Learning platform for smoking cessation project: From begining to date

Although 35% of the adults in Turkey are current smokers, the number of trained physicians and smoking cessation (SC) clinics are not enough to meet the demand. Aim: This national project aimed to create the necessary infrastructure for providing SC therapy all-around the country and to train physicians in this topic. This project was run by Turkish Thoracic Society Tobacco Working Group and supported by a grant from Pfizer Foundation. Methods: For this purpose, an organization network including field training teams was planned. The training materials were prepared and standardized. A website of the project including a wide e-learning platform was created (www.sigarabirakmadaogrenmezemini.org). Results: Firstly, a central training program was planned. Forty volunteers from all regions of Turkey were participated to this program. Afterwards, field training programs were started to perform by these trainers. From the beginning field training sessions were performed in 11 cities with more than 300 participants. The project website was visited by 10.369 visitors and 518 participants completed e-training module since April 2011. Conclusion: The SÖZ project enabled a training ground that will last for years; a professional website and a trainer staff to generalize the program. Through this project, the integration of SC intervention in all health service steps will be provided, the number of SC clinics in Turkey will increase, and in future smoking rate will reduce in our country

The efficacy of cinacalcet in the treatment of hyperparathyroidism in Turkish hemodialysis patient population

WOS: 000393291900012OBJECTIVE: Cinacalcet reduces parathyroid hormone levels by increasing the sensitivity of the parathyroid gland to calcium. in this study, we firstly aimed to evaluate the efficacy of cinacalcet in Turkish hemodialysis patients. MATERIAL and METHODS: 4483 hemodialysis patients were screened and 469 patients who had used cinacalcet were included in the study. the patients were divided into 4 groups according to drug usage durations (Group 1: 3 months, Group 2: 6 months, Group 3: 9 months and Group 4: 12 months). the patients' Parathormone, Ca, P and CaxP levels at the 3rd, 6th, 9th and 12th months were compared to the start of treatment and previous months. RESULTS: the levels of Parathormone, Ca, P and CaxP significantly decreased compared to their initial levels in all groups (from 1412 pg/ml to 1222 pg/mL for Parathormone, p< 0,001) in the 3rd month. However, this reduction was not continued in the subsequent months (Parathormone: 1381 pg/ml for the 12th month). CONCLUSION: Cinacalcet may not provide adequate benefit in control of hyperparathyroidism in Turkish hemodialysis patient population

Pioglitazone reduces peritoneal fibrosis via inhibition of TGF-ß, MMP-2 and MMP-9 in a model of encapsulating peritoneal sclerosis

