Turkish assessment of SURF (SUrvey of Risk Factor Management) study: Control rates of cardiovascular risk factors derived from databases of 15 different levels of health centers in Turkey.

OBJECTIVE: The aim of this study was to evaluate the adherence to recommendations for secondary prevention and the achievement of treatment targets for the control of risk factors in patients with established coronary heart disease (CHD) who were followed-up at various healthcare facilities in Turkey. METHODS: According to the protocol of the international Survey of Risk Factor Management study, questionnaire forms were completed and demographic, anthropometric, and laboratory data of CHD patients who were followed-up at a total of 15 selected primary, secondary, and tertiary healthcare centers were recorded. RESULTS: Among a total of 724 CHD patients (69.8% male; mean age: 63.3±10.7 years) included in the study, 18.4% were current smokers, only 19.1% had normal body mass index, and 22.1% had waist circumference below the limit of abdominal obesity. Physical activity was insufficient in 53% of the patients, 47.3% had low high-density lipoprotein cholesterol value, 46% had triglyceride level above 150 mg/dL, and 67% had glycated hemoglobin value of 6.5% or above. Of all the patients, 88.1% were using antiplatelet drugs, 71.4% were using beta-blockers, 55.7% were using statins, and 41.9% were using angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Blood pressure was under control in 56.7% of the hypertensive patients using antihypertensive drugs, and the proportion of diabetic patients who reached glycemic control targets using antidiabetic drugs was 35.9%. Low-density lipoprotein cholesterol was below 70 mg/dL in 12.2% of the patients using statins. CONCLUSION: According to the data obtained, among Turkish CHD patients, the control rate of cardiovascular risk factors is low, and implementation of the recommendations regarding lifestyle modification and medication use for secondary prevention in the current guidelines are insufficient.

An assessment of indoor air concentrations and health risks of volatile organic compounds in three primary schools.

Concentrations of volatile organic compounds (VOCs), including formaldehyde, in classrooms, kindergartens, and outdoor playgrounds of three primary schools were measured in spring, winter, and fall terms in Izmir, Turkey. A health-risk assessment was conducted for odor detection, sensory irritation, chronic toxic effects, and cancer. Active sampling was applied for VOCs and formaldehyde on Tenax TA and DNPH tubes, respectively. VOCs were analyzed in a thermal desorption-GC-MS system. Formaldehyde analysis was performed using an HPLC instrument. Benzene, toluene, and formaldehyde were the most abundant compounds with 95th percentile indoor air concentrations of 29, 87, and 106 µg/m(3), respectively. Naphthalene and xylenes followed them with an order of magnitude lower concentrations. Two isomers of dichlorobenzene (1,3 and 1,4) were the other notable compounds. The concentrations were utilized to classify the indoor air pollutants with respect to potential health effects. In addition, carcinogenic and chronic toxic risks were estimated using Monte-Carlo simulation. Formaldehyde appears to be the most concerning pollutant with high chronic toxic and carcinogenic risk levels according to the health assessment followed by naphthalene, benzene, and toluene due to their chronic effects.

Using eddy covariance sensors to quantify carbon metabolism of peatlands: a case study in Turkey.

Net ecosystem exchange (NEE) of carbon dioxide (CO(2)) was measured in a cool temperate peatland in northwestern Turkey on a continuous basis using eddy covariance (EC) sensors and multiple (non-)linear regression-M(N)LR-models. Our results showed that hourly NEE varied between -1.26 and 1.06 mg CO(2) m(-2) s(-1), with a mean value of 0.11 mg CO(2) m(-2) s(-1). Nighttime ecosystem respiration (R(E)) was on average measured as 0.23 ± 0.09 mg CO(2) m(-2) s(-1). Two best-fit M(N)LR models estimated daytime R(E) as 0.64 ± 0.31 and 0.24 ± 0.05 mg CO(2) m(-2) s(-1). Total R(E) as the sum of nighttime and daytime R(E) ranged from 0.47 to 0.87 mg CO(2) m(-2) s(-1), thus yielding estimates of gross primary productivity (GPP) at -0.35 ± 0.18 and -0.74 ± 0.43 mg CO(2) m(-2) s(-1). Use of EC sensors and M(N)LR models is one of the most direct ways to quantify turbulent CO(2) exchanges among the soil, vegetation and atmosphere within the atmospheric boundary layer, as well as source and sink behaviors of ecosystems.

Cut-off values for waist circumference in Turkish population: Is there a threshold to predict insulin resistance?

OBJECTIVES: To identify the cut-off values for waist circumference (WC) that may best predict cardiometabolic risk associated with insulin resistance in adult Turkish men and women. STUDY DESIGN: A total of 1,039 non-diabetic subjects (592 females, 447 males; mean age 40.2+/-12.8 years) aged = or >18 years were enrolled. Insulin resistance was assessed with homeostasis model assessment of insulin resistance (HOMA-IR). The subjects were classified into quantiles based on the WC values and quantiles were compared with respect to the HOMA-IR levels. Receiver operating characteristic (ROC) analysis was used to identify the WC cut-off value that would best predict insulin resistance. RESULTS: HOMA-IR values increased in parallel with increasing WC quantiles for both genders (p=0.001). The cut-off values for WC that showed the highest sensitivity and specificity to predict insulin resistance were 93 cm for men (91.6% and 51%, respectively) and 83 cm for women (91.1% and 34.8%, respectively). CONCLUSION: Our results demonstrate that the cut-off values for WC that would best predict cardiometabolic risk associated with insulin resistance are 93 cm for men and 83 cm for women in Turkish adults. However, our findings also raise the question as to whether it is indeed necessary to define a WC cut-off value for the prediction of insulin resistance, because, regardless of the cut-off WC value taken into account, insulin resistance will be overlooked in a significant number of individuals with a WC below this cut-off value.