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I is essential for thyroid hormone synthesis and neurological development. Various changes occur in thyroid hormone metabolism during pregnancy and I requirements increase significantly. The purpose of this study was to investigate I status among pregnant women in Trabzon, formerly a severely I-deficient area but shown to have become I sufficient following mandatory iodisation of table salt based on monitoring studies among school-age children (SAC) in the area. A total of 864 healthy pregnant women with a median age of 28 (25th–75th percentile 17–47) years participated in the study. None of them were using I-containing supplement. All of them were screened for use of iodised salt, obstetric history, thyroid function tests and urinary I concentrations (UIC), and thyroid ultrasonography was performed. Median UIC was 102 (25th–75th percentile=62–143) μg/l. Median UIC of the patients according to trimesters were 122 µg/l at the 1st, 97 µg/l at the 2nd and 87 µg/l at the 3rd trimester. UIC in the 1st trimester was higher compared with the 2nd and 3rd trimesters (P<0·017). Nodules were present in 17·7 % of women (n 153). The rate of iodised salt usage among pregnant women was 90·7 %. Our study demonstrates that, although the I status among SAC has been rectified, I deficiency (ID) is still prevalent among pregnant women. Current knowledge is in favour of I supplementation in this group. Until the effects of maternal I supplementation in mild ID have been clarified by large-scale prospective controlled trials, pregnant women living in borderline defficient and I-sufficient areas, such as Trabzon city, should receive 100–200 µg/d of I-containing supplements in addition to iodised salt. [ABSTRACT FROM PUBLISHER]

Monitoring flap viability in the postoperative period is important for the prediction of partial or total flap failure. Many alternative methods such as laser Doppler flowmetry, photoplethysmography, infrared spectroscopy, fluorescein injection, evaluation of flap color, turgor, temperature and capillary reflow have been used for this purpose. Although these methods are valuable in the determination of flap condition, they are not sufficient prognostic markers for flaps. In this study, we investigated the relationship between serum ischemia-modified albumin (IMA) values and flap viability. In 20 Wistar rats, caudal-based 9 × 3 cm dorsal flaps were prepared. IMA values were measured before the flap elevation as well as 6 h and 1 week after the surgical procedure. Seven days after the operation, the viable flap areas were calculated. The relationship between changes in the IMA level during the study and viable flap area measurements was investigated. There was no statistically significant correlation between serum IMA level alterations during the preoperative to postoperative 6th hour period and necrotic flap area measurements. This lack of correlation was also present between the change in IMA levels during the preoperative to postoperative 7th day period and necrotic flap area measurements. In conclusion, serum IMA levels do not predict rat skin flap viability. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract Background Multiple Myeloma (MM) is a B cell neoplasm characterized by the clonal proliferation of plasma cells. Skeletal complications are found in up to 80% of myeloma patients at presentation and are major cause of morbidity. Methods 49 patients were enrolled with MM admitted to Black Sea Technical University Hospital between 2002–2005. Pathologic fractures (PFs) were determined and the patients with or without PF were followed up minumum 3 years for survival analysis. Results PF was observed in 24 patients (49%) and not observed in 25 patients (51%). The risk of death was increased in the patients with PF compared with patients who had no fractures. While overall survival was 17.6 months in the patients with PFs, it was 57.3 months in the patients with no PFs. Conclusion These findings suggest that PFs may induce reduced survival and increased mortality in the MM patients, however, larger sample size is essential to draw clearer conclusions added to these data.

