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Tetanoz, akut gelişen, nadir izlenen, ileri yaşlarda ölümcül seyredebilen ve nörotoksinlerle oluşan bir hastalıktır. Olgumuz, 61 yaşında, trismus, opistotonus, risus sardonicus, abdominal rijidite bulguları ile jeneralize tetanoz gelişen ve sonuçta sekel kalan erkek bir hastaydı. Olgu sunumumuz ile geçmiş aşılama öyküsü bilinmeyen, yaralanma veya mukozadan/açık yaradan yabancı cisim ile temas öyküsü olanlarda tetanoz profilaksisinin ve erişkin bağışıklamasının önemine dikkat çekmek amaçlanmıştır.

Amaç: Çalışmada evde sağlık hizmeti alan Alzheimer hastalarına bakım verenlerin yaşam kalitelerini etkileyen faktörleri değerlendirmek amaçlanmıştır. Yöntem: Tanımlayıcı ve kesitsel tipteki bu araştırma, 24.06.2021 ve 10.07.2021 tarihleri arasında, Samsun ilinde Evde Sağlık Hizmetleri Birimi’nden hizmet alan 118 Alzheimer hastasına primer bakım veren 118 bakım veren ile yürütüldü. Bakım verenlere sosyo-demografik veriler formu ve 17 soruluk kısa form SF-36 Yaşam Kalitesi Ölçeği uygulanmıştır. Ortalama puan 0-100 arasında değişmektedir ve puan arttıkça yaşam kalitesi artmaktadır. Yatağa bağımlılık durumu Katz’ın Günlük Yaşam Aktiviteleri Ölçeği ile değerlendirilmiştir. Verilerimiz Ki-kare testi ve Kruskal Wallis testi, Mann-Whitney U testi ve Student t-test uygulanarak karşılaştırılmıştır. İstatistiksel olarak p

Amaç: COVID-19 şüphesi ile COVID-19 servislerinde takip edilen hastaların, hastaneye başvuru sırasında yapılan Protrombin Zamanı (PT), aktive Parsiyel Tromboplastin Zamanı (aPTT), INR (International Normalized Ratio), D-Dimer düzeyleri, Trombosit (PLT) düzeyleri ile Polimeraz Zincirleme Tepkimesi (PCR) sonucunun pozitif veya negatif durumu arasındaki ilişkiyi araştırmak amaçlanmaktadır.Gereç ve Yöntem: Bu çalışma 11 Mart 2020- 30 Mayıs 2020 tarihleri arasında, Samsun ilinde, hastanemizde COVID-19 şüphesi ile yatan 238 hasta ile yapılmıştır. COVID-19 sonuçlarına göre PCR testi negatif 119 kişi ve PCR testi pozitif 119 hasta çalışmaya dahil edilmiştir. PT, aPTT, D-dimer, INRve PLT düzeylerine bakılmıştır.Bulgular: PT; PCR testi negatif katılımcılarda ortalama 11,46±0,86 sn değeri bulunurken, PCR testi pozitif hastalarda 12,97±3,65 sn, (p0,05) olarak bulunmuştur. D-Dimer, PCR testi negatif katılımcılarda ortalama 0,23±0,12 μg/ML, PCR testi pozitif hastalarda ise 2,10±5,60 μg/ML, (p, Objective: This study aims to investigate the relationship between prothrombin time (PT), activated partial thromboplastin time (aPTT), INR (International Normalized Ratio), and D-dimer levels, platelet (PLT) levels at hospital admission, and positivity or negativity of Polymerase Chain Reaction (PCR) test results in patients with suspected coronavirus disease-19 (COVID-19) followed at COVID-19 services.Method: This study was performed on 238 patients with the prediagnosis of COVID-19, all patients are hospitalised in Samsun city at our hospital between 11 March 2020-30 May 2020. According to COVID-19 PCR test results, PCR test negative 119 individua and PCR test positive 119 patients were included in the study. PT, aPTT, D-dimer, INR, and PLT levels were examined. Result: While PCR test negative individuals had a mean PT value of 11.46±0.86 sec, PCR test positive patients had a mean PT value of 12.97±3.65 sec (p

Introduction: Palliative Mobile Health Unit started to serve in in February 2019 at University of Health Sciences Samsun Training and Research Hospital. In our study, it is aimed to evaluate the symptoms and ongoing status of the registered patients by mobile health services of palliative care unit.Methods: The population of this descriptive, cross-sectional study consists of individuals who are registered in Samsun Training and Research Hospital's palliative mobile unit and discharged from the palliative service. In our study, all patients enrolled in mobile services were evaluated. The data were obtained from computer records. Pearson chi-square and Mann-Whitney U tests were used to evaluate the data. p

