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ABSTRACT: Introduction: The aim of our study is; to assess the approach of smokers to tobacco law, examine changes in their smoking related behaviors after the new law and determine the factors associated with these changes. Materials and Methods: Data collected by questionnaire including 30 question. We applied the questionnaire to 1509 current smokers, and ex-smokers who quitted smoking after the law. SPSS packet programme was used for analyses. Results:Participants consisted of 419 (28.0%) female, 1090 (72.0%) male with an average age of 33.6 ± 10.5 years. Although 80% of them knew that passive smoking is harmful to non-smokers, rate of smoking at home and in the car were very high. 869 (58.0%) of participants supported the law. 87 (5.8%) smokers quitted smoking after the law, 316 (20.9%) reduced. While health problems (37.3%) were the most frequent reason for quitting, restriction of smoking area had the most effect to reduce (54.2%). Conclusion:We satisfied that; the new tobacco law encouraged smokers to quit smoking. In addition, the majority of smokers supported the law.
Tuberkuloz ve toraks 12/2012; 60(4):350-4.
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ABSTRACT: The purpose of this study was to investigate the ovarian protective effects of resveratrol in rats exposed to total body irradiation.
Experimental study.
University hospital.
Thirty female rats were randomized into four groups: (1) control group (n = 7); (2) low-dose (10 mg/kg) resveratrol group (n = 8); (3) high-dose (100 mg/kg) resveratrol group (n =7); and (4) sham irradiation group (n = 8). The drugs were administered intraperitoneally as single doses, and the rats were exposed to total body radiation 24 h after the treatment. The animals were sacrificed the following day, and their ovaries were excised for histopathological and biochemical analysis.
The ovarian follicle counts were calculated, and irradiation-dependent ovarian damage and tissue levels of antioxidant enzymes were evaluated.
Group 2 and Group 3 showed significantly higher numbers of total follicle counts compared with Group 1 (P < 0.01). The low-dose resveratrol treatment was associated with significantly higher numbers of primary follicles than the high-dose group. The tissue activities of glutathione peroxidase (GsH-Px) and catalase (CAT) were significantly elevated in the resveratrol-treated animals. Evaluation of ovarian histology revealed no remarkable changes in fibrosis and leucocyte infiltration among the resveratrol-treated and control rats; however, vascularity was significantly reduced in the high-dose group (P = 0.014).
Resveratrol attenuated irradiation-dependent ovarian damage, suggesting that this natural antioxidant is effective in reducing the follicle loss induced by ionizing radiation.
Journal of pediatric and adolescent gynecology 08/2012; 25(4):262-6. · 0.90 Impact Factor
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ABSTRACT: The purpose of this study was to investigate the relationship between the serum apelin, salusin-alpha and salusin-beta levels and preeclampsia.
Twenty-one healthy pregnant women (control group) and 48 patients with preeclampsia (study group) were included in the study between August 2010 and February 2011. Serum apelin, salusin-alpha and salusin-beta levels of the groups were compared.
The patients in the study group were divided into two categories: mild preeclampsia and severe preeclampsia. The mild preeclampsia group consisted of 31 patients, and the severe preeclampsia group consisted of 17 patients. Serum salusin-alpha and salusin-beta levels of the control and study groups were not significantly different (p > 0.05). Apelin levels were statistically significantly higher in the study group. No statistically significant difference was detected between the mild and severe preeclampsia groups in terms of the mean serum apelin levels.
The serum levels of apelin were higher in the pregnant women with preeclampsia; however, there was no positive relationship between serum salusin-alpha and salusin-beta levels and the disease. Larger prospective studies are needed to validate our findings.
The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 04/2012; 25(9):1705-8. · 1.36 Impact Factor
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ABSTRACT: Context: A number of skin diseases can be observed in chronic renal failure (CRF). Their incidence have changed in different series. Objective: To compare the prevalence of cutaneous changes in CRF undergoing hemodialysis (HD) with healthy persons and to study the potential relationship with various parameters in the patients. Materials and methods: The study comprised one hundred patients with CRF under regular HD as well as one hundred healthy control subjects of matched age and sex. Both groups were subjected to full history and thorough skin examination. Results: Numerous skin lesions (at least one in each patient) were detected in all patients examined. Of these patients, nail abnormalities were observed in 92%, xerosis in 87%, fungal infection in 68%, hyperpigmentation in 62%, pruritus in 51%, and paleness in 51%. The nail changes included absence of lunula (55%), half and half nail (51%), splinter hemorrhages (36%), subungual hyperkeratosis (34%), onychomycosis (31%), koilonychia (19%), and onycholysis (9%). Oral changes were oral candidiasis (50%), xerostomia (40%), angular cheilitis (27%), and ulcerative stomatitis (18%). Specific cutaneous findings such as acquired perforating dermatosis, pseudoporphyria cutanea tarda, calciphylaxis, calcinosis cutis, and nephrogenic fibrosing dermopathy were not detected in any of the patients. In our study, when the patients were evaluated on the relationship between xerosis and pruritus, pruritus was found to be significantly increased parallel to the increase in the severity of xerosis. Conclusions: Xerosis and pruritus are common problems in HD-dependent patients. The early recognition of cutaneous signs can relieve suffering and decrease morbidity.
