Tablet and inhaled controller medication refill frequencies in children with asthma.

Poor medication adherence is an important problem in children with asthma. This study compared prescription refill frequencies between tablet and inhaled medications in children aged 3 to 18 years with mild (n = 45) and moderate (n = 52) persistent asthma over 4 months. Refill frequencies were higher for tablet versus inhaled medications in both groups (mild: 69% vs. 31%, p = .02; moderate: 55% vs. 41%, p = .03). Refills peaked at the first month and incrementally declined (p < .05). Expanded asthma education did not increase refill frequency. Other methods of improving medication adherence may be warranted in this population.

Turkish military personnel's expectations for health care services provided to them.

OBJECTIVE: The goal was to determine the expectations of patients using the health care services provided in the health care institutions of Turkish Armed Forces (TAF). METHODS: This study was performed between August 2002 and March 2003, with an open-ended question placed on the World Wide Web site of TAF Health Command. The framework was an intranet, which is a special Internet structure across the TAF institutions. Eight hundred four TAF personnel answered by typing their own words in response to the open-ended question. RESULTS: In the data obtained from this study, the participants' expectations focused more on the behaviors they encountered during utilization of the services, the health care personnel-patient relationship, and the services provided by the personnel, rather than the technical options and opportunities presented by the hospitals. CONCLUSIONS: In addition to the efforts and financial resources dedicated to improving the medical technology used in the health care institutions, providing information to the health care personnel about ethically appropriate behavior and patient-health care professional communication and designing new regulations concerning these issues should contribute greatly to the satisfaction of the people receiving health care services and their relatives.

Effects of electromagnetic radiation from a cellular phone on human sperm motility: an in vitro study.

BACKGROUND: There has been growing public concern on the effects of electromagnetic radiation (EMR) emitted by cellular phones on human health. Many studies have recently been published on this topic. However, possible consequences of the cellular phone usage on human sperm parameters have not been investigated adequately. METHODS: A total number of 27 males were enrolled in the study. The semen sample obtained from each participant was divided equally into two parts. One of the specimens was exposed to EMR emitted by an activated 900 MHz cellular phone, whereas the other was not. The concentration and motility of the specimens were compared to analyze the effects of EMR. Assessment of sperm movement in all specimens was performed using four criteria: (A) rapid progressive, (B) slow progressive, (C) nonprogressive, (D) no motility. RESULTS: Statistically significant changes were observed in the rapid progressive, slow progressive and no-motility categories of sperm movement. EMR exposure caused a subtle decrease in the rapid progressive and slow progressive sperm movement. It also caused an increase in the no-motility category of sperm movement. There was no statistically significant difference in the sperm concentration between two groups. CONCLUSIONS: These data suggest that EMR emitted by cellular phone influences human sperm motility. In addition to these acute adverse effects of EMR on sperm motility, long-term EMR exposure may lead to behavioral or structural changes of the male germ cell. These effects may be observed later in life, and they are to be investigated more seriously.

Some sociodemographic and diagnostic characteristics of military patients treated in the Department of Medical Oncology, Gülhane Military Medical Academy.

Today, chronic diseases have increased importance. Cancer, for which 10 million new cases are diagnosed around the world each year, is in the lead of such diseases. This study included military personnel with cancer who applied to the Department of Medical Oncology, Gülhane Military Medical Academy, in the period between 1998 and 2003, and it aims to describe some sociodemographic and diagnostic characteristics of the patients. The total number of cases was 938, which included both active duty and retired military personnel with diagnoses of cancer who were given medical care between 1998 and 2003 in the Department of Medical Oncology. For the study group, the five most common diagnoses were lung cancer, colorectal cancer, testicular cancer, non-Hodgkin's lymphoma, and Hodgkin's disease. Although the first three diagnoses among officers were lung cancer, testicular cancer, and Hodgkin's disease, those among retired officers were colorectal cancer, lung cancer, and prostate cancer. Among noncommissioned officers, the first three diagnoses were colorectal cancer, testicular cancer, and Hodgkin's disease for active duty patients and lung cancer, colorectal cancer, and gastric cancer for retired patients. In the group of privates, testicular cancer, Hodgkin's disease, and non-Hodgkin's lymphoma were the first three diagnoses. When we consider the characteristics of cancers, such as high costs of treatment, loss of manpower, and high mortality rates, prevention of cancers and early diagnosis are very important. Because the frequent types of cancers differed for groups according to age and occupation, those characteristics should be considered when cancer screening programs are being developed for the Armed Forces.

A study of the opinions and behaviors of physicians with regard to informed consent and refusing treatment.

OBJECTIVE: To examine the opinions and the self-reported behaviors of physicians regarding the issues of informed consent and refusing treatment. DESIGN: This study was performed between July and September 2003, with 51 physicians selected by simple random sampling. The data were collected by using a questionnaire. SETTING: A training hospital of medicine faculty. PARTICIPANTS: Fifty-one clinicians working in the branches of internal medicine and surgery. RESULTS: Although the majority (80.4%) of the participants think that information about diagnosis and treatment should always be disclosed to patients, 60.8% reported that they always disclose information about the diagnosis and 49% did the same for information about treatment. A total of 84.3% think that patients' consent should always be obtained before diagnostic and therapeutic procedures, whereas 47% reported that they always obtain consent in their clinical practice. It was also seen that physicians have doubts concerning the comprehension of the information they disclose to their patients. In addition, most (86.3%) of the participants think that a competent patient always has the right to refuse treatment, regardless of the disease and the outcomes. CONCLUSIONS: Although opinions favoring the duties implied by informed consent are in the majority, these do not always reflect the behaviors in daily clinical practice, and there may be problems in carrying out the duties implied by the elements of informed consent. Some recommendations that could be beneficial in addressing these problems are presented at the end of the study.

