Publications by authors named "Mustafa Necmi Ilhan"

21 Publications

  • Page 1 of 1

Non-pharmaceutical interventions in Turkey and worldwide during COVID-19 pandemic.

Turk J Med Sci 2021 Sep 30. Epub 2021 Sep 30.

Non-pharmaceutical interventions (NPIs) are actions apart from getting vaccinated and medications, in order to promote deceleration of the spread of illness among people and communities during pandemic. In this article, we aim to examine NPIs applied in Turkey and worldwide due to the COVID-19 pandemic. Some of the NPIs such as isolation, quarantine, and contact tracing were maintained with updates of the Ministry of Health guidelines in Turkey. Some NPIs including travel and partial or full curfew mobilization restrictions were set in accordance with the various periods by the number of cases. Periods of restrictions at autumn 2021 to summer 2022 are national partial curfews, national extended curfews, local decision-making phase, revised local decision-making phase, partial lockdown, full lockdown and gradual normalization. Mitigation and suppression have been implemented in Turkey with restrictions of varying severity throughout the course of the epidemic. It is seen that the restrictions implemented in Turkey contributed to the flattening of the epidemic curve. Even some countries mainly applied the suppression method, and others applied the mitigation method, in general it is seen that similar methods were applied with different weights. Examples of different countries demonstrated that NPIs are effective for flattening epidemic curve. NPI have been the main instrument for a year and a half from the beginning of the epidemic to mid-2021 in Turkey as well as worldwide.
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http://dx.doi.org/10.3906/sag-2106-210DOI Listing
September 2021

Anxiety Levels of Primary Caregivers of Children With Tracheostomy During the COVID-19 Pandemic.

Clin Pediatr (Phila) 2021 Aug 19:99228211040661. Epub 2021 Aug 19.

Gazi University, Ankara, Turkey.

We aim to evaluate the anxiety levels of caregivers of children with tracheostomy during the COVID-19 (coronavirus disease 2019) pandemic. Caregivers of 31 children with tracheostomy and 105 healthy children (control group) were included. The State-Trait Anxiety Inventory was administered via teleconference in order to investigate how participants describe how they feel at a particular moment (State) and how they generally feel (Trait). The trait anxiety levels of caregivers of children with tracheostomy were significantly higher ( = .02). Their state anxiety levels were similar. The state and trait anxiety levels of caregivers of children with tracheostomy correlated ( = 0.70, < .001). At the end of the teleconference, caregivers of children with tracheostomy experienced greater anxiety relief than controls ( < .001). Trait anxiety scores were higher among caregivers of children with tracheostomy, but their state anxiety levels were comparable to those of controls. Caregivers with high trait anxiety also exhibited high state anxiety. Informing caregivers of children with tracheostomy about COVID-19 via teleconference can reduce their anxiety during such stressful times.
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http://dx.doi.org/10.1177/00099228211040661DOI Listing
August 2021

Reliability and Validity Study of Turkish Version of Pediatric Eosinophilic Esophagitis Symptom Scores® (Tr-PEESS v2.0) Led to Development of a New Pediatric Eosinophilic Esophagitis Scale: GaziESAS.

Turk J Gastroenterol 2021 04;32(4):365-373

Gazi University Pediatric Eosinophilic Gastrointestinal Diseases Working Group.

Background/aims: There has been no valid and reliable Turkish scale that measures symptoms in children with eosinohilic esophagitis (EoE). The aim of the study is test the validity and reliability of Turkish version of Pediatric Eosinophilic Esophagitis Symptom Scores® (Tr-PEESS v2.0) Materials and Methods: Relevant forms of Tr-PEESS v2.0 were applied to 2-18 years old children with EoE and to their parents. KINDL QoL patient and parent questionnaires and GaziESAS scale which was developed in this study were used to test convergent validity of Tr-PEESS v2.0. Discriminant validity was evaluated among three EoE treatment groups: under treatment, off treatment due to remission and uncompliant with treatment. Reliability was evaluated by internal consistency, test-retest reliability, and item analysis.

Results: Fiftytwo children/teens (mean age 130.2±60.3 months) and 84 parents were interviewed twice one week apart. Mean duration of EoE was 47.2±35.6 months. Tr-PEESS v2.0 reports correlated with GaziESAS (range,0.361-0.855) and KINDL QoL questionnaires (range,-0.316-0.413). Parent report of Tr-PESS v2.0 discriminated children uncompliant with treatment from the ones off treatment and undertreatment. Cronbach's α values and intraclass correlation coeffcients (ICC) values of Tr-PEESS v2.0 ranged from 0.614 to 0. 895 and 0.646 to 0.910, respectively.

