The prevalence and risk factors of low back pain in the eastern Black Sea region of Turkey.

BACKGROUND: Low back pain (LBP) is a public health problem commonly seen in all societies. OBJECTIVE: The aim of this study was to determine the prevalence and specific risk factors of low back pain (LBP) in the central and outlying districts of the province of Trabzon, a Black Sea region of Turkey. METHOD: A random sample of 7897 (4006 men and 3789 women) adults was collected by using sampling techniques of stratification. In this study questionnaires were completed at face-to-face interviews with participants selected on the basis of place of residence, gender and age group. The used variables in this study were: use of cigarettes, status of marriage, level of education, and presence of chronic disease, the prevalence of lifetime LBP and of LBP in the preceding year. Chronic LBP was determined as being present for more than 6 weeks. RESULTS: The lifetime prevalence of LBP in the general population was determined at 62.1%. Prevalence in the preceding year was 46.1%, and that of LBP lasting more than six week was 18.1%. Lifetime prevalence of LBP, prevalence of LBP in the preceding year and prevalence of pain lasting more than six week were all statistically significantly higher in women (p< 0.001). Use of cigarettes, female gender, marriage, a low level of education and presence of chronic disease were identified as independent risk factors for LBP (p< 0.001). CONCLUSION: Lower back pain is a common public health problem. Recommendations were made for local health services to prevent LBP, including health education through combating chronic diseases, reducing cigarette consumption, improvement of working environments and life styles.

Comparison of pulsed-field gel electrophoresis and enterobacterial repetitive intergenic consensus PCR and biochemical tests to characterize Lactococcus garvieae.

Biochemical test, pulsed-field gel electrophoresis (PFGE) and enterobacterial repetitive intergenic consensus sequence PCR (ERIC-PCR) were used to compare 42 strains of Lactococcus garvieae isolated from different regions of Turkey, Italy, France and Spain. Twenty biotypes of L. garvieae were formed based on 54 biochemical tests. ERIC-PCR of genomic DNA from different L. garvieae strains resulted in amplification of multiple fragments of DNA in sizes ranging between 200 and 5000 bp with various band intensities. After cutting DNA with ApaI restriction enzyme and running on the PFGE, 11­22 resolvable bands ranging from 2 to 194 kb were observed. Turkish isolates were grouped into two clusters, and only A58 (Italy) strain was connected with Turkish isolates. Similarities between Turkish, Spanish, Italian and French isolates were <50% except 216-6 Rize strain. In Turkey, first lactococcosis occurred in Mugla, and then, it has been spread all over the country. Based on ERIC-PCR, Spanish and Italian strains of L. garvieae were related to Mugla strains. Therefore, after comparing PFGE profiles, ERIC-PCR profiles and phenotypic characteristics of 42 strains of L. garvieae, there were no relationships found between these three typing methods. PFGE method was more discriminative than the other methods.

Ultrasonographic evaluation of femoral cartilage thickness in patients with ankylosing spondylitis.

OBJECTIVE: To evaluate femoral cartilage thickness in patients with ankylosing spondylitis (AS) by using ultrasonography. METHODS: Eighty-four patients (55 M, 29 F) with a diagnosis of AS and 84 age-, gender- and body mass index-matched healthy subjects were enrolled. Demographic and clinical characteristics of the patients including disease duration, morning stiffness and medications were recorded. The femoral cartilage thicknesses of both knees were measured with a 7-12 MHz linear probe while subjects' knees were held in maximum flexion. Three mid-point measurements were taken from both knees (lateral femoral condyle (LFC), intercondylar area (ICA) and medial femoral condyle (MFC)). RESULTS: Concerning both ICA (p < 0.001) and left MFC (p = 0.013), cartilage measurements were significantly thicker in AS patients than control subjects. In a subgroup analysis (anti-tumour necrosis factor (TNF) users vs anti-TNF naive), cartilage thickness measurements - bilateral ICA (p = 0.000) and left MFC (p = 0.017) - were found to be greater in AS patients under anti-TNF treatment (n = 65) when compared with those of healthy controls. CONCLUSION: We imply that AS patients seem to have thicker femoral cartilage, which could be related to anti-TNF treatment.

