Prevalence of genital warts in reproductive-aged Turkish women presenting at gynecology outpatient clinics for any reason.

The objective of this multicenter descriptive study was to calculate the frequency of genital warts among Turkish women aged 15-49 years, who visited outpatient gynecology clinics for a variety of reasons. The study was conducted in February 2011 to collect data for a minimum of 154 patients at each center, and the total sample size reached 2,967 women (95.1% completion rate). Oral informed consents were obtained. A questionnaire including data on socio-demographic characteristics and reasons for admission was administered, and a pelvic examination was performed. The overall point prevalence was 35% (95% CI = 3.1%-4.0%), correcting for sampling design, with the highest rates observed in the 15 to 19-year-old group. The odds of having a genital wart was 1.82 times (95% CI = 0.99-3.33) higher among non-pregnant participants than in pregnant women (p = 0.051). The overall point prevalence of genital warts among reproductive-aged women attending gynecology outpatient clinics for any reason in Turkey was 35%.

Ameloblastic carcinoma: a multicenter Nigerian study.

PURPOSE: To obtain a national profile on the prevalence and management of ameloblastic carcinoma in Nigerians. MATERIALS AND METHODS: Data were collected from the case files of patients with a histologic diagnosis of ameloblastic carcinoma from 4 tertiary referral centers in Nigeria from January 1980 to December 2008. RESULTS: Twenty patients were seen within the study period. There were 11 male and 9 female patients, with a male-to-female ratio of 1.2:1. Their ages ranged from 16 to 85 years (mean +/- SD, 41.63 +/- 19.8 years). The duration of the lesion before presentation was 6 months to 4 years. Twelve cases occurred in the posterior mandible alone, 1 case occurred in the anterior mandible alone, and 4 cases involved the anterior and posterior mandible. The posterior part of the maxilla was involved in 3 cases. A majority of the cases (17) occurred de novo, and 3 patients presented with carcinoma ex-ameloblastoma. Treatment included surgical resection with or without neck dissection. Eight patients declined treatment after diagnosis. Surgery was planned for 12 patients, but 2 patients died of intractable bleeding episodes before surgery. Mandibulectomies and maxillectomies were performed for 10 patients. Follow-up was carried out for 5 patients. Recurrence ranged from 6 to 96 months after the first surgery. Overall deaths recorded involved 6 patients. Three patients died within 3 years after the initial surgery and 1 patient died about 8 years after the initial surgery. One patient is still alive and well 1 year after surgery. CONCLUSION: Ameloblastic carcinoma is an uncommon malignancy. Most cases occur in the mandible and arise de novo. Early diagnosis and radical local excision remain the mainstay of treatment.

Organophosphate intoxication presenting as diabetic keto-acidosis.

Organophosphate (OP) poisoning is common in developing countries. The presenting symptoms and signs of OP intoxication are multiple and may cause difficulty in differential diagnosis, especially in children. A case of OP intoxication is reported who presented as diabetic keto-acidosis.

Tackling the African "poverty trap": the Ijebu-Ode experiment.

An experiment in poverty reduction began in 1998 in the city of Ijebu-Ode, Nigeria (estimated 1999 population 163,000), where, without the remittances from relatives abroad, an estimated 90% of the population lived below the poverty line of $1.00 (U.S.) per person per day. Central to the experiment was whether poverty can be dramatically reduced through a city consultation process that seeks to mobilize the entire community along with its diaspora. With 7 years of experience, the Ijebu-Ode experiment has been successful in many ways. There is increasing evidence that poverty in the city has been reduced significantly through the microfinancing of existing and new productive activities and the estimated >8,000 jobs these activities have created. Training based on both sustainability science and technology and indigenous practitioner knowledge has been a critical factor in the establishment of cooperatives and the development of new enterprises in specialty crops, small animal, and fish production. Much of this success has been possible as a result of harnessing social capital, especially through the dynamic leadership of the traditional authorities of the city and by the provision of ample loanable funds through the National Poverty Eradication Program of the federal government. The city consultation process itself engendered a participatory focus to the experiment from the beginning and has encouraged sustainability. Yet long-term sustainability is still in question as the initial leadership needs replacement, and credit, the heart of the experiment, lacks sufficient collateral.

The relationship between males' attitudes to partner violence and use of contraceptive methods in Turkey.

Interventions have been carried out to improve the reproductive health and status of women in Turkey. However, these efforts are limited due to lack of male involvement. Lifestyle risks such as partner violence need to be evaluated in terms of any effects on the use of contraception. Data collected from interviews of married women and their husbands for the 1998 Turkish Demographic and Health Survey and 1971 husbands were included in the study. The percentage of husbands who were against partner violence was 20.4%. However, 22 (0.9%) husbands had an attitude toward the use of violence against their wives. The frequency of contraceptive use was increased from the group of men who had unfavorable attitudes towards violence to the group of men who had favorable attitudes. A similar trend was found in the percentages of condom use for men, with multiple factors influencing contraceptive use. The study suggests that further investigations are needed for couple-related issues to improve the status of women in the community and to empower women for sexual health.

