Heavy Metal and Trace Element Levels in Hair Samples from Fishermen in Turkey: The Fish/Ermen Heavy Metal Study (FHMS)

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.

The effect of postoperative ventilation strategies on postoperative complications and outcomes in patients with esophageal atresia: Results from the Turkish Esophageal Atresia Registry

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.

The prevalence of diabetes and associated risk factors among adult population in a Turkish population (Trabzon city)

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.

An Investigation of Changing Attitudes and Behaviors and Problematic Internet Use in Children Aged 8 to 17 Years During the COVID-19 Pandemic

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.

Sociodemographic characteristics and clinical risk factors of Helicobacter pylori infection and antibiotic resistance in the Eastern Black Sea region of Turkey

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.

Reliability and validity of Turkish version of pediatric balance scale

Assessment tool is a key point to evaluate balance disturbances in children. The aim of this study was to analyze reliability and validity of Turkish version of pediatric balance scale. The present study included 34 children (13 girls; 21 boys) with balance impairments. The scale consists of 14 items. Eight observers assessed the video records of the participants for interrater agreement. One observer evaluated the records twice in 2 weeks for intrarater agreement. Intraclass correlation coefficient was used for the interobserver and intraobserver agreement. The Functional Reach Test was used to calculate concurrent validity. Mean age of the sample was 11.68 ± 3.53 years. The Turkish version of the scale was found to be reliable, perfectly (intraclass correlation coefficient for interobserver agreement = 0.915). Intraobserver agreement was also reliable, perfectly (ICC = 0.927). The strong correlation between pediatric balance scale and functional reach test was found (r = 0.692; p < 0.001). The Turkish version of the scale is a valid and reliable tool to evaluate children with balance impairments. Moreover, it is easy to use for health providers working with disabled children.

[Seroprevalence of Toxoplasmosis among 20 Years and Older Individuals in Trabzon, Turkey]

Introduction

Materials and Methods

Result

Conclusions

Heavy Metals and Trace Elements in Whole-Blood Samples of the Fishermen in Turkey: The Fish/Ermen Heavy Metal Study (FHMS)

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.

Heavy Metal Concentrations in Trachurus Mediterraneus and Merlangius Merlangus Captured from Marmara Sea, Turkey and Associated Health Risks

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.

Reliability and validity of Turkish version of pediatric balance scale

Assessment tool is a key point to evaluate balance disturbances in children. The aim of this study was to analyze reliability and validity of Turkish version of pediatric balance scale. The present study included 34 children (13 girls; 21 boys) with balance impairments. The scale consists of 14 items. Eight observers assessed the video records of the participants for interrater agreement. One observer evaluated the records twice in 2 weeks for intrarater agreement. Intraclass correlation coefficient was used for the interobserver and intraobserver agreement. The Functional Reach Test was used to calculate concurrent validity. Mean age of the sample was 11.68 ± 3.53 years. The Turkish version of the scale was found to be reliable, perfectly (intraclass correlation coefficient for interobserver agreement = 0.915). Intraobserver agreement was also reliable, perfectly (ICC = 0.927). The strong correlation between pediatric balance scale and functional reach test was found (r = 0.692; p < 0.001). The Turkish version of the scale is a valid and reliable tool to evaluate children with balance impairments. Moreover, it is easy to use for health providers working with disabled children.

Turkish version of Brief Ataxia Rating Scale

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.

Turkish validity and reliability of the patient satisfaction scale in physiotherapy for patients with musculoskeletal pain

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.

Determination of Seroprevalence of Borrelia burgdorferi IgG in Adult Population Living in Trabzon

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.

The intraoperative effect of pentoxifylline on the inflammatory process and leukocytes in cardiac surgery patients undergoing cardiopulmonary bypass

Background: Inflammation plays a pivotal role in the pathogenesis of organ dysfunction after cardiopulmonary bypass (CPB). The aim of this study was to investigate whether pentoxifylline (PTX) has effects on the inflammatory process and leukocytes in cardiac surgery patients undergoing CPB.