Abstract Study objective The primary aim of this study was to investigate whether IMA levels are helpful in the diagnosis of pulmonary embolism (PE). The secondary aim was to determine whether IMA was more effective alone or in combination with clinical probability scores in the diagnosis of PE. Thirdly, the sensitivity and specificity of IMA is compared with D-dimer both with and without clinical probability scores in patients with suspected PE. Methods Consecutive patients presenting to the emergency department with suspected PE were prospectively recruited, and healthy volunteers were also enrolled as controls. D-dimer and IMA levels were measured for the entire study group. Wells and Geneva scores were calculated and s-CTPA was performed on all suspected PE patients. Results The study population consisted of 130 patients with suspected PE and 59 healthy controls. Mean IMA levels were 0.362 ± 0.11 ABSU for Group A, the PE group (n = 75); 0.265 ± 0.07 ABSU for Group B, the non-PE group (n = 55); and 0.175 ± 0.05 ABSU for Group C, the healthy control group (p < 0.0001). At a cut-off point of 0.25 ABSU, IMA was 93% sensitive and 75% specific in the diagnosis of PE. PPV was 79.4% and NPV was 78.6%. Mean D-dimer levels were 12.48 ± 10.88 μg/ml for Group A; 5.36 ± 7.80 μg/ml for Group B and 0.36 ± 0.16 μg/ml for Group C (p < 0.0001). The D-dimer cut-off point was 0.81 μg/ml with a sensitivity of 98.9% and a specificity of 62.7%, PPV of 69.4% and NPV of 83.3%. The use of IMA in combination with Wells and Geneva clinical probability scores was determined to have a positive impact on these scores' sensitivity and negative predictive values. Conclusion IMA is a good alternative to D-dimer in PE diagnosis in terms of both cost and efficiency. Used in combination with clinical probability scores, it has a similar positive effect on NPV and sensitivity to that of D-dimer. The PPV of IMA is better than D-dimer, but it is still unable to confirm a diagnosis of PE without additional investigation.

Viral hepatitis are infections that can cause liver damage, become chronic, lead to cirrhosis, hepatocellular carcinoma and ultimately result in death due to their ability to spread in the community through blood and infected body fluids. The aim of this study was to determine the seroprevalence of hepatitis B (HBV), hepatitis C (HCV), and hepatitis D (HDV) transmitted through blood among individuals living in Trabzon province and to examine the factors potentially associated with seroprevalence. This cross-sectional study was conducted in Trabzon province, located in the northeast of Türkiye, including a total of 10 districts, including the central district. Since seroprevalence was calculated for HBV, HCV, and HDV in the study, the sample size was separately calculated for each, and the calculated maximum sample size of 1116 was accepted as the minimum sample size for the study. The study was completed with 1502 participants. Serological tests for HBV included HBsAg, anti-HBs, and anti-HBc IgG; for HCV, anti-HCV; and for HDV, anti-HDV were analysed. Data were evaluated for HBV risk factors using univariate analyses with Chi-square test and for multiple analyses using enter model logistic regression analysis. The mean age of the participants was 45.7 ± 16.6 years, with 767 (51.1%) being female. The prevalence of HBV seropositivity, indicating vaccination, was 23.0%, while the seroprevalence of HBV among unvaccinated adults was 27.4%. HBsAg positivity was 5.1%, and isolated anti-HBc IgG positivity was 4.2%. The proportion of individuals with HBsAg in the gray zone was 0.5%, while the positivity rates for anti-HBs and anti-HBc IgG (indicating past infection) were 17.6%. The prevalence of anti-HCV was six per thousand, while anti-HDV was not detected in the analyses. HBsAg positivity and co-infection with HCV were found in one person, and among the nine individuals positive for anti-HCV, isolated anti-HBc IgG positivity was detected in three. Increasing age, presence of a person with jaundice in the family, presence of diabetes mellitus, alcohol use and cupping therapy were identified as risk factors for HBV in the logistic regression analysis. Risk factors for HCV in univariate analyses were being over 40 years old, presence of hepatic steatosis and receiving dialysis treatment. The results of the study indicate that despite being included in our vaccination schedule and the administration of vaccines to high-risk adults, HBV still requires intensive attention as a public health problem. HCV, lacking a vaccine has been evaluated as an infectious agent that needs to be taken into consideration due to its potential risks and requires the complete implementation of individual and social precautions.

