Epidemiology of pertussis in adolescents and adults in Turkey.

Two hundred and fourteen patients who had a cough illness lasting at least 2 weeks were studied to investigate Bordetella pertussis as a cause of prolonged cough in adolescents and adults. Medical history and nasopharyngeal swab specimens for culture and polymerase chain reaction (PCR) were obtained at presentation. Three (1·4%) patients were B. pertussis culture-positive; 15 (7%) were B. pertussis PCR-positive (including the culture-positive patients) and 11 (5·1%) were Bordetella spp. PCR-positive. Symptom combinations were significantly high both in patients with pertussis and patients with indeterminate results (P < 0·05). We conclude that B. pertussis should be considered among differential diagnoses of prolonged cough in adolescents and adults and PCR and culture should be used to detect these cases and facilitate public health response.

Experimental hyperhomocysteinemia disturbs bone metabolism in rats.

OBJECTIVE: To investigate whether experimental hyperhomocysteinemia (HHCY) can induce adverse changes in bone metabolism. METHODS: Blood and urine samples were collected from rats fed with a methionine-enriched diet (HHCY, n = 18) or an isocaloric control diet (control, n = 10) for 12 weeks. Biochemical bone turnover markers (osteocalcin, hydroxyproline, N-terminal collagen I telopeptides and homocysteine (HCY), folate and vitamin B12) were measured. Whole body bone mineral density (BMD) was assessed by dual energy X-ray absorptiometry. RESULTS: HCY was significantly higher in HHCY than in control rats (16.2 versus 3.2 micromol/L; p = 0.0006). Bone resorption parameters hydroxyproline (1.60 +/- 0.6 versus 0.85 +/- 0.4; p<0.05) and N-terminal collagen I telopeptides (150.8 +/- 78 versus 48.1 +/- 26 nmol/L BCE; p<0.05) increased, whereas bone formation marker osteocalcin (9.01 +/- 3.8 versus 15.07 +/- 4.2 ng/mL; p<0.05) decreased in HHCY compared to control rats. The relation N-terminal collagen I telopeptides/osteocalcin significantly increased in HHCY compared to control rats (13.14 +/- 3.1 versus 4.14 +/- 1.9). BMD measurement did not reveal any differences between groups. CONCLUSION: These findings demonstrate a significant modification of bone turnover in HHCY rats. The relation between bone resorption and formation indicates a shift toward bone resorption, which might be a plausible explanation for the relation between HHCY and fracture risk.

Clinical features and natural course of Behçet's disease in 661 cases: a multicentre study.

BACKGROUND: Behçet's disease (BD) is a systemic inflammatory disease with unpredictable exacerbations and remissions. The natural course of BD is not fully known. OBJECTIVES: We aimed retrospectively to determine the occurrence of the symptoms in chronological order. We also evaluated the influence of the treatment and follow-up on the clinical severity and tried to identify the factors determining severe organ involvement. METHODS: Six hundred and sixty-one patients were involved in this multicentre study. The symptoms of the disease were recorded retrospectively in the time order of the manifestations in each patient. RESULTS: Oral ulcers were the most common manifestation (100%), followed by genital ulcers (85.3%), papulopustular lesions (55.4%), erythema nodosum (44.2%), skin pathergy reaction (37.8%), and articular (33.4%) and ocular involvement (29.2%). Oral ulcers were the most common onset manifestation (88.7%). The mean +/- SD duration between the onset symptom and the fulfilment of diagnostic criteria was calculated to be 4.3 +/- 5.7 years. The clinical severity score was significantly increased in the noncompliant treatment group compared with the compliant group with the passage of time (P < 0.001). The frequency of ocular involvement and genital ulcers was significantly higher in patients whose disease onset was at < 40 years. Genital ulcers, ocular involvement, papulopustular lesions, thrombophlebitis and skin pathergy reaction were found to be significantly more frequent in males. CONCLUSIONS: Mucocutaneous lesions are the hallmarks of the disease, and especially oral ulcers precede other manifestations. The increase in clinical severity score is more pronounced in patients without regular treatment and follow-up. Male sex and a younger age at onset are associated with more severe disease.

Public opinion regarding oocyte donation in Turkey: first data from a secular population among the Islamic world.

INTRODUCTION: We aimed to reveal the general attitudes of Turkish people toward various aspects of oocyte donation. METHODS: This descriptive study was carried out in two separate districts of a large Turkish city. Four hundred participants were chosen by cluster sampling methods. The questionnaires were performed by 4th year medical students face to face with the participants. RESULTS: The participants consisted of 232 women (58%) and 168 men (42%); 65% were married, 5% were divorced; 64% had children, 15 (4%) had infertility problems, 263 (66%) were graduates of high school or university; 269 (67%) considered themselves religious. Only less than one-third of the respondents actually knew what oocyte donation meant. Approval of oocyte donation was high in our study sample. Only 61 (15%) respondents showed complete objection to oocyte donation and more men were in favour than women. Less than half of the participants thought that their religion would prevent oocyte donation if they needed it. More than half of the participants would prefer the use of oocyte donation treatment rather than adoption of a child. CONCLUSION: This is the first report on the attitudes towards oocyte donation from a country having a secular constitution and whose population is mainly Muslim. The most important conclusion to be drawn from the present study is the fact that most of the participants did not have any objection to oocyte donation treatments.

Seroprevalence of antibodies to legionella pneumophila in hemodialysis patients.

Patients with chronic renal failure are at increased risk for infections because of impaired cellular immunity. This study was designed to determine the prevalence of antibodies to Legionella pneumophila serogroups 1 to 6 and to evaluate the possible risk factors for Legionnaires' disease in hemodialysis patients. Serum samples to be screened for antibodies against L pneumophila and risk factor data were collected from 252 hemodialysis patients. The overall prevalence of L pneumophila antibodies in hemodialysis patients was found to be 5.16% There was no statistically significant difference between L pneumophila seropositivity and potential risk factors. Further studies are needed to determine possible risk factors for Legionnaires' disease in hemodialysis patients.

Pharmacy approach to a case of acute diarrhoea with dehydration in Antalya, Turkey.

A study examining the approach of pharmacies to diarrhoeal disease in childhood was carried out in Antalya, Turkey. A fictitious case history of a 10 month infant with an acute diarrhoea of three days duration, which was clinically identical with viral diarrhoea and accompanied by moderate dehydration was hypothesised. Following this, final semester students of the medical faculty posed as relatives of the infant and sought the advice of pharmacy attendants. The approach, to this hypothesised case, of all 214 pharmacies in the Antalya municipality district was examined. Most of the pharmacy attendants (57.7%) did not ask any questions to determine a differential diagnosis or establish the degree of dehydration. Only 21.6% of the pharmacy attendants recommended consulting a doctor or health centre, 6.5% recommended Oral Rehydration Solution (ORS) without giving an explanation about the amount needed or for how long it should be administered, 44.4% only dispensed a drug, 23.8% dispensed a drug with ORS and 3.7% recommended infant formula. Antidiarrhoeals were dispensed by 67.2% of the pharmacies and 14% gave antibiotics. Also 5.6% of the pharmacy attendants advised a reduction in the infant's fluid intake, 17.3% said that they could not give an opinion regarding breast feeding 19.2% advised stopping breast feeding and 7.0% did not know. All the pharmacies except the ones with the appropriate recommendation 'consult a doctor or a health centre' responded with advice given without hesitation although they did not intend to inspect or examine the infant. The approaches for acute diarrhoea of the pharmacies were determined as inappropriate and harmful.