Objectives This study aimed to investigate the relationship between breast magnetic resonance imaging (MRI) parameters; clinical features such as age, tumor diameter, N, T, and TNM stages; and serum human epididymis protein 4 (HE4) levels in patients with breast carcinoma and use this as a means of estimating possible signaling pathways of the biomarker, HE4. Methods Thirty-seven patients with breast cancer were evaluated by breast MRI and serum HE4 levels before therapy. Correlations between parameters including age, tumor diameter T and N, dynamic curve type, enhancement ratio (ER), slope washin (S-WI), time to peak (TTP), slope washout (S-WO), and the serum level of HE4 were investigated statistically. Human epididymis protein 4 levels of early and advanced stage of disease were also compared statistically. Results Breast MRI parameters showed correlation to serum HE4 levels and correlations were statistically significant. Of these MRI parameters, S-WI had higher correlation coefficient than the others. Human epididymis protein 4 levels were not statistically different in early and advanced stage of disease. Conclusions High correlation with MRI parameters related to neoangiogenesis may indicate signaling pathway of HE4.

Amaç: Bu çalışmada, Erzurum il merkezinde çocuklarda febril konvülsiyon prevalansını araştırmak ve epidemiyolojik özelliklerini belirlemek amaçlanmıştır. Gereç ve Yöntemler: Erzurum merkezde yürütülmüş kesitsel bir alan çalışmasıdır. Erzurum il merkezi mevcut aile hekimlerinde kayıtlı bir ay-beş yaş arası çocukların oluşturduğu evren içinden, örneklem hacmi hesaplanarak

Ataturk University, which was established in 1957, is one of the oldest universities of Turkey. Ataturk University School of Medicine was found in 1962, and began the education life in 1964 [1]. The official journal of Ataturk University School of Medicine started the publication life as ‘Medical Bulletin of Ataturk University’ in Turkish language in 1968. In 1995, the name of the journal was changed as ‘Medical Journal of Ataturk University’. In 2006, the current name of the journal was approved as ‘The Eurasian Journal of Medicine’, and its publication language is English since 2008 [2]. The Eurasian Journal of Medicine is indexed by PubMed Central since 2008, by ULAKBIM/Turkish Medical Index since 2009, by Turkiye Citation Index, ProQuest, DOAJ, CINAHL, Gale/Cengage, and EBSCO since 2010, by Index Copernicus since 2011, by Scopus since 2012, and finally by ESCI/Emerging Sources Citation Index beginning with 2015 [3]. The Eurasian Journal of Medicine is currently the official journal of Ataturk University School of Medicine, which is published three issues per year on February, June and October. The journal is aimed to be indexed by SCIE/Science Citation Index expanded in near future as a general medicine journal with increasing recognition and impact in a geographic location which is bridging many cultures [2]. As known, the publication of a journal needs a team work, in which editors, members of the editorial board, other employees of the journal, and reviewers play important roles. We, as the editors of The Eurasian Journal of Medicine, are grateful for their helps in our success story.

Epidemiologic studies have suggested that the incidence of congenital penile anomalies, particularly hypospadias, is increasing in the last three decades. In this study we aimed to assess the prevalence of congenital penile anomalies (CPA). Risk factors, which were thought to be related, were examined in male children attending school and nursery in the Northeast of Turkey. A total of 2040 male students from 14 nurseries and 18 primary schools in the Erzurum city urban Center/ Turkey participated in the study. All children were examined by one single expert doctor, a pediatric surgeon, in a room which was previously isolated by the school and at a suitable temperature. The total penile abnormalities, penile torsion and hypospadias prevalances were found to be 7.3%, 6.52% and 0.78%ü, respectively. The frequency of genitoscrotum abnormalities in families (father and siblings) was found to be 4.3% for hypospadias. The degree of the penile torsion was at the most 45 with 32% and 90 with 25%. The least was 70 and 120 degrees with 0.78%. The effects of environmental agents on the development of congenital abnormalities have not been researched in our country. Publications, which indicate an increase in CPA incidences in various geographical regions over a short period of 30 years does not make it possible to render this situation by way of genetic transfer. On the other hand, contrary to some publications, our current study shows a high number of CPA in other family members form the same family, nevertheless, this situation cannot be explained with genetic transfer as it does not contain statistical meaning. However, an explanation with environmental contamination is possible. For us to find CPA incidences in our study parallel to the highest value in the world in general puts forth that the use of environmental agents used in our country and region and its widespread should be put under control and that further studies should be carried out.

