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Öğe Determination of occupation and other factors that may have an impact on diagnosis and treatment in medical records(Ortadogu Ad Pres & Publ Co, 2008) Pinar, Tevfik; Cakmak, Z. Aytuel; Saygun, Meral; Ulu, NuriyeObjective: Industrialisation increased the impact of occupation on health. Accurate diagnosis and treatment requires detailed medical and occupational history. Material and Methods: The study has been performed in 19 different departments of Kirikkale University Hospital. A total of 950 patients' charts were retrospectively reviewed for accuracy of medical records whether they contain knowledge about occupation, environment and nutritional status as well as other important factors. Results: Only 34.7% of the necessary parameters were recorded in the medical charts, remaining 65.3% of the parameters were not recorded. Regarding the occupational history, 10.3% of the patients' jobs were properly recorded, 2.4% of the charts contained length of work and 2.5% had the information of previous jobs. Environmental hazards exposures were reported in 3.9% and nutritional status in 7.5%. These parameters are the least recorded in the charts. Conclusion: Our study showed that medical charts have insufficent medical knowledge. Occupational, environmental and nutritional status were seldom questioned and recorded that may lead improper diagnosis and treatments.Öğe Effects of combined female sex hormone replacement therapy on body fat percentage and distribution(Springer, 2006) Delibasi, Tuncay; Berker, Dilek; Aydın, Yusuf; Pinar, Tevfik; Özbek, MustafaThe effectiveness of hormone replacement therapy for patients with cardiovascular disease and for postmenopausal women with associated cardiovascular risks is currently under wide investigation. Among the cardiovascular risks are those related to body fat percentage and distribution. The present study undertook to investigate the effects of combined hormone replacement therapy on body fat percentage and distribution in postmenopausal women. Data for the present study were collected via retrospective analyses of 287 healthy postmenopausal women (146 as a study group, 141 as controls). Participants in the study group received 0.625 mg conjugated equine estrogen combined with 2.5 mg medroxyprogesterone acetate per day for 18 months. Body fat percentage and fat distribution were evaluated through the electrical impedance method and measurements of skinfold thickness, respectively. Two indices of centripetal fat distribution were defined: ratio of trunk-to-extremity skinfold thickness (T/E index), and ratio of upper-to-lower body skinfold thickness (U/L index). Investigators found that a daily dose of 0.625 mg of conjugated equine estrogen combined with 2.5 mg of medroxyprogesterone acetate taken for 18 months increased body fat percentage by decreasing lean body mass and by affecting upper-to-lower body fat distribution, without producing significant changes in overall weight. A slight decrease in the trunk-to-extremity body fat ratio was noted at 18 months of treatment, but this decrease did not reach statistical significance. Data related to the effects of hormone replacement therapy on body fat percentage and distribution in postmenopausal women are scarce. Additional research is needed to clarify the possible health benefits of hormone replacement therapy.Öğe Effects of long-term low-level solvent exposure on cognitive function(Canadian Soc Clinical Investigation, 2012) Saygun, Meral; Ekici, Aydanur; Muluk, Nuray Bayar; Cakmak, Aytul; Pinar, Tevfik; Dag, Ersel; Ekici, MehmetPurpose: The effects of long-term low-level exposures to solvents on cognitive function were investigated. Methods: A total of 389 workers at a gun factory, those exposed to solvents (n = 193) and those that were not exposed to solvents during work (n = 196), were included. All the workers were given a questionnaire. Cognitive function was evaluated by Mini-mental Status Examination (MMSE) and psychological status was assessed by Hospital Anxiety and Depression (HAD) Scale. Results: No differences were found in the MMSE and HAD scores between solvent-exposed workers and control workers (p>0.05). In the workers who had used a mask for a longer time, orientation scores were lower. Daytime sleepiness was related to lower recall scores.. Left-handed workers had higher total HAD scores than right-handed workers. Conclusions: Long-term low-level exposure to solvents did not affect cognitive function in the workers, according to their MMSE scores. Duration of solvent exposure was also not related to MMSE Scores. Short sleep duration and daytime sleepiness may negatively affect cognitive function.