[Seroprevalence and Risk Factors of Hepatitis B, C and D in Adults in Trabzon, Türkiye]. / Trabzon'da 20 Yas Üstü Eriskinlerde Hepatit B, Hepatit C ve Hepatit D Seroprevalansi ve Risk Faktörleri.

Viral hepatitis are infections that can cause liver damage, become chronic, lead to cirrhosis, hepatocellular carcinoma and ultimately result in death due to their ability to spread in the community through blood and infected body fluids. The aim of this study was to determine the seroprevalence of hepatitis B (HBV), hepatitis C (HCV), and hepatitis D (HDV) transmitted through blood among individuals living in Trabzon province and to examine the factors potentially associated with seroprevalence. This cross-sectional study was conducted in Trabzon province, located in the northeast of Türkiye, including a total of 10 districts, including the central district. Since seroprevalence was calculated for HBV, HCV, and HDV in the study, the sample size was separately calculated for each, and the calculated maximum sample size of 1116 was accepted as the minimum sample size for the study. The study was completed with 1502 participants. Serological tests for HBV included HBsAg, anti-HBs, and anti-HBc IgG; for HCV, anti-HCV; and for HDV, anti-HDV were analysed. Data were evaluated for HBV risk factors using univariate analyses with Chi-square test and for multiple analyses using enter model logistic regression analysis. The mean age of the participants was 45.7 ± 16.6 years, with 767 (51.1%) being female. The prevalence of HBV seropositivity, indicating vaccination, was 23.0%, while the seroprevalence of HBV among unvaccinated adults was 27.4%. HBsAg positivity was 5.1%, and isolated anti-HBc IgG positivity was 4.2%. The proportion of individuals with HBsAg in the gray zone was 0.5%, while the positivity rates for anti-HBs and anti-HBc IgG (indicating past infection) were 17.6%. The prevalence of anti-HCV was six per thousand, while anti-HDV was not detected in the analyses. HBsAg positivity and co-infection with HCV were found in one person, and among the nine individuals positive for anti-HCV, isolated anti-HBc IgG positivity was detected in three. Increasing age, presence of a person with jaundice in the family, presence of diabetes mellitus, alcohol use and cupping therapy were identified as risk factors for HBV in the logistic regression analysis. Risk factors for HCV in univariate analyses were being over 40 years old, presence of hepatic steatosis and receiving dialysis treatment. The results of the study indicate that despite being included in our vaccination schedule and the administration of vaccines to high-risk adults, HBV still requires intensive attention as a public health problem. HCV, lacking a vaccine has been evaluated as an infectious agent that needs to be taken into consideration due to its potential risks and requires the complete implementation of individual and social precautions.

One-lung ventilation duration-dependent stress response in thoracotomies and the effect of a low-volume, high-frequency differentiated ventilation strategy on this response.

BACKGROUND: This study aims to investigate the effect of ventilation of the non-ventilated lung in patients undergoing one-lung ventilation by a separate low-tidal-volume (1 mL/kg) ventilator at high frequency (30/min) on preventing the effect of one-lung ventilation-associated oxidative damage. METHODS: The study included 45 patients (24 males, 21 females; mean age 54.6±7.7 years; range, 18 to 65 years) with an American Society of Anesthesiologists risk group of 1 to 2 and scheduled for elective thoracotomy. Patients were randomly divided into three groups as those due for thoracotomy without one-lung ventilation (group 1, n=15), those due for thoracotomy with one-lung ventilation (group 2, n=15), and those due for thoracotomy in whom both lungs were ventilated (group 3, n=15). Blood specimens were collected for ischemia-modified albumin, malondialdehyde, and lactate measurements one minute before one-lung ventilation (t0), 30 minutes after one-lung ventilation (t1), 60 minutes after one-lung ventilation (t2), and at postoperative 24th hour (t3). For group 1, t0 was defined as the time at which the thorax was opened. RESULTS: A statistically significant increase in ischemia-modified albumin, malondialdehyde, and lactate levels occurred in group 2 as the duration of one-lung ventilation increased (p<0.01). Plasma ischemia-modified albumin and malondialdehyde levels in group 3 were statistically significantly lower at t1, t2, and t3 compared with group 2 (p<0.01). Plasma lactate levels were significantly lower in group 3 at t1 (p<0.05) and t3 compared with group 2 (p<0.01). CONCLUSION: Separate ventilation of the non-ventilated lung with low tidal volume and high frequency reduces the response to one-lung ventilation-associated oxidative stress in thoracic surgery.

