Protective effects of swimming exercises and metformin on cardiac and aortic damage caused by a high-fat diet in obese rats with type 2 diabetes, by regulating the Bcl2/Bax signaling pathway.

Background/aim: Due to the increasing mortality and morbidity rates in diabetes mellitus (DM), which is one of the biggest health problems of our age, many treatment modalities are still being tried. The positive effects of metformin (MET) and physical exercise (EXE) on the pathophysiology of diabetes are well known. In this study, it was aimed to detail these positive effects of MET and EXE in combination on the basis of inflammation, apoptosis mechanisms, and endogen nesfatin-1 (NES-1) synthesis. Materials and methods: Twenty-seven type 2 DM (DM-2) male Wistar Albino rats were divided into 4 groups, as the high-fat diet (HFD), MET, EXE, and MET+EXE groups. The total duration of the study was 3 months. At the end of the experiment, blood glucose and lipid profiles were measured. Histopathological evaluation was performed on the cardiac and aortic tissues and apoptotic markers were evaluated immunohistochemically. Inflammatory markers and NES-1 levels were analyzed by enzyme-linked immunosorbent assay. Results: The plasma glucose, homeostatic model evaluation-insulin resistance (HOMA-IR), low-density lipoprotein (LDL) levels increased, and high-density lipoprotein (HDL) levels decreased significantly in the HFD group. In the treatment groups, the glucose, HOMA-IR, LDL, NES-1 levels in the plasma, as well as tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1ß), IL-6, caspase-3 (Cas-3), Bcl-2-associated X protein (Bax), and histopathological findings of inflammation in tissues were decreased. Additionally, there was an increase in plasma insulin, HDL, and tissue B-cell lymphoma-2 and levels. Conclusion: It was observed that the MET and EXE treatments in the DM-2 model reduced cellular damage mechanisms such as inflammation and apoptosis. The decrease in NES-1 levels was thought to be secondary to this antiinflammatory effect. In conclusion, the results demonstrated the effectiveness of EXE in reducing DM-2 and the NES-1 levels. Further studies are needed to evaluate the effect in different EXE models and treatment durations.

Elderly people's quality of life in rural areas of Turkey and its relationship with loneliness and sociodemographic characteristics.

BACKGROUND: The aim of the present study was to examine the relationships between loneliness, quality of life and the factors that may be related to the quality of life in individuals ≥65 years old living in rural areas of Turkey. METHODS: The World Health Organization Quality of Life Instrument Older Adults Module (WHOQOL OLD) and Loneliness Scale for the Elderly (LSE) was administered to 427 elderly participants. Multiple linear regression was used to determine the variables that affected QOL. RESULTS: The results of the multivariate linear regression analyses indicated that gender, marital status, education level, family income status, general health condition, living arrangement, and loneliness level for subdomains were within the predictors. Loneliness level had the strongest negative impact on the four WHOQOL OLD subdomains and total WHOQOL OLD score. It was the most important predictor for autonomy, past present future activities, social participation, death-and-dying, and intimacy subdomains and for the total QOL. CONCLUSIONS: Remarkably, a sense of loneliness in the elderly was determined to be the most important factor for predicting their QOL. Loneliness should be considered in attempts to improve QOL for the elderly, interventions to reduce loneliness should specifically target this group, and activities with the potential to increase QOL should be encouraged.

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.

Prevalence of Sport Injuries among Middle School Children and Suggestions for Their Prevention.

[Purpose] The purpose of this study was to determine the incidence of injuries of children participating in sports, and to present advice on injury prevention. [Subjects and Methods] The study subjects were 445 children involved in sports with a mean age of 12.74±1.03 years, a mean height of 156.56±10.82 cm, and a mean weight of 45.39±10.29 kg; 52.8% of the study subjects were male, and 47.2% were female. The subjects were surveyed using a questionnaire developed by the author. [Results] The highest incidence of sport injury was in the foot-ankle region, and the lowest incidence was in the hip-femur region. The incidences of injuries to the neck, shoulder, elbow, hand, wrist, superior dorsal region, waist, hip-femur region, knee, and foot-ankle regions weren't statistically significant. [Conclusion] This study established that children participating in competitive sports are at risk of injury. The causes of injuries were examined to propose preventive measures to minimize their occurrence and severity. It should not be overlooked that injuries can occur more easily among children because their musculoskeletal system is not fully developed, and coaches should be educated in the appropriate training intensities for children.

Evaluation of health anxiety in adults admitting to primary healthcare institutions.

