GÝRÝÞ ve AMAÇ: Bu araþtýrmanýn amacý Aile Saðlýðý Merkezlerine baþvuran hastalarýn saðlýk okuryazarlýðý düzeyinin deðerlendirilmesidir.
YÖNTEM ve GEREÇLER: Kesitsel nitelikteki bu araþtýrmada hastalarýn saðlýk okuryazarlýðý düzeyini belirlemek için Avrupa Birliði tarafýndan geliþtirilen ‘‘Saðlýk Okuryazarlýðý Anketi’’ kullanýlmýþtýr. Araþtýrmanýn evrenini Türkiye’nin sosyo-ekonomik seviyesi en yüksek ilçesi olan Çankaya’da ikamet eden, ayný ilçedeki Aile Saðlýðý Merkezlerine baþvuran, 18 yaþ ve üzerindeki hastalar oluþturmaktadýr. Araþtýrmaya 25 Aile Saðlýðý Merkezinden 500 hasta katýlmýþtýr.
BULGULAR: Hastalarýn genel saðlýk okuryazarlýðý indeksi ortalama 30,25±7,28 olarak hesaplanmýþtýr. Hastalarýn %20,90’ýnýn yetersiz, %48,30’unun sýnýrlý, %24,90’ýnýn yeterli ve %5,90’ýnýn mükemmel saðlýk okuryazarlýðýna sahip olduðu görülmüþtür. Yaþ, eðitim durumu, çalýþma durumu, aylýk gelir durumu, genel saðlýk durumu, kronik hastalýk varlýðý, son 12 ayda aile hekimine baþvuru sayýsý ve aile hekimi tarafýndan ziyaret edilme durumu açýsýndan hastalarýn saðlýk okuryazarlýðýnýn genel düzeyinin veya alt indekslerinin istatistiksel olarak anlamlý farklýlýklar gösterdiði bulunmuþtur (p<0,05).
TARTIÞMA ve SONUÇ: Hastalarýn büyük bir çoðunluðunun saðlýk okuryazarlýðý yetersiz veya sýnýrlý düzeydedir. Bu durum saðlýk okuryazarlýðýnýn artýrýlmasýna yönelik faaliyetlerin gerçekleþtirilmesi gerektiðini ortaya koymaktadýr.

INTRODUCTION: The aim of this study was to evaluate the health literacy level of patients applied to Family Health Centers.
METHODS: ‘‘The Health Literacy Questionnaire’’ developed by the European Union was used to determine the level of health literacy of the patients in this cross-sectional study. The population of the study was composed of adult patients who applied to the Family Health Centers in Çankaya and live in same district. Çankaya is the district with the highest socio-economic level in Turkey. Five hundred patients from 25 Family Health Centers participated in the study.
RESULTS: The mean of overall health literacy index of the patients was 30.25±7.28. It was observed that 20.90% of the patients had inadequate, 48.30% had limited, 24.90% had sufficient and 5.90% had excellent health literacy. It was found that the general level or sub-indices of patients’ health literacy differed significantly by age, educational status, working status, monthly income status, general health status, having a chronic disease, number of visits to family physician and visits by family physician in the last 12 months (p <0.05).
DISCUSSION AND CONCLUSION: The health literacy of the majority of patients is insufficient or limited. This reveals the need to carry out activities aimed at increasing health literacy.

GÝRÝÞ ve AMAÇ: Amaç: Bu çalýþmada çoklu ilaç kullanan yetiþkin hastalarýn tedaviye uyumlarýný, öz-etkililik düzeylerini ve uyumu etkileyen faktörlerin etkisini deðerlendirmeyi amaçladýk.


YÖNTEM ve GEREÇLER: Materyal ve method: Daha önce kronik hastalýk tanýsý konmuþ ve son 2 aydýr birden fazla ilaç kullanan 35 yaþ ve üzeri bireyler çalýþmaya alýndý. Hastalara sosyodemografik özelliklerini, hastalýk durumu ve kullanýlan ilaç türlerini belirlemek amacýyla araþtýrmacýlar tarafýndan hazýrlanmýþ bir anket formu, Ýlaç Tedavisine Uyum Öz-Etkililik Ölçeði Kýsa Formu (MASES-SF) ve Modifiye Morisky Ölçeði (MMÖ) uygulanmýþtýr.
BULGULAR: Bulgular: Çalýþmaya dahil edilen 275 hastanýn %39,6’u (n=109) erkek, %60,4’ü (n=166) kadýn, yaþ ortalamasý 67,42±11,5 yaþ idi. Hastalarýn %53,8’inin ilaçlarýný düzenli olarak kullandýðý, %44,7’sinin ise “unutkanlýk” nedeniyle ilaçlarýný düzenli kullanmadýðý tespit edildi. Deðerlendirilmeye alýnan hastalarýn MASES-SF puan ortalamasý 33,65±8,6 (17-52) puan bulundu. Çalýþmamýzda 65 yaþ altý olanlarýn, evli olanlarýn, ilköðretim ve üstü eðitimli olanlarýn, geliri giderine eþit veya fazla olanlarýn, il merkezinde eþi ile yaþanlarýn ve hastalýðýnýn tedavisi hakkýnda bir saðlýk çalýþaný tarafýndan eðitim verilmiþ olanlarda hem tedaviye uyum puanlarý, hem de MMÖ’den aldýklarý motivasyon ve bilgi skorlarý daha yüksek bulundu (p<0,001).

TARTIÞMA ve SONUÇ: Sonuç: Çalýþmamýza katýlan hastalarýn %46,2’si düzenli ilaç kullanmamaktadýr. Hastalýklarý ve tedavi süreci hakkýnda bir saðlýk çalýþaný tarafýndan eðitim verilmiþ hastalarýn ilaç uyum ve tedaviye motivasyon oranlarýnýn artmýþ olduðu görülmüþtür.

INTRODUCTION: Background: In this study, we aimed to evaluate the treatment adherence, self-efficacy levels of adult patients using multiple drugs and the effects of individual factors affecting adherence.


METHODS: Methods: A 35-year-old or older patients who has been diagnosed with chronic disease who has been using more than one medication for the last 2 months were included in the study. A questionnaire prepared by the researchers to determine sociodemographic characteristics, disease status and drug types, a Short Form of Self-Efficacy Scale for Adherence/Adaptation to Medical Treatment and Modifiye Morisky Scale were applied to the patients.

RESULTS: Results: Of the participants, 39.6% (n = 109) were male, 60.4% (n = 166) were female and the mean age was 67.42 ± 11.5 years. While 53.8% of patients said they were using their medication regularly, 44.7% were unable to use their medication regularly due to forgetfulness. The mean score of the Self-Efficacy Scale for Adherence/Adaptation to Medical Treatment was 33.65 ± 8.6 (17-52). In our study, it was found that those who were under 65 years of age, those who were married, those who were educated by elementary school or higher, those who were equal or higher than the income, those who lived with their wife in the city center, those who have been trained by a health worker about the treatment of the disease had higher both treatment adherence and Modified Morisky motivation and knowledge scores (p<0,001).
DISCUSSION AND CONCLUSION: Conclusion: Of the participants, 46.2% do not use regular drugs. It has been observed that the patients who were trained by a health worker about their disease and treatment process have increased the rate of drug compliance and treatment motivation.

GÝRÝÞ ve AMAÇ: Acil servislerin gerçek kullanýlma nedenleri dýþýnda uygunsuz kullanýlmasý her geçen gün artmakta ve acil servislerin iþleyiþini bozmaktadýr. Çalýþmamýzda Acil Servise müracaat eden hastalarýn bir yýllýk verileri incelenerek, bu hastalarýn son tanýlarýna göre, ne kadarýnýn acil servisleri uygun kullandýðýný belirlemek ve bu konuda oluþturulacak yeni politikalara yardýmcý olmak amaçlanmýþtýr


YÖNTEM ve GEREÇLER: 1 Ocak -31 Aralýk 2017 tarihleri arasýnda hastanemiz acil servisine müracaat eden hastalarýn dosyalarý incelenmiþtir. Veriler SPSS 22 programý ile deðerlendirilmiþ, analizde Ki-kare testi kullanýlmýþtýr. Anlamlýlýk deðeri p<0.05 olarak kabul edilmiþtir.
BULGULAR: Acil servise bir yýl içinde baþvuranlarýn %72.20’sinin (n: 42785\59282) birinci basamak veya uzman polikliniði baþvurusu gerektiren nedenler ile baþvurduðu, baþvuru yapanlarýn sadece %19.2’sinin (n: 11359\59282) gerçekten acil baþvurusuna uygun olduðu bulunmuþtur. Tüm müracaatlar içinde solumun sistemi ve aðrý þikâyetleri en sýk baþvuru nedenleridir.
TARTIÞMA ve SONUÇ: Acil servise baþvuran hastalarýn büyük çoðunluðunun aslýnda acil kategorisinde olmadýðý görülmüþtür. Acil servislerdeki iþ yükünün azaltýlmasý aile hekimliði sisteminin etkin kullanýlmasý için sevk sisteminin uygulanmasý, acil servislerde triaj uygulanmasýnýn kullanýlmasý ve uygunsuz þekilde acil servisi kullananlardan ekstra ücret alýnmasý gibi önlemlerin uygulanabileceði kanaatindeyiz.

