Showing papers in "Balkan Medical Journal in 2010"

Exercise and Quality of Life

Abstract: Quality of Life is the totality of features and characteristics of the varying environments and changing conditions/circumstances that bear on the ability to satisfy the human needs for actualization at four levels of awareness: Physical, Emotional, Mental and Spiritual. alsquo;Exercisea#39; is defined as any bodily activity enhancing or maintaining physical fitness and overall health. The aim of this review article was to assess whether exercise improves quality of life. Yasam kalitesi, fiziksel, duygusal, zihinsel ve ruhsal olmak uzere dort farkindalik seviyesini gerceklestirmek icin insanin ihtiyaclarini karsilayabilme becerisiyle ilgili olan degisen cevre ve durumlarin ozelliklerinin butunudur. Egzersiz, fiziksel zindeligi ve genel sagligi artirici ya da koruyucu bedensel aktivite seklinde tanimlanmaktadir. Bu derlemenin amaci “egzersizin yasam kalitesini gelistirip gelistirmedigini degerlendirmektir.

Postpartum Depression Frequency and Quality of Life Among a Group of Mothers Having a Child Aged 2 Weeks-18 Months

Abstract: Amac: Calismanin amaci postpartum depresyon (PPD) sikligi, iliskili faktorler ve yasam kalitesi uzerine etkisini belirlemektir. Gerec ve Yontemler: Bu calisma 2 hafta-18 aylik bebegi olan 708 anne uzerinde yurutulmustur. Calismada veri kaynagi olarak annenin tanimlayici ozellikleri ve postpartum depresyon icin risk faktorlerine yonelik anket formu; Eddinburgh Postpartum Depresyon Olcegi (EPDO) ve WHOQOLBREF Yasam Kalitesi Olcegi kullanilmistir. Bulgular: PPD sikligi %15'dir. Gestasyonel yas, gebelikte ruhsal sorun, huzursuzluk endise yasamis olmak, premenstruel duygu durum degisiklikleri yasamak, ailede depresyon/PPD oykusu, gecirilmis depresyon/ PPD oykusu, evlilikten memnuniyet durumu, bebeginin evliligini olumsuz etkiledigini dusunmek PPD ile iliskili faktorlerdir. Postpartum depresyon saptanan annelerin yasam kalitesi postpartum depresyonu olmayanlardan daha kotudur (p < 0.05). Sonuc: PPD oldukca yuksek sikliga sahiptir ve annenin yasam kalitesini dusurmektedir.

Son Trimester Gebelerin Depresyon ve Kaygı Düzeyleri ile Bunları Etkileyen Etmenler

Abstract: Amac: Bebek sahibi olmak mutlu bir olaydir fakat kadinlar gebelik doneminde zor ve stresli zaman gecirebilir. Gebe kadinlarin kendilerinin ve bebeklerinin ruhsal sagligini etkileyen faktorlerden uzak durmasi onemlidir. Bu calismanin amaci Edirne'de yasayan ucuncu trimester gebe kadinlarin depresyon ve kaygi duzeyleri ve bunlari etkileyen etmenleri belirlemektir. Hastalar ve Yontemler: Hamile kadinlarin sosyodemografik ve obstetrik ozellikleri, durumluluk kaygi duzeyi olcegi, birinci basamak icin Beck depresyon olcegi ve WHOQOOL-BREF(TR) yasam kalitesi olcegini iceren anket Nisan-Haziran 2007 tarihleri arasinda Edirne'de saptanan son trimester 340 gebe kadina uygulandi. Bulgular: Gebe kadinlarin %56.6'sinin ilk gebeligiydi ve %90.9'u istenilen gebelikti. Gebe kadinlarin %97.7'sinde onemli bir saglik problemi yoktu. Gebelikte sigara kullananlarin orani %14.4, ortalama doktor ziyareti sayisi %7.2 defaydi ve gebelerin %85';ine ebelerce ev ziyareti yapilmamisti. Kaygi duzeyi artan yasla dusmekteydi. Kalabalik aileler, sosyo-ekonomik durumun dusuk olmasi, istenmeyen gebelikler, sigara ve alkol tuketimi depresyon seviyesini arttirmaktaydi. Sonuc: Gebe kadinlarin sosyo-ekonomik ve egitim durumlarinin iyilesmesi, gebelik takiplerinde ruhsal durum ve etkileyen faktorlerin izlenmesi saglikli bir gebelik donemi gecirilmesini saglayacaktir.

Prevalence of Multiple Sclerosis in the Metropolitan Area of Edirne City, Turkey

Abstract: Objective: The prevalence and incidence of multiple sclerosis may vary according to the influence of the altitude of a geographical area as well as the genetic and environmental factors. This study ained to determine the incidence and prevalence of multiple sclerosis in Edirne population. Material and Methods: Patients with a definite diagnosis of MS according to McDonald's criteria, admitted to one of the three MS clinics in Edirne, were included in this two-stage study. Also the records of hospitals in Istanbul serving patients from Edirne, have been evaluated. Results: The prevalence rate of confirmed MS patients was 33.9/100000 (95% CI: 32-36) in 2003. The mean annual incidence was 3.48/100000 (95% CI: 2.90-4.00). Mean age of the patients was 36.5p9.6 years. Mean age at onset was 29.2p8.5 years. Mean duration of disease was 6.9p5.2 years. Overall, 69.2% had a relapsing-remitting course, 20.5% had a primary progressive course and 10.3% had a secondary progressive course. Mean Expanded Disability Status Scale score was 3.04p2.18. The prevalence and annual incidence after one year was 36.5 per 100000 (95% CI: 33.2-38.6) and 2.60 per 100000 (95% CI: 2.1-3.8), respectively. Conclusion: This is the first city-based MS prevalence study performed in Turkey. The MS prevalence in Edirne is similar to that of Greece and Bulgaria but lower than that of European countries.

The effects of gabapentin therapy on pruritus, quality of life, depression and sleep quality in pruritic hemodialysis patients

