The suitability of using death certificates as a data source for cancer mortality assessment in Turkey.

AIM: To compare the quality of the 2008 cancer mortality data of the Istanbul Directorate of Cemeteries (IDC) with the 2008 data of International Agency for Research on Cancer (IARC) and Turkish Statistical Institute (TUIK), and discuss the suitability of using this databank for estimations of cancer mortality in the future. METHODS: We used 2008 and 2010 death records of the IDC and compared it to TUIK and IARC data. RESULTS: According to the WHO statistics, in Turkey in 2008 there were 67255 estimated cancer deaths. As the population of Turkey was 71517100, the cancer mortality rate was 9.4 per 10000. According to the IDC statistics, the cancer mortality rate in Istanbul in 2008 was 5.97 per 10000. CONCLUSION: IDC estimates were higher than WHO probably because WHO bases its estimates on a sample group and because of the restrictions of IDC data collection method. Death certificates could be a reliable and accurate data source for mortality statistics if the problems of data collection are solved.

Assessment of knowledge, behaviour and sun protection practices among health services vocational school students.

There has been a significant increase in the cases of skin cancer throughout the world in the last few decades. Although the mortality rate of skin cancer is relatively low, its impact on other health aspects is high and the treatment of undesired aesthetic damage is costly. According to disability-adjusted life year rates (DALY), 1.5 million days are estimated to be lost from people's lives every year worldwide due to ultraviolet (UV) radiation. The purpose of this study was to raise sun health awareness levels among health services vocational school students. A total of 414 students were included in the analysis. A questionnaire form was used to evaluate knowledge, attitudes and behaviours among the survey sample. The average level of knowledge concerning the effects of the sun was found to be 8.64 ± 2.5 out of 15 points. All socio-demographic factors were analysed, but the only significant variables found were age and the possible presence of skin cancer within the immediate family (p < 0.05).

Prevalence of smoking and related risk factors among Physical Education and Sports School students at Istanbul University.

The purpose of this study was to evaluate smoking prevalence and factors associated with smoking among students at the Physical Education and Sports School of Istanbul University. A cross-sectional study was performed on total of 373 students who have been continuing their education at the school from February to March 2011. A total of 166 responders were male (44.5%) and 207 responders were female (55.5%) out of 373 participants. Of the 373 students, 94 (25.2%) were current smokers and the average age for beginning smoking was 18.03 ± 2.6 (min: 12-max: 30). In this study, we found that the smoking prevalence associated with some variables such as age place of residence, mother's education, father's education, cigarette or tobacco use in the living place, knowledge status of students about their teacher's smoking habits and alcohol consumption (p ≤ 0.05). These findings suggest that the students, who will train the sportspeople of the future, and should be considered a role model of healthy behavior in society. Consequently, we believe that sports school students should take an active role in providing health education programs to increase their awareness about the detrimental effects of smoking and to extensively quit smoking in public.

Glutathione S-transferase M1, GSTT1 and GSTP1 genetic polymorphisms and the risk of age-related macular degeneration.

PURPOSE: To determine the possible effects of glutathione S-transferase (GST) M1, GSTT1 and GSTP1 genetic polymorphisms on the risk of developing age-related macular degeneration (AMD). PATIENTS AND METHODS: This case-control study included a total of 120 patients with AMD (65 with dry-type AMD and 55 with wet-type AMD) and 198 disease-free controls. GSTM1 and GSTT1 polymorphisms were analyzed by using a multiplex polymerase chain reaction (PCR), and GSTP1 polymorphism was detected by real-time PCR assay. RESULTS: GSTM1-null genotype was significantly associated with the development of AMD (p = 0.01, OR = 1.82, 95% CI = 1.14-2.91). Stratification by AMD subtypes revealed a significant relationship between GSTM1-null genotype and dry-type AMD (p = 0.02, OR = 1.98, 95% CI = 1.10-3.53). In a stepwise regression model, only GSTM1-null genotype was significantly associated with the development of AMD (p = 0.01, OR = 1.77, 95% CI = 1.11-2.81). CONCLUSIONS: Our findings suggest that genetic polymorphisms of GST may have a role in the development of AMD.

Knowledge, attitudes, and opinions of Turkish private school principals regarding substance abuse.

OBJECTIVE: To determine the knowledge, attitude, and opinion of private school principals in Kocaeli, Turkey regarding substance abuse. METHODS: Data of this descriptive study was collected by questionnaires in December 2008. The questionnaire, developed based on Turkey's "substance abuse regulations," was applied to the principals of private schools in Kocaeli affiliated with the Ministry of National Education. A survey was conducted and risk factors for these schools were determined. The data was analysed with Pearson correlation test, Spearmen correlation test and Kruskal-Wallis one way analysis used. RESULTS: Principals of 27 of 31 schools were reached. Six (22.2 %) were women; 21 (77.8 %) were men. Average age was 43.37 +/- 10.08 years. Average years of teaching was 21.55 +/- 10.77 years. Mean period as a school principal was 9.42 +/- 9.36 years. Seventy-one percent of the principals who participated in the survey were non-smokers. CONCLUSION: The majority of principals considered substance abuse as a problem in Turkey and believed it to be more among primary and high school students.