Giriş: Periton fibrozisi sürekli ayaktan periton diyaliz tedavisinin (SAPD) sonlandırılmasında önemli bir nedendir. Günümüzdeki kanıtlar periton fibrozisinin gelişmesinde matriksin aşırı üretiminin sorumlu olabileceğini düşündürmektedir. SAPD'li hastalarda gelişen periton fibrozisinin tedavisi yüz güldürücü değildir. Ağızdan anti-diyabetik ilaçların yeni bir sınıfı sayılan tiazolidinedionlar (TZD), nükleer reseptör hormon ailesinin üyesi olan peroksizom proliferatör aktive reseptör-? (PPAR-?)'yı uyarmaktadırlar. In vitro çalışmalarla, PPAR-aktivatörlerinin hücre dışı matriks yapımını, TGF-ß, tip 1 kollajen, fibronektin ve MMP-9 başta olmak üzere MMP sentezini de baskıladığı ortaya konmuştur. PPAR etkinliğinin, plazminojen aktivatör inhibitör (PAI-1) ve TGF-ß sentezini baskılayarak glomeruler hücre artışını azalttığı gösterilmiştir Peritonda ya da periton fibrosis modelinde PPAR-? ve agonistlerinin işlevi iyi bilinmemesine karşın, insan periton mezotel hücrelerinde PPAR-? bulunduğu ve agonistlerinin TGF- ß1 yapımını azalttığı gösterilmiştir Amaç: Klorheksidin ile oluşturulan periton fibrozisinde pioglitazonun fibrozis üzerine olan etkisini belirlemek ve periton dokusundaki MMP-2, MMP-9, TIMP-1, TIMP-2 ve TGF- ß'yi baskılayarak yapımı üzerine etkisini araştırmaktır. Gereç ve Yöntem: Çalışmaya 32 adet Wistar albino sıçan alındı. Periton fibrozisi oluşturmak için %0,1'lik klorheksidin (KH) kullanıldı. Sıçanlar 4 gruba ayrıldı: Grup 1æ SF grubu, Grup 2æ SF+Pioglitazon grubu, Grup 3æ KH grubu, Grup 4æ KH+Pioglitazon grubu. Model için KH ve tedavi14 gün boyunca uygulandı .Sıçanlar sakrifiye edildi ve paryetal periton için karın ön duvarından ve visseral periton için karaciğerden örnekler alındı. Bulgular: KH ile oluşturulan periton fibrozisi modelinde, pariyetal ve visseral peritonda enflamasyon, periton zarında kalınlık artışı ve fibrozis yüzdesinde anlamlı bir artma saptandı. Pioglitazon tedavisi uygulanan grupta KH grubu ile karşılaştırıldığında, enflamasyon skorunda, periton zarı kalınlığı ve fibrozis yüzdesinde anlamlı bir azalma olduğu gösterilmiştir. KH grubuna Pioglitazon tedavisi verildiğinde pro-MMP-2 ve pro-MMP-9'da anlamlı bir baskılanma saptanmıştır. Pioglitazon tedavisi EPS modelinde TIMP-1 ve TGF-ß etkinliğinde de anlamlı bir baskılanma sağlamıştır. Sonuç: Sonuç olarakæ PPAR- ? agonisti pioglitazon, deneysel EPS modelinde jelatinazları ve TGF-ß'yı baskılayarak, periton zarı enflamasyonunu, periton duvar kalınlığını ve fibrozisi iyileştirmiştir. Bu bulgular ışığında, diyabetik nefropati ilişkili SDBY hasta sayısının hızla arttığı göz önünde bulundurulduğunda, bu hasta grubunda uygulanabilecek tiazolidinedion tedavisinin kalp damar sağlığı yanı sıra, periton işlevi üzerine de olumlu etkisinin olabileceği düşünülebilir. Risk altındaki hastalarda, pioglitazonun bu potansiyel etkisi, nadir ancak ölümcül bir komplikasyon olan EPS'nin önlenmesi ya da tedavisinde göz önünde bulundurulmalıdır. Introduction: Peritoneal dialysis (PD) is an established renal replacement therapy modality in end-stage renal disease (ESRD) patients. Although, after long-term treatment, peritoneal fibrosis (PF) results as a serious complication in some patients, causing membrane failure. Long term and progressive fibrosis may lead to encapsulating peritoneal sclerosis (EPS), the irreversible sclerosis of both visceral and peritoneal peritoneum which is associated with the symptoms of ileus and is life threatening. It is well known that increased production of ECM and decreased production of matrix-degrading proteinases (MMPs) results with the cumulation of ECM leading to fibrosis. Thiazolidinediones (TZDs), synthetic peroxisome proliferator-activated receptor (PPAR)-? ligands, having central role in insulin sensitization and adipogenesis and used extensively in patients with diabetes, are involved in the inflammatory cascade and reduce inflammation and fibrosis due to their ability to down-regulate proinflammatory gene expression and inflammatory cell functions. Objective: We investigated the effects of pioglitazone on fibrosis, tissue TGF-ß, MMP-2 and MMP-9 activation in an experimental model of EPS. Method: The EPS model was induced by the injection of 0.1% CG and 15% ethanol dissolved in saline (3ml) for 14 days intraperitoneally (IP). A total of 32 female Wistar albino rats were randomized to four groups. Group 1 (n:8)æ the control (C) group, received 0.9% saline, group 2 (n:8)æ the pioglitazone (Pio) group, received pioglitazone and 0.9% saline, group 3 (n:8)æ the encapsulating peritoneal sclerosis group, received intraperitoneal chlorhexidine gluconate (CG), group 4 (n:8)æ the treatment group, received CG and pioglitazone (CG+Pio). Pioglitazone (30mg/kg) was administered daily (group Pio and CG+Pio) by gavage for 14 days. Results: In the EPS group, all rats developed parietal and visceral peritoneal inflammation and fibrosis. The treatment group (CG+Pio) showed significant reduction in parietal and visceral peritoneal inflammation and submesothelial tickness as well as fibrosis. Rats with EPS receiving Pioglitazone demonstrated a similar visceral peritoneal inflammation score with the control groups (C, Pio). pro-MMP-2 was importantly supressed by pioglitazone treatment in EPS. Pioglitazone itself (Pio) induced pro-MMP-2 supression. Both EPS and treatment groups had a significant higher MMP-2 activity than the controls. Pro-MMP-9 level in the EPS group was higher when compared with the controls (C and P). Pioglitazone treatment showed a significant pro-MMP-9 supression. When compared with controls (C, Pio), TIMP-1 level was higher in the CG group. Pioglitazone treatment significantly supressed TIMP-1 level. However the TIMP-1 activity in the treatment group was still higher than the control groups (C, Pio). The EPS model resulted with an induction of TGF-ß level and Pioglitazone treatment provided a significant reduction of TGF-ß level. Conclusion: Considering statistically significant decrease in peritoneal inflammation, submesothelial tickness as well as fibrosis, along with decreased pro-MMP-2, pro-MMP-9, TIMP-1 and TGF- ß activation in pioglitazone treated group, it seems pioglitazone, via MMP and TGF- ß inhibition, may lessen accumulation of peritoneal ECM and fibrosis to some extent in an EPS model