Conclusion: Tr-PEESS v2.0 is a valid and reliable tool to use in Turkish children. GaziESAS is a new parent-proxy pediatric EoE scale with additional adaptive behaviour domain that passed scale developmental stages successfully for Turkish children with EoE.
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http://dx.doi.org/10.5152/tjg.2020.20674DOI Listing
April 2021

Substance Use in Refugee Camps and Local Community: Şanlıurfa Sample.

Noro Psikiyatr Ars 2021 Jun 11;58(2):121-127. Epub 2020 Oct 11.

Dokuz Eylül University Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey.

Introduction: Although substance use has increased in recent years in Turkey, it is still lower than in other European countries. Turkey is home to the largest Syrian refugee population. In this study, it was aimed to evaluate the prevalence of tobacco, alcohol, and substance use among local people living in city centers and refugees living in refugee camps in Şanlıurfa.

Methods: The study was based on a cross-sectional epidemiologic survey conducted with a total of 6041 people, 4040 (67%) from camps and 2001 (33%) from districts. Face-to-face interviews were accompanied by local interviewers or interpreters who spoke Arabic, and a survey form used in our country for drug addiction screening was used. According to the number of samples selected, households with proportional distribution were chosen from the districts, which were selected from the address based from Turkish Statistical Institute. In the refugee camps, interviews were conducted in tents selected using a random numbers table according to the number of samples.

Results: The lifetime prevalence of tobacco use was 22.3% (n=902) in the camps, whereas in the districts this rate was 33.5% (n=670). The lifetime prevalence of alcohol use was found as 0.2% in the camps and 3.5% in the districts. The lifetime prevalence of substance use was found as 2.6% in the camps and 4.3% in the districts. The most commonly used substance type was cannabis. Some 45.7% of the people who used a substance in the camps were male and 54.3% were female. In districts, these rates were 64.4% and 35.6%, respectively.

Conclusion: Alcohol and substance use rates are low in Turkey compared with most countries in the world. Substance use in the city center is higher than in refugee camps in Şanlıurfa. Substance use is a significant mental health problem that concerns every community including refugees. Identifying characteristics and attitudes related to substance use may help to improve policies regarding protective measures.
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http://dx.doi.org/10.29399/npa.24856DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8214742PMC
June 2021

Sleep disturbances in children with cystic fibrosis, primary ciliary dyskinesia and typically developing children during COVID-19 pandemic.

J Paediatr Child Health 2021 Oct 18;57(10):1605-1611. Epub 2021 May 18.

Department of Public Health, Gazi University Faculty of Medicine, Ankara, Turkey.

Aim: We aimed to investigate sleep disturbances in children with cystic fibrosis (CF) and primary ciliary dyskinesia (PCD) and typically developing (TD) children during the COVID-19 pandemic.

Methods: Primary care givers of children with CF and PCD aged 3-16 years were asked to enrol in the study. Primary care givers of TD children were included as control group. The Sleep Disturbance Scale for Children (SDSC) was used, and questions related to sleep habits during the pandemic were asked. Results of the three groups were compared.

Results: Primary care givers of 33 children with CF, 16 children with PCD and 66 TD children were included in the study. There were no differences in terms of age and gender between the three groups. Changes in sleep patterns during the pandemic were more common among TD children and their families, with 75% of the children and 80% of their families sleeping later than before. The sleep initiation and maintenance disorder scores were higher in TD children (P = 0.001), whereas the sleep breathing disorder scores were higher in children with PCD (P = 0.001), and the sleep hyperhidrosis scores were higher in children with CF and PCD (P = 0.011). No relationships were found between sleep parameters and clinical findings of children with lung disease.

Conclusions: Children's sleep habits have changed during the pandemic. Children with chronic lung diseases and even TD children may experience sleep disturbances during this period.
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http://dx.doi.org/10.1111/jpc.15553DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242396PMC
October 2021

Is cervical swab an efficient method for developing a new noninvasive prenatal diagnostic test for numerical and structural chromosome anomalies?

Turk J Med Sci 2021 06 28;51(3):1043-1048. Epub 2021 Jun 28.