INTRODUCTION: Inappropriate use of Emergency Department (ED) for non-urgent complaints compromises the functioning of ED and has been increasing day by day. In this study we examined the annual data of the patients who admitted to the Emergency Department in order to determine the ratio of appropriate usage according to the definitive diagnoses of the patients and to help forward new policies regarding this issue.



METHODS: Files of patients, who admitted to our ED between January 1 and to December 31 2017, were examined. Data were evaluated by SPSS software version 22 and the analyses were performed by using Chi-square test. A value of p <0.05 was accepted to be statistically significant.
RESULTS: We found that 72.20% (n: 42785\59282) of the people who admitted to the ED during one year had admitted for complaints that should be addressed in the primary healthcare centers or specialist policlinics and only 19.2% (n: 11359\59282) of the ED visits were appropriate. We also found that the most frequent reasons for ED visits were respiratory system symptoms and pain.
DISCUSSION AND CONCLUSION: We found that the vast majority of the patients who admitted to the emergency department were not actually urgent. We suggest that measures such as effectuation of the referral system for effective use of the family medicine system, use of triage in emergency departments, and extra fees for using the emergency department inappropriately can be implemented to reduce the workload in emergency services.

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, Erzincan'ýn Üzümlü ilçesine yerleþtirilen Ahýska Türkü göçmenlerin saðlýk durumlarýný ve saðlýk ihtiyaçlarýný belirlemek, elde edilen veriler ýþýðýnda saðlýk politikalarýný iyileþtirmektir.
YÖNTEM ve GEREÇLER: Kesitsel tipte bir çalýþmadýr. Çalýþmanýn evrenini Üzümlü'de yaþayan 1231 Ahýska Türkü oluþturmaktaydý. Örneklem büyüklüðü en az 233 olarak hesaplanmýþ, örneklemi belirlemek için sistematik örneklem metodu kullanýlmýþtýr. Araþtýrma 1 Nisan ile 30 Eylül 2017 tarihleri arasýnda demografik bilgi, saðlýk durumu ve saðlýk ihtiyaçlarýna yönelik 41 soru içeren bir anket aracýlýðýyla uygulanmýþtýr. Tanýmlayýcý istatistiksel analizler için SPSS 23 istatistik programý kullanýlmýþtýr.
BULGULAR: 237 katýlýmcý çalýþmaya dahil edilmiþtir. Kronik hastalýk oraný %47.00 olup, bu hastalarýn %54.00'ý kronik hastalýklarýnýn kontrol altýnda olmadýðýný belirtmiþlerdir. Ortalama hekim ziyareti sayýsý 3,56 olarak saptanmýþtýr. Katýlýmcýlar en çok ziyaret ettikleri saðlýk profesyonelini ‘aile hekimi’ olarak belirtmiþlerdir. Katýlýmcýlarýn %17.50'si kýsa depresyon tarama ölçeðinin iki sorusuna da olumlu cevap vermiþtir. Katýlýmcýlarýn %60,10'u saðlýk hizmeti alýrken sorun yaþadýklarýný belirtmiþlerdir. En çok ifade edilen sorunlar: iletiþim (% 34.00), özensiz bakým (% 18.50) ve ayrýmcýlýk (% 8.40) idi.
TARTIÞMA ve SONUÇ: Kronik hastalýk prevalanslarýnýn Türk popülasyonundan daha düþük olduðu söylenebilir. Göçmenlerin destek almak için saðlýk profesyoneli olarak akýllarýna ilk gelen aile hekimleriydi. Ayrýmcýlýðýn azaltýlmasý amacýyla “çeþitlilik yönetimi” politikasýnýn uygulanmasý, aile hekimlerinin göçmenlere yönelik etkili saðlýk hizmeti sunmalarý için bu doðrultuda eðitilmeleri önerilebilir.

INTRODUCTION: The aim of this study was to determine health status and health needs of Ahýska Turks immigrants settled in Uzumlu district of Erzincan, and to improve health policies in the light of data obtained.
METHODS: This is a cross-sectional study. Targeted population of study was 1231 Ahiska Turks who lived in Uzumlu. Sample size was calculated as at least 233. Systematic sample method was used for determining sample. Researches applied a questionairre, which was including 41 questions for demographic information, health status and health needs between April 1 to September 30, 2017. SPSS 23 statistical program was used for descriptive statistical analyses.
RESULTS: 237 participants were included in the study. The rate of chronic diseases (CDs) was 47.00%, and 54.00% of chronic diasese patients indicated that their chronic disease had not been under control. The mean number of physician visits was 3.56, and the most visited physician was primary care physician (PCP). The 17.50% of participants answered positively to the two questions of short depression screening scale. The 60.10% of participants stated that they have problems during getting health care. The mostly stated problems were: communication (34.00%), inattentive care (18.50%), discriminition (8.40%).
DISCUSSION AND CONCLUSION: It can be emphasized that our CDs prevalences are lower than Turkish population. The first healthcare profession came to immigrants’ mind for getting support was PCPs. For the purpose of decreasing discrimination, ‘diversity management’ policy should be implement, and PCPs should be trained for efficient healthcare service.

GÝRÝÞ ve AMAÇ: Tubal ligasyon, çiftler için en etkili ve en güvenilir aile planlamasý yöntemlerinden biri olmasýna raðmen, bu yöntemin kabulü toplumdan topluma deðiþiklik göstermekte ve bazý medikal, sosyo-ekonomik, dini ve kültürel nedenlerden dolayý kullanýmý reddedilebilmektedir. Araþtýrma, Türk ve Suriyeli kadýnlarýn tubal ligasyon hakkýnda bilgi ve tutumlarýný belirlemek amacýyla yapýlmýþtýr.
YÖNTEM ve GEREÇLER: Araþtýrma, Türkiye'nin güneydoðusunda bir devlet hastanesinde postpartum servisi'nde doðum yapan 420 Türk ve Suriyeli kadýn ile tanýmlayýcý ve kesitsel olarak yapýlmýþtýr. Araþtýrmada veri toplama araçlarý olarak “Tanýlama Formu” kullanýlmýþtýr. Türk ve Suriyeli kadýnlarýn cevaplarýný karþýlaþtýrmak için tanýmlayýcý istatistikler kullanýlmýþtýr.
BULGULAR: Türk kadýnlarýn %32.1'i, Suriyeli kadýnlarýn %46.8'si tüplerin baðlatýlmasýnýn günah olduðunu; Türk kadýnlarýn %22.8'i, Suriyeli kadýnlarýn %37.6'si tüplerin baðlatýlmasýnýn kadýna aile hayatýnda otorite kaybettireceðini; Türk kadýnlarýn %22.8'i, Suriyeli kadýnlarýn %43.9'u tüplerin baðlatýlmasýnýn cinsel hayatý olumsuz etkileyeceðini; Türk kadýnlarýn %20.9'u, Suriyeli kadýnlarýn %36.1'i tüplerin baðlatýlmasýnýn yasaklanmasý gerektiðini; Türk kadýnlarýn %60.4'ü, Suriyeli kadýnlarýn %45.9'u tüplerin baðlatýlmasýnýn güvenilir bir yöntem olduðunu ve Türk kadýnlarýn %34.4'ü, Suriyeli kadýnlarýn %48.3'ü bir kadýnýn çok çocuðunun olmasýnýn kadýna toplumda güç ve statü kazandýrdýðýný düþündükleri saptanmýþtýr (p=<.05)
TARTIÞMA ve SONUÇ: Çalýþmanýn sonucunda kadýnlarýn tubal ligasyon hakkýnda yetersiz bilgiye sahip olduðu, Suriyeli kadýnlarýn Türk kadýnlarýndan tubal ligasyon hakkýnda daha fazla olumsuz tutuma sahip olduðu belirlenmiþtir. Bulgularýmýz kültürel farklýlýklarýn tubal ligasyona yönelik tutumlarý ve kabulleri üzerinde önemli etkileri olabileceðini vurgulamaktadýr.

INTRODUCTION: Although tubal ligation (TL) is a safe and effective method of permanent contraception, women may reject it for medical, social, economic, religious, and/or cultural reasons. The study was conducted to determine knowledge about and attitudes toward TL among Turkish and Syrian women.
METHODS: Cross-sectional, descriptive study was conducted with 420 women in the women’s health unit of Hospital affiliated with the Ministry of Health in the southeastern Turkey. It was used an information form data collection. It was used descriptive statistics to compare the responses of Turkish and Syrian women.
RESULTS: The investigation of the Turkish and Syrian women’s perspectives of tubal ligation demonstrated that 32.1% of the Turkish women and 46.8% of the Syrian women considered it as a sin, 22.8% of the Turkish women and 37.6% of the Syrian women thought they might lose their authority in the family life, 22.8% of the Turkish women and 43.9% of the Syrian women thought that the intervention might have a negative impact on their sexual life, 20.9% of the Turkish women and 36.1% of the Syrian women thought that tubal ligation should be banned, 60.4% of the Turkish women, 45.9% of the Syrian women believed that tubal ligation was a reliable method and 34.4% of the Turkish women and 48.3% of the Syrian women thought that having a lot of children gained them strength and status in the society (p = <.05)
DISCUSSION AND CONCLUSION: Overall knowledge of women about TL was insufficient, and Syrian participants displayed more negative attitudes towards TL than Turkish participants. Our findings underscore the fact that cultural differences may have important effects on attitudes toward and acceptance of TL.