Material and methods: A double-blind, prospective, randomized, placebo-controlled study was undertaken to assess the effect of PTX on leukocyte counts, tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) levels in 60 patients undergoing CPB for elective coronary artery bypass grafting. In 30 patients, 200 mg of PTX was added to 500 mL NaCl and perfused for 180 min after induction of anaesthesia and also 100 mg of PTX was added to the warm cardioplegic solution; another 30 patients received saline solution as placebo.

Results: All measurements were performed before PTX infusion (T0), after induction of anaesthesia (T1), 30 min after weaning from CPB (T2), and 6 hours (T3) and 24 hours postoperatively (T4). PTX did not change the percentage of eosinophils, basophils, neutrophils, monocytes, or lymphocytes, or CRP levels. In the control group, however, total leukocyte count and IL-6 level at T3 and T4 period were significantly higher than the study group. The progressive increment in TNF-α level observed at each period was also significantly prominent in the control group.

Conclusion: CPB-related whole body inflammatory response could be partially inhibited by intraoperative PTX administration. This effect of PTX would be helpful in preventing the well-known complications of CPB-induced systemic inflammation.

Prevalence of Allergic Rhinitis in Children in the Trabzon Province of the Black Sea Region of Turkey

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.

Energy drink use in university students and associated factors

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.

Attitudes and behavior regarding organ donation and transplantation on the part of religious officials in the Eastern Black Sea region of Turkey

AIM

This study evaluated the opinions and attitudes toward organ donation and transplantation on the part of religious officials in the Eastern Black Sea region of Turkey.

METHOD

This descriptive study was performed between December 2008 and November 2009 with 550 among Muslim religious officials, including 541 males and 9 females, who attended educational seminars on the subject arranged in collaboration with Mufti Offices in the provinces of Trabzon, Rize, Gümüşhane, and Giresun in the Eastern Black Sea region of Turkey. A supervised questionnaire administered before the seminars contained questions investigating whether subjects have volunteered to donate organs, reasons for not volunteering, whether they would donate the organs of a close relative in the event such a death, and what they would think in the event they required an organ transplantation themselves. Questions were also asked regarding permission for organ transplantation and donation in 5 main religions.

RESULTS

Although no female religious officials had previously volunteered to donate organs, 4 men (0.7%) had done so. After attending seminars, 32 (5.9%) volunteered to donate. The main reasons cited for not volunteering to donate organs were lack of sufficient knowledge of the procedures involved (30.6%) and lack of interest (17.4%). Three hundred five religious officials stated they would not agree to organ donation in the event of the death of a close relative. When asked "What would you think about organ donation and transplantation if you needed an organ transplant now?", 46.0% replied "I would want an organ transplant." Finally, 83.3% of religious officials stated that Islam permits organ donation and transplantation, whereas 13.6% stated that Christianity permits it, other figures being 7.3% for Judaism, 2.5% for Buddhism, and 2.0% for Hinduism.

CONCLUSIONS

Religious views affect organ donation. The fact that religious officials agreed to donate organs after appropriate education emphasized that Islam is the most sensitive faith on the subject, indicating that the issues can be improved through collaboration with religious officials.

Universal newborn hearing screening; automated transient evoked otoacoustic emissions

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.

Epilepsy prevalence in the 0-17 age group in trabzon, Turkey

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.

[Effects of human amniotic fluid on posterolateral spinal fusion: an experimental preliminary study]

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.

Does propofol prevent testicular ischemia-reperfusion injury due to torsion in the long term?

OBJECTIVES

Our aim was to investigate the long-term preventive effect of propofol on testicular ischemia-reperfusion injury in a rat model.

METHODS

Twenty-four adult male Sprague-Dawley rats were randomly divided into four groups (n = 6 for each group), control, sham-operated, torsion/detorsion (T/D) and T/D + propofol. Testicular ischemia was achieved by twisting the left testis 720° clockwise for 2 h. Half an hour before detorsion, 50 mg/kg propofol was given intraperitoneally to the T/D + propofol group. Ipsilateral orchiectomies to determine mean testicular weights and histopathological examination according to Johnsen's mean testicular biopsy score criteria were performed 30 days after surgical procedure in all groups.

