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Öğe Alcoholism prevalence and some related factors in Edirne, Turkey(Yonsei Univ College Medicine, 2004) Ekuklu, G; Deveci, S; Eskiocak, M; Berberoglu, U; Saltik, AThe aim of this research was to estimate the community prevalence of alcoholism and the potential risk factors that affect it in the Edirne provincial centre by using a scanning test. A cross-sectional study was carried out in the Edirne provincial centre. A sample population composed of 500 women and 200 men was selected randomly after the categorisation of the population according to ethnicity, age and sex. Through face-to-face interviews, data collection sheets, which were prepared to analyse potential factors affecting alcoholism frequency, were filled in by the sample population. The Michigan Alcoholism Scanning Test (MAST) was employed. According to MAST's normal grading, individuals with 5 or more points are evaluated as alcoholics. Accordingly, 8.2% of the sample population fit the definition of alcoholic. Alcoholism frequency was considerably higher in gypsies, the self-employed, smokers, and people with higher income. From logistic regression analysis alcoholism frequency was 12.4 times higher in men than in women, 3.2 times higher in gypsies than in others, 1.9 times higher in people who earned an income in the preceding week than in the unemployed, and 3.7 times higher in individuals who had smoked more than 100 cigarettes during their life or those who had smoked at least 1 cigarette for 3 months or for a longer period than in those who hadn't smoked any cigarettes. The prevalence of alcoholism in the Edirne provincial centre was similar to that in other countries in Europe. The most important finding was that alcohol consumption decreased in the unemployed, a finding that differs from that in other parts of the world. Gypsies, who differ in tradition, way of life, and job compared to the other strata of society, also suffered from higher alcohol consumption. This group usually consumed wine and generally did not cat while drinking.Öğe Body mass index percentiles among adolescent girls living in Edirne, Turkey(Wiley, 2003) Karasalihoglu, S; Öner, N; Ekuklu, G; Vatansever, Ü; Pala, ÖBackground : Body mass index (BMI) is the simplest way to measure obesity; therefore, it is chosen by many authorities as a screening method for adolescent obesity. Body mass index is positively correlated with the complications of childhood and adolescent obesity, such as hypercholesterolemia, insulin resistance, hyper-tension and long-term development of cardiovascular diseases. The aim of the present study was to produce percentile curves for bodyweight, height and BMI in a representative sample of adolescent girls living in urban and rural areas of Edirne, Turkey, and to compare these percentile curves with curves from other countries. Methods : The present study was a cross-sectional study, including a representative sample of 1687 adolescent girls from rural and urban areas of Edirne, who were evaluated between May and July 2001. Bodyweight and height were measured using standard procedures. Body mass index (kg/m(2) ) was calculated as the ratio of bodyweight to body height squared. Smoothed percentiles for these variables were calculated using polynominal regression models. Crude weight, height and BMI percentile values, as well as smoothed percentile curves are presented. Results : Body mass index, weight and height reference curves for adolescent girls were produced. When we compared the BMI values of subjects in the present study with those of other countries, 85th and 95th percentiles of BMI in the present study were found to be generally lower than those for other ethnicities. Conclusion : Our findings show ethnic differences in BMI among adolescent girls. It will be usefull for each country to produce its own BMI percentiles.