GÝRÝÞ ve AMAÇ: Bu araþtýrma, adölesanlarda internet baðýmlýlýðý ile beslenme egzersiz davranýþlarý arasýndaki iliþkinin incelenmesi amacýyla yapýlmýþtýr.
YÖNTEM ve GEREÇLER: Tanýmlayýcý türdeki araþtýrmanýn evreni, Giresun ilindeki bir ortaokulda öðrenim gören 6, 7 ve 8. sýnýftaki adölesan dönem öðrencileridir (n=440). Araþtýrmaya katýlmayý kabul eden ve ulaþýlabilen 400 öðrenci ile araþtýrma tamamlanmýþtýr (%91). Veriler, Tanýtýcý Bilgi Formu, Ýnternet Baðýmlýlýk Ölçeði (ÝBÖ) ve Beslenme Egzersiz Davranýþlarý Ölçeði (BEDÖ) ile toplanmýþtýr. Veriler SPSS 20.00 programý ile analiz edilmiþ ve tanýmlayýcý istatistikler (frekans, yüzde, varyans, t testi, Kruskall Wallis testi) kullanýlmýþtýr.
BULGULAR: Araþtýrmaya katýlanlarýn yaþ ortalamasý 12,25±0,98 olup %51,25’i kadýn, % 50,75’i interneti en az bir saat kullanmakta ve %31,75’i interneti bilgilenmek amacýyla kullanmaktadýr. Adölesanlarýn ÝBÖ ve Saðlýksýz Beslenme-Egzersiz Davranýþý boyutu puanlarý erkeklerin aleyhine bulunmuþ, adölesan okul baþarýsý ile internet baðýmlýlýðý ve beslenme egzersiz davranýþlarý arasýnda bir iliþki olduðu ve adölesanlarýn günlük olarak internette geçirdikleri zaman ve internet kullaným amacýna göre ÝBÖ ve BEDÖ puanlarý arasýnda iliþki olduðu bulunmuþtur.
TARTIÞMA ve SONUÇ: Adölesanlarýn farklý tanýmlayýcý özelliklerine göre internet baðýmlýlýðý ve beslenme egzersiz davranýþlarý arasýnda iliþki olduðu görülmektedir. Risk faktörlerinin erken dönemde belirlenmesi, okul-aile-öðrenci ile iþbirliði yapýlmasý gerekmekte olup adölesanlarýn uygun eðitimlerle desteklenmesi önerilmektedir.

INTRODUCTION: The aim of this study was to investigate the relationship between internet addiction and nutrition exercise behaviors in adolescents.
METHODS: The universe of the descriptive study is the 6th, 7th and 8th grade adolescent students studying in a secondary school in Giresun (n = 440). The study was completed with a total of 400 students who agreed to participate in the study (91%). Data were collected by using the Descriptive Information Form, Internet Addiction Scale (IAS) and Nutrition Exercise Behavior Scale (NEBS). The data were analyzed with SPSS 20.00 program and descriptive statistics (frequency, percentage, variance, t test, Kruskall Wallis test) were used.
RESULTS: The mean age of the participants was 12.25±0.98 and 51.25% were women, 50.75% were using the internet for at least one hour and 31.75% were using the internet for information purposes. The IAS and Unhealthy Nutrition-Exercise Behavior dimension scores of adolescents were found to be against the males. There is a relationship between adolescent school achievement and internet addiction and nutrition exercise behaviors, IAS and NEBS scores according to the time spent by the adolescents on the internet daily and the purpose of internet use.
DISCUSSION AND CONCLUSION: It is seen that there is a relationship between internet addiction and nutrition exercise behaviors according to different descriptive characteristics of adolescents. Early identification of risk factors and cooperation with school-parents-students is required and it is recommended that adolescents are supported with appropriate training.

GÝRÝÞ ve AMAÇ: Obezite merkezleri hastalara doðru yaþam tarzý deðiþikliklerini kazandýrarak, hastalarýn ideal kilolarýný koruyabilmelerini saðlayan merkezlerdir. Çalýþmamýz elde edilen veriler ile obezite için potansiyel risk faktörlerini saptamayý, merkez eðitimlerinin etkinliðini deðerlendirerek yeni geliþme gösteren bu alanda faydalý öneriler sunmayý amaçlamaktadýr.
YÖNTEM ve GEREÇLER: Çalýþma 01.11.2018-31.08.2019 tarihleri arasýnda Saðlýk Bilimleri Üniversitesi, Konya Eðitim ve Araþtýrma Hastanesi Obezite Merkezi’nde yapýlmýþtýr. Toplam 1986 hastadan VKÝ≥30 kg/m2, 18 yaþ ve üzeri merkeze kabulleri merkez sorumlu hekimi ve 5 farklý branþ hekimi tarafýndan onaylanmýþ 254 hastanýn verilerinin retrospektif olarak deðerlendirildiði, tanýmlayýcý ve kesitsel bir çalýþmadýr.
BULGULAR: Çalýþmaya alýnan hastalarýn %91,33’ü kadýn, %8,67’si erkekti. Hastalarýn obezite merkezinde verilen eðitimlere devamlýlýk durumlarý klinik ve bazý laboratuvar parametrelere göre karþýlaþtýrýldýðýnda; eðitimlere düzenli katýlan hastalarýn 3. ay kilo, VKÝ, vücut yað yüzdesi, bel çevresi, kalça çevresi, HbA1c, LDL ve trigliserid ortalamasý eðitimlere devamlý katýlmayan hastalarýn 3. ay deðerlerine göre istatistiksel olarak anlamlý derecede daha düþük saptanmýþtýr.
TARTIÞMA ve SONUÇ: Merkeze devamlýlýðý olup, eðitimlere düzenli katýlan hastalarýn daha kolay kilo verdikleri, kan ile lipid parametrelerinde anlamlý derecede düzelme olduðu saptanmýþtýr. Hastalarýn merkezde verilen grup içi eðitimlere katýlmalarýnýn saðlanmasý ve sýk sýk merkeze davet edilmeleri obezite tedavisinin önemli basamaklarýndan birini oluþturmaktadýr.

INTRODUCTION: Obesity centers are the centers that provide patients with the right lifestyle changes and enable them to maintain their ideal weight. Our study aims to identify potential risk factors for obesity with the data obtained, and to present useful suggestions in this newly developing area by evaluating the effectiveness of the center trainings.
METHODS: The study was conducted between 01.11.2018-31.08.2019 at the Obesity Center of Health Sciences University, Konya Training and Research Hospital. This is a descriptive and cross-sectional study in which the data of 254 patients aged 18 years and over, whose BMI was 30 kg / m2, and whose admissions were approved by the center responsible physician and 5 different branch physicians, were evaluated retrospectively.
RESULTS: 91.33% Of the patients included in the study were female and 8.67 % were male. When the attendance status of the patients in the obesity center were compared according to clinical and some laboratory parameters; the weight, BMI, body fat percentage, waist circumference, hip circumference, HbA1c, LDL and triglyceride mean values of the patients who attended the trainings regularly were compared to the third month values of the patients who did not attend the trainings.
DISCUSSION AND CONCLUSION: As a result of our study, it has been determined that patients who attend the center regularly and lose weight more easily and have a significant improvement in blood and lipid parameters. It is one of the most important steps of obesity treatment that patients are encouraged to participate in in-group trainings and frequently invited to the center.