Abstract: Objectives: We aimed to determine possible changes in pruritus, quality of life, depression and sleep quality in pruritic hemodialysis (HD) patients with gabapentin therapy. Patients and Methods: Fourteen adult HD patients (7 men, 7 women; mean age 59.7aplusmn;17.2 years; range 41 to 88 years) with history of pruritus of more than eight weeks were assigned to receive 8-week gabapentin (300 mg per day) therapy. The daily pruritus were recorded using visual analogue scale for each period of the study during one week preceding the trial, the active treatment phase, the placebo phase and the intervening 1-week washout period. Sleep quality was determined with a modified post-sleep inventory, quality of life with a short form of Medical Outcomes Study (SF-36), depression using the Beck Depression Inventory. Results: The mean pruritus score and total of post-sleep inventory were decreased significantly with gabapentin therapy (p=0.01 and p=0.002 respectively). Physical and mental component scales of SF-36 increased, whereas cognitive and somatic depression index decreased with gabapentin. Conclusion: We concluded that beneficial effects of gabapentin therapy on pruritus, quality of life, depression and sleep quality are clinically important in HD patients with pruritus. Gabapentin therapy should be taken into account as an important choice of therapy in pruritic HD patients. Amac: Gabapentin tedavisi ile kasinti sikayeti olan hemodiyaliz (HD) hastalarinda kasinti, yasam kalitesi, depresyon ve uyku kalitesindeki olasi degisiklikleri tespit etmeyi amacladik. Hastalar ve Yontemler: Sekiz haftadan daha uzun sureli kasinti oykusu olan 14 HD hastasina (7 erkek, 7 kadin; ort. yas 59.7aplusmn;17.2; dagilim 41-88) gunde 300 mg gabapentin 8 hafta sure ile verildi. Calisma oncesi 1 hafta, aktif tedavi fazi, plasebo fazi ve araya giren 1 haftalik temizlenme fazi esnasinda gorsel analog olcegi kullanilarak gunluk kasinti skorlari kaydedildi. Uyku kalitesi modifiye uyku-sonrasi kaydi ile, yasam kalitesi Tibbi Sonuc Calismasi Kisa Form-36 sekli (SF-36) ile ve depresyon da Beck Depresyon kaydi kullanilarak degerlendirildi. Bulgular: Gabapentin tedavisi ile ortalama kasinti skorunda ve toplam uyku-sonrasi kaydi skorunda anlamli derecede dusus gozlendi (sirasiyla p=0.01 ve p=0.002). SF-36a#39;nin fiziksel ve mental komponent skorlari gabapentin tedavisi ile artarken, bilissel ve somatik depresyon indeksleri gabapentin ile azaldi. Sonuc: Gabapentin tedavisi kasinti sikayeti olan hemodiyaliz hastalarinda kasinti, yasam kalitesi, depresyon ve uyku kalitesi uzerinde klinik olarak onemli yararli etkilere sahiptir. Gabapentin tedavisi kasintisi olan hemodiyaliz hastalarinda onemli bir tedavi secenegi olarak goz onunde bulundurulmalidir.

Trace Elements in a Rat Model of Cadmium Toxicity: the Effects of Taurine, Melatonin and N-Acetylcysteine

Abstract: Objectives: This study was undertaken to investigate copper, zinc, iron, and selenium in a rat model of cadmium toxicity and effects of antioxidant substances such as taurine, melatonin and N-acetylcysteine. Materials and Methods: Ninety male Sprague Dawley rats were divided into nine groups. Group 1 received tap water comprising the controls; the remaining eight groups received 200 amicro;g/ml cadmium chloride (CdCl2) for three months. Group 2 had CdCl2. Groups 3, 4, and 5 were administered taurine, melatonin and N-acetylcystein for three months together with CdCl2. Groups 6, 7, 8, and 9 had CdCl2 for three months and then only water as the second control or antioxidants for seven days. Cadmium, copper, zinc, iron, and selenium levels of heart and brain were measured by atomic absorption spectrophotometer. Results: Cadmium accumulated in significant amounts in brain and heart tissues when compared with controls. CdCl2 levels in Group 1 and Group 2 were 2.56aplusmn;0.77 and 27.2aplusmn;5.82 in the heart, 46.16aplusmn;14.81 and 300.34aplusmn;58.19 in the brain, respectively (palt;0.001). We found that melatonin was more effective in brain tissue (palt;0.05) whereas N-acetylcysteine was more effective in heart tissue (palt;0.001) against cadmium accumulation. Conclusion: We suggest that taurine, melatonin and N-acetylcysteine have some protective effects in brain and heart tissues against cadmium accumulation. Furthermore, trace element levels were restorated in different degrees after taurine, melatonin and N-acetylcysteine administration. Amac: Bu calisma kadmiyum toksisitesi olusturulan sican modelinde bakir, cinko, demir ve selenyum duzeylerini arastirmak ve taurin, melatonin ve N-asetilsisteinin etkilerini belirlemek amaciyla yapilmistir. Gerecler ve Yontemler: Doksan erkek Sprague Dawley sican dokuz gruba ayrildi. Hayvanlara serbestce ulasabilecekleri pellet yem ve su verildi. Grup 1a#39;e cesme suyu verildi ve kontrol olarak kullanildi, diger sekiz grup uc ay sureyle 200 amicro;g/ml kadmiyum klorid (CdCl2) aldi. Grup 2, CdCl2, Grup 3, 4, ve 5 CdCl2 ile birlikte sirasiyla taurin, melatonin ve N-asetilsistein aldi. Grup 6, 7, 8, ve 9 uc ay sureyle CdCl2 ve sonra yedi gun sureyle kontrol olarak sadece su veya antioksidan aldi. Kalp ve beyinde kadmiyum, bakir, cinko, demir, ve selenyum duzeyleri atomik absorpsiyon spektrofotometresi ile olculdu. Bulgular: Kontrollerle karsilastirildiginda kadmiyum beyin ve kalpte anlamli duzeylerde birikim gosterdi. Grup 1 ve Grup 2 CdCl2 duzeyleri sirasiyla kalpte 2.56aplusmn;0.77 ve 27.2aplusmn;5.82, beyinde ise 46.16aplusmn;14.81 ve 300.34aplusmn;58.19 idi (palt;0.001). Kadmiyum birikimine karsi koruyucu olan en etkili maddenin beyin dokusunda melatonin (palt;0.05), kalpte ise N-asetilsistein (palt;0.001) oldugunu bulduk. Sonuc: Bu bulgular kadmiyumun beyin ve kalpte birikimine karsi taurin, melatonin ve N-asetilsisteinin bazi koruyucu etkileri oldugunu dusundurdu. Ayrica, eser element duzeylerinin taurin, melatonin veya N-asetilsistein uygulamasi ile farkli duzeylerde olsa da kontrol degerlerine yaklastigi gozlendi.

Factors Effecting Job Satisfaction Among Academic Staff

Abstract: Amac: Akademisyenlik ozveri ve dolayisiyla mesleki tatmin gerektiren alanlardan biridir Bu calismada Trakya Universitesinde calisan tum akademik personelin sosyodemografik ozellikleri ile is doyumu duzeylerinin arastirilmasi amaclanmistir Gerec ve Yontemler: Arastirmada Minnesota Tatmin Olcegi kisa formunu iceren bir anket kullanildi Verilerin degerlendirilmesinde frekans tablolari, capraz tablolar, Pearson Ki-kare, Exact Ki-kare, Kruskal Wallis ve Dunn coklu karsilastirma testleri ve “Chi-squared Automatic Interaction Detector” (CHAID) analiz testleri kullanildi Bulgular: %47’si (n=263) kadin, %53’u (n=297) erkek olan 560 katilimci- nin yas ortalamasi 3386±733’tu Ogretim elemanlarinin genel is doyumu ortalamalari 6306±1096, ortanca 6400’tu Katilimcilarin icsel is doyumu ortalamalari 4479±749, dissal is doyumu ortalamalari 1827±464 olarak saptandi Ogretim elemanlarinin is doyumu duzeyleri %854’unde (n=478) orta, %146’sinda (n=82) yuksek olarak saptandi Gelir duzeylerine gore is doyumu duzeyleri arasinda anlamli fark saptandi Yapilan CHAID analizinde is doyumu ile bagimsiz degiskenlerden yas, ogrenim durumu, toplam hizmet yili ve bolumdeki hizmet yili degiskenlerinin iliskili oldugu saptandi Sonuc: Is doyumu, calisanlarin genel duygusal durumunu gosterebilmekte ve ise yonelmeyi saglayan olumlu etki olarak tanimlanmaktadir ve kisilerin basarili, mutlu ve uretken olabilmelerinin en onemli gereklerinden biridir Ozellikle meslek disi yasamlari dogrudan etkileyen ve surekli ozveri gerektiren mesleklerde is doyumu buyuk onem tasimaktadir Verimliligi artirabilmek icin yoneticilerin is doyumunu artiracak onlemler almalari gerekmektedir