The frequency and effecting factors of consanguineous marriage in a group of soldiers in Ankara.

This cross-sectional study was carried out to investigate the frequency of consanguineous marriage in a group of army conscripts in Ankara and the factors affecting this. Of 4153 soldiers, 387 were married. The rate of marriage between first cousins was found to be 19.1%, and the overall rate of consanguineous marriage was 24.1%. Consanguineous marriage was found to be significantly prevalent among soldiers who were born in and still living in the Eastern region; among those who lived in villages; among those whose parents as well as themselves had low educational levels; and among those whose marriages were arranged by their families. Neither the payment of bride-price nor the presence of consanguinity between parents was a significant factor for consanguineous marriage. In addition, the age of the soldier and the age at marriage were significantly lower among soldiers married to first cousins than among soldiers whose marriages were not consanguineous.

Horizontal transmission of hepatitis B virus in children with chronic hepatitis B.

AIM: To determine the possible routes of intrafamilial transmission pattern in pediatric cases of chronic hepatitis B virus (HBV) infection. METHODS: In this descriptive retrospective study, 302 children with chronic HBV infection from 251 families and their parents attending the Social Security Children's Hospital and Doctor Sami Ulus Children's Hopsital in Ankara between December 1998 and May 2000, were enrolled in. Screenings and diagnosis of chronic HBV infections were established according to the Consensus 2000. RESULTS: In the studied 302 children with chronic HBV infection, mothers of 38% and fathers of 23% were HBsAg positive. The HBsAg positivity in at least two siblings of the same family was 61% when both parents were HBsAg positive. CONCLUSION: It is well known that horizontal transmission is quite common in countries where Hepatitis B Virus is moderately endemic. To our best knowledge, this is the largest series observed regarding the horizontal transmission in pediatric chronic HBV infection in Turkey. It is necessary to expand the preventive programs to target not only the newborn period but also all stages of childhood.

How medical students use the computer and Internet at a Turkish military medical school.

The aim of this study was to determine how medical students use the computer and World Wide Web at a Turkish military medical school and to discuss characteristics related to this computer use. The study was conducted in 2003 in the Department of Public Health at the Gulhane Military Medical School in Ankara, Turkey. A survey developed by the authors was distributed to 508 students, after pretest. Responses were analyzed statistically by using a computer. Most of the students (86.4%) could access a computer and the Internet and all of the computers that were used by students had Internet connections, and a small group (8.9%) had owned their own computers. One-half of the students use notes provided by attending stuff and textbooks as assistant resources for their studies. The most common usage of computers was connecting to the Internet (91.9%), and the most common use of the Internet was e-mail communication (81.6%). The most preferred site category for daily visit was newspaper sites (62.8%). Approximately 44.1% of students visited medical sites when they were surfing. Also, there was a negative correlation between school performance and the time spent for computer and Internet use (-0.056 and -0.034, respectively). It was observed that medical students used the computer and Internet essentially for nonmedical purposes. To encourage students to use the computer and Internet for medical purposes, tutors should use the computer and Internet during their teaching activities, and software companies should produce assistant applications for medical students. Also, medical schools should build interactive World Wide Web sites, e-mail groups, discussion boards, and study areas for medical students.

Training enlisted men on sexually transmitted diseases and preparation of a training model.

Sexually transmitted diseases (STDs) are serious public health concerns in many countries. One of the main strategies in prevention of STDs is training people who are at high risk for STDs. We aimed to train enlisted men in the Turkish Armed Forces while they served their compulsory military service because every healthy Turkish man has to complete this service and they are at high risk for STDs, as well. This study contains two main parts: trainer training and training of enlisted men. The target groups are health noncommissioned officer school students for the trainer training and enlisted men serving in a military medical academy for STD training. For both groups, we prepared and applied different training programs considering each group's knowledge needs on the topic. To describe knowledge needs, we administered a pretest on both groups. First, we trained candidate trainers, then they trained the enlisted men. We evaluated both programs comparing pre- and posttest results. In both programs, mean test scores of the groups increased significantly. Success levels of the groups also increased significantly after using a cutoff point for test scores. With respect to relative effectiveness, attributed effectiveness, and effectiveness ration, the trainers training program was more effective than the other. As a result, our approach to training enlisted men as young adults is effective. We should evaluate the limitations of the study and consider our experiences to make the program more effective.

Determination of the reasons for unfitness for military service in Turkey.

This study aims to evaluate the frequencies and diagnosis types of cases in which young adult males were classified as unfit for military service before or during military service. This cross-sectional study was conducted between November 1998 and October 1999 by investigating the military medical board records of 21,985 "unfit" cases. Unfit for military service decisions were based on any of 436 different diagnoses. Twenty-three diagnosis types, each with a frequency of greater than 1.0%, collectively accounted for the majority of cases (59.2%). Initial medical examinations before service detected 64.0% of cases, whereas the remaining 36.0% were detected during service. Initial medical examinations can be a remarkable data source to determine the health profile of a young adult male population. High rates of failure in initial medical examinations call for improvements to initial medical examination procedures, which should eventually lead to cost savings for the military.