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Background: The family medicine residents and final year medical students are challenged with increased workload and they experience various emotions during their clinical trainings. They are confronted with uncertainties in their role descriptions and they witness illness, suffering and deaths as part of their everyday duties which may lead to burnout. Only several studies have focused on these experiences to find out what the family medicine residents and medical students were literally feeling. Aim: The aim of this study was to explore the family medicine residents’ and final year medical students’ emotions during their clinical trainings. Method: This qualitative study was performed with 15 family medicine residents and 24 final-year medical students using a convenience sample from two medical faculties to explore and analyze their emotions. Data were gathered by means of focus group interviews, including six interviews conducted and recorded through online meetings. Data were analyzed for themes using a thematic analysis approach. Since the interviews reached saturation in terms of content, the interviews were terminated at the end of sixth focus group meetings. Each interview took an average of 45–60 min. Results: Three main themes emerged from the data regarding residents’ and interns’ emotions. These were the “clinical climate’s role”, “emotions during patient encounters” and “coping strategies with negative emotions”. The most commonly encountered emotions were tension and anxiety followed by frustration and uncertainty. Conclusions: The family medicine residents and final-year medical students are challenged with emotions during their clinical trainings. Therefore, medical educators have to be aware of the need to support them in reflecting their emotions by prioritizing residents’and interns’ well-being.

Amaç: Bu çalışmanın amacı, tüp bebek uygulamalarında aydınlatılmış onam elde edilmesi ve bu süreci etkileyen faktörleri belirlemektir.Yöntem: Bu makale tam metin özgün bir araştırma makalesidir. Tanımlayıcı ve kesitsel araştırma tüp bebek tedavisi gören 193 kadın ve 54 erkek ile yapılmıştır. Çalışma formu, sosyodemografik özellikler ve aydınlatılmış onam ile ilgili sorulardan oluşmuştur. Form, yumurtaların toplandığı gün doldurulmuştur. Etik kurul, çalışmanın protokolünü onaylamış ve tüm katılımcılardan sözlü bilgilendirilmiş onam alınmıştır.Bulgular: Araştırmanın sonucuna göre, katılımcıların üçte birinden fazlasının (%38,5) sözlü olarak bilgilendirilmediği, bilgilendirilenlerin ise %34,1'inin anlatılanları anlayamadığı tespit edildi. Özel doktora başvuranlar daha fazla bilgilendirilmiştir. Açıklamalar, başlıca bilgilendirme sürecinden kaynaklanan sorunlar nedeniyle anlaşılamamıştır. Onam formu tüm katılımcılara tedavi başladıktan sonra verilmiştir. Katılımcıların üçte ikisi onam formunu okumuş ve %22,7'si okuduğunu anlamamıştır. Onay formunu okumayanların yaklaşık yarısı (%41,3) formu okumayı ve imzalamayı işlemin uygulanması için bir prosedür olarak gördüğünü belirtmiştir. Onam formunu okumak için zamanı olanlar daha çok okumuş (p, Objective: The aim of this study is to obtain informed consent in vitro fertilization applications and to determine the factors affecting this process.Methods: This article is a full-text original research article. Descriptive and cross-sectional study was conducted with 193 women and 54 men, undergoing in vitro fertilization treatment. Study form consisted of questions regarding sociodemographic features and informed consent. The form was filled on the day the eggs were collected. The ethical committee approved the protocol of the study and all participants were provided with verbal informed consent.Results: According to result of the study, it was found that more than one third (38.5%) of the participants were not informed verbally, 34.1% of those who were informed could not understand what was told. Those who applied to a private physician were more informed. The explanations were not understood mainly due to the problems arising from informing process. The consent form was given to all participants after starting treatment. Two thirds of the participants read the consent form and 22.7% of them did not understand what they read. Almost half (41.3%) of those who did not read the consent form stated that they consider the reading and signing the form as a procedure for the implementation of the transaction. Those who had time to read the consent form read more (p

The aim of this study is to determine the problems faced by individuals living with cancer (ILCs) in accessing health services during the COVID-19 pandemic in Turkey. This qualitative study\"s sample consisted of 18 volunteer interviewees from 10 cancer-related patient associations in Turkey. Research data were collected by semi-structured interview method. Data collection and analysis were carried out simultaneously. In the sessions where all researchers participated together, the data were coded with a common view, and main and sub-themes were determined. In die analysis of the data the inductive thematic analysis method was applied. Information was gathered under two main themes: compliance with the measures taken and access to health services. Lack of information about nutrition, physical activity, psychological problems, caused by the lockdown and social distance measures taken within the scope of the pandemic should be accepted as problems within the scope of the right of individuals to access health, and additional programs should be prepared to minimize these. Cancer types should be considered in delaying diagnosis, treatment, and controls related to cancer, so that patients are not harmed at least or at all. It is important to ensure that patients do not hesitate to attend diagnosis, treatment, and controls with the anxiety of being infected with COVID-19, both in transportation to health facilities and in terms of preventing transmission in health facilities. El objetivo de este estudio es determinar los problemas a los que se enfrentan las personas que viven con cáncer (ILC) para acceder a los servicios sanitarios durante la pandemia de COVID-19 en Turquía. La muestra consistió en 18 entrevistados voluntarios de 10 asociaciones de pacientes relacionados con el cáncer en Turquía. Los datos de la investigación se recogieron mediante el método de la entrevista semiestructurada. La recogida y el análisis de los datos se llevaron a cabo simultáneamente. En las sesiones los datos se codificaron con una visión común y se determinaron los temas principales y los subtemas. En el análisis de los datos se aplicó el método de análisis temático inductivo. La información se recogió bajo dos temas principales: el cumplimiento de las medidas adoptadas y el acceso a los servicios sanitarios. La falta de información sobre nutrición, actividad física, problemas psicológicos, causados por el encierro y las medidas de distanciamiento social tomadas en el ámbito de la pandemia, deben ser aceptados como problemas dentro del ámbito del derecho de las personas a acceder a la salud, y se deben preparar programas adicionales para minimizarlos. Los tipos de cáncer deben tenerse en cuenta a la hora de retrasar el diagnóstico, el tratamiento y los controles relacionados, para que los pacientes no se vean perjudicados en lo más mínimo. Es importante asegurar que los pacientes no duden en acudir al diagnóstico, tratamiento y controles con la ansiedad de ser infectados con COVID-19, tanto en el transporte a los centros de salud como en la prevención de la transmisión en estos centros. O objetivo deste estudo é determinar os problemas enfrentados pelas pessoas que vivem com câncer (PLWC) no acesso aos serviços de saúde durante a pandemia da COVID-19 na Turquia. A amostra consistiu de 18 respondentes voluntários de 10 associações de pacientes relacionados ao câncer na Turquia. Os dados da pesquisa foram coletados usando o método de entrevista semi-estruturada. A coleta e análise de dados foram realizadas simultaneamente. Nas sessões, os dados foram codificados com uma visão comum e os principais temas e subtemas foram determinados. O método de análise temática indutiva foi aplicado na análise de dados. As informações foram coletadas sob dois temas principais: conformidade com as medidas tomadas e acesso aos serviços de saúde. A falta de informação sobre nutrição, atividade física, problemas psicológicos causados pelo confinamento e medidas de distanciamento social tomadas no contexto da pandemia deve ser aceita como problemas dentro do escopo do direito de acesso à saúde das pessoas, e programas adicionais devem ser preparados para minimizá-los. Os tipos de câncer devem ser levados em consideração ao atrasar o diagnóstico, tratamento e check-ups relacionados, para que os pacientes não fiquem em desvantagem mínima. É importante assegurar que os pacientes não hesitem em ir para diagnóstico, tratamento e check-ups com a ansiedade de serem infectados pela COVID-19, tanto no transporte para instalações de saúde quanto na prevenção da transmissão nessas instalações.

