Associations between obesity and the radiographic phenotype in knee osteoarthritis.

BACKGROUND/AIM: Investigation of the association between obesity and the distinction of radiographic patterns in knee osteoarthritis. MATERIALS AND METHODS: Seven hundred and thirty-four women underwent weight-bearing antero-posterior knee radiography. Osteophytes and joint space narrowing (JSN) were graded according to the OARSI atlas. Each subject was assigned to one of the following groups with respect to the maximum score: osteophyte-dominant, indeterminate, JSN-dominant, and radiographically normal. RESULTS: Obese patients had a significantly more frequent osteophyte-dominant pattern compared to nonobese subjects (74.5% and 38%, respectively, P < 0.001). Logistic regression analysis demonstrated that obesity had a stronger association with an osteophyte-dominant pattern compared to a JSN-dominant pattern (OR and 95% CI = 7.16 (3.15-16.26) and 1.63 (0.96-2.78), respectively). Age had a very weak effect on the distinction to an osteophyte-dominant pattern and no effect on JSN dominance (OR and 95% CI = 1.1 (1.06-1.15) and 1.02 (0.99-1.05), respectively). CONCLUSION: There might be an association between obesity and the radiographic phenotype in patients with knee osteoarthritis. The findings suggest that the association between obesity and the osteophyte formation is stronger than that of JSN.

IMPACT OF COMORBIDITY AND SOCIOECONOMIC STATUS ON QUALITY OF LIFE IN PATIENTS WITH CHRONIC DISEASES WHO ATTEND PRIMARY HEALTH CARE CENTRES.

AIM: The aim of the study was to analyse the impact of chronic disease on the quality of life (QoL) and how QoL changes with comorbidity and socioeconomic status in persons who attend primary health care centres. METHODS: The group of participants comprised 2,560 people who contacted six primary health care centres in Ankara. The level of QoL was determined by the World Health Organization Quality of Life Questionnaire Abbreviated Version (WHOQOL-BREF). RESULTS: Mental disorders and diabetes-hypertension comorbidity had the most negative effect on the QoL. In the physical domain of the WHOQOL-BREF, the effect of diabetes-hypertension comorbidity is greater than the additive effect of hypertension and diabetes individually. The co-occurrence of any disease with cardiovascular disease does not change QoL within any domain, except for the co-occurrence of any disease with musculoskeletal diseases which deteriorated QoL in the physical domain. The higher income and socioeconomic status corresponded to higher QoL. CONCLUSIONS: The effect of comorbidity on QoL can be different from the additive effects of the co-occurring diseases. Socioeconomic factors undoubtedly affect the relationship between chronic diseases and QoL, and this relationship points to health inequities among socioeconomic groups.

The 5-year incidence of type 2 diabetes mellitus in women older than 15 years in Ankara, Turkey: a population-based study.

BACKGROUND: Type 2 diabetes mellitus (DM) is a significant cause of morbidity and premature mortality especially in adults. In Turkey, there are few studies on DM incidence. This study aimed to determine the incidence of type 2 DM in women 15 years or older in Turkey. METHODS: This prospective cohort study was performed from December 2002 to May 2003. Preliminary population-based screening was performed in 1997 and 1998 on women 15 years or older living in 4 villages in the Gölbasi, Ankara province. Five hundred sixty-three women who were considered nondiabetic in the first study comprised the population for the present study. Data collection was accomplished by using a questionnaire and randomly measuring the blood glucose levels of the women. The chi and Fisher exact tests were used to analyze the risk factors for DM. RESULTS: The 5-year incidences of type 2 DM, impaired glucose tolerance, and impaired fasting glucose were 2.3%, 0.4%, and 0.7%, respectively. The 5-year incidence of type 2 DM increased with age (P < 0.05). The DM incidence was 6.2% in those with mixed-type hypertension and 4.0% in those with a body mass index of 30 kg/m or higher. At 5-year follow-up, age (>or=35 years), hypertension, and body mass index (>or=30 kg/m) were the risk factors for incidence of abnormal glucose metabolism (P < 0.05). CONCLUSIONS: The incidence of abnormal glucose metabolism in this study is in accord with that in the literature. Our results will contribute to our understanding of the incidence of DM in women in Turkey.

