Esen Savas

Knowledge, attitudes and anxiety towards influenza A/H1N1 vaccination of healthcare workers in Turkey

BackgroundThis study aimed to analyze the factors associated with knowledge and attitudes about influenza A (H1N1) and vaccination, and possible relations of these factors with anxiety among healthcare workers (HCW).MethodsThe study used a cross-sectional descriptive design, and it was carried out between 23 November and 4 December 2009. A total of 300 HCW from two hospitals completed a questionnaire. Data collection tools comprised a questionnaire and the State-Trait Anxiety Inventory (STAI).ResultsVaccination rate for 2009 pandemic influenza A(H1N1) among HCW was low (12.7%). Most of the respondents believed the vaccine was not safe and protective. Vaccination refusal was mostly related to the vaccines side effects, disbelief to vaccines protectiveness, negative news about the vaccine and the perceived negative attitude of the Prime Minister to the vaccine. State anxiety was found to be high in respondents who felt the vaccine was unsafe.ConclusionsHCW considered the seriousness of the outbreak, their vaccination rate was low. In vaccination campaigns, governments have to aim at providing trust, and media campaigns should be used to reinforce this trust as well. Accurate reporting by the media of the safety and efficacy of influenza vaccines and the importance of vaccines for the public health would likely have a positive influence on vaccine uptake. Uncertain or negative reporting about the vaccine is detrimental to vaccination efforts.

Awareness and practices regarding breast and cervical cancer among Turkish women in Gazientep.

BACKGROUND Cancer is a major public health problem both in our country and worldwide due to its disease burden, fatality and tendency for increased incidence. In Turkey, breast cancer ranks first with an incidence of 41.6% and cervical cancer is the tenth most common cancer with an incidence of 4.4%. OBJECTIVES AND DESIGN This descriptive, cross-sectional study was conducted with 240 women aged from 15 to 65 years admitted to a gynecology-obstetrics outpatient clinic of a private hospital in Gaziantep. Study data were collected by the investigators through a 36-item questionnaire form which was generated using information gathered from similar surveys in the literature. RESULTS It was determined that 34.6% of women were high-school graduates, and 64.2% had a medium income level. The majority (79.2%) stated that they never performed BSE and 49.5% of them said that they did not know how to do it. Some 79.2% did not know what a Pap smear was and 73.3% had not experienced a smear test ever. CONCLUSIONS In this study, we found that most of the women had insufficient knowledge of breast and cervical cancer, while knowledge and practices increased with the education level. Based on these findings, we suggest that there is a need for planning, implementation and assessment of health policies and healthcare services at the national and regional level and we believe that nurses working in the field of protective health services should develop educational programmes for women with a primary focus on cancer in order to increase awareness among the female population in Turkey.

Atypical Antipsychotic Usage-Related Higher Serum Leptin Levels and Disabled Lipid Profiles in Euthymic Bipolar Patients

Atypical antipsychotics (AA)-induced weight gain is associated with increased leptin levels. AA have been increasingly used in the treatment of bipolar disorders. This cross-sectional study aimed to evaluate the association between serum leptin and lipid profiles considering the drug treatments in euthymic bipolar outpatients. Leptin and lipid profiles were compared, and no differences were noted in leptin, cholesterol, and low-density lipoprotein levels among the patients and controls. Glucose, very-low-density lipoprotein, and triglyceride levels in patients were higher than in controls, while high-density lipoprotein levels were low. Patients were divided into three groups according to their type of drug usage: AA users, AA + mood stabilizer users, and mood stabilizer users. Each group of patients was compared with a healthy control group for mentioned biochemical parameters. Lipid profiles were disordered by using both AA and mood stabilizers, but higher leptin levels are associated with AA usage. However, leptin does not seem to be responsible for dyslipidemia caused by AA or mood stabilizers in euthymic bipolar patients.

Is there a link between neutrophil-lymphocyte ratio and microvascular complications in geriatric diabetic patients?

Background: Chronic inflammation plays an important role on development and progression of Type 2 diabetes (T2DM) through immunologic inflammatory mechanisms. Neutrophil to lymphocyte ratio (NLR) is a new, simple and cheap marker of subclinical inflammation. NLR has recently been used as a systemic inflammation marker in chronic diseases as well as a predictor of prognosis in cardiovascular diseases and malignancies. Aim: The objective of the present study was to investigate the relationship between NLR and microvascular complications of diabetes mellitus (DM) in elderly population. Subjects and methods: Two hundred and forty-two patients with DM (145 diabetic patients with complications, 97 diabetic patients without complications) and 218 control subjects were enrolled in this study. NLR and microvascular complications because of DM were evaluated and compared with other inflammatory markers. Results: NLR was higher in the diabetic group (2.21±1.14) than in the controls (2.18±0.76). Furthermore, there was a statistically significant difference between NLR levels in diabetic patients with and without complications (2.46±1.26 vs 2.04±0.51, respectively; p<0.001). The results of the multiple logistic regression analysis depicted that NLR is also an independent predictor for microvascular complications (odds ratio 2.217; 95% confidence interval 1.086–4.526, p=0.029). Receiver operating curve analysis suggested that the optimum NLR cutoff point for microvascular complication was 2.89 with 96.72% specificity, 94.4% positive predictive value. Conclusion: Increased NLR levels may be associated with microvascular complications of DM in the elderly population.