The Eurasian Journal of Medicine, which is the official journal of Ataturk University School of Medicine, started the publication life in Turkish in 1968, and it has been published as three issues per year in English since 2008 [1]. Change of the publication policy in 2008, aiming to reach the worldwide researchers and audience, bore its fruits, and it is now indexed in PubMed Central and Thomson Reuters’ Emerging Sources Citation Index (ESCI), as well as in some other indexes [2].

Amaç: Tıp eğitiminde çoktan seçmeli sorular, yüksek kapsam geçerliliği olması, objektifliği, uygulama ve analizinin kolaylığı nedeniyle sık tercih edilir. Ancak, çoktan seçmeli soru hazırlamak ustalık gerektirir. Bu çalışmada Atatürk Üniversitesi Tıp Fakültesi’nde sınavlarda sorulmuş çoktan seçmeli soruların analizinin yapılması (zorluk ve ayırıcılık indeksi) ve Modifiye Bloom Taksonomisi temel alınarak düzeylerinin belirlenmesi amaçlanmıştır. Ayrıca eğitici eğitimi alan ve almayanların soruları, indeks değerlerine göre sınıflandırılmıştır. Gereç-Yöntem: Kurul ve final sınavlarından rastgele yöntemle on ayrı sınavdan seçilen 945 soru çalışmaya alındı. Modifiye Bloom Taksonomisine göre düzeyleri belirlendi. Soruların zorluk ve ayırıcılık analizleri yapıldı. Veriler, sayı, yüzde, ortalama ve standart sapma olarak verildi. Sürekli verilerin normallik dağılımı Kolmogorov Smirnov ile test edildi. Verilerin analizinde Ki-kare, bağımsız gruplarda t testi ve tek yönlü ANOVA kullanıldı. Çoklu karşılaştırma Post Hoc LSD testi kullanıldı. Bulgular: İyi ve çok iyi kalitedeki soru oranı toplam %44,1 (n= 416) idi. Doçentlerin hazırladığı sorular yardımcı doçent ve profesörlere göre ayırıcılık indeksi daha yüksek ancak daha kolaydı. Modifiye Bloom Taksonomisine göre soruların büyük bir kısmı hatırlama ve anlama düzeyindeydi. Soruların düzeye göre zorluğunda fark yokken anlama ve değerlendirme düzeylerindeki sorular daha ayırıcı bulundu (p=0,021). Öğretim üyelerinin eğitici eğitimi alıp almamaları karşılaştırıldığında eğitim alanların soruları daha kolaydı ve ayrıcılıklarında istatistiksel olarak fark bulunmadı (p>0,05). Sonuç: Sınavlardan sonra madde analizlerinin yapılarak öğretim üyelerine bildirilmesi ile soru kalitesinin arttırılması sağlanabilir. Eğiticilerin soru hazırlama için eğitim almaları önemlidir.

