Push and Pull Factors of Why Medical Students Want to Leave Türkiye: A Countrywide Multicenter Study.

Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians' migration decisions are still unclear. Despite its wide coverage in the media and among physicians in Türkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in Türkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in Türkiye in 2022. Besides participants' migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in Türkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research & Development were 1.37 (95% CI: 1.22-1.54) times more likely to emigrate. The push factor that was related to emigration intention was the "working conditions in the country" (OR: 1.89, 95% CI: 1.56-2.28) whereas the "social environment/lifestyle abroad" was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45-2.06). In addition, the quality problem in medical schools also had a significant impact on students' decisions (OR: 2.20, 95% CI: 1.83-2.65). Insights: Although the percentage of those who want to emigrate "definitely" was at the same level as in the other developing countries, the tendency to migrate "permanently" was higher in Türkiye. Improving working conditions in the country and increasing the quality of medical faculties seem vital in preventing the migration of physicians.

Evaluation of depression, social support and quality of life in perimenopausal and postmenopausal women in semi-rural Turkey.

BACKGROUND: This study aimed to determine the prevalence of depression in perimenopausal and postmenopausal women in a semi-rural area in a city in Turkey and to evaluate perceived social support and quality of life by examining some of the variables thought to be related. METHODS: The study was conducted on 827 perimenopausal and postmenopausal women aged 40-60 years. The questionnaire included sociodemographic characteristics, some variables associated with depression, questions from the Beck Depression Inventory, Multidimensional Scale of Perceived Social Support, and European Health Impact Scale - Quality of Life-8 (EUROHIS-QOL-8) scale. RESULTS: The prevalence of depression was 23.1% (n = 191) in the study. The prevalence of depression was found to be higher in single/widowed/separated individuals (odds ratio (OR): 2.539; 95% CI: 1.593-4.047) and at poor income levels (1.980; 1.000-3.021). The frequency of depression was found to be lower in those who gave birth once or twice (0.470; 0.294-0.752), those with a high level of social support (0.959; 0.948-0.971), and those with a high level of QOL (0.836; 0.794-0.879). There was a moderate negative correlation between the depression scale and QOL scale scores (r = -0.405, P = 0.001). A weak negative correlation was found between depression and social support scores (r = -0.383, P = 0.001). CONCLUSION: Women are more vulnerable to depression in premenopausal and postmenopausal periods. Being single/widowed, having a poor income level, having low social support, and low QOL are important risk factors which increase the frequency of depression.

A comparative evaluation of the Eustachian tube cartilage between healthy and diseased ears using a 3 Tesla MRI.

PURPOSE: The purpose of this study was to prospectively assess the Eustachian tube (ET) cartilage using 3 Tesla (3T) magnetic resonance imaging (MRI) and compare the results between healthy ears and those with a middle ear disease. MATERIAL AND METHODS: The study included 56 ears with a middle ear disease as the patient group and 100 ears without a middle ear disease as the control group. The patients' age ranged from 18 to 65 years. The axial three-dimensional (3D) multiple echo recombined gradient echo (MERGE) sequence and oblique parasagittal planes were obtained. Visualisation of the ET cartilage was assessed on the MR images using a three-point numerical rating score. In the axial plane, the ET lumen's diameter was measured from the mid-portion of the cartilage. RESULTS: There was no significant difference between the patient group and the control group according to patients' age and gender, and the medial laminal thickness of the ET cartilage. In the patient group, the diameter of the ET cartilage was significantly smaller than in the control group. The ET lumen diameter was significantly lower according to each of the three scoring systems. CONCLUSIONS: 3T MRI provides an evaluation of the ET cartilage and isthmus level, which are small but important anatomical localisations and surgical landmarks. MR imaging has the potential to provide essential information on ET prior to new surgical treatments, such as balloon dilation for middle ear diseases.

Menstruation-related headache in adolescents: Point prevalence and associated factors.

