The 5-year incidence of type 2 diabetes mellitus in women older than 15 years in Ankara, Turkey: a population-based study.

BACKGROUND: Type 2 diabetes mellitus (DM) is a significant cause of morbidity and premature mortality especially in adults. In Turkey, there are few studies on DM incidence. This study aimed to determine the incidence of type 2 DM in women 15 years or older in Turkey. METHODS: This prospective cohort study was performed from December 2002 to May 2003. Preliminary population-based screening was performed in 1997 and 1998 on women 15 years or older living in 4 villages in the Gölbasi, Ankara province. Five hundred sixty-three women who were considered nondiabetic in the first study comprised the population for the present study. Data collection was accomplished by using a questionnaire and randomly measuring the blood glucose levels of the women. The chi and Fisher exact tests were used to analyze the risk factors for DM. RESULTS: The 5-year incidences of type 2 DM, impaired glucose tolerance, and impaired fasting glucose were 2.3%, 0.4%, and 0.7%, respectively. The 5-year incidence of type 2 DM increased with age (P < 0.05). The DM incidence was 6.2% in those with mixed-type hypertension and 4.0% in those with a body mass index of 30 kg/m or higher. At 5-year follow-up, age (>or=35 years), hypertension, and body mass index (>or=30 kg/m) were the risk factors for incidence of abnormal glucose metabolism (P < 0.05). CONCLUSIONS: The incidence of abnormal glucose metabolism in this study is in accord with that in the literature. Our results will contribute to our understanding of the incidence of DM in women in Turkey.

Iodine intake is still inadequate among pregnant women eight years after mandatory iodination of salt in Turkey.

BACKGROUND: A recent study showed first sign of reduction in goiter prevalence and elimination of iodine deficiency state among school-age children in Turkey after a decade of mandatory iodination of table salt. However, iodine status among pregnant women is a still debated issue in our country. AIM: To investigate iodine status, iodized salt consumption rate, and goiter prevalence in 1st trimester pregnant women 8 yr after the mandatory iodination. MATERIAL/ SUBJECTS AND METHODS: One hundred and forty-one 1sttrimester pregnant women who had been followed-up between January and October 2006 in the obstetric outpatient clinics in Turkey were included. Besides a physical examination, subjects underwent laboratory investigations for free T(3), free T(4), and urinary iodine concentration (UIC). All subjects completed a questionnaire regarding sociodemographic parameters, use of iodized salt, and pregnancy history. Goiter status was revealed by a palpation method according to World Health Organization (WHO) guidelines. RESULTS: In this study, we found that the median UIC of pregnant women was 149.7 microg/l (range 20.9-275.1 microg/l). Almost half of the subjects were below the WHO, United Nations Children's Fund, and International Council for the Control of Iodine Deficiency Disorders lower median reference limits of 150 microg/l. Total goiter prevalence was 24.8%, of which 9.2% were visible goiters. Among the study patients, 2.1% had subclinical hypothyroidism, and 0.7% had overt hypothyroidism. The rate for iodized salt use among the pregnant women was 95%. CONCLUSION: Our study revealed that iodine deficiency still remains a serious problem for pregnant women. Based on our results, antenatal follow-up protocols in the primary care setting in Turkey must include iodine supplementation.

Behaviors toward methods of breast cancer early detection in women over 40 years in a rural region of Ankara, Turkey.

BACKGROUND: In this study, we aimed to determine behaviors of women over 40 years toward methods of breast cancer early detection in a rural region of Ankara, Turkey. METHODS: Of the 1277 women aged over 40 years, 910 (71.3%) participated in the study. RESULTS: Not performing breast self-examination was 3.1 times more frequent in those aged 60 years and older (95% confidence interval [CI], 1.8-5.2), 2.1 times more frequent in those who could only read and write (95% CI, 1.5-2.9), and 2.5 times more frequent in housewives (95% CI, 1.5-4.3). The likelihood of clinical breast exam was 1.8 times less in women aged 60 years old and older compared with younger women. Primary school graduates had a 1.9 times (95% CI, 1.3-2.9) greater chance of not having had a mammography compared with those that been at least primary school graduates. CONCLUSIONS: For women to change their behavior and adopt early methods of diagnosing breast cancer, it is necessary to reach priority target groups during the training provided by primary care institutions.

The effectiveness of training for breast cancer and breast self-examination in women aged 40 and over.

BACKGROUND: Training on breast health is required to increase awareness of early detection of breast cancer, especially in countries with limited resources. METHODS: Of the 784 invited women, 462 participated in the study (58.9%). The training included both theoretical and breast self-examination (BSE) training between preeducation and posteducation tests. Following the theoretical presentation, breast examination training was performed using a breast simulator. The competency of the participants on breast examination was assessed by an evaluation guide. RESULTS: All breast cancer symptoms were stated at significantly higher rates compared to those before education (P < .05). The most commonly stated risk factor in both preeducation and posteducation tests was "no breast-feeding," with ratios of 15.2% and 56.3%, respectively. Early detection modalities for breast cancer were also stated more often in the posteducation test compared to the preeducation (P < .05). In the preeducation test, only 4.3% to 18.7% of the participant women could state most of the BSE steps. After BSE training, 85% to 92% of the participants were competent in BSE steps. CONCLUSIONS: Theoretical education on breast cancer and BSE training in low-educated women, even illiterate, is highly effective.

[Comparison of patients undergoing functional endoscopic sinus surgery combined with septoplasty or septorhinoplasty]. / Fonksiyonel endoskopik sinüs cerrahisi ile eszamanli septoplasti veya septorinoplasti uygulanan hastalarin karsilastirilmasi

OBJECTIVES: We compared patients who underwent functional endoscopic sinus surgery combined with septoplasty or septorhinoplasty and evaluated the concurrent applicability of septorhinoplasty and endoscopic sinus surgery. PATIENTS AND METHODS: We retrospectively analyzed 145 patients (96 males, 49 females; age range 16 to 78 years) who underwent endoscopic sinus surgery in conjunction with septoplasty or septorhinoplasty. The two patient groups were compared with respect to demographic characteristics, systemic diseases, allergy histories, the presence of nasal polyposis, preoperative paranasal sinus tomographies, Lund-Mackay scores, surgical procedures, operation times, and complication rates. RESULTS: Patients who underwent septorhinoplasty were younger than those undergoing septoplasty. There were no significant differences between the two groups in terms of paranasal sinus tomography scores, allergy histories, systemic diseases, and complication rates (p>0.05). The number of patients with nasal polyposis was significantly greater in the septoplasty group (p<0.05). Septorhinoplasty in conjunction with endoscopic sinus surgery required a significantly longer operation time (p<0.05). CONCLUSION: Complications and the severity of sinus pathologies were similar in the two groups. Concurrent applications of septorhinoplasty and endoscopic sinus surgery significantly increase operation time.