Öğe C-reactive protein and body mass index in women with pre-eclampsia(Wiley, 2004) Kilic-Okman, T; Kucuk, M; Ekuklu, G[Abstract Not Available]Öğe Clinical utility of dorsal sural nerve conduction studies in healthy and diabetic children(Elsevier Ireland Ltd, 2004) Turgut, N; Karasalihoglu, S; Kücükugurluoglu, Y; Balci, K; Ekuklu, G; Tütüncüler, FObjective: Monitoring of the dorsal sural sensory nerve action potential (SNAP) is a sensitive method for detection of peripheral neuropathies. We tried to determine the normal dorsal sural nerve conduction values of the childhood population and assessed the clinical utility of this method in diabetic children who have no clinical sign of peripheral neuropathy. Methods: In the study, 36 healthy and 27 diabetic children were included. In all subjects peripheral motor and sensory nerve studies were performed on the upper and lower limbs including dorsal sural nerve conduction studies. Results: The dorsal sural SNAP mean amplitude was 8.24 +/- 3.08 muV, mean latency was 2.47 +/- 0.48 ms, mean sensory conduction velocity was 41.63 +/- 5.43 m/s in healthy children. Dorsal sural SNAPs were absent bilaterally in one diabetic patient. In the other 26 diabetic patients, the mean dorsal sural nerve distal latency was longer (2.93 +/- 0.63 ms, P = 0.004), mean SCV was slower than in healthy subjects (36.68 +/- 7.66 m/s, P = 0.005). However, dorsal sural nerve amplitude was not different between the groups. A dorsal sural nerve latency of more than 2.9 ms had a sensitivity of 50% and a specificity of 75%. A dorsal sural nerve velocity of less than 36 m/s had a sensitivity of 54% and a specificity of 92%. Conclusions: We designated the reference values of the dorsal sural nerve in healthy children. In addition, our findings suggest that dorsal sural nerve conduction studies may have value to determine neuropathy in the early stages in children with diabetes. Significance: The dorsal sural nerve conduction studies in diabetic children may have value to determine the neuropathy in its early stages. (C) 2003 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.Öğe Cognitive evaluation and functional outcome after stroke(Lippincott Williams & Wilkins, 2001) Özdemir, F; Birtane, M; Tabatabaei, R; Ekuklu, G; Kokino, SObjective: To investigate the initial overall cognitive ability and its components as a predictor of functional improvement and ambulation during rehabilitation. Initial cognitive status is widely known to be a predictive factor in functional recovery in patients with stroke although some reports have found no such relationship. Design: Baseline cognitive status was scored by Minimental State Examination and its subsections with such headings as orientation, registration, attention and calculation, recall, and language in 43 patients with postacute stroke, aged between 51 and 68 yr. Function was evaluated in terms of motor FIM(TM) and functional ambulation as categorized in Adapted Patient Evaluation and Conference System functional scale at the time of admission and discharge. Results: Only total baseline Minimental State Examination score showed a significant correlation with discharge motor FIM improvement (r = 0.31, P = 0.04) and baseline orientation score correlated significantly with functional ambulation score improvement (r = 0.31, P = 0.03). In stepwise linear regression model, the same Variables had an effect on similar outcome parameters. Conclusions: Cognitiveion evaluation should be taken as a whole to predict functional outcome in patients with postacute stroke, except for the baseline orientation score that seemed more predictive for ambulation.Öğe Comparing stroke rehabilitation outcomes between acute inpatient and nonintense home settings(W B Saunders Co-Elsevier Inc, 2001) Özdemir, F; Birtane, M; Tabatabaei, R; Kokino, S; Ekuklu, GObjective: To compare outcomes in stroke survivors who received rehabilitation services in an acute inpatient rehabilitation setting (multidisciplinary rehabilitation team) with outcomes in survivors in a home-based setting (family caregivers, limited team supervision). Design: Randomized clinical trial, with mean follow-up after 60 days. Setting: Inpatient rehabilitation setting and home-based settings. Patients: Sixty patients (age range, 43-80yr) who had a stroke between 1996 and 1999 and had been referred after medical stabilization, randomly divided into 2 groups: group 1, inpatient rehabilitation; group 2, home-based rehabilitation. Interventions: Group 1: therapeutical and neuromuscular exercises with occupational therapy with professional supervision; group 2: conventional exercises with family caregiver and limited professional supervision. Main Outcome Measures: Spasticity was evaluated with the Ashworth Scale, motor status with Brunnstrom's stages, functional status with the FIMTM instrument, and cognitive status with the Mini-Mental State Examination before and after rehabilitation. Results: Patients rehabilitated in acute inpatient settings had better motor, functional, and cognitive outcomes (p < .05). Spasticity changes did not differ between the groups. Conclusion: Intense inpatient rehabilitation services for stroke survivors provide significantly more favorable functional and cognitive outcomes with relatively low complications than did nonintense rehabilitation efforts in home settings.