BACKGROUND: The aim of this study was to investigate the prevalence of menstruation-related headache and the impact of associated factors in adolescents. METHODS: This cross-sectional study was conducted in seven randomly selected high schools, and 3,886 girls attending those schools were invited to take part. After the consent of the school principals, a final total of 2,485 girls (63.9%) were involved in the study. A specific questionnaire was distributed to adolescent girls (14-19 years old). The first part of the survey investigated the features of menstruation (age at first menstruation, duration of period, pad fully soaked per day). The last part of the questionnaire surveyed the presence of headache during the menstrual period. The severity of headache was measured using a visual analog scale. Last, participants were requested to complete the Beck Depression Inventory (BDI). The prevalence of menstruation-related headache and associated factors were studied. RESULTS: Mean subject age was 15.89 ± 1.07 years (range, 14-19 years) and mean age at menarche was 12.96 ± 1.09 years old. The prevalence of menstruation-related headache was 25.9% (n = 646). Onset of menstruation at <12 years of age, longer duration of menstruation period, dysmenorrhea, daily consumption of coffee and cola and smoking significantly affected the frequency of menstruation-related headache. Mean BDI score was 21.68 ± 13.65 and was significantly associated with menstruation headache. CONCLUSION: Menstruation-related headache is a common problem in adolescent girls. It might be associated with different comorbidities such as depression. Accordingly, a multidisciplinary treatment approach must be considered to improve the quality of life.

Assessment of internet addiction and loneliness in secondary and high school students.

OBJECTIVE: To determine the frequency of Internet addiction and loneliness in secondary and high school students. METHODS: The cross-sectional study was conducted between May 7 and June 8, 2012, among secondary and high school students in Sivrihisar, which is a district in rural part of Anatolia, Turkey. The study group consisted of 1157 students. Young Internet Addiction Scale was used to assess the internet addiction. University of California, Los Angeles Loneliness Scale was used for the evaluation of the level of loneliness. SPSS 15 was used for statistical analysis. RESULTS: Of the 1157 students, there were 636 (55.0%) male and 521 (45.0%) female aged 11 to 19 years (mean: 15.13 ± 1.71 years). According to the Internet Addiction Scale, 91 (7.9%) of the subjects were addicted to the internet. Obesity (odds ratio: 9.57), "Type A" personality (odds ratio: 1.83), first time usage of internet before age 12 (odds ratio: 2.18), using the internet every day (odds ratio: 2.47) and use the internet more than 2 hours a day (odds ratio: 4.96) were risk factors of internet addiction (p < 0.05). A positive correlation was found between the internet addiction and loneliness (rs = 0.121; p < 0.001). CONCLUSION: Internet addiction was found to be a major health problem in middle and high school students. A positive correlation between loneliness and internet addiction was also found.

Prevalence of domestic violence and associated factors among married women in a semi-rural area of western Turkey.

UNLABELLED: Objective : To determine the prevalence of domestic violence and associated factors among married women in a semi-rural area of western Turkey. METHODS: This descriptive study was conducted between March 1 and April 29, 2011 on married women aged 15-49 years. Exposure to at least one of these types of violence at least one time within the past one year was regarded as the presence of domestic violence. Chi-square test and Logistic Regression analysis was used for statistical analysis. RESULTS: Prevalence of domestic violence against women was found to be 39.0%. About 38,4% and 26.8% of women reported verbal and psychological violence respectively. The risk factors found for the domestic violence included youngest age group, an educational level of secondary/high school for men, form of the first marriage, number of children, alcohol and gambling habits of the husband. CONCLUSION: Our study found higher prevalence of domestic violence than expected. Verbal violence is also a significant problem particularly in terms of its consequences. It was concluded that further informative studies are needed on domestic violence to find out the causative factors to chalk out preventive strategies.

The Validity and Reliability of the Turkish Version of the Autism Family Experience Questionnaire (AFEQ).

The aim of this study was to examine the reliability and validity of the Turkish version of the AFEQ for Turkish parents of children with ASD. The Turkish-translated version of the AFEQ was administered to 241 parents of children aged 2-12 years with ASD to examine the construct validity and internal consistencies. Parents completed the Autism Behavior Checklist (ABC), and Quality of Life in Autism Questionnaire Parent version, along with the AFEQ. The mean age of the children of 241 individuals in the study group was 7.63 ± 3.02 and 88.4% (n = 213) were male. Cronbach's alpha coefficient was 0.921 of the total variance. Cronbach alpha coefficients are 0.813 for the "Experience of being a parent" subscale, 0.768 for the "Family Life" subscale, 0.810 for the "Child Development, Understanding and Social Relationships" subscale, and 0.804 for the "Child Symptoms (Feelings and Behaviour)" subscale. In conclusion, the translated and culturally adapted AFEQ shows good reliability and validity to measure the priorities of autistic children and their families in Turkey. It can also be useful in monitoring the effectiveness of intervention programs and changes in the child.

