Dropout and compliance to physical exercise in menopausal osteopenic women: the European "happy bones" project.

Introduction: Decline in muscle mass and bone density seem to be two of the most disabling side effects of menopause that negatively affect women's quality of life. Promoting physical activity protocols in the workplace can represent a focal point in the prevention and management of several diseases. The study aims to evaluate the compliance and drop-out of menopausal osteopenic women engaged in combined training performed inside and outside the workplace. Strength and balance were analyzed to evaluate the effect of this protocol on osteoporosis prevention and the risk of falling. Methods: 73 menopausal women were enrolled in 5 European countries. They performed 72 lessons of a combined training proposed in the working place (IW) or sport center (SC). Results: Out of the total 39 women enrolled in the IW, 12.8% had to leave the program, while out of the 34 women enrolled in SC, 41.2% did not complete the training. According to the compliance results, 47% of women that completed the trained IW and 85% in the SC recorded high compliance (p = 0.019). Moreover, the strength of the lower limbs (p < 0.001) and static balance (p = 0.001) significantly improved in the whole group. Discussion: In conclusion, proposing well-structured training in the workplace for menopausal women seems to reduce drop-out. Strength and balance results suggest its positive impact on bone health and risk of falls, despite where it is performed.

How health literacy associates with healthcare utilization and health promotion behaviours in Turkey?: Contributions to discussions concerning the Anderson model and ecological models.

BACKGROUND: This study examined how health literacy (HL) levels are associated with health care utilization (HCU) and health promotion behaviours (HPB) in Turkey. METHODS: We conducted face-to-face interviews and utilised the Turkish HL Scale-32 (n = 6228). RESULTS: HL score was inversely related to the number of outpatient admissions (OAs) (ß = -0.001) and emergency department admissions (EAs) (ß = -0.006) in the Poisson regression model. Sex, age, perceived health, income group, and education level were other variables related to the number of OAs and EAs. Health literacy levels were related to physical activity (PA) (for excellent HL, OR: 3.93 (95% CI: 2.54-6.08)) and acquiring healthy eating habits (HEHs) (for excellent HL, OR: 3.56 (95% CI: 2.40-5.29) in the logistic regression model. Education levels are related to PA, HEHs, and smoking cessation or reduction. Income groups, except those with very sufficient income, are related to PA and HEHs. CONCLUSION: Improving HL can help reduce health admissions. The relationship of HCU with gender, age, education, perceived health, and income group supports the Anderson model. Limited HL groups should be prioritised as risk groups in health promotion programs. The association of HL and socio-economic variables with HPB supports the ecological model.

Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases.

BACKGROUND: Transversus abdominis plane (TAP) block is a method for postoperative pain management. Studies on children are gradually increasing. The aim of this retrospective study was to evaluate effectiveness of TAP block on pain control, its side effects, and parental satisfaction levels in children. METHODS: Study included patients operated between January 2019 and December 2020 in Gazi University Faculty of Medicine. Total of 97 patients (35 girls, 62 boys) between 5 and 18 years who had an ultrasound guided TAP block for lower abdominal or inguinal surgery were examined retrospectively. TAP block application time, hemodynamic variables, postoperative pain scores, postoperative analgesic requirement, sex, surgical history and satisfaction levels were evaluated. RESULTS: : The average application time of TAP block was 9.48 ± 3.4 and the time between TAP block and surgical incision was 12.06 ± 6.1 min. Pain scores in postanesthesia care unit (PACU) and at the postoperative first hour decreased as the time between TAP block and surgical incision increased (p < 0.05). Girls have higher pain scores at PACU than boys (p < 0.05). Previous surgical history increased postoperative 1st hour pain scores (OR: 13.8; 95% CI 1.7-113.3; p = 0.01). There was a significant negative correlation between pain scores at PACU, postoperative 1st, 2nd, 4th, 6th, 12th and satisfaction levels (r = -0.45, r = -0.56, r = -0.60, r = -0.54, r = -0.52, r = -0,43, respectively, p < 0.05). DISCUSSION: Ultrasound-guided TAP blocks can be performed safely in children in lower abdominal surgeries. However, the efficacy of TAP block on late term postoperative pain scores is limited. Time interval between the TAP block and the incision, sex, and pain memory, as well as other factors that may improve the quality of TAP block should be considered.

