Sevgi Canbaz

A comparative evaluation of health related quality of life and depression in patients with fibromyalgia syndrome and rheumatoid arthritis

The aim of this study was to compare health related quality of life (HRQoL) and assess functional and psychological status in rheumatoid arthritis (RA), fibromyalgia syndrome (FS) patients and controls (each 30 subjects). Demographic characteristics, pain and sleep disturbance by Visual Analog Scale, depression by Beck Depression Inventory (BDI), disease impact by fibromyalgia impact questionnaire, DAS-28, and HRQoL by SF-36 were gathered. The FS group scored significantly worser than the RA group with respect to physical role, social functioning and bodily pain subscales of SF-36. The scores of all SF-36 subscales were significantly lower in FS and RA patients than controls except mental health score. All of the subscales of SF-36 were negatively correlated with BDI scores in FS patients. In RA group, the DAS-28 scores were inversely correlated with all of SF-36 subscales. In conclusion, presence of comorbid depression must be taken into account when determining HRQoL in FS and RA. Essentials improving the HRQoL are management of depression in FS and control of disease activity in RA.

Antibiotic prescribing and urinary tract infection.

The aim of this study was to evaluate the diagnostic and therapeutic approach to urinary tract infections (UTIs) by primary care physicians, in Samsun, Turkey. Data were obtained from the records of 2083 visits at eight primary care areas. Trained research students were stationed on site at each of the eight primary care centres between 1 June, 1999 and 1 July, 1999. Patients who had acute cystitis, recurrent UTIs, acute pyelonephritis and acute urethritis were included in the study. A total of 2083 office visits were recorded and 419 (20.1%) of the patients had UTIs and acute urethritis. Antibiotics were prescribed for 94.7% of the patients with UTIs and urethritis. Some 74% of prescriptions were consistent with current recommendation, but only 41% of the antibiotic prescriptions were rational according to dosage, dosage interval and duration of therapy. Urinary antiseptic agents were prescribed to 75% of patients with UTIs. These data indicate that polypharmacy is widespread in our region; primary care physicians need to review their knowledge about the diagnosis and treatment of UTIs and acute urethritis.

Establishment of interdisciplinary child protection teams in Turkey 2002–2006: Identifying the strongest link can make a difference!

OBJECTIVES The University of Iowa Child Protection Program collaborated with Turkish professionals to develop a training program on child abuse and neglect during 2002-2006 with the goals of increasing professional awareness and number of multidisciplinary teams (MDT), regional collaborations, and assessed cases. This paper summarizes the 5-year outcome. METHODS A team of instructors evaluated needs and held training activities in Turkey annually, and provided consultation when needed. Descriptive analysis was done via Excel and SPSS software. RESULTS Eighteen training activities were held with 3,570 attendees. Over the study period, the number of MDTs increased from 4 to 14. The MDTs got involved in organizing training activities in their institutions and communities. The number of medical curriculum lectures taught by MDTs to medical students/residents, conferences organized by the MDTs, and lectures to non-medical professional audiences increased significantly (R(2)=91.4%, 83.8%, and 69.2%, respectively). The number of abuse cases assessed by the MDTs increased by five times compared to pre-training period. CONCLUSIONS A culturally competent training program had a positive impact on professional attitudes and behaviors toward recognition and management of child abuse and neglect in Turkey. The need to partner with policy makers to revise current law in favor of a greater human services orientation became clear. PRACTICE IMPLICATIONS Pioneers in developing countries may benefit from collaborating with culturally competent instructors from countries with more developed child protection systems to develop training programs so that professional development can improve recognition and management of child abuse and neglect.

Effects of pars plana vitrectomy on retrobulbar haemodynamics in diabetic retinopathy

Background:  The purpose of the present study was to determine the effects of pars plana vitrectomy on retrobulbar haemodynamics in patients with proliferative diabetic retinopathy (PDR).

Obstetric outcomes of adolescent pregnancies in Turkey

Pregnancy in adolescence has been and continues to be a problem in public health. The purpose of this study was to investigate obstetric outcomes of adolescent pregnancies in Samsun, Turkey. A cross-sectional study was conducted between January 1 and December 31, 2004, at 3 hospitals in Samsun, Turkey. Of the 10,100 women who gave birth during this period, 357 (3.5%) were 18 years of age or younger; these patients were included in the study. Participants with a history of any chronic disease were excluded. Data were provided as median values (minmax) and percentages. In this study, the rate of birth for females 18 years or younger was found to be 35 per 1000. The median age of participants was 18 (14–18) years. The prevalence of cesarean section was calculated at 55.7%. Prevalences of lowbirthweight infants, preterm delivery, and eclampsia/preeclampsia were recorded as 44 (12.3%), 34 (9.5%), and 30 (8.4%) cases, respectively. Although the stillbirth rate was determined to be 1.7%, no congenital deformity was noted in infants, and none of the mothers died. The cephalopelvic disproportion rate was 5.9%, and only 2 adolescents experienced abruptio placentae. To reduce the occurrence of adolescent childbearing, pregnancy intentions must be assessed in multiple ways. Information/education may provide benefit to those female adolescents with inconsistent pregnancy intentions.

