Mustafa N. Ilhan

Burnout and its correlates among nursing staff: questionnaire survey.

AIM This paper is a report of a study to determine the burnout level and its correlates in nurses. BACKGROUND Healthcare providers and especially nurses are generally considered a high risk group regarding work stress and burnout and this syndrome has been a major concern in the field of occupational health. METHOD The study was carried out at a university hospital in Turkey during May-June 2005. A total of 418 nurses from the 474 working at the hospital at the time (88.2%) answered a self-administered questionnaire including the Maslach Burnout Inventory. FINDINGS All the nurses were female, with a mean age of 30.6 (5.4) and a median age of 29 years. The mean score was 17.99(6.35) for the Emotional Exhaustion subscale, 5.72 (3.87) for the Depersonalization subscale and 19.83 (4.66) for the Personal Accomplishment subscale. Emotional Exhaustion decreased with increasing age (P < 0.05). Total time in the job, weekly working hours, shift-working and the unit where employed influenced burnout scores (P < 0.05). Not being happy with relations with superiors, not finding the job suitable, feeling anxious about the future, perceived poor health, problems with personal life and financial difficulties were also factors influencing burnout scale scores (P < 0.05). CONCLUSION It is necessary to consider nurses having the characteristics shown as the correlates of burnout in this study as a target group, to screen periodically the burnout status and improve their working conditions, especially relationships with colleagues.

Prevalence of skin diseases among pediatric patients in Turkey

The pediatric population is composed of persons under 16 years of age, and few studies are available on the dermatological diseases of this group. In the present study, data on a total of 6300 pediatric patients admitted between the years 2004–2006 were analyzed. Hospital‐based patient registry records were used for data collection. The data were analyzed according to age, sex and time of admittance. A female preponderance (53%) was observed, and adolescents (12–16 years old) constituted the largest group within the patient population (47.6%). A total of 125 dermatoses were recorded. Acne vulgaris was the most prevalent dermatosis (12.4%), followed by atopic dermatitis (11.8%), contact dermatitis (11.3%), warts (9.5%), seborrheic dermatitis (4.3%) and impetigo (4.1%). Atopic dermatitis was the most frequently seen dermatosis in both infants and preschool‐age children, whereas contact dermatitis was more prevalent in school‐age children, and acne vulgaris was more prevalent in the adolescent group. The frequencies of some diseases showed seasonal variations. Acne vulgaris, atopic dermatitis, contact dermatitis, psoriasis, xerosis and alopecia areata were more common in winter. In contrast, insect bites, vitiligo, dyshidrotic eczema, impetigo and tinea corporis were more common in summer. Studies of the pediatric population, which constitutes the cornerstone of the community, can play an important role in determining the policies of protective medicine and public health. New studies will help us to better understand the frequency of dermatological diseases in the pediatric population according to age, gender and season, and take precautions with regard to these conditions.

Self-medication with antibiotics: questionnaire survey among primary care center attendants.

The aim of this study was to determine the frequency and reasons for self‐medication with antibiotics within the last 12 months among primary healthcare center attendants aged 18 or over, in Ankara.

Frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey.

Background:  The aim of this study was to establish the frequencies of vitamin D deficiency and insufficiency among healthy children aged 1–16 years and also to determine the factors affecting the levels of vitamin D in Turkey.

Intravenous theophylline decreases post-dural puncture headaches.

Post-dural puncture headache (PDPH) is a common complication of lumbar puncture. As invasive treatments for PDPH have known complications, pharmacologic management may be preferable. The aim of this study was to evaluate and to compare the efficacy of intravenous theophylline treatment for PDPH, in comparison with a placebo. We found that intravenous theophylline infusion was effective for decreasing the painfulness of PDPH compared with the control group. The mean visual analogue scale (VAS) value was 7.05+/-1.47 before the theophylline infusion and 2.88+/-2.31 after infusion. An average of 59.1% relief of pain was obtained in the group treated with theophylline infusion. The improvement in VAS in the study group was significant (p < 0.001), whereas that in the control group was not (p = 0.15). The mean VAS decrease after theophylline infusion was 4.17+/-2.03 in the study group and 0.41+/-0.71 in the control group; the difference in improvement between the groups was significant (p < 0.001). Intravenous theophylline infusion is an easy, rapid, minimally invasive, an effective treatment for PDPH. It may be attempted in PDPH patients before invasive techniques are used. To the best of our knowledge, this is the first report on the effect of intravenous infusion of theophylline compared with a placebo in the treatment of PDPH.

Serotonin transporter gene polymorphisms and sertraline response in major depression patients.

Major depression (MD) has a complex multifactorial etiology with genetic and environmental factors contributing to the disorder. As with all antidepressant treatments, there is variability in drug response due to heredity, generally focusing on genetic polymorphism of the drug-metabolizing transporter genes. The serotonin transporter (5-HTT) gene is a particularly important candidate for genetic involvement in MD disorders owing to its key role in the regulation of serotonergic transmission and is therefore considered to be an interesting candidate in the mechanism of antidepressant drugs. In this study, we have focused on the associations between genetic polymorphisms in two regions of the 5-HTT gene (5-HTTLPR and VNTR) related to sertraline responses. Our sample consisted of 64 unrelated Turkish subjects who strictly met DSM-IV and CGI scores. There was no significant difference between the frequency of the SS, LS, LL, 9/10, 10/10, 9/12, 10/12, and 12/12 genotypes and responses to sertraline. However, the number of patients can be increased and different drugs can be studied in order to find a specific pharmacogenetic relation.