Ameloblastoma in Nigerian children and adolescents: a review of 79 cases.

PURPOSE: To descriptively review the clinicopathologic presentation and management of ameloblastoma in Nigerian children and adolescents and compare this with previous reports in the literature. METHODS AND MATERIALS: Data were collected from the case files of patients managed at 4 tertiary referral centers in Nigeria. RESULTS: Out of a total of 360 patients with a diagnosis of ameloblastoma, 79 were under 20 years of age at presentation (21.9%). Only 2.5% of the patients were under 10 years of age. The male-female ratio was 1.3 to 1 with a peak age incidence of 15 years in males and 17 years in females. All the tumors were intraosseous and the majority (94.9%) were situated in the mandible. The most common morphologic type was solid multicystic ameloblastoma (82.3%). The majority (66.2%) had a multilocular radiographic presentation. In most patients (57.3%), the symphysial region of the mandible was involved by the tumor. However, exclusively anterior tumors constituted only 15.2% of the cases, while tumors involving anterior and posterior jaw regions constituted 41.1%. Resection was the predominant (72.2%) form of surgical management. CONCLUSION: Ameloblastoma in Nigerian children and adolescents exhibit some peculiar clinical features: these include the predominance of males, and of the solid multicystic morphologic type. In addition, there is site predilection for the symphysial region of the mandible. Radical surgical resection remains the predominant form of treatment. Therefore, varying degrees of interference with facial growth will be present in these children.

Is Q fever an emerging infection in Turkey?

Between 4 May and 8 August 2002,46 cases of acute fever were reported near the Black Sea region in northern Turkey. The infection was treated rapidly and successfully with tetracyclines, so clinical diagnosis of rickettsial or ehrlichial infection was considered. Analysis of serum and blood samples taken from 19 patients identified the causative organism as Coxiella burnetii; 7 cases were reported as acute Q fever and 8 as seropositive for past infection. The most common clinical symptoms among the acute cases were vomiting (100.0%), nausea (85.7%), diarrhoea (57.1%), fever (42.9%), abdominal pain (42.9%) and headache (42.9%). Liver enzymes were elevated in all patients. It is considered that epidemiological investigation for Q fever will be essential in the affected region in future.

Is Q fever an emerging infection in Turkey?

Between 4 May and 8 August 2002,46 cases of acute fever were reported near the Black Sea region in northern Turkey. The infection was treated rapidly and successfully with tetracyclines, so clinical diagnosis of rickettsial or ehrlichial infection was considered. Analysis of serum and blood samples taken from 19 patients identified the causative organism as Coxiella burnetii; 7 cases were reported as acute Q fever and 8 as seropositive for past infection. The most common clinical symptoms among the acute cases were vomiting [100.0%], nausea [85.7%], diarrhoea [57.1%], fever [42.9%], abdominal pain [42.9%] and headache [42.9%]. Liver enzymes were elevated in all patients. It is considered that epidemiological investigation for Q fever will be essential in the affected region in future

Seroprevalence and some correlates of Helicobacter pylori at adult ages in Gülveren Health District, Ankara, Turkey.

The purpose of the study was to detect the frequency and distribution of Helicobacter pylori in the Gülveren Health Centre service area among residents aged between 25 and 64 years and to evaluate the relation of H. pylori infections with general health status, socioeconomic status, and some lifestyle habits. The study included a representative sample of Gülveren Health Centre residents, aged between 25 and 64 years. A stratified random sample of 1672 individuals was selected for study purposes out of 10,569 residents, stratified by age and gender. A standardized questionnaire was completed for all study participants using a face-to-face interview and all participants were invited to the local health centre for a thorough physical examination and blood tests. The overall prevalence of H. pylori was found to be 77.5 % among individuals aged between 25 and 64 years. The frequency of H. pylori was higher among individuals with low socioeconomic status; those who migrated to Ankara after the age of 20 years; members of large families (household size of 4 or above); non-alcohol drinkers; and those who regularly drink tea.

Screening for tuberculosis in a primary school in Ankara.

Tuberculosis is still an important health problem in developing countries. A screening program was conducted upon learning that one of the teachers of a primary school in Ankara was diagnosed to have active pulmonary tuberculosis. A total of 341 students in the same building with the index case were screened for tuberculosis. There were 109 students with positive tuberculin test reaction. A higher ratio of tuberculin test positivity among the students of the teacher with active tuberculosis versus students vaccinated with BCG one year previously according to the routine vaccination program was determined. Isoniazid prophylaxis was given to the students with positive tuberculin test. The study shows the importance of an urgent work-up of index cases and their environment to prevent the spread of tuberculosis.

Inhibition of gastric emptying by acarbose is correlated with GLP-1 response and accompanied by CCK release.

