Investigation of Effectiveness Studies Conducted by Using Cognitive Behavioral Group Therapy, Psychodrama and Art Therapy in Turkey

The aim of this study was to review the studies conducted in Turkey which evaluated the effectiveness of cognitive behavioral group therapy, psychodrama, and art group therapy programs. Articles only in Turkish that were published between 2000-2018 were searched by using specified keywords in Ebscohost, Ulakbim, DergiPark, Turkish Psychiatry Index, and Google Scholar databases. Among the articles, studies which were not effectiveness studies, those which did not have CBT group therapy, psychodrama, art therapy, those which did not indicate the effectiveness of the therapy, those which were thesis, case reports, studies that using two different group therapies, and psychoeducation and psychological counseling programs were excluded from the review. A total of 27 studies that met the inclusion criteria were included. Studies were examined in terms of research method, samples, therapy characteristics, and obtained results. The results showed that CBT group therapy, psychodrama, and art therapy were effective in alleviating different problems. Examined results suggested that more experimental and effectiveness studies regarding group psychotherapy are neede

HIV pozitif kişilerde cinsel yolla bulaşan etkenlerin sıklığı

AMAÇ: Cinsel yolla bulaşan enfeksiyonlar (CYBE), toplum sağlığı açısından önemli, dünyanın her bölgesinde sık görülen enfeksiyonlardır. Ülkemizde de CYBE’ler öncelikli sağlık sorunları arasındadır. Türkiye de HIV pozitif kişilerdeki cinsel yolla bulaşan etkenlerin sıklığını saptamaya yönelik daha önce herhangi bir çalışma yapılmamıştır. Bu çalışmada, HIV pozitif kişilerdeki cinsel yolla bulaşan hastalık etkenlerinden Neisseria gonorrhoeae (N. gonorrhoeae) , Chlamydia trachomatis (C. trachomatis) , Trichomonas vaginalis (T. vaginalis), Mycoplasma genitalium (M. genitalium) , Mycoplasma hominis (M. hominis), Ureaplasma urealyticum (U. urealyticum), Ureaplasma parvum (U. parvum), Herpes simpleks virüs tip 1 ve 2 (HSV 1 ve 2), Human Papilloma virüs'ün (HPV) 19 yüksek riskli genotipi (16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 69, 73, 82) ve 9 düşük riskli genotipini (6, 11, 40, 42, 43, 44, 54, 61, 70) taramak ve etkenlerin HIV pozitif kişilerdeki sıklığını araştırmak amaçlanmıştır. GEREÇ ve YÖNTEM: Eylül 2015 ile Nisan 2016 tarihleri arasında, 90 [14’ü kadın (%15.6), 76’sı erkek (%84.4)] HIV pozitif hastadan vajinal ve üretral sürüntü örnekleri toplandı. Klinik örneklerden nükleik asitlerin ekstraksiyonu üretici firma protokolüne göre yapıldı (Ribospin vRD viral RNA / DNA Ekstraksiyon Kiti, GeneAll, Seegene, Güney Kore). Chlamydia trachomatis, N. gonorrhoeae, M. genitalium, M. hominis, U. urealyticum, U. parvum, T. vaginalis etkenleri çoklu olarak amplifiye edildi (AnyplexTM II STI-7 Detection (V1.1), Seegene, Güney Kore) ve BioRad cihazı kullanılarak etkenler saptandı. HPV’nin yüksek ve düşük riskli genotiplerini belirlemede üretici firma (Anyplex II HPV28 Detection kit, Seegene, Güney Kore) protokolü uygulandı. Klinik örneklerden HSV tip 1 ve tip 2 saptanmasında HSV 1/2 Qual Kit (Roche Diagnostics GmbH, Mannheim, Almanya ) kullanıldı ve etken Light-Cycler cihazında saptandı. BULGULAR: HIV pozitif hastaların 49’unda (%54,4) en az bir cinsel yolla bulaşan etken pozitif bulundu. Kadın hastaların 12'sinde (%85,7), erkek hastaların 37'sinde (%48,7) etken pozitifliği saptandı. Hastaların 17'sinde (%18,8) tek etken saptanırken, 32'sinde (%35,5) birden fazla etken saptandı. Trichomonas vaginalis, HSV-1 ve HSV-2, klinik örneklerin hiç birinde saptanmadı. Örneklerin 31'inde (%34,4) HPV, 20'sinde (%22,2) U. urealyticum, 15'inde (%16,6) U. parvum, 8'indee(%8,8) M. genitalium, 8'inde (%8,8) M. hominis, 5'inde (%5,5) N. gonorrhoeae, 2'sinde (%2,2) C. trachomatis, saptandı. HPV DNA pozitif bulunan 31 örneğin 13'ünde (%41,9) olası yüksek riskli ve yüksek riskli tip, 