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1.
Artigo em Inglês | MEDLINE | ID: mdl-38192518

RESUMO

Purpose: Breast cancers exhibit molecular heterogeneity, leading to diverse clinical outcomes and therapeutic responses. Immune checkpoint inhibitors targeting PD-L1 have shown promise in various malignancies, including breast cancer. Lipocalin 2 (LCN2) has also been associated with tumor aggressiveness and prognostic potential in breast cancers. However, the expression of PD-L1 and LCN2 in breast cancer subtypes and their prognostic implications remains poorly investigated. Methods: A retrospective analysis of 89 primary breast cancer cases was conducted to assess PD-L1 and LCN2 expressions using immunohistochemistry. Cases were classified into four different molecular subtypes based on ER, PR, HER2, and Ki-67 status. Associations between PD-L1 and LCN2 expressions and various prognostic factors were examined. Results: Although low expression of LCN2 (Allred score of <3) was observed even in normal breast tissue, LCN2 expression with increasing Allred score (≥3) positively correlated with the histological grade, high Ki-67 proliferation index, and ER/PR negativity. Significant elevations of LCN2 and PD-L1 expressions were observed in triple-negative and HER2-positive breast cancers. Conclusion: The results of the study highlight the association of LCN2 with known prognostic factors and molecular subtypes. To identify potential immunotherapy recipients, it would be useful to evaluate LCN2 as well as PD-L1 immune targets in different subgroups of breast cancer patients. Further studies with larger patient numbers are warranted to validate these observations and establish standardized scoring criteria for LCN2 expression assessment.

2.
Forensic Sci Res ; 7(2): 279-284, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35784424

RESUMO

As social media becomes increasingly ubiquitous, many events are recorded and released on social media platforms, including chemical weapon attacks. We develop an objective tool in order to evaluate brief and unstructured social media videos for analysing sarin exposure from a civilian medical pathology perspective. We developed and validated this new questionnaire using a standardized procedure that includes content domain specification, item pool generation, content validity evaluation, a pilot study, and assessment of reliability and validity. In total, 51 sarin attacks and 48 matched videos were analysed. Cronbach's α for all 20 items was 0.75, which indicates adequate internal reliability. The test-retest reliability was 0.96, which indicates good internal reliability. The inter-observer intraclass correlation coefficient was 0.97. After verifying sampling adequacy with the Kaiser-Meyer-Olkin measure and the factorability of the items with Barlett's test of sphericity, a factor analysis was performed. According to the principal axis factoring, a six-factor solution explained 51.86% of the total variance. The receiver-operating characteristic curve analysis showed that the Video Score Questionnaire has a sensitivity of 0.817, a specificity of 0.478, and an efficiency of 65.3. Therefore, the Video Score Questionnaire is reliable and valid for evaluating sarin attacks from brief and unstructured social media videos.Key pointsChemical weapons are still used as a method of warfare.Social media videos are an important source of information.We developed a validated scale which can analyse sarin exposure in short and unstructured videos.

3.
Int Arch Allergy Immunol ; 183(3): 298-305, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34666333

RESUMO

BACKGROUND: Compared to penicillin, cephalosporin allergies are less common in children, and their diagnostic approach is less standardized. A recent European Academy of Allergy and Clinical Immunology position paper provided a risk stratification system for patients with suspected ß-lactam hypersensitivity reactions. OBJECTIVE: This study aimed to evaluate risk stratification and predicting factors for confirmed cephalosporin hypersensitivity. METHODS: The case-controlled study included patients with confirmed cephalosporin hypersensitivity (skin tests, n = 53; drug provocation, n = 19). For each patient, 2 age- and gender-matched control subjects were included in the study. Data were retrieved from patients' records and analyzed retrospectively. Risk stratification was performed according to the severity of index reactions, which was initially divided as high and low risk and then further divided as immediate and nonimmediate. RESULTS: According to risk stratification, the patient and control groups were divided as follows: high-risk immediate (66.7% vs. 13%, respectively), high-risk delayed (1.4% vs. 8.3%, respectively), low-risk immediate (16.7% vs. 16%, respectively), and low-risk delayed (15.3% vs. 62.9%, respectively). Immediate reactions (odds ratio [OR]: 12.1, 95% confidence interval [CI]: 9-24.8, p < 0.001) and high-risk reactions (OR: 7.8, 95% CI: 4.1-14.6, p < 0.001) were associated with confirmed cephalosporin hypersensitivity in univariate analysis. Multivariate regression analysis indicated that immediate reactions (OR: 7.5, 95% CI: 3.3-16.8, p < 0.001) and high-risk reactions (OR: 5.2, 95% CI: 2.1-12.9, p < 0.001) were significant risk factors for the prediction of cephalosporin hypersensitivity. CONCLUSION: This model can be applied in children with suspected cephalosporin allergy. Skin testing provides diagnostic information in high-risk patients with immediate reactions and reduces the need for drug provocation testing in these patients. It is highly likely to confirm the diagnosis of low-risk patients directly with provocation tests without skin tests. High-risk and immediate reactions were found to be predictive factors for confirmed cephalosporin allergy.