Cutaneous and Ocular Toxicology 02/2012; · 0.91 Impact Factor
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ABSTRACT: Abstract Objective: The purpose of this study was to investigate the relationship between the serum apelin, salusin-alpha, and salusin-beta levels and preeclampsia. Method: Twenty-one healthy pregnant women (control group) and 48 patients with preeclampsia (study group) were included in the study between August 2010 and February 2011. Serum apelin, salusin-alpha, and salusin-beta levels of the groups were compared. Results: The patients in the study group were divided into two categories: mild preeclampsia and severe preeclampsia. The mild preeclampsia group consisted of 31 patients, and the severe preeclampsia group consisted of 17 patients. Serum salusin-alpha and salusin-beta levels of the control and study groups were not significantly different (P>0.05). Apelin levels were statistically significantly higher in the study group. No statistically significant difference was detected between the mild and severe preeclampsia groups in terms of the mean serum apelin levels. Conclusion: The serum levels of apelin were higher in the pregnant women with preeclampsia; however, there was no positive relationship between serum salusin-alpha and salusin-beta levels and the disease. Larger prospective studies are needed to validate our findings.
The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 02/2012; · 1.36 Impact Factor
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ABSTRACT: The purpose of this study is to determine prevalence of metabolic syndrome (MetS) and its relationship with mental health (anger) and sociodemographic characteristics in women residing central district of Malatya.
This cross-sectional observational study was conducted between April and September 2008. The relationships between MetS and mental health (anger) and sociodemographic properties were examined. Chi-square and Student t-test were used for the statistical analysis.
Mean age of the women included in this study was 41.9 ± 12.7 years. MetS prevalence was 30.9%, for the age group of 60 and over prevalence was 61.3%. There was a statistically meaningful relation between MetS prevalence and the educational background, marital status, body-mass index (BMI) and family type (p<0.05). There was no significant relationship between MetS and anger status in the study group (p>0.05). The most common MetS parameters findings of our study were abdominal obesity (45.6%, waist circumference>88 cm) and low high-density lipoprotein cholesterol. Among MetS diagnosed women included in this study the most common finding was fasting blood glucose (76.7%), which were followed by high triglycerides (69.4%) and hypertension (63.5%).
Taking control over or avoiding obesity plays a crucial role in prevention of MetS development. There was a significant relationship between MetS prevalence and education, BMI and family type in the study group. In the current study, there was no any significant relation between MetS and anger scale.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 01/2012; 12(1):53-9. · 0.44 Impact Factor
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ABSTRACT: Two Demodex species are known to live on people. Demodex folliculorum lives in the openings of hair follicles alone or in groups. D brevis lives in the depths of the sebaceous glands alone. There are different related on the epidemiology of Demodex species have been published.
In this study, taking into account that the parasite is transmitted through close contact from person to person, we aimed to evaluate the relation between the presence of Demodex spp with gender and age among the Health hazard bearing and sanitary establishment operators and workers who came for porter examination.
For this purpose, 862 male and 215 female patients with a total of 1077 volunteers from the face area of the standard superficial skin biopsy (SSSB) method and studied samples were taken. More than five mites in 1 cm(2) density was defined as positive. In investigated samples 37.3% Demodex spp. positivity was detected. Only two were found to be D brevis and the others were D folliculorum. The study revealed statistically significant relationships between the positivity of parasites with the occupational group, age and sex.
Since the prevalence of Demodex among healthy individuals without any complaint was found to be 37%, we believe Demodex spp should be investigated in porter examinations of people who have dermatological complaints.