GÝRÝÞ ve AMAÇ: Çalýþmanýn amacý, kullaným yoðunluðunu dikkate alarak, problemli akýllý telefon kullanýmýný belirlemek için kullanýlabilecek bir ölçek geliþtirmekti. Önerilen ölçeðin güvenilirliði ve geçerliliði de deðerlendirilerek, ileri epidemiyolojik çalýþmalarda kullanýlabilmesi amaçlandý.
YÖNTEM ve GEREÇLER: Çalýþmaya katýlanlar 2016 yýlýnda Eskiþehir Osmangazi Üniversitesi'nde öðrenim gören 1492 öðrenciden oluþmuþtur. Anket formu katýlýmcýlarýn sosyodemografik özellikleri, akýllý telefon baðýmlýlýðýnýn öznel deðerlendirmesi, akýllý telefon kullaným yoðunluðu ile ilgili sorular ve Akýllý Telefon Baðýmlýlýðý Ölçeði Kýsa Formu’nu içermektedir.
BULGULAR: Araþtýrmaya katýlanlar 18-24 yaþ grubunda % 48,26'sý (n = 720) kadýn, % 51,74'ü (n = 772) erkek olmak üzere 1492 öðrenciden, oluþmaktadýr. Ölçeðin geliþtirilmesi için Akýllý Telefon Baðýmlýlýðý Ölçeði - Kýsa Formu adlý ölçekte bulunan tüm sorular ve akýllý telefon kullaným yoðunluðu ile ilgili sorular açýmlayýcý faktör analizine alýnmýþtýr. Sonuç olarak, 10 maddelik Problemli Akýllý Telefon Kullaným Ölçeði geliþtirilmiþtir. Açýmlayýcý faktör analizi sonucunda ölçeðin kullaným yoðunluðu, günlük yaþamda bozulma ve çekilme olmak üzere üç faktörlü bir yapýda olduðu ortaya çýkmýþtýr. Üç faktör toplam varyansýn % 63.36 'sýný açýkladý. Güvenirlik analizi sonucunda, ölçeðin Cronbach alfa katsayýsý 0.81'dir. Ayrýca doðrulayýcý faktör analizi ölçeðin üç faktörlü yapýsýný doðrulamýþtýr.
TARTIÞMA ve SONUÇ: Sonuç olarak Problemli Akýllý Telefon Kullaným Ölçeðinin, problemli akýllý telefon kullanýmýný deðerlendirmek için geçerli, güvenilir ve etkili bir ölçek olduðu bulundu.

INTRODUCTION: The aim of the study was to develop a scale that, by taking intensity of use into account, can be used to identify problematic smartphone usage. The reliability and validity of the proposed scale were also evaluated and it may be used in further epidemiological studies.
METHODS: Participants of the study consisted of 1492 students studying at Eskisehir Osmangazi University, Turkey in 2016. The questionnaire included questions about the sociodemographic characteristics of the participants, the self-evaluation of smartphone addiction, and smartphone usage intensities and Smartphone Addiction Scale-Short Version.
RESULTS: Participants of the study consisted of 1492 students aged 18-24, 48.26 % (n = 720) female, 51.74 % (n = 772) male. In order to develop the scale, all questions that are present in the current scale, named Smartphone Addiction Scale-Short Version, and questions about the intensity of smartphone usage were taken into exploratory factor analysis. As a result, the 10-item Problematic Smartphone Usage Scale was developed. The result of the exploratory factor analysis revealed that the scale had a three-factor structure consisting of usage intensity, daily life disturbance and withdrawal. The three factors explained 63.36 % of the total variance. As a result of the reliability analysis, Cronbach’s alpha coefficient of the scale was 0.81. Confirmatory factor analysis also confirmed the three-factor structure of the scale.
DISCUSSION AND CONCLUSION: As a result, the Problematic Smartphone Usage Scale is seen as a valid, reliable and effective scale for assessing problematic smartphone usage.

GÝRÝÞ ve AMAÇ: Mastalji en sýk görülen meme yakýnmasýdýr. Bu çalýþmanýn amacý meme aðrýsýna neden olan faktörleri araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Atatürk Eðitim ve Araþtýrma Hastanesi cerrahi polikliniðine meme rahatsýzlýðý veya diðer þikayetler ile baþvuran 18-65 yaþlarý arasýnda 159'u meme aðrýsý olan ve 159'u meme aðrýsý olmayan toplam 318 kadýn 1 Aralýk 2018 ve 31 Ocak 2019 tarihleri arasýnda çalýþmaya dahil edildi. Bu hastalara meme aðrýsýna neden olduðu düþünülen faktörleri içeren bir deðerlendirme anket uygulandý.
BULGULAR: Meme aðrýsý 50 yaþ ve üstü hastalarda anlamlý olarak daha yüksek bulundu (OR = 3.496,% 95 CI: 3.496-11.056). Emziren kadýnlarýn emzirmeyen kadýnlardan yaklaþýk 3 kat daha fazla mastaljisi olduðu belirlendi (OR = 2.667,% 95 CI: 1.262-5.637). Mastalji prevalansýnýn sigara içenlerde sigara içmeyenlere göre 2,5 kat daha yüksek olduðu belirlendi (OR = 2.466,% 95 CI: 1.306-4.659). Alkol kullanan kadýnlarda mastaljinin içmeyenlere göre 4,5 kat daha fazla olduðu görüldü (OR = 4.456,% 95 CI: 1.394-14.244). Kilo alan kadýnlarda mastalji geliþme olasýlýðýnýn kilo almayanlara göre yaklaþýk 2,5 kat daha fazla olduðu belirlendi (OR = 2.593,% 95 CI: 1.396-4.818). Ayrýca mastaljinin diðer benign meme rahatsýzlýklarý olan hastalarda 21 kat daha fazla geliþtiði bulundu (OR = 20.996,% 95 CI: 10.344-42.620).
TARTIÞMA ve SONUÇ: Bu çalýþmada mastaljinin 50 yaþ ve üstü kadýnlarda daha sýk görüldüðü, emzirme, iyi huylu meme hastalýðý, sigara ve alkol tüketimi ve kilo almanýn mastaljiye neden olan risk faktörleri olduðu ortaya konuldu.

INTRODUCTION: Mastalgia is the most common breast complaint. The aim of this study is to investigate the factors that cause breast pain.
METHODS: A total of 318 women between the ages of 18 to 65 with 159 having breast pain and 159 without breast pain who applied to the surgery outpatient clinic of Atatürk Training and Research Hospital with breast discomfort or other complaints December 1, 2018, and January 31, 2019, were included in the study. An assessment questionnaire including the factors thought to cause breast pain was applied to these patients.
RESULTS: Breast pain was found to be significantly higher in patients aged 50 years and older (OR=3.496, 95% CI: 3.496-11.056). It was determined that breastfeeding women approximately 3 times more mastalgia than non-breastfeeding women (OR=2.667, 95% CI: 1.262-5.637). It was determined that the prevalence of mastalgia was 2.5 times higher in smokers than in non-smokers (OR=2.466, 95% CI: 1.306-4.659). It was found than mastalgia was 4.5 times higher in women that drink alcohol than in non-drinkers (OR=4.456, 95% CI: 1.394-14.244). It was determined that women who gained weight were approximately 2.5 times more likely to develop mastalgia than those without weight gain (OR=2.593, 95% CI: 1.396-4.818). It was also found that mastalgia is 21-fold more likely to develop in patients with other benign breast discomforts (OR=20.996, 95% CI: 10.344-42.620).
DISCUSSION AND CONCLUSION: This study revealed that mastalgia was more common in women aged 50 years and older, breastfeeding, the presence of benign breast disease, cigarette, and alcohol consumption, and gaining weight are risk factors causing mastalgia.

GÝRÝÞ ve AMAÇ: COVID-19 (SARS CoV-2) pandemisi tüm dünyayý etkisi altýna almýþ olup, ülkelerin saðlýk imkanlarýný zorlayýcý bir hal almýþ durumdadýr. Salgýnýn çeþitli ülkelerde farklý mortalite oranlarýyla seyretmesi altýnda yatan en önemli etkenler arasýnda þüphesiz ülkelerin saðlýk sistemleri, saðlýða ayrýlan bütçe ve halkýn saðlýk imkanlarýndan yararlanma oraný gibi parametreler sayýlabilir. Bu sebeple, çalýþmamýzda Türkiye, Avrupa birliði ülkeleri ve Amerika Birleþik Devletleri’ne ait pandemi verilerinin karþýlaþtýrýlmasý ve hastalýðýn seyrinin hangi parametrelerle iliþkili olduðunun araþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Worldometer dijital veri tabanýndan alýnan 04/05/2020 tarihli coronavirus istatistikleri ve OECD (Organisation for Economic Co-operation and Development) dijital veri tabanýndan elde edilen, 28 Avrupa Birliði Ülkesi, Amerika Birleþik Devletleri ve Türkiye’ye ait sosyo-demografik veriler ve saðlýkla ilgili göstergeler incelendi. Ülkelere ait veriler arasýndaki iliþkiler Spearman korelasyon analizi ile deðerlendirildi. Analizlerde alfa hata oraný üst limiti %5 olarak alýndý.
BULGULAR: Ýncelenen tarih itibariyle COVID-19 toplam vaka sayýsýnýn Türkiye’de 127.659, Avrupa Birliði ülkelerinde 1.234.918 ve ABD de 1.212.835 olduðu görüldü. Avrupa birliðinde en çok vaka görülen 3 ülke sýrasýyla Ýspanya (248.301), Ýtalya (211.938) ve Birleþik Krallýk (190.584), en çok COVID-19 sebepli ölüm görülen 3 ülke ise sýrasýyla Ýtalya (29.079), Birleþik Krallýk (28.734) ve Ýspanya (25.428) idi. Mortalite oranýnýn, ülkelerin saðlýða ayýrdýklarý bütçe ile doðru orantýlý olduðu görüldü.
TARTIÞMA ve SONUÇ: COVID-19 enfeksiyonu Avrupa ve Amerika’ya kýyasla Türkiye’ de daha düþük mortalite ile seyretmektedir. Saðlýða daha fazla bütçe ayýran ülkelerde hastalýk kaynaklý mortalite daha doðru saptanýyor olabilir. Ayrýca çeþitli parametrelerin hastalýðýn seyri ile iliþkili olduðu görülmüþtür.