Toxic chemicals from polluted seas can enter the human body through seafood consumption and cause health problems. The aim of this study was to evaluate the levels of selected heavy metals and trace elements among fishermen who frequently consumed seafood and controls who consumed seafood less frequently in four provinces on the shores of the Sea of Marmara, which is heavily polluted by industrial activities. Fourteen elements (antimony, arsenic, cadmium, chromium, copper, iron, lead, manganese, mercury, nickel, selenium, strontium, vanadium, and zinc) were analyzed in hair samples using the inductively coupled plasma-mass spectrometer method. Levels of arsenic (0.147 ± 0.067 µg/g vs. 0.129 ± 0.070 µg/g, p = 0.025), chromium (0.327 ± 0.096 µg/g vs. 0.269 ± 0.116 µg/g, p < 0.01), nickel (0.469 ± 0.339 µg/g vs. 0.403 ± 0.368 µg/g, p = 0.015), strontium (1.987 ± 1.241 µg/g vs. 1.468 ± 1.190 µg/g, p < 0.01), and zinc (103.3 ± 43.1 µg/g vs. 92.7 ± 37.4 µg/g, p = 0.047) were higher in the fisherman group than in the control group. No difference was found between the groups in terms of other elements. The findings suggest that heavy metal-trace element contamination in the Sea of Marmara may increase the exposure levels of individuals to some chemicals through seafood consumption., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Galactosemia is a carbohydrate metabolism disorder often caused by galactose-1-phosphate uridyl transferase (GALT) deficiency. Detecting GALT deficiency involves measuring intra-erythrocyte enzyme activity. We aimed to create a robust liquid chromatography-mass spectrometry (LC-MS/MS) method to assess GALT activity in dried blood spot (DBS) samples. We validated this method and compared it to the fluorometric approach. We investigated the impact of K2EDTA and lithium heparin tubes on enzyme activity to identify the best sample collection tube. We also assessed the reaction-stopping method. The developed approach employed [13C6]-galactose-1-phosphate as a substrate and UDP-N-acetylglycosamine as an internal standard (IS). The mean ± SD value for GALT activity of DBS samples was determined as 6.37 ± 1.96 μmol/gHb/hour. The linear range was 0.4-50 μM (2.4-310% of normal) in the DBS method. The % coefficient of variation (%CV) values were less than 15 for intra-day and inter-day repeatability studies. Over 90% recovery was achieved in recovery studies, and no ion suppression from matrix was detected. DBS samples were quite stable for 31 days under different storage conditions. Enzyme activity results reported as <3.5 U/g Hb by fluorometric method, were quantitatively determined for even very low concentrations by LC-MS/MS method., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objectives: Postoperative ventilatory strategies in patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF) may have an impact on early postoperative complications. Our national Esophageal Atresia Registry was evaluated to define a possible relationship between the type and duration of respiratory support on postoperative complications and outcome., Study Design: Among the data registered by 31 centers between 2015 and 2021, patients with esophago-esophageal anastomosis (EEA)/tracheoesophageal fistula (TEF) were divided into two groups; invasive ventilatory support (IV) and noninvasive ventilatory support and/or oxygen support (NIV-OS). The demographic findings, gestational age, type of atresia, associated anomalies, and genetic malformations were evaluated. We compared the type of repair, gap length, chest tube insertion, follow-up times, tensioned anastomosis, postoperative complications, esophageal dilatations, respiratory problems requiring treatment after the operation, and mortality rates., Results: Among 650 registered patients, 502 patients with EEA/TEF repair included the study. Four hundred and seventy of patients require IV and 32 of them had NIV-OS treatment. The IV group had lower mean birth weights and higher incidence of respiratory problems when compared to NIV-OS group. Also, NIV-OS group had significantly higher incidence of associated anomalies than IV groups. The rates of postoperative complications and mortality were not different between the IV and NIV-OS groups., Conclusion: We demonstrated that patients who required invasive ventilation had a higher incidence of low birth weight and respiratory morbidity. We found no relation between mode of postoperative ventilation and surgical complications. Randomized controlled trials and clinical guidelines are needed to define the best type of ventilation strategy in children with EA/TEF., (© 2022 Wiley Periodicals LLC.)