Öğe The effect of dental training on the reactions of mentally handicapped children's behavior in the dental office(Amer Soc Dentistry Child, 1999) Yilmaz, S; Özlü, Y; Ekuklu, GThis study was planned to observe the negative reactions shown by mentally handicapped children during the dental examination and prophylaxis, and to confirm whether there was a difference in these reactions after dental training. Twenty mentally handicapped children (between 6-18 years) were examined by a dentist and their reactions were reported, before dental training was given. Later, a special educator and a dentist trained the children about the dental process. After the training the children were examined and their reactions were reevaluated. The results obtained from the first and the second appointments were compared using McNemar Test. There were significant differences between the first and the second results.Öğe A food-borne outbreak caused by salmonella enteritidis(Yonsei Univ Coll Medicine, 2003) Tansel, Ö; Ekuklu, G; Otkun, M; Tatman-Otkun, M; Akata, F; Tugrul, MThis study was designed to define the epidemiology of a food-borne outbreak caused by Salmonella enteritidis that affected only one squadron of a military battalion located in the vicinity of the city of Edirne in Turkey. The outbreak was analyzed by a standard surveillance form of the Centers for Disease Control and Prevention. The relationship between the eaten foods and cases was analyzed by Fisher's exact chi-square test, and odds ratios were calculated by a case-control study. The outbreak affected 60 of 168 soldiers in the squadron, 16 of whom were hospitalized. S.enteritidis was cultured in stools from 13 of the hospitalized soldiers and from 3 soldiers who had prepared the food. All strains were completely susceptible to antibiotics; their plasmid profiles were also identical. The highest attack rate detected was 55.7% in an omelet eaten 24 hours before (p<0.001). Furthermore, it was the riskiest food according to the case-control study (OR=7.88; 95% CI=3.68-16.89). The food samples were unobtainable because they had been discarded. All of the hospitalized cases recovered, and none of the control cultures of stools yielded the pathogen after three weeks. In conclusion, although our results didn't indicate the exact source of the outbreak microbiologically, the omelet was considered to be the source based on the epidemiological proofs.Öğe Hypercoagulopathy in stroke patients with nonvalvular atrial fibrillation(Westminster Publ Inc, 2006) Turgut, N; Akdemir, O; Turgut, B; Demir, M; Ekuklu, G; Vural, Ö; Özbay, GThe coagulation system is activated and coagulation activation markers are elevated in acute ischemic stroke with nonvalvular atrial fibrillation (NVAF). The etiology, severity, and prognosis of the ischemic stroke might be estimated with the level of the activation of the coagulation system. In this study, prothrombin F1+2 (F1+2), D-dimer, and fibrinogen levels were measured in patients with acute ischemic stroke with and without NVAF, and stroke severity was compared with these hemostatic parameters. Of 55 patients, 29 had sinus rhythm (group I), 26 had NVAF (group II); 20 healthy subjects (group III) were included in the study. Subtypes of cerebral infarction were classified. The patients underwent stroke severity, electrocardiography, echocardiography, cranial computed tomography, cervical duplex ultrasonography, and hemostatic parameter studies. In group II, F1+2 level (2.83 +/- 0.89) was significantly higher than in group I (2.33 +/- 0.80) and III (1.94 +/- 0.64) (p values: group I-II, 0.036; groups II-III, 0.001; groups I-III, 0.104). In group III, fibrinogen level (251.64 +/- 60.96) was significantly lower than that in groups I (347.97 +/- 111.49) and II (364.04 +/- 86.20) (p = 0.001). D-dimer was not significantly different between groups. In group I, lacunar syndrome (LACS), and in group II, partial and total anterior circulation syndrome (PACS + TAGS) were more common (p = 0.013, p = 0.001, respectively). In group II, Scandinavian Stroke Scale scores were lower than those in group I (group I = 45.2 +/- 14, group II = 35.4 +/- 18.9, p = 0.02). In conclusion, activation of coagulation, demonstrated by increment F1+2, is more abundant in the stroke patients with NVAF than in the stroke patients with sinus rhythm. Our results also showed that activation of the hemostatic system might be related to stroke subtype and stroke severity. It is suggested that the oral anticoagulation treatment as prophylaxis is important in the prevention of stroke in patients with NVAFÖğe Migraine prevalence and some related factors in Turkey(Wiley, 2005) Çelik, Y; Ekuklu, G; Tokuç, B; Utku, UObjectives.