Department of Medical Genetics, Faculty of Medicine, Gazi University, Ankara, Turkey

Background/aim: Prenatal diagnosis is vital to obtain healthy generation for risky pregnancies. There have been several approaches, some of which are routinely applied in clinics to evaluate the possible prenatal deficiencies and/or diseases. In the present study, we aimed to isolate the fetal cells from endocervical samples and try to identify possible anomalies which were proved by Amniocentesis (AS) and chorionic villus sampling (CVS) methods.

Materials And Methods: Endoservical specimens were collected from 100 pregnant women. Cells were separated in parallel by fluorescence-activated cell sorting (FACS) and magnetic-activated cell sorting (MACS) using human leukocyte antigen (HLA) G233 and placental alkaline phosphatase (PLAP) antibodies. CMA (comprehensive meta-analysis) were carried out and male fetuses were confirmed with Sex determining region Y (SRY) amplification.

Results: The percent of HLA G233 and placental and placental alkaline phosphatase (PLAP) positive cells were 4.55% and 84.59%, respectively. The percent of cells positive for both markers was 14.75%. CMA analyses were not informative. (SRY) was amplified in 67% of the samples.

Conclusion: However, the success rate of the both cell sorting and scanning of DNA anomalies by aCGH and/or RT-PCR was limited, preventing the applicability of this proposal in the clinics. Still, the success of the proposed method depends on the development of the novel fetal cell-specific antibodies and the improvements in the sorting systems.
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http://dx.doi.org/10.3906/sag-2009-347DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283453PMC
June 2021

Determination of epidemiological characteristics of addicts treated in drug addiction clinics in Kabul.

J Ethn Subst Abuse 2020 Oct 15:1-20. Epub 2020 Oct 15.

General Directorate of Public Health, Republic of Turkey, Ministry of Health, Ankara, Turkey.

According to the Afghanistan Ministry of Health, 3.5 million people use drugs, 2.4 million of which are regular users. In this cross-sectional study, it was aimed to determine epidemiological characteristics of addicts in a treatment center in Kabul. Eight hundred people were included. Statistical analysis was done with SPSS 22.0. The average age was 30.74 years, 88.9% were male, and 50.6% were married. Further, 35.9% have never been trained, 60.5% of participants were living in urban areas, 62.8% were refugees, 17.5% were unemployed, and 30.3% of them had monthly income below 147.1 USD. The average age of starting substance use was 19.9 years. "Friendship environment" was the leading reason to start (36.6%), followed by "reduce troubles" with 22.3%. The most preferred substance was cannabis (46.0%), followed by opium (25.3%) and heroin (17.0%). Heroin was the most commonly used substance lifelong (87.1%), followed by cannabis (66.3%) and opium (65.5%). When compared to individuals younger than 18, heroin use rates were 3.52 times higher in the 18-to-30 age range, 5.49 times higher in the 31-to-45 age range, and 1.86 times higher in urban residents than rural. Cannabis use was 12.24 times more among men than women, 2.79 times higher among divorced or widowed individuals than singles, 1.68 times higher among refugees than non-refugees, and 2.26 times higher among drug traffickers than non-traffickers. Opium use was 1.63 times higher for refugees than non-refugees and 3.24 times higher in those who worked in drug fields than those who did not. Periodic assessment of prevalence of drug use and the establishment of drug use monitoring systems are recommended.
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http://dx.doi.org/10.1080/15332640.2020.1824842DOI Listing
October 2020

Alcohol consumption and alcohol policy

Turk J Med Sci 2020 08 26;50(5):1197-1202. Epub 2020 Aug 26.

Department of Public Health, Faculty of Medicine, Gazi University, Ankara, Turkey

Alcohol is a unique addictive substance used by many people for different reasons. Alcohol use affects not only the users but also the family and the whole society in a negative way. Alcohol is one of the most commonly used substances for entertainment purposes in the world and 1 in 3 people is a current drinker. 2348 billion people (43% of the population) aged 15 and over are current drinkers and males drink about 2 times more frequently than females (53.6%/32.3%). According to the Global Alcohol and Health Report published by the World Health Organization (WHO) (2018), total alcohol per capita consumption (APC) worldwide aged 15 and over increased from 5.7 liters in 2000 to 6.4 liters in 2016. Harmful alcohol consumption is a major public health problem and it is known to be associated with more than 200 diseases and injuries. Policies and measures to prevent alcohol use are not implemented adequately and the burden of alcohol-related illnesses continues to increase tremendously. In order to prevent and reduce the harmful effects of alcohol, alcohol policies should be formulated based on the best evidence from a public health perspective.
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http://dx.doi.org/10.3906/sag-2002-237DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491269PMC
August 2020

Comparison of Efficacy and Safety of Two Tea Tree Oil-Based Formulations in Patients with Chronic Blepharitis: A Double-Blinded Randomized Clinical Trial.