Amaç: Tıp eğitiminin amaçlarından birisi de yaşam boyu öğrenme ilkesinin benimsenmesidir. Sürekli Mesleksel Gelişme; insanların bilgi ve becerilerini geliştirmeleri ve meslek hayatları için gerekli kişisel gelişimleri elde etme, kariyer hedeflerine ulaşma, kendine güven ve yaratıcılık özelliklerinin gelişmesi için yaptıkları çalışmalardır. Kurslar, konferanslar, dersler gibi etkinliklerin yanında kendi kendine öğrenme aktivitelerini de kapsar. Çalışmada amacımız öğrencilerin tercih ettikleri Sürekli Mesleksel Gelişme etkinliklerini ve yaklaşımlarını belirlemek ve Sürekli Mesleksel Gelişme ile ilgili farkındalık oluşturmaktır.Materyal ve Metot: Çalışmanın evrenini Atatürk Üniversitesi Tıp Fakültesi birinci sınıf öğrencileri oluşturmaktadır. Beş bölümden oluşan bir anket uygulanmış olup 2’si açık uçlu olan 26 sorudan oluşmaktadır. Katılım gönüllülük esasına göredir. Tanımlayıcı tipte bir çalışmadır. Veriler sayı (n) ve yüzde ( % ) olarak belirtilmiştir.Bulgular: Çalışmaya 120’si (%50,20) kız öğrenci olmak üzere toplam 239 öğrenci katıldı. Sürekli Mesleksel Gelişme etkinliklerine katılmama nedeni olarak öğrencilerin çoğu (n=175; % 73,20) haberlerinin olmamasını ifade ettiler. İlgilenmeme ve gereksinim duymama da nadir olmakla birlikte diğer nedenler arasındaydı. Büyük bir kısmının (n=191; %79,90’ı ) hedefi uzman doktor olmaktı. Etkinliklerin dekanlık, proje ya da YÖK tarafından karşılanması gerektiği fikrindeydiler. En çok katıldıkları etkinlikler; video gösterimleri, beceri eğitimleri, kurslar ve internet üzerinden eğitimlerdi.Sonuç: Sürekli Mesleksel Gelişme ile ilgili aktiviteler meslekle ilgili beceriler geliştirip bilgi birikimi oluşturarak öğrencilerin meslek hayatına hazır duruma gelmesine yardımcı olabilir. Bu konuda farkındalık oluşturup onlara destek olmak eğiticilerin görevidir.

Variability in children’s allergic sensitization has been detected not only among different countries but also among cities within the same nation but yet different climatic areas. The aim of this study was to investigate the sensitization pattern of asthmatic children who lived in different altitude areas: the two largest Turkish cities, Istanbul (sea level) and Erzurum (high altitude). Five hundred and twelve asthmatic children (6–15 years old) from Istanbul (western Turkey, at sea level) and 609 from Erzurum (eastern Turkey, at an altitude of 1800 m) were included in the study. All participants underwent skin testing with common inhalant allergens, spirometry, total IgE level, and clinical examination. The positive sensitization ratio to aeroallergens in children with asthma living at sea level was statistically higher than that in children living in the high altitude group [p = 0.001, OR (odds ratio) 4.9 (confidence interval (CI) 3.67–6.459)]. However, pollen sensitization in asthmatic children living in high altitudes was significantly higher than that in children living at sea level [p = 0.00, OR 2.6 (CI 1.79–3.87)]. Children with asthma who live at high altitudes are characterized by higher pollen but lower mite sensitization rates than those living at sea level in Turkey. Different climatic conditions and altitudes may affect aeroallergen sensitization in children with asthma.

Objective: To document peer teaching activity performed by first-year medical students and their views on the teaching activity.Study Design: Survey.Place and Duration of Study: Medical Education Department, Ataturk University, Erzurum, Turkey, in the 2012 - 2013 academic year.Methodology: Volunteer students were selected for peer teaching model by an academician from the Medical Education Department. Students were taught subjects selected from classes such as biochemistry and microbiology in the same way as the academicians do. Following each class activity, the teaching student was assessed by the other students on a 5-point rating scale. Written and verbal feedback was also obtained from both teaching students and participated students. Verbal feedbacks were noted by a faculty member and similar opinions were categorized. Data were analyzed by SPSS version 20 statistical program.Results: Eleven students took part in the program. Feedback was received from students 171 times. The mean number of students participated was 24.4 +/- 14.3 in each program. Statistical analysis revealed that mean value for teaching materials, peer instructors and teaching environment were 4.62 +/- 0.49, 4.63 +/- 0.47 and 3.88 +/- 1.27 respectively.Conclusion: Peer teaching method is a pretty good way of teaching for medical students. It is a practicable technique that can be used in medical training. Taking part in this program as a lecturer, student increased students' self-confidence in the learning and teaching activities. Quite positive feedbacks were received.

Many childhood psychiatric disorders present their first symptoms as challenging behaviors at school. Evidence from cross-national studies enhance the understanding of the biological and cultural variables underlying these behaviours. In this study, we aim to identify the psychopathology among children with office disciplinary referrals and assess psychosocial risk factors related to this situation. Forty-seven students who had received an office discipline referral and eighty-three controls who had never been given an office disciplinary referral participated in this study. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime, socio-demographic data form were administered to children to assess their respective psychopathologies and psychosocial risk factors. Attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, and obsessive compulsive disorder were significantly higher in children with Office discipline referrals. Psychiatric assessment should be one of the first steps in the evaluation processes of assessing challenging behaviors at school.