-The aim of our study is to determine the prevalence of migraine in Provincial Center of Edirne. Methods.-A systematic random sample of 386 inhabitants over 14 years old were interviewed face to face. Diagnosis of migraine was based on the International Headache Society (IHS) classification. Results.-Migraine was identified in 77 subjects (60 female, 17 male). The lifetime prevalence of migraine was found to be 19.9% (95% CI: 18.3-21.5) (9.34% (95% CI: 8.6-10) in males, 29.3% (95% CI: 27-31.6) in females). Conclusions.-These results show that while migraine prevalence in Turkish females is higher than that reported in previous studies from Europe and United States, lifetime prevalence is similar in all populations.Öğe Nucleated red blood cell counts and erythropoietin levels in high-risk neonates(Blackwell Publishing Asia, 2002) Vatansever, Ü; Acuna, B; Demir, M; Karasalihoglu, S; Ekuklu, G; Ener, S; Pala, ÖBackground : The presence of increased numbers of nucleated red blood cells (NRBC) and increased levels of erythropoietin (EPO) in the circulation of neonates has been associated with states of relative hypoxia. The aim of this study is to assess the pattern of NRBC counts and EPO levels in a group of high-risk neonates under stress conditions and determine the short-term outcome for these babies by using these parameters. Methods : There were 69 high-risk neonates; 14 intrauterine growth retarded ( IUGR), 25 preterm infants, 18 term infants with asphyxia and 12 infants of diabetic mothers. Control groups included healthy, term infants delivered either vaginally (n=18) or with cesarean section (n=19). Three blood samples were obtained from each infant within 12 h (initial), 3 days and 7 days after birth to measure NRBC counts and EPO levels. Neonatal and short-term outcomes at 3 and 6 months of age were determined. Results : There was no significant difference among the groups with regard to the initial serum EPO concentrations. The initial NRBC counts were significantly lower in the control groups compared with the study groups (P=0.002). While there was no significant difference between patients with good and poor outcome in terms of EPO concentrations of initial samples, a significant difference existed in terms of NRBC counts (P=0.038). Conclusions : Both serum EPO level and NRBC count provide limited clinical benefit in the detection of pathological conditions of the neonatal period, but NRBC count determination seems to be especially helpful in predicting short-term neurodevelopmental outcome.Öğe Pressure-induced pain on the tibia: an indicator of low bone mineral density?(Springer Tokyo, 2004) Birtane, M; Tuna, H; Ekuklu, G; Demirbag, D; Tuna, F; Kokino, SPrevious literature investigating bone pain in osteoporosis has prominently focused on painful conditions following osteoporotic fractures. Is osteoporosis really a silent disease without bone pain and tenderness unless a fracture occurs? Our aim in this study was to answer the question by assessing the questionable tenderness on tibia bones of fracture-free patients with low bone density and to compare the findings with a normal population. One-hundred-thirty-three consecutive postmenopausal female patients with the mean age of 56 years admitted to our clinic for bone mass measurement were included in the study. Bone mineral density (BMD) values of lumbar spine (L2-L4) and right proximal femur (neck, trochanter, Ward's triangle) were measured by dual-energy X-ray absorptiometry (DXA). Patients with T scores lower than -1 formed the osteopenic-osteoporotic group of patients (low BMD group) whereas those with T scores higher than -1 constituted the normal BMD group according to the osteoporosis definition regarding T score for DXA. Mechanical pressure was applied by a hand algometer on the middle points of three equally divided sections on the anterior part of tibia, and the pressure levels starting the pain sensation (POPL) were recorded. Although the patients in the normal BMD group reported consistently high POPL at all regions of tibia for all BMD measurement sites, this difference reached to a statistical significance level only for the femur neck region. Only mean POPL for the whole tibia had independent association with only femur neck BMD by multiple linear regression analysis. These results are encouraging for assessing the significance of pressure-induced tibial pain as an indicator of low BMD in the future.