Iatrogenic bladder neck rupture due to traumatic urethral catheterization: A case report.

BACKGROUND: In this article, we present a case of iatrogenic bladder neck rupture due to catheter insertion in a 94-year-old comorbid male patient. CASE SUMMARY: The patient, who had a urethral catheter inserted in the palliative service 3 d ago, was consulted because the catheter did not work. Because the fluid given to the bladder could not be recovered, computed tomography was performed, which revealed that the catheter had passed the bladder neck first into the retrovesical area then into the intraabdominal area. The appearance of the anterior urethra and verumontanum was normal at cystoscopy. However, extremely severe stenosis of the bladder neck, and perforated posterior wall of the urethral segment between the prostatic urethra and the bladder neck were observed. Internal urethrotomy was applied to the bladder neck with a urethrotome. An urethral catheter was sent over the guide wire into the bladder. The patient was followed in the palliative care service and the catheter was removed 7 d later. No extravasation was observed in the control urethrography. CONCLUSION: Although catheter insertion is a simple and frequently performed procedure in hospitalized patients, it is necessary to avoid unnecessary extra-indication catheter insertion.

Bladder stone due to late clip migration after prostatic urethral lift procedure: A case report.

BACKGROUND: Prostatic urethral lift (PUL) therapy is an alternative to minimally invasive and other surgeries in younger patients who want to preserve their sexual and ejaculatory functions, and in elderly male patients with benign prostatic hyperplasia who cannot be anesthetized because of the risk of anesthesia. The procedure can be performed as an outpatient and without anesthesia, and complications are few and temporary. In long-term follow-up, encrustations that require retreatment are rarely seen. CASE SUMMARY: In our case, a 62-year-old prostate patient who had a PUL operation 8 years ago and had a stone on the PUL material near the bladder neck was treated. The patient's stone was removed by endoscopic cystolithotripsy using pneumatic fragmentation. Bipolar transurethral resection of the prostate was applied to the patient in the same session. After the patient's 7-year follow-up, the patient's complaints relapsed, and cystoscopy was performed again. In cystoscopy, stone formation adjacent to the wall was observed at the junction of the bladder neck to the left lateral wall. The stone was fragmented with a pneumatic lithotripter. CONCLUSION: Placing clips too close to bladder neck in the PUL procedure may result in clip migration.

Prognosis Markers and Patient Health Behavior of COVID-19 on Treatment in Turkey.

Objective: During the COVID-19 outbreak, the medical sector services to the public were reportedly not appropriate. Due to the novelty of the disease, the patients were not aware of the right treatment and what health facilities were required. Method: The current research is designed to determine the relationship between prognosis markers and patient health behavior in treatment of COVID-19 patients in Turkey. The sample was identified through cluster sampling method. A smart PLS statistical tool was utilized for structural equation model findings. Result: The findings show that patient treatment performance can be improved with adequate treatment strategies, patient health behavior, prognosis markers and performance status. This research is significant by its nature because it adopted a novel research model which established new relationships between the variables of the study. Practically, this research deliberated the importance of prognosis markers, patient health behavior, adequate treatment strategies, and performance status on patient treatment performance. Conclusion: This research faced several limitations that are reported in the end with the future directions for scholars to contribute further to the knowledge of patients' treatment performance.

Can amniotic fluid protect developing fetal lungs against the harmful effects of oxidative stress?

BACKGROUND: Preterm births cause fetuses to be born without completing the development of their organs. Due to this undesirable situation, it is the pulmonary tissue which has to be most exposed to harmful effects of extrauterine environment. Early disappearance of the prophylactic and constructive effects of amniotic fluid (AF) on developing tissues, such as pulmonary tissue, facilitates the formation of pulmonary morbidities resulting from oxygen. Setting out from this knowledge, we wanted, in addition to assessing the beneficent effects of AF on pulmonary tissue, to study the importance of AF in morbidities of this tissue thought to originate from oxygen. METHODS: In this experimental study, while the study group was made up of the fetuses of pregnant rats exposed to hyperbaric oxygen, (hyperoxic pregnant rat fetuses-HPRF), the control group was formed of the fetuses of the rats pregnant in the usual room setting (normoxic pregnant rat fetuses-NPRF). The pulmonary and hepatic tissues taken from the fetuses of these pregnant rats on the 21st day of their pregnancy were compared biochemically and histologically. For biochemical assessment, total glutathione (tGSH), catalase (CAT), malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α) values and for histopathological assessment, apoptosis, alveolar wall count (AWC), vena centralis count (VCC) were included. RESULTS: Statistical significance was found in the pulmonary tissue values of tGSH on behalf of NPRF, and MDA on behalf of HPRF (p < 0.05). In liver tissue, statistical significance was detected in tGSH and CAT values in favor of NPRF and in MDA, and TNF-α values in favor of HPRF (p < 0.05). DISCUSSION: : Our study has demonstrated that AF protects the pulmonary tissue from the harmful effects of oxygen in the intrauterine period. In addition, our data have suggested that the pulmonary tissue's being deprived of the useful effects of AF owing to premature birth may be an important trigger in the occurrence of the pulmonary morbidities thought to result from oxygen.