Water usage habits and the incidence of diarrhea in rural Ankara, Turkey.

This aim of this study was to determine water usage behavior and incidence of diarrhea during the summer months among people in rural areas of Turkey. Information was collected using a questionnaire during face-to-face interviews with people aged 18 years and over in their homes. Diarrhea was detected in 31.7% of the 543 households included in the study in the summer of 2003. The percentage of those living in the study area experiencing at least one bout of diarrhea was 10.0%. The diarrhea episode rate was 18.7%. A logistic regression model of factors that could influence the incidence of diarrhea showed that the reported distance between the septic tank and the well, the total monthly household income and water shortages of longer than 12h had a significant effect on diarrhea incidence (P<0.05). The fact that water shortages are the biggest risk factor for diarrhea points to the need for (i) health education to raise awareness and (ii) the supply of equipment to enable households to use both the first running water after a water shortage and the water they have collected during the shortage as drinking water.

Prevalence of insomnia symptoms: results from an urban district in Ankara, Turkey 1.

Objective. Characteristics of insomnia symptoms in Turkey are not well established. The goal of this study was to determine the prevalence of insomnia and related symptoms in an urban district of Turkey. Method. The study was carried out in Ankara, in an urban district with a population of 2665. Out of the 1332 people in the sample, 1034 in the 15-65 age range were included in the study. Interviews were conducted according to the "Sleep Disorders Assessment Questionnaire" developed by the researchers. The Insomnia Severity Index (ISI) was also given to the subjects with a sleep problem to measure the subjective quality and quantity of insomnia symptoms. Results and conclusion. A total of 29.4% of all participants reported a sleep problem, out of which 23.7% defined one or more of the insomnia symptoms which included difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), non-restorative sleep (NRS) and sleep deprivation (SD). Insomnia risk was found to be significantly increased with age, female sex, smoking and chronic medical illness. A total of 75.9% of participants who reported insomnia symptoms did not seek medical help for their complaint. According to the ISI, among the subjects with insomnia symptoms, 79 (32.2%) had subthreshold insomnia, 43 (17.6%) had clinical insomnia, 12 (4.9%) had severe clinical insomnia, while 88 (35.9%) did not score in the range indicating insomnia. The findings are discussed in the light of previous research and in relation to sociocultural factors emphasizing the need for public education on sleep disorders as medical conditions.

Determination of formaldehyde levels in 100 furniture workshops in Ankara.

One of the airborne pollutants in wood products industry is formaldehyde, which may pose some health effects. Therefore this study is conducted to determine formaldehyde levels in 100 furniture-manufacturing workshops in Ankara and also to determine the symptoms, which may be related with formaldehyde exposure among the workers. Indoor formaldehyde levels ranged from 0.02 ppm to 2.22 ppm with a mean of 0.6 +/- 0.3 ppm. Outdoor formaldehyde levels also ranged from 0.0 ppm to 0.08 ppm with a mean of 0.03 +/- 0.03 ppm. Formaldehyde levels were higher in workplaces located at basement than in workplaces located at or above ground level (p < 0.01). An association was found between indoor formaldehyde levels and the types of fuel used (p < 0.05). The levels were higher in workplaces where only sawdust was used for heating, than in workplaces where wood, coal, and sawdust are used (p = 0.02). An association was found between runny nose and indoor formaldehyde levels (p = 0.03). Formaldehyde levels were lower in workplaces where employees had no symptoms than in those where employees had 4 or more symptoms (p = 0.02). Of 229 employees 57 subjects (24.9%) work under the formaldehyde levels of 0.75 ppm and above. Thus, approximately one fourth of the employees in workplaces are working in environments with formaldehyde levels exceeding those permitted by Occupational Safety and Health Administration (OSHA). The employees working in small-scale furniture workshops are at risk of formaldehyde exposure. Measures, such as improved ventilation, have to be taken in these workplaces, in order to decrease the formaldehyde levels.

