High prevalence of obesity and diabetes mellitus in Konya, a central Anatolian city in Turkey.

INTRODUCTION: The objective of this study was to determine the prevalence of overweight, obesity, impaired fasting glucose, diabetes and the relationship between adiposity and carbohydrate metabolism, by age and gender in Konya, a city in central Anatolia. METHODS: A cross-sectional population based survey was performed. One month before the field survey a media campaign was started in each district by local municipalities. Ten percent of the target population age 20 and over were invited to participate and the participation rate was 82.1%. Twelve thousand eight hundred and sixty-six inhabitants (7000 women and 5866 men, mean age 46.7+/-15.9 years) were evaluated for height and body weight between May and September of 2001. Two thousand eight hundred and thirty consecutive subjects (1788 women and 1042 men, mean age 48.2+/-15.7 years) were tested for fasting blood glucose in addition to an anthropometric evaluation. RESULTS: The crude IFG rate was 24% (27.1% in women and 18.5% in men) and the diabetes rate 8.4% (8% in women and 9.1% in men). The survey identified previously undiagnosed diabetes in 3.7% (4.3% of women and 2.9% of men). The prevalence of diabetes (p=0.0005) and obesity (p=0.0005) increased with age. Obese men and women had a higher risk of being diabetic than their normal weight counterparts (OR, 2.05; CI 95%, 1.13-3.71; p=0.0186 and OR, 2.53; CI 95%, 1.57-4.07; p=0.0001, respectively). Overall, the overweight rate was 34.2% (33.5% of women and 36.3% of men) and the obesity rate was 23.7% (32.4% of women and 14.1% of men) (n=12,866). Women had a significantly higher risk of being obese than men (OR, 2.84; CI 95%, 2.62-3.08; p=0.0005). The diabesity rate was 3.4% (4.1% in women and 2.1% in men). CONCLUSION: Carbohydrate intolerance and adiposity are highly prevalent in Konya, and the two conditions are positively correlated with each other, by age and gender.

Reasons for early loss of primary molars.

PURPOSE: The aims of this study were to investigate the principal reasons for untimely loss of primary molars and to evaluate the risk factors of early primary molar loss in children aged four to nine years. MATERIALS AND METHODS: 1150 untimely lost primary molars were analyzed from 546 patients. The early loss of primary molars was analyzed in relation to age, sex, dmf (t), DMF (T) scores, toothbrushing frequency, history of treatment and maternal education. The data were converted to SPSS format. Pearson Chi-square test was used for statistical analysis. RESULTS: Among the investigated subjects, 15.2% of children reported regular toothbrushing. Only 23.1% of subjects had a history of treatment before the tooth extraction and 33% of mothers had a low education level. Untimely loss of primary molars due to pain, caries and sepsis were 30.2%, 31% and 38.8%, respectively. The frequency of 'only one primary molar loss' was significantly higher in group 1 (p < 0.05), however the frequency of 'more than one primary molar loss' for group 2 was more than group 1 (p < 0.05). Irregular toothbrushing for the children in group 2 was found significantly high than in group 1 (p < 0.05). Irregular toothbrushing was associated with number of early primary molar loss in group 2 (p < 0.05). The level of maternal education was associated with dmf (t) scores (p < 0.05). The caries incidence was associated with number of early primary molar loss in both groups (p < 0.05). The mean number of treated teeth before extraction for group 2 was significantly higher than for group 1 (p < 0.05). CONCLUSION: Results of this study suggested that irregular toothbrushing, high dmf (t) scores and untreatment of carious primary molars were significant risk factors in early loss of primary molars. Every effort must be taken into account in restoring rather than extracting carious teeth.

Clinical performance of sealants with and without a bonding agent.

OBJECTIVES: The objective of this study was to assess the effect of a one-bottle bonding agent on sealant success after 3, 6, 12, and 24 months. METHOD AND MATERIALS: The sample group consisted of 30 schoolchildren (8 to 10 years of age) who had all their permanent first molars sound and unsealed. Occlusal sealants were placed on first molars according to a split-mouth design. Sealant scoring occurred at 3, 6, 12, and 24 months and was performed by two clinicians blinded to the treatment group. Fisher's exact test was used to analyze the data. RESULTS: The clinically acceptable marginal integrity rates for sealants with a bonding agent after 3, 6, 12, and 24 months were 93%, 93%, 83%, and 79%, respectively. For sealants without a bonding agent, the clinically acceptable marginal integrity rates after 3, 6, 12, and 24 months were 90%, 88%, 81%, and 77%. The rates for no color change in sealants with a bonding agent after 3, 6, 12, and 24 months were 96%, 93%, 81%, and 75%, respectively. For sealants without a bonding agent, the no color change rates after 3, 6, 12, and 24 months were 93%, 93%, 79%, and 72%. After 24 months, 73% of the sample group were available for recall. The retention rates for sealants with and without a bonding agent after 24 months were 79% and 75%, respectively. The results of the statistical analysis showed that there were no differences among the sealants with and without bonding agents evaluated in relation to marginal integrity, marginal discoloration, and anatomic form. CONCLUSION: The success of a sealant is related to whether the sealant is applied under optimal conditions. The results of this study show that at the 2-year mark, the placement of a bonding agent under sealants did not significantly affect the clinical success of sealants.

