). Data collection was achieved prospectively. RESULTS: A total 210 procedures (100 surgery, 110 endovascular) were performed over a 6-year period. A 72% of all bypasses were performed using saphenous vein grafts with above-the-knee bypass as the technique of choice in 80% of the cases. 6-mm DCB was used in 41% of the patients. Procedural success rates (98% vs. 99%, NS) as well as clinical success rates (99% vs. 99%, P=NS) and operative mortality (3.7% vs. 2%, NS) was similar in both groups. Primary patency for DCB vs. bypass groups 91.8% vs. 88.9%, respectively (P=0.31) at 12 months and 82.7% vs. 82.8% at 24 months, respectively (P=0.28). Freedom from clinically-driven target lesion revascularization at 12 months was similar in both groups (87.6% vs. 85%, P=0.33). Primary patency for DCB vs. bypass groups at 24 months was 82.7% vs. 82.8%, respectively (P=0.28). CONCLUSIONS: DCB angioplasty yields comparable results to surgery in the setting of critical ischemia. The efficacy and the safety of DCBs in more complex lesions is to be investigated with randomized trials. VEITH, Int Soc Vasc Surg

Objective: The aims of this study are to evaluate if occlusal types affect the type of temporomandibular disorders and if the onset of complaints are related to the type of internal derangements. Methods: One hundred thirty-four patients were evaluated. Occlusion types were grouped as Angle Class I, II, and III. The temporomandibular disorders were classified as masticatory muscle disorders, anterior disc dislocation with reduction, and anterior disc dislocation without reduction. Results: No significant relationships were found between the occlusion types, pain severity, the onset of the complaints, and the temporomandibular disorders. Premature contacts were found to be significantly higher in Class II and Class III patients, but no significant relations were found between premature contacts and temporomandibular disorders. Discussion: Occlusal features are not discriminant factors in the occurrence of temporomandibular disorders. Also, it cannot be concluded that the longer the patients have temporomandibular disorders, the higher their pain scores will be.

OBJECTIVE Parathyroid hormone (PTH) enhances bone healing. Strontium ranelate (SR) is an antiresorptive agent that increases bone formation. Reports about combined effects of PTH and SR on local bone regeneration in osteoporotic subjects are limited. We aimed at investigating the efficacy of PTH and SR for promoting new bone formation in critical-sized defects of ovariectomized rats. MATERIALS AND METHODS Parathyroid hormone- and/or SR-containing poloxamer implant tablets with/without chitosan microparticles were delivered locally to calvarial defects of 90 Wistar rats. Biopsies were analyzed histologically and histomorphometrically at 4 and 8 weeks of healing. RESULTS Histomorphometry revealed that PTH alone promoted new bone formation at 4 weeks but the efficiency declined in 8 weeks. There was no positive effect of SR alone on bone formation at 4 or 8 weeks. Calvarial defects treated with PTH+SR combinations showed statistically significant greater new bone formation than either treatment alone at both time intervals. Tissue responses were modest and supported the good biocompatibility of the biomaterials used. CONCLUSION Parathyroid hormone and SR combinations can be effective for calvarial bone regeneration of ovariectomized rats. PTH plus SR may have potential use as bone graft material in orthopedic and dental surgery to enhance bone healing and osseointegration.

ABALI, SAYGIN/0000-0001-6552-2801; Turan, Serap/0000-0002-5172-5402; Hatun, Sukru/0000-0003-1633-9570; Akgun, Abdurrahman/0000-0002-2917-2469; yesiltepe mutlu, gul/0000-0003-3919-7763; Ozgen, Ilker Tolga/0000-0001-6592-9652 WOS: 000451667000006 PubMed: 29789274 Objective: To assess the incidence of type I diabetes mellitus (T1DM) in children under 18 years of age in the northwest region of Turkey during 2013-2015. Methods: All newly diagnosed T1DM cases were recorded prospectively during 2013-2015. Total, as well as gender and age group specific (0-4, 5-9. 10-14 and 15-17 age) mean incidences per 100,000 per year were calculated. Results: There were 1,773 patients diagnosed during 2013-2015 (588 cases in 2013, 592 cases in 2014, 593 cases in 2015). Of these, 862 (48.6 %) were girls and 911 (51.4%)were boys. The mean age at diagnosis was 9.2 +/- 4.2 years and it was not significantly different between girls (9.0 +/- 4.1 years) and boys (9.4 +/- 4.4 years) (p = 0.052). The crude mean incidence was 8.99/100.000 confidence interval (CI) (95% CI: 8.58-9.42). Although mean incidence was similar between boys [8.98/100.000 (CI: 8.40 to 9.58)] and girls [9.01/100.000 (CI: 8.42 to 9.63)], there was male predominance in all groups except for 5-9 year age group. The standardized mean incidence was 9.02/100.000 according to the World Health Organization standard population. The mean incidence for the 0-4, 5-9, 10-14 and 15-17 age groups was 6.13, 11.68, 11.7 and 5.04/1 00.000 respectively. The incidence of T1DM was similar over the course of three years (p = 0.95). A significant increase in the proportion of cases diagnosed was observed in the autumn-winter seasons. Conclusion: The northwest region of Turkey experienced an intermediate incidence of T1DM over the period of the study.

