No abstract

Amaç: Bu çalışmada romatolojik hastalıklarda tamamlayıcı ve alternatif tıp (TAT) kullanım sıklığının ve en sık kullanılan TAT yöntemlerinin belirlenmesi ve bunun yanı sırahastaları TAT kullanımına teşvik eden bilgi kaynaklarının ve hekimlerin TAT kullanımı ile ilgili tutumlarının değerlendirilmesi amaçlandı. Hastalar ve yöntemler:Romatolojik hastalığı olan 318 hasta (212 kadın, 106 erkek; ort. yaş 48.0±15.1 yıl; dağılım 18-79 yıl) ile demografik değişkenler, TAT kullanım öyküsü, tercih edilen TAT yöntemleri ve hastaları TAT kullanımına teşvik eden bilgi kaynakları ile ilgili yüz yüze görüşmeler yapıldı. Tamamlayıcı ve alternatif tıp yöntemleri; 1-Akupunktur, 2-Biofeedback, 3-Beslenme değişiklikleri, 4-Vücut temelli uygulamalar, 5-Manyetik veya bakır cihazlar, 6-Davranışsal yöntemler ve 7-Diğerleri olarak kategorize edildi. Bulgular:Hastaların yaklaşık yarısı (%46.2) en az bir TAT yöntemini tecrübe etmişti. En sık kullanılan TAT yöntemleri beslenme değişiklikleri (%28.9) ve vücut temelli (%16.4) uygulamalardı. Hastalığı inflamatuvar olmayan kişiler, inflamatuvar olanlara kıyasla, daha sık TAT kullanmışlardı (p= 0.023). Kullananların %26.5'i TAT'ın faydalarından memnun iken, %73.5'i yetersiz ya da etkisiz olduğuna inanıyordu. Tamamlayıcı ve alternatif tıp kullanan hastaların çoğu, yakınları veya kitle iletişim araçları tarafından teşvik edilmişti; yalnızca %13.6'sı hekimlerin önerisi doğrultusunda TAT kullanmıştı. Hekimlerin yarısı TAT kullanımı konusunda ilgisizdi.Sonuç: Romatolojik hastalığı olanlar arasında TAT yöntemleri sıkça kullanılır. Ancak TAT hakkında en sık bilgi kaynağı bir sağlık çalışanı yerine, ne yazık ki, hasta yakınları veya kitle iletişim araçları olmaktadır. Bu nedenle, hekimler hastalarını TAT yönteminin kullanımı hakkında geniş olarak bilgilendirmek için yeterli bilgi donanımına sahip olmalıdır.

Tularemia is highly infectious and different clinical forms can occur in a single epidemic.

Turkey has continuously experienced problems with abuse of, and addiction to, opium derivatives. In this study, we analyzed the relationship between heroin overdose deaths and the characteristics of seized opium derivatives. Data were gathered from the Council of Forensic Medicine of the Ministry of Justice in Istanbul from 1990 to 2000. There were 636 heroin-related deaths during this period, 595 of which were classified as heroin overdose deaths. Mean crude and weighted heroin purities remained relatively constant and were calculated to be 46% (57-34%) and 51% (39-59%), respectively. The weight of heroin and the number of heroin seizures, but not the heroin purity, were significantly associated with the number of heroin-related deaths. Prevention strategies are needed to reduce the number of deaths caused by overdoses in countries situated on drug trafficking routes. These strategies should focus on drug trafficking, by providing increased levels of, and support for, law enforcement, stopping the supply of precursor chemicals, and combating corruption among border officials.

Studies suggest that determination of the TSH reference intervals may differ due to environmental influences or due to age, gender, and race. It is suggested that the lower limit of normal TSH for the adult Turkish population would be 0.38 mIU/L and the upper limit similar to the traditional value of 4.2 mIU/L. If each clinician uses their population-specific reference interval for TSH, thyroid function abnormalities can be accurately estimated.

We aimed to assess the prevalence of CKD in the Black Sea Region, Turkey, and to evaluate any relationship between age, gender, diabetes, obesity, hypertension, and CKD. This study was conducted in 70 different areas in Tokat Province in the Black Sea Region, in the northern part of Turkey. The estimated glomerular filtration rate (eGFR) was calculated from the serum creatinine using MDRD formulas. CKD-defined estimated GFR was lower than 60 mL/min/1.73 m(2). A total of 1,079 persons were included in this study (mean age 41.4+/-17 years [range: 18-95 years], 49.4% males, 50.6% living in an urban area). Of the 1,079 individuals, 5.28% were diabetic, 22.9% were obese, and 37.8% were hypertensive. CKD was found in 62 of them (5.75%). The prevalence of CKD was 5.58% in non-diabetics and 8.77% in diabetics. No significant differences were found between two groups. The prevalence of CKD was 3.77% in non-hypertensive individuals and 8.82% in hypertensive patients, and 4.46% in non-obese and 9.31% in obese. The evident significant differences were found between groups (p < 0.0001 and p = 0.004, respectively). The prevalence of CKD increased with age within our population. A salient observation was the markedly higher prevalence of CKD in females than males (p = 0.046). There was an inverse correlation between eGFR and age (r = 0.529, p < 0.0001). The overall prevalence of CKD was 5.75% in general population. The prevalence of CKD increased with age within our population. Age, gender, obesity and hypertension were found to be significant risk factors for development of CKD in our population.

These risk factors were similar those identified in developed countries. Similar risk factors were shared between different substances. Hence, preventive measures should target substance abuse in general, rather than focusing on controlling the abuse of individual substances.

We described the spatiotemporal change of malaria (Plasmodium vivax) in Turkey over 34 years (1975-2008), and assessed the role of environmental variables in this change. We developed seven 5-year-period raster maps by using geo-referenced malaria case data from the centres of 81 provinces and the kriging method with a spherical variogram model in a geographic information systems (GIS) model. We also modelled malaria incidence in GIS by using our average malaria incidence raster map, and complementary spatial database including the raster map layers of 14 environmental variables. We chose linear regression analysis with backward method to investigate relationships among variables and develop a model. The model was run in GIS to obtain a model incidence raster map. We tested the reliability of the model map by residual statistics, and found the model map dependable. Five-year-period maps revealed that the distribution of malaria cases moved from the East Mediterranean region to the Southeast Anatolia region due to changing human activities. The latitude, minimum temperature, distance to seas and elevation variables were found to have significant impacts on malaria. Consequently, the model incidence map established a good background for early warning systems to predict epidemics of malaria following environmental changes.