Imaging Lung Disease in Systemic Sclerosis

Interstitial lung disease and pulmonary hypertension (PH) are the most common cardiopulmonary findings in patients with systemic sclerosis (SSc). About two thirds of patients suffering from SSc develop scleroderma interstitial lung disease. PH is present in about 20% of SSc patients and is typically associated with severe lung disease, although it may be an isolated manifestation of SSc. High-resolution CT scanning is a key method for evaluating chest involvement. There are four roles of imaging in scleroderma interstitial lung disease: 1) detection of lung involvement, 2) identification of patients likely to respond to treatment, 3) assessment of treatment efficacy, and 4) exclusion of other significant diseases to include PH and cardiac and esophageal abnormalities

Plasma concentrations of soluble IL-2 receptor α (CD25) are increased in type 1 diabetes and associated with reduced C-peptide levels in young patients.

AIMS/HYPOTHESIS: Type 1 diabetes is a common autoimmune disease that has genetic and environmental determinants. Variations within the IL2 and IL2RA (also known as CD25) gene regions are associated with disease risk, and variation in expression or function of these proteins is likely to be causal. We aimed to investigate if circulating concentrations of the soluble form of CD25, sCD25, an established marker of immune activation and inflammation, were increased in individuals with type 1 diabetes and if this was associated with the concentration of C-peptide, a measure of insulin production that reflects the degree of autoimmune destruction of the insulin-producing beta cells. METHODS: We used immunoassays to measure sCD25 and C-peptide in peripheral blood plasma from patient and control samples. RESULTS: We identified that sCD25 was increased in patients with type 1 diabetes compared with controls and replicated this result in an independent set of 86 adult patient and 80 age-matched control samples (p = 1.17 × 10(-3)). In 230 patients under 20 years of age, with median duration-of-disease of 6.1 years, concentrations of sCD25 were negatively associated with C-peptide concentrations (p = 4.8 × 10(-3)). CONCLUSIONS/INTERPRETATION: The 25% increase in sCD25 in patients, alongside the inverse association between sCD25 and C-peptide, probably reflect the adverse effects of an on-going, actively autoimmune and inflammatory immune system on beta cell function in patients

The training needs of Turkish emergency department personnel regarding intimate partner violence

<p>Abstract</p> <p>Background</p> <p>Violence against females is a widespread public health problem in Turkey and the lifetime prevalence of IPV ranges between 34 and 58.7%. Health care workers (HCW) sometimes have the unique opportunity and obligation to identify, treat, and educate females who are abused. The objective of this study was to evaluate the knowledge, attitudes, and experiences of the emergency department (ED) staff regarding intimate partner violence (IPV) at a large university hospital in Turkey.</p> <p>Methods</p> <p>A cross-sectional study was conducted in a large university hospital via questionnaire. The study population consisted of all the nurses and physicians who worked in the ED during a two month period (n = 215). The questionnaire response rate was 80.5% (41 nurses and 132 physicians). The main domains of the questionnaire were knowledge regarding the definition of IPV, clinical findings in victims of IPV, legal aspects of IPV, attitudes towards IPV, knowledge about the characteristics of IPV victims and abusers, and professional and personal experiences and training with respect to IPV.</p> <p>Results</p> <p>One-half of the study group were females, 76.3% were physicians, and 89.8% had no training on IPV. The majority of the nurses (89.5%) and physicians (71.1%) declared that they were aware of the clinical appearance of IPV. The mean of the knowledge scores on clinical knowledge were 8.84 ± 1.73 (range, 0–10) for acute conditions, and 4.51 ± 3.32 for chronic conditions. The mean of the knowledge score on legal procedures and the legal rights of the victims was 4.33 ± 1.66 (range, 0–7). At least one reason to justify physical violence was accepted by 69.0% of females and 84.7% of males, but more males than females tended to justify violence (chi square = 5.96; p = 0.015). However, both genders accepted that females who experienced physical violence should seek professional medical help.</p> <p>Conclusion</p> <p>The study participants' knowledge about IPV was rather low and a training program is thus necessary on this issue. Attention must be given to the legal aspects and clinical manifestations of IPV. The training program should also include a module on gender roles in order to improve the attitudes towards IPV.</p