Objective: The objectives of this study were to determine the prevalence of diagnosed and undiagnosed diabetes mellitus (DM) and prediabetes, and to evaluate the associated risk factors in a sample of adult Turkish population., Methods: A total of 4000 eligible study subjects, aged 20 years or older, chosen by multistage sampling on a field were considered. Of those 3721 subjects (2139 women and 1582 men) participated in the study., Results: The prevalence of prediabetes and DM were found to be as 6.4% and 10.4% (3.6% being newly diagnosed by this study), respectively. In multivariate logistic regression analysis, advanced age (OR:26.7, p < 0.0005 in the group 70 years and over), marriage (OR:2.05, p = 0.047), housewives (OR:1.34, p = 0.003), family history of diabetes (OR:2.84, p < 0.0005), overweight (OR:1.61, p = 0.026), obesity (OR:2.25, p < 0.0005), hypertension (OR:1.42, p = 0.007) and dyslipidemia (OR:1.38, p = 0.028) were independent risk factors for being diabetic., Conclusions: DM is an important health problem in the adult population of Trabzon city. Newly diagnosed diabetic patients who were unaware of their status are at high risk. To control DM and associated risk factors, effective public health education and taking urgent steps are needed., (Copyright © 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Purpose: To examine the effects of the COVID-19 pandemic on the lifestyle, habits, and behavioral differences in children, and their changing internet use habits., Methods: The research was planned as a cross-sectional study involving 4892 children aged 8 to 17 years attending schools in the city center of Trabzon, Turkey. Children's daily living activities, social habits, mood and temperament changes, and internet use were investigated before and during the pandemic. In terms of problematic internet use, internet addiction rates were evaluated using the validated Turkish-language version of the Parent-Child Internet Addiction Scale (PCIAT-20)., Results: The children's mean age was 13 ± 2.45 years, and 17.1% (n = 837) exhibited problematic internet use features on the PCIAT-20. Problematic internet use was higher in boys and in children older than 13 years. The presence of COVID-19 infection among members of the household, quarantine measures, attending private schools, the mother's occupation, the time spent by the mother and father on their mobile phones, and high parental education levels were associated with a high level of internet addiction. Families also described significant changes in their children's temperament and character compared with the pre-pandemic period., Conclusion: The prevalence of problematic internet use increased during the COVID-19 pandemic compared with previous studies from Turkey. Children were also more introverted, irritable, and pessimistic during the pandemic.

Aim: Our aim was to perform the Turkish-language adaptation of a practical ataxia rating scale for children., Methods: The Brief Ataxia Rating Scale was subjected to cultural adaptation following receipt of the requisite permissions. Thirty-six children aged 4-18 years followed-up with a diagnosis of ataxia were included in the study. Evaluation of each child was recorded on video. The video recordings were scored independently by nine observers (four physiotherapists, one pediatric neurologist, and four pediatricians). Intra-rater reliability was tested by the same video images being scored twice, at 15-day intervals, by a pediatric neurologist. Intraclass correlation coefficients were used for inter-rater and intra-rater reliability. The Scale for the Assessment and Rating of Ataxia was used for concurrent validity., Results: Good to excellent reliability was determined among the nine observers in terms of total scores with the intraclass correlation coefficient among the nine observers (intraclass correlation coefficient = 0.926; 95% CI: 0.885-0.956). Intra-rater reliability analysis results exhibited strong reliability in terms of scores elicited at two-week intervals (intraclass correlation coefficient = 0.967; 95% CI: 0.890-0.987, r  = 0.97, p  < 0.001). At concurrent validity analysis, a strong relation was determined between total Scale of the Assessment and Rating of Ataxia score and total Brief Ataxia Rating Scale score ( r  = 0.942, p  < 0.001)., Conclusion: The Turkish-language adaptation of the Brief Ataxia Rating Scale is reliable and valid for application in children.Implications for RehabilitationThis study shows the reliability and validity of the Turkish language adaptation of brief ataxia rating scale in children.The scale being both practical and easily applicable to ataxic children will contribute to broadening its use in the pediatric age group in particular.