Evaluation of oxidant and antioxidant status and relation with prolidase in systemic sclerosis.

SummaryPurposeSystemic sclerosis (SSc) is a disease characterized by fibrosis of the skin and organs; it is associated with diffuse fibroproliferative microangiopathy and autoimmune background. The studies have shown that the production of excessive free radicals and increased collagen synthesis by the fibroblasts play an important role in the pathophysiology of SSc. Prolidase is an important marker in collagen turnover. We aimed to compare total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and prolidase levels of SSc patients and healthy controls. We also investigated the relationship between prolidase and oxidative stress.MethodsA total of 38 SSc patients and 33 healthy volunteers were included in the study. Serum TAS, TOS, and prolidase activity were evaluated in the groups.ResultsIt was found that the TOS and OSI levels of patients were higher than those in the control group (P = 0.012 and 0.015, respectively), whereas TAS was not significantly different between groups (P = 0.451). Prolidase activity was lower in patients than in controls (P = 0.008). There was a weak correlation between prolidase and OSI in patients. It was found that TAS was lower by marginal significance in the patients with lung and gastrointestinal tract (GT) involvement than the patients without those (P = 0.067 and 0.059, respectively).ConclusionsOur data suggest that oxidative stress is increased in SSc. TAS is decreased in patients with lung and GT involvement. These results support that antioxidant treatment may be useful in SSc, especially in patients with lung and GT involvement. Antioxidant treatment may prevent organ involvement in SSc. TAS may be a marker that predicts the risk of involvement of a specific organ. In addition, prolidase may be a marker of SSc.ZusammenfassungZiel der StudieDie systemische Sklerose (SSc) ist eine Erkrankung, die durch Fibrose der Haut und der Organe gekennzeichnet ist; sie ist vergesellschaftet mit einer diffusen fibroproliferativen Mikroangiopathie und einem autoimmunen Hintergrund. Es konnte in verschiedenen Studien gezeigt werden, dass die überschießende Produktion von freien Radikalen und die gesteigerte Kollagensynthese durch Fibroblasten eine wichtige Rolle in der Pathophysiologie der SSc spielen. Prolidase ist ein wichtiger Marker des Turnovers von Kollagen. Ziel unserer Studie war es, den gesamten oxidativen Status (TOS), den gesamten antioxidativen Status (TAS), den oxidativen Stress Index (OSI) und die Serum-Konzentrationen der Prolidase bei Patienten mit SSc und bei gesunden Kontrollen zu erheben. Außerdem untersuchten wir, ob ein Zusammenhang zwischen Prolidase und oxidativem Stress besteht.Methodik38 Patienten mit SSc und 33 gesunde Freiwillige wurden in die Studie aufgenommen. Serum TAS, TOS und Prolidase-Aktivität wurden in beiden Gruppen erhoben.ErgebnisseDie TOS und OSI waren bei den Patienten höher als bei der Kontrolle (P = 0,012 beziehungsweise 0,015). Die TAS unterschied sich allerdings nicht signifikant zwischen beiden Gruppen (P = 0,451). Die Aktivität der Prolidase war bei den Patienten niedriger als bei den Gesunden (P = 0,008). Bei den Patienten bestand eine schwache Korrelation zwischen Prolidase und dem OSI. Bei den Patienten mit Beteiligung der Lunge und des Gastrointestinaltraktes (GI-Trakt) waren die TAS grenzwertig signifikant niedriger (P = 0,067 beziehungsweise 0,059) als bei den Patienten ohne Befall dieser Organe.SchlußfolgerungenUnsere Ergebnisse lassen vermuten, dass der oxidative Stress bei SSc erhöht ist. TAS ist bei Beteiligung der Lungen und des GI-traktes erniedrigt. Eine antioxidative Behandlung könnte daher bei SSc – vor allem wenn Lungen und GI-Trakt befallen sind, von Nutzen sein. Diese Behandlung könnte der Organbeteiligung vorbeugen. TAS könnte ein Marker sein, der das Risiko des Befalls eines bestimmten Organs vorhersagt. Außerdem könnte die Prolidase ein Marker der SSc sein.

Do Ramadan Fasting Restrictions Alter Eating Behaviours in Obese Women

Ramadan fasting can be considered as a kind of dietary restriction. Eating restriction is a risk factor for later development of eating disorders. The purpose of this study is to evaluate whether Ramadan fasting changes the eating behaviours of obese women. Our sample consisted of 34 obese women who fasted during the Ramadan month. The data were collected by using Questionnaire Form, Eating Attitude Test (EAT) and Bulimic Investigatory Test, Edinburgh (BITE). No statistically significant differences were found between the scores of EAT, BITE, BMI, which were administered within the weeks before and after Ramadan. According to our results, Ramadan fasting restrictions do not seem to change the eating behaviours of obese women.

