Periodontal disease awareness in pregnant women in eastern Black Sea region and its relationship with socioeconomic level

Giriş ve Amaç: Diş eti sağlığını birçok faktör etkilemektedir.Oral hijyeninin yetersiz olması periodontal hastalıkların oluşmasınınprimer etkenidir. Periodontal hastalıkların sistemikdurum üzerine etkileri son yıllarda yapılan çalışmalarla ortayakonulmuştur. Preterm ve düşük ağırlıklı doğum ağırlığı, gelişmişve gelişmekte olan ülkeler için önemli bir sorundur. Literatürde,periodontal hastalık ile erken doğum ve düşük doğumağırlığının ilişkili olduğu gösterilmiştir. Bu çalışmanın amacı,Doğu Karadeniz Bölgesindeki gebe kadınlarda periodontalsağlık bilgisi ve farkındalık derecesini değerlendirmektir.Gereç ve Yöntem: Çalışmaya Temmuz 2018 ile Aralık 2018 tarihleriarasında Trabzon ve Giresun illerindeki iki ayrı merkezdekadın doğum polikliniğine başvuran ve araştırmaya katılmayıkabul eden gönüllü gebeler dahil edilmiştir. Veriler, hastalarınbizzat kendilerince doldurdukları, araştırmacılar tarafından yapılandırılmışkesitsel anketler kullanılarak toplanmıştır. Anketmaddelerinde gebelik bilgileri, periodontal sağlık bilinci, kişiselve sosyo-demografik değişkenler ele alınmıştır.Bulgular: Çalışmamızda yaş ortalaması 30,1 5,3 olan 397gebenin % 30,7’ si üniversite, % 35’ nin ise lise mezunu olduğubelirlendi. Gebelerin azınlığının (%16,8) dental plak hakkındabilgi sahibi olduğu, %32,6 ’sının dental plağın zararlı etkilerinibildiği ortaya çıktı. Bununla beraber gebelerin %51,4’ünün dişetindeki kanamanın periodontal hastalığı gösterdiğini ifadeetmiştir. Çalışmamız, gebelerin çoğunluğunun (%80,1) diş etihastalığının ana nedenini bilmemesine ve sadece %15,1’ ininperiodontal hastalığın erken doğuma yol açabileceğini bilmesinerağmen, % 56’ sının gebelikte diş fırçalama sıklığının arttırılmasıgerektiğine inandığını göstermektedir.Sonuç: Çalışmanın sonucunda elde edilen veriler, gebe kadınlardadiş ve diş eti sağlığı konusunda bilgi ve farkındalıkdüzeyinin zayıf olduğunu ortaya koymuştur. Periodontal hastalığıve buna bağlı gelişebilecek erken doğum gibi obstetrikkomplikasyonları önlemek için antenatal dönemde gebelereağız sağlığını iyileştirecek eğitim programları planlanmalı, bilgidüzeyi arttırılmalıdır.Introduction: There are many factors that affect gingivalhealth. The primary factor that leads to the development ofperiodontal disease is poor oral hygiene. The influences ofperiodontal diseases on systemic health have been reportedthrough research conducted in recent years. Preterm and lowbirth weight is a significant problem in developed and developingcountries. In literature, it has been shown that periodontalhealth is associated with preterm birth and low birthweight. The aim of this study is to evaluate the knowledge ofpregnant women from Eastern Black Sea region of Turkey regardingtheir periodontal health and awareness on the issue.Material and Methods: Research includes pregnant womenwho volunteered to take part in the study, after having consultedthe clinic of obstetrics and gynecology of two distinct centers in Trabzon and Giresun between the dates July2018 and December 2018. Data was collected from surveysstructured by researchers, filled in by the patientsthemselves. In the survey data regarding the pregnancyinformation of the volunteers, periodontal health awareness,personal and socio-economic variables were alsoexamined.Results: In the study, of the 397 pregnant women witha mean age of 30.1 5.3; %30.7 were college graduatesand %35 were high school graduates. It was realized thata minority of the pregnant women (%16.8) had knowledgeabout the dental plaque and %32.6 knew the harmfuleffects of the dental plaque. In addition, %51.4 of pregnantwomen have stated that bleeding of the gums representedperiodontal disease. Our study shows that eventhough majority of pregnant women (%80.1) do not knowthe main reason of periodontal disease and only %15.1know periodontal disease may lead to preterm birth; %56believe that tooth brushing frequency should be increasedduring pregnancy.Conclusion: The data obtained through this study revealedthat pregnant women have insufficient knowledgeand low awareness level regarding their dental and periodontalhealth. In order to prevent periodontal disease andobstetric complications, which may result from periodontaldisease such as preterm birth, during antenatal period,pregnant women, should be provided with the neededknowledge on these subjects through educational programs.Such programs should be planned and knowledgeshould be increased