An evaluation of the tuberculin skin test for anti TNF alpha prophylaxis in patients with ankylosing spondylitis and rheumatoid arthritis.

AIM: The tuberculin skin test (TST) has recently been proposed as a screening procedure for latent TB prior to anti-tumor necrosis factor (TNF) alpha therapy. Our aim was to evaluate TST levels in patients receiving anti TNF alpha due to ankylosing spondylitis (AS) and rheumatoid arthritis (RA). MATERIALS AND METHODS: 73 AS patients (52 male, 21 female) and 33 RA patients (11 male, 22 female) were enrolled in the study. Patients' clinical and demographic characteristics were recorded. Average age +/- standard deviation was 38.8 +/- 7.2 years for AS and 40.7 +/- 13 for RA. Median number of immunosuppressive agents used was 1 (min-max) (0-2) in AS and 2 (2-3) in RA. To determine the activity of the disease, BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) was measured in AS patients, and DAS 28 (Disease Activity Index) was used in RA patients. TST was performed using the Mantoux method in all patients. RESULTS: Mean BASDAI was 5.1 +/- 0.8 in AS, and DAS 28 score in RA was 5.7 +/- 0.5. Both, AS and RA patients had active disease. TST values were higher in AS than in RA patients. TST values were 11.5 +/- 6.5 mm in AS patients, compared to 7.0 +/- 6.4 mm in RA patients. A positive correlation between disease duration and TST was determined in AS patients. There was also a weak correlation in RA patients between immunosuppressive use and TST (r = 0.37, p = 0.032). No correlation was determined with disease activation in AS or RA patients. CONCLUSION: This is the first study to evaluate the correlation between the use of multiple immunosuppressive agents and TST. We determined that TST is correlated with disease duration in AS and with the use of multiple immunosuppressive agents in RA (Tab. 3, Ref. 21).

Age-related diseases; degenerative aortic valve disease and osteoarthritis.

OBJECTIVE: To examine the relationship between degenerative aortic valve disease and osteoarthritis Background: Degenerative aortic valve disease (DAVD) and osteoarthritis (OA) are age-related degenerative diseases whose pathogenesis involves mechanical stress and local inflammation. METHODS: Forty-four patients with DAVD (Group 1) and 21 controls (Group 2) were included in this study, which was intended to investigate the similarity between the two conditions. The two groups were similar in terms of age, sex, body mass index, a history of hypertension, cholesterol levels, diabetes mellitus and cigarette consumption. RESULTS: The average age + standard deviation of the DAVD patients were 71.3 +/- 7.5, compared to 67.5 +/- 10.6 in the control group. In radiological OA analysis, the Lane scale was employed in the lumbar region and the Kellgren-Lawrence scale in the knee joint. Comparison of Groups 1 and 2 revealed no difference in radiological OA in the lumbar region and knee joint. CONCLUSION: Our study has shown that there is no relationship between these diseases that increased with age. However, extensive studies examining pathogenic mechanisms are needed (Tab. 2, Ref. 11).

Effects of dietary probiotic supplementations on prevention/treatment of yersiniosis disease.