Genotype Distribution and 5' UTR Nucleotide Changes in Hepatitis C Virus

Abstract: Objective: HCV is a single-stranded RNA virus which has 9500 nucleotide. On the 3a#39; and 5a#39; ends of the genome, there are two untranslated regions (UTR) which are highly protected and which have 92% homology among various HCV types. 5a#39; UTR is used for the genotype detection. In this study, genotype and nucleic acid changes in this region were analyzed. Material and Methods: In 51 patients diagnosed with HCV, HCV-RNA was isolated and purified from serum samples. The 341 nucleotide-long UTR region at the 5a#39;end of the genome was sequenced and genotypes were detected. Nucleotide changes were analyzed with on-line BLAST program. Results: In 45 (88.2%) of 51 patients, genotype-1 (78.4% of all genotypes were 1b, 9.8% were 1a) was detected. In 41 (80.4%) of the 51 sequences, nucleic acid changes were detected. These changes generally occurred as an insertion in codon 84 ; deletion in codon 43 and codon 46; transversion in codon 15, 17 and 18, and transition in codon 62. No significant relationship was found between viral load and nucleic acid changes. Conclusion: Although the 5a#39;UTR region is a protected region, mutation can be observed, and the mutations may affect the genotype, viral load and treatment response. Therefore, further investigation is required in a large series Turkish Baslik: Hepatit C Virusu Genotip Dagilimi ve 5a#39; UTR Nukleotid Degisiklikleri Anahtar Kelimeler: HCV, Genotip, 5a#39;UTR nukleotid degisiklikleri Amac: HCV, tek zincirli 9500 nukleotid uzunlugunda bir RNA virusdur. Genomun 3a#39; ve 5a#39; uclarinda oldukca korunmus ve farkli HCV tipleri arasinda %92 oraninda homoloji gosteren iki adet translasyona ugramayan bolge (untranslated region=UTR) bulunmaktadir. 5a#39;UTR bolgesi genotip saptanmasinda kullanilmaktadir. Calismada genotip ve bu bolgedeki nukleik asid degisiklikleri arastirilmistir. Gerec ve Yontemler: HCV tanisi almis 51 hastanin serumunda HCV RNA ekstraksiyonu ve purifikasyonu yapilmistir. Genomun 5a#39;ucundaki 341 nukleotid uzunlugundaki UTR bolgesinin sekans analizi yapilmis ve HCV genotipleri saptanmistir. On-line BLAST programi kullanilarak elde edilen dizilerdeki nukleotid degisiklikleri arastirilmistir. Bulgular: Ellibir hastanin 45a#39;inde (%88.2) genotip 1 (tum genotiplerin %78.4a#39;u 1b, %9.8a#39;i 1a) saptanmistir. Dizilerin 41a#39;inde (%80.4) nukleik asit degisiklikleri belirlenmistir. Bu degisiklikler genellikle 84. kodonda insersiyon, 43. ve 46. kodonlarda delesyon, 15., 17. ve 18. kodonlarda transversiyon, 62. kodonda ise transisyon seklinde gorulmektedir. Nukleik asit degisiklikleri ile viral yuk arasinda anlamli bir iliski bulunmamistir. Sonuc: 5a#39;UTR bolgesi korunmus bolge olmasina ragmen bu bolgede mutasyonlar gorulebilmektedir ve bu mutasyonlar genotipi, viral yuku ve tedavi cevabini etkileyebilir. Bu nedenle genis serilerde ileri arastirmalara gereksinim vardir.

Depressive, Anxiety Levels and Affecting Factors of Third Trimester Pregnant Women

Abstract: Objectives: Having a baby is a happy event but the mother may have a hard and stressful time in pregnancy. It is important that pregnant women should stay away from factors that have an effect on their mental health for themselves and their babies. The aim of this study was to determine the anxiety and depression levels and effecting factors in third trimester pregnant women living in Edirne, Turkey. Patients and Methods: A questionnaire including items about socio-demographic and obstetric characteristics, state anxiety inventory, Beck depression scale for primary care and WHOQOOL-BREF(TR) quality of life scale was applied to 340 last trimester pregnant women determined in Edirne, Turkey between April-June 2007. Results: It was the first pregnancy for 56.6% and a wanted one in 90.9% of them. There was not an important health problem in 97.7% of participants; smoking rate in pregnancy was 14.4%. Average physician visits was 7.2 times and 85% of them did not receive any home visit by midwives. Anxiety level decreased by age. Crowded families, low socio-economic status, unwanted pregnancies, cigarette and alcohol consumption increased depression level. Conclusion: Enhancing the socio-economic and educational status, surveying mental state and affecting factors in pregnancy follow-ups would provide a healthy pregnancy period for pregnant women. Amac: Bebek sahibi olmak mutlu bir olaydir fakat kadinlar gebelik doneminde zor ve stresli zaman gecirebilir. Gebe kadinlarin kendilerinin ve bebeklerinin ruhsal sagligini etkileyen faktorlerden uzak durmasi onemlidir. Bu calismanin amaci Edirnea#39;de yasayan ucuncu trimester gebe kadinlarin depresyon ve kaygi duzeyleri ve bunlari etkileyen etmenleri belirlemektir. Hastalar ve Yontemler: Hamile kadinlarin sosyodemografik ve obstetrik ozellikleri, durumluluk kaygi duzeyi olcegi, birinci basamak icin Beck depresyon olcegi ve WHOQOOL-BREF(TR) yasam kalitesi olcegini iceren anket Nisan-Haziran 2007 tarihleri arasinda Edirnea#39;de saptanan son trimester 340 gebe kadina uygulandi. Bulgular: Gebe kadinlarin %56.6a#39;sinin ilk gebeligiydi ve %90.9a#39;u istenilen gebelikti. Gebe kadinlarin %97.7a#39;sinde onemli bir saglik problemi yoktu. Gebelikte sigara kullananlarin orani %14.4, ortalama doktor ziyareti sayisi %7.2 defaydi ve gebelerin %85a#39;ine ebelerce ev ziyareti yapilmamisti. Kaygi duzeyi artan yasla dusmekteydi. Kalabalik aileler, sosyo-ekonomik durumun dusuk olmasi, istenmeyen gebelikler, sigara ve alkol tuketimi depresyon seviyesini arttirmaktaydi. Sonuc: Gebe kadinlarin sosyo-ekonomik ve egitim durumlarinin iyilesmesi, gebelik takiplerinde ruhsal durum ve etkileyen faktorlerin izlenmesi saglikli bir gebelik donemi gecirilmesini saglayacaktir.