6'sında (%6,6) düşük riskli tip ve 12' sinde (%13,3) hem yüksek hem de düşük riskli tip birlikte bulundu. SONUÇ: Cinsel yolla bulaşan herhangi bir hastalık belirtisi olmayan HIV (+) kişilerin yaklaşık %55’inde bir veya birden fazla HIV dışı cinsel yolla bulaşan etken pozitif bulunmuştur. Bu hastaların %35’inde çoklu etken saptanmıştır. HIV(+) kişilerde en sık rastlanan ilk üç etken sırasıyla HPV (%35), U.urealyticum (%22) ve U.parvum (%17) olmuştur. Diğer bakteriyel etkenlerin sıklığı %2-8 arasında bulunmuştur. T. vaginalis ve HSV1-2 hiçbir hastada saptanmamıştır. HPV pozitif bulunan hastaların yaklaşık yarısında yüksek riskli tipler saptanmıştır ve en sık saptanan tip HPV 16 olmuştur. HPV enfeksiyonunun hastanemize başvuran HIV pozitif hastalarda önemli bir cinsel yolla bulaşan etken olduğu görülmüştür ve herhangi bir belirti göstermeyen hastalarda bile etkene yönelik tarama yapılması sonucuna varılmıştır.OBJECTIVE: Sexually transmitted infections (STIs) are infections that are common in many parts of the World. Turkey has also been studied previously for determining factor in the incidence of sexually transmitted HIV-positive people. The aim of this study was to investigate the effects of sexually transmitted disease agents such as N. gonorrhoeae, C. trachomatis, T. vaginalis, M. genitalium, M. hominis, U. urealyticum, U. parvum, HSV 1 and HSV 2, 19 high risk genotype HPV (16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 69, 73, 82) 9 low risk genotype (6, 11, 40, 42, 43, 44, 54, 61, 70) and determining the frequency of the agents in HIV-positive individuals. MATERIALS AND METHODS: Between September 2015 and April 2016, vaginal and urethral swab samples were collected from 90 HIV positive patients (14 female, 15.6% male, 84.4%). Nucleic acid extraction was performed according to the manufacturer's protocol. (Ribospin vRD viral RNA / DNA Extraction Kit, GeneAll, Seegene, South Korea). The factors of C. trachomatis, N. gonorrhoeae, M. genitalium, M. hominis, U. urealyticum, U. parvum, T. vaginalis were amplified with AnyplexTM II STI-7 Detection (V1.1) (Seegene, South Korea) and products were detected by BioRad real time PCR. Amplification of nucleic acid was performed Anyplex II HPV28 Detection kit (Seegene, South Korea). PCR products were detected by BioRad. HSV type 1 and type 2 were performed Light-Cycler HSV 1/2 Qual Kit (Roche Diagnostics GmbH, Mannheim, Germany). RESULTS: At least one sexually transmitted agent was positive in 49 (54.4%) of the HIV-positive patients. STI positivity was found in 12 (85.7%) of the female patients and 37 (48.7%) of the male patients. In 17 (18.8%) of the patients, only one agent was detected, while 32 (35.5%) were multiple. Trichomonas vaginalis, HSV-1 and HSV-2 were not detected in any of the clinical specimens. HPV was found in 31 (%34,4), U. urealyticum in 20 (22.2%), U. parvum in 15 (16.6%), M. genitalium in 8 (8.8%), , M. hominis in 8 (8.8%), N. gonorrhoeae in 5 (5.5%) and C. trachomatis in 2 (2.2%). High-risk and probably high-risk types were found in 13 (41.9%) of the 31 HPV DNA-positive cases, 6 (6.6%) were in the low-risk type, and 12 (13.3%) were both high and low risky type found together. CONCLUSION: Approximately 55% of HIV (+) individuals without any sexually transmitted disease were found to have one or more non-HIV sexually transmitted agents positive. More than one human papillomavirus serotypes were detected in 35% of these patients. HPV (35%), U.urealyticum (22%) and U.parvum (17%) were the most frequent in HIV (+) individuals. The frequency of other bacterial agents was found to be between 2-8%. T. vaginalis and HSV 1-2 were not detected in any patient. The most common HPV type in patients was 16. Overall, half of the patients were found to be infected with high-risk HPV types. HPV positive patients were referred to the clinic for follow up

Genotype distribution of Mycobacterium tuberculosis in theAegean Region and associated demographic factors