Ginkgo Biloba improves bone formation during fracture healing: an experimental study in rats / Ginkgo Biloba melhora a formação dos ossos durante a consolidação da fratura: estudo em ratos

ABSTRACT OBJECTIVES: Ginkgo biloba extract (EGb 761) is a plant extract obtained from the leaves of the G. biloba tree. The aim of this study was to assess the histological and radiological effects of G. biloba extract on fracture healing in an experimental fracture model using rat femurs. METHODS: Forty-eight female Sprague-Dawley rats (weight: 195-252 g; age: 20 weeks) were used in the study. The rats were randomly divided into six groups (n=8). A transverse fracture was made in the middle of the right femur of each rat and fixed with a Kirschner wire. The G. biloba groups received 60 mg/kg oral G. biloba extract once daily. No medication was given to the control groups. On days 7, 21 and 35, both sets of femurs were evaluated radiologically and histopathologically. RESULTS: Histological evaluation revealed that the G. biloba groups had significant differences at 21 and 35 days (p<0.05). The G. biloba group showed a significant difference in terms of bone formation on day 21 when compared to the control group (p<0.05). CONCLUSIONS: This study indicated that the use of G. biloba extract accelerated fracture healing. Both radiological and histological differences were detected, but the histological differences were more remarkable. Level of Evidence I, High Quality Randomized Trial.

RESUMO OBJETIVOS: O extrato de Ginkgo biloba (EGb 761) é um extrato vegetal obtido das folhas da árvore Ginkgo biloba. O objetivo deste estudo foi avaliar os efeitos histológicos e radiológicos do extrato de Ginkgo biloba sobre a consolidação de fraturas em um modelo experimental de fratura em fêmures de rato. MÉTODOS: Foram utilizados 48 ratos Sprague-Dawley fêmeas (peso: 195-252 g, idade: 20 semanas). Os ratos foram divididos randomicamente em seis grupos (n = 8). Uma fratura transversal foi feita no meio do fêmur direito de cada rato e fixada com fio de Kirschner. Os grupos G. biloba receberam 60 mg/kg de G. biloba por via oral uma vez por dia. Não foi administrada nenhuma medicação aos grupos de controle. Nos dias 7, 21 e 35, ambos os fêmures foram avaliados radiológica e histopatologicamente. RESULTADOS: A avaliação histológica revelou que os grupos G. biloba apresentaram diferenças significativas aos 21 e 35 dias (p < 0,05). O grupo G. biloba mostrou uma diferença significativa em termos de formação óssea no dia 21 quando comparado com o grupo controle (p < 0,05). CONCLUSÕES: Este estudo indicou que o uso de extrato de G. biloba acelerou a consolidação de fraturas. As diferenças radiológicas e histológicas foram detectadas, mas as diferenças histológicas foram mais notáveis. Nível de Evidência I, Estudo Clínico Randomizado de Alta Qualidade.

Validity and Reliability of the Turkish Version of Needs Based Biopsychosocial Distress Instrument for Cancer Patients (CANDI).

BACKGROUND: Needs based biopsychosocial distress instrument for cancer patients (CANDI) is a scale based on needs arising due to the effects of cancer. OBJECTIVES: The aim of this research was to determine the reliability and validity of the CANDI scale in the Turkish language. PATIENTS AND METHODS: The study was performed with the participation of 172 cancer patients aged 18 and over. Factor analysis (principal components analysis) was used to assess construct validity. Criterion validities were tested by computing Spearman correlation between CANDI and hospital anxiety depression scale (HADS), and brief symptom inventory (BSI) (convergent validity) and quality of life scales (FACT-G) (divergent validity). Test-retest reliabilities and internal consistencies were measured with intraclass correlation (ICC) and Cronbach-α. RESULTS: A three-factor solution (emotional, physical and social) was found with factor analysis. Internal reliability (α = 0.94) and test-retest reliability (ICC = 0.87) were significantly high. Correlations between CANDI and HADS (rs = 0.67), and BSI (rs = 0.69) and FACT-G (rs = -0.76) were moderate and significant in the expected direction. CONCLUSIONS: CANDI is a valid and reliable scale in cancer patients with a three-factor structure (emotional, physical and social) in the Turkish language.

Prevalence of Allergic Rhinitis in Children in the Trabzon Province of the Black Sea Region of Turkey.