Evaluation of irrational drug use of individuals over the age of 18 who applied to a university hospital.

BACKGROUND: Irrational drug use not only causes a delay in the treatment of patients, failure to achieve full well-being, drug interactions and side effects, drug resistance but also creates economic negativities such as waste of resources and unnecessary workload. This study aims to investigate the irrational drug use behaviors of individuals over the age of 18 who applied to a university hospital. METHODS: This sectional study included 1247 people over the age of 18 who applied for Gazi University Health, Research and Application Center. A questionnaire was applied to the applicants by face-to-face interview technique. Logistic regression analysis was performed among the factors associated with the subcomponents of irrational drug use. RESULTS: Participants (20.1%) used medication without a doctor's prescription (self-medication), 3.4% did not comply with the recommended dose and duration for medications, 47.4% applied to the physician to prescribe the medication they wanted, 65% had medication for later use at home. It was determined that 24.1% of them used drugs without looking at the expiration date and 45.5% of them used drugs without reading the patient information leaflet. Among the risk groups identified for the different irrational drug use behaviors mentioned are the following: males, lower educational groups, housewives, not having social insurance, continuous drug users. DISCUSSION: Irrational drug use behaviors are still observed in society. The fact that the risk is higher in lower education groups is an example of the negative consequences of limited health literacy. The fact that different risk groups have been identified for different behaviors related to irrational drug use shows that intervention studies on this subject should be directed to specific groups. The effect of having social security reveals its connection with universal health coverage and rational drug use.

Evaluation of Echinococcosis Pre-Diagnosis Patients Admitted to the National Parasitology Reference Laboratory of Turkey from 2014-2019.

Background: Echinococcosis is a common parasite with zoonotic character created by a small cestode, Echinococcus spp., and is an important public health problem in Turkey as well as all over the world. We aimed to investigate antibodies in serum samples of suspected Echinococcosis patients sent to the National Parasitology Reference Laboratories of the General Directorate of Public Health. Methods: Serum samples of 2390 patients sent to our laboratory between January 1, 2014 and May 01, 2019, evaluated by ELISA, Indirect Hemagglutination Test (IHA) and Western Blot (WB) methods are presented. Our laboratory is the national reference laboratory. All kinds of tests requested from suspected patients can be performed. Results: Overall, 1199 (50.2%) of 2390 serum samples were female and 1191 (49.8%) were male. It was observed that 178 (14.9%) of men and 210 (17.5%) of women were seropositive. There was no statistical difference between the sexes in terms of seropositivity. Of all samples, 1941 (81.2%) were negative, 388 (16.2%) were positive, and 61 (2.6%) were borderline. Results determined as borderline are considered suspicious and a recommendation is made to repeat the test after 15 days. A statistical difference was found in the distribution of seropositivity by years. While seropositivity was lowest in 2014, it was found to be highest in 2018 and 2019. Conclusion: Despite all the precautions taken, it is seen that echinococcosis still continues to exist in Turkey as a zoonotic disease. Hence, CE has been involved in Turkey Zoonotic Diseases Action Plan (2019-2023) and decided to carry out studies for the protection and prevention of the disease.

Evaluation of criteria and COVID-19 patients for intensive care unit admission in the era of pandemic: A multi-criteria decision making approach.

