Tevfik Pınar

Workplace Violence in the Health Sector in Turkey A National Study

Violence in the workplace is an increasing occupational health concern worldwide. Health care workers are at high risk of assault. To develop, monitor, and manage prevention policies, baseline data should be available. This cross-sectional study was designed to determine the current extent of workplace violence nationwide in Turkey. The study population of 12.944 health care workers was a stratified sample of all health care workers (612,639) in the country. A probabilistic sampling was made on the basis of the “multistage stratified random cluster sampling method.” This study was conducted by a structured questionnaire in a face-to-face interview. The questionnaire items were adapted and translated into Turkish based on questionnaires of International Labor Organization, International Council of Nurses, World Health Organization, and Public Services International. The percentage of health care workers who experienced workplace violence in Turkey in the previous 12 months was 44.7%. The types of violence included physical 6.8%, verbal 43.2%, mobbing (bullying) 2.4%, and sexual harassment 1%. Multivariate analysis showed that level of health care system, type of institution, gender, occupation, age, working hours, and shift work were independent risk factors for experiencing workplace violence (p < .05). Our study indicates that the workplace violence among health care workers is a significant problem. The results of the study can serve as the basis for future analytical studies and for development of appropriate prevention efforts.

Five Annual Observations of Respiratory Findings in Gun Factory Workers Exposed to Solvents

Objective: We investigated whether long-term, low-level exposures to solvents had adverse longitudinal effects on pulmonary functions. Methods: The study was performed on 1091 workers 5 years ago and then on 697 workers 5 years later. Chronic respiratory symptoms were recorded using a questionnaire on respiratory symptoms. Results: The annual decrease in forced expiratory volume in 1 second in the workers exposed to solvents was not significantly different from that of the unexposed workers (69.7 ± 89.9 vs 75.8 ± 87.6 mL/yr, P = 0.5, respectively). In 453 workers who were exposed to solvents 5 years ago, the prevalence rate of asthma was 1.1%. Five years later, it was 3.6% in 193 workers from the same group. The difference was statistically significant (P = 0.03). Conclusions: Longitudinally, the chronic exposure to low doses of solvents does not adversely affect the pulmonary functions, whereas it increases the asthma prevalence.

The presence of metabolic syndrome and associated quality of life in Turkish women with cardiovascular disease

O adults world-wide are becoming obese at an alarming rate. More than 35% of U.S. men and women were obese in 2009– 2010. There was no significant difference in prevalence between men and women at any age. The World Health Organization reports that worldwide over 200 million men and nearly 300 million women were obese in 2011. The purpose of this research is to understand the challenges older adults face when trying to lose weight. A focus group with older adults who have struggled with trying to lose weight revealed that these older adults are frustrated by their lack of sustainable success in weight loss. They felt that lack of knowledge is not the problem. They all understood that weight loss involves the balance of nutrition and exercise but found weight loss difficult, with weight lost quickly regained. Difficulties cited were living alone and not wanting to cook for one, the expense and short shelf life of fresh fruits and vegetables, medications, eating out of habit, fast food, lack of motivation, eating for comfort, and more difficulty exercising. More research is needed on the difficulty of losing weight among older adults who are basically healthy but want to lose weight before the advent of serious health consequences such as diabetes or reduced mobility. A greater understanding of what strategies can be successfully implemented could also contribute to reduced health care costs by preventing diseases which are costly in terms of health care dollars as well as quality of life.