AIMS: To evaluate Enterobacter cloacae and Bacillus mojavensis, isolated from rainbow trout gut in the present study, as a probiotic to control yersiniosis disease. METHODS AND RESULTS: A strain of Ent. cloacae and B. mojavensis, isolated from the digestive tract of rainbow trout had an antagonistic effect to Yersinia ruckeri, which causes yersiniosis. After feeding fish with 1 x 10(8) cells g(-1) probiotic containing feed for 60 days, the fish survival rate increased to 99.2% following challenge with Y. ruckeri compared with controls that had 35% survival rate. Effects of Ent. cloacae and B. mojavensis on weight gains and stimulation of red blood cells, white blood cells, platelets and hemoglobin were also evaluated in separate groups of fish fed probiotic containing feed for 2 months. Probiotic significantly affected white blood cells, hemoglobin and weight gains of the experimental fish. CONCLUSIONS: Enterobacter cloacae and B. mojavensis, can be used to prevent and control yersiniosis disease. SIGNIFICANCE AND IMPACT OF THE STUDY: In conclusion, concomitant use of Ent. cloacae and B. mojavensis as a feed supplement is beneficial to rainbow trout. Use of these organisms can protect fish from yersiniosis and enhance digestibility and utilization of feed. Use of such probiotics may also limit the use of antibiotics and other chemicals in control and treatment of diseases, and thus contribute to the effort to reduce environmental contamination by residual antibiotics and chemicals.

Performance of simple calculated osteoporosis risk estimation in a sample of women with suspected osteoporosis in the Turkish population.

The aim of this study was to evaluate the performance of the simple calculated osteoporosis risk estimation (SCORE) in a random sample of postmenopausal women. We collected data on 177 consecutive patients aged over 45 years. Bone mineral density (BMD) measurements were taken at the hip and lumbar spine. The test performance cut-off value was evaluated according to scores of 5, 6, 7, 8 and age distribution. When all groups were evaluated, SCORE 6 sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were 86.7, 59.1, 63, 82.5%, respectively. In the age ranged 45-49, we determined SCORE 6 results of Sn 85, Sp 100%. The test was able to identify women not requiring detailed densitometric investigation in this age group to a high level of accuracy. At SCORE 6 receiver operating characteristic (ROC) analysis, the area under the curve (AUC) was 0.6. We determined that the SCORE questionnaire performance in estimating those women with low BMD in the Turkish population was limited. However, since it is a simple, economical and practical pre-test, a SCORE 6 cut-off value can be used together with the physician's clinical analysis in sending patients with suspected low BMD for dual energy X-ray absorptiometry (DEXA) measurement.

Water quality and fish size affect toxicity of endosulfan, an organochlorine pesticide, to rainbow trout.

The acute toxicity of endosulfan in juvenile rainbow trout (Oncorhynchus mykiss, 10.61+/-1.69 g) was evaluated in glass aquaria under static conditions. Nominal concentrations of endosulfan in the toxicity test ranged from 1.3 microg l(-1) to 29 microg l(-1). The concentrations of endosulfan that killed 50% of the rainbow trout within 24-h (24-h LC50), 48-h LC50, 72-h LC50, and 96-h LC50 were 19.78, 8.89, 5.28, and 1.75 microg l(-1), respectively. None of the unexposed control fish died, and the first fish died 4 h after exposure to 26.3 microg l(-1) of endosulfan. Survival of fish was significantly increased with increasing fish size and decreased with decreased fish size at the same temperature (p<0.001). Temperature also had a significant effect on survival of fish. Alkalinity at levels above 20 mg l(-1) as CaCO3 significantly increased survival of fish at 19.78 microg l(-1) of endosulfan. Increasing alkalinity from 20 mg l(-1) as CaCO3 to 42 or higher concentrations tested in this study (121 mg l(-1) as CaCO3) significantly increased survival of fish (p<0.01). Total hardness ranging from 55 mg l(-1) as CaCO3 to 126 mg l(-1) as CaCO3 did not affect survival of fish exposed to endosulfan. Endosulfan toxicity was found to be irreversible when fish were exposed to minimum concentrations of endosulfan tested. Histologically, fish gills had lamellar edema, separation of epithelium from lamellae, lamellar fusion, and swelling of the epithelial cells. Melanomacrophage centers were scattered throughout the trunk kidney, head kidney, and spleen. The liver of endosulfan-exposed fish had severe focal necrosis. None of these lesions were seen in unexposed control fish. Results indicate that alkalinity, temperature, and fish size affect endosulfan toxicity of rainbow trout.