Objective: The aim of this study is to determine the perceptions, attitudes, and behaviour of medical students and lecturers regarding the lectures and their effects on students’ learning behaviour.Materials and Methods: This was a qualitative study including multi-methods. Researchers observed lecture ambiance and activities in two courses. Lectures were observed and slide-presentations were evaluated. Additionally, in-depth and focus group interviews were conducted.Results: Two researchers attended and observed 75 lectures. The average number of attendees was 51.21. Eighty percent of lecturers did not introduce any activities to attract attention and prepare students for the lecture. Only 12% of lectures were taught interactively. Of the evaluated 43 (69.80%) slide-presentations, sufficient association or integration was not made between clinical and basic sciences.Conclusion: This study revealed that the lectures created negative feelings and thoughts in students and lecturers, and led to undesirable attitudes and behaviour. It is essential to focus on giving interactive lectures which aim at developing reasoning, decisionmaking, and evaluation competencies. The most significant factors determining students’ attendance and appraisal of the lectures were related to the preparation of the lecturers, the intensity of the content, integration between basic science and clinical science, and the presentation skills.

With the increasing refugee population in our country, which has faced an intense wave of migration since 2011, xenophobia is increasing day by day. During the delivery of health services, the immorality of xenophobia, which grows usually by hiding behind the increasing average number of patients and unsolvable communication problems, was discussed from the perspective of the medical profession, which has ethical codes and deontology. First of all, the medical and social science literature on xenophobia, the current, historical and psychopathological background of this phenomenon, and its explicit or implicit relationship with medicine were investigated. The xenophobic attitudes and actions of physicians, who are the main actors of health care delivery all around the world, were evaluated from the perspective of medical ethics and history. In this article, the findings of the socioeconomic, political, and psychological foundations of xenophobia, its relationship and context with new racism theories, and the historical existence of medical xenophobia, which is discussed as a current phenomenon in health services, and especially in South Africa, and what it can cause today are tried to be revealed. The fact that xenophobia may arise against a vulnerable subject who is about to lose his self-respect in the society in a place and encounter, with where all kinds of identity and biographical information are of no importance except for medical reasons, not only puts all kinds of ethical contexts of the patient-physician and physician physician relationship (confidentiality, secrecy, intimacy, mutual respect, professional solidarity, courtesy, etc.) at risk but also it turns the issue into a morality one. Medicine should be practiced by the physician in a neutral space where all kinds of knowledge and identity, except for illness, are ignored., 2011 yılından bu yana yoğun bir göç dalgasıyla karşı karşıya olan ülkemizde artan mülteci nüfusu ile birlikte zenofobi de günbegün artmaktadır. Sağlık hizmetlerinin sunumu sırasında, çoğu zaman artan ortalama hasta sayıları ve çözülemeyen iletişim problemlerinin arkasına saklanarak serpilen zenofobinin, etik kodları ve deontolojisi olan hekimlik mesleğinde, gayrı ahlakiliği tartışmaya açılmaya çalışılmıştır. Öncelikle zenofobi ile ilgili tıp ve sosyal bilimler literatürü, bu fenomenin mevcut, tarihsel ve psikopatolojik arka planı, tıpla açık veya örtük ilişkisi kapsamında araştırılmıştır. Dünya genelinde sağlık hizmetleri sunumunun ana aktörleri olan hekimlerin zenofobik tutum ve eylemleri tıp etiği ve tarihsel perspektiften değerlendirilmiştir. Bu makalede zenofobinin sosyoekonomik, politik ve psikolojik temelleri ve yeni ırkçılık teorileri ile ilişki ve bağlamına dair bulgular ve özellikle Güney Afrika’da sağlık hizmetlerinde mevcut bir fenomen olarak tartışılan zenofobinin, tarihsel varlığı ve günümüzde nelere sebebiyet verdiğine dair bulgular ortaya konulmaya çalışılmıştır. Zenofobinin her türlü kimliksel ve biyografik bilginin tıbbi sebepler dışında hiçbir önem arz etmediği bir mekân ve karşılaşmada, toplum içinde öz-saygısını yitirmeye yüz tutmuş yabancıya/incinebilir özneye karşı ortaya çıkması/çıkabilecek olması hasta-hekim ve hekim-hekim ilişkisinin her türlü etik içerimini (gizlilik, sır saklama, mahremiyet, karşılıklı saygı, mesleki dayanışma, nezaket vb.) riske atmakla birlikte, meseleyi ahlaki bir soruna dönüştürür. Hekimlik, hekim tarafından, hastalık dışında her türden bilgi ve kimliğin gözardı edildiği tarafsız bir mekânda icra edilmelidir.

