A STUDY ON THE RELATIONSHIP BETWEEN SELF-PERCEPTION OF PARENTAL ROLE AND MARITAL ATTITUDE

Individuals’ perceptions of parental roles is a significant aspect of their parenting and one's appraisal of parental roles might be related to their global appraisal of marriage. Therefore in this study, it was aimed to examine the relationship between self perception of parental role and marital attitude. The participants of the study are comprised of 220 females and males. In order to gather socio-demographic information, the parents were administered an “Individual Information Form”. In order to assess participants’ self-perception of parental roles Self-Perception of Parental Role Scale, and in order to assess marital attitudes of the participants Marital Attitude Scale (MAS), were administered. As a result, it was found that there are significantly positive correlations (p<0.05) between the scores of the competence and role balance subdimensions of SPPR and the scores of MAS, whereas there are no significant correlations (p>0.05) between the scores of the role satisfaction and investment subdimensions of SPPR and the scores of MAS. The findings are discussed in terms of the relevant literature.  Article visualizations

DRD4 genotyping may differentiate symptoms of attention-deficit/hyperactivity disorder and sluggish cognitive tempo

Objective: Studies to reduce the heterogeneity of attention-deficit/hyperactivity disorder (ADHD) have increased interest in the concept of sluggish cognitive tempo (SCT). The aim of this study was to investigate if the prevalence of two variable-number tandem repeats (VNTRs) located within the 30 -untranslated region of the DAT1 gene and in exon 3 of the dopamine D4 receptor (DRD4) gene differ among four groups (31 subjects with SCT but no ADHD, 146 individuals with ADHD but no SCT, 67 subjects with SCT + ADHD, and 92 healthy controls). Methods: We compared the sociodemographic profiles, neurocognitive domains, and prevalence of two VNTRs in SCT and ADHD subjects versus typically developing (TD) controls. Results: The SCT without ADHD group had a higher proportion of females and lower parental educational attainment. Subjects in this group performed worse on neuropsychological tests, except for psychomotor speed and commission errors, compared to controls. However, the ADHD without SCT group performed significantly worse on all neuropsychological domains than controls. We found that 4R homozygosity for the DRD4 gene was most prevalent in the ADHD without SCT group. The SCT without ADHD group had the highest 7R allele frequency, differing significantly from the ADHD without SCT group. Conclusion: The 7R allele of DRD4 gene was found to be significantly more prevalent in SCT cases than in ADHD cases. No substantial neuropsychological differences were found between SCT and ADHD subjects

Explaining the decline in coronary heart disease mortality in Turkey between 1995 and 2008.

BACKGROUND: Coronary heart disease (CHD) mortality rates have been decreasing in Turkey since the early 1990s. Our study aimed to determine how much of the CHD mortality decrease in Turkey between 1995 and 2008 could be attributed to temporal trends in major risk factors and how much to advances in medical and surgical treatments. METHODS: The validated IMPACT CHD mortality model was used to combine and analyse data on uptake and effectiveness of CHD treatments and risk factor trends in Turkey in adults aged 35-84 years between 1995 and 2008.Data sources were identified, searched and appraised on population, mortality and major CHD risk factors for adults those aged 35-84 years. Official statistics, electronic databases, national registers, surveys and published trials were screened from 1995 onwards. RESULTS: Between 1995 and 2008, coronary heart disease mortality rates in Turkey decreased by 34% in men and 28% in women 35 years and over. This resulted in 35,720 fewer deaths in 2008.Approximately 47% of this mortality decrease was attributed to treatments in individuals (including approximately 16% to secondary prevention, 3% angina treatments, 9% to heart failure treatments, 5% to initial treatments of acute myocardial infarction, and 5% to hypertension treatments) and approximately 42% was attributable to population risk factor reductions (notably blood pressure 29%; smoking 27%; and cholesterol 1%). Adverse trends were seen for obesity and diabetes (potentially increasing mortality by approximately 11% and 14% respectively). The model explained almost 90% of the mortality fall. CONCLUSION: Reduction in major cardiovascular risk factors explained approximately 42% and improvements in medical and surgical treatments explained some 47% of the CHD mortality fall. These findings emphasize the complimentary value of primary prevention and evidence-based medical treatments in controlling coronary heart disease