Journal of the Formosan Medical Association 01/2012; 111(1):30-3. · 1.13 Impact Factor
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ABSTRACT: The aim of the present study was to evaluate the hypothesis that preeclampsia is associated with increased systemic inflammatory responses of Th1-type as well as decreased Th2-type responses compared with normal pregnancy. We also sought to determine whether there was a correlation between these markers with severity of preeclampsia and fetal birth weight.
The study population consisted of maternal age, gestational age, and body mass index matched 138 pregnant women; 56 normotensive healthy pregnant women (group 1), 42 women with mild preeclampsia (group 2), 40 women with severe preeclampsia (group 3).
Plasma interleukin (IL)-8 and C-reactive protein (CRP) levels were significantly higher in group 3 than group 1 (p<0.05). Plasma IL-4, IL-12, and interferon (IFN)-γ levels were similar in all groups. Although plasma IL-8 and CRP levels of mild preeclamptic group were higher than control group and lower than severe preeclamptic group, the differences were not statistically significant. There was a positive correlation between IL-12 and fetal birth weight in severe preeclamptic group (p<0.05).
Elevated maternal serum pro-inflammatory cytokine IL-8 and CRP in severe preeclamptic women compared with normal pregnant women supports the hypothesis that preeclampsia is associated with increased inflammatory responses.
The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 12/2011; 25(9):1569-73. · 1.36 Impact Factor
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ABSTRACT: OBJECTIVES: Epidemiological studies indicate that more than half of the elderly population suffers from chronic sleep disturbances. Therefore, this descriptive study was conducted to examine sleep quality, excessive daytime sleepiness, daytime napping, and depression among a population of nursing home residents. METHODS: The study's sample included 73 elderly people living in a nursing home in Turkey. Geriatric Depression Scale, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and a sleep diary were used. RESULTS: The participants' mean age was 74.0 years (standard deviation (SD) = 6.7). Forty-four of the individuals had a poor sleep quality prevalence of 60.3%; and the mean global PSQI score was 6.6 (SD = 3.6). Their mean ESS score was 5.9 (SD = 4.6) and 14 participants (19.2%) had daytime sleepiness. The mean daytime napping duration was 1.0 h (SD = 1.3) according to the participants' sleep diaries. The study found that 60.3% of the participants were depressed, furthermore the mean depression score was 15.9 (SD = 7.0). There was a significant correlation between the PSQI subscores; subjective sleep quality, the sleep latency, and sleep disturbances scores and depression scores. Also, daytime napping frequency and daytime napping duration, according to the sleep diary, were correlated positively with depression scores. CONCLUSIONS: The current study's results confirm the previously reported high prevalence of poor sleep quality and depression in this nursing home population. Clinicians need to assess patients appropriately to identify high prevalence of sleep problems and depression in nursing home patients and initiate appropriate referrals and interventions.
Sleep And Breathing 11/2011; · 1.84 Impact Factor
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ABSTRACT: (1) To investigate the cesarean rate among actively practicing obstetricians in Turkey and reasons why they choose this mode of delivery for themselves/partners. (2) To investigate the attitudes, practices, and beliefs with respect to cesarean delivery on maternal request (CDMR) among actively practicing obstetricians in Turkey.
This is a descriptive study performed at 7th Congress Of Turkish Society Of Gynecology and Obstetrics. A self-administered questionnaire was used for data collection. During the congress, from the obstetricians attending the congress, 500 were randomly selected; due to the room numbers, the questionnaires (total, 500) and the consent forms were distributed every fourth room. The sampled obstetricians were instructed to return the completed questionnaires and signed consent forms to the congress information desk located throughout the congress. In total, 387 (77.4%) obstetricians responded.
Of the respondents (if female) or their partners (if male), 239 (61.8%) respondents had undergone at least one previous cesarean section (CS), and, of these, 212 (88.7%) were primary elective cesarean deliveries. The most common reason influencing the decision of obstetricians in choosing CS for themselves/partners was reduced anorectal trauma (63.6%). In addition, 158 (40.8%) of the respondents believe that every woman has the right to request a cesarean as a mode of delivery. About half of the respondents (53.2%) said that they would perform a patient-requested CS. The most common reason why obstetricians perform CS due to maternal request was 'anxiety of patient and her partner and due to their insistence'.
Two-thirds of Turkish obstetricians prefer CS as mode of delivery for themselves/partners. Also half of the obstetricians in our study believe that a woman has the right to request and obtain CDMR, and half of them would agree to perform one.