BACKGROUND AND OBJECTIVE: The COVID-19 pandemic results in an intense flow of patients to hospitals especially to the intensive care units (ICUs) to be treated. The ICUs will therefore be confronted with a massive influx of patients (e.g. Spain and Italy). However, if the number of patients is higher than the resources available in ICUs, rationing decisions such as determining and evaluating the criteria for ICU admission becomes essential. In this case, the decision of which patients will be admitted to the ICUs may put significant pressure on healthcare personnel. The goal of this paper is to determine the criteria to be used in the decision of admission of COVID-19 patients to the ICUs. METHODS: A three-step methodology is applied. In the first step, the evaluation criteria are determined, and then the criteria are prioritized using a fuzzy analytical hierarchy process (AHP) in an uncertain and multiple-criteria environment choice. Finally, COVID-19 patients are ranked using the Multi-Objective Optimization Method by Ratio Analysis to find out which patient is more urgent. RESULTS: According to experts' evaluation of ICU admission criteria, "increment of >2 in SOFA score" seems the most dominant factor among others. The proposed methodology is tested on 10 anonymous COVID-19 positive patients being treated in a public hospital and the ICU admission results are discussed. CONCLUSIONS: Obtained priorities and ranking is in line with the hospitals' behavior that potentially depicts the usefulness and validity of the proposed approach.

Assessment of anxiety in elderly population during the COVID-19 pandemic and the impact of compulsory home-stay in the central districts of Ankara, Turkey: A quantitative, qualitative mixed method study.

OBJECTIVE: This study aimed to determine the level of anxiety in elderly individuals during the COVID-19 pandemic in Ankara province of Turkey and determine its associated factors. METHODS: A quantitative, qualitative mixed-method study performed in 1-10 June 2020 during the compulsory home-stay for elderly people in Turkey. The quantitative study was conducted using a structured online questionnaire with 278 participants aged 65 or older. The Geriatric Anxiety Inventory (GAI) was used to assess the anxiety. An in-depth interview with 20 participants was used to fill the gap of face-to-face interview due to pandemic situation and strengthen the results of quantitative survey. Qualitative and quantitative data were analyzed separately. RESULTS: Of all participants, 88 (31.7%) had a score above the cut-off point for GAI. The prevalence of Generalized Anxiety Disorder (GAD) was significantly higher in female (37.8%) than in male (23.8%). Female gender, economic loss, uncertainty, and the time participants expend to follow news about COVID-19 pandemic were risk factors of GAD. On the other hand, higher education level, hobbies, and regular physical activity were protective factors against GAD. CONCLUSION: During the pandemic, social isolation and lockdown for elderly people make serious risk factor for their mental well-being. Measures must be taken to support the psychological well-being of elderly by promoting physical activity and hobbies at home, and reducing their economic concerns.

The Relationship Between Health Literacy Level and Media Used as a Source of Health-Related Information.

BACKGROUND: Previous studies have not shown the level of health literacy or associated factors on a national level in Turkey using a scale that has been adapted to the country and its culture. OBJECTIVE: This study aimed to determine health literacy levels in Turkey and to investigate the association of health literacy with socioeconomic factors as well as with the instruments used as sources of health-related information. METHODS: This cross-sectional, nationally representative study was conducted using a computer-assisted personal interview approach and included 6,228 households (response rate, 70.9%). The Turkey Health Literacy Scale was used to measure health literacy. Sources of health-related information, such as newspapers, television, internet, and smartphones, were included in the regression model for health literacy. KEY RESULTS: The proportion of participants with inadequate and problematic health literacy was 30.9% and 38%, respectively, showing that approximately 7 of 10 participants had limited health literacy. The frequencies of inadequate and problematic health literacy were higher in the disease prevention and promotion domains (37.4% and 34.2%, respectively) compared with those in the health care domain (27.1% and 31.3%, respectively). The most frequently used medium as a source of health-related information was the internet (48.6%), followed by television (33%). In controlled models, higher health literacy scores were associated with higher education and income levels. The effects of television (ß = 1,917), internet (ß = 2,803), newspapers (ß = 1,489), and smartphones (ß = 1,974) as sources of health-related information were statistically significant in the general health literacy index model. CONCLUSIONS: Health literacy in Turkey reflects social inequalities. The model accounting for socioeconomic variables demonstrated the relevance of sources of health information to level of health literacy. These findings emphasize the importance of improving sources of health information to improve health literacy. [HLRP: Health Literacy Research and Practice. 2021;5(2):e109-e117.] Plain Language Summary: This is a cross-sectional study that is representative of the population of Turkey. We reported that health literacy scores were higher for people in higher levels of socioeconomic status. We showed that using the television, internet, newspapers, and smartphones as a source of health-related information is associated with health literacy even when accounting for socioeconomic variables.