Does Cardiovascular Disease Risk Decrease after Smoking Cessation in Occupational Risk Groups?

Objectives: Smoking cessation is very important for workers due to the possibility of exposure to additional environmental risks in the workplace environment. This study was performed to determine the changes in the Framingham Risk Score (FRS) and 10-year risk of cardiovascular disease (CVD) of employees before smoking cessation and after 6 months. Materials and Methods: Five hundred and sixty-two employees who want to quit smoking were included in the study. In this prospective study, the baseline and 6-month FRS, and 10-year risk of CVD of workers were calculated. Furthermore, the Hospital Anxiety and Depression Scale was used for assessments of employees' anxiety and depression symptoms. Results: After 6 months, 37% of the participants quit smoking. It was determined that 11.9% of employees have a high CVD risk and 10.6% moderate CVD risk. After 6 months, there was a statistically significant reduction in FRS who quit smoking (P < 0.001). In addition, within the 6 months after smoking cessation, 10-year coronary heart disease risk reduction was higher in quitters than those who cannot quit smoking (47.6% decrease in quitters and 14.9% in nonquitters, P < 0.001). Significant decreases in fasting blood glucose levels were determined after smoking cessation (P = 0.003). Conclusions: The FRS and CVD risk of smoker employees were decreased 6 months after smoking cessation. In 6 months, CVD risk is reduced in almost half of those who quit smoking. Even in the short term, it is possible to reduce the CVD risk of a worker who quits smoking.

The investigation of the protective effects of nimesulide on experimental testicular ischemia-reperfusion injury in rats / La investigación de los efectos protectores de nimesulida en la lesión de isquemia y reperfusión testicular experimental en ratas

INTRODUCTION AND OBJECTIVES: Testicular ischemia/reperfusion (I/R) injury develops after torsion and following detorsion of the testis. Reactive oxygen species were produced and oxidative damage begins to occur due to I/R process. Nimesulide, which is a specific cyclooxygenase-2 inhibitor drug, have antioxidant, antiinflammatory, analgesics and antipyretic effects. We aimed to investigate biochemically and histopathologically effect of nimesulide on testis I/R injury in rats induced by the testicular torsion-detorsion. MATERIAL AND METHODS: In this study, 24 albino Wistar male rats were divided into four groups (6 rats in each group): ischemia/reperfusion applied+50mg/kg nimesulide administrated (NIM-50), ischemia/reperfusion applied+100mg/kg nimesulide administrated (NIM-100), ischemia/reperfusion applied (IR) and Sham surgery (SS) groups. Nimesulide was administered to NIM-50 and NIM-100 groups at the 50mg/kg and 100mg/kg doses before 2h applied I/R procedures. The IR group were applied only I/R procedures, no drug treatment was applied. Animals were sacrificed under high dose anesthesia and left testes were extracted. Testes were examined biochemically and histopathologically. RESULTS: Total glutathione (tGSH) and cyclooxygenase-1 (COX-1) levels were increased in the NIM-50 and NIM-100 groups compared to IR group. The levels of COX-2, malondialdehyde (MDA), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) were lower in the NIM-50 and NIM-100 groups than in the IR group. Some histopathological changes seen in IR group. This findings were decreased in NIM-50 group and prevented in NIM-100 group. CONCLUSION: Nimesulide prevented inflammation and oxidative stress. Our results suggest that nimesulide may be have a protective effect on testicular I/R injury