Archives of Gynecology 09/2011; 284(3):543-9. · 0.91 Impact Factor
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ABSTRACT: Tobacco control effort should be first started in people that are looked upon as role models for the general population. We aimed to determine the knowledge, attitude, and behavior of religious officials towards smoking and the new tobacco law.
The study group was comprised of 492 Imams and 149 Quran course instructors working in Kahramanmaras city of Turkey, 641 religious officials in total, and our survey form was applied on 406 (63.3%) of those religious officials who agreed to participate in the study.
Twenty-eight (6.9%) participants were current smokers and 35 (8.6%) were ex-smokers. 99.8% of the religious officials believed that smoking was harmful and/or prohibited in terms of religion. While 43.6% respondents thought smoking was "haram" (forbidden by Islam), 56.2% believed it was "makruh" (something regarded as reprehensible, though not forbidden by God according to Islam). 85.2% of the participants were aware of the recent tobacco law. 55.5% of the respondents, who were aware of the recent tobacco law, evaluated their knowledge level on the law as adequate, whereas 44.5% evaluated it as inadequate 92.4% of the participants noted that religious officials should play active roles in tobacco control effort.
Smoking rate among religious officials is much lower than that of general public. In order to help religious officials to take a more active role on this issue, they should be trained on the subject and appropriate platforms should be established.
BMC Public Health 07/2011; 11:602. · 2.00 Impact Factor
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ABSTRACT: It has been shown that the trace elements and lipids play role in the growth, development and maintenance of bones. We aimed to investigate serum selenium (Se), zinc (Zn), copper (Cu) and lipid (total cholesterol, triglyceride (TG), high density lipoprotein-cholesterol, low-density lipoprotein-cholesterol) levels in postmenopausal women with osteoporosis, osteopenia and in healthy controls, and to determine the relationship between Se, Zn, Cu and lipid parameters and bone mineral density (BMD). The study included 107 postmenopausal women; 35 healthy (group 1), 37 osteopenic (group 2) and 35 osteoporotic (group 3). The women in all three groups were carefully matched for body mass index (BMI). Serum concentrations of Se, Zn and Cu were measured by atomic absorption spectrophotometry. Plasma Se, Cu, Zn and lipid levels were similar in all groups (p > 0.05). When we combined the women in each of the three groups, and considered them as one group (n = 107) we found a positive correlation between BMI and lumbar vertebra BMD, femur neck BMD, femur total BMD; a positive correlation between TG and femur neck BMD, femur total BMD; a positive correlation between Zn and lumbar vertebra BMD (total T score) (p < 0.05). There was no correlation between Se, Cu, Zn, P and lipid parameters (p > 0.05). Although BMI has a positive effect on BMD, trace elements and lipids, except Zn and TG, did not directly and correlatively influence BMD. Further studies are needed to clarify the role and relationship of trace elements and lipid parameters in postmenopausal osteoporosis.
Biological trace element research 06/2011; 144(1-3):407-17. · 1.92 Impact Factor
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ABSTRACT: In this study we investigated the level of knowledge and ideas of the university students and staff, about the last stage of Tobacco Law No. 5727, which came into force on 19 July 2009 in our country. This is descriptive questionnaire survey. Study's universe was consisting of the students 2009-2010 academic year studying in our universities and academic and administrative staff. A total of 2271 people were included the study. In our study, smoking prevalence was 21.3%. The prevalence for narghile smoking as 4.8% was the highest among students. 94.9% of participants thought that passive smoking increased the risk for human health. Asked whether the banned places, the most correct answers were; the school (97.0%), bank branches (96.3%) and hospitals (96.2%) as the most incorrect answers were; in the garden of hospital (55.7%), garden of private education (53.4%) and the school playground (46.1%). 87.6% of the participants were supporting the new tobacco law. 61.3% of smokers were supporting the law (p= 0.000). 54.3% of narghile-smokers support the law, and this rate was lower than cigarette smokers. Overall, tobacco law is known and supported between our students and staff. More information and supervision should be given about the banned places like school garden and private course gardens which were the high rate of false knowledge. The support to law among students is lower than staff. Similarly narghile use among students is often more. The community should be informed also about the other tobacco products.
Tuberkuloz ve toraks 06/2011; 59(2):132-9.
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ABSTRACT: To compare lipocalin-2 (LCN2) levels in pre-eclamptic women with those in healthy pregnant women, and to determine whether there is a correlation between LCN2 levels and the severity of the disease.