Oxidative Stress in Patients with Chronic Hepatitis B and C

Abstract: Objective: Hepatitis B and hepatitis C virus infections are extensively seen throughout the world. Disturbances in the antioxidant system and oxidative stress may play a role in the pathogenesis of chronic liver diseases. The aim of this study was to evaluate the oxidant/antioxidant status in the serum of patients with chronic hepatitis B (CHB) and C (CHC). Material and Methods: Twenty patients with CHB, 20 with CHC and 30 healthy volunteers were included in this study. Catalase (CAT), superoxide dismutase (SOD) activities and malondialdehyde (MDA) levels were measured in all patients and control group specthrophotometrically. Results: While CAT and SOD activities were significantly lower in patients with CHC, these enzymes were significantly higher in patients with CHB compared to controls. However, MDA levels were increased in each patient group as compared to the control group. Also, antioxidant enzyme activities were found to be significantly lower and MDA levels were higher in patients with CHC, compared to patients with CHB. Conclusion: We considered that insufficiency of antioxidant barrier may cause oxidative stress in patients with CHB and CHC, so antioxidant treatment should be useful for these patients.

3D Motion Analysis of Hip, Knee and Ankle Joints of Children Aged Between 7-11 Years During Gait

Abstract: Objective: The purpose of this study is to constitute a normative walking kinematic database and to investigate the differences between 7-11 aged children and between the left and right sides of those age groups. Materials and Methods: Fifty children between the 7 and 11 years old (10 from each age group) participated in this study. The measurements were made with Zebris© CMS 70 P 3D motion analysis system. Flexion- extension, abduction-adduction angles of the hip joint, the fl exion-extension of the knee and ankle joints and foot rotations for each age group for both sides were recorded. Results: Even all the groups’ gait patterns were similar with the literature, 9 years old group has lower knee fl exion and higher ankle extensions (p<0.05). Eight and 9 years old groups have higher maximum ankle extension values when compared with the other age groups (p<0.05). Conclusion: Kinematic analysis results of 7 to 11 years old children suggests adult-like gait patterns especially for the hip and knee. These fi ndings stress the importance of age-matched normative data for the kinematic gait analysis.

Antibiotic Susceptibilities and Serotyping of Clinical Streptococcus Agalactiae Isolates

Abstract: Objective: Streptococcus agalactiae (Group B streptococci, GBS) are frequently responsible for sepsis and meningitis seen in the early weeks of life. GBS may cause perinatal infection and premature birth in pregnant women. The aim of this study was to serotype GBS strains isolated from clinical samples and evaluate their serotype distribution according to their susceptibilities to antibiotics and isolation sites. Material and Methods: One hundred thirty one S. agalactiae strains isolated from the clinical samples were included in the study. Of the strains, 99 were isolated from urine, 20 from soft tissue, 10 from blood and 2 from vaginal swab. Penicillin G and ceftriaxone susceptibilities of GBS were determined by the agar dilution method. Susceptibilities to erythromycin, clindamycin, vancomycin and tetracycline were determined by the Kirby-Bauer method according to CLSI criteria. Serotyping was performed using the latex aglutination method using specific antisera (Ia, Ib, II-VIII). Results: While in 131 GBS strains, serotypes VII and VIII were not detected, the most frequently isolated serotypes were types Ia (36%), III (30.5%) and II (13%) respectively. Serotype Ia was the most frequently seen serotype in all samples. All GBS isolates were susceptible to penicilin G, ceftriaxone and vancomycin. Among the strains, tetracycline, erythromycin and clindamycin resistance rates were determined as 90%, 14.5%, and 13% respectively. Conclusion: Penicillin is still the first choice of treatment for the infections with all serotypes of S. agalactiae in Turkey.

A Retrospective Analysis of Pediatric Patients Admitted to the Pediatric Emergency Service for Carbon Monoxide Intoxication

Abstract: Objective: The aim of the study is to analyze the general aspects of cases with carbon monoxide intoxication in order to improve the approach to future patients. Material and Methods: The hospital records of 84 children (mean age 4.71aplusmn;2.64 years; 48 male, 36 female) who had been admitted to Paediatric Emergency Department for carbon monoxide intoxication between October 2007 and February 2009, were retrospectively evaluated in a descriptive analysis. Results: The source of carbon monoxide intoxication was heaters, waterheaters and fi re in 82.1%, 7.1% and 6% of cases, respectively. There was a statistically signifi cant difference between the carboxyhemoglobin levels of the patients according to the clinical classifi cation (palt;0.05). The intoxication caused by heaters was observed signifi cantly in November, December and January (palt;0.001), between 16:00-24:00 hours (palt;0.001) and among more than one member of a family (palt;0.001). A medium level correlation was detected between the treatment approach and clinical classifi cation (r=0.50, palt;0.001). Conclusion: Carbon monoxide intoxication, in the presented series, was found to develop accidentally; mostly in the Winter season; during night hours when the family members gathered together. The carboxyhemoglobin levels were appropriate with the developing clinical findings. Carboxyhemoglobin level solely was not enough for achieving the diagnosis and planning the treatment. Turkish Baslik: Cocuk Acil Servise Karbon Monoksit Entoksikasyonu ile Basvuran Cocuk Hastalarin Geriye Donuk Analizi Anahtar Kelimeler: Cocuk, karbon monoksit zehirlenmesi, cocuk acil servis Amac: Karbon monoksit zehirlenmesi olgularinin genel ozellikleri incelenerek bundan sonra karsilasilacak vakalarin yonetimine katkida bulunmak amaclanmistir. Gerec ve Yontemler: Karbon monoksit zehirlenmesi nedeniyle Ekim 2007-Subat 2009 arasinda acile getirilen 84 hastanin (yas ortalamasi 4.71aplusmn;2.64 yil, 48 erkek, 36 kiz) kayitlari retrospektif olarak incelendi. Bulgular: Vakalarda karbon monoksit zehirlenme kaynagi isiticilar, su isiticilari ve ates olarak sirasiyla %82.1, %7.1 ve %6a#39;dir. Hastalarin klinik siniflandirmasina gore karboksihemoglobin seviyeleri arasinda istatistiksel olarak anlamli bir fark vardi (palt;0.05). Isiticilar tarafindan kaynaklanan zehirlenme, Kasim, Aralik ve Ocak aylarinda (palt;0.001), 16:00-24:00 saatleri arasinda (palt;0.001) ve bir ailenin birden fazla uyesinde onemli derecede gozlendi (palt;0.001). Tedavi yaklasimi ve klinik siniflandirma arasinda orta duzeyde korelasyon tespit edildi (r=0.50, palt;0.001). Sonuc: Olgularimizda karbon monoksit zehirlenmesi kaza nedeniyle, en sik kis aylarinda, aksam saatlerinde gerceklesmistir. Klinik siniflamaya gore hastalarin ortalama COHb duzeyleri arasindaki fark anlamliydi. Karbon monoksit zehirlenmelerinde taninin konulmasinda ve tedavinin duzenlenmesinde karboksihemoglobin duzeyi tek basina yeterli degildir.

Efficiency of Magnetic Field Treatment on Pressure Sores in Bedridden Patients

Abstract: Objective: Pressure sores are an important source of complications in patients who are immobilized and bedridden. We aimed to investigate the efficiency of magnetic field treatment in pressure sores. Material and Methods: This was a randomized, double blind controlled design study. 20 patients in the study group received magneto-therapy, once a day for 30 minutes and with 150G, keeping to the BTL09 magnetotherapy device's program. In the control group, 20 patients received the dressing only once a day. The surface areas of the pressure sores were evaluated at the onset of the treatment (1st day), and on the 7th and 15th days. Results: When within group comparisons were conducted, a significant difference was observed between the 1st and 7th day, 7th and 15th day, and 1st and 15th day measures in both the groups in terms of the scar area. The average healing time for the treatment group was 10.80p4.06 (6-20) days, and the average healing time for the control group was 18.85p9.75 (5-32) days. There was a statistically significant difference between the two groups (z=-2.114, p=0.034). Also, there was a significant difference in the scar area between the two groups in the 15th day measure (z=-3.818, p=0.000). Conclusion: The healing process of the tissue can be accelerated.with the use of magnetotherapy in the treatment of pressure sores of stage II and III.