Rapid industrialization and excessive human population growth may cause deterioration in marine water quality and biodiversity. Heavy metals are one of the most common pollutants in the seas and marine organisms, including demersal and pelagic fish, can accumulate them from the environment. Assessment of the ecological risk of heavy metals from fish has an important role in public health. In this study, some heavy metal (Pb, Cd, As, Cr, Hg, Cu, Zn, and Fe) concentrations were determined in the muscle tissues of two commonly consumed fish species, Trachurus mediterraneus (Mediterranean horse mackerel) and Merlangius merlangus (Whiting), which are the fifth (14,222 tons/year) and sixth (6814 tons/year) highest commercial catches of marine fish species in Turkey, respectively. Heavy metal concentrations of samples collected from four sites (Adalar, İzmit Bay, Yalova, and Tekirdağ) in the Marmara Sea were determined using ICP-MS. Fish samples caught at Yalova station were found to have the highest heavy metal concentrations. According to the World Health Organization (WHO), in terms of the mean values, only As, and Cr were higher than permissible limits in T. mediterraneus, while Pb, Cd, As, and Cr were higher in M. merlangus. Arsenic concentrations were higher than maximum limits in both T. mediterraneus and M. merlangus. The estimated weekly intake (EWI) was calculated to assess the potential health impact. The EWI for arsenic, cadmium, lead, and mercury for some sites was above the provisional tolerable weekly intake.

Selected heavy metal-trace element (Ag, As, Ba, Cd, Cu, Hg, Pb, Sb, Se, Sr, and V) levels were determined by the ICP-MS method in whole-blood samples of fishermen and control group who accommodate in four provinces of the Marmara Sea. Mercury (1.267 ± 1.061 µg/L to 0.796 ± 0.853 µg/L) and lead (17.8 ± 9.0 µg/L to 12.0 ± 6.83 µg/L) levels were higher in the fishermen group than that of control group (p < 0.001 for both). There was no difference between the fishermen group and the control group in terms of whole-blood levels of other elements. Total monthly fish consumption was 9340.4 gr in the fishermen group and 326.4 gr in the control group, and the difference between the groups was significant (p < 0.001). There was no difference between the groups in terms of having amalgam dental filling (p > 0.05). The results suggest that consuming high amounts of sea products caught from the Marmara Sea is a source for some heavy metals such as mercury and lead, which poses a public health risk. Unlike the control group, the positive correlation between arsenic, copper, and strontium levels and age in fishermen can also be evaluated as an indicator of chronic exposure.

Background/aims: The aim of this study was to assess the clinical and sociodemographic risk factors of Helicobacter pylori infection and antibiotic resistance in the eastern Black Sea region of Turkey., Materials and Methods: In total, 344 patients with dyspeptic symptoms who completed an extended questionnaire were enrolled in the study. Diagnosis of H. pylori infection was made by rapid urease test, histopathological investigation, and culture. Susceptibility of H. pylori strains was assessed by agar dilution (amoxicillin, tetracycline, metronidazole, levofloxacin) and E-test (clarithromycin) methods., Results: The H. pylori positivity rate was 40.4% (139/344). Logistic regression analysis indicated that age and the presence of duodenal ulcer were independent risk factors associated with H. pylori positivity (odds ratio (OR): 0.96, 95% CI: 0.93-0.99, p=0.013; OR: 5.42, 95% CI: 1.96-14.98, p=0.001, respectively). Of 104 H. pylori-positive cultures, 43 strains (41%) were susceptible to all antibiotics, whereas 61 (59%) were resistant to at least one antibiotic. H. pylori resistance rates were 34% for levofloxacin, 31.1% for metronidazole, 28.2% for clarithromycin, 2.9% for amoxicillin, and 1% for tetracycline. Logistic regression analysis indicated that previous use of clarithromycin was the only independent risk factor for H. pylori resistance (OR: 6.25, 95% CI: 1.59-24.52, p=0.009)., Conclusion: An understanding of the risk factors for H. pylori positivity and antibiotic resistance in an extended anamnesis may affect treatment choice and facilitate H. pylori eradication. In regions where antibiotic resistance rates are elevated, performing antibiotic susceptibility tests may lead to effective eradication treatment.

