Investigation of intrafamilial transmission in Hepatitis B surface Antigen (HBsAg) positive cases in Harran University Hospital [Harran Üniversitesi Araştirma Hastanesinde Hepatit B yüzey Antijeni (HBsAg) pozitif olgularda aile i·çi bulaşin i·ncelenmesi]

Yengil E. | Kurçer M.A. | Sirmatel F.

Makale | 2009 | Turkiye Klinikleri Journal of Medical Sciences29 ( 6 ) , pp.1612 - 1617

Objective: Hepatitis B virus (HBV) is a public health problemowing to communicable and widespreant. In addition to It is important issue because of preventable and prevent to people from contaminated persons. Transmission of HBV may be connected to transmission carrecteristics such as horizontal, vertical, sexual and blood, priority. Aim of this study is to determine the possible route of HBV transmission throughout a family setting. Material and Methods: 173 members (29 spouses, 82 offspring, 11 mothers, 11 fathers and 40 siblings) of 40 index cases (HBsAg carriers and chronic active hepatitis cases) attending the Harran University . . . Medical Faculty Hospital between Augst 2006 and March 2007 were screened prospectively for markers of HBV by using an ELISA. The chi-squared and Logistic regression analyses were used for statistical analysis. Results: Index cases was 18.8% of all family members, while HBsAg prevalence is 15.0% among family members except index cases. Among family members, the highest prevalences of antiHBc were in the mothers (54.5%) and sisters (45.5%), brothers (33.3%), sons (32.6%)and wifes (31.3%), the least prevalences of antiHBc were husbands (7.7%), fathers (18.2%), and doughters (22.2%) of all index cases. Transmission of HBV to both the mothers and sisters were positive was high, Transmission of HBV to fathers was low in all families. There was significant difference in cases where only the mother and husbands of index cases for HBV transmission (p= 0.012). In the logistic regression model; living with chronic hepatitis B index case (OR= 1.92; CI= 1.03-3.57), to be illiterate (OR= 6.81 CI= 1.27-22.13), born at home with traditional methods (OR= 3.70; CI= 1.15-11.87) and born at home with the help of midwife (OR= 3.44; CI= 1.47-7.91) were higher risk for hepatitits B transmision. Conclusion: The family members of index cases with inactive HBV carriers, particularly in the case of chronic active hepatitis have a high risk of transmission. Copyright © 2009 by Türkiye Klinikleri Daha fazlası Daha az

Adjusting the effect of baseline differences between groups in trials with which have two or more groups [Iki veya daha fazla gruplu denemelerde gruplar arasindaki başlangiç degerleri farkliliginin etkisinin düzeltilmesi]

Ankarali H. | Ankarali S.

Makale | 2009 | Turkiye Klinikleri Journal of Medical Sciences29 ( 1 ) , pp.91 - 98

Objective: In many clinical and experimental trials, researchers assess the effect of treatment by measuring the value of a continuous variable before and after the treatment. If there is an imbalance in baseline values between groups, some statistical comparisons may result with mistakes in estimation of the treatment effect. The aim of this study was to explain which statistical methods were more suitable in the estimation of the treatment effect when there was an imbalance for the baseline values between groups. Material and Methods: Different statistical methods, which are used in estimation of treatment effects, were briefly ex . . .plained and were applied to a hypothetical data set, which had significant differences between groups according to baseline values of the related variable. In addition, a limited simulation study for several conditions was carried out to determine suitable statistical methods. Results: Baseline values were different between two groups and correlation was low between baseline and follow up values of related variable in each group for hypothetical data set. In this condition, comparison of simple differences between baseline and follow up values was the best method for the estimation of treatment effect. In the simulation study, the power of the test for simple differences was higher (85%) than the value in the analysis of covariance (40%) when correlations were low and sample sizes were small in each group. Moreover, the powers of these two tests were high and similar to each other, when sample sizes were moderate. When the correlation was high, the powers of both tests were high in both small and moderate sample sizes. Conclusion: The presence of a significant difference should be sought between groups according to baseline values of the related variable even though groups are randomly assigned. In addition, the degree of the correlation between baseline and follow up values should be taken into consideration. When significant differences exist between baseline values and the correlation is low, we suggest that the classical methods should be used to determine the significance of the effect; however, when the correlation is high, covariance analysis is a suitable method. Copyright © 2009 by Türkiye Klinikleri Daha fazlası Daha az

Analysis of the correlation between children's eating behavior and parent's feeding style using canonical correlation analysis [Çocuklarda Yeme Davranisi ile Ebeveyn Besleme Tarzi Arasindaki Iliskinin Kanonik Korelasyon Analizi ile Incelenmesi]

Erkorkmaz U. | Yilmaz R. | Demir O. | Sanisoglu S.Y. | Etikan I. | Özçetin M.