öğrencilerinin kürtaj ile ilgili görüşlerinin saptanması amacıyla yapılmıştır. Araştırmaya ilişkin veriler Gazi Üniversitesi Tıp Fakültesi’nde öğrenim gören 1., 4. ve 6. sınıf öğrencilerine uygulanan soru kâğıdı ile toplanmıştır. Örneklem, basit rastgele örnekleme yöntemi ile belirlenmiştir. 1358 öğrenciden 698’ü soru kâğıdını doldurmuştur. Döllenmeden itibaren, “Sizce fetüsün birey sayılması için, sınır kaçıncı hafta olmalıdır?” şeklindeki soruya tıp fakültesi öğrencilerinin %32,0’ı kalp atımının başladığı zaman olan 6. haftayı belirtmiştir. Öğrencilerin %26,0’ü ise bu sınırı döllenmeden itibaren çizmiştir. Çalışmada görüldü ki öğrencilerin çoğu (%81,2) kürtajı bir doğum kontrol yöntemi olarak görmemektedir. Kürtajın bir gerekçesi olarak annenin ileri derece mental retarde olması ya da annede ölümcül bir hastalığının olmasının gösterilmesine çoğu öğrenci kararsız kalmıştır. Öğrencilere kürtaj hakkında babadan izin alınması ile ilgili görüşleri de sorulmuştur. Buna göre öğrencilerin çoğu (%81,0) anne ve babanın evli olması durumunda babadan izin alınması gerektiğini düşünürken, evliliğin olmaması durumunda ise görüşlerinin değiştiği, yüzdelerin babadan izin alınmasının gerekli olmadığı yönüne doğru kaydığı görülmüştür. Araştırmada ayrıca öğrencilerin %57,0’ı kürtajın yasal sınırı olarak gebeliğin 10. haftasını uygun bulmuş ve çoğu öğrenci (%67,9) kürtajın tamamen yasaklanmasına karşı olduklarını belirtmiştir. Araştırmada tıp fakültesi öğrencilerine örnek verilen kürtaj olgusu ne kadar karmaşıksa yani ele alınması gereken etik ilke ne kadar çoksa, yaşadıkları etik ikilemin o derecede fazla olduğu görülmüştür. Ayrıca öğrencilerin kararlarını etkileyen önemli faktörlerden birinin Türkiye’nin kürtaj ile ilgili mevcut yasal düzenlemeleri olduğu görülmüştür., The research was carried out to determine the opinions of Gazi University Faculty of Medicine students about abortion. Data related to the research were collected with a questionnaire applied to 1st, 4th and 6th grade students studying at Gazi University Faculty of Medicine. The sample was determined by simple random sampling method. 698 out of 1358 students filled out the questionnaire. After fertilization, "Do you think what week should be the limit for the fetus to be considered an individual?" 32.0% of the medical faculty students stated the 6th week, which is the time when the heartbeat starts. 26.0% of the students drew this limit after fertilization. It was seen in the study that most of the students (81.2%) do not see abortion as a birth control method. Most students were undecided about whether the mother had severe mental retardation or the mother had a fatal illness as a justification for abortion. The students were also asked about their opinions about getting permission from the father about abortion. According to this, most of the students (81.0%) thought that if the parents were married, permission should be obtained from the father, while in the absence of marriage, their views changed and the percentages shifted to the direction that it is not necessary to get permission from the father. Also in the study, 57.0% of the students found the 10th week of pregnancy appropriate as the legal limit for abortion, and most students (67.9%) stated that they were against the prohibition of abortion altogether. It was seen that the more complex the case of abortion, which is given as an example to medical school students in the research, the more ethical principles that need to be addressed, the more ethical dilemmas they experience. In addition, it has been seen that one of the important factors affecting students' decisions is Turkey's current legal regulations regarding abortion.

Acupuncture is recommended by the World Health Organization (WHO) as an alternative and complementary strategy in a group of clinical syndromes. Indication list of acupuncture includes chronic pain, migraine, stroke and some other neurological diseases. Meanwhile increasing clinical studies are evidenced the mechanisms underlying the beneficial effects of acupuncture in stroke and chronic pain.But in some clinical conditions such as traumatic brain injury and neurogenic bladder methodology of studies are not sufficient as they did not yield the net effect of acupuncture. In conclusion acupuncture could improve clinical outcome in many chronic conditions if it is used as an adjunct to rehabilitation treatment., Akupunktur Dünya Sağlık Örgütü (DSÖ) tarafından tavsiye edilen bir grup klinik sendromda kullanılan tamamlayıcı ve alternatif bir tedavi olarak tavsiye edilmektedir. Akupunkturun endikasyon listesine kronik ağrı, migren, inme ve diğer bazı nörolojik hastalıklar dahildir. Bu arada artan klinik araştırmalar, akupunkturun inme ve kronik ağrıda faydalı etkilerinin altında yatan mekanizmaları kanıtlamaktadır. Fakat travmatik beyin yaralanması ve nörojenik mesane gibi bazı klinik koşullarda çalışmaların metodolojisi yetersiz olduğu için bu alanlarda akupunkturun klinik etkileri belirgin olarak ortaya konulamamıştır. Sonuç olarak akupuntur; rehabilitasyon tedavisinde mevcut tıbbi uygulamalara yardımcı olarak kullanıldığında birçok kronik hastalıkta sonuçların düzelmesine katkı sağlayabilecek bir yöntemdir.

The aim of this study was to assess vitamin D serum levels in autoimmune thyroid disease, Hashimato thyroiditis in the Turkish population. the subjects with Hashimato thyroiditis (HT, n=67, mean age 45.1±10.9,F/M-61/6), control subjects (mean age 42.1±15.7, n=29, F/M-26/3) were recruited for the study. Thyroid function tests, thyroid antibodies (AntiTg, AntiTPO, TSHRAb), ultrasound features, demographic and antropometric variables were recorded. Vitamin D level was not different between the HT and the control groups (53.1±24.7 nmol/L and 54.1±19.8 nmol/L, as mean, respectively, p = 0.482) in the HT group, 35.8% of subjects had vitamin D insufficiency, only 16.4% of subjects with HT were vitamin D sufficient. There was no significant difference between the HT and the control groups according to the vitamin D classification status (p = 0.666). Vitamin D levels were significantly higher in the subjects who were taking replacement compared to subjects who were not (58.7 ± 26.0 vs. 46.0 ± 23.3, as mean, respectively, p = 0.033). There was no significant correlation between vitamin D levels and TgAb and TPOAb levels in HT group (p = 0.754 r = -0.039, p = 0.134 r = -0.290, respectively). in both HT and control groups, vitamin D levels were significantly correlated only with the fT4 levels (p

The achievement of euthyroid state has been suggested in patients with thyrotoxicosis undergoing surgery to reduce the risk of thyroid storm. However, euthyroid state could not always be achieved by antithyroid drugs. Therefore, therapeutic plasma exchange (TPE) is an option in this condition. A 58-year-old male patient with a history of type-2 diabetes using 200 mg amiodarone per day, admitted for diabetic ketoacidosis (DKA), induced by thyrotoxicosis. with palpitation, sweating, polyuria, and polydipsia. Euthyroid state could not be achieved, despite all apropriate treatments for thyrotoxicosis. Therefore, preparation with TPE followed by total thyroidectomy was planned. A 35% decrease in fT3 (free T3) and fT4 (free T4) levels were achieved, after two sessions of TPE. A 74-year-old male patient, admitted for acute anterior myocardial infarction (AMI) induced by thyrotoxicosis due to Graves disease. Multiple vessel disease was detected on primer percutanous coronary angiography, and an emergency coronary artery bypass grafting (CABG) was planned. Therefore, preperation with TPE was planned before surgery. A substential decrease in fT4 and fT3 levels (45% and 72%, respectively) levels were achieved, after one session of TPE. Most of the studies evaluating the efficacy of TPE in patients with thyrotoxicosis are including patients with Graves disease and toxic multinodular goiter, and TPE was indicated as an effective option for preparation of these patients for surgery. However, as presented in case 1, TPE may not be effective in amiodarone induced thyrotoxicosis (AIT) as in cases with thyrotoxicosis due to Graves disease. [Med-Science 2019; 8(1.000): 233-6]