Introduction Caregivers of hemodialysis patients may experience stress, depression, fatigue, and decreased quality of life. This study aimed to examine the caregiver burden and related factors in patients’ caregivers under dialysis treatment. Method Our study was conducted between February and April 2019 in the Hemodialysis Unit of our Hospital Internal Diseases Clinic. Eighty-three people providing primary care to patients who had received hemodialysis service for at least three months were included in the study. The socio-demographic data of the caregivers were recorded. Care burden was evaluated by Zarit Burden Interview (ZBI) and dependency status with Katz Activities of Daily Living (ADL) instrument. Quality of life was evaluated with the 36-Item Short Form Survey (SF-36). Results The mean age of 183 caregivers included in the study was 46.35 ± 24.20 years; 67.5% of them were female. The mean ZBI score of the caregivers was 32.5 ± 14.4. Care burden was observed to be absent or very mild in 20.5% of the caregivers, mild-moderate in 57.8%, moderate-heavy in 19.3%, and heavy in 2.4%. The care burden was higher in those who felt insufficient to provide care or did not receive help from other family members for patient care (p

Objective: In our study, we aimed to determine vitamin D levels among obese patients registered to Obesity Center and to investigate its relationship with body mass index (BMI). Methods: The study was conducted in the Obesity Center of Health Sciences University Samsun Training and Research Hospital. Records of 102 patients with BMI> 30 kg/m², 18 years of age and over, admitted to the obesity center between 01.12.2018 and 01.12.2019 were retrospectively analyzed. Serum 25-OH D level30 ng/ml proficiency. Mann-Whitney U, Pearson chi-squared and Spearman tests were used in the evaluation of the data. The data were evaluated by the SPSS 22.00 program. p

This study aims to evaluate the impact of urinary incontinence on the quality of life in those receiving home care services and the factors that influence this. This cross-descriptive study was performed in 180 patients who were served from Home Care Services between 01 and 28 February 2018. An International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF) was implemented in person to those who gave their informed consent with orientation and cooperation. The mean age of a 180 patients was 74.40 ± 7.80 years (min = 18, max = 104), of which 55.2% were women. The mean ICIQ-SF score was found to be 12.42 ± 4.83 (min = 0, max = 21). The lowest points were given as responses to the question, “In your opinion, what amount of leakage do you experience?” The highest points, however, were given to the question of “How much does urinary leakage interfere with your everyday life?” It was seen that when quality of life is assessed with a visual analog scale within the ICIQ-SF, the quality of life for 66.6% of elderly individuals was affected moderately or significantly. The mean ICIQ-SF scores were higher in those with chronic diseases ( p < .005). Urinary Incontinence negatively affects quality of life to a moderate and significant degree in those receiving home care. The quality of life for those who have chronic diseases was worse. In this respect, there is a need to support patients in those receiving home care services.

The author aimed to evaluate the risk factors for pressure injuries in those receiving home care units. This cross-sectional descriptive study was performed in 786 patients who were served from home care unit between 1st March 2016 and 31st April 2016. Patients’ pressure injury was evaluated with Braden risk assessment scale. The mean age of seven hundred eighty six patients was 71.22 ± 16.23 y; 51.3% of them were female. In home care unit patients, the pressure injury prevalence is 29.8%. It was observed that in patients who had 11.9 ± 3.0 point averages from the Braden risk assessment scale. It was seen the pressure injury evaluation and in patients who had 21.1 ± 3.4 point averages it was not seen any evaluation of the pressure injury (t=14.6, p=0.000). In home care patients, the pressure injury prevalence is found in 29.8% age, having chronic illness, nutrition status are risk factors to pressure injury in home care patients. Patients who were served in home care unit had high risk for pressure injuries. In this respect, in home care patients should be evaluated for pressure injuries.

The author aimed to evaluate the quality of life and the factors affecting the caregivers of cancer patients receiving home care. This cross-sectional descriptive study was performed in 48 cancer patients who were served from home care unit and 48 caregivers between 01 and 28 February 2014. Patients’ functional status was evaluated with Katz Index for Activities of Daily Living and the Lawton Scale for Instrumental Activities of Daily Living. The levels of quality of life of caregivers of patients with cancer were determined with Caregiver Quality of Life Index-Cancer (CQOLC). The mean age of forty-eight patients was 69.79 ± 16.09 years; 62.5% of them were female. The mean duration of home care was 5.99 ± 5.26 years; 25% of patients were fully dependent on the bed. 83.3% of caregivers were female, mean age of caregivers was 50.75 ± 14.89 years, and 77.1% of them were family members. The mean CQOLC score was 74.43 ± 24.45. The highest score was detected in the financial distress and the lowest score was detected in the positive adaptation. The quality of life is increasing as the length of care is reduced and income status increased. The quality of life of caregivers is very low. Each characteristic of the caregiver will affect the care he/she gives. From this point of view, it is important to consider the characteristics of caregivers in improving the care given to cancer patients. In this respect, there is a need to support caregivers both materially and spiritually.