Background: Obstructive sleep apnea syndrome (OSAS) and obesity frequently occur together. The relationship between increased appetite and obesity is well known; however, despite existing knowledge about the relationship between OSAS and obesity, it is not fully understood. Objectives: This study aimed to evaluate the relationship between OSAS and the appetite-suppressing hormone nesfatin-1 independent of body mass index (BMI). Methods: A total of 134 cases were included in the study; 102 with OSAS (OSAS group) and 32 healthy controls (control group). All cases underwent polysomnography, and nesfatin-1 levels were determined. Results: Nesfatin-1 levels were significantly lower in the OSAS group compared to the control group (3,776.5 ± 204.8 and 4,056.2 ± 101.5 pg/ml, respectively; p < 0.001). In addition, there was a statistically significant negative correlation between nesfatin-1 and the apnea hypopnea index (r = -0.543; p < 0.001). The statistically significant relationship persisted after adjusting for confounding intergroup factors such as age, gender and BMI (p < 0.001). In the OSAS group, there was a statistically significant correlation between nesfatin-1 and neck circumference (r = -0.304; p = 0.02) but not between nesfatin-1 and BMI and waist circumference. There was no statistically significant difference in nesfatin-1 levels between the sexes. Conclusion: OSAS patients have lower nesfatin-1 levels compared to controls, and a greater nesfatin-1 deficit corresponds to an increased severity of OSAS and an increased neck circumference. Replacement therapy may be a potential treatment for obese OSAS patients who have lower nesfatin-1 levels, which may have additional benefits through appetite suppression and weight loss.

OBJECTIVE:To assess and compare three different types of feedback for presentation skills, self, peer and trainer feedback. STUDY DESIGN:Cross-sectional study. PLACE AND DURATION OF STUDY:Faculty of Medicine at Atatürk University, Erzurum, Turkey, from March 2012 to December 2012. METHODOLOGY:Participants were faculty members and instructor nurses. Each participant gave a 10-minute presentation, which was rated by peers, course trainers and the presenter himself/herself using a thirteen-item questionnaire (designed as a 5-point Likert scale). Peers and trainers conducted the assessment during the presentation while the self-assessment was done later by watching a video recording of the presentation. Comparison of the points between the groups was made using the two-way ANOVA. Pearson correlation analysis was conducted to evaluate the relationship between the mean scores of self-assessment, peer and trainer assessment. RESULTS:Ten faculty members, 27 instructor nurses and 4 trainers participated in the study. A total of 775 feedback reports were collected for 37 participants. There was no significant difference between the feedback scores of the evaluators as well as the occupation groups (p > 0.05). There was a strong positive and statistically significant correlation between trainer and peer (r = 0.73, p < 0.001). CONCLUSION:Consequently, there were no differences in the evaluations of presentation skills between different stakeholders. Trainers should use the video recording method to self-evaluate their presentation skills, and they should invite their peers from time to time to improve their own personal development by using peer review methods.

INTRODUCTION:Lung cancer is the most common cause of cancer death in the world, and the most common type is non-small-cell lung cancer (NSCLC). At present, surgical resection, chemotherapy, and radiation therapy are the main treatments for patients with NSCLC, but unfortunately outcome remains unsatisfactory.OBJECTIVES:This study aimed to determine whether Class I and II histocompatibility leukocyte antigen (HLA) alleles are related with response to chemotherapy and survival of lung cancer.METHODS:A total of 65 NSCLC patients (56 men and 9 women, mean age 58.4 ± 11 years) were included in the study. Patient groups were compared with a control group of 88 unrelated healthy kidney or bone marrow donors in order to clearly identify susceptible and protective HLA alleles in lung cancer. Target lesions and tumor response were assessed using the Response Evaluation Criteria for Solid Tumors (RECIST) guidelines. Results were classified into two groups: complete-partial response and stable-progressive disease.RESULTS:We found that expression of HLA-A32, HLA-B41, HLA-B57, HLA-DRB1*13, and HLA-DQ5 were more frequent in the complete and partial response groups to chemotherapy than in the control group. The frequency of HLA-A11, HLA-A29, HLA-BW6, HLA-CW3, HLA-DR1*1, and HLA-DRB1*3 were determined to be higher in the stable and progressive disease groups taking chemotherapy than in the control group. Additionally, expressions of HLA-A2 and HLA-B49 were statistically related with 5-year survival.CONCLUSION:Our results suggested that expressions of HLA-BW6 and HLA-DRB1*13 alleles may be predictable markers for response to chemotherapy in lung cancer patients.