Contrasting cardiovascular mortality trends in Eastern Mediterranean populations: contributions from risk factor changes and treatments

Background Middle income countries are facing an epidemic of non-communicable diseases, especially coronary heart disease (CHD). We used a validated CHD mortality model (IMPACT) to explain recent trends in Tunisia, Syria, the occupied Palestinian territory (oPt) and Turkey. Methods Data on populations, mortality, patient numbers, treatments and risk factor trends from national and local surveys in each country were collated over two time points (1995–97; 2006–09); integrated and analysed using the IMPACT model. Results Risk factor trends: Smoking prevalence was high in men, persisting in Syria but decreasing in Tunisia, oPt and Turkey. BMI rose by 1–2 kg/m2 and diabetes prevalence increased by 40%–50%. Mean systolic blood pressure and cholesterol levels increased in Tunisia and Syria. Mortality trends: Age-standardised CHD mortality rates rose by 20% in Tunisia and 62% in Syria. Much of this increase (79% and 72% respectively) was attributed to adverse trends in major risk factors, occurring despite some improvements in treatment uptake. CHD mortality rates fell by 17% in oPt and by 25% in Turkey, with risk factor changes accounting for around 46% and 30% of this reduction respectively. Increased uptake of community treatments (drug treatments for chronic angina, heart failure, hypertension and secondary prevention after a cardiac event) accounted for most of the remainder. Discussion CHD death rates are rising in Tunisia and Syria, whilst oPt and Turkey demonstrate clear falls, reflecting improvements in major risk factors with contributions from medical treatments. However, smoking prevalence remains very high in men; obesity and diabetes levels are rising dramatically

The effect of rivaroxaban in inflammation and fibrosis on TNBS induced chronic colitis model