Duration of untreated psychosis may predict acute treatment response in first-episode schizophrenia.

There is growing evidence for a relationship between the duration of untreated psychosis (DUP) and the prognosis in schizophrenia. The objective of this study is to evaluate whether DUP and premorbid level of social functioning are related to treatment response in acute treatment of first-episode schizophrenia. Seventy-nine first-episode schizophrenia patients were assessed with BPRS, SAPS, and SANS on admission and discharge during their first hospitalisation. Percentage of the difference between admission and discharge in total scores of all scales were taken as measures of absolute symptom reduction. The median DUP was 6 months (mean=8.6). DUP was correlated with reduction in BPRS and SAPS scores but not SANS scores. Patients with a short DUP (n=41) also showed a higher reduction in BPRS, and SAPS scores than those with a long DUP. Premorbid Adjustment Scale (PAS) scores were inversely correlated with age at onset and positively correlated with BPRS scores at admission. We did not find any relationship between PAS scores and response to treatment. Our findings suggest that DUP may be an important predictor of response in acute treatment of first-episode schizophrenia and thus, attempts for early diagnosis may also have a positive effect on acute treatment response.

Handwriting changes under the effect of alcohol.

Document examiners are often faced with difficulties in evaluating handwriting by persons under the influence of alcohol. Although numerous articles are available on the subject of alcohol influence on handwriting quality, most of them were based on empirical data such as "few" or "increased", without any statistical evaluation. The aim of this research is to determine whether previous observations on reported effects of alcohol on handwriting are valid and to establish the predictability of observing specific effects. A total of 73 participants, who completed all steps of the experiment, were surveyed. Handwriting samples were taken before and after the consumption of alcohol. The test form, including criteria of prior studies used by document examiners, was evaluated with the help of a Olympus X-Tr stereo microscope, direct and oblique angle lighting and a video spectral comparator (VSC 2000). Measurements were done by means of digital caliper, statistics using repeated measures ANOVA, Pearson correlation, Pearson Chi square test, McNemar test and Wilcoxon signed rank test. The results revealed that the handwriting parameters such as word lengths, height of upper and lower case letters, height of ascending letter, height of descending letter, spacing between words, number of angularity, number of tremor, and number of tapered ends are all significantly increased under the effect of alcohol. It was also determined that the significant correlation between the alteration of handwriting parameters such as height of upper and lower case letters, number of angularity, number of tapered ends and the amount of alcohol. Furthermore, it does not confirm the conclusions of previous studies stating that alcohol levels are not proper indicators. Our data strongly confirms that handwriting changes can be observed at any level of alcohol. None of the alterations in handwriting can be attributed to the effects of alcohol intake alone. However, the presence of some alterations together is strongly suggestive that the person was under the influence of alcohol. First of all, the duty of handwriting examiner is to identify if the questioned and known sample are coming from the same source. Consequently, as this explanatory analysis suggests that differences between sober and intoxicated persons can be identified in handwriting, but the examiner's judgement must be proportionately cautious, keeping in mind the abnormally wide range of variation.

Bond strength of a resin composite to a polyacid-modified resin composite under different conditions.

OBJECTIVE: The aim of this in vitro study was to evaluate the tensile bond strength values between polyacid-modified resin composite ("compomer") and resin composite materials under different conditions. METHOD AND MATERIALS: There were five experimental groups in the study. In group A, resin composite was placed directly on polyacid-modified resin composite surfaces. In group B, bonding agent was applied to polyacid-modified resin composite surfaces and then resin composite was placed on the compomer. In group C, compomer specimens were stored for 1 week and then resin composite was placed directly on these aged compomers. In group D, compomer specimens were again stored for 1 week, and then the bonding agent and resin composite were applied to the compomer surfaces. In group E, the surfaces of aged (1 week) compomers were roughened before the bonding agent was applied and the resin composite was placed on the prepared surfaces. A statistical analysis of the results was made with the Kruskal-Wallis test method. RESULTS: The mean tensile strength values of the groups were as follows: group A = 12.84 MPa; group B = 15.03 MPa; group C = 10.60 MPa; group D = 11.56 MPa; group E = 24.87 MPa. There were statistically significant differences between groups E and A; groups E and C; groups E and D; and groups C and B. CONCLUSION: Mechanical roughening of a polyacid-modified resin composite surface was found to be the most effective factor in increasing the tensile bond strength between an aged compomer and a resin composite.

Fire-eater's pneumonia characterized by pneumatocele formation and spontaneous resolution.