Background: This study aims to investigate the effect of ventilation of the non-ventilated lung in patients undergoing one-lung ventilation by a separate low-tidal-volume (1 mL/kg) ventilator at high frequency (30/min) on preventing the effect of one-lung ventilation-associated oxidative damage., Methods: The study included 45 patients (24 males, 21 females; mean age 54.6±7.7 years; range, 18 to 65 years) with an American Society of Anesthesiologists risk group of 1 to 2 and scheduled for elective thoracotomy. Patients were randomly divided into three groups as those due for thoracotomy without one-lung ventilation (group 1, n=15), those due for thoracotomy with one-lung ventilation (group 2, n=15), and those due for thoracotomy in whom both lungs were ventilated (group 3, n=15). Blood specimens were collected for ischemia-modified albumin, malondialdehyde, and lactate measurements one minute before one-lung ventilation (t0), 30 minutes after one-lung ventilation (t1), 60 minutes after one-lung ventilation (t2), and at postoperative 24th hour (t3). For group 1, t0 was defined as the time at which the thorax was opened., Results: A statistically significant increase in ischemia-modified albumin, malondialdehyde, and lactate levels occurred in group 2 as the duration of one-lung ventilation increased (p<0.01). Plasma ischemia-modified albumin and malondialdehyde levels in group 3 were statistically significantly lower at t1, t2, and t3 compared with group 2 (p<0.01). Plasma lactate levels were significantly lower in group 3 at t1 (p<0.05) and t3 compared with group 2 (p<0.01)., Conclusion: Separate ventilation of the non-ventilated lung with low tidal volume and high frequency reduces the response to one-lung ventilation-associated oxidative stress in thoracic surgery., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2019, Turkish Society of Cardiovascular Surgery.)

Background: Patient satisfaction is a key point in evaluating the quality of physiotherapy services., Objecive: The aim of this study was to determine the Turkish language validity and reliability of the Patient Satisfaction Scale in Physiotherapy (PSSP)., Methods: The study included 168 participants, aged 18-74 years, with musculoskeletal pain. The PSSP, which comprises 14 items in the four sub-dimensions of treatment, admission, logistics and general satisfaction, was applied to all participants. Structural validity was assessed using the principal components method with varimax rotation. Internal consistency and the intraclass correlation coefficient (ICC) were used for the reliability analysis. The Patient Satisfaction Scale for Physical Therapy Outpatient Clinics (PCCPTO) was used to assess concurrent validity., Results: The participants comprised of 71% females and 29% males with a mean age of 41.9 ± 14.9 years. The sampling competency index was 0.874. The Turkish version of the scale was found to be perfectly reliable (Cronbach's alpha reliability coefficient = 0.922). Internal consistency ranged from 0.762 to 0.904 in the subscales. Factor analysis revealed that the 14-item scale had four factors explaining 75.59% of the total variance. Floor and ceiling effects were not determined. Concurrent validity analysis showed a strong correlation between the PSSP and PCCPTO (r= 0.78; p< 0.0005)., Conclusion: The Turkish version of the PSSP is a valid, reliable and easily applicable measure.

Background: Lyme borreliosis is a tick-borne, multi-systemic infectious disease that is thought to be wide spread in Turkey even though studies on its seroprevalence are limited., Aims: To determine the seroprevalence of Lyme borreliosis in part of north-eastern Tur-key (in the city of Trabzon), and to identify possible relationships between seropositivity and various factors such as location, gender, age group, occupation, income, and educational level., Study Design: Retrospective cross-sectional study., Methods: A total of 884 blood samples collected from provincial and district health centers serving a population of about 800,000 were included in this study. ELISA was used to determine the anti-Borrelia IgG antibody levels in the samples. Samples that yielded positive results by ELISA were further subjected to western blot (WB)., Results: IgG antibodies were found in 128 samples (14.5%). Statistical analysis revealed significant differences between age groups and educational levels in terms of the incidence of seropositivity, whereas location, gender, occupational group and income level had no effect (p<0.001, p<0.001, p=0.948, p=0.645, p=0.131, p=0.080 respectively)., Conclusions: The risk of contracting Lyme borreliosis in Trabzon is high, and necessary measures need to be taken to avoid the spread of disease., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Objective: We aimed to determine the prevalence of allergic rhinitis in children aged 12-15 years who lived in the Trabzon Province, specify possible risk factors, and compare the data obtained with those of the other studies conducted in our country and in other countries., Methods: First, 1372 students from nine primary schools determined according to the recommendations of Department of Public Health and approval of The Provincial Directorate of Health were screened in their schools with questionnaire forms. Second, students providing the response "yes" to the first and/or second questions in the questionnaire forms were considered as possible allergic rhinitis patients and invited to our clinic. Then, 246 students were subjected to a skin prick test. Data were collected with the evalution of questionnaire and skin prick test results together., Results: The prevalance of allergic rhinitis in children between 12 and 15 years age was found to be 14.5% in Trabzon. Female gender was found to be a relative a risk factor for allergic rhinitis (p=0.015). The prevalence of allergic rhinitis in children whose both parents were smoking was significantly higher than that in children whose only one parent was smoking or both parents were nonsmokers (p=0.0024). In addition, living in an apartment flat (p=0.015) and owing pets (p=0.04) were detected to be other risk factors for allergic rhinitis., Conclusion: According to our investigations, this is the first prevalence study in Trabzon, which is the largest settlement in the Eastern Black Sea Region. The prevalence of allergic rhinitis in children was found to be 14.5%. Female gender, smoking habits of the parents, owing pets, and living in an apartment flat are risk factors for allergic rhinitis., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

