Effects of different warm-up periods on knee proprioception and balance in healthy young individuals.

CONTEXT: There is limited information on the effects of different warm-up periods on proprioception and balance in the context of injury prevention. OBJECTIVE: To determine the effects of warm-up exercises on knee proprioception and balance and to compare the effectiveness of warming up periods. DESIGN: Pretest/posttest. SETTING: Research laboratory. PARTICIPANTS: 30 healthy subjects (19 women, 11 men; mean age 20.70 +/- 0.99 years). INTERVENTIONS: Exercise groups performed warm-up exercises (group 1, 5 minutes; group 2, 10 minutes). Joint Position Sense (JPS) was tested at 15 degrees , 30 degrees , and 60 degrees knee flexion (KF) on a JPS device. Balance was measured using the Neurocom Balance Master System. MAIN OUTCOME MEASURES: JPS absolute error (AE) was measured at 15 degrees , 30 degrees , and 60 degrees KF and postural control was measured. RESULTS: After exercise, we found significant improvements for AE of JPSs of 30 degrees right (R) KF, 15 degrees left (L) KF, and 60 degrees L KF in group 1. In group 2, AE of JPS values increased for all angles of both knees except 60 degrees R KF. AE of JPS values of 15 degrees R KF, 30 degrees R KF, 15 degrees L KF, 60 degrees L KF were significantly different in group 2 compared with group 1. In balance measurements, there were significant improvements for standing on foam with eyes closed (EC) position, velocity and R-L unilateral stance EC in group 1. There were significant improvements for velocity, end point, maximum excursion, and L unilateral stance EC in group 2. CONCLUSIONS: Both warm-up periods have positive effects on knee proprioception and balance. The 10-minute warm-up exercise improved proprioception by a greater amount than the 5 minutes warm-up exercise.

The impact of passive smoking on the development of lower respiratory tract infections in children.

Environmental tobacco smoke is an important public health problem. The objective of this study was to evaluate the effect of passive smoking on lower respiratory tract infections (LRTIs) in children aged 2-12 years. A case-control study was conducted on matched-pair design. One-hundred and fifty children with LRTIs and 150 healthy children were included in the study. Data were collected through questionnaire and urine samples for the determination of cotinine levels, and were analysed by McNemar chi-square, paired t-test and Pearson correlation tests. The prevalence of parental self-reported, indoor smoking was 71.3% in children with LRTI and 72.0% in healthy children. Employing 30 ng mg(-1), the cut-off level of urinary cotinine/creatinine as commonly accepted, 87.3% of the children with LRTIs and 84.7% of healthy children were found to be passive smokers (p = 0.61, odds ratio (OR) = 0.93; confidence interval (CI) = 0.34-2.53). If 60 ng mg(-1) of urinary cotinine/creatinine was accepted as a cut-off level, it was observed that the rates of passive smoking were 76.7% and 50.7%, respectively (p = 0.000, OR = 4.72; 95% CI = 2.62-8.52). Dose-dependent exposure to environmental tobacco smoke was found to be associated with the incidence of LRTI.

PCR and serology were effective for identifying Chlamydophila pneumoniae in a lower respiratory infection outbreak among military recruits.

During endemic infections, the sensitivity of diagnostic tests and rapid diagnosis of the respiratory tract pathogens is particularly important. Utilization of just one diagnostic technique, such as serological tests or polymerase chain reaction (PCR)-based detection methods, during outbreaks of lower respiratory tract infections (LRI) can result in some of the patients being missed. In this study we aimed to investigate the etiology of LRI in military recruits in Izmir, Turkey, among whom several pneumonia cases have been reported and 47 patients have been hospitalized. Nasopharyngeal swabs were used for PCR analysis of Chlamydophila pneumoniae, Mycoplasma pneumoniae and Legionella spp. Serum samples were collected in the acute and convalescent phase of infection for C. pneumoniae and M. pneumoniae. Thirty-nine patients were diagnosed with C. pneumoniae infection by PCR and/or serology. Diagnoses were established by PCR in the acute phase of infection in 40.4% of the group. Based on the results of these studies, PCR is a useful method for early detection and identification of C. pneumoniae-related LRI outbreaks. However, this technique is not sufficient to detect all positive cases per se. After effective therapy and introduction of appropriate infection control measures, the outbreak ceased without mortality. This is the first closed-community C. pneumoniae outbreak report from Turkey.

Relationships between cotinine, lower respiratory tract infection, and eosinophil cationic protein in children.

INTRODUCTION: The aim of this study was to investigate the effect of passive smoking on urine eosinophil cationic protein (u-ECP) in children with lower respiratory tract infections (LRTI). METHOD: This was a case-control study. The study cohort consisted of 150 children with LRTI (case group) and 150 healthy children (control), all from a urban setting. The statistical parameters were: a minimum of 139 children for a 95% confidence interval (95% CI), 80% power, and a possible exposure prevalence of 50%. The u-cotinine and u-ECP levels were measured by radioimmunoassay and fluoroimmunoassay methods, respectively. Data were analyzed by the McNemar chi-square test, t-test, and Pearson correlation. RESULTS: When the generally accepted cut-off level of 30 ng/mg urinary cotinine/creatinine was applied, 87.3% of the children with LRTI and 84.7% of healthy children were passive smokers. Using a cut-off level of 60 ng/mg, passive smoking increased the prevalence of LRTI by 4.7-fold (p=0.000). The mean u-ECP values were significantly higher in the case group than in the healthy control group (p=0.018). A positive association was found between u-cotinine and u-ECP values in children with LRTI (p=0.034). CONCLUSION: The results of this study indicate that passive smoking may play an important role in the development of respiratory infections and can cause airway inflammation in children with existing LRTI.

