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    Are Primary Health Care Workers Aware of Cervical Cancer Risk?
    (Asian Pacific Organization Cancer Prevention, 2014) Can, Huseyin; Erdem, Ozgur; Oztekin, Coskun; Celik, Sercan Bulut; Onde, Mete; Celepkolu, Tahsin; Ongel, Kurtulus
    Background: We here examined the awareness of female health employees (doctors, nurses, midwives) working in primary health care service about cervical cancer and its risk factors. Additionally attitude and behavior for gynecologic examination and pap smear screening wwere researched. Materials and Methods: This cross-sectional, descriptive study con cerned female health employees working at primary health care services in two southern cities of Turkey, over a four month period in 2013. Participants were recently or previously sexually active research was explained and verbal informed consent was obtained face to face. The questionnaire consisted of two parts; socio-demographic characteristics and level of knowledge about cervical cancer and its risk factors. Results: The average age of the participants (midwives 43.7%, n=143; nurses 40.4%, n=132; doctors 6.4%, n=21; emergency medical technicians and others, 9.5%, n=31; total, n=327) was 30.9 +/- 6.41 years. 64.2% (n=210) were working in Diyarbakir and 35.8% (n=117) in Batman. A large proportion reported low knowledge and inadequate screening practice Conclusions: Health employees should be better informed about the importance of screening for cancers, given their preventive roles for the general population.
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    Association between sequence variations of the Mediterranean fever gene and the risk of migraine: a case-control study
    (Dove Medical Press Ltd, 2016) Coskun, Salih; Varol, Sefer; Ozdemir, Hasan H.; Celik, Sercan Bulut; Balduz, Metin; Camkurt, Mehmet Akif; Cim, Abdullah
    Migraine pathogenesis involves a complex interaction between hormones, neurotransmitters, and inflammatory pathways, which also influence the migraine phenotype. The Mediterranean fever gene (MEFV) encodes the pyrin protein. The major role of pyrin appears to be in the regulation of inflammation activity and the processing of the cytokine prointerleukin-1 beta, and this cytokine plays a part in migraine pathogenesis. This study included 220 migraine patients and 228 healthy controls. Eight common missense mutations of the MEFV gene, known as M694V, M694I, M680I, V726A, R761H, K695R, P369S, and E148Q, were genotyped using real-time polymerase chain reaction with 5' nuclease assays, which include sequence specific primers, and probes with a reporter dye. When mutations were evaluated separately among the patient and control groups, only the heterozygote E148Q carrier was found to be significantly higher in the control group than in the patient group (P=0.029, odds ratio [95% confidence interval] =0.45 [0.21-0.94]). In addition, the frequency of the homozygote and the compound heterozygote genotype carrier was found to be significantly higher in patients (n=8, 3.6%) than in the control group (n=1, 0.4%) (P=0.016, odds ratio [95% confidence interval] =8.57 [1.06-69.07]). However, there was no statistically significant difference in the allele frequencies of MEFV mutations between the patients and the healthy control group (P=0.964). In conclusion, the results of the present study suggest that biallelic mutations in the MEFV gene could be associated with a risk of migraine in the Turkish population. Moreover, MEFV mutations could be related to increased frequency and short durations of migraine attacks (P=0.043 and P=0.021, respectively). Future studies in larger groups and expression analysis of MEFV are required to clarify the role of the MEFV gene in migraine susceptibility.
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    Association of polymorphisms in the vitamin D receptor gene and serum 25-hydroxyvitamin D levels in children with autism spectrum disorder
    (Elsevier Science Bv, 2016) Coskun, Salih; Simsek, Seref; Camkurt, Mehmet Akif; Cim, Abdullah; Celik, Sercan Bulut
    Vitamin D is implicated in several aspects of human physiology, and polymorphisms in the vitamin D receptor gene (VDR) are associated with a variety of neuropsychiatric disorders. The aims of this study are to determine whether VDR polymorphisms are associated with autism spectrum disorder (ASD), to examine serum 25-hydroxyvitamin D (25(OH)D) levels in ASD, and to explore whether VDR polymorphisms influence serum 25(OH)D levels. We investigated 480 subjects (237 children with ASD and 243 healthy controls) for the following VDR polymorphisms: TaqI, BsmI, FokI, ApaI, and Cdx2. Within the same samples, 25(OH)D levels were available only for 85 patients and 82 controls. The Cdx-2 variation was shown to deviate from Hardy-Weinberg equilibrium in the controls and was therefore excluded from the study. We found that the frequency of rare FokI TT, TaqI CC, and BsmI AA genotypes differed significantly between children with ASD and the controls (p = 0.042, p = 0.016, p = 0.038, respectively). After correction for multiple testing, only the TaqI CC genotype remained significant. Further analysis using a recessive model showed that rare genotypes of these polymorphisms were significantly higher in patients compared to controls (p = 0.045, p = 0.005 and p = 0.031, respectively). However, no significant association was found between ApaI and ASD. We found serum 25(OH)D levels to be significantly higher in children with ASD (p < 0.001) and that the FokI polymorphism had an effect on serum 25(OH)D levels in children with ASD (p = 0.041). Additionally, we found the haplotype GTTT (BsmI/TaqI/FokI/ApaI) conferred an increased risk for developing ASD (p = 0.022; odds ratio [95% confidence interval] = 2.322 [1.105-4.879]). This is the first clinical study evaluating the association between serum 25(OH)D levels and VDR polymorphisms in children with ASD. Our results demonstrated a significant association between TaqI, BsmI, and FokI polymorphisms and ASD and showed for the first time that FokI polymorphisms and haplotype GTTT (BsmI/TaqI/FokI/ApaI) are associated with an increased risk of ASD. Our findings support the hypothesis that 25(OH)D is involved in the pathophysiology of autism and that serum 25(OH)D levels may be affected by FokI polymorphisms in children with ASD. Our results should be considered as preliminary and needs confirmation by future studies. (C) 2016 Elsevier B.V. All rights reserved.