Assuntos
Antibacterianos , Hipersensibilidade a Drogas , Antibacterianos/efeitos adversos , Cefalosporinas/efeitos adversos , Criança , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/epidemiologia , Hipersensibilidade a Drogas/etiologia , Humanos , Estudos Retrospectivos , Medição de Risco , Testes Cutâneos
4.
J Pediatr Orthop B ; 31(2): e264-e270, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33741834

RESUMO

The objective of this study was to determine the impacts of preventable causes of fracture, such as vitamin D deficiency, disturbed calcium homeostasis and obesity on fracture occurrence in minor traumas. In this way, the effects of relevant parameters on fracture may be further elucidated. A prospective case-control study in children aged 2-18 years children with and without fractures was performed. Participants with a pediatric trauma score higher than 10 presenting to minor trauma were included to exclude the significant impact of severe trauma on fracture. The effects of obesity, parameters associated with vitamin D and Ca homeostasis on fracture occurrence were evaluated. Univariate and multivariate analyses were used to test for associations between fracture status and the assessed variables. The relationships between the variables and the odds of fracture occurrence were examined using logistic regression models. The sample consisted of 76 patients and 50 controls. There were no significant differences between the patients and controls in terms of age, sex, trauma type and pubertal period. The patients had a significantly higher mean BMI percentile (61.2 ± 30.7, 36.7 ± 30.7; P < 0.001). Likewise, patients were more likely than controls to have a lower mean 25(OH)D level and mean phosphorus level (respectively, 13.4 ± 7.0, 17.3 ± 7.8; P = 0.004, and 4.6 ± 0.7, 5.1 ± 0.8; P < 0.001). Moreover, fractures were substantially more frequent in children with vitamin D deficiency (<20 ng/mL, χ2: 7.781, df: 1, P = 0.005). In the multivariate logistic model, BMI percentile and vitamin D levels remained significantly associated with increased odds of fracture [1.02 (1.01-1.04), P < 0.001 and 0.93 (0.89-0.98), P = 0.01]. The present study supports an association of high BMI and vitamin D deficiency with an increased odds of fracture occurrence in children. The findings may help physicians to reduce the risk factors of fracture by preventive efforts. Thus, unexpected health costs and morbidity may be minimized.


Assuntos
Fraturas Ósseas , Deficiência de Vitamina D , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/etiologia , Humanos , Fatores de Risco , Vitamina D , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia
5.
Forensic Sci Med Pathol ; 16(4): 633-640, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32984922

RESUMO

Although chlorine (Cl2) has been used as a chemical warfare agent since World War I there is no known specific and reliable biomarker to indicate the presence of chlorine. We distinguished chlorinated human nails from unchlorinated ones using Raman spectroscopy and Fourier Transform Infrared (FT-IR) Spectroscopy. This research was carried out between October 2018 and July 2019 on two nail samples taken from 55 male and 104 female volunteers. One sample from each participant was chlorinated, while the second sample was used as a control. Spectral data were collected from chlorinated and unchlorinated (control) human nails using Raman and FT-IR spectroscopy. Raman measurements were made between 100 and 3200 cm-1, while FT-IR measurements were recorded over the range of 650 to 4000 cm-1. Partial least squares regression-discriminant analysis (PLS-DA) was used to develop classification models for each spectral instrument. Results showed that the control and chlorinated nail samples were successfully discriminated with similar results achieved with both instruments. Minor differences were observed in the performance of classification models. The FT-IR spectroscopy model (sensitivity = 95%, specificity = 99%, accuracy = 97%) was found to be more successful with a smaller margin of error (sensitivity = 95%, specificity = 99%, accuracy = 96%) compared to the Raman spectroscopy model. This method can be used successfully for both ante-mortem and post-mortem diagnosis of chlorine exposure.