Association between red blood cell distribution width and disease activity in patients with Behçet’s disease

Objectives To examine associations between red blood cell distribution width (RDW) and organ involvement and disease activity in patients with Behçet’s disease. Methods Haematological and inflammatory parameters including RDW, high-sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) were examined in patients with Behçet’s disease and in healthy controls. Patients were divided into those with active or inactive disease. Results Data from 236 patients with Behçet’s disease (77 with active and 159 with inactive disease) and 72 controls were analysed. RDW, ESR and hsCRP were significantly higher in patients with Behçet’s disease than in controls, and in those with active disease compared with inactive disease or controls. In addition, ESR and hsCRP were significantly higher in those with inactive disease than controls. No correlations were found between hsCRP, ESR and RDW. No differences were observed in RDW, ESR or hsCRP between patients with or without ocular or vascular involvement. Multivariate logistic regression analysis revealed that RDW was significantly higher in active disease compared with inactive disease. Conclusions RDW was increased in active disease compared with inactive disease. No relationships were found between organ involvement and RDW. RDW may be a cost-effective, novel potential parameter to evaluate disease activity in Behçet’s disease.

The evaluation in terms of sarcopenia of patients with fibromyalgia syndrome

SummaryBackgroundFibromyalgia syndrome (FMS) is an extra-articular rheumatic illness, characterized by widespread body pain and decreased muscle function. Generalized loss of muscle mass and strength is named as sarcopenia. The objective of this study was to evaluate patients with FMS regarding sarcopenia.MethodsThis was a cross sectional, case-controlled, single-blinded, and single-centered study. The FMS patients were assessed by Fibromyalgia Impact Questionnaire (FIQ), visual analog scale (VAS), Beck Depression Index (BDI), and Pittsburg Sleep Quality Scale (PSQI). All the participants were evaluated for sarcopenia by bioimpedance analysis (BIA), anthropometric measurements, handgrip strength, and the parameters of walking speed.ResultsIn this study, 82 patients with FMS and 38 healthy control female subjects were included. VAS, BDI, and PSQI scores were statistically higher in the FMS group than the control group (p < 0.001). Handgrip strength (HS) and walking speed (WS) scores in the group with FMS were statistically lower than the control group (p = 0.023, p < 0.001 respectively). VAS score of FMS patients was significantly correlated with BIA, body mass index, waist circumference, HS, and WS scores (r = 0.284, p = 0.012; r = 0.228, p = 0.045; r = 0.249, p = 0.028; r = − 0.361, p = 0.001; and r = − 0.230, p = 0.043 respectively). Also FIQ in patients was significantly correlated with BIA, waist circumference, HS, WS, and body mass index (r = 0.267, p = 0.018; r = 0.291, p = 0.010; r = − 0.319, p = 0.004; r = − 0.360, p = 0.001; and r  = 0.304, p = 0.007 respectively).ConclusionEvaluation of female patients with primary FMS by the sarcopenia parameters could contribute a more objective evaluation during the patients’ follow-up.

Jaundice and hepatic enzyme induction during lamotrigine therapy in a bipolar II patient

Lamotrigine is a novel mood stabiliser as well as an anti-epileptic drug that has already been used for the prevention of convulsions. Despite several known side effects, hepatic dysfunction related to the drug has not been widely reported. A few cases have been observed in neurological, especially paediatric patients, but not in psychiatric patients. We report a case of cholestatis which occurred 6 weeks after starting lamotrigine therapy and which resolved after discontinuation, during the acute phase of disease. To the best of our knowledge, this is the first case of lamotrigine associated with cholestasis reported in patients with bipolar disorder.

Serum prolidase activity is associated with non-diabetic metabolic syndrome

ObjectiveThe aim of this study was to determine the role of serum prolidase activity and the possible association with oxidative stress parameters in non-diabetic metabolic syndrome.Methods30 obese patients without metabolic syndrome (MetS), 34 non-diabetic obese patients with MetS, and 23 volunteer control subjects were enrolled in the study. Fasting plasma glucose (FPG), plasma glucose following 75 g glucose administration, high-density lipoprotein- cholesterol (HDL-C), high-density lipoprotein- cholesterol (LDL-C), total cholesterol, triglyceride (TG), total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index (OSI), and prolidase activities of all subjects were analyzed.ResultsProlidase levels was significantly higher in MetS group compared to both obese and control groups (p < 0.001 and p < 0.05 respectively). Prolidase was also higher in the obese group than in the control group (p < 0.05). Prolidase was negatively correlated with TAS and HDL-C (r = −0,362, p < 0.001; r = −0.320, p < 0.01, respectively) and positively correlated with BMI, weight, waist-c, SBP, DBP, TG, TC, LDL-C.ConclusionProlidase activity may have a role in the pathogenesis of metabolic syndrome.