Öğe The Effects of Noise on Oxidative and Antioxidative Balance in Human Erythrocytes(Akad Doktorlar Yayinevi, 2011) Pinar, Tevfik; Atli, A. Kadir; Alacam, Hasan; Karabulut, Ismail; Soguksulu, Ismail; Atas, Ahmet; Akyol, OmerReactive oxygen and nitrogen species have been implicated in the pathogenesis of noise-induced hearing loss. In this case-control study, we investigated the oxidative and antioxidative status of erythrocytes from workers in noisy workplace. Blood samples of 127 workers in noisy workplace (WNW) and 117 workers in non-noisy workplace (WNNW) from the same company were taken into tubes with potassium EDTA as anticoagulant in order to obtain hemolysate. Total superoxide dismutase (SOD) and catalase (CAT) activities as the enzymes of antioxidative defense mechanism in the erythrocytes together with malondialdehyde (MDA) as the lipid peroxidation index and total nitric oxide (NO) as an index for nitrogen species analyses were performed by spectrophotometric methods. SOD activity was found to be 450.0 +/- 106.4 U/g Hb in WNW and 443.1 +/- 83.1 U/g Hb in WNNW. The difference between two groups were not statistically significant (p= 0.582). CAT activity was found to be 426.0 +/- 98.0 k/g Hb in WNW and 432.6 +/- 109.0 k/g Hb in WNNW showing statistically insignificant difference (p= 0.621). MDA levels in erythrocytes from WNW was significantly higher than WNNW (39.28 +/- 10.22 nmol/g Hb and 32.51 +/- 10.73 nmol/g Hb, respectively and p= 0.0001). On the other hand, NO levels were found to be significantly reduced in WNW (0.275 +/- 0.187 mu mol/g Hb) compared to WNNW (0.382 +/- 0.284 mu mol/g Hb) (p= 0.001). When we analyzed the hematological parameters, all the cell counts increased in WNW except monocytes and platelets compared to WNNW (p= 0.0001). Related to this changes, hemoglobin, MCHC, and hematocrit also increased in WNW (p= 0.0001). The oxidative stress, which is possibly propagated by the physical environment, seems to have an important pathophysiological role in hearing loss and lipid peroxidative cellular changes in all of the workers who work in noisy occupations.Öğe Five annual observations of respiratory findings in gun factory workers exposed to solvents(2007) Saygun, Meral; Çakmak, Aytul; Ekici, Aydanur; Pinar, Tevfik; Bulcun, Emel; Ulu, Nuriye; Ekici, MehmetOBJECTIVE: We investigated whether long-term, low-level exposures to solvents had adverse longitudinal effects on pulmonary functions. METHODS: The study was performed on 1091 workers 5 years ago and then on 697 workers 5 years later. Chronic respiratory symptoms were recorded using a questionnaire on respiratory symptoms. RESULTS: The annual decrease in forced expiratory volume in 1 second in the workers exposed to solvents was not significantly different from that of the unexposed workers (69.7 ± 89.9 vs 75.8 ± 87.6 mL/yr, P = 0.5, respectively). In 453 workers who were exposed to solvents 5 years ago, the prevalence rate of asthma was 1.1%. Five years later, it was 3.6% in 193 workers from the same group. The difference was statistically significant (P = 0.03). CONCLUSIONS: Longitudinally, the chronic exposure to low doses of solvents does not adversely affect the pulmonary functions, whereas it increases the asthma prevalence. ©2007The American College of Occupational and Environmental Medicine.Öğe Health-related quality of life and health care services expectations of the patients with lung cancer(Akad Doktorlar Yayinevi, 2008) Gultekin, Zuhal; Pinar, Guel; Pinar, Tevfik; Kiziltan, Guel; Dogan, Nevin; Algier, Lale; Ozyilkan, OzgurNon-small cell lung cancer is approximately 80% of all lung cancer. This type of lung cancer is usually presented with advanced stage at diagnosis and have a very poor prognosis. The management of non-small cell cancer at those stages generally is chemotherapy and/or concurrent chemoradiotherapy. However, potent chemotherapeutic agents and radiotherapy have serious adverse effects. This study aimed to determine lung cancer