Evaluation of state and trait anxiety levels of parents and children before electroencephalography procedures: A prospective study from a tertiary epilepsy center.

BACKGROUND: Inadequate or misinformation about electroencephalography (EEG) and epilepsy may lead to anxiety in children and their parents. The purpose of this study was to make a simultaneous evaluation of the anxiety levels of children and parents before EEG procedures and to make a brief assessment of their knowledge about EEG. METHODS AND MATERIALS: Children aged between 8 and 18 years who were referred for EEG tests at Department of Pediatric Neurology, Gazi University Faculty of Medicine, Ankara, Turkey and their parents were included in the study, prospectively. Data were collected through Personal Information Forms; an EEG questionnaire form, which questioned the knowledge of the participants about EEG; the Spielberger's State-Trait Anxiety Inventory (STAI) to determine anxiety levels of the parents; and the State-Trait Anxiety Inventory for Children-State form (STAIC) to determine the anxiety levels of the children. The following parameters were collected in a database: demographic data about children and parents (sex, age), indication of suspected diagnosis on EEG request (i.e., the referral diagnosis), history of epilepsy, number of EEG recordings, and results of previous EEG recordings. The state and trait anxiety test results of the children were compared between the girls and boys, between age groups, and their parents' results in terms of both trait and state anxiety in terms of EEG, sex, ages, educational levels, and working. RESULTS: Eighty-five children (mean age: 13.25 ±â€¯3.02 years) and 85 parents (mean age: 41.16 ±â€¯7.65 years) were included in the study. The children's mean trait anxiety score was 32.51 ±â€¯8.09, and the mean state anxiety score was 34.97 ±â€¯7.62. Half of the children who had a trait anxiety score of ≤30 points had increased state anxiety levels because they received more than 30 points in the state anxiety evaluation score. No significant differences were found between the boys and girls in terms of the state and trait anxiety scores (p > 0.05). The parents' mean trait anxiety score was 39.16 ±â€¯7.74, and the mean state anxiety score was 42.74 ±â€¯6.22. Forty (47%) parents were found to have trait anxiety, and 52 (61.2%) parents had state anxiety before the EEG. The trait anxiety score of the mothers was statistically significantly higher than that of the fathers (p < 0.01). The investigation of the knowledge level of both parents and children about EEG demonstrated some misunderstandings or points of insufficiency. CONCLUSION: The present study revealed that both parents and children had insufficient knowledge about EEG, and the procedure caused anxiety for both the parents and children. When EEG procedures are requested, parents and children should be given brief information about EEG and epilepsy. We think that in this way, the knowledge of both parents and children about this issue may be increased and their anxiety may be decreased.

Comparative analysis of epi-miRNA expression levels in local/locally advanced and metastatic prostate cancer patients.

Abnormal expression of enzymes involved in epigenetic mechanisms, such as DNA methyl transferases, can trigger large chaos in cellular gene expression networks and eventually lead to cancer progression. In our study, which is a pioneer in the literature that clinicopathologically evaluates the expression of 30 epi-miRNAs in prostate cancer (PCa), we investigated which of the new miRNA class epi-miRNAs could be an effective biomarker in the diagnosis and progression of PCa. In this study, the expression levels of 30 epi-miRNAs in whole blood samples from 25 control, 25 PCa and 40 metastatic PCa patients were investigated by the Quantitative Real-Time PCR method. Then, promoter methylation levels of 11 epi-miRNAs, whose expression levels were found to be significantly higher, were examined by methylation-specific qPCR method. The correlations between miRNA expression levels and clinicopathological parameters (Gleason Score (GS), PSA levels, TNM Staging) in different stages of PCa groups as well as disease-specific expression levels were examined. We found a hypomethylation in the promoter regions of miRNAs that showed a direct proportional increase with PSA levels (miR-34b/c, miR-148a, miR-152), GS's (miR-34a-5p, miR-34b/c, miR-101-2, miR-126, miR-148a, miR- 152, miR-185-5p) and T staging (miR-34a-5p, miR-34b/c, miR-101-2, miR-126, miR-140, miR-148a, miR-152, miR-185-5p) (p < 0.05). When miR-200a/b was evaluated according to clinicopathological parameters, it acted as an onco-miR in local/local advanced PCa and as a tumor-suppressor-miR in metastatic stage. This study is novel in the sense that our findings draw attention to the important role of miRNAs as diagnostic and prognostic biomarkers in PCa.