Laparoscopic Approach To Obturator Lymph Node Positivity in Positron Emission Tomography Assisted Computerized Tomography (PET-CT) of a Preoperative Stage 1B1 Cervical Cancer Patient

Objective: Although positron emission tomography assisted computerized tomography (PET-CT) is used to evaluate staging, treatment planning and prognosis in cervical cancer, its definite role is not established. It is especially used to rule out lymph node and distant metastasis in early stage cervical cancer patients who are candidates for radical hysterectomy. Recent literature suggests that by doing so unnecessary surgery, in patients who will ultimately require radiotherapy, would be prevented. We are presenting a case of cervical cancer patient preoperatively staged as 1B1 but revealed a lymph node positivity in PET-CT scan in left obturator fossa. She had a laparoscopic lymph node dissection and frozen section. Setting: University clinic. Results: A 52-year-old postmenopausal woman with a complaint of frequent spotting was diagnosed to have stage 1B1 squamous carcinoma of the cervix of 1.5 cm in diameter. Her preoperative PET-CT revealed a positivity in left obturator fossa suggesting metastasis in addition to cervical uptake. She was planned to have a radical hysterectomy if laparoscopic lymph node dissection and frozen section were negative for malignancy. Intra-operative frozen section of a 1 cm lymph node from the left obturator fossa was positive for metastasis. The decision of radical hysterectomy was abandoned and she was referred to concomitant chemoradiotherapy. Interestingly, her final pathology revealed an additional microscopic metastasis in one of right pelvic lymph nodes that was sampled during the operation. Conclusions: If PET-CT scan is negative for lymph node metastasis, these patients have low risk for postoperative radiotherapy after radical hysterectomy. In accordance with current literature, microscopic lymph node metastasis may not be revealed by PETCT, as it was in our case. If PET-CT reveals metastatic uptake, laparoscopic lymph node sampling and frozen section may be helpful in confirming metastatic disease. PET-CT seems to be beneficial in planning therapy preoperatively in cervical cancer

Guideline on Pregnancy and Diabetes by the Society of Specialists in Perinatology (PUDER), Turkey

ABS TRACT Diabetes mellitus (DM) is the most common endocrinologic problem in pregnancy. In Turkey, the reported prevalance is between 1.9-27.9%, with an average of 7.7%. While some of these cases are pregestational diabetes (PGDM), about 90% are detected during the pregnancy for the first time and diagnosed as gestational diabetes (GDM). Diabetes in pregnancy confers serious risks regarding the fetus, newborn and the mother. Therefore, we offer GDM screening for all pregnant women preferantially between 24-28 weeks of gestation. Either one-step 75-g oral glucose tolerance test (OGTT) or two-step 50-g glucose challenge test and 100-g OGTT may be used for the screening and diagnosis. In pregnancies with high-risk for DM, screening should be performed earlier, if possible, in the first antenatal visit. When GDM is diagnosed, maternal glycemic control is tried to be achieved by diet and exercise program, and if necessary, by using insulin. The use of metformin or glyburide in pregnancy is also possible. In women with the diagnosis of DM before pregnancy, preconceptional control of plasma glucose levels is of utmost importance in order to prevent adverse pregnancy outcomes. In pregnancies with GDM regulated by diet and exercise, pregnancy follow-up may be performed as in the low risk group without any pregnancy complications. If maternal or fetal distress is not observed, delivery is planned between 39+0 -40+6 weeks. Although caesarean section is recommended when estimated fetal weight is 4500 g or more, the mode of delivery may be decided more appropriately on a case-by-case basis

ISOLATED ABERRANT RIGHT SUBCLAVIAN ARTERY: SHOULD INVASIVE INTERVENTION BE RECOMMENDED IN THE ERA OF NONINVASIVE PRENATAL TESTS? İZOLE ABERAN SAĞ SUBKLAVYAN ARTER: NONİNVAZİV PRENATAL TESTLERİN VARLIĞINDA PRENATAL TANI İÇİN İNVAZİV GİRİŞİM ÖNERİLMELİ Mİ?

