Nilay Etiler

Environmental tobacco smoke exposure in school children: parent report and urine cotinine measures.

Background: Environmental tobacco smoke (ETS) in the home continues to be a major health risk for children around the world. Measuring ETS is a central feature of clinical and epidemiological studies, with children’s exposure often assessed through parental estimates. The authors examined the relationship between parent‐reported estimates of children’s exposure to ETS and children’s urinary cotinine levels and evaluated the ETS exposure and its effect on respiratory health in children.

Prevalence of metabolic syndrome in schoolchildren and adolescents in Turkey: a population-based study.

AIM To determine prevalence of the metabolic syndrome (MS) in the pediatric population. METHODS We studied 2,491 schoolchildren randomly selected aged 10-19 years using a multistage, stratified sampling design. Obese and overweight participants were called for further investigation (n = 456). Of these, 310 participants underwent OGTT. MS was defined according to IDF, NCEP and modified WHO guidelines. RESULTS The prevalence of obesity and overweight were 6.8% and 11.5%, respectively. While MS was found in 2.3% of the total population according to IDF guidelines, its prevalence was increased among overweight and obese individuals. MS prevalence was similar by both IDF and NCEP definitions but higher according to WHO definition. Individuals with MS were consistent by both IDF and NCEP definitions (sensitivity = 100%, specificity = 99%, positive predictive value = 95.2%). IDF and WHO defined different individuals as having MS (sensitivity = 67.5%, specificity = 90%, positive predictive value = 67.5%). CONCLUSIONS Although not as high as in developed countries, MS prevalence determined in schoolchildren and adolescents in Turkey warrants preventive measures. MS diagnosis in one of every three obese children shows that MS is an important public health problem in Turkey as well.

Fatal Occupational Injuries among Workers in Kocaeli, Turkey, 1990–1999

Abstract The authors evaluated occupational accidents in Kocaeli, Turkey, using epidemiologic criteria. Data were derived from the registries of the service on Occupational Injuries and Diseases of the Social Insurance Institutions District Authority in Kocaeli. The analysis was based on data from 387 deaths. The rates of occupational injuries and mortality and fatalities from them were 5.1 %, 30.6 per 100,000 workers, and 6.0%, respectively, compared with 2.8%, 35.2 per 100.000 workers, and 12.7% in Turkey. Sectors with the highest rates of fatal occupational injuries were construction (30.2%), transportation (13.2%), basic metal industry (9.0%), manufacturing of metal products (5.9%), and heating with electricity, gas, and steam (5.9%). 38.2% of these workers were 25–34 years old. Nearly all were male, most were married, and three fourths had children. Of all deaths due to occupational injuries, 121 (31.3%) were caused by traffic injuries, 93 (24.1 %) by falling from high places, and 43 (11.1%) by electrocution; 89% occurred at workplaces, 42% of the workplaces were small, and 45.9% of the deceased workers had been working there for less than three months. Although the situation was better than that in the rest of Turkey in terms of epidemiologic criteria, the death rates, as in other developing countries, are higher than those in the world in general.

Effect of vancomycin, teicoplanin, and cefuroxime on Staphylococcus epidermidis adherence to intraocular lenses