Makale | 2013 | Turkiye Klinikleri Journal of Medical Sciences33 ( 1 ) , pp.138 - 148

Objective: The aim of this study was to analyze the correlation between eating behaviors of children in kindergarten and nursery classes and the feeding styles of their parents with canonical correlation analysis. Material and Methods: Cross-sectional study data collected with the Children's Eating Behavior Questionnaire (CEBQ) and Parent's Feeding Style Questionnaire (PFSQ) were used. CEBQ data were considered the dependent variable and PFSQ data the independent variables. Canonical correlation analysis was used to determine the relationship between two sets. Results: There was a statistically significant correlation between CEBQ s . . .ub-dimensions with PFSQ sub-dimensions at the same direction (r=0.475, Daha fazlası Daha az

The effect of different magnetic field intensities on regeneration at injured peripheral rat nerves [Degişik şiddetteki manyetik alanlarin hasarlanmiş siçan periferik sinir rejenerasyonu üzerine etkileri]

Güneş S. | Büyükakilli B. | Ankarali H.

Makale | 2008 | Turkiye Klinikleri Journal of Medical Sciences28 ( 6 ) , pp.857 - 866

Objective: We investigated the effects of different intensities of sinusoidal magnetic fields of daily life exposures on the peripheral nerve regeneration daily life exposure. The effects of magnetic field (50 Hz frequency and 1, 2, 3 mT intensities) treatment on sciatic nerve regeneration were studied in a model of crush injury of the sciatic nerve of rats. Material and Methods: Prior to crush injury, compound muscle action potentials were recorded for all rats. Then, the sciatic nerve was compressed for 15 sec with a jewelers forceps (no: 5). One rat group was kept as control and the remaining were assigned as 1, 2 and 3 mT magnet . . .ic field treatment groups. The magnetic fields 1, 2 and 3 mT were applied to 30 rats for 4 hours per day for a week using Helmholtz coil systems. The control group was included in the system for 4 hours per day for a week while the system was turned off. Results: In terms of nerve regeneration, 3- and 7-days treatments of different magnetic field intensities had no statistically significant effect on amplitude and conduction velocity of correspound muscle action potential. Conclusions: The intensities and frequency of magnetic fields used in this study had no effect on conduction and excitability of nerves and consequently did not influence the nerve regeneration. We could not prove a neuroprotective effect of magnetic field in rat crush injury model using electrophysiological method. Copyright © 2008 by Türkiye Klinikleri Daha fazlası Daha az

Turkish version of the parenting stress index short form: A psychometric study

Mert E. | Hallioglu O. | Ankarali Çamdeviren H.

Makale | 2008 | Turkiye Klinikleri Journal of Medical Sciences28 ( 3 ) , pp.291 - 296

Objective: The aim of this study was to assess the psychometric details of the Turkish version of the Parenting Stress Index/Short Form (PSI/SF). Material and Methods: PSI/SF was administered to 90 mothers of children with congenital heart disease in the cardiology outpatient clinic. In 51 mothers the scale was re-administered 2 months later. Psychometric testing was carried out by using Cronbach's alpha, item-total correlations, test-retest reliability and validity. The concurrent validity of the instrument was established by correlating test scores with scores from 2 other well-known depression inventories (Beck and Zung Depressio . . .n inventories). Results: Psychometric analysis showed that the Turkish version of the PSI/SF demonstrated satisfactory internal consistency (Cronbach's alpha) for Total Stress Score (0.71) and also for subscales including Parental Distress (0.81), Parent-Child Dysfunctional Interaction (0.76) and Difficult Child (0.78). Test-retest correlations (r= 0.88) indicated good stability over a mean time period of two months. The PSI/SF was in good correlation with Beck Depression (r= 0.77) and Zung Depression (r= 0.69) inventories. Conclusion: PSI/SF is an appropriate tool for measuring parenting stress in Turkish mothers of children with congenital heart disease and has cross-cultural validity Daha fazlası Daha az

The effects of a subhypnotic dose of ketamine on neuromuscular block characteristics of rocuronium and intubation quality [Subhipnotik dozda ketaminin rokuronyumun nöromusküler blok özellikleri ve Entübasyon Kalitesine Etkileri]

Abduşoglu M.N. | ÖZkoçak Turan I. | Yurtlu B.S. | Hanci V. | Okyay R.D. | AyogLu H.