Öğe The prevalence of folic acid deficiency among adolescent girls living in Edirne, Turkey(Elsevier Science Inc, 2006) Öner, N; Vatansever, Ü; Karasalihoglu, S; Ekuklu, G; Çeltik, C; Biner, BPurpose: A high incidence of iron-deficiency is a common observation among adolescent girls, whereas only limited data are available regarding the folic acid status of this group. This study was designed to determine the prevalence of biochemical folic acid deficiency in a group of Turkish adolescent girls. Methods: We Surveyed the serum folic acid, complete blood count, and dietary folic acid intake of Turkish adolescent girls after using three-clay self-reported food intakes in urban and rural areas of Edirne, Turkey. Results: A sample population was composed of 704 adolescent girls; their serum folic acid levels were found to be adequate for 37.6% (>= 6 ng/mL), marginal for 46% (3 to 5.9 ng/mL), and at deficient levels for 16.3% (< 3 ng/mL). Folic acid deficiencies were found in 20.1% (36 of 179) and 14.7% (61 of 416) of adolescent girls from rural and urban areas, respectively. Self-reported three-day folic acid intakes were correlated with the corresponding blood values for this nutrient. In the logistic regression analysis, three factors emerged as significant independent predictors of folic acid deficiency: low income (odds ratio [OR]: 2.4, 95% confidence interval [CI]: 1.3-4.2, p < .001), low vitamin C (OR: 1.9, 95% CI: 1.1-3.5, p < .05), and folic acid intake (OR: 4.8, 95% CI: 2.8-8.1, P < .001). Conclusion: Data from the present study may indicate that serum folic acid is low in a group of Turkish adolescent girls. These low values appear to be associated with low income, and low dietary intakes of folic acid and vitamin C. (c) 2006 Society for Adolescent Medicine. All rights reserved.Öğe Prevalence of postpartum depression in Edirne, Turkey, and related factors(Sci Printers & Publ Inc, 2004) Ekuklu, G; Tokuc, B; Eskiocak, M; Berberoglu, U; Saltik, AOBJECTIVE: To estimate the community prevalence of postpartum depression (PPD) in Edirne, Turkey, and the potential risk factors for it. STUDY DESIGN: The study was performed on mothers during the 6-week postpartum visit at home. A questionnaire that was devised to collect data on basic demographic information on the mothers and the Edinburgh Postnatal Depression Scale (EPDS) were applied. A total of 210 mothers were interviewed between January and April 2002, and 178 of them whose data were complete were analyzed. We evaluated EPDS cutoff scores greater than or equal to 12. RESULTS: With an EPDs cutoff score of greater than or equal to12, the prevalence of PPD was 40.4%. Such factors as the husband's unemployment and a low educational level, living in a rented house, and having psychological or other problems during a previous pregnancy were the most significant risk factors for PPD. In the logistic model, the family's preference for a male infant in the previous pregnancy, female infant in the previous delivery and unwanted pregnancy were associated with PPD. The OR for these 3 variables and their 95% CI are, respectively, OR=3.10, 95% CI 1.57-6.12; OR=2.18, 95% CI 1.09-4.37, and OR = 2.84, 95% CI 1.22-6.61). CONCLUSION: The prevalence of PPD was high. Although the risk factors were similar to those in other studies, other family members' mention of wanting a son can cause depression in the mothers.Öğe Prevalence of underweight, overweight and obesity in Turkish adolescents(E M H Swiss Medical Publishers Ltd, 2004) Öner, N; Vatansever, Ü; Sari, A; Ekuklu, G; Güzel, A; Karasalihoglu, S; Boris, NWBackground: The aim of this study was to determine under-weight, overweight and obesity prevalence in a representative sample of adolescents living in urban and rural area of central Edirne, Turkey, and to compare the 95(th) percentile BMI curve to the curves of other countries. Material and methods: Data concerning the height and weight of 989 adolescents, aged between 12 and 17 years were collected. The prevalence of underweight was defined as the percentage of adolescents below the 5(th) percentiles of the American adolescents' age and gender specific BMI; prevalence of overweight and obesity were based on