OBJECTIVE: We aimed to determine the prevalence of allergic rhinitis in children aged 12-15 years who lived in the Trabzon Province, specify possible risk factors, and compare the data obtained with those of the other studies conducted in our country and in other countries. METHODS: First, 1372 students from nine primary schools determined according to the recommendations of Department of Public Health and approval of The Provincial Directorate of Health were screened in their schools with questionnaire forms. Second, students providing the response "yes" to the first and/or second questions in the questionnaire forms were considered as possible allergic rhinitis patients and invited to our clinic. Then, 246 students were subjected to a skin prick test. Data were collected with the evalution of questionnaire and skin prick test results together. RESULTS: The prevalance of allergic rhinitis in children between 12 and 15 years age was found to be 14.5% in Trabzon. Female gender was found to be a relative a risk factor for allergic rhinitis (p=0.015). The prevalence of allergic rhinitis in children whose both parents were smoking was significantly higher than that in children whose only one parent was smoking or both parents were nonsmokers (p=0.0024). In addition, living in an apartment flat (p=0.015) and owing pets (p=0.04) were detected to be other risk factors for allergic rhinitis. CONCLUSION: According to our investigations, this is the first prevalence study in Trabzon, which is the largest settlement in the Eastern Black Sea Region. The prevalence of allergic rhinitis in children was found to be 14.5%. Female gender, smoking habits of the parents, owing pets, and living in an apartment flat are risk factors for allergic rhinitis.

The indicator of hypoxia in acute leukemia: Ischemia-modified albumin.

BACKGROUND: Hypoxia plays an important role in the development and progression of hematologic malignancies. OBJECTIVE: This study was intended to investigate the effectiveness of ischemia-modified albumin (IMA) for demonstrating hypoxia in patients with acute leukemia. METHODS: Blood specimens were collected from 132 subjects (44 acute leukemia patients, 40 iron deficiency anemia (IDA) patients and 48 healthy controls). Serum levels of IMA and malondialdehyde (MDA) were analyzed using conventional methods. RESULTS: Serum levels of IMA were higher in patients with acute leukemia than in those with IDA and healthy controls (acute leukemia patients; 0.69 ± 0.14 ABSUs, IDA patients; 0.61 ± 0.09 ABSUs, controls; 0.50 ± 0.09 ABSUs, respectively). There was a negative correlation between serum IMA levels and hemoglobin (Hb) values (r = - 0.312) and between serum IMA levels and hematocrit (Hct) values, (r = - 0.305) in patients with acute leukemia. Serum levels of MDA were higher in patients with acute leukemia than in those with IDA. But there was no difference in patients with acute leukemia and IDA compared to healthy controls (acute leukemia patients; 2.23 ± 1.82 nmol/mL, IDA patients; 1.36 ± 0.94 nmol/mL, healthy controls; 1.79 ± 0.78 nmol/mL, respectively). CONCLUSIONS: IMA can be effective for demonstrating hypoxia in patients with acute leukemia.

The effects of spinal, inhalation, and total intravenous anesthetic techniques on ischemia-reperfusion injury in arthroscopic knee surgery.

PURPOSE: To compare the effects of different anesthesia techniques on tourniquet-related ischemia-reperfusion by measuring the levels of malondialdehyde (MDA), ischemia-modified albumin (IMA) and neuromuscular side effects. METHODS: Sixty ASAI-II patients undergoing arthroscopic knee surgery were randomised to three groups. In Group S, intrathecal anesthesia was administered using levobupivacaine. Anesthesia was induced and maintained with sevoflurane in Group I and TIVA with propofol in Group T. Blood samples were obtained before the induction of anesthesia (t1), 30 min after tourniquet inflation (t2), immediately before (t3), and 5 min (t4), 15 min (t5), 30 min (t 6), 1 h (t7), 2 h (t8), and 6 h (t9) after tourniquet release. RESULTS: MDA and IMA levels increased significantly compared with baseline values in Group S at t2-t 9 and t2-t7. MDA levels in Group T and Group I were significantly lower than those in Group S at t2-t8 and t2-t9. IMA levels in Group T were significantly lower than those in Group S at t2-t7. Postoperatively, a temporary 1/5 loss of strength in dorsiflexion of the ankle was observed in 3 patients in Group S and 1 in Group I. CONCLUSIONS: TIVA with propofol can make a positive contribution in tourniquet-related ischemia-reperfusion.

Effects of perioperative remifentanil with controlled hypotension on intraoperative bleeding and postoperative edema and ecchymosis in open rhinoplasty.