Ocul Immunol Inflamm 2020 Aug 20;28(6):888-897. Epub 2019 Aug 20.

Department of Ophthalmology, Health Science University, Numune Health Practice and Research Center , Ankara, Turkey.

Introduction: It was aimed to evaluate the efficacy of two tea tree oil (TTO)-based cleansing gels in chronic blepharitis patients.

Methods: Group-1 (basic gel containing 3%(w/w)-TTO) included 50 eyes of 25 patients and group-2 (advanced gel containing 3%(w/w)-TTO plus essential oils and vitamins) included 48 eyes of 24 patients. Ocular Surface Disease Index (OSDI), tear breakup time (TBUT), ocular surface staining pattern, Schirmer's test, impression cytology, Demodex presence and TNF-α, IL-6, IL-1β levels were evaluated at the first visit and 1 month after treatment.

Results: In both groups, the mean OSDI score decreased (p1:0.001, p2:0.001), TBUT increased (p1:0.002, p2:0.004). In group-1, Demodex presence decreased from 42% to 27.8%; in group-2 from 54.2% to 20.6% (p1:0.302, p2:0.004). IL-1β and IL-6 decreased in group-2 (p1:0.002, p2:0.050). TNF-α decreased in both groups (p1:0.001, p2:0.001).

Conclusion: Both formulations improved ocular surface parameters. Group 2 showed more reduction in tear cytokines and Demodex count.
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http://dx.doi.org/10.1080/09273948.2019.1644349DOI Listing
August 2020

Fundamental Characteristics, Attitudes and Behaviors Regarding Substance Use Focusing on Cannabis: Findings from the General Population Survey in Turkey, 2011.

Community Ment Health J 2019 05 20;55(4):709-713. Epub 2018 Aug 20.

Department of Psychiatry, Medical Faculty, Gazi University, Ankara, Turkey.

Cannabis is the most prevalent illicit drug used in the world. We aimed to determine prevalence and some characteristics of cannabis use in Turkey. The study was based on a cross-sectional survey conducted with a nationally representative sample of 8045 individuals with in-house interviews. The life-time prevalence of substance use was found as 2.8%. Cannabis with 0.7% life-time prevalence, was the most commonly used substance. Cannabis users were concerned about some adverse outcomes such as anxiety with withdrawal (14%), losing control about using the drug (14%), daily performance problems (10.9%) and problems about interpersonal violence (6.9%). 35.1% of them wanted to quit and 18% regretted using cannabis. Prevalence of cannabis use is lower in Turkey compared with most of the other countries in the world. Nevertheless, it is a significant health concern. Identifying characteristics and attitudes related with cannabis use may help to improve policies about protective measures.
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http://dx.doi.org/10.1007/s10597-018-0328-7DOI Listing
May 2019

Predicting intraoperative pain in emergency endodontic patients: clinical study.

Braz Oral Res 2018 Aug 6;32:e38. Epub 2018 Aug 6.

Gazi University, Faculty of Dentistry, Department of Endodontics, Ankara, Turkey.

This prospective observational study sought to investigate the incidence of intraoperative pain (IOP) among emergency endodontic patients and to construct an IOP prediction model that includes preoperative pain level (PPL). All patients who underwent emergency endodontic treatment at Gazi University, Ankara, Turkey, during the spring term of 2016 were considered for inclusion in the study. Demographic and clinical variables and PPL were recorded. Local anesthesia was provided to all patients before beginning routine endodontic treatment. IOP was defined as the condition of requiring supplementary anesthesia before the working length was established and exhibiting persistent moderate or severe pain despite supplementary anesthesia. Data from 85% and 15% of 435 patients (178 men, 257 women; mean age: 35 years) were used to develop predictive models by multiple logistic regression analysis and to test external validity of the models, respectively. Two multiple logistic regression models achieved good model fits. Model 1 included age, pulpal diagnosis, and arc (p < 0.05). In addition to these variables, Model 2 included periapical diagnosis and PPL (p < 0.15). Models 1 and 2 showed accuracies of 0.76 and 0.75, sensitivities of 0.74 and 0.77, and specificities of 0.76 and 0.74, respectively for the modeling data (internal validity), and accuracies of 0.82 and 0.80, sensitivities of 0.83 and 0.67, and specificities of 0.81 and 0.81, respectively for the control data (external validity). The IOP incidence was 10.3%. IOP in patients undergoing emergency endodontic treatment can be successfully predicted by using models that account for demographic and clinical variables, including PPL.
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http://dx.doi.org/10.1590/1807-3107bor-2018.vol32.0038DOI Listing
August 2018