Assuntos
Substâncias para a Guerra Química/análise , Cloro/análise , Unhas/química , Espectroscopia de Infravermelho com Transformada de Fourier , Análise Espectral Raman , Adolescente , Adulto , Análise Discriminante , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Adulto Jovem
6.
J Craniofac Surg ; 29(8): 2319-2326, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30320684

RESUMO

The sphenoid sinus is located in the center of the cranial base and is surrounded by numerous neurovascular structures. The aim of this study was to determine sphenoid sinus types and subtypes, dimensions of the sinus and cranium, and the relations of these to age and gender.Computed tomography data was obtained from 144 patients to determine right sphenoidal volume (sphVOLR), left sphenoidal volume (sphVOLL), total sphenoidal volume (sphVOLT), anteroposterior length of the sphenoid sinus (sphAP), laterolateral length of the sphenoid sinus (sphLL), head circumference (crHC), fronto-occipital length (crFO), and biparietal length (crBP), with OSIRIX software. The patients' ages ranged between 9 and 83 years (mean age 38 ±â€Š15.5 years). The study included 89 males (mean age 39 ±â€Š15.5 years) and 55 females (mean age 38 ±â€Š15.6 years).Conchal (1.4%), presellar (8.3%), sellar (23.6%), and postsellar (66.7%) type sphenoid sinuses were determined based on the extension of pneumatization around the sella turcica. Each type of sphenoid sinus was classified into the following 5 types based on the direction of pneumatization: body, full lateral, pterygoid, lesser wing, and greater wing subtypes. Mean sphAP was determined as 29.72 mm and mean sphLL as 37.73 mm. In 5 patients only (3.4%), the sphenoid sinus was not divided into right and left by the intersphenoidal septum.The variations in the extensions of pneumatization of the sphenoid sinus and its dimensions might be used to estimate the selection of a surgical approach to lesions bordering the sinus.


Assuntos
Seio Esfenoidal/anatomia & histologia , Seio Esfenoidal/diagnóstico por imagem , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Cefalometria , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Tomografia Computadorizada por Raios X , Turquia , Adulto Jovem
7.
Pediatr Emerg Care ; 34(3): 169-173, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27050739

RESUMO

AIM: The aim of the study was define the normal values of tympanic and axillary body temperature in healthy children. METHODS: This observational cross-sectional study was performed in healthy children aged 0 to 17 years who visited the ambulatory general pediatric of Istanbul Medical Faculty. RESULTS: Of 1364 children, 651 (47.7%) were girls and 713 were boys, the mean (SD, range) age was 72.5 (53.6, 1-204) months. The mean (SD) axillary body temperature was 36.04°C (0.46°C; minimum, 35.0°C; maximum, 37.6°C). The 95th and 99th percentiles were 36.8°C and 37.0°C, respectively. The mean (SD) tympanic body temperature was 36.91°C (0.46°C; minimum, 35.15°C; maximum, 37.9°C). The 95th and 99th percentiles were 37.6°C and 37.8°C, respectively. There were statistically significant differences between sexes for only tympanic body temperatures. Both axillary and tympanic body temperatures were statistically higher in 0 to 2 months compared with other age groups. For this age group, the 99th percentile was 37.5°C for axillary and 37.85°C for tympanic temperature. CONCLUSIONS: Axillary and tympanic body temperatures should be considered as fever when they are more than 37.0°C and 37.8°C, respectively. For 0 to 2 months, fever is 37.5°C and 37.85°C in axillary and tympanic temperatures, respectively.


Assuntos
Temperatura Corporal/fisiologia , Febre/diagnóstico , Termômetros/estatística & dados numéricos , Adolescente , Axila/fisiologia , Criança , Pré-Escolar , Estudos Transversais , Orelha Média/fisiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Valores de Referência , Turquia
8.
PLoS One ; 12(8): e0182409, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28832596

RESUMO

Although intimate partner violence (IPV) is an important problem that threatens women's health, very few studies focus on the victim-perpetrator relationship or examine this relationship across Turkey. The aim of this study is to contribute to a better understanding of femicide cases in Turkey and to describe the socio-demographic, clinical, forensic, and criminological characteristics of femicide victims and offenders. This study analysed 162 femicide cases that occurred in 12 cities in Turkey from 1 January 2000 to 31 December 2010. Eighty women were killed by their partners (classified as intimate partner femicide, IPF), and 81 women were killed by one of their relatives, friends, or strangers (classified as non-intimate partner femicide, non-IPF). According to our results, the typical IPF victim is of child-bearing age, does not have a paid job, is married or divorced, is killed in a domestic setting due to injuries to the thorax or abdomen produced by an edged/pointed weapon or firearm, and is possibly a victim of overkill. The typical IPF perpetrator is close to his victim's age, has a paid job, has no mental disability, owns a gun, and has threatened his partner or ex-partner previously because of jealousy/infidelity/honour or separation. The typical non-IPF victim is very similar to the IPF victim; however, her marital status can be single, married or divorced, and she is commonly killed by a relative. The surveillance and screening of femicide and IPV is an important step when analysing and attempting to prevent femicide. Second, the training and sensitization of health professionals are important. Moreover, health staff should be encouraged to participate in advocacy interventions. Third, gun ownership must be brought under control.