PURPOSE: To compare the adherence of Staphylococcus epidermidis on AcrySof (Alcon) and poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) treated with vancomycin, teicoplanin, and cefuroxime. SETTING: Kocaeli University, School of Medicine, Kocaeli, Turkey. METHODS: The lenses were contaminated with S epidermidis solutions containing 108 colony‐ forming units. Intraocular lenses were placed in sterile triptic soy broth after being held in antibiotic solutions for 15 minutes. After that, sonication and vortex procedures were performed to remove all the attached bacteria that could not be removed by antibiotics. Ten microliters from each broth were taken and inoculated into sheep blood agar. The colonies were counted overnight. The statistical analyses were made using Mann‐Whitney U and Kruskal‐Wallis tests, and a P value less than 0.05 was considered statistically significant. RESULTS: Regarding the inhibitory effect of antibiotics on bacterial adhesion, there was no statistically significant difference between AcrySof and PMMA lenses. In the cefuroxime group, the mean numbers of colony‐forming units on AcrySof and PMMA lenses were 35.2 ± 6.94 and 30.8 ± 18.69, respectively (P>.05). In the teicoplanin group, the mean number of colony‐forming units on AcrySof lenses was 100.1 ± 20.97 and 70.6 ± 43.75 on the PMMA lenses. The adherence in the vancomycin group was 245 ± 273.74 colony‐forming units for AcrySof lenses and 159.8 ± 101.94 for PMMA lenses (P>.05). Regarding the inhibitory effect of antibiotics, cefuroxime was the most effective, followed by teicoplanin and vancomycin, respectively. Overall, the mean numbers of colony‐forming units on the lenses that were held in cefuroxime, teicoplanin, and vancomycin solutions were 33.0 ± 13.90, 85.35 ± 36.66, and 202.4 ± 205.74, respectively (P = .000). CONCLUSIONS: The results suggest that cefuroxime, teicoplanin, and vancomycin significantly inhibit bacterial adherence to IOLs. The effect of cefuroxime on adherence inhibition was significantly higher than that of teicoplanin and vancomycin. Bacterial adherence is an important factor in bacterial virulence. Antibiotics, especially cefuroxime, can successfully inhibit bacterial adherence.

Deaths from drug overdose and toxicity in Turkey: 1997-2001

Turkey is located on the main overland connection between Asia and Europe, making the country potentially vulnerable to drug trafficking and its associated harms. The aim of the present study is to explore the frequency of all deaths from drug overdose and toxicity in Turkey and to describe some of the characteristics of these deaths. We collected data on all deaths from drugs in Turkey between 1997 and 2001 using records from the Council of Forensic Medicine. Data obtained from autopsy reports were retrospectively analyzed. In the present study, 374 deaths from drugs were reported in Turkey, with a mortality rate of 0.17 per 100,000 population. Highest mortality rates were found in Istanbul (0.83) and Gaziantep (0.71). The mean age was 34.0, and most cases (71.7%) were below the age of 40. The proportion of female cases was 13.6%. Opiates were implicated in 91.5% of deaths and benzodiazepines in 25.9%. Two fifths (38.8%) of the cases involved use of more than 1 drug. In 36.6% of cases, the route of final drug administration was by injection. The most common location of death was at a home (33.7%). Interventions to reduce drug use nationally are urgently required. International cooperation in social-educational activities, scientific research, and security measures is essential for this war.

Contact sensitivity in Behçet's disease

Context: Behçet’s disease (BD) is a multisystemic inflammatory disorder with unknown etiology. Many immunological changes were reported in BD previously and these changes may affect the frequency of contact sensitivity in these patients. Objective: We aimed to identify whether there is an interaction between contact sensitivity and BD. Methods: The ‘European standard series’ with 27 allergens were performed on the upper backs of patients and healthy volunteers according to international standards using the IQ-Chamber. The test-units which contain these allergens were removed after 2 days. According to International Contact Dermatitis Research Group Recommendations test areas were evaluated on days 2, 3 and 7 to detect any delayed allergic reactions. The results of both groups were compared by using chi-square test. Results: One hundred adult persons (50 BDs and 50 healthy controls) were tested. Positive patch test reaction to 1 or more allergens was observed in 7 (14%) patients in BD group and in 12 (24%) persons in control group. There was no statistically significant difference between these two groups. Conclusions: The frequency of contact sensitivity in BD is not different from healthy persons.

An analysis of the environmental threats posed by industry in Kocaeli, turkey

Purpose – This paper has been produced to enumerate and discuss threats which are caused by industry and may affect health in the province of Kocaeli.Design/methodology/approach – Industries in the province, depending on their function, were grouped into sectors. Air, water and solid waste pollutants produced by each sector were assessed for each region of the province.Findings – Of the 7,400 industries in the province, only 1,198 are registered with the Kocaeli Chamber of Industry and of this number only a minority are subject to controls by the Ministry of the Environment through the Kocaeli Provincial Directorate of the Environment (KPDE). Data on pollutants were obtained from the KPDE. Liquid waste was controlled in 370 firms (5 per cent) of all industries in the province, air quality in 444 (6 per cent) and dangerous waste in 4 (0.06 per cent). A total of 41 firms were designated as having dangerous pollution profiles.Practical implications – These figures suggest that industrial development in the p...