Prevalence and Socio-Demographic Determinants of Tobacco, Alcohol, Substance Use and Drug Misuse in General Population in Turkey.

Noro Psikiyatr Ars 2016 Sep 15;53(3):205-212. Epub 2016 Feb 15.

Department of Anti-Smuggling and Organized Crime, Republic of Turkey Ministry of Interior Turkish National Police, Ankara, Turkey.

Introduction: The aim of the current study is to determine prevalence ratios of tobacco, alcohol, substance use and drug misuse in a large scale sample of general population and recognize related socio-demographic factors.

Methods: The study was based on a cross-sectional survey conducted with a nationally representative sample of 8045 individuals with face-to-face, in-house interviews implemented by a trained team of interviewers.

Results: Life-time prevalences of tobacco, alcohol, substance use and drug misuse are 51.8%, 28.3%, 2.8% and 10.5% respectively. Age, gender, education level and marital status are important socio-demographic determinants for tobacco, alcohol use and drug misuse. Income level is an important determinant for alcohol and substance use.

Conclusion: Tobacco, alcohol, substance use and drug misuse are significant health concerns in Turkey. Socio-demographic status is an important determinant of several aspects of tobacco, alcohol, substance use and drug misuse and should therefore be evaluated carefully to develop effective protective and preventive strategies.
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http://dx.doi.org/10.5152/npa.2015.10050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378212PMC
September 2016

Military Medical Students' Awareness and Practice Concerning Occupational Health and Safety.

Mil Med 2016 09;181(9):1088-94

Department of Public Health, Gulhane Military Medical Academy, General Tevfik Saglam Street, 06018, Kecioren, Ankara, Turkey.

This study aimed to investigate the awareness and practices of military medical students concerning occupational health and safety. In this cross-sectional study, a questionnaire composed of 20 open- and closed-ended questions was administered to medical students of the Gulhane Military Medical Faculty (n = 754). The response rate of the questionnaire was 82.4% (n = 622/754). The mean age of the participants was 21.5 ± 1.84 years, and the majority of participants were male (94.1%). A substantial number of participants (41.1%) described their level of awareness and practice as "low/very low," although 95.0% and 76.7% of them had never acquired any occupational disease or had any work accidents, respectively. In total, 28.1% of all students had at least one vaccination, and 5th- and 6th-year students were 92 times and 63 times more likely to have been vaccinated than 1st-year students, respectively (odds ratio = 92.66, 95% confidence interval = 26.70-321.59; odds ratio = 63.01, 95% confidence interval = 17.96-221.01). The knowledge and practice level of medical students concerning occupational health and safety appeared to be increasing by the grades of medical faculty, however students expressed themselves as insufficient about their knowledge and practice level.
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http://dx.doi.org/10.7205/MILMED-D-15-00423DOI Listing
September 2016

Estimating high-risk cannabis and opiate use in Ankara, Istanbul and Izmir.

Drug Alcohol Rev 2017 09 27;36(5):626-632. Epub 2016 Jun 27.

Centre for Interdisciplinary Addiction Research, Hamburg University, Hamburg, Germany.

Introduction And Aims: Information on high-risk drug use in Turkey, particularly at the regional level, is lacking. The present analysis aims at estimating high-risk cannabis use (HRCU) and high-risk opiate use (HROU) in the cities of Ankara, Istanbul and Izmir.

Design And Methods: Capture-recapture and multiplier methods were applied based on treatment and police data stratified by age and gender in the years 2009 and 2010. Case definitions refer to ICD-10 cannabis (F.12) and opiate (F.11) disorder diagnoses from outpatient and inpatient treatment records and illegal possession of these drugs as recorded by the police.