Amaç: İnflamasyon ve koagülasyon iki önemli konak savunma sistemidir İnflamatuar barsak hastalıkları (İBH) etiyopatogenezinde; genetik, çevresel faktörler, enterik mikroflora ve doku cevabı yanında pıhtılaşma sitemi, platelet, endotel, epitel ve mezenkimal hücreler gibi nonimmun hücreler ve sistemler de önemli rol oynamaktadır. FXa prokoagülan etki ile trombin oluşumunu sağlayıp indirek olarak, ayrıca direk PAR -2 aktivasyonuna neden olarak inflamasyon ve fibrozisi uyarmaktadır. Çalışmamızda FXa'nın rivaroksabanla inhibisyonunun İBH hastalarında gözlenen inflamasyon ve fibrozis üzerine etkisini araştırmayı planladık. Gereç ve Yöntem: 24 adet Wistar-albino dişi rat ve kolit indüksiyonu için %50 etanol içinde 30 mg 0,5 ml trinitrobenzene sulfonic acid (TNBS) kullanıldı Hayvanlar sağlıklı kontrol (Sham: Grup A), hastalık kontrol (kontrol: Grup B) ve metilprednizolon (standart grup: Grup C), rivaroksaban (test grubu: Grup D) alan grup olarak 4 dört gruba ayrıldı. TNBS indüksiyonun 8. gününde hayvanlar sakrifiye edildi. Grupların makroskopik ve mikroskobik kolit skorları, doku myeloperoksidaz (MPO), Malondialdehit (MDA), süperoksit dismutaz (SOD), Metalloproteinaz-3 (MMP-3), doku metalloproteinaz inhibitörü-1 (TIMP-1), TGF-B1 düzeyleri değerlendirildi. Bulgular: Grup B, C, D ile Grup A karşılaştırıldığında; Makroskopik ve mikroskobik skor değerleri Grup A'da istatistiki olarak anlamlı düşük bulundu, Grup D ile yalnızca Grup B karşılaştırıldığında makroskopik ve mikroskobik skor değerleri Grup D'de istatistiki olarak anlamlı düşük bulundu. Grup D ve C arasında makroskopik skorlar istatistiki olarak benzer bulunurken, mikroskobik skorlar C grubunda daha yüksekti. Medyan MPO değerleri Grup A: 0,17 (0,31-0,61), Grup B: 0,47 (0,31-0,61), Grup C: 0,29 (0,25-0,41), Grup D0,30 (0,25-0,37), Medyan MDA Grup A: 1,1 (1,0-2,8), Grup B: 4,3 (3,1-5,5), Grup C: 3,8 (3,1-4,3), Grup D: 3,9 (3,1-4,4) gruplar arasında MPO ve MDA değerleri yönünden istatistiki anlamlılık mevcuttu Grup A'ya göre Grup B, C, D'nin değerleri istatistiki olarak anlamlı yüksek olduğu gözlendi. Grup D ve Grup C 'nin MPO ve MDA değerleri istatistiki yönden benzerlik göstermesine rağmen grup D ve C, Grup B ile karşılaştırıldıklarında Grup B'nin MPO ve MDA değerleri istatsitiki olarak anlamlı yüksek bulundu (p<0,001 ve p=0,047). MMP-3 (ng/g doku) medyan değerleri; Grup A: 32,5 (14,5-52,2) Grup B: 124,3 (109,9-144,5) Grup C: 127,8 (103,4-138,2), Grup D: 66,7 (28,3-86,4) gruplar arasında karşılaştırıldığında Grup A'ya göre Grup B, C, D'nin değerleri istatistiki olarak anlamlı yüksek bulunurken, Grup B ve C'nin değerleri istatistiki olarak benzer bulundu, Grup D'nin değerleri, Grup B ve Grup C'ye göre istatistiki olarak anlamlı düşük olduğu gözlendi. TGF-&#946;1 (ng/g doku) medyan değerleri;Grup A: 0,97 (0,60-1,53), Grup B: 5,02 (3,87-6,35) Grup C: 3,98 (3,01-5,45), Grup D: 2,29 (1,04-2,91), TIMP-1 (ng/gdoku) medyan değerleri; Grup A: 6,8 (6,5-10,9) Grup B: 20,0 (17,1-24,4)Grup C: 17,3 (10,5-28,2), Grup D: 12,7 (7,2-15,3), TGF-&#946;1,TIMP-1 değerleri gruplar arasında karşılaştırıldığında Grup A'ya göre Grup B, C, D'nin değerleri istatistiki olarak anlamlı yüksek bulunurken, Grup B ye göre Grup C ve Grup D'nin değerleri, Grup C'ye görede ve Grup D'nin değeri istatistiki olarak anlamlı düşük bulundu (p<0,001; p<0,001 ve p=0,002). Sonuç: Bu sonuçlara göre FXa'nın, rivaroksaban ile inhibisyonu antinflamatuar, antifbrotik ve antioksidan etki ile sonuçlanmaktadır. Bu durum bize antikoagülan olan rivaroksabanın İBH tedavisinde mevcut tedaviye ek olarak veya tek başına; aktif hastalık döneminde inflamasyonu baskılayabileceğini, prokoagülan aktiviteyi engelleyip tromboza yatkınlığı azaltabileceğini ve antifibrotik etki ile stenoz ve striktür gibi komplikasyonları engelleyebileceğini düşündürdü.AİM: Inflammation and coagulation are two important host defense systems. Nonimmun cells and systems such as coagulation system, platelet, epithelium and mesenchimal cells play important role in the ethiopathogenesis of inflammatory bowel disease (IBD), besides genetic factors, environmental factors, enteric microflora and tissue response. FXa has a indirectly procoagulant effect for generating thrombin, as also directly cause activation of PAR-2 which induces inflammation and fibrosis. In our study, we planned to investigate the impact of FXa inhibition with Rivaroxaban on inflammation and fibrosis seen in patients with IBD MATERIAL AND METHODS: Twenty-four female Wistar-Albino rats and 30 mg 0.5 ml trinitrobenzene sulphonic acid (TNBS) dissolved in 50% ethanol which induces colitis by intrarectal installation. Rats divided into four groups; healty control (Sham: Group A), colitis control (Control: Group B), metilprednisolone (standart group: Group C) and rivaroxaban (test group: Group D). The rats were sacrificed on 8th day. Macroscopic and microscopic scores, tissue myeloperoxidase (MPO), Malondialdehit (MDA), superoxide dismutase (SOD), Methalloproteinase-3 (MMP-3), tissue methalloproteinase inhibitor-1 (TIMP-1) and TGF-B1 levels were measured. FINDINGS Macroscopic and microscopic scores levels in Group A were significantly lower than Group B,C and D. Macroscopic and microscopic scores levels in Group D were significantly lower than Group B. Macroscopic scores were statistically similar between Group C and D. Microscopic scores were higher in Group C. Median MPO levels were in Group A: 0,17 (0,31-0,61), Group B: 0,47 (0,31-0,61), Group C: 0,29 (0,25-0,41), Group D: 0,30 (0,25-0,37), Median MDA Group A: 1,1 (1,0-2,8), Group B: 4,3 (3,1-5,5), Group C: 3,8 (3,1-4,3), Group D: 3,9 (3,1-4,4). MPO and MDA levels were statistically significant difference between each group. These levels in Group B,C and D were significantly higher than Group A; in Group C and D were statistically similar; in Group B were statistically higher than Group C and D (p<0.001 & p=0,047). MMP-3 (ng/g tissue) median levels; Group A: 32,5 (14,5-52,2) Group B: 124,3 (109,9-144,5) Group C: 127,8 (103,4-138,2), Group D: 66,7 (28,3-86,4). MMP-3 levels in Group B,C and D were significantly higher than Group A; in Group C and D were statistically similar; in Group D were significantly lower than Group C and D. TGF-&#946;1 (ng/g tissue) median levels were in Group A: 0,97 (0,60-1,53), Group B: 5,02 (3,87-6,35) Group C: 3,98 (3,01-5,45) and Group D: 2,29 (1,04-2,91). TIMP-1 (ng/g tissue) median levels were in Group A: 6,8 (6,5-10,9), Group B: 20,0 (17,1-24,4), Group C: 17,3 (10,5-28,2) and Group D: 12,7 (7,2-15,3). TGF-&#946;1 and TIMP-1 levels in Group B,C and D were significantly higher than Group A; in Group C and D were significantly lower than Group B and in Group D were significantly lower than Group C (p<0,001; p<0,001 and p=0,002, respectively). RESULT As a result;FXa inhibition with Rivaroxaban is resulted with anti-inflammatory, anti-fibrotic and anti-oxidant effect. Therefore, we thought that Rivaroxaban supresses inflammation during active disease of IBD by addition to current treatment or alone, decreases thrombophilia by inhibition of procoagulant activity and prevents from complication such as stenosis and stricture by antifibrotic effect. Our study is first study which evaluate the efficiency of FXa inhibiton with Rivaroxaban in experimental colitis model. There is no clinical and experimental trials with Rivaroxaban in IBD. Further trials about efficiency and clinical use is required