BACKGROUND: This randomized, double-blind study was designed to assess the effect of perioperative remifentanil with controlled hypotension on intraoperative bleeding, postoperative edema, and ecchymosis. METHODS: Fifty-two patients undergoing rhinoplasty were divided into 2 groups. The remifentanil group received 1 µg · kg(-1) intravenously as a bolus before induction of anesthesia, 0.5 to 1 µg · kg(-1) · h(-1) by continuous intravenous infusion during the operation. After anesthesia induction with propofol (2-3 mg · kg(-1)) and fentanyl (1-15 µg · kg(-1)), muscle relaxation was achieved with rocuronium (0.45-0.90 mg · kg(-1)). Mean arterial pressure was maintained at 50 to 60 mm Hg in controlled hypotensive anesthesia achieved using remifentanil infusion. Perioperative hemodynamics and bleeding; early postoperative pain and agitation scale; postoperative first, third, and seventh day edema; and ecchymosis were evaluated. Edema and ecchymosis were evaluated using graded scale from 0 to 4. RESULTS: Remifentanil reduced mean arterial pressure during the entire operative period and the first 30 minutes postoperatively (P < 0.05 for these comparisons). Intraoperative bleeding also decreased (P < 0.001). There was a significant decrease in edema in both upper and lower eyelid edema on the first and third days in the remifentanil group, although this difference was not detected on the seventh day (P(1upper) = 0.000, P(1lower) = 0.000, P(3upper) = 0.008, and P(3lower) = 0.002). Ecchymosis decreased significantly in both upper and lower eyelids on the first, third, and seventh days in the remifentanil group (P(1upper) = 0.000, P(3upper) = 0.000, P(3upper) = 0.002, P(3lower) = 0.002, P(7upper) = 0.049, and P(7lower) = 0.038). There were no differences in postoperative pain and agitation between 2 groups. CONCLUSIONS: Remifentanil with controlled hypotension may reduce edema and ecchymosis of the upper and lower eyelids, by reducing mean arterial pressure and amount of bleeding in rhinoplasty.

C950T and C1181G osteoprotegerin gene polymorphisms in myeloma bone disease.

OBJECTIVES: Bone disease is one of the hallmarks of multiple myeloma (MM). The role of osteoprotegerin (OPG) in the RANK/RANKL/OPG signaling system is well defined in the myeloma bone disease. Polymorphisms of the TNFRSF11B gene encoding OPG have been studied in various bone diseases. However, relationship between the levels of OPG and development of bone lesions regardless of RANKL is yet unknown. In this study, the effects of OPG gene polymorphism on the development of bone lesions in MM were investigated. METHODS: C950T and C1181G polymorphisms of the OPG gene were studied in 52 MM patients (36 with bone lesions and 16 without bone lesions) and in another 20 control subjects using DNA sequencing. RESULTS: 1181 G and 950 T alleles were overrepresented in MM patients having bone lesions. 950 TT/1181 GG haplotype frequency and TT/GG combined haplotype were also higher in MM patients having bone lesions compared to MM patients without bone lesions or to control. DISCUSSION: This is the first study searching for the relationship between OPG gene variants C950T (promoter), C1181G (exon 1), and myeloma bone disease. It was concluded that the presence of polymorphic 1181 G/950 T alleles and 950 TT/1181 GG genotypes may play a role in the development of bone disease.

The protective effects of glutamine on radiation-induced diarrhea.

INTRODUCTION: Glutamine is a neutral amino acid that is used by rapidly dividing cells such as erythrocytes, lymphocytes, and fibroblasts. It is also the substrate of glutathione synthesis. In normal metabolic rates, glutamine is an amino acid synthesized endogenously, but in high metabolic conditions such as cancer, it must be taken exogenously. Animal studies strongly demonstrate that glutamine protects both the upper and lower gastrointestinal tract mucosa from the effects of chemotherapy, radiotherapy, or other causes of injury. In this study, we investigated the protective effect of glutamine on radiation-induced diarrhea. PATIENTS AND METHOD: The patients were divided into glutamine-treated and placebo groups. In the glutamine-treated group, 15 g of oral glutamine was administered three times daily. The patients were evaluated for diarrhea grade according to the National Cancer Institute Common Toxicity Criteria version 3.0, (Table 1), need for loperamide use, need for supportive parenteral therapy, and treatment breaks due to diarrhea. RESULTS: There was no difference in overall diarrhea incidence when the two groups were compared. When diarrhea grade was evaluated, none of the patients in the glutamine-treated group had grade 3-4 diarrhea, but in the placebo group, grade 3-4 diarrhea was seen in 69 % of the patients. In the placebo-treated group, patients requiring loperamide and parenteral supportive therapy were 39 and 92 %, respectively. There was no treatment break in glutamine-treated patients. CONCLUSION: Glutamine may have protective effect on radiation-induced severe diarrhea.

