Relationship between 1,25‑dihydroxy Vitamin D levels and homeostatic model assessment insulin resistance values in obese subjects

Aim: In this study, our aim is to evaluate the insulin resistance and quality of life in obese subjects and nonobese subjects and to find out the Vitamin D (VD) status and correlations between obesity and control groups and also according to their quality of life scores.Materials and Method: The study was carried out between May and October 2013 which is the period of VD synthesis in Turkey. The participants of this study were volunteering individuals – obese and nonobese individuals defined according to the body mass index (BMI) – that did not receive any VD support in the last 1‑year and did not have any known chronic diseases. 1,25‑OH VD status and homeostatic model assessment insulin resistance (HOMA‑IR) values were evaluated.Results: The study population consisted of 39 individuals with normal weight (23 women, 16 men) and 66 individuals categorized as obese (51 women, 15 men). The difference in HOMA‑IR and VD values between the group of obese individuals and the group of nonobese individuals was significant (P < 0.001 vs. P <0.001). The median value of HOMA‑IR was higher in the obese group than in the nonobese group (P < 0.001) while the median value of VD was higher in the nonobese group than in the obese group (P < 0.001). The results regarding the relationship of BMI with HOMA‑IR and VD show that there was a positive correlation between HOMA‑IR and BMI (rs = 0.507; P < 0.001) and there was a negative correlation between HOMA‑IR and VD (rs = −0.316; P = 0.0001).Conclusion: Given serious diseases associated with low serum VD levels such as diabetes and cardiovascular disorders as well as low side effect incidence and low cost of VD treatment, it would be a reasonable approach to identify routine serum 25(OH) D and/or 1,25‑OH VD levels of obese patients and administer a treatment to patients with low levels of VD.Key words: 1,25‑OH Vitamin D, insulin resistance, obesit

Residents' views about family medicine specialty education in Turkey

<p>Abstract</p> <p>Background</p> <p>Residents are one of the key stakeholders of specialty training. The Turkish Board of Family Medicine wanted to pursue a realistic and structured approach in the design of the specialty training programme. This approach required the development of a needs-based core curriculum built on evidence obtained from residents about their needs for specialty training and their needs in the current infrastructure. The aim of this study was to obtain evidence on residents' opinions and views about Family Medicine specialty training.</p> <p>Methods</p> <p>This is a descriptive, cross-sectional study. The board prepared a questionnaire to investigate residents' views about some aspects of the education programme such as duration and content, to assess the residents' learning needs as well as their need for a training infrastructure. The questionnaire was distributed to the Family Medicine Departments (n = 27) and to the coordinators of Family Medicine residency programmes in state hospitals (n = 11) by e-mail and by personal contact.</p> <p>Results</p> <p>A total of 191 questionnaires were returned. The female/male ratio was 58.6%/41.4%. Nine state hospitals and 10 university departments participated in the study. The response rate was 29%. Forty-five percent of the participants proposed over three years for the residency duration with either extensions of the standard rotation periods in pediatrics and internal medicine or reductions in general surgery. Residents expressed the need for extra rotations (dermatology 61.8%; otolaryngology 58.6%; radiology 52.4%). Fifty-nine percent of the residents deemed a rotation in a private primary care centre necessary, 62.8% in a state primary care centre with a proposed median duration of three months. Forty-seven percent of the participants advocated subspecialties for Family Medicine, especially geriatrics. The residents were open to new educational methods such as debates, training with models, workshops and e-learning. Participation in courses and congresses was considered necessary. The presence of a department office and the clinical competency of the educators were more favored by state residents.</p> <p>Conclusions</p> <p>This study gave the Board the chance to determine the needs of the residents that had not been taken into consideration sufficiently before. The length and the content of the programme will be revised according to the needs of the residents.</p

Retrospective Evaluation of Adult Poisoning Cases Admitted to Emergency Department of a University Hospital in Turkey

Objective: We aimed to evaluate demographic, etiological, clinical features, and prognosis of poisoning cases applied to a tertiary emergency department retrospectively. Materials and Methods: The recordings of poisoning cases aged 18 years old and over which applied to the department of emergency medicine between the dates of 2010–2015 were examined. Age, gender, admission date, amount of time passed since exposure to the poisonous substance, application method, cause of poisoning, laboratory findings at arrival, vital signs, type of poisonous substance, the way of taking, treatment method in urgent care, consultation need, and the outcome of cases were recorded. Results: Of the poisoning cases, 437 (52.1%) were female, and 402 (47.9%) were male. The mean age was calculated as 33.50. When the cause of poisonings are examined; 456 patients were found to be poisoned by a suicide attempt, 350 were accidentally poisoned, and 33 were poisoned by treatment complication. As the causing substance of poisoning, medicinal drugs were found in 465 cases (55.4%), carbon monoxide in 205 cases (24.4%), and narcotics in 119 cases (14.2%). Of medicinal drug poisonings, 221 (46.8%) were multiple drug intake. It was seen that 46.6% of the patients were kept under observation with only symptomatic treatment while nasogastric lavage and activated charcoal were applied in 40.2% of them. Conclusion: It can be suggested that poisonings are encountered more commonly in young people, especially in women, with medicinal drugs and for suicidal purposes. Drugs detected at high rates in poisonings, such as painkillers and antidepressants, should be used more cautiously.Keywords: Emergency service, poisonings, retrospectiv

Interrelation between the Poisoning Severity Score, carboxyhaemoglobin levels and in-hospital clinical course of carbon monoxide poisoning