Immediate unprepared polyethylene glycol-flush colonoscopy in elderly patients with severe lower gastrointestinal bleeding

Aims: Colon preparation is vital yet more difficult in elderly patients with severe lower gastrointestinal bleeding (LGIB). The aim of this study is to show the efficacy, safety and outcomes of unprepared polyethylene glycol (PEG)-flush retrograde colon cleansing in the diagnosis and treatment of elderly home care patients with LGIB. Methods: A single-center study was performed between January 2014 and June 2018. Elderly home healthcare patients presenting with hematochezia were enrolled, and an unprepared retrograde bowel cleansing colonoscopy was performed within the first 8 h after admission to the emergency department. PEG solution (2 L) was added to the water jet tank, and jet pump injection was started from the left side of the colon to the right segment of the colon and ended up at the cecum. Results: In total, 33 elderly patients presenting with hematochezia were evaluated. Mean inward and outward procedure times were 17.06 ± 4.92 (8–33 min) and 28.66 ± 6.88 (10–30 min), respectively. Most of the bleeding was localized in the right colon at 22 patients (66.3%). Endoscopic treatment was performed in 87.9% of patients. The average length of stay in hospital was 44.70 ± 42.81 (range 18.00–240.00 h). Conclusions: Immediate unprepared PEG-flush colonoscopy in elderly home care patients with acute LGIB is a safe and effective method, which detects bleeding sources and provides endoscopic therapy. With this procedure, the time of hospital stay is reduced. This approach may be used for the initial intervention in patients admitted to emergency departments or intensive care unit with severe acute LGIB. Geriatr Gerontol Int 2020; ••: ••–••. © 2020 Japan Geriatrics Societ