[Effects of human amniotic fluid on posterolateral spinal fusion: an experimental preliminary study]. / Insan amniyon sivisinin posterolateral spinal füzyon üzerindeki etkileri: Deneysel bir ön çalisma.

OBJECTIVES: In this study, the effects of human amniotic fluid on posterolateral spinal fusion were investigated in a rat model. MATERIALS AND METHODS: Twenty-eight 20-week-old male Sprague Dawley rats were included in the study. The subjects were divided into two main groups as the control group and the amniotic fluid group. Posterolateral spinal fusion was performed by using autografts in all groups whereas 0.3 ml of centrifuged human amniotic fluid was added to the fusion area in amniotic fluid groups. Groups were further divided into subgroups each including seven rats and evaluated radiologically and histologically at the third and sixth weeks. RESULTS: The radiological fusion observed in the amniotic fluid group was significant at the sixth week when compared to that in the control group. The histological fusion quality was significant in the amniotic fluid groups both at the third and sixth weeks when compared to the control groups. CONCLUSION: We conclude that human amniotic fluid enhances posterolateral spinal fusion. We believe that the growth factors and hyaluronic acid present in the amniotic fluid played a role in this result.

Does propofol prevent testicular ischemia-reperfusion injury due to torsion in the long term?

OBJECTIVES: Our aim was to investigate the long-term preventive effect of propofol on testicular ischemia-reperfusion injury in a rat model. METHODS: Twenty-four adult male Sprague-Dawley rats were randomly divided into four groups (n = 6 for each group), control, sham-operated, torsion/detorsion (T/D) and T/D + propofol. Testicular ischemia was achieved by twisting the left testis 720° clockwise for 2 h. Half an hour before detorsion, 50 mg/kg propofol was given intraperitoneally to the T/D + propofol group. Ipsilateral orchiectomies to determine mean testicular weights and histopathological examination according to Johnsen's mean testicular biopsy score criteria were performed 30 days after surgical procedure in all groups. RESULTS: Mean testicular weights were 1.57 ± 0.12 g in group I, 1.59 ± 0.36 g in group II, 0.84 ± 0.20 g in group III and 0.87 ± 0.29 g in group IV. Mean testicular weights decreased significantly in the T/D groups, but no improvement in testicular weight was observed with propofol administration (p 0.9372). Similarly, the Johnsen's mean testicular biopsy scores of the T/D groups were lower than those of the control and sham-operated groups, but no positive effect was determined with the administration of propofol in the T/D groups (p 0.1797). CONCLUSIONS: Our results showed that there is no apparent long-term therapeutic potential attendant on using propofol in the treatment of testicular ischemia-reperfusion injury caused by testis torsion.

Treatment related changes in antifibrinolytic activity in patients with polycythemia vera.

Polycythemia vera (PV) is a clonal myeloproliferative disorder characterized by predominantly excessive erythrocyte production. During the course of the disease, bleeding or thrombosis may be observed. In PV patients, the influence of antifibrinolytic activities on development of thrombohemorrhagic complications remains to be elucidated. In the present study, alterations in antifibrinolytic activity of PV patients and the effects of treatments on these alterations were investigated. Newly diagnosed and therapy-naive 22 PV patients were included. Thrombomodulin (TM), plasmin-alpha 2-antiplasmin complex (PAP), plasminogen activator inhibitor-1 (PAI-1) and thrombin activable fibrinolysis inhibitor antigen (TAFIa) levels were measured in all individuals and after phlebotomy and 5-hydroxyurea (5-HU) therapy in PV patients. TM, PAP, PAI-1 and TAFIa values of the patient group were higher than those of the controls. After phlebotomy, no changes were detected in TM, PAI-1 and TAFIa values, but PAP values decreased. On the contrary, 5-HU treatment resulted in a marked decrease in TM, PAI-1, PAP and TAFIa levels. These findings suggested that the changes in antifibrinolytic activity and endothelial dysfunction might be contributed to formation of intravascular thrombosis in PV patients, even though not clinically overt. 5-HU in addition to phlebotomy affects antifibrinolytic activity and may have an influence on diminishing predisposition of thrombosis.