PON1 55 and 192 Gene Polymorphisms in Type 2 Diabetes Mellitus Patients in a Turkish Population

Diabetes mellitus is a multifactorial metabolic disease, caused by the complete or relative absence of insulin hormone, which results in the deterioration of carbohydrate, protein, and lipid metabolism. The PON1 55 and 192 polymorphisms have been reported to be associated with type 2 diabetes and its complications. In this study, the involvement of the PON1 55 and 192 polymorphisms and paraoxonase enzyme activity in diabetic complications was assessed. The MM and QQ genotypes were the most frequent in complications of type 2 diabetes in both of the polymorphisms. PON enzyme activity was lower in the type 2 diabetes group with respect to the control group. Regarding both genotypes and enzyme activity, correlations were found between the PON1 55 and 192 genotypes and diabetic complications. This study thus helps to outline a genotype–phenotype relation for the PON1 gene in a Turkish population.

Generalized pruritus: a prospective study concerning etiology.

AbstractBackground:Generalized pruritus can often be the primary manifestation of systemic disease. Objective:To determine how frequently generalized pruritus had a systemic etiology in an outpatient population seen in a dermatology department and whether any identifiable patient characteristics meant a systemic explanation of generalized pruritus was more likely. Methods:A prospective controlled study of 55 patients with generalized pruritus and 41 healthy age- and sex-matched control subjects. Clinical data were collected from patients and laboratory parameters investigated in both patients and healthy control subjects to determine the frequency of systemic disease in each group. Results: Of 55 patients, 12 had a systemic cause of pruritus. Pruritus was the initial symptom of systemic disease in eight of these patients. The underlying diseases included hypothyroidism, chronic lymphocytic leukemia, hepatitis C, hepatitis B, diabetes mellitus, lung cancer, uremia, and iron deficiency anemia. Of these, iron deficiency anemia was the most common cause. Compared with the control group, mean serum hemoglobin, iron, and cyanocobalamin (vitamin B12) levels in patients with generalized pruritus were lower. No other patient characteristics were statistically associated with systemic causes of pruritus. Conclusion:Generalized pruritus was the initial symptom of a systemic disease in 8 of 55 patients presenting to a dermatology outpatient clinic with this complaint. A number of underlying diseases were identified, of which the most common was iron deficiency anemia.

Diagnostic value of rapid antigen detection test for streptococcal pharyngitis in a pediatric population.

Acute upper respiratory tract infections in children may result in overuse of antibiotics as throat culture cannot be performed in every setting and results cannot be obtained early. A rapid and reliable test might decrease unnecessary antibiotic usage. The purpose of this study was to determine the prevalence of group A beta-hemolytic Streptococcus (GABHS) infections in different pediatric age groups and to assess the diagnostic value of rapid antigen detection test (RADT) for streptococcal pharyngitis. This study was performed in a pediatric outpatient clinic. All children who were admitted with signs and symptoms of acute upper respiratory tract infections were included in the study. Throat culture and RADT were performed and prevalence of GABHS was assessed. Diagnostic value of RADT was determined. This study included 1248 children with a mean age of 6.3+/-3.6 years. There were 655, 518, and 75 children in age groups of 0-6, 7-12 and 13+ years, respectively. The overall prevalence of GABHS was 38.1% (475/1248), as judged by throat culture. The prevalence was highest in the 7-12-year age group (53.9%) and lowest in the 0-6-year age group (25.2%). Considering all patients, RADT gave a sensitivity of 89.7%, specificity of 97.2%. The sensitivity and specificity of RADT were similar in different age groups (p values >0.05). Diagnostic value of RADT is high and can be used safely in populations where streptococcal pharyngitis and its complications such as acute rheumatic fever and acute glomerulonephritis are common.

Microanatomy of Milk Ducts in the Nipple

The aim of this study was to determine number and diameter of milk ducts in the nipple and to investigate the possible influences of age, breast weight, and diameter of the nipple on the number of ducts. Two hundred and twenty-six carcinoma mastectomy specimens were weighed and the nipple diameters measured. The number of ducts was counted in histological cross sections. Mean diameter of the nipple and mean breast weight were 13.9 mm and 844.6 g, respectively. There was a small but statistically significant positive correlation between nipple diameter and number of milk ducts (rho = 0.158; p = 0.01), but no correlation with breast weight. The mean number of ducts in the nipple duct bundle was 17.5. This is significantly higher than the number of ducts reported to open on the nipple surface. This discrepancy could reflect duct branching within the nipple or the presence of some ducts which do not reach the nipple surface. Smaller breast ducts (diameter <0.5 mm) represent nearly 50% of the nipple ducts and could be a challenge to the ductoscopy technology.