INTRODUCCIÓN Y OBJETIVOS: La lesión de isquemia y reperfusión testicular (I/R) se desarrolla después de la torsión y la consiguiente detorsión del testículo. Se produjeron especies reactivas de oxígeno y el daño oxidativo comienza a producirse debido al proceso de I/R. La nimesulida, que es un fármaco inhibidor específico de la ciclooxigenasa 2, tiene efectos antioxidantes, antiinflamatorios, analgésicos y antipiréticos. El objetivo fue investigar el efecto bioquímico e histopatológico de la nimesulida sobre la lesión testicular I/R en ratas inducida por la torsión-detorsión testicular. MATERIAL Y MÉTODOS: En este estudio se dividió a 24 ratas albinas Wistar macho en 4 grupos (6 ratas en cada grupo): isquemia y reperfusión aplicada+50mg/kg de nimesulida administrada (NIM-50), isquemia y reperfusión aplicada+100mg/kg de nimesulida administrada (NIM-100), isquemia y reperfusión aplicada (IR) y cirugía simulada (SS). La nimesulida se administró a los grupos NIM-50 y NIM-100 a las dosis de 50 y 100mg/kg, respectivamente, 2h antes de aplicar los procedimientos de I/R. Al grupo IR se aplicó solo procedimientos I/R, no se aplicó tratamiento farmacológico. Los animales se sacrificaron con anestesia a dosis altas y se extrajeron los testículos izquierdos. Los testículos se examinaron bioquímicamente e histopatológicamente. RESULTADOS: Los niveles totales de glutatión (tGSH) y ciclooxigenasa-1 (COX-1) aumentaron en los grupos NIM-50 y NIM-100 en comparación con el grupo IR. Los niveles de COX-2, malondialdehído (MDA), interleucina 1β (IL-1β) y factor de necrosis tumoral-α (TNF-α) fueron menores en los grupos NIM-50 y NIM-100 que en el grupo IR. Se vieron algunos cambios histopatológicos en el grupo IR. Estos hallazgos disminuyeron en el grupo NIM-50 y se evitaron en el grupo NIM-100. CONCLUSIÓN: La nimesulida previno la inflamación y el estrés oxidativo. Nuestros resultados sugieren que la nimesulida puede tener un efecto protector sobre la lesión testicular I/R

The investigation of the protective effects of nimesulide on experimental testicular ischemia-reperfusion injury in rats.

INTRODUCTION AND OBJECTIVES: Testicular ischemia/reperfusion (I/R) injury develops after torsion and following detorsion of the testis. Reactive oxygen species were produced and oxidative damage begins to occur due to I/R process. Nimesulide, which is a specific cyclooxygenase-2 inhibitor drug, have antioxidant, antiinflammatory, analgesics and antipyretic effects. We aimed to investigate biochemically and histopathologically effect of nimesulide on testis I/R injury in rats induced by the testicular torsion-detorsion. MATERIAL AND METHODS: In this study, 24 albino Wistar male rats were divided into four groups (6 rats in each group): ischemia/reperfusion applied+50mg/kg nimesulide administrated (NIM-50), ischemia/reperfusion applied+100mg/kg nimesulide administrated (NIM-100), ischemia/reperfusion applied (IR) and Sham surgery (SS) groups. Nimesulide was administered to NIM-50 and NIM-100 groups at the 50mg/kg and 100mg/kg doses before 2h applied I/R procedures. The IR group were applied only I/R procedures, no drug treatment was applied. Animals were sacrificed under high dose anesthesia and left testes were extracted. Testes were examined biochemically and histopathologically. RESULTS: Total glutathione (tGSH) and cyclooxygenase-1 (COX-1) levels were increased in the NIM-50 and NIM-100 groups compared to IR group. The levels of COX-2, malondialdehyde (MDA), interleukin-1ß (IL-1ß) and tumor necrosis factor-α (TNF-α) were lower in the NIM-50 and NIM-100 groups than in the IR group. Some histopathological changes seen in IR group. This findings were decreased in NIM-50 group and prevented in NIM-100 group. CONCLUSION: Nimesulide prevented inflammation and oxidative stress. Our results suggest that nimesulide may be have a protective effect on testicular I/R injury.