RESULTS

Mean testicular weights were 1.57 ± 0.12 g in group I, 1.59 ± 0.36 g in group II, 0.84 ± 0.20 g in group III and 0.87 ± 0.29 g in group IV. Mean testicular weights decreased significantly in the T/D groups, but no improvement in testicular weight was observed with propofol administration (p 0.9372). Similarly, the Johnsen's mean testicular biopsy scores of the T/D groups were lower than those of the control and sham-operated groups, but no positive effect was determined with the administration of propofol in the T/D groups (p 0.1797).

CONCLUSIONS

Our results showed that there is no apparent long-term therapeutic potential attendant on using propofol in the treatment of testicular ischemia-reperfusion injury caused by testis torsion.

Information, attitude, and behavior toward organ transplantation and donation among health workers in the eastern Black Sea region of Turkey

AIM

We sought to evaluate the information, attitude, and behaviors toward organ donation among health workers in the eastern Black Sea region of Turkey.

METHOD

This descriptive study was performed between December 2008 and November 2009. It involved 1,545 health personnel in 8 state hospitals in the eastern Black Sea region of Turkey, excluding the university hospitals in the towns of Trabzon, Rize, Gümüşhane, and Giresun. Educational seminars regarding organ transplantation and donation were arranged for the hospitals in the study. Questionnaires on the subject distributed to the participants were collected before the seminars began. They contained questions about occupation, gender, age, previous organ donation, whether the person would consider donating if they had not already volunteered (if not, the reasons why), whether any relatives had volunteered to donate organs, whether anyone close to them had volunteered to donate organs, whether they would donate organs in the event of a relative's death, and what they might think if they were to require an organ transplant. Following the seminars, participants were given the opportunity to obtain organ donation cards from a stand on site. Data were analyzed using the chi-square test.

RESULTS

Eighty-one participants (5.2%), including 46 women (5.2%) and 35 men (5.3%), had previously officially volunteered to donate organs (P = .875). One hundred thirty-seven health personnel were willing to donate organs by visiting the donation stand after the seminars. The main reasons for participants who had not volunteered to donate organs failing to do so were lack of information about donation and procedures (28.4%), lack of interest in the subject (23.2%), and Islamic religious beliefs and/or traditions (19.6%). One hundred eighty health personnel (11.7%) had family members or relatives who had volunteered to donate organs. Asked whether they would donate that person's organs in the event of the death of a relative, 93 doctors (67.6%), 225 nonphysician health personnel (41.1%), and 345 other participants (43.1%) stated that they would not (P < .0005).

CONCLUSIONS

Health workers play a key role to overcome the difficulties encountered regarding organ donation. This study showed the need for constant effective education seminars to enhance knowledge and sensitivity on the part of health workers.

Ischemia-modified albumin reduction after coronary bypass surgery is associated with the cardioprotective efficacy of cold-blood cardioplegia enriched with N-acetylcysteine: a preliminary study

BACKGROUND

The aims of this preliminary study were to determine the alteration of serum ischemia-modified albumin (IMA) levels and to investigate whether IMA may be used as an indicator of the cardioprotective efficacy of N-acetylcysteine (NAC) in patients undergoing coronary bypass grafting (CABG).

PATIENTS AND METHODS

Forty-four patients were randomized into one of two groups on the basis of cardioplegic strategies, either cold-blood cardioplegia enriched with NAC (50 mg/kg) or cold-blood cardioplegia alone. Serum IMA, cardiac troponin T (cTnT) and malondialdehyde (MDA) levels determined in NAC-enriched patients before and after CABG were compared with those of the NAC-free group. The albumin cobalt binding assay was used for IMA determination.

RESULTS

Serum IMA levels were significantly elevated after cross-clamping and peaked at 6 h after reperfusion in the two groups. In NAC-enriched patients, IMA levels determined 6, 12, 24 and 48 h after reperfusion were significantly lower than those of the NAC-free group (p < or = 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). IMA returned to baseline 24 h after reperfusion differently from cTnT and MDA in the NAC-enriched group.