The study included 66 pregnant women: 22 healthy pregnant women (Group 1), 23 women with mild pre-eclampsia (Group 2), and 21 women with severe pre-eclampsia (Group 3). Pre-eclamptic women and normal controls were carefully matched for maternal age, gestational age, and body mass index (BMI). The maternal levels of plasma LCN2 were determined by enzyme-linked immunosorbent assay.
Plasma LCN2 levels in the pre-eclamptic group were significantly lower than those in the healthy control group (p < 0.05). Although plasma LCN2 level was lower in the severe compared to the mild pre-eclamptic group, the difference was not statistically significant (p > 0.05). There was no significant correlation between LCN2 levels and the homeostasis model assessment of insulin resistance (HOMA-IR), BMI, triglyceride, gestational week at delivery, birth weight, and systolic and diastolic blood pressure in pre-eclamptic and healthy pregnant women (p > 0.05).
Our results show that there are decreased concentrations of plasma LCN2 in pre-eclamptic subjects and this may indicate that LCN2 plays a role in the pathogenesis of pre-eclampsia. However, further experiments are needed to clarify this role.
The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 02/2011; 24(2):291-6. · 1.36 Impact Factor
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ABSTRACT: The purpose of this study was to identify the rate of night eating syndrome (NES) in a depressed population.
The study sample was composed of 162 depressed patients and 172 healthy control participants.
The rates of night eating in our sample with depression (35.2%) was higher as compared with healthy control participants (19.2%) (p less than 0.05). In addition, in the depression group, the rate of NES-positive patients did not differ in accordance with body mass index (BMI) classification (p more than 0.05). However, in the control group, the rate of NES-positive patients was significantly different with regard to BMI classification, and NES diagnosis was highest in the obese members of the control group (p less than 0.05). Multiple logistic regression analysis was then used to evaluate the relationships of four variables: depression, gender, education status and BMI with the diagnosis of NES. Results showed that significant independent predictors of NES were depression, gender, and a BMI of 25 or greater.
This is the first study to find that depressed patients are at a significantly greater risk for NES. Depression, male gender and BMI may account for the high rate of NES found in this population.
The Israel journal of psychiatry and related sciences 01/2011; 48(3):212-7. · 0.68 Impact Factor
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ABSTRACT: This study was carried out to determine Medical Faculty and School of Health student knowledge of and behavior regarding swine flu and vaccine. The study was carried out at Kahramanmaras Sutcuimam University School of Health among the medical faculty and students. All 296 students of the Kahramanmaras Sutcuimam University School of Health and 76 students of the Faculty of Medicine were supposed to participate in the study. Ninety-six point one percent of the students in the study know high fever was one of the symptoms of swine flu, 91.8% said it was spread directly by sneezing or coughing and 95.5% knew washing hands with soap and water especially after coughing and sneezing, should be done to reduce the.risk of infection. Sixty-five point four percent of students knew fatigue and body aches were adverse effects of the swine flu vaccine. Only 9.6% of students received the pandemic flu vaccine. Their knowledge regarding symptoms and methods of spread was low, but regarding measures taken for prevention was high. Both swine flu knowledge and vaccine knowledge were higher in those who received the flu vaccine than in those who did not receive it. In pandemic situations, training should be given immediately to medical, midwifery and nursing students who are models for society.
The Southeast Asian journal of tropical medicine and public health 01/2011; 42(1):161-7. · 0.60 Impact Factor
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ABSTRACT: The aim of this study was to determine the knowledge levels of students in the Midwifery and Nursing Departments of the School of Health Sciences in Kahramanmaras Sutcuimam University (KSU) about Crimean-Congo hemorrhagic fever (CCHF) and to examine the factors influencing those knowledge levels. The study was conducted between April-June 2009 in the School of Health Sciences, KSU, Turkey. All the midwifery and nursing students in the School of Health Sciences at that time, 296 individuals, were included in the study. Questionnaire forms, developed from literature data and comprised of 66 questions, were given to the students, and they were asked to fill them out. Twenty-four point seven percent of the students were not available, thus 223 students(75.3%) were included in the study. Seventy-five point three percent of students stated a viruse was the cause for CCHF, 78.9% stated CCHF is seen between April and September in Turkey, and 80.7% stated there was no vaccine avaiable against it. Ninety-three point three percent of the study group stated that CCHF was transmitted by tick bite, 75.8% and 53.4% stated CCHF can be transmitted by exposure to blood of an infected animal or direct contact with an acutely infected animal, respectively. Thirty-three point two percent of students stated CCHF had no specific treatment. The mean knowledge score of students regarding CCHF was 54.6 +/- 14.8. The CCHF scores of the nursing students were significantly higher than those of the midwifery students. The CCHF knowledge scores did not vary by age or college year.