Development and Validation of a Semi-Quantitative Food Frequency Questionnaire to Assess Dietary Intake of Turkish School-Aged Children

The aim of this study was to develop and validate a food frequency questionnaire (FFQ) on the dietary intake of Turkish school-aged children. Fifty randomly selected students aged 7–12 from urban areas of Istanbul were included in this study. An FFQ, containing a list of 138 frequently consumed foods was developed. Dietary records (DRs) including three days, and FFQs were collected during autumn and spring. Daily consumption of each food group was assessed and the nutrient compositions of diet were calculated. The Pearson correlation coefficient, weighted kappa, the Bland-Altman scatter plots between averages of the reported (FFQ) and the references method (DR) were used as validity coefficient

Serum Procalcitonin and Proinflammatory markers in Polycystic Ovary Syndrome

Objective: We evaluated levels of procalcitonin and proinflammatory markers in patients with polycystic ovary syndrome (PCOS) and compared them with controls in the Black Sea region of Turkey. Study Design: This prospective controlled study involved patients with PCOS (n=59) and healthy age-matched controls (n=26; total, n=85). Serum procalcitonin (PCT), white blood cells (WBCs), high-sensitivity C-reactive protein (h-CRP), homocysteine (Hcy) levels, insulin resistance, and lipid profiles were compared between the PCOS and control groups. The same parameters were also compared between overweight and normal-weight PCOS patients. Results: Serum PCT, Hcy, h-CRP, and WBC levels were similar in the PCOS and control groups. High-density lipoprotein (HDL) levels were lower in the PCOS group than in the control group (p <0.05). In a subgroup analysis of the PCOS group, there were no significant differences between overweight and normal-weight PCOS patients with regard to proinflammatory markers (serum WBC, h-CRP, Hcy, PCT levels). However, total cholesterol, LDL, and triglyceride levels were significantly higher in overweight PCOS patients (p <0.005). Serum HDL levels were significantly lower in the overweight PCOS group than in the normal-weight group (p <0.005). Fasting insulin and HOMA-IR levels were significantly higher in overweight PCOS than normal-weight PCOS patients (p<0.05). Conclusions: Serum PCT, h-CRP, WBC, and Hcy levels were within normal ranges in PCOS patients. These results may be related to the relatively young age and regional differences in the study group

Hydrogen peroxide extends postharvest life of Ctenanthe setosa leaf cuts under osmotic stress by reducing leaf rolling

Reducing effects of exogenous hydrogen peroxide on leaf rolling in detached leaves of Ctenanthe setosa were studied. The leaves were kept in H2O2 solutions ranging from 0 to 1 mM for 48 h and then, osmotic stress was applied for 4 h by polyethylene glycol (PEG). Degree of leaf rolling, loss of leaf water, and malondialdehyde (MDA) content were reduced by 0.2 mM H2O2. Antioxidant enzymes were induced by 0.2 mM H2O2. Endogenous H2O2 content was increased after the 0.5 and 1 mM H2O2 treatments but was decreased after 0.2 mM H2O2 treatment. Proline was decreased after exogenous H2O2 applications. Total soluble sugar content was increased as compared to the control after 0.2 mM H2O2 treatment. In conclusion, low-dose exogenous H2O2 treatment could delay leaf rolling by inducing tolerance to osmotic stress due to modulation of the antioxidant system, soluble sugar accumulation, and maintenance of leaf hydration. Therefore, postharvest life of C. setosa cut foliage could be extended by 0.2 mM H2O2 treatments