Acute mercury poisoning among children in two provinces of Turkey.

Elemental mercury exposure occurs frequently and is potentially a toxic, particularly in children. Children are often attracted to elemental mercury because of its color, density, and tendency to form beads. Clinical manifestations of elemental mercury intoxication vary depending on its form, concentration, route of ingestion, and the duration of exposure. We present data on 179 pediatric cases of elemental mercury poisoning from exposure to mercury in schools in two different provinces of Turkey. Of all patients, 160 children had both touched/played with the mercury and inhaled its vapors, while 26 children had only inhaled the mercury vapor, two children reported having tasted the mercury. The median duration of exposure was 5 min (min 1-max 100), and 11 (6 %) children were exposed to the mercury for more than 24 h at home. More than half of the children (51.9 %) were asymptomatic at admission. Headache was the most common presenting complaint. The results of physical and neurological examinations were normal in 80 (44.6 %) children. Mid-dilated/dilated pupils were the most common neurological abnormality, and this sign was present in 90 (50.2 %) children. Mercury levels were measured in 24-h urine samples daily, and it was shown that the median urinary level of mercury was 29.80 µg/L (min, 2.40 µg/L; max, 4,687 µg/L). A positive correlation was also found between the duration of exposure and urinary mercury levels (r = 0.23, p = 0.001). All patients were followed up for 6 months. On the first follow-up visit performed 1 month after discharge, the neurological examinations of all patients were normal except for those patients with peripheral neuropathy and visual field defects. On the last follow-up visit at the sixth month, only two children still experienced visual field defects. In conclusion, this study is one of the largest case series of mercury intoxication of students in schools. Elemental mercury exposure can be potentially toxic, and its symptomatology is variable, particularly in children. Therefore, school staff and children should be aware of the risk of mercury toxicity. Pediatricians also need to warn parents and children about the hazards of playing with any chemical.

Breath holding spells: point prevalence and associated factors among Turkish children.

BACKGROUND: Breath holding spells (BHS) are known as paroxysmal non-epileptic disorder. There are two subtypes of BHS: cyanotic and the pallid. BHS have been reported to occur in 0.1-4.6% of children in Western countries. Although it is easy to diagnose in its typical form, the data on prevalence of BHS are insufficient in developing countries. METHODS: This study was performed in Turkey's Eskisehir province. A total of 1000 randomly selected 0-6-year-old children were invited to family health centers. A specific questionnaire was given to parents. Children who had a history BHS were referred to the hospital to for investigation of medical history and neurological examinations. RESULTS: A total of 933 children participated and were included in analysis. Thirty-four children (3.6%) had had BHS. Children's birthweight, parent consanguinity and mothers' education status significantly affected the frequency of BHS. Increase in birth sequence decreases the risk of BHS 0.65-fold. Fathers' education status also affected the prevalence of BHS, with the risk of BHS being 0.39-fold less if the father had completed high school or some higher education. And, as the age of the fathers increased, the risk that their children would have BHS was 1.14-fold higher. CONCLUSIONS: Although the calculated prevalence rate was compatible with previous studies, positive family history for BHS, birth sequence, parents' education status and fathers' age were identified as risk factors associated with BHS.

Evaluation of MicroRNAs in Pediatric Epilepsy.