patients' expectations from health care providers, and levels of anxiety and depression besides health-related quality of life. This study was performed on 40 patients diagnosed as advanced stage non-small cell lung cancer at Baskent University hospitals in Turkey. SF-36 questionnaire was used to determine health-related quality of life, Hospital Anxiety and Depression Scale (HAD) was used to determine depression and anxiety level, and ECOG performance scale was used for performance evaluation. SF-36 scale yielded less than 50 points in all subscale evaluations (p < 0.05). The lowest mean scores were observed in emotional and physical role enforsement subscales. Calculations of hospital anxiety and depression scale showed 8.4 +/- 4.16 mean scale for anxiety (at borderline), and 7.6 +/- 4.8 for depression (normal). ECOG performance status was 0 for 20.5%, 1 for 44.1%, 2 for 32.4% and 3 score for 2.5% of the patients. Most of the non-small cell lung cancer patients had poor quality of life, with deterioration of both psychological and physiological function. We observed that those patients could not get necessary health care.Öğe Healthcare workers and workplace violence(Gulhane Military Medical Academy, 2013) Pinar, Tevfik; Pinar, GülWorkplace violence is a threatening worldwide public health problem. Healthcare workers have under particular risk of workplace violence, and they are being exposed to violence 4-16 times more than other service workers. The frequency of violence in the health sector in the world has indicated in different range of results since there is no consistent definition of workplace violence and differences in research methodology (any type of violence: 22,0% - 60,0%; physical violence: 2,6% - 57,0%; verbal violence: 24,3% - 82,0%; sexual harassment: %1,9 - 10,5%). All healthcare workers have right to work in a safe working place. The safety of healthcare workers should deserve the same priority as patient safety. Various risk factors including social, cultural, environmental, organizational and personal elements play a role in the formation of workplace violence that is very important for our country. Considering all those factors, the workplace violence in health sector should be seriously handled and the strategies and policies must be developed for prevention.Öğe Occupation and Cancer(Akad Doktorlar Yayinevi, 2012) Pinar, TevfikOccupational cancer is malignant neoplasm caused by exposures to carcinogenic agents at workplace. It is estimated that one out of every three people will subsequently develop cancer during their lifetime in industrialized countries. Undeveloped countries are also at increasing risk due to transfer of hazardous industries. An occupational cancer does not differ either pathologically or clinically from their counterparts, and treated with the same approaches as similar cancers that are not related to occupational exposures. Whereas, the identification of occupational cancers in public health terms is very important, because all occupational cancers are preventable like other occupational diseases. Physicians generally underestimate the questioning of occupational history of their patients. However, a complete and detailed query of their occupations, and the determination of agents, which they exposed in workplace simply provide us earlier diagnosis, even prevention of occupational cancers. In occupational settings, the most successful measure for the prevention of occupational cancer is the complete removal of known or suspected carcinogenic agents from the workplace. Substitution, changing production process, industrial hygiene practices and education of employees may reduce exposure levels and prevent development of cancer. So that, occupational cancers can be successfully prevented without any harm to industry.