OBJECTIVE: Health anxiety is defined as the negative over-interpretation of the usual physical sensations, although the person does not have any physical illness. The study aims to evaluate the health anxiety levels of individuals over the age of 18 who admit to primary healthcare institutions in Eskisehir and the factors that may be associated with it. METHODS: This is a cross-sectional study. The study was conducted in adults who admitted to primary healthcare institutions in Eskisehir. The study group consists of 1200 individuals. For the purpose of collecting data, a questionnaire including the questions regarding the factors related to health anxiety and the Health Anxiety Scale were used. In the analysis of the data, a logarithm of The Short Health Anxiety Inventory (SHAI) scores was performed to determine the factors affecting the inventory score and hierarchical multiple linear regression analysis was used. RESULTS: The total scores from The SHAI ranged from 1 to 47, with an mean of 16.4±8.7 and a median score of 15. Of 41.9% of study group scored above mean score. Female gender, deterioration of family income, presence of chronic disease, worsening of general health status, symptoms of mental and behavioral disorders, high number of admissions to health institutions, and hospitalization history were found to be factors affecting the level of health anxiety. CONCLUSION: Health anxiety was found to be an important problem among those who admitted to primary healthcare institutions in Eskisehir. Providing education to individuals in risky groups in terms of health anxiety, and these groups should be closely monitoring in terms of health anxiety and providing psychosocial support when necessary will prevent excessive use of health services in the long-term.

The Role of EREG, PTPN1, and SERPINB7 Genes in the Pathogenesis of Psoriasis: May SERPINB7 Be Protective and a Marker of Severity for Psoriasis?

INTRODUCTION: Psoriasis is a chronic inflammatory dermatological disease with complex pathogenesis in which many immune system cells, including keratinocytes, play a role. Many genes regulate the proliferation of keratinocytes and other immune cells that have essential roles in the pathogenesis of psoriasis. The expressions of EREG, PTPN1, and SERPINB7 genes were shown as upregulated in psoriatic skins in a few studies previously. OBJECTIVES: We aimed to evaluate the expressions of these genes in psoriatic lesional skin and compared them with non-lesional adjacent skin of the same patients and normal skin of healthy controls. RESULTS: Our results revealed that the expressions of EREG and PTPN1 genes were upregulated, whereas the SERPINB7 gene expression was down regulated in the psoriatic skin of the patients than normal skin of controls. Moreover, the expression level of the SERPINB7 gene was also negatively correlated with the severity of the disease among patients. CONCLUSIONS: According to our results, overexpression of EREG and PTPN1 genes, and decreased expression of SERPINB7 gene may lead to the development of psoriasis.

Assessment of hearing loss in patients with rosacea.

OBJECTIVES/AIMS: Rosacea is not only a skin condition but a systemic inflammatory disease that includes chronic inflammation, vascular alterations, and autoimmunity in pathogenesis. We aimed to evaluate the presence of a sensorineural hearing loss in the patients with rosacea in comparison with the healthy control group and, also to compare the audiometric results according to the severity of disease among the patient group. METHODS: Fifty-three patients with erythematelangiectatic or papulopustular type of rosacea and 105 age- and sex-matched healthy controls were included. Each participant had audiometric measurements after a complete ear-nose-throat examination by the same otorhinolaryngologist. RESULTS: The results of air and bone conduction thresholds showed statistically significant differences in particularly high frequencies between the groups in both the right and left ear (for all p < 0.05), but there was no correlation between audiometric measurements and the severity or the type of rosacea (p > 0.05). CONCLUSIONS: Regardless of disease severity or type, rosacea patients are likely to have sensorineural hearing loss, and it is important to refer these patients in the early period.

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.

Prevalence of early-onset androgenetic alopecia and its relationship with lifestyle and dietary habits.

BACKGROUND: Early-onset androgenetic alopecia (AGA) is the most common cause of alopecia in men under 30 years of age; however, its prevalence and non-genetic risk factors are not well documented. The aim of our study was to determine the early-onset AGA prevalence and to evaluate its relationship with lifestyle and dietary habits. METHODS: This study was conducted on 1507 male university students aged 18-30 years. Students with AGA were grouped as mild and moderate-severe according to the Hamilton-Norwood classification. They were asked to complete a questionnaire regarding information about lifestyle and dietary habits including the Adolescent Food Habits Checklist (AFHC) and International Physical Activity Questionnaire (IPAQ) short form. RESULTS: The prevalence of early-onset AGA was 19.2% in the students. Each year over the 18 years age, positive family history, unhealthy vegetable-fruit and red meat consumption, presence of a hair disease apart from AGA and smoking were associated with increased risk for early-onset AGA. The median score of AFHC was lower than those without early-onset AGA which reflects the unhealthy dietary habit. Students with moderate-severe AGA had a higher body mass index and waist circumference than those with mild AGA (P<0.05). CONCLUSIONS: In addition to family history, lifestyle and dietary habits have roles in early-onset AGA. Therefore, regulation of lifestyle and dietary habits may have a possible contribution in the prevention of early-onset AGA.