Factors Affecting the Quality of Life in Climacteric Women in Manisa Region

Abstract: Objectives: To determine the factors affecting the severity of menopausal symptoms and the quality of life among women living in Manisa, a western city of Turkey. Patients and Methods: After statistical estimation of the sample size reflecting the whole population, 268 climacteric women (mean age 50.7aplusmn;6.6 years; range 40 to 60 years) with menopausal symptoms were investigated by sociodemographic questionnaire, menopause rating scale (MRS), and Quality of Life Scale (WHOQOL-BREF-TR) in Celal Bayar University Hospital. Results: Almost 1/3 of women had no knowledge on menopause. The MRS scores of women were inversely correlated with Physical Health, Psychological well-being, Social Relationship domains of quality of life. Educational level, menopausal knowledge, participation in decision-making in the family and economic status positively affected most domains of quality of life, whereas being married and having high BMI scores had negative effects. Conclusion: In climacteric women, quality of life was negatively affected by the severity of menopausal symptoms, low education level, limited menopausal knowledge, and being overweight. Amac: Bu calismadaki amacimiz, Manisa ve cevresinde yasayan klimakterik donemdeki kadinlarda yasam kalitesi ve menopoza iliskin semptomlarin siddetine etki eden faktorleri belirlemektir. Hastalar ve Yontemler: Arastirmanin orneklemi evreni belli orneklem secim yontemi ile 268 klimakterik donem kadin (ort. yas 50.7aplusmn;6.6; dagilim 40-60) olarak belirlendi. Verilerin toplanmasinda sosyo-demografik sorularin bulundugu anket formu, Menopoz Semptomlarini Degerlendirme Olcegi (MRS) ve Yasam Kalitesi Olcegi (WHOQOLBREF- TR) kullanildi. Bulgular: Kadinlarin yaklasik 1/3a#39;u menopoza iliskin bilgilerinin olmadigini belirttiler. MRS skoru ile yasam kalitesi alan puanlari karsilastirildiginda, MRS skoru ile bedensel, ruhsal ve sosyal alanlarda istatistiksel olarak anlamli fark bulundu. Kadinlarin egitim durumu, menopoza iliskin bilgileri, ailedeki kararlara katilma ve ekonomik durumu yasam kalitelerini olumlu etkilemekte, evli ve yuksek vucut kitle indeksi skoru olan kadinlarda ise yasam kalitesi olumsuz etkilenmekte idi. Sonuc: Klimakterik donemdeki kadinlarda, menopozal semptomlarin siddeti, egitim duzeylerinin dusuklugu, menopoza iliskin bilgilerin sinirli olmasi ve kilolu olunmasi yasam kalitesini olumsuz etkilemektedir.

Protective Effect of Curcumin on Liver Damage Induced by Biliary Obstruction in Rats

Abstract: Objective: The aim of this study is to evaluate the possible protective effects of curcumin against cholestatic oxidative stress and liver damage in common bile duct ligated rats. Material and Methods: A total of 18 male Wistar albino rats were divided into three groups: control, common bile duct ligation (BDL) and BDL+curcumin. Each group contained 6 animals. The rats in the curcumin treated group were given curcumin (100 mg/kg) once a day orally for 14 days, starting 3 days prior to BDL operation. Following 14 days of treatment, all the animals were decapitated and liver tissue samples were obtained for histopathological investigation. Results: The changes demonstrating the bile duct proliferation and fibrosis in expanded portal tracts, including the extension of proliferated bile ducts into lobules, mononuclear cells, and neutrophil infiltration into the widened portal areas, were observed in BDL group. Treatment of BDL with curcumin attenuated liver damage. Both the elevated alpha smooth muscle actin (aalpha;-SMA), and the activity of TUNEL in the BDL were observed to be reduced with the curcumin treatment. Conclusion: Our data indicate that curcumin reduced BDL-induced cholestatic liver injury, bile duct proliferation, fibrosis.

Examination of Inequality of Life Span by Using the Gini Coefficient in the Turkish Population for the Period 1990-2008

Abstract: Objective: The aim of this study is to show that the Gini coefficient used in economics, particularly in exposing inequality in income levels can also be used in the field of health, especially for measuring inequality specific to any issue of concern. Based on life tables, this study uses the Gini coefficient in measuring the extent of inequality in years lived and shows the level of these inequalities in Turkey for the period 1990-2008. Material and Methods: Lorenz Curves were constructed by using data from life tables pertaining to years 1990, 2000, 2006 and 2008 as given by WHO database, Gini coefficients were calculated in measuring variability in length of life expectancies in general, for the male and female population and then used in examining reducing inequality over time. Results: Taking 1990 as the base year, life expectancy at birth has increased by 9.3 years by 2008 and inequality has decreased from 0.188 to 0.114 (by 39%) in the same period. Conclusion: In addition to the target of increasing life expectancy, the assessment of success in ensuring all individuals live up to average life expectancy should be conducted by using this measure of inequality.

Evaluation of Effects of Quercetin (3, 3', 4', 5, 7-pentohidroxyflavon) on Apoptosis and Telomerase Enzyme Activity in MCF-7 and NIH-3T3 Cell Lines Compared with Tamoxifen

Abstract: Objective: Quercetin has been shown to inhibit the proliferation of cancer cells. Tamoxifen is used for breast cancer. In this study, we have aimed to investigate the effects of quercetin and tamoxifen on telomerase enzyme activity and apoptosis in two cell lines. Methods: In this study, 10, 50 and 100 amu;M of quercetin and tamoxifen were used to treat MCF-7 and NIH-3T3. Apoptosis was determined by the TUNEL method (Terminal Deoxynucleotide Transferase dUTP Nick End Label) and telomerase enzyme activity was determined by ELISA (Enzyme-Linked Immunosorbent Assay). Results: In the NIH3T3 cell line, only 100 amu;M quercetin and tamoxifen induced significant apoptosis. In the MCF-7 cell line 10 amu;M and 100 amu;M quercetin in the 24th hour and 100 amu;M quercetin in the 72 hour induce apoptosis. In 24th and 48th hours, 50 amu;M tamoxifen and 100 amu;M tamoxifen in the 24th and 48th hours induce apoptosis in the MCF-7 cell line. In MCF-7 and NIH-3T3 cell lines, all doses of quercetin and tamoxifen reduced telomerase enzyme activity compared to the control group. Conclusion: In this study, it was shown that quercetin has similar effects to tamoxifen. However quercetin induces apoptosis more than decreasing telomerase enzyme activities, being different from tamoxifen. We hope that the findings will assist in developing new therapeutic pathways for preventing breast cancer. However, there should be many more studies in order to discover quercetin and other potential drugs.