Background/aim: The Aegean Region is the second-ranking region in Turkey according to the Human Development Index and population density and it hosts 1/8 of Turkey’s population. İzmir is the largest city of the region, receiving internal migration both from inside and outside the region. The tuberculosis incidence in İzmir is lower than overall in Turkey: 17.7/100,000 in 2011. Our aims were to determine genotypes of Mycobacterium tuberculosis isolates; to explore possible associations between genotypes with casedemographic data, clinical presentation, and antimicrobial susceptibility patterns; and to determine variations in genotype distribution of strains isolated in Ege University Hospital, İzmir. Materials and methods: Forty-nine M. tuberculosis isolates from 49 patients in 1996–2000 and 421 M. tuberculosis isolates from 421 patients in 2009–2014 were spoligotyped. Drug susceptibility testing and demographic data of the 421 isolates were investigated. Chisquare, Student’s t, and Mann–Whitney U tests were used for analyses. Results: Among the 470 M. tuberculosis strains, 132 different spoligopatterns were identified and 46 different clusters for 384 strains were determined. The most predominant spoligotypes were ST53 (n = 116; 24.7%) and ST41 (n = 38; 8.1%), followed by ST50 (5.7%), ST284 (4.7%), and ST4 (4.3%), respectively. ST53 was the most predominant type in both sexes. Multidrug resistance (MDR) was determined in 12 isolates, of which six were ST1. Conclusion: As a consequence of worldwide migration and increasing status of HIV-infected hosts, the increasing prevalence of Beijing strains with higher MDR rates may threaten disease control programs. With its increasing trend, ST284 could replace ST41 in the following years in this region.Background/aim: The Aegean Region is the second-ranking region in Turkey according to the Human Development Index and population density and it hosts 1/8 of Turkey’s population. İzmir is the largest city of the region, receiving internal migration both from inside and outside the region. The tuberculosis incidence in İzmir is lower than overall in Turkey: 17.7/100,000 in 2011. Our aims were to determine genotypes of Mycobacterium tuberculosis isolates; to explore possible associations between genotypes with casedemographic data, clinical presentation, and antimicrobial susceptibility patterns; and to determine variations in genotype distribution of strains isolated in Ege University Hospital, İzmir. Materials and methods: Forty-nine M. tuberculosis isolates from 49 patients in 1996–2000 and 421 M. tuberculosis isolates from 421 patients in 2009–2014 were spoligotyped. Drug susceptibility testing and demographic data of the 421 isolates were investigated. Chisquare, Student’s t, and Mann–Whitney U tests were used for analyses. Results: Among the 470 M. tuberculosis strains, 132 different spoligopatterns were identified and 46 different clusters for 384 strains were determined. The most predominant spoligotypes were ST53 (n = 116; 24.7%) and ST41 (n = 38; 8.1%), followed by ST50 (5.7%), ST284 (4.7%), and ST4 (4.3%), respectively. ST53 was the most predominant type in both sexes. Multidrug resistance (MDR) was determined in 12 isolates, of which six were ST1. Conclusion: As a consequence of worldwide migration and increasing status of HIV-infected hosts, the increasing prevalence of Beijing strains with higher MDR rates may threaten disease control programs. With its increasing trend, ST284 could replace ST41 in the following years in this region

The effectiveness of topical 1% lidocaine with systemic oral analgesics for ear pain with acute otitis media

Background: Acute otitis media (AOM) is one of the most common childhood infections. Ear pain, the main symptom of AOM, results in parents frequently seeking medical assistance for their children. The aim of this study was to compare the effectiveness of topical 1% lidocaine ear drops administered with oral analgesics with that of oral analgesics alone. Methods: This multicenter randomized, open-labeled study was conducted at 15 centers with 184 pediatric AOM patients with bilateral ear pain (aged 1–5 years) between May 1, 2016, and June 31, 2018. All patients received oral paracetamol or ibuprofen and topical 1% lidocaine, which was administered to each ear according to the randomization list. The ear pain score was evaluated within 48 h using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale, and the patients were followed up for 10 days. Results: The median age was 31.8 months (min–max, 12–84.2 months). Of those patients enrolled, 22.3% received paracetamol, and 24.5% received paracetamol with lidocaine ear drops; 23.4% received ibuprofen, and 29.9% received ibuprofen with lidocaine ear drops. Lower pain scores were significantly measured at baseline and 10th minutes by a reduction 25% (RR 13.64, 95% CI 4.47–41.63, p = 0.001, RR 0.14, 95% CI 0.06–0.35, p = 0.001) and 50% (RR 4.76, 95% CI 1.63–13.87, p = 0.004, RR 0.14, 95% CI 0.05–0.4, p = 0.001) in the paracetamol and lidocaine versus paracetamol groups and the ibuprofen and lidocaine versus ibuprofen groups, respectively. No serious side effects were evident during follow-up. Conclusion: This randomized study suggests that topical 1% lidocaine ear drops with paracetamol or ibuprofen seems to provide effective and rapid relief for children presenting with ear pain attributed to AOM