Gastric cancer comprises 10% of all cancers in the world and is rarely seen before the age of 30. Different genetic interactions or molecular changes like e-cadherin, P16, APC, c-erb B2, c-met, ras, or c-myc have been described in the pathogenesis of the disease. MiRNAs play critical roles in various biological processes such as cell proliferation, cell differentiation, apoptosis, repairing of DNA damage, angiogenesis, stress response, and stem cell division. The aim of this study is to investigate the relationship between miRNA gene expressions and gastric cancer. Method: Sixty-four patients with gastric cancer diagnosed consecutively in our pathology laboratory and 30 consecutive participants with normal gastric tissue, as a control group, were included in our study between 2011 and 2013. Total miRNAs were obtained by using genomic miRNA extraction kit (QIAGEN Sample & Assay Technologies, Hilden, Germany) after the samples had been deparaffinized. MiR-21, 107, 141, 150, 192, 202, 218, 331 gene expressions were evaluated by using real time-PCR (RT-PCR) from the whole miRNA. Results: MiR-331 was downregulated in the stage 2 patients and the rest of the miRNAs were significantly upregulated (p < 0.001). All miRNAs were significantly upregulated in the stage 3a patients (p < 0.001). In the antrum localized tumors, miR-107, -150, -202, -218, and -331 were significantly upregulated, whereas miR-21, -192 were statistically downregulated (p < 0.05). In the cardia localized tumors, miR-21 (p > 0.05) was downregulated and miR-107, -150, -202, -218, and -331 were upregulated (p < 0.05) Different gene expressions of miRNAs according to the different localizations of gastric cancer and different stages suggest that it can be tumor marker to predict the stage and localization of gastric cancer. [Med-Science 2019; 8(1.000): 255-9]

Chest pain (CP) is the major presenting symptom of coronary artery disease (CAD) wherein history remains to be a fundamental and challenging diagnostic step. Despite the clarity of typical CP characteristics in guidelines; interpretation and description of CP by patients are open to wide variations. The aim of this study was to define the components of CP that most closely associate to presence of obstructive CAD and determine the influence of gender on CP features. Herein, consecutive patients with suspected stable CAD who were scheduled for a coronary angiography(CAG) were prospectively enrolled. The data on demographic and pain characteristics were collected by a questionnaire. Patients were categorized into CAD and Normal groups with respect to presence of obstructive CAD in CAG. Among 402 patients, 86 had chest discomfort or equivalent symptoms but denied CP. Patients with CAD were more commonly male; with older age, lower BMI, more frequent prior revascularization, clopidogrel use, higher creatinine and lower HDL levels. When classical features of CP such as quality; location, duration, relationship to exertion were compared; stabbing/sharp pain, CP related to cold or emotional stress and CP that radiates to back were significant factors against CAD; while absence of precipitating factors was related to CAD. Yet, none of the features of typical angina pectoris were significantly related to presence of CAD. Determinants of CAD were; prior revascularization (OR= 22.7, p=0.021), body mass index (OR=1.4, p=0.007), clopidogrel use(OR=55.5, p=0.018) and blood glucose (OR=1.02, p=0.046) in women; and age (OR=1.2, p=0.029) was the single predictor of CAD in men. This study demonstrated no association between classical features of typical CP and presence of CAD in patients with stable angina pectoris. Clinical factors that influenced presence of CAD in different genders were also different. [Med-Science 2019; 8(1.000): 88-92]

HHV-8 is associated with Kaposi sarcoma, multicentric Castleman disease and primary effusion lymphoma mostly in immunocompromised patients. in this report, we describe a female patient without any immunosuppressive state, encountering those three malignancies throughout her lifetime. A-69-year-old female patient was diagnosed with Kaposi sarcoma in 2009 and multicentric Castleman disease in 2011. She received several chemotherapy regimens during 4 years and stayed in remission during following 5 years. Then, she was diagnosed with primary effusion lymphoma, extracavitary/solitary variant on excisional biopsy of her cervical lymphadenopathy. Despite having 5 different lines of chemotherapy protocols, including autologous stem cell transplantation, and systemic cidofovir treatment, she died because of progressive disease. HHV-8 associated malignancies are not prevalent in immunocompetent patients. Our patient, who has suffered from all three malignancies related to HHV-8, is the only HIV negative patient in the literature with primary effusion lymphoma, extracavitary/solitary variant.

Endometrial cancer is the most common gynecological cancer. Increased postmenopausal endometrial thickness may be an indicator of endometrial cancer. Transvaginal ultrasound (TV-USG) is the primary imaging method for evaluating endometrial thickness in the postmenopausal period. The aim was to employ transvaginal ultrasonography in the evaluation of adnexal masses synchronously seen in postmenopausal women with increased endometrial thickness. The work was designed as a retrospective study. The medical records of 155 patients evaluated for increased postmenopausal endometrial thickness were examined. Ultrasonography had been performed on the women in the study for routine follow-up, postmenopausal hemorrhage, pelvic pain, pelvic mass on examination and family history of gynecological cancer. All patients had undergone endometrial evaluation with fractional dilatation and curettage (D & C) or pipelle endometrial sampling. Histopathological diagnosis was based on endometrial sampling results. Adnexal mass was present simultaneously in 17.4% (n = 27) of the women included in the study, while 82.6% (n = 128) had no gynecological pathology other than increased endometrial thickness. The endometrial thickness in the women with postmenopausal adnexal masses was greater than in those without adnexal mass (11.7 mm vs. 7.8 mm, p = 0.009). Non-atypical and atypical endometrial hyperplasia was more frequent in the group with postmenopausal adnexal mass (11.1% vs. 2.8%, 11.1% vs. 3.79, p = 0.03, p = 0.04, respectively). Final histopathological evaluation of patients operated on for adnexal masses revealed tubo-ovarian abscess in 1.9% (n = 1), benign ovarian tumor in 25.9% (n = 7) and malignant ovarian tumor in 11.1% (n = 3) of the patients. In postmenopausal women, adnexal masses can be seen simultaneously with increased endometrial thickness. In this regard, transvaginal ultrasound offers important opportunities for evaluation of both the endometrium and adnexa. Pre-surgery transvaginal ultrasound as well as multivariate serum markers may be used in evaluation models. [Med-Science 2018; 7(4.000): 848-51]