Assuntos
Violência Doméstica , Homicídio , Parceiros Sexuais , Mulheres , Adolescente , Adulto , Feminino , História do Século XXI , Humanos , Pessoa de Meia-Idade , Adulto Jovem
9.
Int J Pediatr Otorhinolaryngol ; 82: 81-7, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26857321

RESUMO

AIM: Cervical lymphadenopathy (LAP) is a common sign and may raise fears about serious illnesses. The aim of our study was to evaluate the patients with cervical LAPs in a general pediatrics clinic setting, and to evaluate follow-up results for potential causes and risk factors for malignancies. MATERIAL AND METHODS: Two hundred-eighteen patients aged between 79.4±46.7 months with LAP were enrolled in this prospective cohort study. The patients were examined in terms of demographics, clinical, radiologic and serologic aspects like Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus B19. A lymph node biopsy was performed in selected patients. The patients were followed-up for 8 weeks and risk factors for malignancy were evaluated. RESULTS: Seventy patients (41.3%) had specific etiology and 6 (2.7%) had malignant causes. The causes were as follows: 27% (n=59) infections; 2.7% (n=6) malignancies; 11.4% (n=25) other causes. EBV was responsible for 27% of infectious causes. The other common infectious etiologies were CMV 4.3%, parvovirus B-19 2.9%, and group-A beta-hemolytic streptococcus (GAS) 10.8%. Four of the six malignancies were lymphomas. Predictive factors for malignancy were having LAP larger than 30mm, rubbery lymph node, high serum CRP and LDH values, no hilum in ultrasonography, and enlargement of lymph node in follow-up. High uric acid levels and leucopenia were also common in the malignancy group. CONCLUSION: Etiology of cervical LAPs was diagnosed in 41.3% patients. Infectious causes were the most common cause with 27%. Malignancy was diagnosed in 2.7% and lymphoma was the most common malignancy.


Assuntos
Doenças Linfáticas/epidemiologia , Doenças Linfáticas/etiologia , Adolescente , Proteína C-Reativa/análise , Criança , Pré-Escolar , Infecções por Citomegalovirus/epidemiologia , Infecções por Vírus Epstein-Barr/epidemiologia , Feminino , Humanos , Lactente , L-Lactato Desidrogenase/sangue , Leucopenia/epidemiologia , Linfonodos/patologia , Masculino , Pescoço , Infecções por Parvoviridae/epidemiologia , Estudos Prospectivos , Infecções Estreptocócicas/epidemiologia , Streptococcus pyogenes , Turquia/epidemiologia , Ácido Úrico/sangue
10.
J Forensic Leg Med ; 29: 36-42, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25572084

RESUMO

The aim of this is to review deaths associated with the use of Riot Control Agents (RCAs) and to assess how the presenting pathologies is such cases may better inform cause of death conclusions upon autopsy. We also sought to present which additional steps should be added to the Minnesota protocol and the European harmonization of medico-legal autopsy rules in suspected cases of deaths associated with the use of RCAs. We included 10 lethal cases in our study. In three cases, RCAs were found to be the sole cause of death, in three cases RCAs were ruled a secondary cause of death due asphyxia or asthma subsequent to exposure to RCAs and in four cases RCAs were contributory factors to death. In three cases the responsible agents were identified as Chloroacetophenone (CN), Chlorobenzylidene malononitrile (CS) and Oleoresin capsicum (OC) and in the remaining 7 cases, the agent was OC alone. As there are no specific findings in suspected cases of death associated with RCA use, establishing cause of death and whether RCAs are the sole cause or only a contributory factor will be based on the elimination of other possible causes of death. For this reason, a specifically structured autopsy is essential. This specifically structured autopsy should contain basic principles of the Minnesota Protocol and the European harmonization of medico-legal autopsy rules with the following additional steps taken: examination of clothing, eyes, and skin; examination of pharyngeal, tracheobronchial, and eusophegeal mucosas; and a thorough recording of the steps taken by the party conducting the arrest, including other possible causes of in-custody death, as well as a detailed medical history of the deceased.