The prevalence of metabolic syndrome among young adults in Izmir, Turkey.

OBJECTIVE: The aim of this study was to determine the prevalence of metabolic syndrome and its components among the young adult ages in Izmir, Turkey. METHODS: A population-based cross-sectional study was held including 885 subjects aged between 20 to 39 years from 45 primary health care centres in Konak, which is the biggest urban area in Izmir. A stratified sampling method was used to select the participants of 318 males and 567 females. In the study, metabolic syndrome was classified according to NCEP ATP III criterion on the basis of metabolic risk factors evaluated between December 2001 and April 2002. RESULTS: The crude prevalence of metabolic syndrome (having three or more of the metabolic risk factors) was 3.6% among 20 and 29 years old men and 19.6% among 30 and 39 years old men and the increase by age was significant (p<0.001). The results were similar in women and the crude prevalence of metabolic syndrome increased significantly from 7.5 % in 20 and 29 years old women to 24 % in 30 and 39 years old women (p<0.001). With regard to the highest prevalences of the first three metabolic risk factors, hypertriglyceridemia, low HDL-cholesterol and high blood pressure, the age-adjusted prevalence of the metabolic syndrome was significantly higher in women than in men and all subjects (15% vs 10.2% vs 13.6%, p<0.01) respectively. CONCLUSION: This study revealed that the prevalence of metabolic syndrome was extremely high between young adults in urban areas and the most prevalent components of the metabolic syndrome were found to be high triglycerides, low HDL cholesterol, high blood pressure, abdominal obesity and high fasting glucose, respectively.

Comparison of knowledge scores of medical students in problem-based learning and traditional curriculum on public health topics.

BACKGROUND: The purpose of the study was to compare the knowledge scores of medical students in Problem-based Learning and traditional curriculum on public health topics. METHODS: We planned a cross-sectional study including the fifth and sixth year medical students of Dokuz Eylul University in Turkey. The fifth year students (PBL group, n = 56) were the pioneers educated with PBL curriculum since the 1997-1998 academic year. The sixth year students (traditional education group, n = 78) were the last students educated with traditional education methods. We prepared 25 multiple-choice questions in order to assess knowledge scores of students on selected subjects of Public Health. Our data were collected in year 2002. RESULTS: Mean test scores achieved in PBL and traditional groups were 65.0 and 60.5 respectively. PBL students were significantly more successful in the knowledge test (p = 0.01). The knowledge scores of two topics were statistically higher among PBL students. These topics were health management and chronic diseases. CONCLUSION: We found that mean total evaluation score in the PBL group was 4.5 points higher than in the traditional group in our study. Focusing only on the knowledge scores of students is the main limitation of our study. Upon the graduation of the first PBL students in the 2002-2003 academic year, we are planning additional studies regarding the other functions of a physician such as skill, behaviour and attitude.

Age-related changes in pressure pain threshold, grip strength and touch pressure threshold in upper extremities of older adults.

BACKGROUND AND AIMS: Hand function weakens with age in both men and women, especially after the age of 65. As the number of older people increases, more older adults may have sensorimotor impairment, which affects upper extremity (UE) performance and thus independence in the activities of daily life. The purpose of this study was to detect and evaluate the impact of age on pressure pain threshold (PPT), touch/pressure threshold and grip strength in the decades after the age of 60. METHODS: The study was carried out with the participation of older adults living in the Izmir Geriatric Centre. Older adults were subdivided into three age groups and 128 subjects (47 male, 81 female) were selected systematically as one out of every three individuals in each group (group 1: 60 to 69; group 2: 70 to 79; group 3: 80 or over). Touch/pressure threshold test, pressure pain threshold (PPT) test and grip strength measurement were performed on dominant and non-dominant hands. RESULTS: It was found out that touch/pressure thresholds increased with age, but the change was not statistically significant between the three age groups. PPT and grip strength of dominant and non-dominant hands decreased from groups 1 to 3, but analysis indicated that these declines were not statistically significant. CONCLUSIONS: Despite the fact that age-related sensorimotor changes are not statistically significant, a reduction is seen in sensorimotor parameters after the age of 60.

DNA copy number changes detected by comparative genomic hybridization and their association with clinicopathologic parameters in breast tumors.

The purpose of this study was to use comparative genomic hybridization (CGH) to screen breast tumors for copy number changes: 22 ductal, 9 lobular, 7 mixed, 2 micropapillary carcinomas, and 2 ductal carcinoma in situ were studied and various regional genomic imbalances were detected. The majority of the aberrations identified in this study were in line with previous CGH findings. The most frequent DNA sequence copy number changes were 1q, 8q, and 20q gains. The frequency of 16q losses was significantly higher in lobular carcinomas. The nodal involvement was 10 times higher in cases showing losses of 13q than in cases having normal peak profile at this region. Estrogen receptor positivity was significantly higher in cases displaying 20q gains and 16q losses. Unambiguous high-level DNA amplifications have also been detected. These mapped to 4q31, 6q21 approximately q22, 8q21 approximately q24, 8p11.2 approximately p12, 11q13, 15q24 approximately qter, 20q13.1 approximately qter, and 20q12 approximately qter chromosomal locations. Our results highlight several chromosomal regions that may be important in the molecular genetics of distinct clinicopathologic breast cancer subgroups.