Öğe The relationship between occupations and head and neck cancers(Natl Med Assoc, 2007) Pinar, Tevfik; Akdur, Recep; Tunçbilek, Arslan; Altundağ, Kadri; Cengiz, MustafaObjective: The objective of this study was to investigate the relationship between occupation and head and neck cancers. Patients and Methods: In this case-control study, 206 Turkish patients with head and neck cancers comprised the case group. The control group consisted of 206 age- and sex-matched patients without malignant disease. All patients completed a questionnaire regarding occupation; tobacco and alcohol consumption; educational status; and history of any systemic disease, benign head and neck disease, and cancer among family members. High-risk jobs were considered those in the industries of construction, wood, mining, metal, chemistry and agriculture. Results: Patients with head and neck cancers worked in high-risk occupations more frequently than did controls [odds ratio (OR): 3.42, p < 0.05]. Cancer risk decreased with the increase in time interval between quitting the high-risk job and time of interview. Smokers were at higher risk than nonsmokers (OR: 3.33, p < 0.05). The risk was also higher in patients who drank alcohol regularly (OR: 1.59, p < 0.05). However, occupation was found to be an independent high-risk factor for head and neck cancers in regression analysis. Frequency of benign head and neck disease and family history of cancer were not significant risk factors (p > 0.05). Conclusion: Our analysis showed that occupation and smoking were significant independent risk factors for the development of head and neck cancers among workers.Öğe The relationship between symptoms and the results of the skin prick test in patients with allergic rhinitis(Tubitak Scientific & Technical Research Council Turkey, 2012) Karabulut, Hayriye; Gunbey, Emre; Babademez, Mehmet Ali; Acar, Baran; Celik, Emrah; Pinar, Tevfik; Karasen, Riza MuratAim: To determine the relationship between skin prick test results and allergic symptoms and to discover which symptom or symptoms are more commonly associated with the skin prick test. Materials and methods: Of the 1462 patients with a prediagnosis of allergic rhinitis (AR) who underwent the skin prick test, 495 subjects completed the symptoms inquiry form and were included in the study. Results: Out of 495 cases, the skin prick test was found to be positive in 358 and negative in 137. No significant relationship was found between sneezing, runny nose, itchy nose, nasal obstruction, headache, postnasal drip, and skin prick test positivity (P > 0.05). There was a significant relationship between ocular complaints (watering, itching, discharge) and skin prick test results (P = 0.027). The groups with positive and negative skin prick test results were compared in terms of symptom severity. While the difference between itchy nose and ocular symptoms was found to be significant, this difference was not significant in terms of nasal obstruction, postnasal drip, and sneezing. Conclusion: While no significant relationship was found between symptoms accepted as allergic, such as sneezing and itchy nose, symptoms such as eye itching and watering were found to be related to allergy. We recommend performing the skin prick test routinely on patients presenting with AR symptoms. This would also prevent unnecessary antihistamine use.Öğe Skin prick test results and prevalence of allergic symptoms in workers exposed to toluene(Tubitak Scientific & Technical Research Council Turkey, 2012) Karabulut, Ismail; Pinar, Tevfik; Karabulut, Hayriye; Demir, Melike; Karadeniz, Gulistan; Karasen, Riza MuratAim: To determine the distribution of allergens and allergic symptoms according to occupation groups in those who were exposed to toluene and presented with allergic rhinitis symptoms. Materials and methods: Of the 2005 patients who were administered an allergy test with the prediagnosis of allergic rhinitis, the files of 138 patients who were exposed to toluene were analyzed retrospectively. Results: The mean age of the patients was 35 10 years. Distributions of symptoms and allergens of 57 patients (41.3%) with negative skin prick test and 81 patients (58.7%) with positive skin prick test were analyzed according to occupation groups. There was no significant difference between the groups in terms of symptoms at baseline except for the symptom of runny nose (P > 0.05). The groups were compared in terms of complaints that started at the age of 16 or later, which was found as 76.5% in the positive group and 91.2% in the negative group. Conclusion: The occupation of the patient must be considered in patients who present with allergic symptoms; in particular, patients with negative skin prick test should be investigated in terms of occupational exposure.