Results: High-risk cannabis use was estimated at 28 500 (8.5 per 1000; 95% confidence interval 7.3-10.3) and 33 400 (11.9 per 1000; 95% confidence interval 10.7-13.5) in Ankara and Izmir, respectively. Using multipliers based on capture-recapture estimates for Izmir, HRCU in Istanbul was estimated up to 166 000 (18.0 per 1000; range: 2.8-18.0). Capture-recapture estimates of HROU resulted in 4800 (1.4 per 1000; 95% confidence interval 0.9-1.9) in Ankara and multipliers based on these gave estimates up to 20 000 (2.2 per 1000; range: 0.9-2.2) in Istanbul. HROU in Izmir was not estimated due to the low absolute numbers of opiate users.

Discussion And Conclusions: While HRCU prevalence in both Ankara and Izmir was considerably lower in comparison to an estimate for Berlin, the rate for Istanbul was only slightly lower. Compared with the majority of European cities, HROU in these three Turkish cities may be considered rather low. [Kraus L, Hay G, Richardson C, Yargic I, Ilhan N M, Ay P, Karasahin F, Pinarci M, Tuncoglu T, Piontek D, Schulte B Estimating high-risk cannabis and opiate use in Ankara, Istanbul and Izmir Drug Alcohol Rev 2016;00:000-000].
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http://dx.doi.org/10.1111/dar.12447DOI Listing
September 2017

IMPACT OF COMORBIDITY AND SOCIOECONOMIC STATUS ON QUALITY OF LIFE IN PATIENTS WITH CHRONIC DISEASES WHO ATTEND PRIMARY HEALTH CARE CENTRES.

Cent Eur J Public Health 2015 Sep;23(3):188-94

Aim: The aim of the study was to analyse the impact of chronic disease on the quality of life (QoL) and how QoL changes with comorbidity and socioeconomic status in persons who attend primary health care centres.

Methods: The group of participants comprised 2,560 people who contacted six primary health care centres in Ankara. The level of QoL was determined by the World Health Organization Quality of Life Questionnaire Abbreviated Version (WHOQOL-BREF).

Results: Mental disorders and diabetes-hypertension comorbidity had the most negative effect on the QoL. In the physical domain of the WHOQOL-BREF, the effect of diabetes-hypertension comorbidity is greater than the additive effect of hypertension and diabetes individually. The co-occurrence of any disease with cardiovascular disease does not change QoL within any domain, except for the co-occurrence of any disease with musculoskeletal diseases which deteriorated QoL in the physical domain. The higher income and socioeconomic status corresponded to higher QoL.

Conclusions: The effect of comorbidity on QoL can be different from the additive effects of the co-occurring diseases. Socioeconomic factors undoubtedly affect the relationship between chronic diseases and QoL, and this relationship points to health inequities among socioeconomic groups.
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http://dx.doi.org/10.21101/cejph.a3990DOI Listing
September 2015

Predictive Model of Intraoperative Pain during Endodontic Treatment: Prospective Observational Clinical Study.

J Endod 2016 Jan 12;42(1):36-41. Epub 2015 Nov 12.

Department of Statistics, Middle East Technical University, Ankara, Turkey.

Introduction: This observational study sought to assess the incidence of intraoperative pain (IOP) among patients receiving endodontic treatment and to construct a model for predicting the probability of IOP.

Methods: All patients attending the endodontic training clinic at Gazi University, Ankara, Turkey, during the spring term of 2014 were examined (N = 2785 patients; observation completed in 1435 patients; male: 628, female: 807; mean age: 39 years; 1655 teeth total). Demographic and clinical variables were recorded for patients requiring primary endodontic treatment. Local anesthesia was administered and routine endodontic treatment commenced. After the working length was established, each patient was asked to report any pain according to a visual analog scale. Supplementary local infiltration anesthesia was administered if necessary. If pain continued despite supplementary anesthesia, then the pain score was immediately assessed. A visual analog scale score corresponding to more than mild pain indicated IOP. A predictive model was constructed with multiple logistic regression analysis from the data of 85% of cases, with the remaining 15% of cases being used to test the external validity of the model.