OBJECTIVE: The pathophysiology of epilepsy remains unknown. Recent research has shown that microRNA expression changes in epileptic adults. In the present work, we aimed to identify serum microRNA expression in drug-responsive and resistant children with idiopathic general- ized epilepsy. MATERIALS AND METHODS: The study included 43 (20 male and 23 female) epilepsy patients and 66 (43 male and 23 female) control subjects. The mean ages of the groups were 113.41 ± 61.83 and 105.46 ± 62.31 months, respectively. Twenty-eight epileptic patients were classi- fied as drug resistant. Thirteen of the controls were the siblings of patients with epilepsy. The study only included children with idiopathic generalized epilepsy who had normal brain mag- netic resonance imaging. The serum microRNA expressions (microRNA-181a, microRNA-155, microRNA-146, and microRNA-223) were investigated. Expressions of serum microRNA-181a, microRNA-155, microRNA-146, and microRNA-223 were previously investigated in epilepsy patients and children with febrile seizures. Therefore, these microRNAs were chosen. The expressions of serum levels of microRNAs were determined using quantitative real-time poly- merase chain reaction. RESULTS: The results indicated that the expressions of serum microRNA-155 and microRNA-223 were elevated in epileptic children (P < .05). The expression of the same microRNAs was also elevated in individuals with drug-resistant epilepsy compared to healthy controls (P < .05). microRNA-146a, microRNA-155, and microRNA-223 expressions were higher in drug-resistant patients than in drug-responsive children (P < .05). A logistic regression study determined that an increase of microRNA-155 was a risk for epilepsy, while a decrease of microRNA-146a risk for epilepsy. CONCLUSION: Few researchers have investigated the function of microRNAs in the develop- ment of childhood epilepsy. Our findings revealed that epilepsy patients have abnormal microRNAexpression.

Evaluation of Relationship Between Cyberchondria and Obsessive Beliefs in Adults.

OBJECTIVE: The aim of this study was to evaluate the relationship between cyberchondria and obsessive beliefs and determine the potential risk of the former. METHODS: This was a cross-sectional study conducted with 777 individuals. The Cyberchondria Severity Scale and the Obsessive Beliefs Questionnaire were applied to the participants. Univariate and hierarchical multiple linear regression analyses were used to analyze the data. RESULTS: Of the study group 382 (49.2%) were male, 395 (50.8%), female. Their ages ranged from 18 to 63 years, with an average of 32.6 (± 9.6) years. Multiple linear regression analysis found that the frequency of internet use (several times a day; n = 670), using the internet as a source of health-related information (n = 320), using the internet to research a doctor before making and/or attending an appointment with same (n = 363), halting the use of prescribed medication based on information obtained on the internet (n = 177), and obsessive beliefs were factors linked to cyberchondria. Cyberchondria and obsessive beliefs were positively related and in the final model were found to be the strongest determinants of cyberchondria. CONCLUSION: Obsessive beliefs may be a potential risk factor for cyberchondria. Since cyberchondria affects people's health related behaviors, it is important to ensure the safety of health-related information on the internet. The results of this study may guide future ones that thoroughly investigate the factors associated with cyberchondria. More comprehensive studies are needed to reveal the relationship between cyberchondria and obsessive beliefs.

Traditional school bullying and cyberbullying: Prevalence, the effect on mental health problems and self-harm behavior.

Bullying is widely recognized as a major psychosocial problem with substantial negative consequences. The current study aimed to estimate the prevalence of traditional school bullying and cyberbullying and reciprocal associations between bullying involvement and mental health problems. The sample of the study consisted of 6202 middle and high school students (age 11-18, M= 14.4 ±1.9 years, 54% boy). Bullying involvement, self-harm behavior, anxiety, depression, and psychosocial difficulties were assessed by self-report questionnaire. The prevalence of traditional school bullying and cyberbullying victimization was 33% (95% CI 32.1-34.5%) and 17% (95% CI 16.3-18.2%), respectively. The prevalence of traditional school bullying and cyberbullying perpetration was 22.4% (95% CI 21.3-23.4%) and 10.4% (95% CI 9.7-11.3%), respectively. Bullying involvement -as a victim, perpetrator, or both- was associated with anxiety, depression, psychosocial difficulties, and self-harm behavior. Girls were more likely to be affected than boys in mental health outcomes. A significant association between bullying victimization and negative mental health outcomes were also observed. These findings provide evidence to intervention strategies need to target both traditional and cyberbullying involvement. Understanding the risk profile will help create useful and appropriate interventions, which will reduce the early effect of bullying on mental health and modify the clinical course.