Öğe The Strain and Hopelessness in Family Caregivers of Patients with Gynecologic Cancer Receiving Chemotherapy(Akad Doktorlar Yayinevi, 2012) Pinar, Gul; Pinar, Tevfik; Ayhan, AliThis study aimed to investigate strain and hopelessness among family caregivers of patients with gynecologic cancer and corelates patients' symptom burden. This research was planned as a descriptive, cross-sectional and correlation study between May and December 2010, using a sample of 338 patient and family caregivers of gynecologic cancer patients. The results of this study show that family caregivers of patient with gynecologic cancer are at risk for hopelessness and strain. The strongest positive correlation was found between strain and hopelessness (r= 0.23, p < 0.004). Patients reported various problems with their chemotherapy experiences, including nause, feeling weak, mouth problems, and hair loss. Some characteristics were significant predictors of the caregiver's strain and hopelessness such as age, gender, education, income level, had a child, caregiving duration, cancer type, stage of cancer, chemotherapy cycles, lenght of disease, caregiving hours, level of personal and social support, knowledge about diseases, other caregiving responsibilities, and patient's symptoms (p< 0.05). It is our hope that this study will inform oncologists, oncology nurses and mental health workers about the assessment and treatment options for strain and hopelessness in family caregiver. The findings provide a base for future research.Öğe Symptoms of Musculoskeletal Disorders Among Ammunition Factory Workers in Turkey(Routledge Journals, Taylor & Francis Ltd, 2013) Pinar, Tevfik; Cakmak, Z. Aytul; Saygun, Meral; Akdur, Recep; Ulu, Nuriye; Keles, Isik; Saylam, Hamdi SaimThe aim of this study was to assess the prevalence of symptoms of work-related musculoskeletal disorders (MSDs) and to determine the risk factors among ammunition factory workers in Turkey. This cross-sectional study was performed on 955 ammunition factory workers. Potential risk factors were investigated with a questionnaire and multivariate logistic regression analysis was performed. During the previous year, 39.3% of ammunition workers experienced symptoms of work-related MSDs. Logistic regression analysis showed smoking (odds ratio [OR] = 1.372), chronic diseases (OR = 1.795), body mass index (BMI; overweight) (OR = 1.631), working year (OR = 1.509), cold temperature (OR = 1.838), and work load (OR = 2.210) were significant independent risk factors for the development of symptoms of MSDs. It was found that both work-related conditions and personal and environmental factors are important for the development of occupational MSDs.Öğe Workplace Violence in the Health Sector in Turkey: A National Study(Sage Publications Inc, 2017) Pinar, Tevfik; Acikel, Cengizhan; Pinar, Gul; Karabulut, Erdem; Saygun, Meral; Bariskin, Elif; Cengiz, MustafaViolence in the workplace is an increasing occupational health concern worldwide. Health care workers are at high risk of assault. To develop, monitor, and manage prevention policies, baseline data should be available. This cross-sectional study was designed to determine the current extent of workplace violence nationwide in Turkey. The study population of 12.944 health care workers was a stratified sample of all health care workers (612,639) in the country. A probabilistic sampling was made on the basis of the multistage stratified random cluster sampling method. This study was conducted by a structured questionnaire in a face-to-face interview. The questionnaire items were adapted and translated into Turkish based on questionnaires of International Labor Organization, International Council of Nurses, World Health Organization, and Public Services International. The percentage of health care workers who experienced workplace violence in Turkey in the previous 12 months was 44.7%. The types of violence included physical 6.8%, verbal 43.2%, mobbing (bullying) 2.4%, and sexual harassment 1%. Multivariate analysis showed that level of health care system, type of institution, gender, occupation, age, working hours, and shift work were independent risk factors for experiencing workplace violence (p < .05). Our study indicates that the workplace violence among health care workers is a significant problem. The results of the study can serve as the basis for future analytical studies and for development of appropriate prevention efforts.