The prevalence of rheumatic diseases in central Greece: a population survey

<p>Abstract</p> <p>Background</p> <p>Rheumatic diseases are a major health and financial burden for societies. The prevalence of rheumatic diseases may change over time, and therefore, we sought to estimate the prevalence of rheumatic diseases in an adult population of central Greece.</p> <p>Methods</p> <p>In this prospective cross-sectional population survey, a random sample of adult population was drawn from poll catalogues of a region in central Greece. A postal questionnaire was sent to 3,528 people for the presence of any rheumatic disease. All positive cases were further confirmed by clinical examination using the American College of Rheumatoloy criteria. Multiple regression analysis was used to assess risk factors for rheumatic diseases.</p> <p>Results</p> <p>The response rate was 48.3% (1,705 answers). Four hundred and twenty individuals (24.6%) had a rheumatic disease. The prevalence of rheumatoid arthritis was 0.58% (95% confidence interval [CI], 0.32-0.87), of psoriatic arthritis was 0.35% (95% CI, 0.33-1.13), of ankylosing spondylitis was 0.29% (95% CI, 0.28-0.94), of primary Sjögren's syndrome was 0.23% (95% CI, 0.22-0.75) and of systemic lupus erythematosus was 0.11% (95% CI, 0.11-0.37). One individual had systemic sclerosis (prevalence, 0.058%), 1 individual had dermatomyositis (prevalence, 0.058%; 95% CI, 0.05-0.18), 2 individuals had vasculitis (prevalence 0.11%; 95% CI, 0.11-0.37), 81 individuals had gout (prevalence, 4.75%; 95% CI, 4.41-5.13), and 304 individuals had osteoarthritis (OA) (prevalence 17.82%; 95% CI, 16.50-19.34). Gout was associated with male gender, diabetes mellitus, and hypertension, and OA was associated with age, female gender, and hypertension.</p> <p>Conclusions</p> <p>Rheumatic diseases are common in central Greece, affecting nearly a quarter of adult population. OA and gout are the most common joint disorders.</p

Dezavantajlı bir grupta işyerinde sigarayı bırakma programının bir yıllık sonuçları