Kırk bes yas ve üstü kadınlarda osteoporoz risk faktörleri

Osteoporoz ve romatizmal hastaliklar gozun tum tabakalarini etkileyen bulgular ile karsimiza cikmaktadir. Eriskin ve Juvenil Romatoid Artrit, Sjogren Sendromu, Ankilozan Spondilit siklikla goz bulgulari ile beraberlik gosteren romatizmal hastaliklardir. Goz bulgulari siklikla sistemik hastaligin semptomlarina onculuk etmektedirler. Bu hastaliklarda en sik olarak uveit, iridosiklit, vitritis, keratit, sklerit, anterior iskemik optik noropati ve retinal vaskulit gibi okuler inflamasyon bulgulari gorulmektedir. Okuler inflamasyon hastaligin kendisinden kaynaklanabilecegi gibi bu hastaliklarin tedavisinde kullanilan ilaclara bagli olarak da karsimiza cikabilmektedir. Bu calismada osteoporoz ve en sik goz bulgusu izlenen romatizmal hastaliklarin okuler bulgulari literatur esliginde arastirildi.Mirizzi syndrome is an unusual complication of gallstone disease and occurs in approximately 1% of these patients. Some cases can not be identified preoperatively, despite modern imaging techniques. Today, treatment of Mirizzi syndrome is surgical. If Mirizzi syndrome is present, the risk of bile duct injury increases, particularly during laparoscopic surgery. Therefore, preoperative or intraoperative diagnosis is important. Here, we presented a 29 year-old woman with obstructive jaundice who diagnosed as cholelithiasis and choledocholithiasis. Preoperative endoscopic retrograde cholangiography relieved the common bile duct stone but cound not diagnosed the Mirizzi syndrome preoperatively. During laparoscopy, the diagnosis of Mirizzi syndrome was suspected early and the procedure was converted to open cholecystectomy and T-tube to common bile duct. There was no bile duct injury and postoperative course was uneventful.Lenfomalarda akciger tutulumu primer ve sekonder olmak uzere iki sekilde gorulmektedir. Lenfoma hucreleri, akcigerin degisik bolgelerini, yogun bicimde infiltre edebilmektedir. 57 yasinda erkek hastanin 6 aydir devam eden gogus agrisi, boyunda sislik, halsizlik, oksuruk ve balgam yakinmalari mevcuttu. Hasta, hepatosplenomegali, son bir ayda kilo kaybi, ates ve boynunun sol yaninda buyuyen agrili sislik nedeniyle klinigimize yatirildi. Fizik muayenede, boyunda agrili lenfadenopati saptandi. Solunum sistemi muayenesinde sagda solunum seslerinin siddetinde azalma, yer yer krepitan raller mevcuttu. PA akciger grafisinde sag parahiler bolgede non homojen yaygin infiltrasyon saptandi. Toraks tomografisinde ise sag akcigerde santralde hava bronkogrami izlenen konsolide alan, periferde noduler ve retikulonoduler, sol akciger alt lop posterobazal segmentte ve sol akciger ust lop apikoposterior segmentte birkac adet noduler lezyon, paratrakeal lenf bezi ve lokalize alveoler diffuz infiltrasyonlar saptandi. Servikal lenf nodunu histolojik incelenmesinde yuksek grade buyuk hucreli Non-Hodgkin lenfoma tanisi kondu. Hasta 6 siklus CEOP kuru aldi. Kemoterapi tamamlandiktan sonra yapilan incelemelerde daha once varolan akciger lezyonlarinin tumunun kayboldugu goruldu. Bu vaka sistemik non-Hodgkin lenfoma seyri sirasinda akcigeri tutulumu gelisen ve tek basina kemoterapi ile uzun sureli remisyona giren bir nadir olgudur.In this study, we are presenting the results of cytogenetic analysis and molecular cytogenetic analysis (FISH) of the couple and their family, who were referred to our genetic diagnostic laboratory and had bad obstetrics history. We found a normal karyotype (46,XY) in male, and A de novo complex chromosome rearrangement found in a phenotypically normal female was characterized by G-bands, FISH with probes. Her chromosome structure was 46,XX,der(18;22)(18pterrp11.1::22p11.1rqter) del(18)(:p11.1rqter). To determine the parental origin of translocation, we examined the individuals of the family, and we found that the translocation was de novo. We concluded that this carrier family might be due to the unbalanced distribution of translocation, during gamete formation and prenatal diagnosis recommended for their future pregnancies.

The Frequency of Unplanned Rehospitalization and Associated Factors in Gyneoncology Patients: A Retrospective Study

Objective In this study, we aim to analyze rate and associated factors with unplanned rehospitalization in gynecological cancer patients. Materials and Methods The electronic database query (2007 to 2014) was used to evaluate rehospitalization rates within 90 days of index admission in patients with gynecological cancer. Multivariable logistic regression was used to identify factors associated with rehospitalization. Results Mean patient age was 59.05 ± 11.96 years (minimum, 32 years; maximum, 85 years). A total of 152 patients’ data were evaluated. Seventy-three patients (48.0%) were rehospitalized within 90 days of discharge. The median length of index hospital stay (from 3 to 34 days) was 8.90 ± 6.03 days. The most common rehospitalization causes includes pain (24.6%), recurrence (21.9%), ascites (13.7%), surgical site infection (12.3%), acute reoperation (9.6%), thromboembolism (8.2%), renal failure (5.5%), ileus/obstruction (2.7%), and lymphedema (1.4%). In multivariable logistic regression model, difference was found between history of operation, receive chemotherapy, development of the complication during hospitalization comorbidities as well as multiparity variables, and rehospitalization (P < 0.05). Conclusions Unplanned rehospitalization after discharge for gynecological cancer is common with significant associated risk factors and patient outcomes. Integrated multidisciplinary health care strategies, such as safe transition, communication, patient and family education, accurate medication reconciliation, and short-interval outpatient follow-up may help to prevent rehospitalization after discharge and improve patient outcomes.

The prevalence and risk factors for osteoporosis among 18- to 49-year-old Turkish women

ABSTRACT The aim of this study was to determine the prevalence of osteoporosis and associated risk factors in Turkish women aged 18–49 years. A population-based, cross-sectional study was conducted between January and April 2014. The sample (n = 1,792) was comprised of women aged 18–49 years, who resided in Cubuk, Ankara, Turkey, and were selected by simple random sampling. The data were collected in face-to-face interviews using an Individual Information Form and an Osteoporosis Risk Estimation Scale. Bone mineral density was assessed using standard dual-energy X-ray absorptiometry. Multiple logistic regression and chi-square analyses were used for analyses. Most participants (80.1%) were at low risk of developing osteoporosis, while 6.9% were at medium to high risk of developing the disease. From bone mineral density levels, 33.3% were osteopenic; 4.0% were osteoporotic; 33.3% were osteopenic at the femoral neck; and 6.7% were osteoporotic at the lumbar vertebra L1−L4. Further, results of multiple logistic regression analyses showed that osteoporosis risk was significantly associated with smoking, having light skin, multiparity, and having a family history of osteoporosis (p < .05). These results indicated that public health screening strategies for protecting women’s bone health at earlier ages than previously thought might be beneficial.