Objective: Previous studies showed that obstructive sleep apnea syndrome (OSAS) was associated with liver diseases such as elevated liver enzyme levels and hepatic steatosis. The aim of this study was to assess the relationship between serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels and OSAS and its severity. Methods: A total of 617 patients who underwent PSG (polysomnography) between January 2016 and May 2017 were evaluated in this study. AST, ALT, total cholesterol, triglyceride levels and body mass index were analyzed. The data were analyzed using the Student t-test, ANOVA, Chi-square test, and Pearson's correlation coefficient. Results: Five hundreds and thirty patients with OSAS and 60 healthy controls were included in the study. Of the patients in the OSAS group, 17.7% had an elevated ALT level and 7.9% had an elevated AST level. There was a statistically significant difference in ALT and AST levels between the OSAS and control groups (p < 0.001 and p < 0.001, respectively). In the OSAS group, there was a statistically significant positive relationship between serum ALT and AST levels and apnea-hypopnea index (AHI), apnea index, oxygen desaturation index. Both AST and ALT levels were statistically significantly higher in obese patients than in non-obese patients (p < 0.001 and p < 0.001, respectively). ALT level was statistically significantly higher in patients without hypertension than in patients with hypertension (p < 0.001). In OSAS patients without hypertension, there was a statistically significant relationship between serum ALT and AST levels and AHI (r = 0.223, p < 0.001 and r = 0.142, p = 0.007; respectively). Conclusion: OSAS is a risk factor for elevated liver enzyme levels. Hypoxia plays an important role on liver enzymes in OSAS patients.

Aim: In this study, we aimed to investigate the potential role of lung mast cells in migraine by using a nitroglycerin-induced migraine model in rats. Materials and Methods: Thirty-five adult male Wistar rats were divided into five groups. Each treatment being performed intraperitoneally, the NS group received 0.2 ml normal saline, the NTG group 10 mg/kg nitroglycerin, the NTG vehicle group 0.2 ml 0.1% ethanol in normal saline, the L-NAME+NTG group 50 mg/kg L-NAME + nitroglycerin, and the NS+NTG group normal saline + nitroglycerin. Two hours after the nitroglycerin and other treatments, the rats under anesthesia were intracardially perfused with a solution of 150 ml 4% paraformaldehyde. The lungs were harvested and stained with toluidine blue to observe mast cells. The data were analyzed by using one-way ANOVA. Results: Nitroglycerin increased significantly both number (from 94±3.8 to 131±6.7, p=0.0035) and percent of degranulation (from 11.8±1.3% to 35.5±5.7%, p=0.003) of lung mast cells. However, L-NAME prevented the effects of nitroglycerin on the number and degranulation of lung mast cells, attenuating the increase in both number (from 136±5.1 to 93±2.5, p=0.0011) and degranulation percentage of lung mast cells (from 37.3±1.0% to 13.6±3.1%, p=0.001) induced by nitroglycerin. Discussion and Conclusion: Our findings demonstrate that nitroglycerin treatment leads to an increase in the number and degranulation of lung mast cells in a rat model of migraine induced by nitroglycerin. Moreover, L-NAME prevented these effects, suggesting that nitric oxide released from nitroglycerin directly or indirectly leads to the activation of lung mast cells. The results obtained in the current study can pioneer new research on the role of lung mast cells in migraine. Amaç: Bu çalışmada sıçanlarda nitrogliserin ile oluşturulan migren modeli kullanılarak akciğer mast hücrelerinin migrendeki muhtemel rolünü araştırmak amaçlanmıştır. Gereç ve Yöntemler: Otuz beş yetişkin erkek Wistar sıçan beş gruba bölündü. Tüm uygulamalar intraperitoneal yoldan olmak üzere; NS grubuna 0,2 ml normal salin (serum fizyolojik), NTG grubuna 10 mg/kg nitrogliserin, vehikül NTG grubuna 0,2 ml normal salin içinde %0,1’lik etanol, L-NAME+NTG grubuna 50 mg/kg L-NAME + nitrogliserin, NS+NTG grubuna ise 0,2 ml normal salin + nitrogliserin uygulandı. Nitrogliserin ve diğer uygulamalardan iki saat sonra sıçanlar anestezi altında 150 ml %4’lük paraformaldehit ile intrakardiyak olarak perfüze edildi. Akciğerler alındı ve mast hücrelerini gözlemlemek için toluidin mavisi ile boyandı. Veriler tek yönlü varyans analizi ile incelendi. Bulgular: Nitrogliserin akciğer mast hücrelerinin hem sayısında (94±3,8’den 131±6,7’ye; p=0,0035) hem de degranülasyon yüzdesinde (%11,8±1,3’ten %35,5±5,7’ye; p=0,003) anlamlı bir artış sağladı. L-NAME ise akciğer mast hücrelerinin sayı ve degranülasyonu üzerinde nitrogliserinin yol açtığı bu etkileri önledi, böylece akciğer mast hücrelerinin nitrogliserin ile tetiklenerek artan sayısını ve degranülasyon yüzdesini ayrı ayrı azalttı. Tartışma ve Sonuç: Bulgularımız nitrogliserin ile oluşturulan migren sıçan modelinde nitrogliserin uygulamasının akciğer mast hücrelerinin sayısında ve degranülasyonunda bir artışa yol açtığını göstermiştir. Ayrıca L-NAME’nin bu etkileri önlemiş olması, nitrogliserin kaynaklı nitrik oksidin direkt veya indirekt olarak akciğer mast hücrelerinin aktivasyonuna yol açtığını düşündürmektedir. Bu çalışmada elde edilen sonuçlar akciğer mast hücrelerinin migrendeki rolü üzerine yapılacak yeni araştırmalara öncülük edebilir.