CONCLUSIONS

IMA may be used as not only an indicator of myocardial ischemia-reperfusion injury, but also as a useful indicator of the cardioprotective effect of NAC in CABG.

Prevalence of metabolic syndrome and associated risk factors among Turkish adults: Trabzon MetS study

OBJECTIVE

In order to estimate the prevalence of metabolic syndrome (MetS) as defined by NCEP Adult Treatment Panel III (ATP III) criteria in the Trabzon Region and its associations with demographic factors (age, sex, marital status, reproductive history in women, and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, and obesity), lifestyle factors (smoking habits, physical activity, and alcohol consumption) in the adult population.

RESEARCH METHODS AND PROCEDURES

In this cross-sectional survey, a sample of households was systematically selected from the central province of Trabzon and its nine towns. A total of 4,809 adult subjects > or = 20 years (2,601 women and 2,208 men) were included in the study. Blood pressure levels were measured for all subjects. The persons included in the questionnaire were invited to the local medical centers for blood examination between 08:00 and 10:00 following 12 h of fasting. Fasting serum glucose (FBG) levels and lipid profile were measured with autoanalyzer. MetS was defined according to guidelines from the NCEP ATP III diagnostic criteria.

RESULTS

The prevalence of MetS was 26.9%: 31.3 in women and 21.7% in men. The prevalence increased with age, being highest in the 60-69-year-old age group (53.4%) but lower again in the > or = 70 age group. MetS was associated positively with marital status, parity, cessation of cigarette smoking, and negatively with the level of education, alcohol consumption, current cigarette use, household income, and physical activity. Hypertension was found as the most common MetS component in our study (57.4%). Others in decreasing order were abdominal obesity (40.9%), low high-density lipoprotein-C (HDL-C) (31.8%), hypertriglyceridemia (30.7%), and high FBG levels (9.2%). Similarly, in the subjects diagnosed with MetS, HT had the highest prevalence (91.9%). This was followed by abdominal obesity (82.3%), hypertriglyceridemia (74%), low HDL-C (68.6%), and high fasting blood glucose levels (28.6%).

DISCUSSION

MetS is moderately common and an important health problem in the adult population of Trabzon. In order to control MetS and its components, effective public health education and taking urgent steps are needed. These steps include serious education, providing a well-balanced diet and increasing physical activity.

[The prevalence of cigarette smoking in the Eastern Black Sea Region]

The number of studies conducted on the subject of cigarette smoking habits in Turkish society in general is limited. This study presents data regarding the prevalence of cigarette smoking in the Eastern Black Sea Region of Turkey. This cross-sectional study was carried out between March 2003 and March 2005 in the provinces of Trabzon, Giresun, Rize, Artvin and Gümüşhane in the Eastern Black Sea Region. The research was conducted in the provincial capitals and districts. According to the 2000 general census, a total of 459.021 people live in these areas, and 6103 individuals were enrolled in the study, selected to be representative of gender, age groups and settlement locations. Data regarding cigarette smoking were obtained using questions employed by the World Health Organization and the British Health Protection Agency. Daily smoking prevalence (at least one cigarette smoked per day) of 18.3% was determined in women and 50.7% in men, while weekly smoking prevalence (less than one cigarette a day but at least one a week) was determined as 1.3% in men and women. It was also determined that 8.4% of women and 18% of men had quit smoking; 69.7% of women and 27.9% of men stated that they had never smoked in their lives. The difference between men and women in terms of smoking prevalence was statistically significant (p< 0.0005). The highest prevalence was in the 20-29 age group in women (23.3%) and in the 30-39 age-group in men (59.9%). In addition, significantly high levels were determined in high school graduates (46.3%, p< 0.0005), unmarried subjects (41%, p< 0.0005) and in the retired (53.7%, p< 0.0005). Cigarette smoking levels continue to represent a major public health problem in the Eastern Black Sea Region.