Patent vascular access is critical for patients on regular hemodialysis. Prosthetic grafts are good alternatives when the superficial venous system is of poor quality. However, thrombosis is one of the main drawbacks of synthetic grafts, with reports of 59% to 90% patency rates for 1 year. In cases of thrombotic occlusion of prosthetic arteriovenous fistula grafts, percutaneous mechanical thrombectomy has recently gained clinical popularity as a potential alternative to surgical thrombectomy or pharmacologic thrombolysis. We reviewed our preliminary results from 30 percutaneous rotational thrombectomies performed in a total of 22 patients in the setting of acute dialysis–access prosthetic graft occlusion of the upper extremity. Among the 30 cases of acute occlusion of the arteriovenous graft, immediate success with angiographic flow restoration was observed in all patients except for 2 patients (both females; 6%), with de novo occlusion where reocclusion occurred within 12 hours despite apparent immediate angiographic patency. The mean duration between the initial presentation with acute arteriovenous graft occlusion and the thrombectomy procedure was 27.4 ± 12.4 hours. The mean duration of graft patency was 10.45 ± 0.6 months. A total of 75% of the arteriovenous grafts were patent at the end of 12 months of follow-up. Female gender, diabetes mellitus, and diagnosis to intervention interval were reviewed for midterm graft failure, and the presence of diabetes mellitus yielded significance (P < 0.05). Percutaneous techniques play important roles in the treatment of failed or failing arteriovenous fistulae and grafts. Ongoing analysis of outcomes of both percutaneous and surgical intervention is necessary to continue to identify optimum treatment algorithms.

Purpose: To evaluate the effect of hormone replacementtherapy(HRT) on periodontal treatment outcomes ina group of postmenopausal women with periodontitis.Materials and Methods: 23 post-menopausalchronic periodontitis patients were included in thisstudy. The test group(n=11) consisted of womenwho started HRT with this study and receivedconjugated estrogen and medroxyprogesteron. Thecontrol group(n=12) was women not taking any HRTor supplement therapy. Study groups received thesame periodontal treatment. All subjects examiendby recording the following: plaque index (PI), sulcusbleeding index (SBI), periodontal pocket depth (PD)and relative attachment level (RAL) from 6 sites ineach tooth. Measurements were recorded at thebaseline, 1 month, 3 months, and 6 months followingperiodontal treatment. Serum estrogene level andbone mineral density was recorded at baselineand 6 months following periodontal treatment.Results: The GI change was greater in thecontrol group. There wasn’t significant differenceby means of PD, the attachment gain wassignificantly greater in the HRT receiving group.Conclusion: HRT seems to have a positiveeffect on periodontal treatment outcomes., Amaç: Bu çalışmanın amacı periodontitisli postmenopozal kadınlarda postmenopozal hormon tedavisinin (PHT), periodontal başlangıç tedavisi sonuçları üzerindeki etkilerini incelemektir.Gereç ve Yöntem: 23 kronik periodontitisli daha önce hormon tedavisi görmemiş olan postmenopozal kadın çalışmaya dâhil edilmiştir. Deney grubuna (n=11) konjuge östrojen ve medroxyprogesteron kullandırılmış, kontrol grubuna(n=12) herhangi bir hormon tedavisi verilmemiştir. Çalışmadaki tüm bireyler bireylere aynı periodontal başlangıç tedavisi uygulanmıştır. Plak indeksi(PI), dişeti oluğu kanama indeksi (DOKİ), sondalanabilir cep derinliği (SD), rölatif ataşman düzeyi (RAD) ölçümleri başlangıçta, 1., 3., ve 6. aylarda, serum östrojen düzeyi, sistemik kemik yoğunluğu ölçümleri başlangıçta ve 6. ayda gerçekleştirilmiştir. Bulgular: DOKİ, kontrol grubunda daha fazla değişim göstermiştir. SD açısından gruplar arasında fark yoktur. PHT kullanmakta olan kadınlarda klinik atasman kazanci daha fazla bulunmuştur. Sonuç: PHT kullanımının periodontal tedavi sonuclarina olumlu katki sağladığı söylenebilir