INTRODUCTION: COVID-19 (SARS CoV-2) pandemic has influenced the whole world and has become challenging for the health resources of countries. Undoubtedly, some of the most important factors underlying the course of the epidemic with different mortality rates in various countries are the parameters such as the health systems of the countries, the health spending of governments, and the rate of public healthcare utilization. Therefore, in our study, it was aimed to compare the pandemic data of Turkey, European Union countries, and the United States, besides investigating the parameters related to the course of the disease.
METHODS: The coronavirus statistics obtained from the Worldometer digital database on the 4th of May 2020 and socio-demographic data and health-related indicators of 28 European Union countries, USA, and Turkey obtained from OECD digital database were investigated. Relations between countries' data were evaluated by Spearman correlation analysis. In the analysis, the upper limit of the alpha error rate was taken as 5%.
RESULTS: By the investigation date, the total number of COVID-19 cases were found to be 127,659 in Turkey, 1,234,918 in European Union countries, and 1,212,835 in the USA. The three countries with the highest number of cases in the European Union are Spain (248,301), Italy (211,938) and the United Kingdom (190,584), respectively; the three countries with the most COVID-19 related deaths are Italy (29,079), the United Kingdom (28,734) and Spain (25.428), respectively. It was observed that the mortality rate was directly proportional to the budget allocated by countries to health.
DISCUSSION AND CONCLUSION: Compared to Europe and America, COVID-19 infection in Turkey has a lower mortality rate. In countries that allocate more budget to health, mortality rates from the disease may be more accurate. Besides, it has been observed that various parameters are related to the course of the disease.

GÝRÝÞ ve AMAÇ: 31 Aralýk 2019'da Dünya Saðlýk Örgütü (DSÖ) Çin Ülke Ofisi, Çin'in Hubei eyaletinin Vuhan þehrinde etiyolojisi bilinmeyen pnömoni vakalarýný bildirmiþtir. 7 Ocak 2020’de etken daha önce insanlarda tespit edilmemiþ yeni bir Coronavirus (2019-nCoV) olarak tanýmlanmýþtýr. Neredeyse tüm dünyaya yayýlan bu durum sonrasý Dünya Saðlýk Örgütü tarafýndan bu salgýn pandemi olarak ilan edilmiþtir. Bu çalýþmanýn amacý pandemiyi 8 farklý ülkede analiz etmektir.
YÖNTEM ve GEREÇLER: Çalýþmaya 04.05.2020 tarihi itibari ile dünyada en fazla vakanýn görüldüðü ülkeler (A.B.D, Çin, Ýtalya, Almanya, Ýran, Fransa, Türkiye) ve Güney Kore’yi dahil ettik. Ülkelerin toplam vaka ve ölüm sayýlarýný, ölüm oranlarýný, 65 yaþ üstü nüfus oranlarýný ve alýnan tedbirlerin tarihlerini birbirleriyle kýyaslayarak analiz ettik.
BULGULAR: Tüm dünyadaki Covidli vaka sayýsý 3,6 milyonu aþmýþtý ve bu vakalarýn yaklaþýk 75.2% si 7 ülkede (A.B.D, Ýtaya, Çin, Almanya, Fransa, Ýran, Türkiye) görülmekteydi ve yine ayný tarihte (04.05.2020) dünyadaki ölüm sayýsý 250 bini aþmýþtý.
TARTIÞMA ve SONUÇ: Saðlýk alanýndan ekonomiye kadar toplumu tüm yönleriyle etkilemiþ olan son yüzyýlýn belki de insanlýk tarihinin en büyük pandemisiyle karþý karþýyayýz. Ýnsanlýk tarihi için pandemiyle mücadeledeki en büyük silah ülkelerin bilgi birikimlerini birbirlerine aktarmalarý olacaktýr.

INTRODUCTION: On 31 December 2019, the China Country Office of the World Health Organization (WHO) reported on cases of pneumonia with unknown etiology in the Wuhan city of the province of Hubei. On 7 January 2020, the factor was defined as a new Coronavirus (2019-nCoV) that had not been detected in humans before. The aim of this study is to analyze the pandemic in 8 different countries.
METHODS: In the study, we included the countries with the highest numbers of cases by the date 04.05.2020 (USA, China, Italy, Germany, Iran, France, Turkey), as well as South Korea. We comparatively analyzed the countries’ total case and mortality numbers, mortality rates, over-65 years old population rates and dates of precautions that were taken.
RESULTS: The number of COVID cases in the entire world exceeded 3.6 million, and approximately 75.2% of these cases were seen in 7 countries (USA, Italy, China, Germany, France, Iran, Turkey), whereas the number of related deaths worldwide exceeded 250 thousand by the same date (02.04.2020).
DISCUSSION AND CONCLUSION: We are facing the greatest pandemic of the last century, or even the history of humanity, which has affected the society in all aspects from the field of medicine to economics. The greatest weapon for the history of humanity in the fight against the pandemic would be countries’ transfer of their knowledge to each other.

GÝRÝÞ ve AMAÇ: Çalýþmanýn amacý hastanemize baþvuran çocuk ve adolesanlarda D vitamini eksikliði olup olmadýðýný belirlemek; cinsiyet, yaþ, ve mevsimlere göre 25- Hidroksi vitamin D (25-OH D) düzeyleri arasýnda fark olup olmadýðýný tespit etmektir.
YÖNTEM ve GEREÇLER: 2018-2019 kýþ ve yaz mevsimi aylarý arasýnda hastanemiz Çocuk Hastalýklarý Polikliniði'ne herhangi bir sebeple baþvuran 4.153 çocuk ve adolesan çalýþmaya alýndý. Hastalarýn yaþ, cinsiyet ve mevsimlere göre 25-OH D vitamin düzeyleri belirlendi. Serum 25-OH D düzeyinin <20 ng/ml olmasý ciddi yetersizlik, 20-30 ng/ml arasý yetersizlik, 30-100 ng/ml arasý yeterlilik, >100 ng/ml olmasý toksisite olarak kabul edildi. Verilerin deðerlendirilmesinde tek yönlü varyans analizi ve student t testi kullanýldý. SPSS 22.0 paket programý kullanýldý. p<0,05 istatistiksel olarak anlamlý kabul edildi.
BULGULAR: Çalýþmamýzdaki popülasyonun % 55,23 ü kýz idi. Kýzlarda 25-OH D düzeyi 17,29±11,50 ng/ml idi. Erkeklerde ise 19,16±10,68 olarak bulundu. 25-OH D düzeyi ortalamasý 18,13±11,18 ng/mL bulunmuþtur. Çalýþmamýzda D vitamini yetersizliðinin sýklýðý %44,80 olarak saptanmýþtýr. Kýþ aylarýnda D vitamini yetersizliðinin sýklýðý %57,11 iken, yaz aylarýnda %42,89 olarak bulunmuþtur. D vitamini düzeyleri cinsiyet, yaþ aralýðý ve baþvuru mevsimine göre istatistiksel anlamlý farklýlýklar göstermektedir. Adolesan yaþ gruplarýnda D vitamini düzeyleri, çocuk yaþ gruplarýna göre daha düþüktür.
TARTIÞMA ve SONUÇ: Hastanemize baþvuran çocuk ve adolesanlarda ciddi D vitamini yetersizliði bulunmuþtur. Çocuk ve adolesan grubu kiþilerde D vitamini düzeylerinin cinsiyet, yaþa ve mevsimlere baðlý olarak deðiþiklik gösterdiði sonucuna varýlmýþtýr.

INTRODUCTION: The aim of our study was to determine whether vitamin D deficiency was present in adolescents and children who admitted to our hospital; to determine whether there is a difference between 25-hydroxy (25-OH D) vitamin D levels according to age, sex and seasons
METHODS: Between the years 2018-2019, 4.153 adolescents and children who admitted to our Pediatric Outpatient Clinic between winter and summer months. 25-0H D vitamin D levels were determined according to age, sex, and seasons. Serum 25-OH D level<20 ng/ml was accepted as severe insufficiency, 20-30 ng/ml insufficiency, >100 ng/ml toxicity. The data were evaluated by the SPSS 22.0 program. One- way variance analysis test and student t-test were used in the evaluation of the data. p<0.05 was considered significant.
RESULTS: 55.23% of the population in our study was female. The 25-OH D level in girls was 17.29 ± 11.50 ng/ml. In males, it was found to be 19.16 ± 10.68. The mean 25-OH D level was found 18.13 ± 11.18 ng / mL. In our study, the frequency of vitamin D deficiency was found to be 44.80%. While the frequency of vitamin D deficiency was 57.11% in winter, it was found to be 42.89% in summer. Vitamin D levels show statistically significant differences according to gender, age-range, and season of hospital admittance. Vitamin D levels are lower in adolescent age groups than in child age groups.
DISCUSSION AND CONCLUSION: In our study, severe vitamin D deficiency was found in adolescents and children. Vitamin D levels in children and adolescents varied depending on sex, age, and season.