The use of energy drinks is common among adolescents and young age groups. The purpose of this study was to determine energy drink consumption status in students at the Karadeniz Technical University in Turkey and the factors affecting this. The research was performed at the Karadeniz Technical University among a total of 2001 students attending the Administration Department, the Physical Education Department, the Psychological Counseling and Guidance Department and the Faculty of Medicine. The research data were collected using the supervised questionnaire method. The 53.5 % (n = 1070) of students had never tried energy drinks, 22.5 % (n = 450) had tried them once only, 1.5 % (n = 30) had used them for a time and then gave up, 21.1 % (n = 422) consumed occasionally and 1.4 % (n = 29) regularly. The risks of regular energy drink consuming were male gender [2.4 (1.8-3.2)] [OR (95 %CI)], studying at night [1.6 (1.2-2.2)], having friends consuming energy drinks [3.6 (2.6-5.0)], regular physical activity [1.9 (1.4-2.5)], being an alcohol drinker [2.4 (1.7-3.2)]. This study revealed that almost half of university students had experience of energy drinks and that approximately one-fourth still used them. It will be useful for these factors listed above to be borne in mind in the development of policies aimed at protecting young people from the health impacts of energy drinks.

Background: This randomized, double-blind study was designed to assess the effect of perioperative remifentanil with controlled hypotension on intraoperative bleeding, postoperative edema, and ecchymosis., Methods: Fifty-two patients undergoing rhinoplasty were divided into 2 groups. The remifentanil group received 1 µg · kg(-1) intravenously as a bolus before induction of anesthesia, 0.5 to 1 µg · kg(-1) · h(-1) by continuous intravenous infusion during the operation. After anesthesia induction with propofol (2-3 mg · kg(-1)) and fentanyl (1-15 µg · kg(-1)), muscle relaxation was achieved with rocuronium (0.45-0.90 mg · kg(-1)). Mean arterial pressure was maintained at 50 to 60 mm Hg in controlled hypotensive anesthesia achieved using remifentanil infusion. Perioperative hemodynamics and bleeding; early postoperative pain and agitation scale; postoperative first, third, and seventh day edema; and ecchymosis were evaluated. Edema and ecchymosis were evaluated using graded scale from 0 to 4., Results: Remifentanil reduced mean arterial pressure during the entire operative period and the first 30 minutes postoperatively (P < 0.05 for these comparisons). Intraoperative bleeding also decreased (P < 0.001). There was a significant decrease in edema in both upper and lower eyelid edema on the first and third days in the remifentanil group, although this difference was not detected on the seventh day (P(1upper) = 0.000, P(1lower) = 0.000, P(3upper) = 0.008, and P(3lower) = 0.002). Ecchymosis decreased significantly in both upper and lower eyelids on the first, third, and seventh days in the remifentanil group (P(1upper) = 0.000, P(3upper) = 0.000, P(3upper) = 0.002, P(3lower) = 0.002, P(7upper) = 0.049, and P(7lower) = 0.038). There were no differences in postoperative pain and agitation between 2 groups., Conclusions: Remifentanil with controlled hypotension may reduce edema and ecchymosis of the upper and lower eyelids, by reducing mean arterial pressure and amount of bleeding in rhinoplasty.