Makale | 2012 | Turkiye Klinikleri Journal of Medical Sciences32 ( 2 ) , pp.399 - 406

Objective: In this study, we aimed to examine the effects of a subhypnotic dose of ketamine on the neuromuscular block characteristics of rocuronium and intubation quality. Material and Methods: Sixty patients in ASA I-II risk group were included in the study. Group S received 5 mL of 0.9% saline and Group K received 0.5 ketamine in 5 mL volume, one minute before induction. Both groups had anesthesia induction with a propofol dose of 2.5 (Propofol 1%, Fresenius Kabi). This was considered as anesthesia start time. After 1 min, a control single twitch stimulus (0.1 Hz) was applied and recorded. All patients were given . . .0.6 rocuronium (Esmeron® 50 mg.5 ml-1 N.V. Organon, Oss, Holland) in 5 sec. When the single twitch response was depressed 100%, the patient was intubated and the full depression time (onset time) was noted. Anesthesia maintenance was achieved with O2/N2O and sevoflurane. Following the intubation, the application of train-of - four (TOF) stimulation was started. When the TOF ratio reached to 20%, rocuronium was repeated at a dose of 0.2 Clinical duration (T25), recovery index (T25- 75) and spontaneous recovery time to TOF > 0.9 were recorded. Intubation conditions were assessed by using the scale of Fuchs-Buder. The additional drugs used during the operation and neuromuscular blocker amounts were recorded. The hemodynamic values of both groups were recorded throughout the study. Postoperative recovery times, visual analogue pain scores (VAS) and Ramsay sedation scores were also recorded. Results: The time for 100% depression of single twitch in Group K was shorter than that of Group S (p<0.05). The clinical duration, recovery index and spontaneous recovery duration of the first dose of rocuronium were longer in Group K compared to Group S (p<0.05). There was no difference between the total neuromuscular blocker amounts of the study groups. There was no significant difference between the groups according to intubation scores (p>0.05), recovery times (p>0.05), VAS scores, Ramsay sedation scores or mean arterial pressure values. When the mean heart rate values of the groups were compared, all values of Group K were higher than those of Group S except control and 60th min values (p<0.001). Conclusion: According to our findings, ketamine in a subhypnotic dose shortens the onset time of rocuronium block and extends the clinical duration of first dose of rocuronium without improving the intubation quality. © 2012 by Türkiye Klinikleri Daha fazlası Daha az

Rheumatoid arthritis and lyme disease: A case report [Romatoid artrit ve lyme hastaligi birlikteligi]

Borazan A. | Koçak E. | Koçak G. | Arslan T. | Üstündag Y.

Makale | 2005 | Turkiye Klinikleri Journal of Medical Sciences25 ( 5 ) , pp.736 - 739

Rheumatoid arthritis (RA) and Lyme disease are two systemic illnesses with distinctly different clinical manifestations. Although Lyme arthritis is clearly distinct from RA, it can also cause joint erosion due to chronic proliferative synovitis. In the literature we found no case report in which RA and Lyme disease coexisted. In this article we present a 27 year-old woman who had undergone treatment for RA for the previous 6 years. Two months after this period, on the basis of symptoms and laboratory findings, the patient experienced what was initially diagnosed as RA activation. However, after tests were performed, Lyme disease was . . . diagnosed. The patient was treated accordingly and successfully. Copyright © 2005 by Türkiye Klinikleri Daha fazlası Daha az

Evaluation of healthcare workers' and students' knowledge levels about infections transmitted by blood and body fluids, infection control measures, exposure frequencies and serological and hepatitis B vaccination status [Saglik Çalışanları ve ögrencilerin kan ve vücut sıvılarıyla bulşan enfeksiyonlar, enfeksiyon kontrol önlemleri hakkındaki bilgi düzeyleri, temas sıklıkları, serolojik durumları ve hepatit B aşilanma durumlarnin degerlendirilmesi]

Çelik Y. | Akduman D. | Kiran S.

Makale | 2010 | Turkiye Klinikleri Journal of Medical Sciences30 ( 4 ) , pp.1246 - 1255