The evaluation of vitamin K status in children with febrile seizure.

BACKGROUND: Febrile seizure is the most common neurological disorder in childhood. The exact pathophysiology of febrile seizures is unknown. Recent studies showed the role of vitamin K in nonhematological and inflammatory disorders. This study aimed to investigate the serum vitamin K levels in children with febrile seizures. AIMS: To evaluate vitamin K levels in children with febrile seizures. STUDY DESIGN: Prospective case-control study. METHODS: This multicenter study examined representative populations in 8 different cities in Turkey between April 1, 2018 and April 1, 2019. Blood samples were taken from all children at presentation. Vitamin K1, vitamin K2, tumor necrosis factor-alpha, interleukin 1 beta, and interleukin 6 levels were determined by enzyme-linked immunosorbent assay. RESULTS: A total of 155 children were included in the study-84 children with febrile seizures and 71 children in febrile control group. Serum vitamin K1 and vitamin K2 levels were also higher in children with febrile seizures than in the controls. The results of statistical analysis showed that vitamin K1 and vitamin K2 levels were correlated with tumor necrosis factor-alpha, interleukin 1 beta, and interleukin 6 levels. The median vitamin K1 and vitamin K2 levels of children experiencing their first febrile seizure were higher than those in children with recurrent febrile seizures. Type of febrile seizure has no effect on serum vitamin K1 and vitamin K2 levels. CONCLUSION: In children with febrile seizures, vitamin K levels are higher than those in the control group. These new findings may contribute to elucidating the etiopathogenesis of febrile seizures.

The effect of exercise prescription of primary care physician on the quality of life in patients.

PURPOSE: The aim of this study was to examine the effect of exercise prescribed by primary care physicians (PCPs) on the quality of life (QoL) of elderly people. METHOD: Randomisation was performed at PCPs level from 16 primary healthcare centers. Patients were divided into intervention and control groups. Both groups of physicians received theoretical training (14 h), and the intervention group received additional practical training on exercise prescription (10 h). Patients in the intervention group were prescribed endurance, flexibility, balance, and strength exercises and were given training packs. QoL was measured using Short Form-36. Measurements were taken at the beginning of the study, after the 3rd month, and at the end of the 6th month to evaluate the effectiveness of the intervention. RESULTS: The age of participants (Intervention group n = 69, Control group n = 110) was 57.68 ± 5.08 years. At the end of the study, physical function, physical role function, social role function, mental health, vitality, general health perception, and emotional role function scores increased and body pain scores decreased in the intervention group. Significant differences (p < 0.05) between the intervention and control groups were observed for physical function, physical role function, body pain, mental health, vitality, and emotional role function scores but not for social role function or general health perception scores. CONCLUSIONS: Exercise prescriptions given by PCPs containing endurance, strength, flexibility, and balance exercises improve QoL in elderly people.

Investigation of the effect of changes in muscle strength in gestational age upon fear of falling and quality of life.

BACKGROUND/AIM: The aim of this study is the investigation of the effect of changes in muscle strength in gestational age upon fear of falling and quality of life. MATERIALS AND METHODS: This longitudinal, descriptive study included a sample of 37 pregnant women who volunteered to participate. The research data were collected at 20 and 32 weeks of gestation. Data collection instruments included a newly developed questionnaire form, the Tinetti Falls Efficacy Scale, a visual analog scale, and the Turkish language version of the WHO Quality of Life Scale. Upper body flexibility was measured by the back scratch test, while muscle strength was measured by a handgrip dynamometer and balance by the unipedal stance test. RESULTS: It was found that, as pregnancy advanced, pregnant women had an increased fear of falling, as well as elevated systolic and diastolic blood pressure levels. Participants suffered significant impairments in their balance, handgrip strength, and quality of life within the physical, psychological, and environmental domains. CONCLUSION: As pregnancy advances, muscle strength decreases and the fear of falling experienced by pregnant women increases, which significantly impairs the quality of life in the domains of environment, physical, and mental health.