Does Quantitative Tibial Ultrasound Predict Low Bone Mineral Density Defined by Dual Energy X-Ray Absorptiometry?

PURPOSE: Efforts for the early detection of bone loss and subsequent fracture risk by quantitative ultrasound (QUS), which is a non-invasive, radiation free, and cheaper method, seem rational to reduce the management costs. We aimed in this study to assess the probable correlation of speed of sound (SOS) values obtained by QUS with bone mineral density (BMD) as measured by the gold standard method, dual energy X-ray absorptiometry (DEXA), and to investigate the diagnostic value of QUS to define low BMD. MATERIALS AND METHODS: One hundred twenty-two postmenopausal women having prior standard DEXA measurements were included in the study. Spine and proximal femur (neck, trochanter and Ward's triangle) BMD were assessed in a standard protocol by DEXA. The middle point of the right tibia was chosen for SOS measurement by tibial QUS. RESULTS: The SOS values were observed to be significantly higher in the normal BMD (t score >-1) group at all measurement sites except for the lumbar region, when compared with the low BMD group (t score <-1). SOS was negatively correlated with age (r=-0.66) and month since menopause (r=-0.57). The sensitivity, specificity, and positive and negative predictive values for QUS t score to diagnose low BMD did not seem to be satisfactory at either of the measurement sites. CONCLUSION: Tibial SOS was correlated weakly with BMD values of femur and lumbar spine as measured by DEXA and its diagnostic value did not seem to be high for discriminating between normal and low BMD, at these sites.

Alcoholism Prevalence and Some Related Factors in Edirne, Turkey

The aim of this research was to estimate the community prevalence of alcoholism and the potential risk factors that affect it in the Edirne provincial centre by using a scanning test. A cross-sectional study was carried out in the Edirne provincial centre. A sample population composed of 500 women and 200 men was selected randomly after the categorisation of the population according to ethnicity, age and sex. Through face-to-face interviews, data collection sheets, which were prepared to analyse potential factors affecting alcoholism frequency, were filled in by the sample population. The Michigan Alcoholism Scanning Test (MAST) was employed. According to MAST's normal grading, individuals with 5 or more points are evaluated as alcoholics. Accordingly, 8.2% of the sample population fit the definition of alcoholic. Alcoholism frequency was considerably higher in gypsies, the self-employed, smokers, and people with higher income. From logistic regression analysis alcoholism frequency was 12.4 times higher in men than in women, 3.2 times higher in gypsies than in others, 1.9 times higher in people who earned an income in the preceding week than in the unemployed, and 3.7 times higher in individuals who had smoked more than 100 cigarettes during their life or those who had smoked at least 1 cigarette for 3 months or for a longer period than in those who hadn't smoked any cigarettes. The prevalence of alcoholism in the Edirne provincial centre was similar to that in other countries in Europe. The most important finding was that alcohol consumption decreased in the unemployed, a finding that differs from that in other parts of the world. Gypsies, who differ in tradition, way of life, and job compared to the other strata of society, also suffered from higher alcohol consumption. This group usually consumed wine and generally did not eat while drinking.

Serum Lipid Levels in Psoriasis

A predisposition to occlusive vascular diseases has been reported in patients with psoriasis and it has been suggested that some of these patients have some disorders of lipid metabolism. In this study, serum lipid levels were investigated in psoriatic patients to explore to the knowledge of this relationship. One hundred psoriatic patients and 100 non- psoriatic controls were included in the study. Total cholesterol, triglyceride, high-density lipoprotein-cholesterol (HDL-cholesterol), low-density lipoprotein-cholesterol (LDL-cholesterol), and very low-density lipoprotein-cholesterol (VLDL-cholesterol) levels were measured. In patients with psoriasis, total cholesterol and LDL-cholesterol levels were found to be significantly higher than those of controls. No significant differences were found in the other parameters. We concluded that psoriatic patients should be evaluated and followed up for the risk of hyperlipidemia and obstructive vascular diseases.

Utilization of Primary Health Care Services by Turkish Gypsies and Members of the General Population at Muradiye Health Unit District in Edirne, Turkey

This survey was designed to investigate the socio-demographic characteristics of and utilization of a Primary Heath Care Unit (PHCU) by Roma people (Turkish Gypsies), who live in the coverage area of Muradiye Primary Health Care Unit, as compared to members of the general population. This was a cross-sectional field study involving members of the Muradiye PHCU district. The study population comprised 127 Turkish gypsies resident in the region and 302 households selected by a stratified random sampling method. 889 household members were interviewed face-to-face at their home by means of a structured questionnaire. When the two sample groups were compared in terms of their social security coverage, rates of unemployment and educational levels, the situation of the Turkish Gypsies was found to be worse than that of the other members of the general population. 63% of the Gypsies applied to the PHCU because of health problems and 87% of these cases were treated successfully. Among those people making use of the PHCU services 47% evaluated them as being "satisfactory". Access to the PHCU services was found to be conditioned by educational level, being a Gypsy, the possession or not of a Green Card (available only to highly indigent people), whether or not the services were provided free of charge and the possession or not of social security coverage. Muradiye PHCU is well known and highly appreciated in its coverage area and is used by almost all of the residents. The main reason for the significant discrepancies in the level of health care obtained by the two population groups is the Gypsies' poorer economic situation. Among the Gypsies, the leading category of low rate social security coverage is the Green Card, which is granted to the very poor in order to reduce these inequalities. Unfortunately, the Green Card does not provide financial support for ambulatory care.

A Food-Borne Outbreak Caused by Salmonella Enteritidis

This study was designed to define the epidemiology of a food-borne outbreak caused by Salmonella enteritidis that affected only one squadron of a military battalion located in the vicinity of the city of Edirne in Turkey. The outbreak was analyzed by a standard surveillance form of the Centers for Disease Control and Prevention. The relationship between the eaten foods and cases was analyzed by Fisher's exact chi-square test, and odds ratios were calculated by a case-control study. The outbreak affected 60 of 168 soldiers in the squadron, 16 of whom were hospitalized. S.enteritidis was cultured in stools from 13 of the hospitalized soldiers and from 3 soldiers who had prepared the food. All strains were completely susceptible to antibiotics; their plasmid profiles were also identical. The highest attack rate detected was 55.7% in an omelet eaten 24 hours before (p < 0.001). Furthermore, it was the riskiest food according to the case-control study (OR=7.88; 95% CI=3.68-16.89). The food samples were unobtainable because they had been discarded. All of the hospitalized cases recovered, and none of the control cultures of stools yielded the pathogen after three weeks. In conclusion, although our results didn't indicate the exact source of the outbreak microbiologically, the omelet was considered to be the source based on the epidemiological proofs.