Objective: The aim of this study was to investigate the reasons for choosing medical education and the expectations of the new students of the first year of medical school that began in the academic year 2012-2013.Method: A questionnaire was given to the first year students, which consisted of questions concerning gender, place of residence, high school from which she/ he graduated, socio-demographic characteristics, such as education level of parents, whether the parents played a role in preferring medical education, reasons for choosing medical school and the expectations related to medical education. A total of 31 questions were asked, some of which were open-ended. The students responded to the survey on a voluntary basis.Results: A total of 213 students participated in the study. The mean age was 18.71 +/- 1.32 years. Of all the students, 53.5% (n= 114) was female. The place of residence of the students' families was mostly in the Eastern Anatolia Region, the majority of which were in the town center. Of all the parents, 50.0% (n= 106) of the fathers and only 20% (n= 42) of the mothers had a university degree. The parents played a role in making the choice of the students. There were no other physicians in the family in most of the cases. Of all the students, 94.8% (n= 202) had preparation courses for university entrance exams. Violence towards the physicians affected the students' choice in only 7% (n= 15) of the cases. For 99% (n= 208) of respondents, medical education was the first choice. Of all the students, 34.2% had this preference, as this was their dream career. Conclusion: Studying medicine is still popular despite the recently increased adverse events such as violence towards physicians, and most of the students study medicine on their own volition. It is encouraging and promising for the future that the students voluntarily choose for this difficult and long-term training.

Objective: To evaluate the effectiveness of the training-of-trainer courses given to medical school faculty members, and to ensure the standardisation of training..Methods: The study comprised faculty members attending seven training-of-trainer courses held at the Ataturk University, Turkey, from November 2010 to May 2011. Tests were administered to the participants evaluating their level of knowledge on course content before and after the five-day course, which covered topics including concepts of teaching/learning, curriculum development, assessment and evaluation, training methods, and training skills. Oral and written feedbacks were obtained from all participants on the last day of each course. Volunteers from among the participants evaluated the impact of training through a questionnaire after at least two months. SPSS 20 was used for statistical analysis.Results: A total of 136 faculty members participated in the 7 training-of-trainer courses. The mean scores for the pretest and post-test were 6.6 +/- 2.2 vs. 13.9 +/- 3.7, (p<0.001). Questions with highest percentage of correct answers in the pre-test were those about learning style 78 (70.9%) and the one about presentation skills (66.4%).Conclusion: A structured training-of-trainer course is effective in increasing faculty members level of knowledge about training. Such programmes are necessary for faculty members who work in the academic field without receiving formal training in teaching as it is the case with medical education in several countries.

OBJECTIVE:To assess the level of understanding related to the significance of evidence-based medicine among physicians.METHODS:The cross-sectional study was conducted between March and October 2012 using an online questionnaire that was sent out to physicians and academics working as faculty at training hospitals across Turkey. The questionnaire consisted of questions about the knowledge, attitude and behaviour towards evidence-based medicine. Seven of the questions pertained to the learning of evidence-based medicine, six were about teaching evidence-based medicine, and six were about its practice. SPSS 20 was used for statistical analyses.RESULTS:The questionnaire was returned duly filled by 79 physicians. Of them, 41 (51.9%) were males; and 57 (72.2%) were part of the faculty. Only 1(1.2%) participant had attended a course about evidence-based medicine during undergraduate education, while 19 (24.05)had attended one after graduation. Besides, 26 (32.9%) academics were teaching some concepts of evidence-based medicine, and 21 (26.6%) were giving some information about clinical guidelines.CONCLUSION:The study found that levels of learning and teaching of evidence-based medicine among physicians were inadequate. They should be emphasised at both pre- and post-graduate tiers.