Amaç: Bu çalışmada, Istranca meşesi (Quercus hartwissiana Steven) kabuğu ekstraktlarının bakteriyelve fungal patojenlere karşı antimikrobiyal aktivitesini araştırmak amaçlanmıştır.Gereç ve Yöntemler: Istranca meşesinin, etanol, formaldehit, aseton, etil asetat ve metanol çözücüleriile ekstraksiyonu gerçekleştirilmiştir. Bu ekstraktlardan 50 µl alınarak steril disklere emdirildiktensonra ekstraktlarda bulunan çözücülerin sonucu etkilememesi amacıyla diskler 24 saat steril ortamdakurutulmuştur. Disk difüzyon yöntemiyle Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichiacoli, Klebsiella pneumoniae, Salmonella spp., metisilin dirençli Staphylococcus aureus, metisilinduyarlı Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus spp., Candida albicans,Candida glabrata ve Candida tropicalis türlerine karşı antimikrobiyal aktivite araştırılmıştır.Bulgular: En geniş zon çapının etanolle hazırlanan ekstraktta Enterococcus spp. (8 mm) ve S. epidermidis(8 mm) suşlarına, formaldehit ve etil asetatla hazırlanan ekstraktlarda E. Coli suşuna (16 mm,28 mm), asetonla hazırlanan ekstraktta Enterococcus spp. suşuna (21 mm), metanolle hazırlananekstraktta ise metisilin duyarlı S. aureus suşuna (28 mm) karşı oluştuğu görülmüştür. Mayalarda iseen geniş zon çapının etanolle hazırlanan ekstraktta C. glabrata suşuna (12 mm), formaldehitle hazırlananekstraktta C. albicans (28 mm) ve C. tropicalis (28 mm) suşlarına, aseton, etil asetat ve metanollehazırlanan ekstraktlarda C. albicans suşuna (19 mm, 30 mm, 22 mm) karşı oluştuğu saptanmıştır.Tartışma ve Sonuç: Etil asetat ile hazırlanan ekstraktın diğer çözücülerle hazırlanan ekstraktlara kıyaslaçalışılan suşlara karşı daha geniş zon çapı oluşturduğu saptanmıştır. En geniş zon çapı E. coli, S. aureusve C. albicans türlerinde oluştuğundan, ülkemizde doğal olarak yetişen Istranca meşesinin inhibeedici etkilerine yönelik in vivo antimikrobiyal çalışmalar yapılmasının önemli olduğunu düşünmekteyiz. Aim: This study aimed to investigate the antimicrobial activity of extracts from the Istranca oak (Quercushartwissiana Steven) against bacterial and fungal pathogens.Materials and Methods: Extraction of the Istranca oak was carried out with ethanol, formaldehyde,acetone, ethyl acetate, and methanol solvents. After injecting 50 ?l of these extracts into sterile discs,the discs were dried in a sterile environment for 24 hours in order for the results not to be affected bythe solvents present in the extracts. Antimicrobial activity against the species Pseudomonas aeruginosa,Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Salmonella spp., methicillin-resistantStaphylococcus aureus, methicillin-susceptible Staphylococcus aureus, Staphylococcusepidermidis, Enterococcus spp., Candida albicans, Candida glabrata and Candida tropicalis was investigatedby disc diffusion method.Results: It was observed that the extract prepared with ethanol showed the widest zone diameteragainst Enterococcus spp. (8mm) and S. epidermidis (8mm), the extracts with formaldehyde and ethylacetate against E. coli (16mm, 28mm), the extract with acetone against Enterococcus spp. (21mm),and the extract with methanol against methicillin-susceptible S. aureus (28mm). For the yeasts, theextract prepared with ethanol showed the widest zone diameter against C. glabrata (12mm), the extractwith formaldehyde against C. albicans (28mm) and C. tropicalis (28mm), and the extracts preparedwith acetone, ethyl acetate, and methanol against C. albicans (19mm, 30mm, 22mm).Discussion and Conclusion: It was determined that the extract prepared with ethyl acetate showedwider zone diameter against the strains studied, compared to extracts prepared with the other solvents.Given that the widest zone diameters were observed against the strains E. coli, S. aureus and C.albicans, we think that it is important to conduct in vivo antimicrobial studies on the inhibitory effectsof the Istranca oak indigenous to our country.

Objective. The aim of this study was to determine the clinical presentation of tuberculosis cases from our center for the last nine years. Methods. This study was set as descriptive and retrospective. The data was obtained from the hospital records. Subjects who had been diagnosed as tuberculosis and received treatment in our center between the years 2007 and 2015 were included. The cases were classified as newly diagnosed, relapse, transferred, and returning after default. Results. There were 276 (171 males and 105 females) patients with a mean age of 41.5 ± 19.2 years. Pulmonary involvement is the most common presentation and seen in 155 (56.2%) patients. Lymph node and pleura are the most common extrapulmonary involvements those are seen in 53 (19.2%) and 23 (8.3%) patients, respectively. Number of the cases seems to decreased after 2012. Most (85.1%) of the patients were newly diagnosed. Among the subjects, 55.2% of them had bacteriologic diagnosis, 35.1% had histopathologic diagnosis. Two subjects died during the treatment period whereas 274 of them completed the treatment program. Conclusions. Our results show that tuberculosis is seen mainly in the adult age group. While pulmonary involvement is the most common presentation, lymph node and pleura involvements are the most common extrapulmonary presentations. Number of the tuberculosis seems to decrease for the recent years. Strict preventive measures and treatment strategies should be administered.

Ortodontik tedavinin amacı; bireyin dentofasiyal fonksiyonlarını ve estetiğini geliştirerek yaşam kalitesini artırmaktır. Başarılı bir tedavinin kriterleri; en az histolojik hasar ve ağrı, hızlı diş hareketi, kısa tedavi süresi ve stabil sonuçlardır. Son yıllarda ortodontik tedavi talebi giderek artmaktadır. Ortodontik tedavi sürelerinin uzun olması, hem hastaların psikolojik motivasyonlarını etkilemekte, hem de çürük, dişeti çekilmesi ve kök rezorpsiyonu gibi birçok istenmeyen duruma yol açmaktadır. Bu sebeple son yıllarda araştırıcılar ortodontik diş hareketinin hızlandırılması üzerine çalışmalar yapmaktadır. Ancak daha hızlı diş hareketi elde etmek için laboratuvar ve klinik olarak birçok girişimde bulunulmasına rağmen, bu tekniklerle ilgili belirsizlikler ve cevaplanmamış sorular halen mevcuttur. Literatürde ortodontik diş hareketini hızlandırmak amacıyla çoğu henüz hayvanlar üzerinde denenmiş ve insanlar üzerinde uygulanabilirliği kuşkulu olan cerrahi teknikler, fiziksel ve kimyasal uygulamalar bildirilmiştir. Ancak diş hareketi multifaktöriyel bir olgu olduğu için konu hakkında gelecekte daha fazla araştırma yapılması gerekmektedir. Bu derlemede literatürde şu anda var olan ortodontik diş hareketi hızlandırma yöntemlerinden bahsedilecektir., The purpose of orthodontic treatment is to enhance patients’ life quality by improving their dentofacial functions and aesthetics. Minimal histological damage and pain, rapid tooth movement, short treatment duration, and stability of results are the major criteria for successful treatment. In recent years, the demand for orthodontic treatment has been increasing gradually. Prolonged duration of orthodontic treatment affects the psychological motivation of the patients and leads to several undesirable situations, such as caries, gingival recession, and root resorption. Thus, in recent years, related research has investigated the acceleration of orthodontic tooth movement. However, despite the various laboratory and clinical interventions designed to achieve faster tooth movement, uncertainties and unanswered questions about these techniques persist and warrant further investigation. Several surgical techniques as well as physical and chemical applications have been reported by previous studies to accelerate orthodontic tooth movement, most of which have been conducted on animals, with debatable applicability on humans. However, as tooth movement is a multifactorial phenomenon, further research is needed in the future. In this review, we describe the orthodontic tooth movement acceleration methods reported thus far.