Cognitive functions in pediatric multiple sclerosis: 2-years follow-up.

Objective: To assess the neuropsychological status of pediatric multiple sclerosis (MS) patients and its relationship with clinical variables in a longitudinal study.Methods: Patients with MS (n = 46) and age- and gender-matched healthy control subjects (HCs, n = 53) were given tests of non-verbal reasoning, attention/concentration, visuospatial judgement and verbal fluency at baseline visit and after 2 years of follow-up. Cognitive impairment was defined as a failure on at least three of the four tests. Patients were grouped according to the age of disease onset (≤12 years as group 1 and > 12 years as group 2).Results: Cognitive impairment was detected in 22 of 46 patients at follow-up (47.8%). Patients with cognitive worsening had higher EDSS scores at follow-up compared to cognitively improved/stable group (0.68 ± 1.16 vs 0.04 ± 0.2, p = 0.01). The most affected domains were attention/concentration and non-verbal reasoning. Comparison between baseline and follow-up tests showed impairment in non-verbal reasoning over time in group 1 patients while other functions improved over time in patient and control groups as expected.Conclusion: Pediatric MS is likely to affect patients' cognition concurrently with their disability levels. This effect is significant in the non-verbal reasoning area in patients with disease onset before age 12 years. A practical method assessing this function should be part of these patients' regular follow-up for optimal treatment, prevention and rehabilitation.

Hsp-27 and NF-κB pathway is associated with AR/AR-V7 expression in prostate cancer cells.

In the present study, NF-κB inhibitor BAY 11-7082 and/or Hsp-27 inhibitor KRIBB-3 agents were used to investigate the molecular mechanisms mediating androgen receptor expression on prostate cancer cell lines. The decrease observed in androgen receptor and p65 expressions, particularly at 48 h, in parallel with the decrease in the phosphorylation of the p-IKK α/ß and p-Hsp-27 proteins in the LNCaP cells, indicated that androgen receptor inactivation occurred after the inhibition of the NF-κB and Hsp-27. In 22Rv1 cells, androgen receptor variant-7 was also observed to be decreased in the combined dose of 48 h. The association of this decrease with the decrease in androgen receptor and p65 expressions is a supportive result for the role of NF-κB signaling in the formation of androgen receptor variant. In androgen receptor variant-7 siRNA treatment in 22Rv1 cell lines, decrease of expression of androgen receptor variant-7 as well as decrease of expression of androgen receptor and p65 were observed. The decrease statistically significant in androgen receptor and p65 expressions was even greater when siRNA treatment was followed with low dose and time (6 h) combined treatment after transfection. We also showed that increased Noxa and decreased Bcl-2 protein level, indicated that apoptotic induction after this combination. In conclusion, inhibition of NF-κB and Hsp-27 is also important, along with therapies for androgen receptor variant-7 inhibition.

High neutrophil-lymphocyte ratio in schizophrenia independent of infectious and metabolic parameters.

