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AIMS: This study aimed to explore barriers regarding insulin initiation in patients with Type 2 diabetes and investigate the relationship of some demographic characters of patients. MATERIALS AND METHODS: A cross-sectional study was conducted with 142 patients with Type 2 diabetes whose doctors had recommended insulin therapy and who had been unwilling to comply. The participants were patients at an endocrine outpatient clinic in Kovancilar State Hospital in the rural area in Elazig, from November 2016 to May 2017. RESULTS: Half of the patients were illiterate, 60.6% of the participants were female, and the mean age was 57.33 ± 10.56. The most commonly reported barrier was injection-related anxiety (63.4%). In total, 58.5% of the patients refused insulin therapy because they felt it indicated that their disease had worsened and that they had failed at diabetes management. Female patients were 6.9 times more likely to think injection-related anxiety that affecting their decision about insulin therapy than male patients. Elderly patients were 8.2 times more likely to think of their disease worsened than younger patient. CONCLUSIONS: Patients' beliefs related to insulin therapy were very much influenced by their gender, educational status, and age. Giving patient-centered education is a cost-effective way to decrease negative health behaviors.

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INTRODUCTION: The aim of the present study was to evaluate the knowledge level of nursing and theology students, who will deliver health care and religious services in the future, about organ donation. METHODS: This cross-sectional study was conducted with 578 university students at Firat University Faculty of Health Science Nursing Department and Faculty of Theology. RESULTS: Of the participants, 49.3% were nursing students and 50.7% were theology students. Although 3.8% of the students stated that a family member had donated an organ, only 0.5% of all students had a donation card. Among the nursing students, 34.4% stated that they had no reason for not having a donation card and that they might donate in the future. Among the theology students, the rate was 27.3%. In terms of reasons for wishing to be an organ donor, religious beliefs were more important to theology students than to nursing students (18.4% and 16.1%, respectively). The nursing students' total score on the Organ-Tissue Donation and Transplantation Knowledge Scale was significantly higher than that of the theology students (P < .05). CONCLUSIONS: Although the current level of knowledge of nursing and theology students about organ donation and transplantation was adequate, the rate of organ donation was low. Therefore, not only health care professionals, but also religious officials have important roles to play in increasing the organ donation rate. Removing existing barriers to organ donation is important to resolve the current organ donation shortage in Turkey.

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BACKGROUND: Tip-apex distance greater than 25 mm is accepted as a strong predictor of screw cut-out in patients with intertrochanteric femoral fracture treated by dynamic hip screw. The aim of this retrospective study was to evaluate the position of the screw in the femoral head and its effect on cut-out failure especially in patients with inconvenient tip-apex distance. MATERIALS AND METHODS: Sixty-five patients (42 males, 23 females; mean age of 57.6 years) operated by dynamic hip screw for intertrochanteric femoral fractures were divided in two groups taking into consideration the tip-apex distance less (group A; 14 patients) or more (group B; 51 patients) than 25 mm. Patient's age and gender, follow-up period, fracture type, degree of osteoporosis, reduction quality of the fracture, position of the screw in the femoral head, number of patients with cut-out failure and Harris hip score were compared. RESULTS: The average follow-up time was 41.7 months. The mean tip-apex distance was 17.14 mm in group A and 36.67 mm in group B. One (7.1%) patient in group A and three (5.8%) patients in group B had screw cut-out. Except the screw position, no statistical differences were observed between the two groups with regards to study data. The screw was placed in femoral head more inferiorly (p=0.045) on frontal and more posteriorly (p=0.013) on sagital planes in group B, while central placement of the screw was present in group A. The common characteristics of three patients with screw cut-out in group B was the position of the screw which was located in femoral head more superiorly and anteriorly after an acceptable fracture reduction. CONCLUSIONS: Peripheral placement of the screw in femoral head increases tip-apex distance. However posterior and inferior locations may help to support posteromedial cortex and calcar femoral in unstable intertrochanteric fractures and reduce the risk of cut-out failure. LEVEL OF EVIDENCE: IV, retrospective series.

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OBJECTIVES: The aim of this study was to assess the efficacy of topically applied trichloroacetic acid (TCA) for endometrial ablation in patients with dysfunctional uterine bleeding (DUB). This trial has also compared the advantages of prethinning the endometrium with danazol and goserelin acetate before ablation with TCA. METHODS: This prospective trial was conducted on 90 volunteer cases. Patients were allocated into three treatment groups comprised of 30 patients. In group I cases underwent dilatation and curettage before endometrial ablation. In group II cases were administered danazol before ablation. Cases in group III received goserelin acetate on the same day and 28 days after ablation. Endometrium was evaluated by biopsy, transvaginal ultrasonography and hysteroscopy. Endometrial ablation was performed with 95% TCA. All of the patients were evaluated 3 and 6 months after TCA application. RESULTS: After 6 months of treatment, the success rate was recorded as 83% in the first group, 92.3% in the second group and 96.6% in the third group. The mean length of uterine cavity was reduced in all groups, being only significant in Goserelin group (P<0.5). Endometrial thickness was decreased significantly in all treatment groups (P<0.001). CONCLUSIONS: This study concluded that endometrial ablation by TCA may readily be performed as an alternative treatment method in the management of DUB. Moreover, suppression of endometrium with danazol or especially with goserelin acetate before ablation, resulted in significant success rate.

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