The Southeast Asian journal of tropical medicine and public health 01/2010; 41(1):77-84. · 0.60 Impact Factor
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ABSTRACT: Pregnant women are a target group for receipt of influenza vaccine because there appears to be an elevated mortality and morbidity rate associated with influenza virus infection in pregnant women. The goal of this study is to determine the factors affecting the decisions of pregnant women in Turkey to be vaccinated or not for 2009 H1N1 influenza.
We enrolled 314 of 522 (60.2%) pregnant women who attended to the antenatal clinics of the Medical Faculty of Kahramanmaras Sutcuimam University's Department of Gynecology and Obstetrics between December 23, 2009, and February 1, 2010. We developed a 48-question survey which was completed in a face-to-face interview at the clinic with each pregnant woman.
Of the 314 pregnant women, 27.4% were in the first trimester, 33.8% were in the second trimester, and 38.8% were in the third trimester. Twenty-eight pregnant women (8.9%) got vaccinated. Of all the women interviewed, 68.5% stated that they were comfortable with their decisions about the vaccine, 7.3% stated they were not comfortable, and 24.2% stated that they were hesitant about their decisions. The probability of receiving the 2009 H1N1 vaccine was 3.46 times higher among working women than housewives, 1.85 times higher among women who have a child than those who do not, and 1.29 times higher among women with a high-school education or higher than those with only a secondary-school education and below. Correct knowledge about the minimal risks associated with receipt of influenza vaccine were associated with a significant increase in the probability of receiving the 2009 H1N1 vaccine.
The number of pregnant women in the study group who received the 2009 H1N1 vaccine was very low (8.9%) and two-thirds of them stated that they were comfortable with their decisions concerning the vaccine. Our results may have implications for public health measures to increase the currently low vaccination rate among pregnant women. Further studies are required to confirm whether our findings generalize to other influenza seasons and other settings.
PLoS ONE 01/2010; 5(12):e14177. · 4.09 Impact Factor
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Canan Eren Dagli,
Hayriye Sayarlioglu,
Ekrem Dogan,
Gurkan Acar,
Gulen Demirpolat, Ali Ozer,
Nurhan Koksal,
Mehmet Emin Gelen,
Nurhan Atilla,
A Cetin Tanrikulu,
Ismet Onder Isik,
Tuncay Ugur
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ABSTRACT: Background: Pulmonary hypertension (PH) has been reported to be high among end-stage renal disease (ESRD) patients. Objectives: The aim of this study was to investigate the role of arteriovenous fistula (AVF) flow in the pathogenesis of PH and the prevalence of PH in patients with chronic renal failure (CRF) and to suggest other possible etiologic factors. Methods: The prevalence of PH was prospectively estimated by Doppler echocardiography in 116 ESRD patients on regular hemodialysis (HD). Laboratory and clinical variables were compared between patients with and without PH (groups 1 and 2, respectively). PH was defined as systolic pulmonary artery pressure (SPAP) over 30 mm Hg. Patients with PH underwent further evaluation by 2 pulmonologists. AVF flow was measured by Doppler ultrasonography. Blood tests including arterial blood gases, hemoglobin, serum calcium, phosphorus and parathyroid hormone were determined. Results: PH was found in 25 (21.6%) patients (group 1) with an SPAP of 37.9 +/- 2.8 mm Hg. Mean AVF flow was increased (1,554 +/- 207.60 ml/min) in group 1. Left ventricular ejection fraction (LVEF) was significantly different between the 2 groups (55.3 +/- 11.5 and 64.4 +/- 40, respectively; p < 0.05). Neither significant primary lung disease nor parenchymal lesions were detected in group 1. PH showed a significant difference for cigarette smoking (p < 0.05). In group 1 the prevalence of cigarette smoking was higher. The main etiology of CRF was diabetes mellitus with a ratio of 44% in group 1. Conclusion: Our study demonstrated a surprisingly high prevalence of PH among patients receiving long-term HD. PH was related to high AVF flow, low LVEF and cigarette smoking. AVF flow and cigarette smoking are important correctable causes of PH. Early detection is important in order to avoid the serious consequences.
Respiration 10/2009; 78(4):411-415. · 2.26 Impact Factor