BACKGROUND: Immunological and inflammatory mechanisms play an important role in schizophrenia. In the literature, there are studies investigating neutrophil-lymphocyte ratio (NLR) association with schizophrenia. AIMS: The purpose of this study was to compare NLR values between patients with schizophrenia and healthy controls. In addition, the study aimed to investigate the relationship between NLR and disease severity and some metabolic/inflammatory parameters. METHODS: Fifty-two patients diagnosed with schzophrenia and 53 healthy controls were included in the study. A socio-demographic information form was filled out by the clinician. Height, body weight, waist and hip circumference and blood pressure values of each patient were measured. Severity of disease was assessed by positive and negative syndrome scale (PANSS) and clinical global impression-severity scale (CGI-S). Complete blood count was performed to both patient and control groups. Fasting blood glucose, insulin, HbA1c, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride, total cholesterol and C-reactive protein (CRP) were measured. RESULTS: The number of leukocytes, neutrophils, monocytes and NLR values in patients with schizophrenia was significantly higher than in the control group. There was no significant relationship between NLR values and the number of hospitalisation, duration of ilness or disease severity in patients. There was no correlation between other laboratory findings and NLR values. CONCLUSION: NLR levels are high in schizophrenia independent of metabolic parameters according to the results. So, it can be considered that inflammatory processes may play a role in the etiology of the disease.

Contribution of cell blocks obtained through endobronchial ultrasound-guided transbronchial needle aspiration for the determination of lung cancer subtypes.

INTRODUCTION: It is crucial to diagnose the subtype of lung cancer quickly and accurately for effective therapy. Conventional cytology staining sometimes provides limited information, and additional tissue is often required to diagnose lung cancer. Cell blocks (CB) recovered during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) increases the diagnostic accuracy of the procedure and the likelihood of additional valuable histochemical and immunohistochemical staining. OBJECTIVES: To evaluate the diagnostic significance of smears and CBs for lung cancer subtypes METHODS: Records of patients who underwent EBUS-TBNA between July 2014 and December 2016 for lung cancer diagnosis and/or staging were retrospectively analysed. RESULTS: The study included 156 patients and 232 LNs diagnosed as malignancies. Twenty-seven patients were diagnosed with small cell lung cancer (SCLC), and 129 were diagnosed with non-small cell lung carcinoma (NSCLC) (68 patients adenocarcinoma, 36 patients squamous cell carcinoma, 23 patients NSCLC if not otherwise stated, 1 patient large cell carcinoma and 1 patient pleomorphic carcinoma). The mean age was 60.5 ± 10.2 years, and 74.5% of the patients were males. The diagnostic rate for CBs was 231/232 (99.6%) and was 206/232 (88.8%) (P < .001) for smears. The diagnostic rate for SCLC was 37/39 (94.9%) for smears and 39/39 (100%) for CB (P < .001). For NSCLC, it was 169/193 (87.6%) for smears and 192/193 (99.5%) for CB (P < .001). CONCLUSIONS: Cell-block preparation after an EBUS-TBNA is a simple method that provides important additional information related to lung cancer for morphological analyses.

Vitamin D receptor polymorphisms in immune thrombocytopenic purpura.

BACKGROUND: Vitamin D receptor (VDR) polymorphisms have been studied in immune-mediated disorders, but not yet in immune thrombocytopenic purpura (ITP). We investigated whether VDR variants were associated with ITP in children. METHODS: The study included 44 children with a diagnosis of ITP and 100 healthy controls. Five VDR polymorphisms (Cdx-2, FokI, BsmI, ApaI and TaqI) were genotyped and used to evaluate the association of VDR variants with ITP. RESULTS: The distribution of the three Cdx-2 genotype groups (GG, GA, and AA) was significantly different between ITP patients and controls (P = 0.025); the homozygous GG genotype of Cdx-2 was overrepresented in ITP patients. The frequency of the A allele of Cdx-2 was significantly different between patients and controls (P = 0.01). The A allele of Cdx-2 was associated with a decreased risk of ITP (OR, 0.343; 95% CI: 0.150-0.782). No statistically significant difference was found between the ITP group and control group for Fok1, Bsm1, Apa1, and Taq1 polymorphisms (P > 0.5). CONCLUSION: There appears to be an interaction between the Cdx-2 variant of VDR and childhood immune thrombocytopenia.

Diagnostic value of sonography for detecting endometrial pathologies in postmenopausal women with and without bleeding.