The aim of the present study is to evaluate the relationship between the Poisoning Severity Score (PSS) and carboxyhaemoglobin (COHb) levels in patients with carbon monoxide poisoning (COP) using outcome as the measure. The study was designed as a retrospective chart review of patients with final diagnosis of COP. Correlation of PSS and COHb levels at presentation was evaluated with collected data. Majority of the cases were grade 1 (minor) PSS (134 cases, 73.6%) and 93.4% of these patients made a complete recovery. There were six deaths (mortality 3.3%) and six in-hospital major complications (IHMCs) (3.3%) (please specify whether the complications were in the patients who died). There is moderate correlation between PSS and outcome (p < 0.001, r = 0.493). Grade 3 (severe) PSS was significantly different from other grades for outcome (six mortalities and three IHMCs). Patients classified as grade 3 and patients who died had a significantly higher mean age (p < 0.05, 41.8 +/- 23.6 and p < 0.01, 60.1 +/- 20.3, respectively). Mean COHb level of grade 3 (33.2 +/- 13.9%) was significantly higher than that of other grades (p < 0.05). COHb levels according to outcome were not different (? within the patients in grade 3). Decreased level of consciousness, acidosis, tachycardia, high glucose and leucocyte levels showed significant relation with higher PSS, COHb level and adverse outcome. We conclude that the PSS is a reliable guide in COP. Value of the PSS in COP may be enhanced if additional factors and investigations are included

Occupational allergic diseases in kitchen and health care workers: an underestimated health issue.

Objective. This study evaluated the frequencies of allergic symptoms and rate of upper respiratory infections during the past year in the general population, kitchen workers (KW) and health care workers (HCW). Methods. The European Community Respiratory Health Survey (ECRHS) was used to inquire retrospectively about asthma and asthma-like symptoms and the number of treatments required for previous upper respiratory tract infections (URTI: acute pharyngitis, acute sinusitis, etc.) during the past year for health care workers, kitchen workers, and members of the general population. Adjusted odds ratios by gender, age, and smoking status were calculated. Results. 579 subjects (186 from the general population, 205 KW, and 188 HCW; 263 females, 316 males) participated in the study. Noninfectious (allergic) rhinitis was significantly higher in the HCW and KW groups than in the general population (P<0.001). Cumulative asthma was significantly higher only in the HCW group (P<0.05). In addition, the HCW and KW groups had significantly higher risks of ≥2/year URTI (OR: 1.59, 95% CI: 1.07–2.38 versus OR: 1.57, 95% CI: 1.05–2.38) than the general population. Conclusion. Occupational allergic respiratory diseases are an important and growing health issue. Health care providers should become familiar with workplace environments and environmental causes of occupational rhinitis and asthma

First record of red cornetfish Fistularia petimba (Syngnathiformes:Fistulariidae) from Antalya and skenderun Bays along Turkish Coasts of the Mediterranean Sea

WOS: 000439931500025Here, we report the first occurrence of red cornetfish Fistularia petimba in the north-eastern Mediterranean Sea. Altogether four specimens were captured; first two in Antalya Bay on 28 October 2016 and 26 November 2016, and the remaining two in skenderun Bay on 21 May 2017 during the bottom trawl surveys along the Mediterranean coast of Turkey. All specimens were young and more or less uniform in size (383, 335, 419 and 453mm standard length). The possibility that F. petimba could become a new potential invader in the Mediterranean as its congeneric F. commersonii is cautioned against.General Directorate of Agricultural Research and Policies of the Ministry of Food, Agriculture and LivestockGeneral Directorate of Agricultural Research and Policies of the Ministry of Food, Agriculture and Livestoc

Assessment of cardiac autonomic regulation in children with monosymptomatic nocturnal enuresis by analysis of heart rate variability

The pathogenesis of monosymptomatic nocturnal enuresis is controversial. Various urodynamic studies showed bladder hyperactivity in enuretic children. But the exact cause is not precisely known. The aim of this study was to understand whether the autonomic nervous system dysfunction is involved in this bladder hyperactivity or not. Heart rate variability measurement is widely used for evaluation of cardiac autonomic activity. We evaluated cardiac autonomic nervous system functions in monosymptomatic nocturnal enuretic children by using 24-hour Holter electrocardiogram. The study group consisted of 32 enuretic children (20 boys and 12 girls) and the control group consisted of 20 healthy children (12 boys and 8 girls). In these two growps, we assessed cardiac autonomic regulation by analysis of heart rate variability, and found a significantly higher parasympathetic activity in enuretic children than controls. We suggest that the parasympathetic nervous system hyperactivity plays a role in nocturnal enuresis by causing vesical hyperactivity in monosymptomatic enuretic children. © 2004 Tohoku University Medical Press

Mycophagy among Japanese macaques in Yakushima: fungal species diversity and behavioral patterns.

Mycophagy (fungus-feeding) by Japanese macaques (Macaca fuscata yakui) in Yakushima has been observed by many researchers, but no detailed information is available on this behavior, including which fungal species are consumed. To provide a general description of mycophagy and to understand how and whether macaques avoid poisonous fungi, we conducted behavioral observation of wild Japanese macaques in Yakushima and used molecular techniques to identify fungal species. The results indicate that the diet of the macaques contains a large variety of fungal species (67 possible species in 31 genera), although they compose a very small portion of the total diet (2.2 % of annual feeding time). Fungi which were eaten by macaques immediately after they were picked up were less likely to be poisonous than those which were examined (sniffed, nibbled, carefully handled) by macaques. However, such examining behaviors did not appear to increase the macaques' abilities to detect poisonous fungi. Fungi that were only partially consumed included more poisonous species than those fully consumed with/without examining behavior, yet this was not significant. Taste, therefore, might also play an important role in discriminating poisonous from non-poisonous