GÝRÝÞ ve AMAÇ: Sjögren Sendromu (SS), kserostomi ve kseroftalmi ile kendini gösteren etyopatogenezinde özellikle lenfositlerin rol oynadýðý kadýn egemen bir hastalýktýr. Bu çalýþmamýzda Primer SS (PSS)’lu hastalarda Roma IV kriterleri ile fonksiyonel barsak hastalýðý (FBH) sýklýðý araþtýrýlmak istenmiþtir.
YÖNTEM ve GEREÇLER: Haziran 2018 – Eylül 2019 arasýnda Kayseri Þehir Hastanesi Romatoloji Polikliniklerine baþvuran ve 2016 ACR/EULAR PSS sýnýflandýrma kriterleri uyarýnca PSS olarak sýnýflandýrýlan 52 hasta çalýþmaya alýndý. FBH açýsýndan sorgulanan ve son altý ay içinde %10 dan fazla kilo kaybý, dýþkýlama alýþkanlýðýnda eskiye oranla yeni deðiþiklik, ailede erken yaþ intestinal malignite varlýðý, bulantý kusma ve akut batýn bulgularý olan kiþiler alarm semptomu/organik patoloji olasýlýðý sebebiyle çalýþmaya alýnmadý. Kontrol grubu olarak da Hematoloji Polikliniðine baþvuran hastalarýn yakýnlarý, yaþ ve cinsiyet gözetilerek seçildi. Anket kullanýlarak yapýlan sorgulamalar neticesinde FBH varlýðý ve var olan FBH tipi not edildi ve PSS’lu hastalarda ve saðlýklý kontrollerde görülme oranlarý % olarak belirtildi.
BULGULAR: PSS hastalarýnda 24/52 (%46,15) hastada FBH varken saðlýklý kontrollerin 17/75 (%22,66) hastada FBH saptandý [p<0,05; Odds Oraný 2,924 (%95 güven aralýðý 1,35- 6,30)]. FBH alt tiplerinin bakýlan analizlerinde, PSS’de Irritabl Barsak Sendromu oraný 18/52 (%34,61) saðlýklýlarda 14/75 (%18,67) saptanmýþtýr [p=0,044; Odds Oraný: 2,307 (%95 güven aralýðý 1,02 – 5,21)].
TARTIÞMA ve SONUÇ: Bu çalýþmada PSS’li hastalar arasýnda özellikle IBS olmak üzere FBH’nýn prevelansýnýn saðlýklý bireylere oranla yüksek olduðu gözlenmiþtir.

INTRODUCTION: Sjogren's Syndrome (SS) is a female-dominated disease in which lymphocytes play a critical role in the etiopathogenesis and manifested by xerostomy and xerophthalmitis. In this study, we aimed to investigate the frequency of functional bowel disease (FBD) according to Roma IV criteria in patients with primary SS (PSS).
METHODS: 52 patients who admitted to Kayseri City Hospital Rheumatology Polyclinics between June 2018 - September 2019, and classified as PSS according to 2016 ACR / EULAR PSS classification criteria, were included in the study. Subjects were questioned about FBD and who had more than 10% weight loss in the last six months, new changes in defecation habits, presence of early age intestinal malignancy in his family history, nausea/vomiting and acute abdominal findings were excluded due to the possibility of alarm symptoms/organic pathology. The control group was the relatives of the patients who applied to the Hematology Outpatient Clinic and they were selected according to age and gender. Inquiries were made using a questionnaire, the presence of FBD and the type of FBD were noted and the incidence rate in patients with PSS and healthy controls was reported as percent.
RESULTS: In PSS patients, 24/52 (46.15%) patients had FBD and 17/75 (22.67%) healthy controls had FBD [p <0.05; Odds Ratio 2,924 (95% confidence interval 1.35-6.30)]. Irritable Bowel Syndrome ratio in PSS was found to be 18/52 (34.61%) and 14/75 (18.67%) in healthy subjects [p = 0.044; Odds Ratio: 2,307 (95% confidence interval 1.02 - 5.21)].
DISCUSSION AND CONCLUSION: In this study, it was observed that the prevalence of FBD, especially IBS, was higher among patients with PSS compared to healthy individuals.

GÝRÝÞ ve AMAÇ: Bu çalýþmada postmenopozal kadýnlarda subklinik tiroid disfonksiyonu sýklýðýnýn deðerlendirilmesi ve subklinik tiroid disfonksiyonu ile kemik mineral yoðunluðu (KMY) iliþkisinin araþtýrýlmasý amaçlandý.
YÖNTEM ve GEREÇLER: Çalýþmaya Bolu Abant Ýzzet Baysal Üniversitesi Týp Fakültesi Endokrinoloji ve Metabolizma Hastalýklarý Polikliniði’nde Ocak 2018-Aralýk 2019 tarihleri arasýnda osteoporoz ön tanýsý ile deðerlendirilen 300 postmenopozal kadýn dahil edildi. Tüm katýlýmcýlarýn demografik verileri, tiroid stimüle edici hormon (TSH), serbest triiyodotironin (ST3), serbest tiroksin (ST4) düzeyleri, kemik mineral yoðunluðu (KMY) sonuçlarý hastane kayýt sisteminden retrospektif olarak kaydedildi. Tüm katýlýmcýlar ötiroid, subklinik hipertiroidi ve subklinik hipotiroidi olmak üzere 3 gruba ayrýldý. Ötiroid grup ayrýca TSH düzeylerine göre yüksek normal ve düþük normal olmak üzere 2 gruba ayrýldý. Subklinik tiroid disfonksiyonu subklinik hipertiroidi ve subklinik hipotiroidi olarak tanýmlandý. Aþikar hipotiroidi veya hipertiroidisi olan bireyler çalýþma dýþý býrakýldý.
BULGULAR: Bu çalýþmada postmenopozal kadýnlarýn %10.66’sýnda subklinik tiroid disfonksiyonu tespit edildi [subklinik hipertiroidi: 21(%7); subklinik hipotiroidi: 11 (%3.66)]. Subklinik tiroid fonksiyon bozukluðu olan bireylerde lomber vertebra (L1-4) ve femur kemik mineral yoðunluklarýnda ötiroid gruba göre istatistiksel olarak anlamlý bir farklýlýk saptanmadý (sýrasýyla; p=0.674 ve p= 0.184). Ötiroid grupta yüksek normal TSH düzeyleri ve düþük normal TSH düzeylerine sahip subgruplar arasýnda osteoporoz sýklýðý, vertebra (L1-4) ve femur kemik mineral yoðunluklarý benzerdi (sýrasýyla; p=0.935, p=0.850, p=0.734).
TARTIÞMA ve SONUÇ: Bu çalýþmada postmenopozal kadýnlarda subklinik tiroid disfonksiyonlarý ile KMY ölçümleri arasýnda istatiksel olarak anlamlý bir iliþki bulunmadý.

INTRODUCTION: The purpose of this study was to evaluate the frequency of subclinical thyroid dysfunction and the relationship between subclinical thyroid dysfunction and bone mineral density (BMD) in postmenopausal women.
METHODS: 300 postmenopausal women screened for osteoporosis between January 2018 and December 2019 in Bolu Abant Izzet Baysal University Faculty of Medicine, Department of Endocrinology and Metabolic Diseases were included in the study. Demographic data, thyroid -stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) levels and bone mineral densitometry (BMD) measurements of all participants were recorded retrospectively from the hospital registry system. All participants were divided into 3 groups as euthyroid, subclinical hyperthyroidism and subclinical hypothyroidism. The euthyroid group was also divided into two groups, those with high normal TSH and low normal TSH. Subclinical thyroid dysfunction was defined as subclinical hyperthyroidism and subclinical hypothyroidism. Individuals with overt hypothyroidism or hyperthyroidism were excluded from the study.
RESULTS: Subclinical thyroid dysfunction was detected in 10.66% of postmenopausal women [subclinical hyperthyroidism: 21 (7%); subclinical hypothyroidism: 11 (3.66%)]. No statistically significant difference was found in subjects with subclinical thyroid dysfunction in terms of vertebral (L1-4) and femoral bone mineral density compared to the euthyroid group. (p=0.67 and p= 0.18; respectively). Among the subgroups with high normal TSH levels and low normal TSH levels in the euthyroid group, the frequency of osteoporosis, vertebral (L1-4) and femoral BMD measurments were similar (p=0.93, p=0.85, p=0.73, respectively).
DISCUSSION AND CONCLUSION: We found no significant associations between subclinical thyroid dysfunctions and BMD in postmenopausal women.