Background and Design: Alopecia areata (AA) is characterized by non-scatricial hair loss with exacerbations and remissions. Although its etiopathogenesis is not known, autoimmune factors have been suggested. Our aim was to make contribution to the epidemiological properties of AA in Turkey, and to determine the bad prognostic factors that affect the course of the disease. Materials and Methods: One hundred and thirty-four patients who applied to the Dermatology and Venereology Polyclinic in Istanbul Medical Faculty, Istanbul University were included in the study. The patients were investigated retrospectively in terms of the age, gender, clinical type, involved area of alopecia, severity of the disease, number of relapses, disease duration, age at disease onset, presence of nevus flammeus, nail involvement, history of emotional and/or physical stress, history of AA within the family, and history of atopia within the patients and their relatives. Results: Of the 134 patients, 79 (59 percent) were male, 55 (41 percent) were female and M/F: 1.4/1. The clinical type was AA in 86.5%, alopecia totalis (AT) in 3.7% and alopecia universalis (AU) in 9.7% of the cases. The most common involment was the scalp in both genders and clinically 92.1% was patchy. Severe involvement was found significant in the female patients (p=0.029), in the juvenile onset (p=0.001), in ≥1 year of disease duration (p=0.001), in the presence of nevus flammeus (p=0.017) and in the nail involvement (p=0.015). In the 27.6% of the cases, the family history of AA was present and that was higher in the juvenile group (p=0.034).There was no association between the severity of the disease and atopia. Conclusion: Alopecia areata follows a more severe course in the female patients, juvenile onset patients, patients with nail involvement, patients with nevus flammeus, patients with long disease duration, and patients with the family history of AA than the others.

OZ Amac: Bu calismada tromboprofilaksi uygulanan yogun bakim hastalarinda venoz tromboembolizm prevalansi ve insidansi arastirildi. Ca­lis­ma­ pla­ni:­ Medikal-cerrahi yogun bakim unitesine kabul edilen ≥18 yasinda ve ≥72 saat yogun bakimda kalmasi planlanan 74 ardisik hasta (34 kadin, 40 erkek; (ort. yas 55.8±19.4 yil; dagilim 20-86 yil) calismaya dahil edildi. Demografik veriler, Akut Fizyolojik ve Kronik Saglik Degerlendirmesi II skoru, baslangic ve zaman bagimli derin ven trombozu (DVT) risk faktorleri kaydedildi. Iki tarafli alt ekstremite kompresyon ultrasonografi haftada iki kez ve yogun bakimdan ciktiktan bir hafta sonra uygulandi. Yogun bakim yatisi suresince DVT suphesi oldugunda, kompresyon ultrasonografi tekrarlandi. Hastalarin tumune dusuk molekul agirlikli heparin veya mekanik tromboprofilaksi uygulandi. Ayrica, her gun fizyoterapist tarafindan tum hastalara pasif ekstremite egzersizleri uygulandi. Bul gu lar: Ortalama Akut Fizyolojik ve Kronik Saglik Degerlendirmesi II skoru 17±6.1 idi. Yogun bakima kabulde DVT prevalansi %2.7 (CI %95; 3.3-9.42) idi. Hastalarin %89.1’ine dusuk molekul agirlikli heparin, %10.9’una mekanik tromboprofilaksi uygulandi. Yogun bakim yatisi suresince yeni DVT veya pulmoner emboli saptanmadi. So­nuc:­ Yogun bakim unitesinde DVT prevalansi %2.7 olmasina ragmen, uygun ve etkili tromboprofilaksi yogun bakim yatisi suresince yeni DVT gelisimini onledi. Anah­tar­soz­cuk­ler: Derin ven trombozu; yogun bakim unitesi; fizyoterapi; pulmoner emboli; tromboprofilaksi. ABSTRACT Background:­This study aims to investigate the prevalence and incidence of venous thromboembolism in intensive care unit (ICU) patients receiving thromboprophylaxis. Methods: Seventy-four consecutive patients (34 females, 40 males; mean age 55.8±19.4 years; range 20-86 years) admitted to the medical-surgical ICU, who were ≥18 years old and expected to stay in ICU for ≥72 hours, were included. Demographic data, Acute Physiology and Chronic Health Evaluation II scores, baseline and time-dependent deep vein thrombosis (DVT) risk factors were recorded. Bilateral lower extremity compression ultrasound was performed twice weekly, and one week after discharge from ICU. If DVT was suspected at any time during ICU stay, compression ultrasound was repeated. All patients were administered low molecular weight heparin or mechanical thromboprophylaxis. Also, passive extremity exercises were applied by physiotherapist to all patients every day. Results:­ Mean Acute Physiology and Chronic Health Evaluation II score was 17±6.1. The prevalence of DVT was 2.7% (CI 95% 3.3-9.42) on ICU admission. Of the patients, 89.1% were administered low molecular weight heparin, and 10.9% were administered mechanical thromboprophylaxis. We did not detect new DVT or pulmonary embolism during the ICU stay. Conclusion:­Although DVT prevalence in ICU was 2.7%, appropriate and effective thromboprophylaxis prevented the development of new DVT during ICU stay.