The performance of nesfatin-1 in distinguishing irritable bowel syndrome presenting predominantly with diarrhea from celiac disease

PubMed: 32162872Background: We hypothesized that nesfatin-1, an anti-inflammatory peptide, could be used as a non-invasive diagnostic tool in the identification of celiac disease (CD) and irritable bowel syndrome presenting predominantly with diarrhea (IBS-D). Methods: Thirty-five patients with IBS-D who met the Rome III criteria, 28 patients with celiac disease who met the diagnostic criteria of the Marsh-Oberhuber classification, and 30 age- and gender-matched healthy controls were included in this cross-sectional study. All subjects responded to the IBS Severity Scoring System (IBS-SSS) questionnaire that was used to determine pain severity, pain frequency, bloating, dissatisfaction with bowel habits, and life interference. Results: Nesfatin-1 levels were significantly higher in the CD group compared to the IBS-D group and healthy controls. Nesfatin-1 was also higher in the IBS-D group compared to controls. Nesfatin-1 levels were correlated with IBS-SSS (r = 0.884, p 98.1 pg/mL for nesfatin-1 could discriminate subjects with CD from those with IBS-D and also healthy controls with a sensitivity of 82% and a specificity of 80%. Conclusions: The results of this study show that subjects with CD have higher nesfatin-1 levels compared to those with IBS-D or to the healthy controls. Moreover, nesfatin-1 can discriminate subjects with CD from those with IBS-D and also healthy controls, with high sensitivity and specificity. Further studies with histopathological evaluation are required to clearly address the role of nesfatin-1 in the diagnosis of CD. © 2020 Verlag Klinisches Labor GmbH. All rights reserved

Evaluation of colonoscopic and pathological outcomes of patients who have undergone colonoscopy with a positive fecal occult blood screening test