Effect of MDR C3435T polymorphism on Varenicline treatment in quit smoking

Despite so many global efforts, smoking still remains to be one of the most common addictions worldwide. Even though most smokers wish to quit smoking, many of them fail. In this respect, genetic variants are thought to be remarkable factors in nicotine dependence and in treatment of smoking cessation. This is a paper investigating a single variant p-glycoprotein (P-gp) polymorphisms and its effect on Varenicline efficacy in the smoking cessation. 158 smokers and 52 non-smoker healthy volunteers were included. We determined the P-gp C3435T gene polymorphisms in all subjects. Face to face interviews with smokers were performed for smoking cessation and Varenicline was given for smoking cessation. Cessation success was evaluated in the 6th month and success rates were compared according to the P-gp genotype distributions. In our study, smoking cessation rate by Varenicline was 57.0%. This rate was 55.0% in females, and 57.2% in males (p=0.85). The P-gp C3435T gene distribution was similar in control, quitters and not-quitter groups. Cessation rate was at highest point in genotype CT (62.2%) and at the lowest in TT (47.6%). It was 53.8% in genotype CC and there was no statistically significant difference (p=0.27). Our results suggest that genetic variants of P-gp C3435T did not significantly affect Varenicline treatment for smoking cessation.

Respiratory Systems of Dental Technicians Negatively Affected during 5 Years of Follow-Up.

BACKGROUND: Dental laboratory technician is one of the professions in which dust exposure is frequently experienced and therefore the health of workers has to be monitored. AIMS: In this study, changes in the pulmonary functions and of pneumoconiosis frequencies among dental technicians after five years were investigated by comparing the results of two screenings carried out in 2008 and 2013. STUDY DESIGN: Cohort study. METHODS: In 2008 and 2013, Provincial Health Directorate carried out two different health screenings covering all of the dental technicians working in dental laboratories in Denizli. In both screenings, a questionnaire was applied, with which socio-demographic and workplace properties of the technicians were obtained. In addition, Pulmonary function tests (PFT) and standard chest X-rays of the technicians were performed. The results of these two screenings were evaluated by a chest specialist, and physical examinations were performed as necessary. In 2013, technicians who had pathologies underwent computerized tomography (HRCT). In this study, the study group was composed of dental laboratory technicians that participated in both screenings (2008 and 2013) and the data obtained from the screenings were compared. The gathered data were analyzed using paired student-t and X(2) tests. RESULTS: A total of 125 dental laboratory technicians participated in the two screenings. Overall, 92% of the technicians were male and the mean age of the participants was 35. Technicians were working for 9 hours a day, 6 days a week. Total exposure time was calculated to be around 41 thousand hours. Approximately 60% of workers were smokers. When the results of PFT were analyzed, 73% of the first evaluations were found to be normal; however, this ratio decreased to 51% in the second analysis five years later. In the second PFT measurement, compared to the first, there was a 23% decrease in the forced vital capacity (FVC) value, and a 15.7% decrease in forced expiratory volume in one second (FEV1). While restrictive disorder was found 25% in the first PFT evaluations, this ratio increased to 31% in the second PFT. When the radiological results were considered, 62% of the first X-ray results were found to be normal but this ratio decreased to 18% in 2013. While reticular/reticulonodular opacities were found in 11% of cases in 2008, it increased to 30% in 2013. Seven technicians were diagnosed with pneumoconiosis (5.6%). CONCLUSION: Respiratory tracts of the technicians were negatively affected during the five year period. The number of pneumoconiosis cases (5.6%) shows that it is necessary to adopt comprehensive work health and safety precautions for laboratories.

The Prevalence of Nocturia and Nocturnal Polyuria: Can New Cutoff Values Be Suggested According to Age and Sex?

PURPOSE: The aims of this study were to assess the prevalence of nocturia and nocturnal polyuria (NP) and to define new cutoff values according to age and sex for both conditions. METHODS: Data from a population-based prevalence survey conducted among a random sample of 2,128 adults were analyzed in this study. Participants were requested to fill out a questionnaire including the International Continence Society (ICS) definitions of lower urinary tract symptoms and the International Consultation on Incontinence Questionnaire - Short Form. Additionally, a 1-day bladder diary was given to each individual. The participants were divided into 5 age groups. The prevalence of nocturia was calculated based on definitions of nocturia as ≥1 voiding episodes, ≥2 episodes, and ≥3 episodes. NP was evaluated according to the ICS definition. The mean±standard errors and 95th percentile values were calculated in each group as new cutoff values for NP. RESULTS: The prevalence of nocturia was estimated as 28.4%, 17.6%, and 8.9% for ≥1, ≥2, and ≥3 voiding episodes each night, respectively. When nocturia was defined as 2 or more voiding episodes at night, the prevalence decreased significantly. The mean NP index was 29.4%±15.0% in men and 23.1%±11.8% in women. For the age groups of <50 years, 50-59 years, and ≥60 years, the new cutoff values for the diagnosis of NP were calculated as 48%, 69%, and 59% for men and 41%, 50%, and 42% for women, respectively. CONCLUSIONS: We found that the definition of nocturia was still controversial and that waking up once for voiding might be within the normal spectrum of behavior. The definition of NP should be modified, and new cutoff values should be defined using the data presented in our study and in other forthcoming studies.