Complaints related to smoking cessation

Problems experienced during quitting smoking, particularly withdrawal symptoms, make giving up difficult. In this study the description of the complaints arising in individuals quitting smoking thus acts as a guide for health professional who dealt with smoking cessation. Data belonging to 194 patients applying to the smoking cessation clinic and quitting smoking were analysed. Behavioural counselling and nicotine support therapy are administered in the smoking cessation programme. Patients are followed up for at least two years after quitting cigarettes, and their complaints are determined. One hundred and two (52.6%) of the 194 patients quitting smoking had various complaints. One of the most frequently experienced problems was weight gain. According to patients' statements, an average weight gain of 6.8 +/- 3.8 kg, minimum 1 kg maximum 16 kg, occurred. Seventeen (8.7%) patients complain of increased appetite. Those with increased appetite gained the most weight, to a significant extent (p= 0.001). In terms of average weight gain, those with increased appetite gained 4.6 +/- 2.3 kg, while those without increased appetite gained 7.3 +/- 3.9 kg, and the difference was significant (p= 0.033). Thirty-eight (19.6%) patients complain of lesions in the mouth, gums or tongue. Twelve (6.1%) patients had complaints of tension, restlessness, nervousness or sleeplessness, 9 (4.6%) of a desire to smoke, 9 (4.6%) of headache, 8 (4.1%) of constipation, and 7 (3.6%) of drowsiness, numbness or concentration impairment. Forty-five (44.1%) of the 102 patients with smoking cessation related complaints and 57 (62%) of 92 patients with no complaints recommenced smoking. Significantly fewer of those with complaints began smoking (p= 0.013). Counselling services to be provided by health personnel regarding the frequency, intensity and resolutions of problems experienced by those quitting smoking will increase cessation success and duration.

Does cold environment affect Streptococcus pneumoniae adherence to rat buccal epithelium?

BACKGROUND

Colonization of the nasopharyngeal flora by Streptococcus pneumoniae increases in winter. However, in vitro studies suggest that bacterial adherence decreases in low temperatures. These contrasts may be related to the difference between in vitro and physiological conditions.

OBJECTIVES

We investigated whether pneumococcal adherence to buccal epithelial cells of rats increases in cold temperature.

METHODS

The adherence of S. pneumonia (ATCC 49619) was studied in six groups of rats. Basal pneumococcal adherence was checked after 1 h both at room temperature and in a cold environment (at 10 degrees C) for the evaluation of changes in basal flora in the first two groups (basal control). In the remaining four groups, the effect of cold treatment before or after inoculation of S. pneumoniae, or cold treatment during the whole study period was investigated.

RESULTS

The adherence of inoculated pneumococci was found to be significantly decreased in rats exposed to cold air during the whole study period (group 3). However, the decrease was not significant in rats exposed to cold air after bacterial inoculation (group 6). In contrast, pneumococcal adherence was found to be significantly increased in rats staying at 24 degrees C room temperature (control, group 5), during the whole pre- and postincubation period. A slight increase was also detected in rats pretreated in cold air and then kept at room temperature (group 4) (p > 0.05).

CONCLUSION

In contrast to our expectations, pneumococcal adherence was found to be decreased in cold environment in vivo.

Outmoded Attitudes Toward Organ Donation Among Turkish Health Care Professionals

AIM

Our goal was to investigate the attitudes toward and information regarding organ donation possessed by assistant and intern doctors and nurses.

METHOD

A total of 70.4% of assistant doctors, 52.9% of nurses, and 94.3% of interns participated in this descriptive study. Participants were interviewed fact-to-face to ask questions investigating profession; gender; age; whether they had donated organs; if so, which organ(s); if not, which organ(s) they would consider donating; if they would not consider such donation the reason why; whether they would donated another person's organs in the event of the death of a relative; and what their thoughts would be if they themselves required an organ transplant.

RESULTS

Ten (2.2%) individuals had donated organs by applying to an official health institution. Of those participants who had not yet donated organs, the main reason cited for this were lack of information regarding the donation process (28.7%), concerns about the sale of organs (22.1%), and Islamic religious beliefs (21.6%). In the event that they themselves required an organ transplant, 59.8% replied that they "would wish an organ transplant to be performed," and 57.6% of those asked whether they would donate the organs of a deceased relative replied that they would not.