Prevalence of onychophagia and its relation to stress and quality of life.

INTRODUCTION: Onychophagia is defined as putting one's fingers into the mouth and biting the nails. We sought to evaluate the prevalence of onychophagia in university and high school students and its relation to sociodemographic factors, perceived stress, and quality of life. METHODS: A total of 3,475 students were included in the study. A questionnaire including sociodemographic characteristics, items about onychophagia, the Perceived Stress Scale (PSS), and the European Health Impact Scale were used. RESULTS: The prevalence of onychophagia among university students was 17.6%, and among high school students it was 29.2%. In university students with onychophagia, the median score on the PSS was higher than the median score of students without onychophagia. In high school students, the median score on the PSS was 28.2 for students without onychophagia and 28.0 for students with onychophagia; the difference was not significant. The median scores on the quality of life scale for both university and high school students with onychophagia were lower than the mean score of students without onychophagia. CONCLUSIONS: Onychophagia is a common problem in the general population with a multidimensional etiology. It has dermatological, dental, and psychiatric consequences and comorbidities, and so a multidisciplinary approach is necessary for the prevention and treatment of onychophagia.

Expression of MicroRNA 146a, 155, 181 and 223 in febrile seizure.

BACKGROUND: We studied microRNAs (miRNAs) -146a, -155, -181 and -223 expressions and proinflammatory cytokine levels in children with Febrile seizure (FS) and compared to febrile controls. METHODS: This prospective multicenter study examined representative populations in eight different cities in Turkey between June 30, 2018 and July 1, 2019. Blood samples were taken from all children at presentation. The real time (RT) polymerase chain reaction (PCR) were used to measure the expressions of microRNAs and tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1ß), and interleukin 6 (IL-6) levels were studied by enzyme-linked immuno-sorbent assay. RESULTS: The study was conducted with 60 children; 30 children with FS and 30 children in the febrile control group. The seizure was classified as simple FS in 73.3 % and half of the children were experiencing their first FS episode. Although the expression levels of miRNAs-146a, -181a and -155 were higher in febrile seizure patients, only miRNAs 146a level was significantly higher in FS patients. Serum TNF-α, IL-1ß, IL-6 levels were higher in the FS group than the controls. The results of statistical analysis showed that there were correlations within miRNA expressions in children with FS. No differences were found considering miRNA expression between FS type, number of FS experienced. CONCLUSIONS: miRNAs-146a, -181a, -155 and -223 may be involved in FS pathogenesis. Altered miRNA expression levels might be an adaptive response to inflammation. New therapeutic approaches might be developed based on miRNA expressions in children with FS.

Developing a scale of social attitude towards childhood epilepsies: a validity and reliability study.

AIM: There is no scale of social attitude towards childhood epilepsies. In this research study, it was aimed to develop a valid and reliable scale based on three-component attitude model to measure society's attitudes towards childhood epilepsy. MATERIAL AND METHODS: This study was conducted in a province in Central Anatolia with 314 participants (150 males and 164 emales) aged between 18 and 68 years. The data in the study were obtained by applying a draft scale consisting of 52 items. Correlation analysis was performed to determine item discrimination of the items included in the draft scale; exploratory and confirmatory factor analyses were performed to determine the scale's structure validity and Cronbach alpha internal-consistency coefficients were used to determine the scale's measurement reliability. RESULTS: In the study, a two-factor structure with an eigenvalue above 1, which explained 52.39% of the variance, was obtained as a result of principal component analysis and Horn's parallel analysis. Following confirmatory factor analysis, the factor structure modeled in exploratory factor analysis was confirmed within the context of standard fit values. The Cronbach alpha internal consistency coefficient (measurement reliability of the scale) was between 0.75 and 0.85. The Childhood Epilepsy Attitude Scale consists of 12 items included in two factors: (i) Affective and Behavioral Attitude and (ii) Cognitive Attitude. The scale is a 5-point Likert-type scale. CONCLUSION: According to the data obtained in the study, the scale is a valid and reliable data collection tool that can be used for measuring individuals' attitudes towards childhood epilepsy. It is thought that this scale can be used in studies related to childhood epilepsy.