Results: The incidence of IOP was 6.1% (101/1655 cases). One tooth from each patient was randomly selected, with 1435 teeth being retained for further analysis. A multiple logistic regression model was constructed with the variables age, tooth type, arc, pulpal diagnosis, pain present within the previous 24 hours, and anesthetic solution (P < .05). Good fits were obtained for the final model and external control, with a correct classification rate (efficiency) of 0.78, sensitivity (true positive rate) of 0.63, and specificity (true negative rate) of 0.79 for the external control.

Conclusions: A successful predictive model of IOP was constructed with demographic and clinical variables.
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http://dx.doi.org/10.1016/j.joen.2015.09.021DOI Listing
January 2016

Gastric Cancer Regional Detection System.

J Med Syst 2016 Jan 9;40(1):31. Epub 2015 Nov 9.

Department of Public Health, Gazi University, Ankara, Turkey.

In this study, a novel system was created to localize cancerous regions for stomach images which were taken with computed tomography(CT). The aim was to determine the coordinates of cancerous regions which spread in the stomach area in the color space with using this system. Also, to limit these areas with a high accuracy ratio and to feedback to the user of this system were the other objectives. This integration was performed with using energy mapping, analysis methods and multiple image processing methods and the system which was consisted from these advanced algorithms was appeared. For this work, in the range of 25-40 years and when gender discrimination was insignificant, 30 volunteer patients were chosen. During the formation of the system, to exalt the accuracy to the maximum level, 2 main stages were followed up. First, in the system, advanced image processing methods were processed between each other and obtained data were studied. Second, in the system, FFT and Log transformations were used respectively for the first two cases, then these transformations were used together for the third case. For totally three cases, energy distribution and DC energy intensity analysis were done and the performance of this system was investigated. Finally, with using the system's unique algorithms, a non-invasive method was achieved to detect the gastric cancer and when FFT and Log transformation were used together, the maximum success rate was obtained and this rate was calculated as 83,3119 %.
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http://dx.doi.org/10.1007/s10916-015-0399-8DOI Listing
January 2016

Hepatitis B virus and hepatitis C virus seroprevalence in the elderly living in nursing homes.

J Investig Med 2009 Aug;57(6):717-9

Department of Public Health, daggerDepartment of Microbiology and Clinical Microbiology, Beşevler, Gazi University Medical Faculty; and Department of Public Health, Baskent University Medical Faculty, Beşevler, Ankara, Turkey.

Background: : Communal living situations such as nursing homes create a risk for the spread of hepatitis B virus and hepatitis C virus (HCV). The aim of this study was to determine the seroprevalence of hepatitis B virus and HCV in the elderly living in 2 nursing homes in Ankara, Turkey.

Methods: : A total of 227 persons (mean age, 76.11 +/- 8.55 years) participated in this cross-sectional study. All individuals were investigated seroprevalence for hepatitis B surface antigen (HBsAg), anti-HBs immunoglobulin G (IgG), anti-hepatitis B core IgG, and anti-HCV IgG.

Results: : Positive seroprevalence was 11.9% for HBsAg, 48.0% for anti-HBs IgG, 25.1% for anti-hepatitis B core IgG, and 2.5% for anti-HCV IgG. Hepatitis B surface antigen positivity was 12.4% in males and 11.5% in females (P > 0.05); and the seroprevalence was 10.4% for those living in nursing homes for 1 year or less and 13.0% for those living in nursing homes for more than 1 year (P > 0.05).

Conclusions: : The fact that nearly half of those living in nursing homes had not encountered hepatitis B infection or had not received hepatitis B vaccination indicates the need for administering hepatitis B vaccines in this group.
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http://dx.doi.org/10.2310/JIM.0b013e3181ab8cabDOI Listing
August 2009

Lumbar spinal stenosis in elderly patients.

Ann N Y Acad Sci 2007 Apr;1100:173-8

Department of Neurosurgery, Ulus Hospital, 06700 Ulus, Ankara, Turkey.