Sahin, M.Kursat/0000-0002-3490-6009; WOS: 000411848800004 PubMed: 28579057 Aims: Our aim was to evaluate the insulin initiation status, barriers to insulin initiation and knowledge levels about treatment administered by primary care physicians (PCP). Methods: We conducted our study in accordance with a multicenter, cross-sectional design in Turkey, between July 2015 and July 2016. A questionnaire inquiring demographic features, status of insulin initiation, obstacles to insulin initiation and knowledge about therapy of the PCPs was administered during face-to-face interviews. Results: 84 PCPs (19%) (n =446, mean age =41.5 +/- 8.4years, 62.9% male and 90.0% ministry certified family physicians) initiated insulin therapy in the past. Most of the stated primary barriers (51.9%, n=230) were due to the physicians. The most relevant barrier was "lack of clinical experience" with a rate of 19% (n = 84 of the total). The average total knowledge score was 5.7 +/- 2.0 for the family medicine specialist, and 3.81 +/- 2.1 for the ministry certified family physicians (p= 0.000, maximum knowledge score could be 10). Conclusions: The status of insulin initiation in Turkey by the primary care physicians is inadequate. Medical education programs and health care systems may require restructuring to facilitate insulin initiation in primary care. (C) 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Dikici, Mustafa Fevzi/0000-0001-7445-5882 WOS: 000271509600001 PubMed: 19838878 Background. To assess the effect of teaching breaking bad news. Methods. The session incorporated brainstorming, presentation, discussion, small-group exercises using standardized patients. Course was evaluated through a pre-objective structured clinical examination (OSCE), first post-OSCE (post-OSCE1), second post-OSCE (post-OSCE2) (6th month), and questionnaires. Results. Pre-OSCE, post-OSCE1, post-OSCE2 scores: preparing the environment 5.83 +/- 0.23, 7.93 +/- 0.19, 9.78 +/- 0.07; understanding what patient knows and wants to learn 1.83 +/- 0.33, 6.47 +/- 0.27, 9.68 +/- 0.11; giving information 3.25 +/- 0.34, 7.43 +/- 0.19, 9.67 +/- 0.10; developing empathy 2.50 +/- 0.32, 6.92 +/- 0.28, 9.87 +/- 0.06; closing the interview 2.28 +/- 0.28, 6.98 +/- 0.25, 9.83 +/- 0.07. The differences between OSCEs were significant. In the questionnaire, 54.1% of 146 students perceived more competent. Conclusions. Course seems beneficial. Ondokuzmayis University Research Fund [2005- T449] Standardized patients were funded by Ondokuzmayis University Research Fund, project number of 2005- T449.

Undergraduate medical education in Turkey lasts six years. Medical school graduates may choose to either work in a primary health care setting without specialization or to specialize in family medicine or some other specialty. There are about 29 000 physicians without postgraduate professional training working in the National Primary Health Care System (28% of all physicians) (1). These physicians are called “practitioners,” rather than general practitioners (GP) or family physicians (FP), ie, physicians with specialized training in family medicine/general practice (2). Physicians who choose to specialize have to pass a standard examination, which allocates them to a residency program according to their exam score. Only 1 in 10 physicians a year passes this examination, while only 5%-10% of these show preference for the specialty of family medicine (2). The physicians who do not pass the examination but want to specialize are granted a practitioner’s position in the National Primary Health Care System by the Ministry of Health (2). In Turkey, family medicine is a relatively new specialty, as the residency program was implemented in 1985 (3). There are approximately 1800 family medicine specialists and 700 family medicine residents (4). They are employed in vertically organized primary care units (like mother and child health centers), secondary and tertiary care hospitals, and the private sector. According to the Turkish regulations, there are no positions for specialists (of family medicine or other) in primary care centers allied under the Ministry of Health. Other specialty groups work in secondary or tertiary care hospitals or in the private sector (4). Although most of the students will have to work in primary care in the future, family medicine does not seem to be an attractive area. The most important reason for this is the lack of prestige and money (2). Besides, students generally believe that primary care is not an effective area for personal development (2,5-7). There are ongoing efforts to improve such a situation (8). Therefore, the priorities and perceptions of future family physicians have to be determined to maximize the efficacy of a standard core curriculum. The aim of our study was to assess the attitudes of first-year medical students toward primary care and selection of medical specialty in order to construct a better curriculum in the following years.