Aim: Our aim was to introduce and evaluate a smoking cessation program conducted among Izmir Bayraklı Municipality's cleaning workers in 2010. Materials and Methods: The intervention started in March 24,2010. The first 27 participants attended a session and then individual counseling was conducted face-to-face at the workplace. The following 28 participants were only given individual counseling. Knowledge was assessed by a 20-item questionnaire applied before and one month after education. Participants were contacted by telephone to evaluate the six-month and one-year results. Results: The mean age of the 55 participants was 33.4;plusmn;6.9 (23-54) years and only three were women. Sixty percent had primary school or lower education. The mean age at starting smoking was 15.3;plusmn;3.3 years and the mean daily consumption 21.6;plusmn;11.7 cigarettes. Most of the participants had smoked ;gt;10 pack-years (72.7%). There was a significant increase in the knowledge level of the participants, particularly on issues concerning quitting, but not of the harmful effects of smoking. Although pharmacologic treatment was proposed to 46 of the participants, only 18 used the treatment, due to mainly economic reasons (n=18). Participants were followed up 6.2;plusmn;3.5 times (1-15) on the average, including the first counseling. At six months, 13/48 (27.1%) and at one-year, 11/43 (26.2%) participants had quit smoking. Among the followed-up participants at one year, 16 (38.1%) had decreased consumption by a mean of 12.9;plusmn;8.9 (3-30) cigarettes per day. Conclusion: The application of smoking cessation programs at workplaces could have a significant impact in lowering adult smoking rates. The reduction of the costs of cessation treatment or their coverage by the security scheme will improve the outcome.Amaç: İşyerinde sigara bıraktırma girişimlerinin birçok avantajı bulunmaktadır. Bu çalışmanın amacı, İzmir Bayraklı Belediyesi'nin temizlik işleri çalışanlarında 2010 yılında yürütülen sigarayı bırakma programını tanıtmak ve programın etkinliğini değerlendirmektir. Gereç ve Yöntem: Program 24 Mart 2010 tarihinde başlamıştır. İlk üç hafta içinde katılan 27 kişiye eğitim seansının ardından bireysel danışmanlık, sonraki haftalarda katılan 28 kişiye ise bireysel danışmanlık kapsamında eğitim verilmiştir. Eğitim öncesi ve en az bir ay sonrasında 20 maddelik bir soru formuyla bilgi düzeyi sorgulanmıştır. Eğitimler ve izlemler işyerinde yüz yüze gerçekleştirilmiştir. Girişimin altı aylık ve bir yıllık sonuçlarının değerlen-dirilmesi için katılımcılar telefonla aranmıştır. Bulgular: 55 kişiden oluşan araştırma grubunun yaş ortalaması 33,4±6,9'dur (23-54) ve sadece üçü kadındır. Grubun %60'ının eğitim düzeyi ilkokul ve altındadır. Grubun sigaraya başlama yaş ortalaması 15,3±3,3, günde içtikleri sigara sayısı ortalama 21,6±11,7'dır. Katılımcıların çoğunun 10 paket yılının üzerinde tüketimi vardır (%72,7). Katılımcıların bilgi düzeylerinde anlamlı artış saptanmıştır. Bilgi artışı sigaranın sağlığa etkilerinden ziyade bırakma tedavileriyle ilgili konularda olmuştur. Katılımcıların 46'sına farmakolojik tedavi önerildiği halde sadece 18'i önerilen tedaviyi uygulayabilmiştir. Önde gelen uygulayamama nedeni ekonomik sıkıntıdır (n=18). Katılımcılar ilk görüşmeyle birlikte ortalama 6,2±3,5 (1-15) kez izlenmişlerdir. Altı ayın sonunda izlemi tamamlanan 48 kişiden 13'ü (%27,1), bir yılın sonunda 43 kişiden 11'i (%26,2) sigarayı bırakmıştı. Bir yıllık izlemi yapılabilenlerin 16'sı da (%38,1) günlük içtiği sigara sayısını ortalama 12,9±8,9 (3-30) adet azaltmıştır. Sonuç: İşyerlerinde sigara bırakma programlarının uygulanması, bunun işyeri hekimliği eğitiminin bir parçası olması erişkin sigara bırakma oranlarının düşürülmesine önemli katkılar koyabilir. Sigara bırakma tedavilerinin maliyetlerinin düşürülmesi veya bunların güvence kapsamına alınması başarıyı arttıracaktır

Occupational health of Turkish Aegean small-scale fishermen

WOS: 000300715900016PubMed ID: 22113895Background Fishing has always been a dangerous occupation, and numerous factors have a direct or indirect impact on the health of fisherman. Aims To examine the health, safety and working conditions of small-scale fishing fleets in the Turkish Aegean Sea coasts. Methods Data were obtained from a questionnaire distributed to a random sample of small-scale fishermen along the Aegean Sea coast. Data collection took place between September 2009 and January 2010. Results Out of 5714 Aegean Sea small-scale fishermen, 1166 from 76 fishing ports participated. Twenty-nine per cent of fishermen did not have any social security cover. The most prevalent health problems (using International Classification of Diseases and Related Health Problems 10th Revision [ICD-10]) found were musculoskeletal problems (e.g. discopathies, muscular strain, rheumatism) and eye, ear-nose, digestive and urinary system problems. Alcohol consumption was high (68%) in fishermen and 72% reported that they smoked more during fishing trips. Health problems appeared to be associated with a number of factors including migrant status, income satisfaction, rank, type of fishing and cumulative work per year. Conclusions In Turkey, small-scale fishermen experience a significant number of health problems and have unhealthy lifestyles. Interventions designed to improve working conditions of small-scale fishermen could help to reduce the number of occupational injuries, which in turn may impact positively on their health. Prevention policies to reduce alcohol and tobacco consumption should also be developed