GÝRÝÞ ve AMAÇ: Bu çalýþmada obezite polikliniðine baþvuran hastalarýn antropometrik ve biyokimyasal özelliklerinin deðerlendirilmesi ve karþýlaþtýrýlmasý amaçlandý.
YÖNTEM ve GEREÇLER: Bu tanýmlayýcý tipteki çalýþmanýn evrenini Aðustos 2016-Ekim 2017 tarihleri arasýnda obezite polikliniðine baþvuran toplam 1650 hasta oluþturmuþtur. Bu hastalar kayýtlardan retrospektif olarak taranmýþ ve BMI ≥25 kg / m2 olan 925 hasta çalýþmaya dahil edildi. Hastalar DSÖ'nün obezite sýnýflamasýna göre 4 gruba ayrýlmýþ ve bu gruplara göre deðerlendirme yapýlmýþtýr. Hastalarýn antropometrik ölçümleri, Biyoelektrik Empedans Analizi ve laboratuvar sonuçlarý hasta dosyalarý ve hastane veri tabanlarý taranarak elde edilmiþtir. Verilerin istatistiksel analizi SPSS 23 programý ile yapýlmýþtýr ve p<0,05 anlamlý kabul edilmiþtir.
BULGULAR: Katýlýmcýlarýn % 84,3'ünü kadýnlar oluþturmuþtur. Tüm antropometrik özelliklerde gruplara göre anlamlý olarak farklýlýk saptanmýþtýr (p<0,05). Hemoglobin, hematokrit, MCV, demir, ferritin ve D vitamini düzeyleri ile ortalama insülin, insülin direnci, kreatinin, ürik asit, AST, ALT ve TG deðerleri erkeklerde anlamlý olarak daha yüksek saptanmýþtýr (her biri için p<0,001).
Evre 1 obez bireylerin Hb, HCT, MCV, insülin, HOMA-IR, keatinin, ürik asit, AST, ALT, TG, demir, ferritin ve D vitamini deðerleri diðer gruplardan anlamlý derecede daha yüksek; PLT ve HDL deðerleri daha düþük saptanmýþtýr. (her biri için p <0,001).

TARTIÞMA ve SONUÇ: Obezitenin vücut bileþenleri ve biyokimyasal parametreler üzerindeki etkileri cinsiyete ve obezite derecesine baðlýdýr. Obez hastalar deðerlendirilirken BMI ile birlikte bel çevresi, kalça çevresi, vücut yað miktarý ve biyokimyasal parametrelerin ölçümü de yapýlmalýdýr.

INTRODUCTION: In this study, it was aimed to evaluate and compare the anthropometric and biochemical properties of patients who applied to obesity outpatient clinic.
METHODS: The universe of this descriptive study consisted of 1650 patients who applied to obesity outpatient clinic between August 2016 and October 2017. These patients were retrospectively scanned and 925 patients with BMI ≥25 kg/m22 were included in the study.
The patients were divided into 4 groups according to WHO's obesity classification and evaluated according to these groups. Anthropometric measurements, Bioelectrical Impedance Analysis and laboratory results of the patients were obtained by scanning patient files and hospital databases. Statistical analysis of the data was done via SPSS 23 program and p< 0.05 was considered significant.

RESULTS: 84.3% of the participants were women. There was a significant difference in all anthropometric features compared to the groups (p <0.05). Hemoglobin, hematocrit, MCV, iron, ferritin and vitamin D levels and mean insulin, insulin resistance, creatinine, uric acid, AST, ALT and TG values were significantly higher in males (p <0.001 for each).
Hb, HCT, MCV, insulin, HOMA-IR, creatinine, uric acid, AST, ALT, TG, iron, ferritin and vitamin D values of stage 1 obese individuals were significantly higher than other groups; PLT and HDL values were found lower. (p <0.001 for each).
DISCUSSION AND CONCLUSION: The effects of obesity on body components and biochemical parameters depend on gender and degree of obesity. While evaluating obese patients, waist circumference, hip circumference, body fat amount and biochemical parameters should be measured together with BMI.

GÝRÝÞ ve AMAÇ: Ülkemizde ve tüm Dünya’da acil servis kalabalýðý önemli bir sorundur. Bu çalýþmada amaç, Acil servise baþvuran ve yeþil triyaj kodu alan hastalarda Aile Hekimi farkýndalýðýný belirlemek, Aile Hekimi’ne baþvurmama ve Acil servise baþvurma nedenlerini ortaya koymaktýr.
YÖNTEM ve GEREÇLER: Bu çalýþma, bir eðitim ve araþtýrma hastanesi acil týp kliniði yeþil alana bir aylýk dönemde baþvuran hastalar ile yapýldý. Acil Servise baþvuran hastalar Triyaj Bölümünde deðerlendirildikten sonra Yeþil Triyaj Kodu olan hastalar bir hekim tarafýndan deðerlendirildi. Akut acil patolojisi olmayan hastalar çalýþma hakkýnda bilgilendirildi ve aydýnlatýlmýþ onam alýndý. Onam veren hastalara anket uygulandý. Bin yirmi altý hasta çalýþmaya alýndý ve acil ve acil olmayan olarak iki gruba ayrýldý.
BULGULAR: Acil durumu olmayan grupta 721 hasta bulunmakta iken, acil durumu olan grupta 305 hasta bulunmaktaydý. Acil nedenler ile ve acil olmayan nedenler ile Acil Servis’e baþvuran hastalarýn cinsiyet, yaþ eðitim ve acile baþvuru sayýsý arasýnda anlamlý farklýlýk yoktu. Acil nedenler ve acil olmayan nedenlerle yapýlan Acil Servis baþvurularýnda en yüksek oran, 18-29 yaþ aralýðýndaki hasta grubuna aitti. Hasta yaþýnýn artmasýyla Acil Servis’e acil olan ve acil olmayan nedenlerle baþvuru sayýsýnda düþme saptandý. Acil olmayan nedenler ile Acil Servis’e baþvuran hastalarýn % 57,30’u Aile Hekimi’nin kim olduðunu bildiðini; % 42,70’i Aile Hekimi’nin kim olduðunu bilmediðini belirtti. Acil olmayan nedenlerle Acil Servis’e baþvuran hastalarýn % 52,10’u Aile Hekimi’nin çalýþtýðý saðlýk merkezinin yerini bildiðini, % 47,90’ý Aile Hekimi’nin çalýþtýðý saðlýk merkezinin yerini bilmediðini bildirdiler.
TARTIÞMA ve SONUÇ: Aile Hekimliði bilinci oluþturularak, Acil Servis’in yoðunluðunun azalmasý saðlanabilir. Aile Hekimliði’ne baþvuru güçlüðü, hastalarýn daha fazla Acil Servis baþvurusuna neden olmaktadýr. Aile Hekimi’ne baþvuru kolaylýðý Acil Servis’e gereksiz baþvuruyu azaltacaktýr.

INTRODUCTION: In our country and all over the world, the overcrowding of Emergency Service is seen as a problem. Our goal in this study is to determine Family Practice awareness of patients who applies to Emergency Service with green triage code and to find out reasons for using Emergency Service instead of Family Practice.

METHODS: This study was performed in a training and research hospital emergency department for one month of the period. After patients, who applied to Emergency Service, were evaluated in Triage Department, the patients with Green Triage Code were assessed by a physician. Patients without acute emergency pathology were informed about the study, and informed consent was taken. It was provided to patients to answer the questionnaire. One thousand twenty-six patients were taken to the study and divided into two groups as emergencies and non-emergencies.
RESULTS: There were 305 patients in the emergency group, and there were 721 patients in non-emergency group. There was no significant difference between an emergency and non-emergency group according to gender, age, education, and the number of emergency applications. The most frequent application was from the younger group of 18-29 age range in both groups. With the increase in the patient age, the number of applications to the Emergency Department due to emergency and non-emergency reasons decreased. 57.30% of the patients who applied to the Emergency Department for non-emergency reasons know who the Family Physician is; 42.70% stated that they did not know who the Family Physician was. 52,10% of the patients who applied to the Emergency Department for non-emergency reasons stated that they knew the location of the health center where the Family Physician worked, and 47.90% of them stated that they did not know the location of the health center where the Family Physician worked.
DISCUSSION AND CONCLUSION: It can be provided to reduce the density of Emergency Service by creating Family Practice awareness. Application difficulties in Family Practice lead patients to apply to Emergency Service more. We believe that to ease application to Family Practice could reduce redundant applications to Emergency Service.