the cut off points of the International Obesity Task Force values (excess of the 85(th) and 95 h percentiles), respectively. Results: This study demonstrated that the prevalence of underweight, over-weight and obesity among adolescent girls was 11.1%, 10.6% and 2.1%, respectively, while it was 14.4%, 11.3% and 1.6% for adolescent boys. In the urban area the prevalence of underweight, overweight and obesity among adolescent girls was 10.0%, 10.3% and 2.1%, while it was 14.4%, 11.6% and 1.6% for boys, respectively. In the rural area; the prevalence of under-weight, overweight and obesity among adolescent girls was 15.7%, 12.4% and 2.2%, while it was 14.5%, 9.6% and 1.2% for boys, respectively. Discussion: Analyses of data collected during these studies support that adolescents living in the city of Edirne carry relatively lower further risk of over-weight and obesity than adolescents in other countries do.Öğe The protective role of melatonin in experimental hypoxic brain damage(Blackwell Publishing, 2005) Tütüncüler, F; Eskiocak, S; Basaran, ÜN; Ekuklu, G; Ayvaz, S; Vatansever, ÜBackground: It is known that oxygen-derived free radicals play an important role in the pathogenesis of brain injury. Melatonin is a powerful scavenger of the oxygen free radicals. In this study, the protective effect of melatonin against the damage inflicted by reactive oxygen species during brain hypoxia was investigated in newborn rats using biochemical parameters. Methods: For biochemical analyses, the levels of lipid peroxidation product (malondialdehyde ([MDA]), levels of reduced glutathione (GSH) and the activities of superoxide dismutase (SOD) and catalase (CAT) were estimated. Results: After the third day of brain hypoxia, the brain levels of MDA increased. Pretreatment of animals with melatonin abolished the rise in MDA induced by hypoxia. GSH concentration did not increase by pretreatment with melatonin. Additonally, the activities of two antioxidative enzymes (SOD and CAT) decreased after the experimental period with melatonin only preventing the change of CAT. The activity of SOD was not influenced by melatonin administration as expected. Conclusion: In this experimental study, exogenously administered melatonin effectively protected against brain injury by oxidative stress. This protective effect of melatonin may be due to its direct scavenger activity and activation of CAT. Thus, melatonin may potentially be useful in the treatment of neurodegenerative conditions that may involve free radical production, such as perinatal hypoxia.Öğe Regenerative hyperplasia of follicular epithelium in chronic lymphocytic thyroiditis(Lippincott Williams & Wilkins, 2005) Doganay, L; Puyan, FO; Oz, F; Ergul, Z; Bilgi, S; Ekuklu, GThe thyroid gland is an endocrine organ composed of stable cells. It is well known that regenerative capacity of the thyroid tissue is minimal. Various degrees of morphologic alterations do occur in chronic lymphocytic thyroiditis (CLT), including Hashimoto's thyroiditis. Eighty-five CLT cases were analyzed for these morphologic alterations. Small, irregular, atrophic or hyperplastic thyroid follicles were seen adjacent to the lymphocytic infiltration. There was nuclear enlargement, loss of nuclear polarity in thyrocytes and intrafollicular thyrocyte proliferation in these follicles. We thought that the morphologic alterations in involved follicles could be due to regenerative hyperplasia with increased proliferative activity and basement membrane abnormalities. To examine this hypothesis we investigated Ki-67 and laminin immunoreactivity in the involved follicles adjacent to lymphocytic infiltration areas. The uninvolved follicles were used as controls. Immunopositivity of Ki-67 in involved follicles was significantly higher than that in uninvolved follicles (2.97% +/- 2.16 versus 0.83% +/- 1.63, P < 0.001). Laminin immunostaining indicated the destruction or irregular distribution of basement membrane in involved follicles. We conclude that the increased cell proliferation activity and basement membrane abnormalities in the follicles with morphologic changes adjacent to CLT occur in conjunction with regenerative hyperplasia.