The evaluation of the dust-related occupational respiratory disorders of dental laboratory technicians working in Denizli Province.

INTRODUCTION: Dental laboratory technicians (DLTs) get exposed to fibrinogen dusts that are very risky dusts in terms of health. In this study, respiration complaints, pneumoconiosis frequencies and working conditions of the dental technicians in Denizli were investigated. METHODS: All of the registered DLTs working in Denizli were included in the study. A 30-item questionnaire was used to gather data about the participants and their working environments. Then, pulmonary function tests (PFTs) were carried out and standard chest X-rays were taken in order to detect how much the respiratory systems of the workers were affected. Standard chest X-rays were evaluated according to International Labour Organizations classification. Depending on the screening results, technicians who were found to have had pathologies and suspected cases were examined. "High-resolution computerized tomography (HRCT)" was taken from those who were found to have pathology in their chest X-rays and they were evaluated according to the classification of Hering et al. RESULTS: There are a total of 166 DLTs working in Denizli Province participated in the study. One hundred and forty-three (86.1%) of the participants were male, and 23 of them were female. The mean age of the participants is 33.5 ± 8.1. Average working time of the workers is 16 years. Total exposure time was calculated 36,177 h. Approximately, 56% of workers were smokers. When the working conditions were considered, it was found that 98.8% of laboratories had a ventilation system. Technicians' use of personal protective equipment is low. Participants' often or continuous use of masks, gloves, goggles, and vacuum device was found 69%, 36%, 47%, and 63% respectively while working. About 21.2% of the technicians have respiratory symptoms while 15.2% of them have eye complaints. At the analysis of PFT results, 27.7% restrictive type pulmonary disorder was determined. At the analysis of chest X-rays; 1/0 profusion sub-category was 25.5%, and the large opacity rate was 16.9%. Ten pneumoconiosis cases (6%) were diagnosed after the analysis of the HRCT results. The ratio of pneumoconiosis was found much higher among male technicians, particularly those who have been working for a long time in the profession and those working at the town hospitals and Department of metal leveling. DISCUSSION: Technicians' use of personal protective tools is not enough and ratio of smoking is rather high. Pneumoconiosis cases clearly show this exposure. It is necessary to adopt comprehensive work health and safety precautions considering the determined risk factors.

Birth Order and Sibling Sex Ratio in a Population with High Fertility: Are Turkish Male to Female Transsexuals Different?

Western studies have consistently found that androphilic (sexually attracted to men) male-to-female transsexuals have a later birth order and a relative excess of brothers compared with appropriate control participants. However, non-Western studies on birth order and sibling sex ratio in androphilic males (transsexual or non-transsexual) are rare. The objective of the study was to test the hypothesis that androphilic male-to-female transsexuals have a late birth order and a relative excess of brothers in a non-Western culture with a higher fertility rate. The participants were 60 androphilic male-to-female transsexuals and 61 male heterosexual controls. The transsexual participants had significantly more older brothers than the control participants, but the groups did not differ in their numbers of older sisters, younger brothers, or younger sisters. The foregoing pattern is usually referred to as the "fraternal birth order effect." Slater's and Berglin's Indexes both showed that the mean birth order of the control participants was very close to that expected from a random sample drawn from a demographically stable population whereas the mean birth order of the transsexual participants was later. A measure of sibship composition, brothers/all siblings, showed that the transsexual group had a higher proportion of male siblings compared with the control group. In conclusion, the present study found that Turkish androphilic male-to-female transsexuals show the same high fraternal birth order that has been found in comparable androphilic samples in Western Europe, North America, and the South Pacific, which suggests a common underlying biological causal mechanism.

Seroprevalence of human cystic echinococcosis and risk factors in animal breeders in rural communities in Denizli, Turkey.