CONCLUSIONS

The low level of donation among health care professionals, who should be in the forefront of organ transplantation, and the predominance of ethical and religious reasons for not donating, are incompatible with the present state of medicine.

[Alexithymia and anger in women with fibromyalgia syndrome]

OBJECTIVE

Fibromyalgia syndrome is characterized by both somatic and psychic symptoms and it is suggested that psychic factors contribute to the clinical presentation of this syndrome. This study was planned to have a better understanding of fibromyalgia through elaborating the role of alexithymia and anger in the pathogenesis of this illness.

METHOD

The study was carried out in the Physical Therapy and Rehabilitation outpatient clinic with 101 women with fibromyalgia syndrome, 30 women with rheumatoid arthritis and 59 healthy women with no current or past medical history. The subjects were evaluated by the Visual Analog Scale, Toronto Alexithymia Scale-20 items, Spielberger State-Trait Anger Inventory, Beck Depression Scale, Fibromyalgia Impact Questionnaire and a sociodemographic data form.

RESULTS

All these groups were similar to each other in means of age, years of education, marital and economical status. In the fibromyalgia syndrome group, the scores of anxiety and anger-in were calculated significantly higher than other groups. The depression and alexithymia scores were found higher than healthy group.

DISCUSSION

These findings suggest that fibromyalgia patients suffer more anxiety and anger toward oneself, which is anger-in, than rheumatoid arthritis patients. Though the patient groups were more alexithymic than the healthy group, alexitimia scores of the two patient groups were not different. This situation suggest that anger-in, which is suppressed and unexpressed anger style is a part of the fibromyalgia syndrome together as well as high anxiety.

Relationships between nonverbal IQ and brain size in right and left-handed men and women

This study was designed to evaluate the relationship between nonverbal IQ and brain size in men and women. A significant correlation was found between IQ and brain size in total subjects. There was no significant correlation between these variables in women; men exhibited only a weak relation of brain size to IQ. In both left-handed men and women significant correlations were found between IQ and brain size. The results supported the hypothesis about the relation of IQ to brain size, suggesting that the sex difference in the cranial capacity and cerebral asymmetry might contribute to the diversity in cognitive functions.

Plasma fibronectin level and its association with coronary artery disease and carotid intima-media thickness

BACKGROUND

The exact relation of fibronectin with coronary atherosclerosis is unknown. The aim of the present study was to examine the association of fibronectin level with presence and extent of coronary artery disease (CAD) and intima-media thickness (IMT) of common carotid artery (CCA).

DESIGN

The IMTs of CCA of 86 patients who underwent coronary angiography were measured; traditional vascular risk factors were also evaluated in these patients. Fibronectin, lipids, C-reactive protein (CRP) and fibrinogen levels were determined.

RESULTS

Plasma fibronectin levels of the patients with CAD were found to be significantly elevated compared to patients with normal vessels (0.46+/-0.11 and 0.36+/-0.12 mg/dl respectively, P = 0.001). Fibronectin levels were not associated with extent of CAD. No significant association was observed between fibronectin level and traditional risk factors. IMTs of right and left CCA in patients with CAD were found to be elevated compared to patients with normal vessels (0.89+/-0.1 mm compared with 0.76+/-0.1 mm, P = 0.001 and 0.93+/-0.2 mm compared with 0.71+/-0.1 mm, respectively P < 0.001). Fibronectin levels were positively correlated with CRP (r = 0.45, P < 0.001), low-density lipoprotein-cholesterol (r = 0.23, P = 0.03) and total cholesterol (r = 0.21, P = 0.04) levels and negatively correlated with high-density lipoprotein-cholesterol (HDL-C) levels (r = -0.24, P = 0.02). IMT of left CCA was positively correlated with CRP levels (r = 0.23, P = 0.04) and negatively correlated with HDL-C levels (r = 0.2, P = 0.04). Logistic regression analysis showed that age (P < 0.01) and fibronectin levels (P = 0.01) were independent predictors for the existence of CAD.

CONCLUSIONS

The results suggest that fibronectin levels may be a significant predictor of CAD. However, it was shown that fibronectin levels were not associated with extent of CAD and IMT of CCA.