Öğe Serum lipid levels in psoriasis(Yonsei Univ College Medicine, 2003) Piskin, S; Gurkok, F; Ekuklu, G; Senol, MA predisposition to occlusive vascular diseases has been reported in patients with psoriasis and it has been suggested that some of these patients have some disorders of lipid metabolism. In this study, serum lipid levels were investigated in psoriatic patients to explore to the knowledge of this relationship. One hundred psoriatic patients and 100 non-psoriatic controls were included in the study. Total cholesterol, triglyceride, high-density lipoprotein-cholesterol (HDL-cholesterol), low-density lipoprotein-cholesterol (LDL-cholesterol), and very low-density lipoprotein-cholesterol (VLDL-cholesterol) levels were measured. In patients with psoriasis, total cholesterol and LDL-cholesterol levels were found to be significantly higher than those of controls. No significant differences were found in the other parameters. We concluded that psoriatic patients should be evaluated and followed up for the risk of hyperlipidemia and obstructive vascular diseases.Öğe Superoxide dismutase activity and the effect of N-methly-D-aspartate antagonists on lipid peroxidation in the early phase of cold injury(Springer, 1999) Kiris, T; Görgülü, A; Ünal, F; Türkoglu, Ü; Çobanoglu, S; Ekuklu, GFree radicals, lipid peroxidation and excitatory amino acids have been implicated in the secondary mechanisms of traumatic brain injury. We used the cold injury model in rats to assess the endogenous activity of the protective enzyme superoxide dismutase (SOD) and the lipid peroxidation level in the contused tissue at an early phase of injury. Furthermore, we treated the rats with two different N-methyl-D-aspartate receptor antagonists, namely MK-801 and CPP, and evaluated their effect on lipid peroxidation in the contused tissue. Rats were divided into four groups: sham, control, treatment 1 and treatment 2 groups (n = 16 for each group). Thirty and 60 min after craniectomy or injury, tissue samples were removed. SOD activity didn't change in this period. However, lipid peroxidation in terms of malondialdehyde (MDA) amount showed a significant increase at 60 min. Fifteen minutes after injury, MK-801 (1 mg/kg), CPP (10 mg/kg) or saline (1 ml) were applied intraperitoneally in treatment 1, treatment 2 and the control groups, Treatment with MK-801 attenuated MDA levels, whereas treatment with CPP did not. The protective effect of MK-801 achieved statistical significance. These results demonstrate that SOD activity does not change in the Parry period of cold injury. Moreover, these results show that lipid peroxidation increases after 60 min of cold injury, and treatment with MK-801 15 min after injury can prevent this elevation.Öğe Utilization of Primary Health Care services by Turkish gypsies and members of the general population at Muradiye Health Unit District in Edirne, Turkey(Yonsei Univ College Medicine, 2003) Ekuklu, G; Berberoglu, U; Eskiocak, M; Saltik, AThis survey was designed to investigate the socio-demographic characteristics of and utilization of a Primary Health Care Unit (PHCU) by Roma people (Turkish Gypsies), who live in the coverage area of Muradiye Primary Health Care Unit, as compared to members of the general population. This was a cross-sectional field study involving members of the Muradiye PHCU district. The study population comprised 127 Turkish gypsies resident in the region and 302 households selected by a stratified random sampling method. 889 household members were interviewed face-to-face at their home by means of a structured questionnaire. When the two sample groups were compared in terms of their social security coverage, rates of unemployment and educational levels, the situation of the Turkish Gypsies was found to be worse than that of the other members of the general population. 63% of the Gypsies applied to the PHCU because of health problems and 87% of these cases were treated successfully. Among those people making use of the PHCU services 47% evaluated them as being satisfactory. Access to the PHCU services was found to be conditioned by educational level, being a Gypsy, the possession or not of a Green Card (available only to highly indigent people), whether or not the services were provided free of charge and the possession or not of social security coverage. Muradiye PHCU is well known and highly appreciated in its coverage area and is used by almost all of the residents. The main reason for the significant discrepancies in the level of health care obtained by the two population groups is the Gypsies' poorer economic situation. Among the Gypsies, the leading category of low rate social security coverage is the Green Card, which is granted to the very poor in order to reduce these inequalities. Unfortunately, the Green Card does not provide financial support for ambulatory care.