Background: Denim sandblasting may cause silicosis as a result of free crystalline silica inhalation. Its pathogenesis remains unclear, but autoimmunity may play a role in the development of silicosis. The present study aimed to investigate the relationships between human leukocyte antigen (HLA) and the severity and latency period of silicosis. Methods: 48 silicotic patients in the Eastern part of Turkey were classified according to their latency period and disease severity. The distribution of HLAs according to disease severity and latency period was assessed. Results: A23 (7.5%), B49 (7.5%), and B51 (25%) were more common in the mild group than in the severe group, and B55 (8.9%) and DR4 (17.9%) were more common in the severe group than in the mild one. Only B51 was significantly more common in the mild group than in the severe one (25%, n = 10 vs. 7.1%, n = 4; p = 0.016). Conclusions: This study suggests that HLA antigens may play a particular role in the severity of silica-induced lung disease, but there was no association between HLA and progression time of the disease.

Amaç: Atatürk üniversitesi Tıp Fakültesi 3. Sınıf öğrencilerinin hastadan iyi tıbbi hikaye alma konusundaki görüşleri hakkında bilgi vermektir. Gereç ve Yöntem: Ders programımızda iyi bir hasta hekim görüşmesi nasıl olmalı ve tıbbi hikaye alma ders konuları bulunmaktadır. Öğretim üyesi tarafından 20-25 öğrenciden oluşan 10 farklı küçük grupta etkileşimli ders tekniğiyle tıbbi hikaye alma konusunda eğitim verildi (grup başına bir saat ayrıldı). Öğrencilere toplam 23 sorudan oluşan bir anket ders öncesi uygulandı. Öğrencilerle soru - cevap şeklinde tartışıldı. Dersten en az bir hafta sonra da aynı anket uygulandı ve bu dersin faydalı olup olmadığı hakkında öğrenci görüşleri alındı. Veriler 20.0 SPSS programına girilerek analiz edildi ve tekrarlayan ölçümlerde varyans analizi kullanıldı. İstatistiksel önemlilik düzeyi p 0,05). Eğitim sonrasında eğitim öncesine göre (grup içi) hasta-hekim görüşmesine başlama, bilgi alma ve plan yapma alt boyut puan ortalamalarının tamamında istatistiksel olarak önemli artış bulunurken (p0,05). Eğitim sonrasında öğrencilerin 171’i (%93,4) konuya farkındalıklarının artığını, 161’i (%88,0) hastayla görüşmenin göründüğü kadar kolay olmadığını bildirdiler. Sonuç: Hastadan öykü alma ve görüşmeyi planlandığı gibi tamamlama becerisi öğrenciye kazandırılması gereken önemli becerilerden biridir ve deneyim gerektirmektedir. Bu araştırma öğrencilerin eğitimden yararlandığını ve ilerleyen sınıflarda bu beceriyi pekiştirici başka eğitim aktiviteleriyle desteklenmesinin gerekliliğini gösterdi.

Aim: This was a follow-up study to determine postpartum depression (PPD) and its causes in a population previously evaluated in the first trimester of pregnancy. Methods: The study sample consisted of pregnant women who were evaluated in the first trimester and 360 women who were re-evaluated in the postpartum period. Detailed sociodemographic data were obtained from the women, and depression was assessed with the Edinburgh Postpartum Depression scale (EPDS) and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I Disorders (SCID-I). Results: In this follow-up study, the prevalence of PPD was 35% (n = 126). A depressive disorder in the first trimester of pregnancy, previous mental disorder, somatic disorder, exposure to domestic violence during pregnancy, baby’s staying in the incubator and not breastfeeding were predictors of PPD. Exposure to violence and a history of previous depression predicted depression both in pregnancy and in the postpartum period. Conclusion: Depression rates are high in Eastern Turkey. Exposure to violence during pregnancy and the existence of a previous mental disorder were risk factors for perinatal depression in this study. Performing screening tests can identify women at risk of pregnancy-related depression. Prevention programs should be established in areas where the prevalence of depression is high.