Clinical and epidemiological characteristics and associated factors of hair graying: a population-based, cross-sectional study in Turkey.

BACKGROUND: Hair graying is common in humans; but there is scarce data about its epidemiology. OBJECTIVE: This study aimed to evaluate the clinical and epidemiological characteristics and associated factors of hair graying. METHODS: A total of 1541 volunteers between 15 and 65 years old were included in this population-based, cross-sectional study. A questionnaire on characteristics and associated factors of hair graying was filled in by face-to-face interview method. RESULTS: One thousand sixty three participants (69.0%) had hair graying. The mean onset age of hair graying was 32.9±9.8 years. It was 31.7±9.5 years in females, whereas 33.7±10.0 years in males (p=0.001). The most common involved area of hair graying at the onset and at the time of the interview was temporal region. When it was evaluated by gender, it was temporal in males whereas parietal in females. Hair graying was more severe in males than in females and in late-onset hair graying than early-onset hair graying (respectively, p=0.000, p<0.001). The most common involved area at the onset and at the present was temporal in severe hair graying; whereas parietal in mild hair graying. In logistic regression analysis, age, educational status, presence of hair loss, skin type, family history of early-onset hair graying and anxiety were independently related to hair graying (p<0.05). STUDY LIMITATIONS: The study was performed in only Turkish individuals. The recall biases were another limitations. CONCLUSION: Male gender, late-onset and temporal-onset of hair graying may be considered to be poor prognostic factors for hair graying. There is need for further epidemiological studies in people with different ethnic origin to illuminate the clinical and epidemiological characteristics and associated factors of hair graying.

The frequency of alopecia and quality of life in high-school students in rural areas (Sivrihisar, Mahmudiye, Alpu, and Beylikova) of Eskisehir.

OBJECTIVE: The aim of the present study was to determine the incidence of alopecia and related factors and the health-related quality of life (HRQoL) in high-school students in rural areas of Eskisehir. This was a cross-sectional study. METHODS: The study was performed between March 2, 2015 and April 30, 2015. A total of 1662 (74.9%) students were included in the study. The questionnaire performed for the purpose and consisted of four sections was filled out by the students themselves under supervision. The HRQoL was evaluated by Short Form-36 (SF-36). Students' hair and scalps were examined by a dermatologist. The acquired data were analyzed by SPSS 20 statistical package program. Chi-square test, Mann-Whitney U test, and logistic regression analyses were used for statistical analyses. A p value ≤0.05 was accepted as statistically significant. RESULTS: In the present study, the incidence of alopecia was found to be 37.4% (n=622). Alopecia was more frequently seen in male students who have complaints about their scalps and those with a fatty scalp. In the study group, students with alopecia had poor HRQoL in general health perception, vitality, and mental health of SF-36. CONCLUSION: There is a need to provide early diagnosis and treatment to decrease the incidence of alopecia and to improve the quality of life. Health education studies must be performed to increase the awareness of students about alopecia. Integrating hair and scalp examination into school health screening studies, steering the students who have alopecia to the dermatologists, and suggesting students who have fatty scalp regular hair washing will be appropriate.

Viral etiological causes of febrile seizures for respiratory pathogens (EFES Study).