Can ischemia-modified albumin be a valuable indicator of tissue ischemia in polycythemia vera?

The red cell expansion in polycythemia vera (PV) causes hyperviscosity affecting blood flow, which plays a major role in the pathogenesis of both microcirculatory disturbances and ultimately thromboses. Ischemia-modified albumin (IMA) is produced during an ischemic states and is present in blood in early and easily detectable levels. This study investigated whether IMA is a useful adjunct in the determination of ischemia in patients with PV, prior to them exhibiting clinical evidence of thrombotic complications. Blood IMA levels were determined in 20 PV patients and in 20 healthy individuals using a method described by Bar-Or. Mean IMA levels in the PV group were significantly higher than those of the control group (P<0.05). At the optimum cutoff point (0.193 absorbance units), the sensitivity and specificity of IMA were 80 and 100% to ischemia, respectively. In conclusion, IMA may be a valuable biochemical marker in predicting tissue ischemia in PV before the signs of vascular disturbances occur.

Ischemia-modified albumin reduction after coronary bypass surgery is associated with the cardioprotective efficacy of cold-blood cardioplegia enriched with N-acetylcysteine: a preliminary study.

BACKGROUND: The aims of this preliminary study were to determine the alteration of serum ischemia-modified albumin (IMA) levels and to investigate whether IMA may be used as an indicator of the cardioprotective efficacy of N-acetylcysteine (NAC) in patients undergoing coronary bypass grafting (CABG). PATIENTS AND METHODS: Forty-four patients were randomized into one of two groups on the basis of cardioplegic strategies, either cold-blood cardioplegia enriched with NAC (50 mg/kg) or cold-blood cardioplegia alone. Serum IMA, cardiac troponin T (cTnT) and malondialdehyde (MDA) levels determined in NAC-enriched patients before and after CABG were compared with those of the NAC-free group. The albumin cobalt binding assay was used for IMA determination. RESULTS: Serum IMA levels were significantly elevated after cross-clamping and peaked at 6 h after reperfusion in the two groups. In NAC-enriched patients, IMA levels determined 6, 12, 24 and 48 h after reperfusion were significantly lower than those of the NAC-free group (p < or = 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). IMA returned to baseline 24 h after reperfusion differently from cTnT and MDA in the NAC-enriched group. CONCLUSIONS: IMA may be used as not only an indicator of myocardial ischemia-reperfusion injury, but also as a useful indicator of the cardioprotective effect of NAC in CABG.

The effect of anti-TNF agent on oxidation status in patients with ankylosing spondylitis.

The aim of this study was to comparatively evaluate oxidative status of ankylosing spondylitis (AS) patients receiving anti-tumor necrosis factor (TNF) or non-steroid anti-inflammatory drugs (NSAID). Forty-seven patients with AS and 27 healthy controls were enrolled. Of these, 23 were on anti-TNF (group 1) and 24 on NSAIDs (group 2). Groups 1 and 2 were consisted of matched patients with respect to age, gender, body mass index, disease duration, C-reactive protein, erythrocyte sedimentation rate, total cholesterol, and Bath Ankylosing Spondylitis Disease Activity Index. Mean duration of treatment for patients in group 1 was 12.6 +/- 6.8 months. Serum total antioxidative status (TAS) and total oxidative status (TOS) levels were determined using new automated methods. Oxidative stress index (OSI) was calculated. The groups' carotid intima-media thicknesses (IMT-C) were also measured using ultrasonography. Group 1 had the highest TAS and lowest TOS levels. The TOS levels of group 1 was lower than the control, while group 2 being higher than controls. The difference in TOS levels between group 1 and group 2 was statistically significant (p = 0.040). OSI values were highest in group 2 and lowest in group 1. There was no significant correlation between oxidant/antioxidant parameters and IMT-C for group 1 (r = -0.30, p = 0.198 for OSI; r = 0.22, p = 0.366 for TAS; r = -0.22, p = 0.361 for TOS). This is the first study to evaluate total oxidative/antioxidative status in patients with AS on anti-TNF agent. These results clearly indicate positive effects of anti-TNF treatment on oxidative status of AS patients. The limited effects of NSAIDs compared with controls may be due to excess impaired oxidative status in the patients in this study.

Effect of LMO2 protein expression on survival in chronic myeloid leukemia patients treated with imatinib mesylate.