INTRODUCTION: Cystic echinococcosis (CE) is a serious public health problem in sheep-raising regions of Turkey. The aim of this study was to determine the prevalence and associated risk factors of echinococcosis in rural regions of Denizli in Turkey. METHODOLOGY: This study was undertaken in four townships in Denizli County between May 2009 and July 2009. Family members were interviewed to assess possible risk factors for infection and tested for anti-E. granulosus antibodies by enzyme-linked immunosorbent assay (ELISA). RESULTS: Of the 1,133 individuals included in the study, 78 (6.9%) were found to be anti-EG seropositive. Multivariate analysis showed that the 30-39 year age group (odds ratio [OR]: 3.29; 95% confidence interval [CI]: 1.30 ± 8.33; p = 0.01), the ≥ 60 year group (OR: 4.08; 95% CI: 1.57 ± 10.61; p = 0.004), and the group that reported sometimes or never getting veterinary care for their animals (OR: 1.75; 95% CI: 1.05 ± 2.93; p = 0.032) had higher rates of seropositivity. Multivariate analysis showed that education was not significantly associated with seropositivity. Furthermore, no significant correlation with location, occupation, dog ownership or contact with dogs, or with cattle and/or sheep/goat ownership was found. Regular veterinary care and education had significant effects on lowering the prevalence of CE. CONCLUSIONS: Our results suggest that preventive measures, such as regular veterinary care for animals and educative and supportive activities oriented to the people working in farming and animal husbandry should be taken to decrease the prevalence of human CE in Turkey.

Prevalence of lower urinary tract symptoms, overactive bladder and urinary incontinence in western Turkey: results of a population-based survey.

OBJECTIVE: To estimate the prevalence of lower urinary tract symptoms, urinary incontinence and overactive bladder in western Turkey. METHOD: This cross-sectional, population-based survey was carried out between May and October 2012. A random sample of 2128 women and men aged ≥18 years was selected from the health registries. A questionnaire including sociodemographic data, comorbid conditions, lower urinary tract symptoms, overactive bladder and urinary incontinence symptoms, body mass index, vital signs, and dipstick urinalysis was developed. The questions were answered by the participants, and remaining data were provided by the site staff. International Continence Society definitions were used. RESULTS: A total of 1571 (74%) individuals agreed to participate, and analysis were carried out on 1555 people (636 men [40.9%] and 919 women [59.1%]) after 16 individuals with a nitrite-positive dipstick test were excluded. Lower urinary tract symptoms were reported by 71.0% of the study population. The prevalence of storage, voiding and post-micturition symptoms were 56.1% (44.2% men, 64.1% women), 39.3% (40.9% men, 37.8% women) and 30.7% (38.6% men, 28.7% women), respectively. The most prevalent storage symptom was urgency, which was reported by 29.3% of the study population (20.1% men, 35.6% women). The prevalence of urge, stress and mixed urinary incontinence were: 6.5% (3.9% men, 8.2% women), 14.1% (3.9% men, 21.2% women) and 5.6% (0.8% men, 9.0% women), respectively. CONCLUSION: The present study is the first and largest population-based survey evaluating the prevalence of lower urinary tract symptoms, urinary incontinence and overactive bladder in Turkey. Our findings show these symptoms are highly prevalent in western Turkey.

Is transcranial magnetic stimulation effective in treatment-resistant combat related posttraumatic stress disorder?

OBJECTIVE: To examine the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in patients with treatment-resistant posttraumatic stress disorder (PTSD) with co-occurring major depression. METHODS: We examined data on 20 male combat related PTSD patients admitted to the Post Traumatic Stress Disorder Clinic of Gülhane Military Medical Academy, Ankara, Turkey between January 2011 and December 2012 that received rTMS in addition to medical therapy. We obtained the data by examining the case files and hospital computer records. RESULTS: Decreases in the Impact of Event Scale (IES) hyperarousal scores were statistically significant. However, there were no statistically significant differences between the total IES scores, IES intrusion scores, IES avoidance scores, Beck Depression Inventory, and Beck Anxiety Inventory scores before and after rTMS treatment. CONCLUSION: The efficacy of rTMS on the hyperarousal symptoms indicated that rTMS could be used in the treatment of patients with treatment-resistant PTSD. The role of rTMS in the clinical management of PTSD should be identified in further comprehensive studies.

Prevalence of cerebrovascular disease: a door-to-door survey in West Anatolia.