BACKGROUND: Febrile seizure is the most common childhood neurological disorder, is an important health problem with potential short- and long-term complications, also leading to economic burden and increased parental anxiety about fevers and seizures occurring in their children. There are no routine recommendation to detect etiological causes of FS for neurological perspective, further knowledge about the etiological causes of FS in children will support preventive measures and follow-up strategies. The aim of this study is to evaluate the percentage of respiratory viruses in children with FS. METHODS: This prospective multicenter study, entitled "Viral etiological causes of febrile seizures for respiratory pathogens (EFES Study)" examined representative populations in eight different cities in Turkey between March 1, 2016 and April 1, 2017. Nasopharyngeal swabs were taken from all children at presentation. A respiratory multiplex array was performed to detect for influenza A and B; respiratory syncytial virus A and B; human parainfluenza virus 1-2-3 and 4; human coronavirus 229E and OC43; human rhinovirus; human enterovirus; human adenovirus; human bocavirus; human metapneumovirus. RESULTS: During the study period, at least one virus was detected in 82.7% (144/174) of children with FS. The most frequently detected virus was adenovirus, followed by influenza A and influenza B. Detection of more than one virus was present in 58.3% of the children with FS, and the most common co-existence was the presence of adenovirus and influenza B. In children younger than 12 months, Coronavirus OC43 was the most common, while influenza A was most frequently observed in children older than 48 months (p < 0.05). Human bocavirus was common in children who experienced complex FS, while respiratory syncytial virus (RSV) A was more common in children who experienced simple FS. Influenza B virus was the most common virus identified in children who were experiencing their first incidence of FS (p < 0.05). CONCLUSIONS: This study indicates that respiratory viruses are important in the etiology of FS in children. The results show that antibiotics must be prescribed carefully in children with FS since the majority of cases are related to viral causes. Widespread use of the existing quadrivalent influenza vaccine might be useful for the prevention of FS related to the flu. Further vaccine candidates for potential respiratory pathogens, including RSV, might be helpful for the prevention of FS.

Prevalence of osteoporosis in middle Anatolian population using calcaneal ultrasonography method.

BACKGROUND: There are a few studies on the prevalence of osteoporosis in Turkey. Most of such studies have been performed using classical diagnostic methods. Quantitative calcaneal ultrasonography is a contemporary procedure used in the diagnosis of osteoporosis. OBJECTIVE: The aim of this study is to determine the prevalence of the osteoporosis and risk factors in middle Anatolian population aged more than 40, using quantitative calcaneal ultrasonography. SUBJECTS AND METHODS: The present study was carried out in rural and urban areas of primary health care units. Evaluation of skeletal status was based on calcaneal quantitative ultrasound measurement, carried out by the Sahara Clinical Bone Sonometer (Hologic Waltham, MA, USA). RESULTS: There were 1437 individuals, 866 were females (60.3%) and 571 were males (39.7%), aged in between 40 and 89 years. Standardized prevalence rates using Segi's population were found to be 14.0% in total, 17.1% in female and 9.2% in male. Osteoporosis prevalence increased with increasing ages. The highest prevalence value was determined in the individuals older than 70 years of age. Osteoporosis was more common among women compared to men. Osteoporosis prevalence increased in consistent with a decrease in the amount of milk, yoghurt and cheese consumption. CONCLUSION: Based on current study, it is concluded that osteoporosis is an important health problem. Requiring health education about life styles (activity and nutrition) to avoid and even control osteoporosis.

Prevalence of hypertension among individuals aged 50 years and over and its impact on health related quality of life in a semi-rural area of western Turkey.

BACKGROUND: Hypertension is common, especially in individuals aged 40 years and over, and it affects about half of the population aged 60 years and over. This study aimed to determine the frequency and risk factors of hypertension among individuals aged 50 years and over, and to examine its effect on the health related quality of life (HRQOL). METHODS: This population-based cross-sectional study was conducted in two settlements in a region of western Turkey between March 1 and April 30, 2007. A questionnaire concerning life habits associated with hypertension, medical histories, and demographic characteristics was filled in by a face to face interview. The SF-36 scale was used to assess HRQOL. Body mass index (BMI) was calculated by measuring the weight and length of the body. RESULTS: Of 1599 individuals living in the region, 1193 participated in the survey (48.3% men and 51.7% women). The overall prevalence rate of hypertension was 59.5% (n=710), being 58.0% in men and 60.9% in women (P > 0.05). The variables that most positively influenced hypertension (P < 0.05, for each one) were older age (especially the age group of those aged 60 and over), single, no health insurance, consumption of animal fat in meals, and family history of hypertension. The HRQOL of the patients with hypertension was lower than that of those without hypertension (P < or = 0.05). The HRQOL was better in hypertensive patients whose blood pressure was under control, whereas it was worse in those with at least one chronic disorder accompanying hypertension (P < 0.05, for each one). CONCLUSIONS: Great emphasis should be placed on the need for a public health program for the detection, prevention, and control of hypertension, including other risk factors, as well as for the modification of foods and life habits, specifically in individuals who are most likely to be at risk of hypertension.