Assuntos
Patologia Legal/métodos , Substâncias para Controle de Distúrbios Civis/efeitos adversos , Substâncias para Controle de Distúrbios Civis/intoxicação , Adulto , Asfixia/induzido quimicamente , Asma/induzido quimicamente , Toxicologia Forense , Humanos , Masculino , Anamnese , Pessoa de Meia-Idade , Miocárdio/patologia , Extratos Vegetais/efeitos adversos , Extratos Vegetais/intoxicação , Mucosa Respiratória/patologia , Sistema Respiratório/patologia , o-Clorobenzilidenomalonitrila/efeitos adversos , o-Clorobenzilidenomalonitrila/intoxicação , ômega-Cloroacetofenona/efeitos adversos , ômega-Cloroacetofenona/intoxicação
11.
J Pediatr Gastroenterol Nutr ; 59(1): 106-11, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24647335

RESUMO

BACKGROUND: The increasing incidence of obesity in children is a significant risk factor for nonalcoholic fatty liver disease and obesity-associated morbidity. Vitamin D has a major role in bone mineral metabolism and has antimicrobial, antioxidant properties. In this study we aimed to investigate the role of vitamin D in children with obesity with hepatosteatosis. METHODS: A total of 101 children with obesity were included in this study. Hepatosteatosis was diagnosed and graded using ultrasonography. Serum levels of 25-hydroxyvitamin D (25-(OH) vitamin D), calcium, phosphate, alkaline phosphatase, and parathormone were tested. Two-sided t test and Pearson χ tests were used for the relation between vitamin D and hepatosteatosis. RESULTS: In our study group, 45.5% were girls (n=46) and the mean age was 11.5 ± 2.8 years (range 3-17 years). Hepatosteatosis was identified in 58 children (57.4%). The diagnosis of grade 1 and grade 2 hepatosteatosis was made in 41 (40.6%) and 17 (16.8%) children, respectively. Median serum 25-(OH) vitamin D levels in children without hepatosteatosis was 16.4 ng/mL (interquartile range 12.4-24.8 ng/mL), whereas children with grade 1 and grade 2 hepatosteatosis had 25-(OH) vitamin D levels of 14.2 ng/mL (interquartile range 9.5-21.2 ng/mL) and 11.5 ng/mL (interquartile range 7.5-16.7 ng/mL), respectively (P=0.005). There was a positive correlation between insulin resistance and the grade of hepatosteatosis (P=0.03). CONCLUSIONS: Serum vitamin D levels in children with obesity with hepatosteatosis are significantly lower than vitamin D levels in children with obesity without hepatosteatosis. In this observational study we only refer to the association of vitamin D deficiency/insufficiency with hepatosteatosis.


Assuntos
Hepatopatia Gordurosa não Alcoólica/sangue , Obesidade/sangue , Vitamina D/análogos & derivados , Adolescente , Fosfatase Alcalina/sangue , Proteínas de Arabidopsis/sangue , Índice de Massa Corporal , Cálcio/sangue , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Resistência à Insulina , Masculino , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Obesidade/complicações , Hormônio Paratireóideo/sangue , Índice de Gravidade de Doença , Fatores Sexuais , Ultrassonografia , Vitamina D/sangue , Circunferência da Cintura
12.
Coron Artery Dis ; 24(4): 328-33, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23425772

RESUMO

OBJECTIVE: We conducted a clinical trial to examine the effect of ω-3 fatty acids in patients with cardiac syndrome X (CSX). We aimed to evaluate the potential impact of ω-3 fatty acids on endothelial function, oxidative stress, and symptom relief in the CSX. METHODS AND RESULTS: Eighteen patients with CSX were enrolled according to a double-blind, randomized, placebo-controlled design. Patients were randomized to ω-3 fatty acids (1440 mg/day, n=8) or placebo (n=10) for 4 months. We assessed plasma levels of malondialdehyde (MDA), endothelium-dependent vasodilatation [flow-mediated dilatation (FMD)], endothelium-independent vasodilatation [nitroglycerin-mediated dilatation (NMD)], and status of symptom [score with Seattle Angina Questionnaire (SAQ)] before and after the treatment. After 4 months, patients who were treated with ω-3 fatty acids showed significant increases in the FMD (from 47±48 to 104±23%, P<0.05) and NMD (from 51±53 to 93±35%, P<0.05) values, and significant decreases in the plasma MDA levels (4.4±0.86 to 3.35±0.33 µmol/l, P=0.012). SAQ scores were increased significantly in both groups (from 60±14 to 73±15%, P<0.05 placebo, from 67±10 to 81±9%, P<0.05 treatment group). NMD was correlated negatively with the plasma MDA levels. CONCLUSION: Four months of therapy with a moderate dose of ω-3 fatty acids improved the endothelial function and reduced oxidative stress in patients with CSX.


