Ozlem Tanriover

Occult papillary thyroid carcinoma: prevalence at autopsy in Turkish people.

The epidemiological features of occult papillary thyroid carcinoma (OPTC) at autopsy have not previously been reported in Turkish people. This study provides data on the prevalence of OPTC in people from the Marmara region in Turkey. The study includes thyroid glands from 93 male and 15 female cadavers between 18 and 80 years of age. The thyroid glands were removed, fixed and sectioned at 2-mm intervals. The sections were stained with hematoxylin and eosin, and were examined by a single pathologist. A total of 108 thyroid glands were examined. Macroscopic lesions were found in 36 (33.3%) glands (95% confidence interval=24–42). OPTC was found in four (3.7%) cases (95% confidence interval=1.0–7.5). It was concluded that in the Turkish people from the Marmara region, the prevalence of OPTC found at autopsy was relatively low. No age or sex predilection was detected.

Facial Nerve Paralysis Due to Intra-aural Hyalomma Tick Infestation

We present the case of a 33 year-old man from a village of the north-eastern part of central Anatolia admitted to the otolaryngology department of Yeditepe University Hospital with right facial asymmetry and pain on the right ear. A tick of the genus Hyalomma was observed in the external auditory canal of the right ear and it was removed with fine cup forceps under otomicroscopy. We are of the opinion that in patients presenting with sudden acute ear pain and facial palsy, the ear canal should be examined to exclude an infestation by ticks.

Frequency of cigarette smoking among psychiatric inpatients evaluated by the Fagerström Test for Nicotine Dependence.

BACKGROUND In this study our aim was to determine the rate of smoking in a sample of psychiatric in-patients with diagnoses of schizophrenia, bipolar disorder and major depression and to examine factors related to smoking status and the level of dependence in this population. MATERIALS AND METHODS A total of 160 people were included in this descriptive study. 80 were inpatients with schizophrenia, bipolar disorder and major depression and 80 people without any psychiatric diagnoses were included as a control group. The participants were interviewed face-to face using a semi-structured questionnaire and Fagerstrom Test for Nicotine Dependence was used to define smoking habits. RESULTS The mean age of the participants was 37.24 ∓ 12.19 years ranging from 18 to 81 years, 54.4% of the participants were (n=87) female, and 45.6% cases (n=73) were male. 70% (n=56) of the patients and 55% of the control group were smoking and the difference was statistically significant (p<0.01). Total score of Fagerstrom Test for Nicotine Dependence in the patient group was statistically significantly higher than in the control group (p<0.01). CONCLUSIONS In our sample, the frequency of cigarette smoking and nicotine dependence among psychiatric inpatients was high, posing a high risk for smoking related diseases including cancers; therefore there should be counseling on tobacco control and smoking cessation programming targeting this population.

A qualitative study on factors that influence Turkish medical students' decisions to become family physicians after the health transformation programme

Background: In Turkey, general practitioners were authorized to work as family physicians without specialization, within the scope of the Health Transformation Programme, due to inadequate number of family medicine specialists since 2004. With this new implementation Family Medicine specialty became a less preferable option for medical students. Aims: The study was to investigate the perspectives of medical students and understand the issues to choose Family Medicine specialty as a career option. Materials and Methods: This qualitative study was performed with 48 final year medical students using a convenience sample from two medical universities. Results: Three main categories emerged from the data viewing Family Medicine ‘as a specialty’, ‘as an employment’, and finally ‘as a system’. Very few students stated that Family Medicine would be their choice for specialty. Conclusions: Family Medicine does not seem to be an attractive option in career planning by medical students. Several factors that may constrain students from choosing Family Medicine include: not perceiving Family Medicine as a field of expertise, and the adverse conditions at work which may originate from duality in the system.

Knowledge of oral cancer, preventive attitudes, and behaviors of primary care physicians in Turkey.

Oral cancers (OCs) have a high mortality rate because of their typically late diagnosis. Primary care physicians play a vital role in early detection. In this study, we evaluated the family physicians’ (FPs) knowledge, preventive attitudes, and behaviors in terms of OCs. A semistructured questionnaire consisting of 50 questions was prepared and distributed to 200 FPs. Questions were grouped under four main headings: demographic characteristics, general protective attitudes against OCs, risk factors, and daily practices while performing the necessary examinations and referrals. Of 200 FPs, 164 responded to the questionnaire (82% response rate). The mean age of the study participants was 34.8±8.4 years and the mean duration of practice was 10±8.1 years. One-third of the physicians (29.9%, n=49) stated that they did not inquire about the amount of tobacco use. In terms of alcohol use, 45.7% (n=75) and 56.7% (n=93) did not ask about past alcohol consumption or the amount of alcohol consumed, respectively. Moreover, 69.5% (n=114) believed that they did not receive adequate smoking cessation training and 79.9% (n=131) stated that they did not receive any alcohol cessation training. To decrease morbidity and mortality associated with OCs, primary care physicians should be trained to ask their patients about high-risk behaviors, provide counseling and education on tobacco and alcohol-abuse cessation, and provide oral examinations.

A Case Report of Priapism Caused by Ziprasidon

Priapism is defined as having prolonged (more than 6 h), and usually painful penile erection that occurs without a sexual desire or arousal. Only a very few priapism cases caused by ziprasidone are reported in the literature. In this case report we aimed to present a prolonged penile erection due to use of ziprasidone.

Dilated Minute Chambers in Laryngeal Vocal Fold Polyps: Histopathological and Ultrastructural Features

In Reinkes space of human vocal fold, type III collagen forms a three dimensional network and this contains numerous minute chambers in between these fibers. These compartments are occupied by glycosaminoglycans and glycoproteins. In laryngeal fold lesions, such as Reinkes edema and vocal fold polyps, proteoglycan (PG)/hyaluronic acid (HA) components of extracellular matrix increased. We investigated the size and quantity of the minute chambers within Reinkes space, filled with PG/HA with the aid of transmission electron microscopy. Eight vocal fold polyps and 10 mucosal biopsies (as control group) were all evaluated by light microscopy and electron microscopy. We detected that PG/HA in extracellular matrix had been increased in vocal fold lesions when compared with control group, by Alcian Blue-pH 2.5 stain. The mean volume of the chambers in Reinkes space of normal larynx was measured as 0.040233 µm2 whereas the mean volume of these chambers in vocal fold polyps was measured as 6.420221 µm2. The difference between the volumes of these chambers in vocal fold polyps and in control group was statistically significant (P = 0.001). Within these chambers PG/HA were found and PG/HA filling these chambers were increased in vocal fold polyps. We think proteoglycan and glycosaminoglycans, especially HA, play an important role in determining biochemical properties of vocal fold lesions.