Quality of Life After Stroke

Abstract: Several studies have shown that many stroke survivors experience a decline in their Quality of life (QOL) in terms of impaired physical, functional, psychological, and social health. Quality of life is most often assessed by means of either structured interviews or written questionnaires. Many questionnaires have been developed recently for the evaluation of QOL in stroke and many studies have been done on this subject. In this study QOL changes in stroke patients, the evaluation of QOL, the QOL measuring instruments and the results of clinical studies on the subject were discussed. Inme geciren bircok kiside, bozulan fiziksel, fonksiyonel, psikolojik ve sosyal saglik durumlari acisindan yasam kalitelerinde dusme gozlemlendigi cesitli calismalar tarafindan gosterilmistir. Yasam kalitesi cogu kez ya yapilandirilmis gorusme ya da yazili anketler araciligiyla degerlendirilmektedir. Son zamanlarda inme geciren hastalarda yasam kalitesinin olculmesi icin bircok anket gelistirilmis ve bu konu uzerine bircok calisma yapilmistir. Bu makalede, inmeli hastalarda yasam kalitesindeki degisimler, yasam kalitesinin olculmesi, yasam kalitesi olcum araclari ve konu hakkindaki klinik calismalarin sonuclari tartisildi.

Trakya Üniversitesi Öğrencilerinde Şiddet Davranışları ve Algılanan Sağlık İlişkisi

Abstract: Amac: Bu calismada, universite ogrencilerinde siddetle iliskili davranislarin, algilanan saglik ile iliskisi ve bu iliskinin cinsiyete gore farklilasip farkli- lasmadiginin degerlendirilmesi amaclanmaktadir. Gerec ve Yontemler: Calisma Trakya Universitesi’nin tum ogrencilerini temsil eden bir orneklemi kapsayan, kesitsel bir calismadir. Tum okullardan arastirma kapsamina alinan 1 620 ogrenci fakulte ve yuksekokullarin mevcut ogrenci sayilarina ve cinsiyete gore agirliklandirilarak, sistematik ornekleme yontemi ile belirlenmistir. Arastirmacilar tarafindan gelistirilen yapilandirilmis anketler, arastirmaya katilmayi kabul eden ogrencilere, bir ders saati suresince gozlem altinda uygulanmistir. Istatistiksel degerlendirme icin tanimlayici istatistiklerin yani sira Ki-Kare analizi ve lojistik regresyon analizi kullanilmistir. Bulgular: Katilimcilarin %6.3’u son 12 ayda siddete maruz kaldigini, %33.5’i son 12 ayda bir kavgada bulundugunu, %7.2’si son 12 ayda yaralanmali bir kavgada bulundugunu, %4.9’u son 30 gun icinde kendini guvende hissetmedigi icin en az bir gun okula gitmedigini, %4.4’u son 12 ay icinde en az bir kez intihar girisiminde bulundugunu bildirmislerdir. Bu calismada yapilan analizler siddetle iliskili davranislarin, potansiyel karisti- rici faktorler kontrol edildiginde dahi, sagligin kotu algilanmasi ile iliskili oldugunu gostermistir. Sonuc: Siddet ile iliskili olan davranislarin sagliga etkisini belirlemek ve daha ayrintili inceleyebilmek icin prospektif calismalar yapilmasina gereksinim vardir. Siddetle ilgili gencleri kapsayan mudahaleler planlanirken, siddet davranislarinin sagliksizligin belirtileri oldugu akildan cikarilmamalidir.

A Comparison of Cormeck-Lehane and Mallampati Tests with Mandibular and Neck Measurements for Predicting Difficult Intubation

Abstract: Amac: Degisik testler zor entubasyon icin formule edilmistir. Mallampati testi, Wilson skorlamasi, Cormeck-lehane testi ve tiromental mesafe preopertaif olarak kullanilan en yaygin testlerdendir. Bu calismanin amaci Mallampati ve Cormeck-Lehana testlerinin zor entubasyonu tahmin etmede sternomental ve tiromental mesafeler, mandibula uzunlugu, genisligi, boyun uzunlugu ve cevresi gibi parametreler arasinda iliski olup olmadigini incelemektir. Gerec ve Yontemler: Bu amacla elektif sartlarda cerrahi edilen yaslari 17- 70 yas arasi 227 vaka calismaya dahil edildi. Yas, cinsiyet, vucut agirligi, boy ve beden kitle indeksi operrasyon oncesi kayit edildi. Analiz icin Mallampati ve Cormack-Lehane testleri derece 1, 2 kolay (risksiz) ve derece 3, 4 zor (riskli) olarak gruplandirildi. Bulgular: Bu calismada Mallampati sinif 1 ve 2 (risksiz) olgularin %72.7’sinde laringoskopik goruntu %90.7 oraninda sinif 1 ve 2 (risksiz) olarak bulunmustur. Cormeck-Lehane siniflandirmasi ile boyun cevresinin birlikte kullanilmasi ile duyarlilik degeri en yuksek olarak (%94.74) elde edildi. Mallampati siniflamasi ve boyun uzunlugunu birlikte kullanilmasi ile duyarlilik degeri en yuksek olarak (%67.86) elde edildi. Fakat bu durumda da pozitif gosterge degeri cok dusuktu. Sonuc: Bu bulgular isiginda Mallampati ve Cormeck-Lehane testlerinin tek basina anestezide zor entubasyonu tahmin etmede yetersiz oldugu bu yuzden Cormeck-Lehane ile birlikte boyun cevresinin kombine yapilmasi faydali olabilir. Mallampati ile sternomental ve tiromantal mesafelerin yani sira boyun uzunlugunun da preoperatif zor entubasyonu tahmin etmek icin rutin olarak yapilmasi faydali olabilir

Selective Serotonin Reuptake Inhibitors for Treatment of Selective Mutism

Abstract: Some authors suggest that selective mutism should be considered as a variant of social phobia or a disorder in the obsessive-compulsive spectrum. Recent studies indicate that pharmacological treatments may be effective in the treatment of selective mutism. In this article, four cases who were treated with citalopram and escitalopram are presented. The results indicate that the drugs were well tolerated, and the level of social and verbal interactions improved significantly. These findings have shown that citalopram and escitalopram can be considered in medication of selective mutism; nevertheless, it is essential that research be done with more cases than previous ones, in order to prove their accuracy Turkish Baslik: Selektif Mutismin Tedavisinde SSRI' larin Kullanimi Anahtar Kelimeler: Selektif mutism, cocuklar, essitalopram, sitalopram Bazi yazarlar selektif mutismin, sosyal fobinin bir varyanti oldugunu veya obsesif kompulsif bozukluk spektrumu icinde yer aldigini ileri surmektedirler.Son yapilan calismalar selektif mutismin tedavisinde ilaclarin etkili olabilecegini gostermektedir.Bu makalede sitalopram ve essitalopram ile tedavi edilen dort elektif mutism olgusu sunulmaktadir. Sonuclar, bu iki ilacin olgularca iyi tolere edildigini, verbal ve sosyal etkilesimin gelistigini gostermistir. Bu veriler sitalopram ve essitalopramin, selektif mutismin farmakolojik tedavisinde dikkate alinabilecegini dusundurmekle birlikte, daha net bilgiler elde etmek icin genis hasta gruplarinda yeni calismalarin yapilmasi gerekir..