The aim of this study was to demonstrate the prevalence of cerebrovascular disease (CVD), and its relation to age, education, gender, and other risk factors in the city of Denizli, Turkey. The study was performed between 2010 and 2011 in the city center, where 138,000 inhabitants >45 years were included in the research. 2,441 inhabitants were selected by cluster sampling method. A specific questionnaire about CVD was employed during the interview. We inquired about patient's age, gender, and educational history. If there was suspicion of CVD, cranial imaging was performed, and recent medical records were re-evaluated. The mean age was 58 ± 10.1 (45-100) among 2,441 in this study. Of those, 1,257 (51.5 %) participants were female and 1,184 (48.5 %) were male. We found the prevalence of CVD to be 0.9 % with 0.68 % among males and 1.21 % among females (p = 0.023). The mean age of subjects with CVD was 72.4 ± 8.1 (56-86) years. CVD was found to increase with age (p = 0.001), but was lower than reported rates in other European countries; however, it was similar to that of Mediterranean countries. CVD was detected more frequently in women than men. This finding differed from other studies, but was first to evaluate the prevalence of CVD in Turkey.

Seroprevalence of hepatitis e virus among primary school children.

OBJECTIVES: To investigate the seroprevalence of anti-hepatitis E virus antibody among primary school children in the two different areas of Denizli, Turkey. Methodology : Anti-HEV antibodies were investigated in 185 primary school children (91 from rural areas and 94 from urban areas of Denizli). The children were divided into two age groups as seven-year old group and fourteen-year old group. Samples were tested for anti-HEV Ab by an enzyme-linked immunoassay. Results : A total of 23 primary school children were anti-HEV Ab positive, giving a prevalence of 12.4%. The seroprevalence rate was 13.1% in rural areas and 11.7% in urban areas. The difference in the seropositive rates was not statistically significant (p>0.05). Among 185 primary school children, Anti-HEV antibodies were positive 17 (18.1%) in seven-year old group, and 6 (6.6%) in fourteen-year old group. The difference in the seropositive rates was statistically significant (p<0.05). Conclusions : There was no association between the anti-HEV Ab and gender, socioeconomic level, parental educational level, rural or urban areas. Anti-HEV Ab seroprevalence was higher in seven-year old children than fourteen-year old children.

Changes in heart rate variability before and after ECT in the treatment of resistant major depressive disorder.

BACKGROUND: In this study, we aimed to evaluate the effects of electroconvulsive therapy (ECT) on cardiac autonomic functions (CAF) in patients with major depressive disorder (MDD) using heart rate variability (HRV) analysis. METHOD: Fourteen men joined the study. Nine ECTs were administered. Holter monitoring was performed before treatment and at the end of the first, third and sixth weeks of the treatment. The Hamilton Depression Rating Scale (HAM-D) was used to assess symptom severity. RESULTS: Seven patients responded to ECT. There was a change of 2-hour resting HF, pNN50 and RMSSD scores between week 0 and week 6. This change was not significant after week 1 and week 3. HRV values did not differ when we grouped the patients as responders and non-responders to ECT except the 2-hour resting HF value of responders between week 0 and week 6 and the 24-hour HF value of non-responders between week 1 and week 6. All observed changes showed a decrease in parameters. Overall, the LF/HF ratio did not change significantly in either analysis. HRV values did not correlate with HAM-D scores and no relation was found between treatment response and HRV analysis. After Benferroni-adjustment none of the changes were found statistically significant. LIMITATIONS: The limitations of the study are the small sample size and the absence of healthy controls. CONCLUSIONS: A consistent change in HRV was not observed in response to ECT in patients with MDD. Accepting the HRV as a promising surrogate marker of autonomic activity, ECT does not cause a significant change in nine male treatment resistant MDD patients cardiac autonomic functions.

Quality of sexual life in men with obstructive sleep apnoea.

The study investigated the quality of sexual life of male obstructive sleep apnoea patients. Apnoea and non-apnoea participants were assessed with Golombok Rust Inventory of Sexual Satisfaction (GRISS) and Structured Clinical Interview for DSM-IV (SCID) before the sleep test. Folicule Stimulating Hormone (FSH), Luteinising Hormone (LH), prolactin, testosterone and oestrogen levels were also evaluated. The apnoea group had a higher BMI and lower LH and testosterone levels than the non-apnoea group. There were no differences between the apnoea, non-apnoea groups and within the apnoea groups (mild, moderate and high apnoea) in terms of sexual satisfaction. Although there was a change in the hormonal levels of obstructive sleep apnoea patients, the sexual life of apnoea patients was not affected at the clinical level.