Objective: The purpose of this study is to describe the results of universal newborn hearing screening (UNHS) in 2229 newborns and to assess the effectiveness of a two-stage automated transient evoked otoacoustic emission (a-TEOAE) test protocol., Materials and Methods: Between May 2007 and January 2008, a universal newborn hearing screening program, instituting two-stage a-TEOAE, was evaluated. The hearing status of the newborns who failed the two-stage screening tests were evaluated with the auditory brainstem response (ABR) test during the diagnostic stage. The risk factors for hearing loss determined by the Joint Committee on Infant Hearing Loss (JCIH) and prematurity, consanguineous marriage, and birth type as presumptive risk factors were recorded., Results: During the study period, 2229 newborns were screened. Sensorineural hearing loss (SNHL) was identified in 8 newborns. Fourteen newborns were lost to follow-up. One hundred thirty six newborns were high-risk neonatal intensive care unit (NICU) patients. The prevalence of SNHL was 2.9% (4/136) in NICU newborns, and 0.19% (4/2079) in the well-baby nursery. SNHL prevalence in the study group overall was found to be 0.36% (8/2215). Craniofacial anomalies and family history of hearing loss were found to be significantly related to SNHL in newborns. Prematurity and consanguinity that are not listed among JCIH risk factors were also found to be statistically significantly related with SNHL., Conclusions: This is the first report of a universal hearing screening program in the Eastern Black Sea region of Turkey. Two-stage a-TEOAE is an efficient and feasible hospital-based screening protocol in newborns.

Objective: Epilepsy is a most common serious neurological disorder and is one of the world's most prevalent non-communicable diseases. The aim of this study was to determine the prevalence and risk factors of epilepsy in 0-17 year old children in Trabzon, Turkey., Methods: A cross-sectional epidemiological investigation was performed in two phases, a screening phase and a confirmation of the diagnosis phase. The gold standard was a clinical investigation and neurological examination. The diagnosis of epilepsy followed clinical guidelines proposed by the International League against Epilepsy (ILAE). The chi-square test was used in analysis of the results and P-value <0.05 was calculated., Findings: The prevalence per 1000 participants of epilepsy was 8.6 (5.9-11.4; (95%)CI). We detected 37 cases (18 males and 19 females) of epilepsy. The male/female ratio was 0.95. This study showed an increased risk for epilepsy with low socioeconomic level, a history of postpartum seizure, meningitis, head trauma, febrile convulsion and family history of epilepsy. More than one seizure type was present in 15 (40.5%) of epileptic children. Generalized tonic-clonic seizures were determined in 24 patients (64.9%) and absence type in 9 (24.3%). It was found that 25.0% of children with epilepsy had never visited the school at the time the study was performed due to the disease and attendant seizures., Conclusion: The prevalence of epilepsy in Trabzon is low compared to other parts of Turkey and other developing countries.

Objectives: In this study, the effects of human amniotic fluid on posterolateral spinal fusion were investigated in a rat model., Materials and Methods: Twenty-eight 20-week-old male Sprague Dawley rats were included in the study. The subjects were divided into two main groups as the control group and the amniotic fluid group. Posterolateral spinal fusion was performed by using autografts in all groups whereas 0.3 ml of centrifuged human amniotic fluid was added to the fusion area in amniotic fluid groups. Groups were further divided into subgroups each including seven rats and evaluated radiologically and histologically at the third and sixth weeks., Results: The radiological fusion observed in the amniotic fluid group was significant at the sixth week when compared to that in the control group. The histological fusion quality was significant in the amniotic fluid groups both at the third and sixth weeks when compared to the control groups., Conclusion: We conclude that human amniotic fluid enhances posterolateral spinal fusion. We believe that the growth factors and hyaluronic acid present in the amniotic fluid played a role in this result.