Estimation of the Eyeball and Orbital Volume Using the Cavalieri Principle on Computed Tomography Images

Abstract: Objective: The volumes of the eyeball and orbit have been the subject of a few studies, yet none of them have used stereological methods to estimate the volume. In the present study, we estimated the volumes of the eyeball and orbita in normal healthy men and women using the stereological method. Material and Methods: We estimated the volume of the eyeball (VE) and the volume of the orbit (VO) in normal men and women using the Cavalieri principle as a combination of a point-counting technique. We used computed tomography scans taken from 31 subjects (12 men and 19 women). Results: The mean (±SD) VO in the female subjects was 18.47±2.52 cm 3 on the right side and 18.16±2.52 cm 3 on the left side. The VE was 7.45±1.19 cm 3 and 7.45±1.25 cm 3 on the right and left sides, respectively. The mean (±SD) VO in the male subjects was 22.35±3.05 cm 3 on the right side and 22.71±2.80 cm 3 on the left side. The VE was 7.32±0.74 cm 3 and 7.61±1.04 cm 3 on the right and left sides, respectively. Conclusion: Measurement by the technique described is an easy, and quick method of assessing the volumes of the eyeball and orbit.

Pratisyen Hekimlerin Sünnetle İlgili Bilgi Düzeyleri

Abstract: Objective: This study was carried out to investigate knowledge levels of general practitioners and their thoughts about circumcision in Middle Anatolia. Materials and Methods: This descriptive and cross-sectional study was carried out with 247 general practitioners working in Sivas. A questionnaire was prepared by the authors using previous reports. Questionnaires were sent to subjects by post. One hundred and seventy eight general practitioners (57 women, 121 men) responded and were included in the study. For statistical analysis, Chi-square test was used and pl0.05 value was accepted as significant. Results: 42.1% of subjects believed that circumcision should be performed between 2 and 6 years of age. 2.2% of subjects declared that circumcision could be done at home and 7.3% believed that the location of the operation is not important. 9.6% of subjects believed that the person who performs the circumcision does not have to be a doctor. 21.3% of subjects believed that circumcision could be performed without anesthesia during the newborn period because of undeveloped pain sensation. Conclusion: This study demonstrated that general practitioners, who are the most easily accessible health staff for information about health, do not have updated information about the way to perform circumcision and its necessity. Therefore, it is concluded that education programs about circumcision for general practitioners must be continued and updated. Turkish Baslik: Pratisyen Hekimlerin Sunnetle Ilgili Bilgi Duzeyleri Anahtar Kelimeler: Sunnet, pratisyen hekim, tip egitimi Amac: Bu calisma Orta Anadolu'daki pratisyen hekimlerin sunnetle ilgili dusunce ve bilgi duzeylerinin saptanmasi amaciyla gerceklestirildi. Gerec ve Yontemler: Kesitsel ve tanimlayici bir arastirma olarak planlanan calisma, Sivas il sinirlari icinde calismakta olan pratisyen hekimler arasinda yapildi (n=247). Anket formu, arastirmacilar tarafindan literatur isiginda hazirlandi. Anketler posta yoluyla gonderildi. Toplam 178 hekim (erkek=121, kadin=57) anket formunu uygun olarak yanitladi. Karsilastirmalarda c2 testi kullanildi; anlamlilik duzeyi olarak pl0.05 kabul edildi. Bulgular: Hekimlerin %42.1'i 2-6 yas arasinda sunnet yapilmasini onerirken, %2.2'si sunnetin evde yapilmasi gerektigini, %7.3'u de yapilan yerin bir onemi olmadigini belirtmistir. Sunnetin kim tarafindan yapilmasinin uygun oldugu sorusuna ise %9.6'si yapan kisinin onemi olmadigini soylemistir. Sunnetin yapilma sekliyle ilgili olarak da %21.3'u yenidogan doneminde agri duyusu gelismedigi icin anestezi uygulanmadan sunnet yapilabilecegini belirtmistir. Sonuc: En kolay ulasilabilen, saglikli bilgi alinabilecek hekim grubu olan pratisyen hekimlerin sunnetin gerekliligi ve yapilma sekliyle ilgili guncel bilgi eksiklikleri mevcuttur. Pratisyen hekimlerin sunnet konusunda bilgilerinin guncellenmesi ve egitimlerinin surdurulmesi gereklidir.

Pilonidal Sinus of the Scalp: a Case Report and Review of the Literature

Abstract: A 31-year-old man presented with a twenty-year history of a slowly growing nodule on his scalp in the postauricular area. The lesion was excised and with the clinical and histological findings, it was diagnosed as a pilonidal sinus. The purpose of this review is to report the unusual occurrence of a pilonidal sinus on the scalp and review the literature regarding especially this location.

Comparison of Cephalometric Variables in Non-obese and Obese Patients with Obstructive Sleep Apnea

Abstract: Objective: To compare the cephalometric variables of obese (body mass index (BMI) age;30) and non-obese (BMIalt;30) Turkish male patients with obstructive sleep apnea syndrome (OSAS). Materials and Methods: OSAS diagnosed 85 patients who were obese [n=37; mean age (aplusmn;SE), 49.41aplusmn;1.54 year] and non-obese [n=48; mean age (aplusmn;SE) 46.92aplusmn;1.39 year] were included in the study. The cephalometric measurements and polysomnographic data of the patients were compared and a discriminatory analysis was performed. Results: The apnea-hypopnea index (AHI) was significantly higher in obese patients (palt;0.01). Bimaxillary protrusion was found in obese patients (palt;0.05). The non-obese patients with AHI age; 30 had an increased mandibular plane angle In the stepwise discriminant analysis done separately in obese and non-obese patients according to AHI; only the hyoid bone position was included in the model in obese patients and the estimated success of discrimination of AHIa#39;s level (alt;30 and age;30) was 70.3%. Age, anterior face and posterior face height were included to the model in non-obese patients and the estimated success of discrimination was found as 79.2%. Conclusion: Craniofacial morphology has an effect on the severity of OSAS. If the craniofacial morphology tends toward a worsening of OSAS with obesity, the severity of the OSAS increases.