Assuntos
Ácidos Graxos Ômega-3/uso terapêutico , Angina Microvascular/tratamento farmacológico , Adulto , Artéria Braquial/diagnóstico por imagem , Método Duplo-Cego , Endotélio Vascular/efeitos dos fármacos , Ácidos Graxos Ômega-3/farmacologia , Feminino , Humanos , Dinitrato de Isossorbida , Masculino , Malondialdeído/sangue , Angina Microvascular/sangue , Angina Microvascular/diagnóstico por imagem , Pessoa de Meia-Idade , Estresse Oxidativo/efeitos dos fármacos , Resultado do Tratamento , Ultrassonografia , Vasodilatação/efeitos dos fármacos , Vasodilatadores
13.
Tuberk Toraks ; 60(3): 291-4, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23030758

RESUMO

Tuberculosis is a disease as old as human history and has affected every area of human life. The struggle against tuberculosis had been started by non-governmental organizations and achieved success after second world war. In Anatolia as well as all over the world fight against tuberculosis, with the leading names in medicine, started during the Ottoman Empire. In the following years of struggle within the executive team will host association (Istanbul Anti-tuberculosis Association) was founded in 1918. Due to political developments that occurred shortly after standing association studies, in 1923, the Republic of Turkey in Izmir during the re-started. In the 1925 and 1927 a national medical congress, tuberculosis as the main election issue, was organized, and then in 1928 in Istanbul Tuberculosis Association again take action in the fight against decisive role in association studies have begun to undertake. In the years 1953-1973, UNICEF, Ministry of Health and later efforts Turkish National Anti-tuberculosis Association jointly significant results were obtained in the fight against tuberculosis. These positive statements given the lethargy environment, economic and political crises in the last 10 years, in parallel with the increase of tuberculosis around the world experiencing, there was an increase in Turkey. In 1986, the National Anti-Tuberculosis Federation was founded by Anti-Tuberculosis Associations. The Anti-Tuberculosis Federation has put in practice DOTS programme in 2005 in Turkey. In conclusion, we evaluate that the Anti-Tuberculosis Associations in Turkey have played a major role in struggle against tuberculosis in Turkey since the last century.


Assuntos
Tuberculose/epidemiologia , Tuberculose/prevenção & controle , História do Século XX , História do Século XXI , Humanos , Tuberculose/história , Turquia/epidemiologia
14.
Ital J Pediatr ; 38: 25, 2012 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-22682426

RESUMO

BACKGROUND: The exact etiology of recurrent tonsillopharyngitis in children is not clear. Recurrent tonsillitis in children has multifactorial etiology like most of the diseases in childhood. In this study, our aim was to determine the potential role of vitamin D in recurrent tonsillitis by measuring serum 25-OH vitamin D levels and determining the vitamin D receptor polymorphism among children with recurrent tonsillitis. METHODS: Eighty-four children with recurrent tonsillitis and seventy-one healthy children aging between 2 and 10 years were enrolled in this study. Serum 25-OH vitamin D level was measured with ELISA and vitamin D receptor gene polymorphism (Apa1, Taq 1, Fok1) was determined by PCR. Serum 25-OH vitamin D level below 50 nmol/L was accepted as deficiency. The vitamin D receptor gene polymorphism in each group was compared. RESULTS: The mean age was 5.6 ± 2.4 and 6.1 ± 2.7 years in study and control group, respectively. The average serum 25-OH vitamin D level was 142.7 ± 68.1 nmol/L in study group and 192.3 ± 56.1 nmol/L in control group. There was significant difference between the groups (p < 0.01). In study group, 4.7% (n = 4) of children had serum 25 OH vitamin D levels below 50 nmol/L. None of the children in control group had serum 25-OH vitamin D level below 50 nmol/L. There was no significant differences in vitamin D receptor gene polymorphisms between groups. CONCLUSION: Serum 25-OH vitamin D levels in recurrent tonsillitis group were lower than those in healthy children. But, there was no difference in the incidence of vitamin D receptor gene polymorphism between the two groups.