Over a 3-year period in our clinic, surgeons operated on 32 persons over 65 years old with lumbar spinal stenosis. This article presents the retrospective analysis of the clinical, radiological, and short-term surgical outcomes. The stenosis seen most commonly among the elderly develops focally at the intervertebral junctions as a result of a complex process of disc degeneration, facet arthropathy, ligamentum flavum hypertrophy, spondylosis, and sometimes spondylolisthesis. All patients underwent a midline decompressive laminectomy with foraminotomies at the affected levels, and discectomy was performed in persons with lumbar disc hernia. Average age was 71.15 +/- 5.09 (65-80); 50% (16) were women, and 50% (16) were men. The most frequent symptoms were pain (96.9%) and neurological claudication (90.6%). The average preoperative duration of the symptoms was 139.87 +/- 115.03 weeks. The most frequent neurological symptoms were reflex disturbances (62.5%), Lasèques's sign (SLR) (+)(53%), and motor deficit (50%). The anteroposterior diameter of the spinal canal was less than 11.5 mm in 71.9% of the cases. In 62.5% of the patients, partial recovery was observed in the short term; 68.8% of the patients underwent laminectomy. Of those, 87.5% had total and 12.5% had partial laminectomies. In addition to laminectomy, discectomy was performed in 31.3% of the patients. Total laminectomy was more likely to be performed on patients older than 65 years, because the anteroposterior diameter was more likely to be below 11.5 mm in this cohort of patients. In lumbar stenosis, surgical treatment-decompression-is an effective method. Surgery has been demonstrated to be effective even in patients over the age of 75 years.
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http://dx.doi.org/10.1196/annals.1395.015DOI Listing
April 2007

The use of enzyme linked immunosorbent assay (ELISA) and direct fluorescent antibody (DFA) methods for diagnosis of Giardia intestinalis.

Turkiye Parazitol Derg 2006 ;30(4):275-8

Gazi University Medical School Department of Medical Microbiology, Ankara, Turkey.

The aim of this study was to evaluate the value of the direct fluorescent antibody (DFA) techniques reported to have high sensitivity and specificity and the enzyme linked immunosorbent assay (ELISA) test used to determine antigens in stool samples in the routine diagnosis of Giardia intestinalis. When 44 stool samples in which G. intestinalis cysts and/or trophozoites had been seen during native Lugol examination were investigated, positivity detected with the trichrome staining method, monoclonal ELISA method and monoclonal DFA method was found to be 37 (84.0%), 39 (88.6%) and 35 (79.5%) respectively. DFA detected Crytosporidium parvum cysts in addition to G. intestinalis in one sample. Twenty-seven (61.4%) of the samples were positive with all three methods. When compared with the DFA method, the ELISA method had a sensitivity of 88.6%, a specificity of 88.8%, a positive predictive value of 79.5% and a negative predictive value of 20.0% while the trichrome staining method had a sensitivity of 85.7%, a specificity of 77.8%, a positive predictive value of 81.1% and a negative predictive value of 22.2%. There was no statistically significant difference between the DFA and ELISA tests and between the DFA test and the trichrome staining method for diagnosing G. intestinalis (p > 0.05).
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March 2009

Assessment of urinary symptoms in children with dysfunctional elimination syndrome.

Int Urol Nephrol 2007 17;39(2):425-36. Epub 2007 Feb 17.

Faculty of Medicine, Department of Urology, Gazi University, Ankara, Turkey.

Objective: This study was organized to form a symptom scale for diagnosis and assessment of urinary and bowel symptoms in children with dysfunctional elimination syndrome (DES).

Methods: The study group included 81 children presented to our clinic with symptoms of DES like enuresis, abnormal voiding, urinary tract infection and urgency, between January 2003 and February 2004. Age matched 102 children with no history of urological complaints were randomly recruited from a public school as control group. Children with isolated, mono-symptomatic nocturnal enuresis were not taken to the study. All children and parents were requested to fill a 35-item questionnaire related to symptoms of DES. After statistical analysis, questions from the initial form that had a P-value <0.05 and an area under curve (AUC) value >0.6 were selected to form a final scale.

Results: The mean ages for study and control groups were 8.7 +/- 2.5 and 8.3 +/- 2.2 years, respectively (P = 0.236). The final scale was composed of 15 questions. The cut-off score for the presence of DES was determined as 7.5 (sensitivity 85.2%, specificity 93.1%, AUC value = 0.943) for the total population. When only the male population were concerned the cut-off score was 4.5 (sensitivity 93.8%, specificity 78%, AUC value = 0.913) while the cut-off score for the female population was 7.5 (sensitivity 87.7%, specificity 94.2%, AUC value = 0.953).

Conclusion: Providing objective assessment of symptom severity, formation of a validated scoring system for children with DES might be a good tool for diagnosis, confirmation of treatment results and follow up. It might also be useful for screening purposes.
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http://dx.doi.org/10.1007/s11255-006-9062-0DOI Listing
September 2007
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