The aim of this study was to investigate the role of transglutaminase 2(TG2) in renal cell carcinoma (RCC) by comparing the immunohistochemistry staining of primary and metastatic tumor tissues. A total of 33 metastatic RCC(mRCC) and 33 non-metastatic RCC (nmRCC) patients who were matched as closely as possible based on gender, age, nuclear grade and pathologic T stage were retrospectively investigated. TG2 immunohistochemistry staining was performed on paraffin-embedded primary tumor tissues from both patient groups and on metastatic tissues from mRCC patients. The tissues were scored from 0 to 7 according to the TG2 staining. Furthermore, the patients were stratified into two groups using median primary tumor staining score as the cutoff value: Group 1 (high risk, n = 41) and Group 2(low risk, n = 22). The clinical, histopathological and survival outcomes were compared between these risk groups using Chi-square test, t test, Mann–Whitney U test and Kaplan–Meier survival analyses. The median TG2 score for primary tumor was 5 for the entire study population. The median primary tumor TG2 score of the mRCC patients was significantly higher compared to the nmRCC patients (6 vs. 4, p

This study aimed to investigate whether the irritants used in bread and plastic industry cause irritation in the respiratory tract to determine the benefits of adding FeNO measurement method to periodical controls in various business branches. Our cross-sectional study was carried out 88 workers in the plastics and bread sectors in Istanbul. Our control group consists of 49 people. FeNO levels were measured and the relationship between these parameters and pulmonary function test parameters was investigated. When FeNO levels in control and work groups were investigated, they were found over 25 ppb in 8 persons working in bakery, 11 in plastics, and in 9 of the control group. When parameters related with respiratory function were evaluated, people whose parameters were found to be lower than 80% were as follows respectively: PEF levels of 29 people (64,4%) working in bakery in and FEF (25-75%) levels of 5 people (11,1%); whereas PEF values of 26 people (60,5%) among the workers of plastics and FEF (25-75%) levels of 5 people (11,6%) were found to be less than 80%. A statistical significance was found between FeNO and PEF levels which were under 80%. In workers whose FeNO levels were found under 25 ppb and those whose PEF levels were under 80% were found to be significantly high (p=0.03). Measuring FeNO levels will be helpful to identify the various environmental respiratory irritants at workplaces before they cause occupational illness. The widespread use of FeNO level measurement will be beneficial for the protection and development of workers’ health.

Background and objective: The relationship between renal cell carcinoma (RCC) and coagulation/fibrinolysis system has been described in several studies. The aim of this study was to investigate the role of 4 different coagulation/fibrinolysis factors on the prediction of histopathologic and survival prognosis in patients with RCC. Patients and methods: Data from 128 patients who underwent surgical intervention between March 2006 and January 2011 for RCC were evaluated in this prospective study. Blood samples were collected from all patients on the morning of the operation to measure the plasma fibrinogen, D-dimer, coagulation factor VII, and antithrombin 3 levels. The relationships of these factors in the demographic, clinical, and histopathologic outcomes were analyzed using the Student t, Mann-Whitney U, Kruskal-Wallis, and one-way analysis of variance tests. Receiver operating curve analyses were performed to determine the optimal cutoff level for fibrinogen and D dimer, both of which had a strong relation with the clinical and histopathologic parameters. Disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) were assessed using the Kaplan-Meier method. Multivariate Cox regression analyses (forward stepwise logistic regression) were performed to examine the independent prognostic values on survival outcomes. Results: Increased plasma fibrinogen and D-dimer levels were associated with tumor size (P ¼ 0.004 and 0.106), nuclear grade (P o 0.001 and o0.001), TNM category (P o 0.001 and 0.029), and metastasis (P o 0.001 and 0.032). Both increased plasma fibrinogen and D-dimer levels predicted decreased DFS (P ¼ 0.027 and 0.04), CSS (P ¼ 0.007 and 0.043), and OS (P ¼ 0.014 and 0.001) rates based on Kaplan-Meier analyses. Furthermore, multivariate analyses demonstrated that fibrinogen independently predicted poor DFS (hazard ratio [HR] ¼ 2.52; 95% CI: 1.04–6.31; P ¼ 0.029) and CSS (HR ¼ 3.89; 95% CI: 1.13–13.40; P ¼ 0.032), whereas D dimer had negative independent prognostic value on OS (HR ¼ 4.01; 95% CI: 1.54–10.50; P ¼ 0.005). Conclusions: Increased plasma fibrinogen levels accurately predict poor histopathologic and survival outcomes and may be an effective independent prognostic factor in patients with RCC. Moreover, D dimer may serve as a copredictive factor in conjunction with