Giriş ve Amaç: Kolorektal kanser taramasında gaitada gizli kan testi dışında, fekal immünokimyasal test, fleksible sigmoidoskopi ve kolonoskopi kullanılan diğer yöntemlerdir. Bu çalışmada gaitada gizli kan testi pozitif olması nedeni ile kolonoskopi istenmiş olan hastaların kolonoskopik ve patolojik bulgularını değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu çalışmaya Haziran 2014-Ekim 2016 yılları arasında gaitada gizli kan testi pozitif saptanan ve kolonoskopi yapılması için Ahi Evran Üniversitesi Eğitim ve Araştırma Hastanesi endoskopi ünitesine yönlendirilen hastalar alındı. Yetersiz kolon temizliği, aktif hematokezyası, kolon operasyonu öyküsü, inflamatuvar barsak hastalığı öyküsü veya üst gastrointestinal sistem endoskopisinde kanamaya neden olabilecek lezyonu olan hastalar çalışma dışı bırakıldı. Hastaların yaşları, cinsiyetleri, kolonoskopik bulguları, patoloji sonuçları not edildi. Üç ya da daha fazla polip, 1 cm’den büyük adenomatöz polip, patolojik incelemede villöz komponent içeren ya da yüksek dereceli displazi saptanan hastalar yüksek riskli grup olarak değerlendirildi ve bu kriterlere göre kolon kanser tarama programına alındı. Bulgular: Çalışmaya toplam 225 hasta dâhil edildi. Hastaların 111’i (%49.3) erkek, 114’ü (%50.7) kadın, ortalama yaşları 58.52 (24-90), ortalama hemoglobin düzeyi 13.63 (7.2-18) idi. Endoskopik tanıları; normal kolonoskopik bulgular 86 (%38,2), polip 59 (%26,2) , yalnızca perianal hastalık 27 (%12), divertikül 16 (%7,1), kolon kanseri 14 (%6,2), inflamatuvar barsak hastalığı 14 (%6,2), enfeksiyöz kolit 6 (%2,7), anjiodisplazi 3 (%1,3) hasta şeklinde idi. Endoskopik olarak kolon kanseri düşünülen ve polip saptanan 73 (%32,4) hastanın patoloji sonuçları; tübüler adenom 31 (%42,5), adenokarsinom 17 (%23,3), hiperplastik polip 16 (%21,9), tübülovillöz adenom 7 (%9,6), serrated adenom 2 (%2,7) şeklinde değerlendirildi. Kolonoskopik olarak polip saptanan 3 (%5,08) hastanın patolojisinde erken evre karsinom saptandı. Polip saptanan 59 hastanın 30’u (%50,8) yüksek riskli, 29’u (%49,2) düşük riskli olarak bulundu. Sonuç: Gaitada gizli kan testi pozitifliği ile gelen hastaların yaklaşık yarısında kolon patolojisi tespit edilmiştir. Bu test, kolon kanseri ve öncül lezyonlarının tespitinde olduğu gibi, subklinik inflamatuvar barsak hastalığı, kronik kan kaybına yol açan divertikül, anjiodisplazi gibi patolojilerin de tespitinde yardımcı olan ucuz, kolay uygulanabilir bir yöntemdir.Background and Aims: Methods such as guaiac fecal occult blood-screening test, fecal immunological test, colonoscopy, and sigmoidoscopy are generally used in colorectal screening programs. The aim of this study was to evaluate the colonoscopic and pathological findings of patients with a g-fecal occult blood-screening test-positive result. Materials and Methods: This study was conducted between June 2014 and October 2016 on patients who were referred to Ahi Evran University Training and Research Hospital endoscopy unit after a positive stool blood test and then underwent colonoscopy. The exclusion criteria were inadequate colon cleansing, active hematochezia, a history of colonic surgery, inflammatory bowel disease, or any lesion that may lead to hemorrhage in the upper gastrointestinal system. Age, sex, and colonoscopic and pathological findings of the study participants were recorded. Patients with three or more polyps, an adenomatous polyp measuring >1 cm in diameter, pathological examination involving the villous component, or high-grade dysplasia were evaluated as the high-risk group. These patients attended the colon cancer screening program. Results: A total of 225 patients, including 111 (49.3%) males, were recruited in the study. The mean age was 58.52 (range: 24-90) years. Mean hemoglobin levels were 13.63 (range: 7.2-18) g/dl. Endoscopic findings of these patients included normal colonoscopy [86 patients (38.2%)], polyps [59 patients (26.2%)], perianal disease [27 patients (12%)], diverticulum [16 patients (7.1%)], colon cancer [14 patients (6.2%)], inflammatory bowel disease [14 patients (6.2%)], infectious colitis [6 patients (2.7%)], and angiodysplasia [3 patients (1.3%)]. Pathological findings of 73 (32.4%) patients who were diagnosed with colon cancer and polyps through endoscopy were as follows: tubular adenoma [31 patients (42.5%)], adenocarcinoma [17 patients (23.3%)], hyperplastic polyps [16 patients (21.9%)], tubulovillous adenoma [7 patients (9.6%)], and serrated adenoma [2 patients (2.7%)]. Early-stage carcinoma was diagnosed in the pathology of 3 (5.08%) patients who had colonoscopically detected polyps. Of the 59 patients who were diagnosed with polyps, 30 (50.8%) patients were at high risk and 29 (49.2%) were at low risk. Conclusion: Colonic pathology was detected in about half of the patients positive for g-fecal occult blood-screening test. This test is not only an inexpensive and easily applicable method for colon cancer screening, but it is also helpful for the detection of pathologies that could lead to chronic blood loss, such as subclinical inflammatory bowel disease, diverticulitis, and angiodysplasia