We sought to investigate the prevalence of skin tumors in Muğla, which has a Mediterranean climate and a high population of elderly people. This was a cross-sectional study conducted on patients, 65 years old and older, who consulted at our dermatology outpatient clinics between January 2014 and January 2015. Diagnoses of the patients were obtained and retrospectively evaluated from the electronic medical records of the hospital. Of 2297 geriatric patients, 50.8% were females and 49.2% were males. Of these patients, 12% had actinic keratosis, 5.4% had seborrheic keratosis, 2.1% had basal cell carcinoma, 0.8% had squamous cell carcinoma, and 0.1% had malignant melanoma. In patients

Depression is a major mental health issue worldwide, and university students with heavy burdens of study are at a high risk for depression. The purpose of this study was to determine the prevalence of depressive symptoms among nursing students, and to explore the association between socio-demographic factors, health-related quality of life and depressive symptoms. This study adopted a cross-sectional design. A total of 345 nursing students from a Faculty of Health Sciences were assessed by the questionnaire consisted of demographic information, Beck Depression Inventory (BDI), a 12-item Short Form Health Survey. SPSS software, version 16, was used to analyze the data. Pearson Chi-Square, Fishers Exact Test and Independent-Samples T-Test were used to compare different categorical variables. A total of 345 nursing students participated in the study (282 females and 63 males). Overall, 92 (26.7%) of the participants had depression of various grades based on the BDI diagnostic criteria using a cut point of more than 17. The depressive symptoms were statistically associated with gender and the parental attitudes. BDI score at the cut point of 17 was statistically associated with the Physical and Mental Health Composite Scores. This study seems to indicate an alarming rate of depressive symptoms. Female gender, non-democratic parental attitude have the highest association with depressive symptoms. The findings suggested that in order to prevent depression among undergraduate nursing students, school-and family based strategies should be developed and implemented. [Med-Science 2018; 7(1.000): 154-157]

Diabetic retinopathy (DR) is a complication of diabetes mellitus (DM) that may causes blindness. The vitreous is an extracellular matrix and it may have changes through liquefaction and syneresis in patients with DM, even in those without apparent DR. Diffusion-weighted imaging (DWI) is a new technique provide tissue contrast relying on difference with the diffusion of water molecules among tissues, which can be measured by the apparent diffusion coefficient (ADC) value. We aimed to investigate the vitreous of patients in different stages of DR using diffusion-weighted imaging technique. This prospective study included a group of 100 patients with DR and 100 members of an age- and gender-matched control group. All groups were tested using a head coil in conduction with a Achieva 1.5T magnetic resonans imaging (MRI) system (Philips Medical Systems, Best, The Netherlands). The mean ADC values were calculated and used for statistical comparisons. Mean duration of diabetes was 12.22±10.13 years in patients. Compared to controls, both eyes of the DR group had statistically and significantly lower values of ADC (p=0.025 and p=0.002, respectively). No significant correlations were found among the ADC values and central macular thickness, disease duration and stage of DR (all p>0.05) in patients. Mean ADC values revealed no significant differences among the subgroups of patients at different stages of DR (all p>0.05). Decreased ADCs in the vitreous of diabetes patients seem to be associated with the presence of diabetic retinopathy. [Med-Science 2018; 7(1.000): 106-109]

The incidents of hip fractures rise as the population gets older. Weakness of bones cause fractures easily due to falling, which can occur by balance deficiency, side effects of medications and maneuvering difficulties through environmental hazards. Patients with hip fractures are cared by clinicians in different specialties who should be familiar with the management of these injuries. The fascia iliaca compartment block, an easy to perform and low-cost procedure, provides efficient perioperative analgesia for patients who suffer from hip or femur fractures. Increased success rates are due to the facilitation of the block via ultrasound which is easily accessible in many operation theaters and emergency services. Anterior thigh and knee surgery as well as analgesia following hip and knee procedures are the basic indications for this block. In this case, we performed an ultrasound guided fascia iliaca compartment block for postoperative analgesia after a hip fracture surgery. [Med-Science 2019; 8(1.000): 239-41]

Celiac disease is an autoimmune disease of the small intestine, resulted from villusdamage and malabsorbtion due to ingestion of gluten; and production of antibodies to gliadin. Thedisease can manifest with various presentations. Celiac crisis was described as an acute, serious,life-threatening form of celiac disease about sixty years ago with a higher incidence among pediatric patients than adults. It is characterized by gastrointestinal symptoms like profuse diarrhea andsevere metabolic distubances like hyponatremia and hypoproteinemia. Early suspicion and detection is important. This case report presents a 54-year-old female patient who died from celiac crisis and sepsis.

Harlequin ichthyosis (HI) is a rare and severe form of congenital ichthyosis caused by truncating mutations in the ABCA12 gene. Although it has many distinctive signs on perinatal sonography such as short limbs, wide gaping mouth, joint contractures, edema of the hands and feet and cloudy amniotic fluids, it usually can not be diagnosed until birth. Herein, we report a case of recurrent HI, which remained undiagnosed until labor at 38 weeks of gestational age. A multiparous woman presented to hospital at 38th weeks of gestation. There were no personal or family history. Vaginal delivery was performed and a 3300 gram baby was delivered. The body of the neonate was covered with thick, armor like skin, have generalized edema and erythematous fissures, scanty hair, everted eyelids with exposed swollen conjunctiva, open mouth were noted at the first examination. Newborn was diagnosed to be having Harlequin ichthyosis and was given to neonatal intensive care unit (NICU) for supportive care and additional examination. Genetic counseling is important and should be recommended to affected families. With the growing technology electron microscopes, invasive prenatal diagnostic tools and 3D sonography may reveal suggestive features of the disease. In addition, new treatment regimens, experienced and competent NICU facilities may increase survival rates.

Distant metastasis of breast carcinoma frequently occurs within five years after the diagnosis of the primary tumor. A 58-year-old female sharing a history of mastectomy for invasiveductal carcinoma six years previously admitted to our clinic with dyspnea progressively ongoing forpast two weeks. A right-sided massive pleural effusion was diagnosed and also pleural catheterdrained. Radiologic studies and cytological examination of the fluid did not introduce any evidenceof malignancy while she lately underwent thoracoscopy for the residuary effusion and atelectasis.Pathological study of the punch biopsies through the parietal pleura reported the pleural metastasis of the breast carcinoma but still negative evidence of malignancy for the pleural fluid. After discharge, evaluation with positron emission tomography also did not verify an uptake in any of thepleura, lungs or primary malignancy site. This event is of importance revealing that the patientssharing a past of malignancy should be approached with more caution and suspicion since the routine diagnostic algorithms pending to be reliable may not be applicable for all patients.