Objective: An aberrant right subclavian artery (ARSA) is an aortic arch anomaly isolated or associated with other ultrasound markers and/or congenital anomalies. This study aimed to evaluate the necessity of invasive prenatal tests (PIT) in cases with isolated ARSA (iARSA) in prenatal sonography. Materials and Methods: The presence of ARSA was evaluated retrospectively in 7690 fetuses who underwent a second-trimester ultrasonography evaluation between March 2015 and February 2021. PIT was recommended for patients with non-iARSA. cfDNA test (including 22q11.2 microdeletion/duplication syndrome (MMS) or PIT was suggested for patients with iARSA. Results: The mean week of gestation was 20.26±3.93 in 95 fetuses diagnosed with ARSA. Of the fetuses, fourty-two (44%) had iARSA, and 53 (56%) had additional findings. No chromosomal abnormality was found in any of the isolated cases. Trisomy 21 in 14, Trisomy 18 in one, 47,XX,+i(9)(p10) in one of 53 were found in non-isolated cases. Additional abnormalities and/or soft ultrasound markers were accompanied in all fetuses with chromosomal abnormalities. Conclusion: When iARSA is detected in prenatal ultrasonography, cfDNA testing may be sufficient, including 22q11.2 MMS. However, PIT should be recommended in the presence of structural abnormalities, soft ultrasound markers, or increased risk in the antenatal screening test

ERS international virtual congress 2021: Highlights from the Turkish thoracic society early career members

This review aimed to highlight some important points derived from the presentations of the European Respiratory Society 2021 Virtual International Congress by a committee formed by the Early Career Task Group of the Turkish Thoracic Society. We summarized a wide range of topics including current developments of respiratory diseases and provided an overview of important and striking topics of the congress. Our primary motivation was to give some up-to-date information and new developments discussed during congress especially for the pulmonologists who did not have a chance to follow the congress. This review also committed an opportunity to get an overview of the newest data in the diverse fields of respiratory medicine such as post-coronavirus disease 2019, some new interventional and technologic developments related to respiratory health, and new treatment strategies

Clinical characteristics and outcomes of nosocomial COVID-19 in Turkey: A retrospective multicenter study

Objective: To identify the clinical characteristics and outcomes of hospital-acquired SARS-CoV-2 infection during the vaccination period nationwide in Turkey. Methods: COVID-19 patients followed in the pandemic services across Turkey between January 1, 2021, and March 31, 2022 were investigated retrospectively. Nosocomial COVID-19 was defined as a patient neither diagnosed with COVID-19 nor suspected COVID-19 at the hospital admission and was confirmed COVID-19 ≥5 days after hospital admission. The primary outcome of this study was in-hospital mortality; demographic features and vaccination status was compared between survivors and non-survivors. Results: During the study period, 15 573 COVID-19 patients were followed in 18 centers and 543 (3.5%) patients were nosocomial COVID-19. Most patients with nosocomial COVID-19 (80.4%) were transferred from medical wards. 162 (29.8%) of the patients with nosocomial COVID-19 admitted to the intensive care unit due to disease severity and 138 (25.4%) of the patients died during hospital stay. Advanced age (≥65 years) and number of comorbid diseases (≥2) was found to be associated with mortality in nosocomial COVID-19 (OR 1.74, 95% Cl 1.11-2.74 and OR 1.60, 95% Cl 1.02-2.56, respectively). Vaccination was associated with survival in nosocomial COVID-19 (OR 0.25, 95% Cl 0.16-0.38). Conclusions: Patients with nosocomial COVID-19 had increased admission to intensive care units and higher mortality rate. Vaccination can decrease the in-hospital mortality rate

Perceived Need for Mental Health Services Among Healthcare Workers During the Coronavirus disease-19 Pandemic in Turkey: A Multicenter Cross-sectional Study.

Background: The coronavirus disease-2019 pandemic has contributed to work-related psychosocial risks in healthcare workers.Aims: To evaluate the perceived need for mental health services and related factors in Turkish healthcare workers practicing in pandemic hospitals.Study Design: Cross-sectional study.Methods: Data were collected from face-to-face interviews with healthcare workers at 19 pandemic hospitals in 13 provinces between September and November 2021. The study survey included the evaluation of the perceived need for and utilization of mental health services in the previous year, as well as sociodemographic, health-related, and work-related characteristics, the General Health Questionnaire-12, the World Health Organization Quality of Life-BREF (WHOQoL-BREF) questionnaire, and the Fear of coronavirus disease-2019 scale (FCV-19S).Results: Of 1,556 participants, 522 (33.5%) reported a perceived need for mental health services, but only 133 (8.5%) reported receiving these services. Multiple logistic regression analysis of the perceived need for mental health services revealed significant relationships with lower age, female sex, being a current smoker, having a chronic disease, having a mental disorder, coronavirus disease-2019 contact within the last three months in settings other than the home or workplace, a positive coronavirus disease-2019 vaccination history, being a physician, being a non-physician healthcare professional, and coronavirus disease-2019 contact within the last three months at work. After adjustment for these characteristics, higher General Health Questionnaire-12 and FCV-19S scores and lower WHOQoL-BREF domain scores were related to the perceived need for mental health services in logistic regression analyses.Conclusion: The findings indicate a substantial need for mental health services amongst Turkish healthcare workers during the pandemic and outline participants' characteristics regarding high-priority groups for the intervention. Future research may focus on developing actions and evaluating their efficiency