Tracheo-innominate artery fistula: two cases.

Tracheo-innominate artery fistula (TIF) is a rare but catastrophic and almost always fatal complication of tracheostomy. Two surgically intervened TIF cases are presented. In both cases, innominate artery ligation was performed. The first patient died due to respiratory failure 10 hours after operation. The second patient was discharged with normal neurologic examination on the 12th day of operation. Since the mechanism of injury leading to TIF is pressure necrosis, it is of vital importance to be aware of the predisposing factors and to take preventive measures. On the other hand, only patients treated with emergency surgery tend to survive.

Endobronchial hamartoma in a case with neurofibromatosis.

A 60-year-old male patient with neurofibromatosis type 1 presented with a right pulmonary mass. Bronchoscopic evaluation revealed an endobronchial mass on the right upper lobe.He was operated on after a bronchial biopsy and a fine-needle aspiration biopsy revealed non-specific findings. Pathological evaluation of right upper lobectomy material was compatible with an endobronchial hamartoma and right upper lobar abscess.Hamartoma is a component of neurofibromatosis syndrome. However, endobronchial hamartoma, as found in our patient, is a rare condition and is the reason for presenting this case.

Surgical treatment of cardiac hydatid disease: A report of 7 cases.

Cardiac echinococcosis is a rare but potentially very serious complication of hydatid disease. It is a diagnostic and therapeutic challenge due to the variability of signs and symptoms at presentation and to its numerous, often unpredictable, preoperative complications. Our clinical experiences with 7 cases of cardiac echinococcosis are reported, and the diagnostic and therapeutic considerations for the management of patients are discussed, together with a review of the literature.

Primary peritracheal schwannoma: report of a case.

Posterior mediastinal tumors of neurogenic origin commonly arise from the sympathetic or intercostal nerves. However, anterior mediastinal tumors rarely originate from the vagus nerve, and primary neurogenic tumors of the trachea are extremely uncommon. A 19-year-old man was admitted to an emergency department in sudden acute respiratory distress. A tracheostomy was performed and he was transferred to our Ear Nose and Throat Department for further investigation. A bronchoscopic biopsy was taken of a mass occupying the tracheal lumen and intraoperative frozen section examination suggested a schwannoma, so tracheal resection was performed. Although rare, primary tracheal schwannoma should be considered in the differential diagnosis of sudden respiratory distress of unknown origin.

Late infective endocarditis after cholecystectomy in a patient with repaired tetralogy of Fallot: a case report.

Late endocarditis after surgical repair of tetralogy of Fallot is rare. We describe a case of endocarditis following cholecystectomy in a 22-year old patient with repaired tetralogy of Fallot. After cholecystectomy, the patient was referred to a cardiology clinic with unexplained fever and suspicion of endocarditis. Echocardiography revealed a large mass at the basal level of interventricular septum. Endocarditis was diagnosed on the basis of clinical and echocardiographic findings and antibiotic treatment was initiated immediately. Nine days later, the clinical status of the patient deteriorated and urgent surgery was performed. Patch dehiscence which mimicked a large vegetation, and multiple vegetations on the patch were found during operation. The patch was removed and ventricular septum defect was repaired with a new dacron patch. Enterobacter agglomerans was isolated in the vegetation cultures.

A rare presentation of cardiac hydatid cyst: stroke and acute aortic occlusion.

Cardiac involvement in hydatid disease is uncommon. We report a case of a surgically treated ruptured left ventricular hydatid cyst, which presented with acute stroke and was later complicated by distal aortic embolism due to perioperative dislodgement of the germinative membrane.

Effects on reperfusion injury of adding diltiazem to tepid blood cardioplegia.

BACKGROUND: Although the present techniques of myocardial preservation for limiting ischemia/reperfusion injury in open heart operations yield excellent results for most patients, certain subgroups of patients with advanced coronary artery disease present a challenge in terms of intraoperative safety. METHODS: In a prospective, randomized, controlled study, we assessed the myocardial protective effects of a total dose of 150 +/- 150 = 300 microg/kg diltiazem added to induction and terminal (reperfusion) doses of tepid blood cardioplegia. We determined the myocardial morphological (ultrastructural) and enzymatic (serum assays for the cardiospecific isoenzyme of creatine kinase [CK-MB]) changes and functional recovery (atrioventricular [AV]-node recovery time and postoperative need for inotropic support) in patients undergoing elective coronary artery bypass operations. The determinations were made with respect to values for control patients, who received the same cardioplegia but without the addition of diltiazem. RESULTS: The mean isoenzyme CK-MB levels and semiquantitative ultrastructural score values of the diltiazem group were significantly less than those of the control group. Although AV-node recovery time was significantly prolonged (P < .05), this factor did not have major clinical impact. CONCLUSIONS: We concluded that the addition of 150 +/- 150 microg/kg diltiazem to the induction and terminal doses of tepid cardioplegia enhanced myocardial protection in elective aortocoronary bypass surgery in high-risk patients and presented no significant additional operative risk.