PURPOSE: To investigate the diagnostic value of endometrial thickness measurement on sonography in predicting endometrial pathologies in postmenopausal women with vaginal bleeding and in those with asymptomatic thickened endometrium. METHODS: Six hundred two postmenopausal women with vaginal bleeding or asymptomatic thickened endometrium were evaluated in this study. Two hundred seventy-four women with postmenopausal bleeding regardless of endometrial thickness (group 1: symptomatic) and 328 women with an incidental finding of thickened endometrium (≥5 mm) without bleeding (group 2: asymptomatic) underwent endometrial biopsy for histopathologic examination. The receiver operating characteristics curves of endometrial thickness measurement for prediction of endometrial pathologies were analyzed. RESULTS: Endometrial carcinoma was detected in eight women (2.9%) in group 1 and in three (0.9%) in group 2. The best cutoff point for endometrial thickness in predicting endometrial carcinoma in group 1 was 8.2 mm, which provided 75% sensitivity (95% confidence interval [CI], 40.9-92.9%) and 74% specificity (95% CI, 68-78.5%); area under the receiver operating characteristics curve (AUC), 0.88; 95% CI, 0.76-1.00%; p = 0.0001. In group 2, the AUC was 0.76 (95% CI, 0.46-1.00; p = 0.114); the evidence was inconclusive as to the relationship between endometrial thickness and malignancy. For the prediction of polyps, the AUCs of endometrial thickness were 0.77 for group 1 (95% CI, 0.71-0.83%; p = 0.0001) and 0.61 for group 2 (95% CI, 0.54-0.67%; p = 0.002). CONCLUSIONS: Sonographically determined endometrial thickness measurement shows high diagnostic performance for detection of endometrial cancer in symptomatic postmenopausal women at the optimal cutoff thickness of approximately 8 mm, although the evidence supporting the use of sonography for predicting malignancy in asymptomatic women is inconclusive. For polyp detection, this technique shows moderate diagnostic ability in symptomatic women, but its predictive value is low in asymptomatic women. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:339-346, 2016.

The role of interleukin-17 in intrahepatic cholestasis of pregnancy.

OBJECTIVE: Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-specific liver disease, is characterized by pruritus, abnormal liver function and elevated serum bile acid levels. The main cause of ICP has not yet been identified. We aimed to provide a new perspective to the pathogenesis of by investigating the possible association of circulating interleukin-17 (IL-17) that is a recently discovered proinflammatory cytokine levels with ICP. MATERIALS AND METHODS: In this controlled cross-sectional study, maternal venous blood samples were obtained from 33 consecutive pregnant women with ICP (15 with mild and 18 with severe forms of the disease) and 25 healthy women with uncomplicated pregnancies (as the control group) and IL-17 levels were compared among the groups. RESULTS: Although serum IL-17 levels were significantly higher in the severe ICP group than in the control group (p = 0.022), there were no significant differences between the mild and severe ICP groups or between the control and mild ICP groups. CONCLUSION: Explaining the mechanisms of hepatocyte injury might contribute to the existing therapeutic strategies for treating cholestatic diseases. Changes in IL-17 levels may shed light on the pathogenesis of ICP.

Workplace physical violence, verbal violence, and mobbing experienced by nurses at a university hospital.

BACKGROUND/AIM: The aim of this study was to determine the frequency of and risk factors for physical violence, verbal violence, and mobbing experienced by nurses in a university hospital. MATERIALS AND METHODS: This was a cross-sectional study conducted at Gazi University Medical Faculty Hospital. A questionnaire form recommended by the WHO and the International Labor Organization was administered through face-to-face interviews to determine the violence experienced in the past 12 months by nurses. RESULTS: The prevalence of physical violence, verbal violence, and mobbing was 13.9%, 41.8%, and 17.1%, respectively. Working more than 40 h per week increased the risk of physical violence by 1.86 times. The majority of nurses who experienced verbal violence and mobbing were significantly more willing to change their work, their institution, and their profession if given the opportunity. Fewer than one-fourth of the victims indicated they reported any incident. CONCLUSION: We knew that the prevalence of physical violence, verbal violence, and mobbing were high among nurses and that incidents were underreported, and the study corroborated this information. What this study adds to the topic is that long working hours increased the prevalence of physical violence and was defined as an important contributory factor.