Assuntos
Faringite/sangue , Tonsilite/sangue , Vitamina D/sangue , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Polimorfismo Genético , Receptores de Calcitriol/sangue , Receptores de Calcitriol/genética , Recidiva
15.
Int J Pediatr Otorhinolaryngol ; 75(3): 364-7, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21215466

RESUMO

AIM: Although recurrent tonsillitis can be the consequence of defects in immune system, the exact etiology of recurrent tonsillitis is not clear. In this study, our aim was to determine the serum vitamin D levels and vitamin D receptor polymorphism among children undergone tonsillectomy due to the recurrent tonsillitis. METHODS: A 106 children undergone tonsillectomy due to recurrent tonsillitis and a 127 healthy children aging between 2 and 12 years were enrolled in this study, to determine serum 25-hydroxyvitamin D level and vitamin D receptor gene polymorphisms (Apa1, Taq 1, fok1). Serum vitamin D level was measured with ELISA (nmol/L) and receptor gene polymorphism was determined by PCR. Vitamin D serum level below 80nmol/L was accepted as insufficient. RESULTS: The average serum vitamin D level was 176±79nmol/L in recurrent tonsillitis group and 193±56nmol/L in control group. There was no significant difference between the groups (p=0.13). In recurrent tonsillitis group, 18% (n=15) of children had their serum vitamin D levels below 80nmol/L. The vitamin D receptor gene polymorphism (APA1, TAQ 1, FOK 1) in each group was compared (AA, Aa, aa, TT, Tt, tt, FF, Ff, ff). There was no significant difference between the two groups. The vitamin D serum levels and receptor sub-genotypes are also compared, and there was no significant difference between the groups. CONCLUSION: There is no difference between the serum vitamin D level and receptor gene polymorphism among children with recurrent tonsillitis and healthy children. But vitamin D insufficiency is more prevalent in children with recurrent tonsillitis group (18%).


Assuntos
Receptores de Calcitriol/genética , Tonsilite/sangue , Tonsilite/genética , Vitamina D/análogos & derivados , Estudos de Casos e Controles , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Reação em Cadeia da Polimerase , Polimorfismo Genético , Estudos Prospectivos , Recidiva , Tonsilectomia , Tonsilite/cirurgia , Vitamina D/sangue
16.
Psychiatry Res ; 187(1-2): 140-4, 2011 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-21040980

RESUMO

Self-harm, suicidal ideation, and suicide attempts are well represented behaviours in the general population of both developed and developing countries. These behaviours are indicative of underlying risk factors that show a strong interdependent correlation. In this study we attempted to define correlates for and prevalence of self-harm, suicidal ideation, and suicide attempts among Turkish college students. This 2006 study included 636 students from two Turkish state universities. Our results showed that the lifetime prevalence of self-harm was 15.4%, the prevalence of suicidal ideation was 11.4%, and the prevalence of suicide attempts was 7.1%. We uncovered correlates for self-harm, including low income, unsatisfying familial relationships, smoking, and alcohol, inhalant, and tranquilizer abuse. Tranquilizer abuse shared a dual role as a correlate for suicide ideation and as a means to attempt suicide. Additionally, we found that drug abusers and adolescents who practise self-harm presented the highest suicide risk.


Assuntos
Comportamento Autodestrutivo/epidemiologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Adolescente , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Estudantes , Universidades , Adulto Jovem
17.
J Turk Ger Gynecol Assoc ; 11(1): 16-21, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-24591889

RESUMO

OBJECTIVE: This study was designed to evaluate the awareness, knowledge and attitudes of healthcare providers related to HPV infection and vaccine. MATERIAL AND METHODS: A total of 311 healthcare providers working in specialties other than obstetrics and gynecology at the Dr. Lutfi Kirdar Kartal Education and Research Hospital as physicians (n=142) or non-physician healthcare providers (n=169) were included in the present study. A questionnaire developed by researchers based on literature and including items concerning socio-demographic features, awareness of HPV infection and vaccine, attitudes related to HPV vaccine and regular gynecological controls and knowledge about HPV infection was applied to participants via a face to face interview method. Each correct answer was scored as one to decide the level of knowledge and awareness. RESULTS: The frequency of parenthood was lower and the ratio of males was higher in the physician group compared to the non-physician group. Awareness of virus mediated cancer (p=0.01), human papilloma virus (p=0.0001), cervical cancer, HPV vaccine, and types of HPV vaccine was significantly higher in the physician group. While consent levels for vaccine administration for themselves were similar for physician and non-physician subjects, the frequency of subjects favoring vaccine administration for their offspring was significantly higher among physicians (p<0.001 for daughters, p<0.05 for sons). HPV-related level of knowledge in the physicians was significantly higher when compared to the non-physician staff (p<0.001). CONCLUSION: Physicians were more competent regarding the relation of HPV infection to cervical cancer and more aware of the presence and types of HPV vaccines which may lead to a higher degree of willingness for vaccination when compared with non-physician healthcare providers.