Dieulafoy lesion (DL) is an important cause of acute gastrointestinal hemorrhage (GIH) because endoscopic diagnosis is very difficult. We report an ileal DL in a patient with Glanzmann Thrombasthenia (GT). A forty-year old female presented with bloody stool. Records showed that she was diagnosed with GT at 3 years of age. Physical examination on admission, she was clinically stable, except for tachycardia (110 bpm). Rectal examination revealed bright red blood. Her haemoglobin level was 8.7 g/dl. Colonoscopy revealed a DL at the terminal ileum. It was treated with combined endoscopic therapy of epinephrine injection followed by two clips application. Haemoglobin values were stable in the post-procedural period. DL in the terminal ileum is very rare. There have been fewer than 20 cases reported in the literature to date. Also GT is a rare congenital bleeding disorder. This case report revealed the coincidence of two rare disorders.

In this study; we tried to compile risk scoring systems (Original EuroSCORE, EuroSCORE II and STS) used in robotic surgery, minimally invasive cardiac surgery and open-heart surgery in the context of the literature.As a result, literature study of risk scoring systems in the robotic surgery was not found. In minimally invasive cardiac surgery, few studies are available. The effectiveness of existing risk scoring systems has not been established in these studies. Therefore, further investigations are required for developing risk scoring systems in robotic surgery and minimally invasive cardiac surgery. In open heart surgery, there is still no gold standard scoring system in all populations. Due to the increased case diversity, we believe that the commonly used risk scoring systems must be updated. Widely used risk-scoring systems are not effective in minimally invasive cardiac surgery and this is supporting our idea. Each clinic should choose the appropriate risk scoring system according to their own experience and case diversity. [Med-Science 2018; 7(4.000): 959-61]

Histopathologically, calvarial lesions are congenital, inflammatory, neoplastic and traumatic origin and these are rarely seen. The calvarial lesions most commonly manifest as palpable mass on physical examination or they are diagnosed incidentally during a radiological test. Defect, lysis and sclerosis in the bony structure are evaluated with radiography and computed tomography (CT) and relationships of the lesions with the soft tissue components and surrounding soft tissue are evaluated with CT and magnetic resonance imaging (MRI) and especially with MRI. Based on the radiological findings, benign-malignant discrimination of the calvarial lesions can be made and it may be possible to estimate their histopathological diagnoses., Kalvarial lezyonlar histopatolojik olarak, kongenital, enflamatuar, neoplastik ve travmatik kökenli olup, nadir olarak izlenmektedir. Kalvarial lezyonlar en sık klinik muayenede ele gelen kitle şeklinde ya da radyolojik bir tetkikde insidental olarak tanı konur. Kemik yapıdaki defekt, lizis ve skleroz radyografi ve bilgisayarlı tomografi (BT) ile, lezyonların yumuşak doku komponentleri ve çevre yumuşak doku ile ilişkisi, BT ve manyetik rezonans görüntüleme (MRG) ile ve özelikle MRG ile değerlendirilir. Radyolojik değerlendirme sonucu, radyolojik bulgulara göre kalvarial lezyonların benignmalign ayrımı ve histopatolojik tanısını tahmin etmek mümkün olmaktadır.

Amaç: Tamamlayıcı ve alternatif tıp (TAT) yöntemlerinin kullanımı yaşlılar arasında artmıştır. Bakım kalitesini yükseltmek için sağlık profesyonelleri TAT yöntemlerinin kullanımını değerlendirmelidir. Bu çalışma İstanbul’da iki huzurevinde kalan yaşlılarda TAT yöntemlerini kullanma durumunu saptamak amacıyla yapıldı.Materyal ve Metot: Bu çalışma Aralık 2012 ve Mayıs 2013 tarihleri arasında İstanbul’da iki huzurevinde yapıldı. Çalışmanın örneklemini 230 yaşlı birey oluşturdu. Bulgular: Yaşlıların %59,1’i TAT yöntemlerinden birini kullanıyordu. Bitkiler (%55,2) ve bitkisel olmayan destekler (%53,5) en çok kullanılan TAT yöntemleriydi. Ortaokul mezunu, kronik bir hastalığı olan ve düzenli tıbbi tedavi alan yaşlılar arasında TAT kullanım oranı yüksekti (p, Aim: Complementary and alternative medicine (CAM) usage has increased among the elderly. To promote comprehensive quality care, health professionals should assess for CAM usage. This study was planned to determine the CAM usage among elderly living in nursing homes in Istanbul. Material and Method: This study was made in two nursing homes in Istanbul between December 2012 and May 2013. The study sample consisted of 230 elderly. Results: A percentage of 59.1 of elderly (n=136) used CAM. Herbs (55.2%) and non-herbal supplements (53.5%) were the most frequently used therapies. CAM usage rate was higher among elderly who graduated from secondary school, had chronic disorder, and used medicine regularly (p

While a rapid specialization process has started within the field of medicine along with the rapid advancement in technology, particularly for the last bicentenary, the significance of an integrated approach towards the patient in that process has been realized once again. Medical ethics and ethics education have appeared as two interconnected notions from ancient times to present that each new specialization area integrates idiosyncratic ethical priorities into the field of medicine with the advancement in information. Even if ethics courses given during basic medical education list the core values, it is not all that wrong to say that the ethical approach has kind of a perpetual structure shaped by the practices within the physician-patient relationships. Moreover, different notions and values exist in different specialties. However, the ideal approach in a physician-patient relationship which has been recognized in the world today is a patient-centered approach apart from the emergency cases in which patients have a risk of death., Teknolojinin özellikle son iki yüzyıldır hızlı bir şekilde gelişmesiyle birlikte tıp alanında hızlı bir uzmanlaşma süreci başlamış olup bu süreçte hastaya bütüncül yaklaşımının önemi bir kez daha anlaşılmıştır. Antik çağlardan günümüze değin tıp etiği ve tıp eğitimi birbirinden ayrılmaz iki kavram olarak karşımıza çıkmaktadır ki bilginin artmasıyla karşımıza çakın her yeni uzmanlık alanı kendine özgü etik öncelikleri tıp alanına sokmaktadır. Temel tıp eğitimi esnasında alınan etik dersleri temel değerleri listelemekte olsa da etik yaklaşımın hasta-hekim ilişkisinde uygulamalar ile şekillenen süreğen bir yapıya sahip olduğunu söylemek pekte yanlış olmaz. Öyle ki farklı uzmanlık dallarında farklı kavramlar ve değerler göz önünde bulundurulmaktadır bununla birlikte günümüzde dünyada kabul gören hasta-hekim ilişkisinde ki ideal yaklaşım, hastanın hayati tehlikesinin bulunduğu acil durumlar haricinde, hasta merkezli yaklaşımdır.