Objective: Evaluation of healthcare workers', medical and nursing students' knowledge levels about infections transmitted by blood and body fluids, infection control measures, exposure frequencies and serological and hepatitis B vaccination status. Material and Methods: The study was cross-sectional and conducted in Karaelmas University Teaching and Research Hospital Zonguldak, Turkey. Data were collected by questionnaires. The study included 445 subjects (131 medical students [MS], 34 nursing students [NS], 280 healthcare workers). Results: Mean age was 25.5+5.4. Mean knowledge level scores (MKLS) increased with age and education l . . .evel (p=0.001). Doctors had highest MKLS. MKLS of medical students working in clinics was higher than NS (p=0.001) and NS had higher MKLS than preclinical MS (p=0.001). Subjects who received in-service training on bloodborne infections and infection control precautions had higher MKLS than persons who did not (p=0.001). Blood and body fluid exposure frequency was 54%. Exposed subjects had higher MKLS than unexposed ones (p=0.001). Exposure frequency was higher in subjects who wanted to get training on bloodborne infections and infection control measures than subjects who did not (Chi square: 14.92 p=0.0001). Needle-stick injury was declared to be the most common exposure cause. Post-exposure reporting rate to the infectious diseases clinic was 27.3% and mean postexposure follow up duration was 2.9+2.3 months. The highest exposure rate was detected in the emergency department (76.3%), and the lowest rate was detected in dialysis unit (37.1%). Hepatitis B vaccination rate was 71.9%. The most frequent reason for nonvaccination was not having time. Anti HCV positivity was detected in 1.2% and inactive HBsAg carrier state was detected in 1.5% of healthcare workers. Conclusion: Exposure to blood and body secretions can be reduced by educating healthcare workers, increasing adherence to infection control measures, administrative support, and reporting exposures. Knowledge levels of workers should be tested to evaluate current policies. Seronegative workers should get hepatitis B vaccination. © 2010 by Türkiye Klinikleri Daha fazlası Daha az

Surgical anatomy and bifurcation patterns of the popliteal artery: An anatomical study

Barut Ç. | Sevinç Öz. | Özden H. | Cömert A. | Esmer A.F. | Tekdemir I. | Elhan A.

Makale | 2009 | Turkiye Klinikleri Journal of Medical Sciences29 ( 2 ) , pp.338 - 343

Objective: To clarify the anatomy of the popliteal artery and to determine key variations in the bifurcation patterns of the popliteal artery. Material and Methods: The popliteal fossae of 28 (12 right and 16 left) fixed lower extremities were carefully dissected, and the arterial pattern from the distal edge of the adductor hiatus (AH) to the proximal portion of each leg was documented. A digital caliper was used to measure the arterial length. The transverse plane between the distal edges of the femoral condyles (FCs), which is easily located, was used as reference. Results: The mean length of the popliteal artery (PA) from the AH . . . to the FCs was 9.26 ± 1.63 cm on the right side and 10.08 ± 2.12 cm on the left side, while the mean distance from the FCs to the site of bifurcation into the anterior and posterior tibial arteries was 7.20 ± 1.98 cm on the right side and 6.69 ± 1.15 cm on the left. The average arterial length from the level of the FCs to the site of origin of the peroneal artery was 10.01 ± 1.78 cm on the right side and 9.18 ± 1.07 cm on the left side, and the PA/extremity ratio was 0.21 ± 0.04 on the right side and 0.22 ± 0.04 on the left. Variable patterns of adult popliteal artery termination were observed. Conclusion: The data presented here can help reduce the complication rate and improve the success rate of both urgent and elective vascular procedures, which often require exposure of the popliteal artery. Copyright © 2009 by Türkiye Klinikleri Daha fazlası Daha az

A case of Klatskin tumor with high levels of CA 19-9

Koçak E. | Koçak G. | Beşir F.H. | Can M.

Makale | 2007 | Turkiye Klinikleri Journal of Medical Sciences27 ( 5 ) , pp.774 - 777

Carbohydrate antigen 19-9 (CA 19-9) is used as a serum tumor marker for adenocarcinoma of the upper gastrointestinal tract, particularly primary adenocarcinoma of the pancreas. In addition, this tumor marker can be highly elevated in benign diseases such as acute pancreatitis, chronic pancreatitis, chronic liver disease and biliary tract disease. A 69 year-old man was hospitalized with jaundice, colacolored urine, right-sided upper abdominal pain, weight loss and pruritus. Laboratory data revealed a high level of serum CA19-9 of more than 100 000 U/mL and a mass in the left lobe of the liver was detected on computed tomography. ERCP . . ., PTCA and CT-guided biopsy yielded the diagnosis of Klatskin tumor. Review of the literature revealed that Klatskin tumor with high levels of CA 19-9 over 100 000 U/mL was not reported. Copyright © 2007 by Türkiye Klinikleri Daha fazlası Daha az

Varicella infection treated with acyclovir in an elderly patient with rheumatoid arthritis: Case report

Özdolap Ş. | Sarikaya S. | Aktunç E. | Koca R. | Çelebi G.

Makale | 2006 | Turkiye Klinikleri Journal of Medical Sciences26 ( 6 ) , pp.689 - 692

Varicella is a common and extremely contagious disease in childhood. The course of infection is usually mild to moderate in children but it may cause serious complications especially in immunosupressed adults and children. We presented a case with nosocomial varicella zoster virus infection in the form of chickenpox in a 67-year-old woman with rheumatoid arthritis (RA) for 15 years who was on treatment of methotrexate and prednisolon. The patient was treated with acyclovir and not only varicella infection but also physical findings and symptoms of RA improved. Copyright © 2006 by Türkiye Klinikleri.

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