Work-related musculoskeletal problems among pharmaceutical sales representatives in Samsun, Turkey

Objectives: Many studies have been performed about work-related musculoskeletal pain (WRMSP) in various groups of professions. However pharmaceutical sales representatives (PSRs) have not been investigated with regard to their musculoskeletal problems related to their works. This study was aimed to investigate the prevalence of work-related musculoskeletal pain (WRMSP) and depression among PSRs; the quality of life in these subjects and to investigate which socio-demographic variables are associated with the presence of complaints, in Turkey. Methods: Among 170 participants, 73.5% completed the survey. A face-to-face questionnaire was given and SF-36 (Short Form-36) and Beck Depression Inventory (BDI) were applied. Results: The highest frequencies of WRMSP were in low back (55.4%) and shoulder (41.1%). The most frequently self-reported complaints of the PSRs were long time standing at work (68.8%) and driving long distances (61.6%). There was significant difference between the groups with and without WRMSP all subgroups of SF-36 test ( p< 0.05). Fourteen of the participants had depression according to BDI. There was a negative correlation between SF-36 and BDI scores ( p< 0.05). Conclusions: WRMSP is common among PSRs in Turkey. Besides; depression, reduced QOL and low back pain are frequently seen. Modifications in ergonomics at work and work conditions may solve these problems.

Emergency service use by older people in Samsun, Turkey

During the first 50 years of the 21st century, the world population aged 65 and older is expected to triple. Proper care of the older patient is one of the major priorities of many health care systems. In this descriptive study, patients treated and transported by 112 Emergency Help and Rescue Service in Samsun Province during the year 2004 were surveyed through review of command center records. All patients who were 65 years of age and older were included in the study. Collected data included patient sex and age, number of patients accessing emergency medical service (EMS) per hours of the day and per season, clinical diagnosis, and patient outcomes. In all, 2210 patients aged 65 years and older were identified; this group accounted for 24.5% of all records reviewed (n=9015). The rate of EMS use was highest in those older than 65 years of age (26 of 1000/y). Similar associations of ambulance transportation with older age and off-hour presentation were noted, as was increased usage during colder months of the year. Cardiovascular, neurologic, and respiratory problems were the 3 most frequent reasons for use of EMS. In almost three fourths of cases, outcome was recorded as transport to the hospital. Data presented here highlight the need for continued monitoring of EMS usage patterns so that planners will be prepared to accommodate the needs of the increasingly aging population.

Diagnosing carpal tunnel syndrome with Doppler ultrasonography: a comparison of ultrasonographic measurements and electrophysiological severity

Abstract Introduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Diagnosis is based on clinical history, physical examination, and electrophysiological studies. Imaging techniques are performed for difficult-to-diagnose cases because they provide information about the morphology of the median nerve. More recently, it has been shown that Doppler ultrasonography can detect increased intraneural blood flow in CTS. The aim of our study is to evaluate the relationship between the severity of CTS, hypervascularization, and cross-sectional area (CSA) to determine the diagnostic value of Doppler ultrasonography. Patients and methods: The study group comprised 125 wrists of 75 patients who had been diagnosed with CTS, both clinically and electrophysiologically. The control group comprised 100 wrists of 50 healthy volunteers. Wrists were classified into five stages of CTS severity based on electrophysiologic studies. A radiologist examined the wrists blindly with grayscale images and Doppler ultrasonography to assess CSA and hypervascularization. Results: A total of 121 wrists were included. There were 28 wrists with minimal CTS severity stage, 36 with mild, 36 with moderate, and 21 with severe. The sensitivity and specificity of CSA and hypervascularization in detecting CTS was 90.9, 94.0, 93.4, and 90.0%, respectively. There was a significant correlation between CTS severity and hypervascularization (p < 0.005) for all stages. Conclusion: Our study shows that Doppler ultrasonography results strongly correlate with CTS severity. Hence, this is a useful method for diagnosing CTS and estimating its severity.