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    EVALUATION OF THE REACHING TARGET VALUES IN PATIENTS WITH HYPERTENSION AND IMPORTANCE OF TENSION FOLLOW-UP CARDS
    (Carbone Editore, 2014) Can, Huseyin; Celik, Sercan Bulut; Celepkolu, Tahsin; Akbayin, Zelal; Guclu, Yusuf Adnan; Ongel, Kurtulus; Cakir, Lutfullah
    Aim: To detect the efficiancy of the tension follow-up cards, which are used to follow tension, in achieving target values in the treatment of hypertensionl. Material and method: The research planned as a multicenteral, noninterventional observe and follow-up. was made in IS different Family Health Care units in different 7 cities, in Turkey, between November 2011 and April 2012. Patients diagnosed as essential hypertension and who were already taking at least one antihypertensive medicine, who were above 18 years old, were informed about the study and accepted 529 patients were involved into the study The patients involved were divided into two groups as experimental group and control group. The patients in the experimental group were given,a tension follow up card while the control group were not Both of the groups were given appoinments for control at the end of the fourth week. For statistical analysis, chi-square test, t-test and multiple variable logistic regression analysis were used. Results: Study was performed on 529 hypertensive patients; 247 (46.7%) were in the experimental, 282 (53.3%) were in the control group. In total; 332 patients (62.8%) were women and 197 patients (37.2%) were men. Mean age for the patients was 58.15 +/- 10.68 (mm 32 max:90) and mean body mass index was 30.76 +/- 5.18 (min:18.31 max 52.07) No statistical difference Was found between experimental and control groups for the begining tension values, except for the first visit first systole measurement. After one month, all measurements were repeated. For all measurements in the second visit, tension values of the experimental group were statistically lower than the control group (p<0.00 I). Conclusion: Patients who get treatment for hypertension but don't reach target blood pressure values constitudes high risk in the society. Data obtained from the study showed that; to control hypertension effectively, patients must be under control and must participate in the follow-up actively.
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    Screening mixed depression and bipolarity in the postpartum period at a primary health care center
    (W B Saunders Co-Elsevier Inc, 2016) Celik, Sercan Bulut; Bucaktepe, Gamze Erten; Uludag, Aysegul; Bulut, Ibrahim Umud; Erdem, Ozgur; Altinbas, Kutsat
    Introduction: Mixed depression is a clinical condition accompanied by the symptoms of (hypo)mania and is considered to be a predictor for bipolar disorder. Compared to pure major depression, mixed depression is worse in progress. There are limited data on the prevalence of mixed depression since it is a relatively new entity. Therefore, the present study aimed to investigate the prevalence of mixed depression during the postpartum period which is risky for mood disorders. Methods: The study included 63 postpartum women. The participants were administered Beck Depression Scale, Edinburgh Postnatal Depression Scale (EPDS), Mood Disorders Questionnaire (MDQ), and Modified Hypomania Symptom Checklist-32 (mHCL-32). Results: The MDQ scores of the women with expected depression according to the EPDS cut-off scores, were significantly higher than the women with lower EPDS scores (t = 4.968; p < 0.001). The modified hypomania scores were significantly higher in the women with higher depression scores compared to the women under EPDS cut-off scores (t = 4.713; p < 0.001). According to the EPDS and BDS results, 27 (42.9%) and 14 (22.2%) women needed additional clinical examination for depression, respectively. In addition, 3 (4.8%) women require additional clinical examination for bipolar disorder. The scores for the first item of MDQ were above the cut-off value in 11 (17.5%) women. According to the mHCL-32 results, 50 (79.4%) women had at least 1 symptom, 45 (71.4%) women had at least 3 symptoms, and 43 (68.3%) women had at least 5 symptoms of mixed depression. Conclusion: Postpartum mixed depression should be promptly diagnosed by using appropriate diagnostic tools, particularly by primary health care physicians. Patients with mixed depression should be closely monitored to avoid manic switch. (C) 2016 Elsevier Inc. All rights reserved.