The diagonal ear-lobe crease. As sign of some diseases.

OBJECTIVE: The present study dealt with the question of possible association between the diagonal ear lobe crease (ELC) and diabetes mellitus, hypertension, myocardial infarction, coronary artery diseases. METHODS: The present study was carried out as a field study with the contributions of 6 Primary Health Care Centers in Golbasi, Education and Research Area, Ankara, Turkey in May 2003 June 2003 and includes 3722 individuals (1250 males and 2472 females) of different age groups. From each individual, ELC was graded and a thorough medical history was taken. RESULTS: Ear lobe creases were found more in males and there was a statistically significant positive association between ELC and these diseases in both sexes. CONCLUSION: It was thus thought that ELC could well be included as a valuable sign in diagnosing and screening such diseases.

Varicella zoster seroprevalence in children less than 5 years old.

This study was designed to evaluate the age-specific varicella-zoster virus (VZV) seroprevalence in children less than 5 years old who presented at a healthy child outpatient clinic and to compare the results with the data from other countries. The study was a cross-sectional study determining the prevalence of serum IgG against VZV in children who presented to the Healthy Child Outpatient Clinic of the Gazi University Medical Faculty and who were aged between 9 months and 5 years, in the 3rd--97th percentile as regards height and weight, not suffering from any disease, and without a history of vaccination against varicella. The information on the children was obtained from a questionnaire, by physical examination, and from patient files. Serum samples were obtained from babies and children at 9, 15, 24, 36, 48, and 60 months. The 295 serum samples were kept at --20 degrees C following centrifugation until used for serologic analysis (ELISA). The 292 children of the study group consisted of 168 males (57.5 per cent) and 124 females (42.5 per cent). VZV antibodies were found to be positive in 65 children aged between 9 months and 5 years (22.3 per cent); 22.0 per cent in males and 22.6 per cent in females with no statistically significant difference between the sexes (p>0.05). The VZV seroprevalence was highest at the 48th and 60th months and this difference was statistically significant (p=0.000).

Prevalence of epilepsy in Turkish children between the ages of 0 and 16 years.

The aim of this cross-sectional study was to determine the prevalence of epilepsy in Turkey among children between the ages of 0 and 16 years. The study population consisted of 24,773,569 children living in Turkey. Because the prevalence of childhood epilepsy is reported to be 0.001 to 1% in the literature, the sample size was determined as 48,260, with 0.05 error type I and 0.10 error type 2 (power 0.90), and the effect size was 2. With the cluster sampling method, samples were selected from cities, towns, districts, and villages, and 46,813 (97%) children were reached. The study questionnaire contained sections with individual informational questions and questions for the selection of suspected epilepsy cases and physical examination results. The epilepsy classification was designed according to the classification of the International League Against Epilepsy (ILAE). The prevalence of epilepsy was determined as 0.8%; 55.2% of the subjects with epilepsy were grouped as generalized, 39% as partial, and 5.8% as unidentified. Age, place of residence, route of delivery, place of delivery, and social and economic status had no statistically significant effect on the development of epilepsy. Male gender, preterm, and post-term delivery increased the risk of developing epilepsy. Early diagnosis and treatment of epilepsy, as well as the education of health workers and families, are very important.

Measles epidemiology and elimination strategies in Turkey.

In Turkey, 15,000-30,000 measles cases have been reported annually since the 1990s. Epidemics occur every 3-4 years, and >/=90% of cases are <15 years old. The high incidence is due to inadequate vaccination coverage (nationally 84% in 2001) and immunity provided by the first dose of vaccine administered at age 9 months. The second dose, which has been recommended for first grade students since 1998, has been insufficient to provide the herd immunity necessary to control measles. The Ministry of Health launched a comprehensive program for 2002-2010 targeting measles elimination. This plan calls for a national vaccination campaign among all children aged 9 months to 14 years and routine two-dose vaccination coverage will be increased to >/=95% or follow-up campaigns will be conducted in areas not achieving high coverage levels. Also, all military recruits in 2002-2009 will be vaccinated and case-based, laboratory supported surveillance will be initiated.