We investigated the effect of acarbose, an alpha-glucosidase and pancreatic alpha-amylase inhibitor, on gastric emptying of solid meals of varying nutrient composition and plasma responses of gut hormones. Gastric emptying was determined with scintigraphy in healthy subjects, and all studies were performed with and without 100 mg of acarbose, in random order, at least 1 wk apart. Acarbose did not alter the emptying of a carbohydrate-free meal, but it delayed emptying of a mixed meal and a carbohydrate-free meal given 2 h after sucrose ingestion. In meal groups with carbohydrates, acarbose attenuated responses of plasma insulin and glucose-dependent insulinotropic polypeptide (GIP) while augmenting responses of CCK, glucagon-like peptide-1 (GLP-1), and peptide YY (PYY). With mixed meal + acarbose, area under the curve (AUC) of gastric emptying was positively correlated with integrated plasma response of GLP-1 (r = 0.68, P < 0.02). With the carbohydrate-free meal after sucrose and acarbose ingestion, AUC of gastric emptying was negatively correlated with integrated plasma response of GIP, implying that prior alteration of carbohydrate absorption modifies gastric emptying of a meal. The results demonstrate that acarbose delays gastric emptying of solid meals and augments release of CCK, GLP-1, and PYY mainly by retarding/inhibiting carbohydrate absorption. Augmented GLP-1 release by acarbose appears to play a major role in the inhibition of gastric emptying of a mixed meal, whereas CCK and PYY may have contributory roles.

Pediatric and adolescent bipolar disorder: medical resources.

An increasing body of research suggests the existence of early onset childhood bipolar disorder. The population of pediatric bipolar illness may be small, but current research points to early misdiagnosis of ADD/ADHD, and that attention deficit disorder may masquerade as a harbinger of the mania to come. Since ADD/ADHD estimates range up to 10% of the school population, the notion that ADD/ADHD precedes bipolar disorder leads to a significant increase in diagnosed depressives. This in turn produces an increase in information-seeking behaviors by parents, caregivers, and medical personnel. Variables hindering the information-seeking process include vocabulary, tool failure, co-morbidity, social prejudices, age issues, and environmental factors. This research provides reliable sources, Web sites, databases, key authors, electronic groups, and other accessible medical information in order to better serve the pediatric bipolar community.

Cysteine ligand swapping on a deletable loop of the [2Fe-2S] ferredoxin from Clostridium pasteurianum.

The [2Fe-2S] ferredoxin from Clostridium pasteurianum is unique among ferredoxins, both by its sequence and by the distribution of its cysteine residues (in positions 11, 14, 24, 56, and 60). In previous investigations, a combination of site-directed mutagenesis and of spectroscopic techniques showed that cysteines 11, 56, and 60 are ligands of the [2Fe-2S] cluster in the wild type protein and that cysteine 14 is not, but the status of cysteine 24 remained unclear. New mutated forms of this ferredoxin have been obtained and characterized. The data show that cysteine 24 is a ligand of the cluster in the wild type protein. When cysteine 24 is mutated into alanine, it is replaced as a cluster ligand by cysteine 14. The fourth ligand of the cluster can also be a cysteine residue newly introduced in position 16 when both cysteines 14 and 24 are replaced by alanine. These results suggest that the region encompassing cysteines 14 and 24 is a solvent-exposed flexible loop, in agreement with structure predictions. A number of nondeleterious deletions of variable length (3-14 residues) have been performed in the region of residues 17-32. The deletions were found to modify only marginally the spectroscopic properties of the [2Fe-2S] cluster but resulted in variations of its redox potential over a range of nearly 100 mV. This is the first instance of ligand swapping in a [2Fe-2S] protein, and the first time in any ferredoxin that a large loop has been excised from the structure without preventing the assembly of the iron-sulfur chromophore. Some of the molecular variants described here also highlight the similarities between the C. pasteurianum [2Fe-2S] ferredoxin and the 25 kDa subunit of the proton-translocating NADH: ubiquinone oxidoreductase of Paracoccus denitrificans.

In vitro and in vivo studies on microcapsules and tabletted microcapsules of cephradine.

Cephradine was microencapsulated by coacervation. Ethyl cellulose was used as the polymer and a core/wall ratio of 1:1 was selected. The repose angle, apparent and tapped density, particle size distribution of cephradine microcapsules (CM) and of cephradine powder were examined. Then flat-surfaced tablets of CM were prepared using Avicel PH 101 and magnesium stearate. In vitro and in vivo properties of CM and tabletted CM (both equivalent to 150 mg cephradine) were compared with commercial capsules (equivalent to 250 mg cephradine). The dissolution studies were carried out by the rotating basket method and the agar diffusion method was applied for quantitative determinations. Among the investigated kinetic models for the release of cephradine from CM and tabletted CM the best fit was found with the Higuchi model. In vivo studies were made in rabbits. Bioavailabilities of CM and their tabletted form were higher than that of the commercial capsules. In vitro/in vivo correlations between mean residence time (MRT) and mean dissolution time (MDT) for CM and tabletted CM were calculated. A good correlation was found between the in vitro and in vivo results.