Liquid hydrocarbons derived from petroleum are widely used in industry and in households. Aspiration of massive amounts may lead to an acute and fatal form of exogenous lipoid pneumonia (fire-eater's pneumonia). We present a rare case of chemical pneumonitis following accidental lamp oil aspiration characterized by pneumatocele formation and spontaneous resolution. Initial findings on posteroanterior chest radiographs were smoothly circumscribed lower zone masses with and without air-fluid levels. Chest computed tomography also showed multiple thin-walled cavities with and without air-fluid levels. Complete resolution of findings despite initial severe presentation without corticosteroid or antibiotic treatment is noteworthy.

Thyroid status in lithium-treated bipolar disorder patients: An one-year follow-up study / Estudio de un año de seguimiento del estado de la tiroides en pacientes con trastorno bipolar tratados con litio

Objective In this follow-up study, the hormonal changes were determined in bipolar euthyroid patients who were treated with lithium for the duration of one year. Method For the study, 23 bipolar I disorder patients without any axis I co-morbidity were consecutively selected and followed up for one year. All patients were compared with 25 age- and sex-matched healthy controls in terms of thyroid hormone levels and thyroid volumes. The Sociodemographic and Clinical Characteristics Data Form, Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS), Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I and SCID-I/NP) were administered. Initial thyroid hormone levels and thyroid volumes were measured in the patients and controls. Patient and control groups were compared at baseline for thyroid volumes. Patients' lithium levels were measured at baseline, they were re-examined at six months for thyroid hormones, and at the first year for thyroid hormones and lithium levels. Results Thyroid hormone levels changed in no patients during the follow-up period. Thyroid hormone levels were measured within the normal range. No correlation was found between the final TSH levels and duration of illness, duration of lithium treatment, initial thyroid volumes, and the initial TSH levels. Conclusions Lithium can safely be used in bipolar patients who were already receiving this treatment before and not developed any thyroid problem for a substantial period.

En este estudio de seguimiento se determinarán los cambios hormonales que se producen en pacientes eutiroideos con trastorno bipolar en tratamiento con litio durante un periodo de un año. Método Para el estudio se seleccionaron de forma consecutiva 23 pacientes con trastorno bipolar tipo I sin prevalencia concomitante de otros trastornos del eje I, y fueron seguidos durante un año. En todos los pacientes se compararon los niveles de las hormonas tiroideas y el volumen de la glándula tiroides con las del grupo control sano pareado por sexo y compuesto de sujetos de 25 años de edad. La evaluación se hizo por medio de: una hoja de datos de las características sociodemográficas y clínicas, la Escala de Valoración de Hamilton para la Evaluación de la Depresión (HDRS), la Escala de Young para la Evaluación de la Manía (YMRS), Entrevistas clínicas estructuradas para los trastornos del eje I del DSM-IV (SCID-I y SCID-I/NP). A los pacientes y al grupo control se les midieron los niveles iniciales de las hormonas tiroideas y el volumen de la glándula tiroides, a la vez que se les comparó la línea base del volumen de la glándula tiroides. Al inicio del estudio se determinó la línea base de los niveles de litio en los pacientes. Al sexto mes, se reexaminaron las hormonas tiroideas y, al cabo del primer año, los niveles hormonales tiroideos y de litio. Resultados Los niveles de las hormonas tiroideas no sufrieron cambios en ningún paciente durante todo el seguimiento. Dichos niveles se midieron dentro de los intervalos normales. No se detectó ninguna correlación entre los niveles de TSH y la duración de la enfermedad, ni con la duración del tratamiento con litio, ni entre los volúmenes iniciales de las glándulas tiroideas con los niveles iniciales de TSH. Conclusión El litio puede administrarse con seguridad en pacientes bipolares que se hayan sometido antes a este tratamiento, y a los cuales no les produzca problemas tiroideos durante un periodo significativo de tiempo.

Prevalence of overweight and obesity in Turkey.

The objectives of this study were to determine the prevalence of overweight and obesity in Turkey, and to investigate their association with age, gender, and blood pressure. A crosssectional population-based study was performed. A total of 20,119 inhabitants (4975 women and 15,144 men, age > 20 years) from 11 Anatolian cities in four geographic regions were screened for body weight, height, and systolic and diastolic blood pressure between the years 1999 and 2000. The overall prevalence rate of overweight was 25.0% and of obesity was 19.4%. The prevalence of overweight among women was 24.3% and obesity 24.6%; 25.9% of men were overweight, and 14.4% were obese. Mean body mass index (BMI) of the studied population was 27.59 +/- 4.61 kg/m(2). Mean systolic and diastolic blood pressure for women were 131.0 +/- 41.0 and 80.2 +/- 16.3 mm Hg, and for men 135.0 +/- 27.3 and 83.2 +/- 16.0 mm Hg. There was a positive linear correlation between BMI and blood pressure, and between age and blood pressure in men and women. Obesity and overweight are highly prevalant in Turkey, and they constitute independent risk factors for hypertension.