LIM domain only-2 (LMO2) is an important regulator of hematopoietic stem cell development. LMO2 protein is expressed in all three hematopoietic lineages precursors of the hematopoietic system, and its expression has been shown to decrease gradually during differentiation. Chronic myeloid leukemia (CML) is a malignant clonal myeloproliferative disorder in which the terminal differentiation is not altered until the appearance of an accelerated or blast phase. We examined whether LMO2 protein expression can predict outcome CML patients undergoing tyrosine kinase inhibitor therapy, imatinib mesylate (IM). Immunohistochemistry on bone marrow biopsy material for LMO2 protein was performed in 47 CML patients. We report that the LMO2 protein expression is correlated with improved hematologic remission and overall survival in the CML patients treated with IM. The immunohistologic analysis of LMO2 protein expression may become a predictive factor for anticipating the treatment responses of CML patients.

Factors contributing to regular smoking in adolescents in Turkey.

PURPOSE: The objectives of this study were to determine the levels of lifetime cigarette use, daily use, and current use among young people (aged 15-19 years) and to examine the risk factors contributing to regular smoking. METHODS: The number of students was determined proportionately to the numbers of students in all the high schools in the province of Trabzon in Turkey. The data were gathered using the questionnaire method. A total of 4666 students participated in the study. The chi-square test and logistic regression analysis were used in data analysis. RESULTS: Of the 4666 students who took part in the study, the level of lifetime cigarette use was 38.2% (n = 1796), that of lifetime daily cigarette use was 10.5% (n = 491), and that of current cigarette use was 9.5% (n = 447). Male students (P < .0005), those whose mothers were smokers (P < .0005), those whose fathers smoked (P = .005), those whose siblings smoked (P<.0005), those whose friends smoked (P < .0005), those whose teachers smoked (P = .001), and low achievers in school (P < .0005) stated that they significantly smoked on a more regular basis. According to the results of the logistic regression analysis, the following risk factors were statistically significant: male students smoked 3.02 times (95% CI 2.20-4.16) more than females, those whose mothers were smokers smoked 1.57 times (95% CI 1.09-2.28) more than those whose mothers were not, those whose friends were smokers smoked 2.42 times (95% CI 1.73-3.39) more than those whose friends were non-smokers, poor achievers in school smoked 2.62 times (95% CI 1.97-3.49) more than high achievers, and those without poor grades smoked 1.75 times more (95% CI 1.23-2.40), the risk rising 1.06 times (95% CI 1.01-1.11) with earlier age at first experimentation. The risk of daily cigarette use was observed to decline by 0.91 times (95% CI 0.84-0.98) with increasing numbers of siblings. CONCLUSION: Effective smoking prevention programs should take into account the dominant influence of peer groups in the onset and continuation of smoking.

Prevalence of prehypertension and hypertension and associated risk factors among Turkish adults: Trabzon Hypertension Study.

BACKGROUND: To estimate the prevalence, awareness and control of prehypertension (preHT) and hypertension (HT) as defined by JNC-7 criteria in the Trabzon Region and its associations with demographic factors (age, sex, obesity, marital status, reproductive history in women and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, obesity and cardiovascular disease), lifestyle factors (smoking habits, physical activity and alcohol consumption) in the adult population. METHODS: In this cross-sectional survey, a sample of households was systematically selected from the central province of Trabzon and its nine towns. A total of 4809 adult subjects (2601 women and 2208 men) were included in the study. Demographic and socioeconomic factors, family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure (BP) and diastolic BP levels were measured for all subjects. The persons included in the questionnaire were invited to the local medical centers for blood examination between 08:00-10:00 following 12 hours of fasting. The levels of serum glucose (FBG), total cholesterol (Total-C), high density cholesterol (HDL-C), low density cholesterol (LDL-C) and triglycerides were measured with autoanalyzer. Definition and classification of HT was performed according to guidelines from the US JNC-7 report. Prevalence, awareness, treatment and control of HT were assessed. RESULTS: The prevalences of HT and preHT were 44.0% (46.1% in women and 41.6% in men) and 14.5% (12.6% in women and 16.8% in men), respectively. Overall, only 41% of the hypertensive individuals had been previously diagnosed. Furthermore, 54.5% of the hypertensive subjects were being treated with antihypertensive drugs (AHD), but only 24.3% of treated subjects had their BP adequately controlled. Among all hypertensive subjects (known and newly diagnosed), only 5.43% had their BP under control. The prevalence of HT increased with age, being highest in the 60- to 69-year-old age group (84.4%) but lower again in the 70+ age group. Interestingly, the prevalence was 16.9% in the 20-to 29-year old age group. HT was associated positively with marital status, parity, cessation of cigarette smoking, and negatively with level of education, alcohol consumption, current cigarette use, and physical activity. Multinomial logistic regression analysis revealed that HT were significantly associated with age, male gender, BMI, low education level, nonsmoking, positive family history of selected medical conditions, occupation, and parity. CONCLUSIONS: The Trabzon Hypertension Study data indicated that HT is very common and is an important health problem in the adult population of Trabzon. Patients who are unaware of their status and treated uncontrolled hypertensives are at high risk of early cardiovascular morbidity and mortality. To control preHT and HT, effective public health education and urgent precautions are needed. The precautions include serious health education, a well-balanced diet and increasing physical activity.