18.
J Addict Med ; 4(2): 93-8, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21769027

RESUMO

OBJECTIVES: Illicit drug use peaks during late adolescence and young adulthood. Turkey has a young population, and, as an historical opium producing country, it has experienced a continual illicit drug abuse problem. This study aimed to estimate the prevalence of substance abuse, to determine the risk factors associated with drug abuse, and to compare the drug abuse between a metropolitan and a rural area. METHODS: This was a cross-sectional study performed between March 2007 and May 2008 at 2 universities; 1 from a rural area (Gaziosmanpasa University) and 1 from a metropolitan area (Istanbul University). RESULTS: We found that the most common drugs were minor tranquilizers (5.7%), followed by inhalants (4.9%), and cannabis (3.6%). Cannabis and inhalant abuse were especially common among males. The major risk factors were contact with a person, such as a family member or a peer, who practiced substance abuse, a low level of success at school, being arrested or in trouble with the police, and burglary or theft. CONCLUSIONS: These risk factors were similar those identified in developed countries. Similar risk factors were shared between different substances. Hence, preventive measures should target substance abuse in general, rather than focusing on controlling the abuse of individual substances.

19.
J Forensic Sci ; 54(6): 1388-92, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19737338

RESUMO

In this study, we have analyzed the temporal and spatial trends in actor unknown political murders in Turkey. A total of 1852 cases, defined as actor unknown political murders, occurred in Turkey between 1975 and 2006, with the peak years being 1980 and 1994. Three different time frames could be defined: 1975-1993, 1994-1999, and 2000-2006. During the first period, cases were common all over Turkey, but during the second and third periods, they were more frequent in metropolitan areas and in the southeast. Incidents occurring during the first period could be attributed to the struggle between right- and left-wing supporters, while most murders occurring during the second and third periods seem to have been related to Kurdish separatism. Although the most crucial factor in preventing actor unknown political murders is a politically stable atmosphere, forensics can also play an important role. Turkey needs to improve its forensic services to bring them in line with international standards, namely the Minnesota Protocol.


Assuntos
Homicídio/estatística & dados numéricos , Política , Terrorismo , Adulto , Vítimas de Crime/estatística & dados numéricos , Escolaridade , Etnicidade/estatística & dados numéricos , Feminino , Incêndios , Medicina Legal , Humanos , Masculino , Ocupações/estatística & dados numéricos , Sistema de Registros , Estudos Retrospectivos , Tortura/estatística & dados numéricos , Turquia , Ferimentos e Lesões/mortalidade
20.
J Forensic Sci ; 54(5): 1185-8, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19674238

RESUMO

Turkey has continuously experienced problems with abuse of, and addiction to, opium derivatives. In this study, we analyzed the relationship between heroin overdose deaths and the characteristics of seized opium derivatives. Data were gathered from the Council of Forensic Medicine of the Ministry of Justice in Istanbul from 1990 to 2000. There were 636 heroin-related deaths during this period, 595 of which were classified as heroin overdose deaths. Mean crude and weighted heroin purities remained relatively constant and were calculated to be 46% (57-34%) and 51% (39-59%), respectively. The weight of heroin and the number of heroin seizures, but not the heroin purity, were significantly associated with the number of heroin-related deaths. Prevention strategies are needed to reduce the number of deaths caused by overdoses in countries situated on drug trafficking routes. These strategies should focus on drug trafficking, by providing increased levels of, and support for, law enforcement, stopping the supply of precursor chemicals, and combating corruption among border officials.


Assuntos
Heroína/intoxicação , Drogas Ilícitas/química , Drogas Ilícitas/intoxicação , Entorpecentes/intoxicação , Overdose de Drogas , Feminino , Toxicologia Forense , Heroína/química , Humanos , Masculino , Entorpecentes/química , Intoxicação/mortalidade , Sistema de Registros , Estudos Retrospectivos , Turquia
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