Reliability of the Turkish Version of a New Coma Scale: FOUR Score

Abstract: Objectives: Although the most commonly used scale is the Glasgow Coma Scale (GCS) in neurological intensive care units (NICU), it has some shortcomings. Many attempts have been made to design new scales that could provide further neurological detail in coma. The FOUR score (Full Outline of UnResponsiveness) is a new coma scale. The aim of this study is the validation of the Turkish version of the FOUR score and comparison of it with the GCS. Patients and Methods: A total of consecutive 124 patients (65 males, 59 females; mean age 68.4aplusmn;14.7 years; range 26 to 96 years) who were admitted to the seven NICUs between 2006-2007 were enrolled in the study. Each patient was rated on both scales by two different neurologists within one hour after each other without knowledge of the othera#39;s scores. Morbidity was assessed at hospital discharge using the modified Rankin Scale. Results: The inter-rater reliability was excellent for both FOUR score (K=0.68; %95 CI, 0.59-077) and GCS (K=0.69; %95 CI, 0.60-0.77). Outcome prediction of the FOUR score was as effective as GCS. Conclusion: The FOUR score has major advantages and provide important details of the neurologic examination such as brainstem reflexes and eye movements. We believe our results suggest that the FOUR score could be used instead of GCS in the NICUs in Turkey. Amac: Norolojik yogun bakim unitelerinde (NYBU) en sik kullanilan olcek Glasgow Koma Skalasi (GKS) olmakla birlikte bazi eksiklikleri nedeni ile elestirilmekte ve norolojik hastalarin izlenmesinde daha iyi bir olcek gelistirme calismalari devam etmektedir. FOUR skor (Full Outline of UnResponsiveness) yeni bir koma degerlendirme olcegidir. Bu calismanin amaci FOUR skorun Turkce cevirisinin GKS ile karsilastirilmasi ve gozlemciler arasi guvenirliginin saptanmasidir. Hastalar ve Yontemler: Calismaya, 2006-2007 yillari arasinda yedi merkezin NYBUa#39;lerinde yatan toplam 124 hasta (65 erkek, 59 kadin; ort. yas 68.4aplusmn;14.7; dagilim 26-96) dahil edildi. Her hasta, iki noroloji doktoru tarafindan, birbirinin degerlendirmelerinden habersiz ve en fazla bir saat aralikli olacak sekilde muayene edildi ve FOUR skor ve GKS es zamanli olarak uygulandi. Hastalarin prognozu modifiye Rankin Skalasi (mRS) ile degerlendirildi. Bulgular: Uygulayicilar arasi uyumluluk hem FOUR skor icin (K=0.68; %95 CI, 0.59-0.77) hem de GKS icin (K=0.69; %95 CI, 0.60-0.77) iyi bulundu. FOUR skorun prognozu belirlemede GKS kadar etkili oldugu saptandi. Sonuc: FOUR skorun onemli ustunlukleri olup, beyin sapi refleksleri ve goz hareketleri gibi norolojik muayenenin onemli ayrintilari hakkinda bilgi saglar. Calismamizin sonuclarinin Turkiyea#39;deki NYBUa#39;lerde FOUR skorun GKS yerine kullanilabilecegi gorusunu destekledigine inaniyoruz.

Yasal Değişiklikler Sonrası Hekim Sorumluluğu ve Malpraktis

Abstract: Ulkemizde, 2005 yilinda ceza yasalarinda onemli degisiklikler yapildi. Hem adli tip hizmetleri hem de hekimlerin yasal sorumluluklari acisindan farkli uygulamalar gundeme geldi. Hekimler, bu yasal degisiklikler sonrasi, tibbi uygulama hatalari nedeniyle ciddi sikinti yasayabilecekleri endisesine kapildilar. Bu durum yalnizca ulkemize ozgu degildir. Dunyanin pek cok ulkesinde uzun zamandir yururlukte olan benzer uygulamalar vardir. Hekimler, ozellikle malpraktis sigortalarindan kaynaklanan tazminatlar nedeniyle zor durumdadir. Hekimlerin mesleki etik ilkelerine ve kurallarina uygun davranmalari, onlari yasalar onunde koruyacaktir.

The effect of nicotine treatment on propofol injection pain

Abstract: Objectives: Smokers had higher risk than nonsmokers for pain. The incidence of pain on injection of propofol has been reported to be 70%. We explored the relationship between smoking habits and propofol injection pain, whether nicotine replacement has an influence on intensity or incidence of pain associated with propofol in smokers. Patients and Methods: Two hundred patients ASA (American Society of Anesthesiologists) physical status 1, undergoing elective surgical procedures were studied. Hundred (50-50) patients who used cigarette were included in smoker group and nicotine group. Hundred (50-50) patients who never used tobacco were included in nonsmoker (NS) group and NS+nicotine group. Prior to surgery, the anesthesiologist gave a nicotine gum to nicotine group which was randomized in smokers and nonsmokers. The severity of propofol injection pain was evaluated using four point scale (none, mild, moderate, and severe). Results: Incidence of pain was higher in the smoker group compared with the nonsmoker, nicotine and NS+nicotine groups. The intensity of mild pain was higher in the smoker group compared with the nonsmoker group. The intensity of moderate+severe pain was lower in the NS+nicotine group compared with the nonsmoker and smoker and nicotine groups. Conclusion: The incidence of propofol injection pain and intensity of mild pain increased in smokers deprived of nicotine. Nicotine replacement in these patients reduced the incidence of propofol injection pain similar to nonsmokers. When nonsmokers were given nicotine, intensity of moderate+severe pain decreased. These results suggest that smokers' awareness of pain increases and nicotine has an analgesic effect. Amac: Sigara icenlerde icmeyenlere oranla agri riski daha fazladir. Propofol injeksiyon agrisinin insidansi %70'tir. Bu calismada, sigara icme aliskanliklari ile propofol injeksiyon agrisi arasindaki iliskiyi, sigara icenlerde nikotin replasmaninin propofol injeksiyon agrisinin yogunluk ve insidansi uzerine etkisi olup olmadigini arastirdik. Hastalar ve Yontemler: Elektif cerrahi girisim gecirecek olan ASA (American Society of Anesthesiologists) fiziksel durumu I, iki yuz hasta, sigara kullananlar (50'si sigara icenler-50'si sigara icenler/nikotin replasmani yapilanlar) ve sigara kullanmayanlar (50'si sigara icmeyenler, 50'si sigara icmeyenler/nikotin replasmani yapilanlar) olarak rasgele gruplandirildilar. Cerrahi oncesi anestezist, rasgele olarak sigara icenlerin 50'sine ve sigara icmeyenlerin 50'sine nikotin sakizi verdi. Propofol injeksiyon agrisinin siddeti, dort nokta skalasi (hic, hafif, orta, siddetli) kullanilarak degerlendirildi. Bulgular: Agri sikligi, sigara icenler grubunda sigara icmeyenler grubuna, sigara icen/nikotin grubuna, sigara icmeyen/nikotin grubuna oranla daha yuksekti. Hafif agrinin yogunlugu, sigara icenler grubunda, sigara icmeyenler grubundan daha yuksekti. Orta siddetli agrinin yogunlugu, sigara icmeyen/nikotin grubunda; sigara icmeyenler, sigara icenler ve sigara icenler/nikotin grubuna oranla daha dusuktu. Sonuc: Propofol injeksiyon agrisinin sikligi ve hafif agrinin yogunlugu, nikotinden mahrum edilen sigara icicilerinde artmistir. Bu hastalardaki nikotin replasmani, propofol injeksiyon agrisinin insidansini sigara icmeyenler duzeyine dusurmustur. Sigara icmeyenlere nikotin verildiginde, orta ve siddetli agrinin yogunlugu azalmistir. Bu sonuclar gostermektedir ki; sigara icenlerde agrinin farkindaligi daha fazladir ve nikotinin analjezik etkisi vardir.

Intrapulmonary Solitary Fibrous Tumour of the Lung: A Very Unusual Presentation

Abstract: Solitary fibrous tumour (SFT) is a rare neoplasm which most frequently occurs in the pleura, especially visceral pleura, but it is known that intrapulmonary SFT is very rare. We report the case of a 60-year-old woman who was admitted with a 6-year history of slow enhancing intrapulmonary nodular lesion in her right upper lobe on chest computed tomography (CT). A right upper lobectomy was performed for complete excision of the tumour and the postoperative histopathological examination revealed SFT. No pathology was observed during the period of 34-month postoperative follow-up. Herein we present an extremely rare case of intrapulmonary SFT that was located in the deep pulmonary parenchyma.