Prevalence of dyslipidemia and associated risk factors among Turkish adults: Trabzon lipid study.

The objective of this study was to estimate the prevalence of dyslipidemia as defined by NCEP ATP III criteria in the Trabzon Region of Turkey and to determine its associations with cardiovascular risk factors [hypertension (HT), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and fasting serum glucose (FBG)] demographic factors (age, sex, obesity, marital status, reproductive history in women, and level of education), socioeconomic factors (household income and occupation), a family history of selected medical conditions (diabetes, HT, obesity, and cardiovascular disease), and lifestyle factors (smoking habits, physical activity, and alcohol consumption) in the adult population. In this cross-sectional survey, a sample of households was systematically selected from the central province of Trabzon city and its nine towns, namely, Akcaabat, Duzkoy, Vakfikebir, Yomra, Arakli, Of, Caykara, Surmene, and Macka. A total of 4,809 subjects (2,601 women and 2,208 men) were included in the study. Individuals older than 20 years were selected from their family health cards. Demographic and socioeconomic factors, a family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels were measured for all subjects. The individuals included in the questionnaire were invited to the local medical centers for blood tests between 08:00 and 10:00 after 12 h of fasting. The levels of serum glucose (FBG), total cholesterol (TC), high-density cholesterol (HDL-C), low-density cholesterol (LDL-C), and trigylcerides were measured with autoanalyzer. Dyslipidemia was defined according to guidelines from the US NCEP ATP III diagnostic criteria. The ratio of TC to HDL-C was calculated. Definition and classification of HT were performed according to guidelines from the US JNC-7 report. The results obtained indicated that the age-adjusted mean values (mg/dl) of TC, LDL-C, HDL-C, [TC/HDL-C ratio], and TG were 190 +/- 0.6, 127.5 +/- 0.5, 50.3 +/- 0.3, 3.96 +/- 0.02, and 137.3 +/- 1.5, respectively. Overall, the mean levels of LDL-C, TG and TC/HDL-C ratio were higher in men than in women, whereas the mean level of HDL-C was higher in women than in men. The prevalences of hypercholesterolemia (> or =200 mg/dl), elevated LDL-C (> or =130 mg/dl), low HDL-C (<40 mg/dl), and hypertriglyceridemia (> or =150 mg/dl) were 37.5, 44.5, 21.1, and 30.4%, respectively. Prevalences of dyslipidemia were higher in men than in women, except for TC (P < 0.0001). The prevalences of high TC, LDL-C, TG, and TC/HDL-C ratio increased with age, with the highest prevalences in the 60-69-year-old group, and declined thereafter. The prevalences of high TC, LDL-C and TG, a high TC/HDL-C ratio and low HDL-C increased steadily in line with BP, BMI, WC, WHR, and FBG (P < 0.0001). Dyslipidemia was positively associated with marital status, parity, cessation of cigarette smoking and current cigarette use, and alcohol consumption, and negatively associated with the level of education, household income, and physical activity. Multiple logistic regression analysis revealed that dyslipidemia was significantly associated with the factors of age, male gender, BMI, WC (except for TC and LDL-C), HT (only for LDL-C and TG), FBG (only for LDL-C and TG), education level, cigarette smoking (only for HDL-C and TC/HDL-C ratio), alcohol consumption (except for HDL-C and TC/HDL-C ratio), occupation (especially housewives), marital status (widows and widowers), and a family history of selected medical conditions (for only TC). In conclusion, Trabzon Lipid Study data indicate that dyslipidemias are very common and an important health problem among the adult population of Trabzon. To control dyslipidemias, effective public health education and urgent measures are essential.