GÝRÝÞ ve AMAÇ: Bozulmuþ açlýk glukozu olan kadýnlarda fibromiyalji sýklýðýný deðerlendirmek.
YÖNTEM ve GEREÇLER: Dahiliye polikliniðine nonspesifik nedenlerle baþvuran kadýnlar arasýndan, rutin muayenesinde açlýk kan þekeri düzeyi 100-126 olanlar çalýþma grubunu (Grup 1) ve açlýk kan þekeri deðeri 100'den küçük olanlar kontrol grubunu oluþturdu (Grup 2). Bozulmuþ açlýk glukozu (BAG) olan hastalara (Grup 1) oral glukoz tolerans testi (OGTT) yaptýrýldý ve 2. Saat OGTT deðeri 140’ýn altýnda olan hastalar çalýþmaya dahil edildi. Fibromiyalji Etki Anketi (FIQ) kullanýlarak fonksiyonel durum deðerlendirildi. Fibromiyalji tanýsý için aðrý yerleþim skoru (AYS) ve semptom etkilenme skorlamasý (SES) deðerlendirildi.
BULGULAR: Ortalama yaþ Grup 1'de 48.99 ± 7.50 (n = 73) ve Grup 2'de 47.84 ± 7.92 idi (n = 73), aralarýnda anlamlý fark yoktu. Ortalama VKÝ (vücut kitle indeksi) Grup 1'de 30.41 ± 5.01, Grup 2'de 28.00 ± 4.61 idi, aradaki fark anlamlýydý (p <0.05). Gruplar mesleki durum, eðitim yýlý, medeni durum bakýmýndan benzerdi. Grup 1'deki hastalarýn% 26'sýna, Grup 2'deki hastalarýn% 11'ine fibromiyalji tanýsý kondu ve aradaki fark anlamlýydý (p <0.001). Ortalama FIQ Grup 1'de 44.27 ± 21.98 ve Grup 2'de 24.95 ± 21.49 idi, aradaki fark anlamlýydý (p <0.001). Glukoz düzeyi, AYS (r = 0.368, p <0.001), SES (r = 0.322 p <0.001) ve FIQ (r = 0.287, p <0.001) ile iliþkiliydi.
TARTIÞMA ve SONUÇ: Fibromiyalji, bozulmuþ açlýk glukozu bozuk olan kadýn hastalarda, açlýk glukoz düzeyi normal olanlara göre daha yaygýndýr. Glukoz düzeyi AYS, SES ve fonksiyonellik ile iliþkilidir. Klinik bir hastalýk olmasa da bozulmuþ açlýk glukozu sadece diyabet geliþimi için bir risk faktörü deðil ayný zamanda kadýnlarda fibromiyalji için bir risk faktörüdür.

INTRODUCTION: To assess the frequency of fibromyalgia among women with impaired fasting glucose.
METHODS: The sample was selected from the female patients who applied to the Internal Medicine clinic and whose fasting blood glucose level were 100-126 in their routine examination (Group1) and patients whose fasting blood glucose were less than 100 constituted the control group (Group2). Oral glucose tolerance test (OGTT) has been applied to patients with impaired fasting glucose (IFG) and whose 2nd hour OGTT levels were under 140 has been included. Functional status was assessed by using the Fibromyalgia Impact Questionnaire (FIQ). Pain Location Inventory (PLI), and Symptom Impact Questionnaire (SIQR) were evaluated for the diagnosis of fibromyalgia.
RESULTS: Mean age was 48.99±7.50 in Group1 (n=73) and 47.84±7.92 in Group2 (n=73) with no significant difference between them. Mean BMI (body mass index) was 30.41±5.01 in Group1 and 28.00±4.61in Group2, this difference was significant (p<0.05). 26% of the patients in Group1, 11% of the patients in Group2 were diagnosed with fibromyalgia and difference was highly significant (p<0.001). Mean FIQ was 44.27±21.98 in Group1 and 24.95±21.49 in Group2, this difference was also significant (p<0.001). Glucose level was associated with PLI (r=0.368, p<0.001), SIQR (r=0.322 p<0.001) and FIQ (r= 0.287, p<0.001).
DISCUSSION AND CONCLUSION: Fibromyalgia is more prevalent in female patients with IFG than in patients with normal fasting glucose levels. Glucose level is associated with both PLI, SIQR and functionality. Although not a clinical disease, IFG is not only a risk factor for development of diabetes but also a risk factor for fibromyalgia in women.

GÝRÝÞ ve AMAÇ: Bu çalýþmada FDG PET görüntülemede prostat bezinde izlenen insidental tutulumlarýn görülme sýklýðýný ve klinik önemini deðerlendirmek amaçlanmýþtýr.

YÖNTEM ve GEREÇLER: Prostat ve mesane kanserleri dýþý endikasyonlarla FDG PET/BT görüntüleme yapýlan 1839 erkek hastanýn PET raporlarý retrospektif olarak prostatta insidental FDG tutulumu açýsýndan tarandý. PET/BT görüntülerinde prostatta FDG tutulum varlýðý ve paterni (fokal-diffüz), prostat volümü ve kalsifikasyon varlýðý deðerlendirildi. Takipte prostata yönelik yapýlmýþ ileri inceleme sonuçlarý FDG PET bulgularý ile karþýlaþtýrmalý olarak deðerlendirildi.
BULGULAR: Takipte 1839 hastanýn %2.22’sinde prostatta insidental artmýþ FDG tutulumu saptanmýþtýr. Takipte 41 hastadan 14’üne biyopsi yapýlmýþ(%34,14), biyopsi yapýlan olgularýn 3’ünde(%7,31) histopatolojik olarak prostat adenokarsinomu konfirme edilmiþtir. Ayrýca 2 hastada inflamasyon/prostatit, 4 hastada ise BPH ile uyumlu bulgular izlenmiþtir. FDG tutulumu 12 hastada diffüz tutulum, 29 hastada fokal tutulum þeklinde izlenmiþtir. Malign olan hastalarýn hepsinde FDG tutulumu periferal yerleþimli olup;fokal tutulum paterninde izlenmiþtir. Benign ve malign gruplarýn SUVmaks ve PSA düzeyleri arasýnda anlamlý fark izlenmemiþ olup; SUVmaks deðerinin iki grupta örtüþtüðü gözlenmiþtir.
TARTIÞMA ve SONUÇ: Prostatta izlenen insidental FDG tutulumlarý prostat kanseri ile uyumlu olabileceði gibi benign patolojilerde ve normal prostat dokusunda da artmýþ FDG tutulumu izlenebilmektedir. Malign ve benign patolojilerde izlenen SUVmaks deðerlerinin örtüþmesi nedeniyle malignite ayýrýcý tanýsýnda tek baþýna SUVmaks deðerinin kullanýmý uygun görünmemektedir. Prostatta fokal FDG tutulumu izlenen hastalarda olasý malignite açýsýndan ileri klinik deðerlendirme önerilir.

INTRODUCTION: This study aims to disclose the frequency and clinical significance of incidental prostatic uptake during FDG PET imaging.
METHODS: FDG PET images of 1839 male patients undergoing imaging for non-prostate and non-urinary bladder malignancy indications were retrospectively reviewed for the presence of incidental prostatic FDG uptake. Prostatic volume, calcification and the presence and pattern of FDG uptake were evaluated. Further follow-up prostatic evaluation results were comparatively assessed.
RESULTS: Incidental prostatic FDG uptake was detected in 41 out of 1839 patients(2.22%). Biopsy was done in 14 patients(34,14%) on follow-up and disclosed prostatic adenocarcinoma in 3(7.31%), inflammation/prostatitis in 2 and findings compatible with BPH in 4 patients.The pattern of FDG uptake was diffuse in 12 and focal in 29 patients. Patients who were found to have adenocarcinoma on follow-up disclosed FDG uptake with a focal pattern at a peripheral location. No significant difference existed between patients with malignant or benign disease of the prostate with respect to either the SUVmax or the PSA levels; SUVmax levels were found to overlap in the two groups.
DISCUSSION AND CONCLUSION: Incidental prostatic FDG uptake may be associated with prostate cancer, benign pathologies and even a normal prostate gland. Overlapping SUVmax levels in the benign and malignant pathologies make SUVmax level alone an inappropriate tool in the diagnosis of cancer. Further clinical investigation is warranted to disclose a probable prostatic malignancy in patients who display incidental prostatic FDG uptake on PET imaging employed for various other indications.

Koronavirüsler, hayvanlarý veya insanlarý enfekte edebilen ve Orta Doðu Solunum Sendromu (MERS) ve Þiddetli Akut Solunum Sendromu (SARS) gibi hastalýklara neden olan büyük bir virüs ailesidir. Yeni koronavirüs (SARS-CoV-2) Aralýk 2019'da Wuhan þehrinde ortaya çýkan ve pnömoni, pulmoner ödem, ARDS, multiorgan yetmezliði ve ölüme sebebiyet verebilen bir solunum yolu enfeksiyon etkenidir. Tedavi çalýþmalarý devam etmekle birlikte þu an hidroksiklorokin, azitromisin, plazma tedavisi ve favipravir gibi anti-viraller öne çýkan tedavilerdir. Hastalýðýn ölüm oraný %3,8'dir. Yayýlýmýn azalmasýný saðlamak amacýyla yasal düzenlemeler yapýlmýþtýr. Aile saðlýðý merkezleri (ASM) çocuk, gebe, yaþlý, kronik hastalýðý olan hastalar ve birtakým saðlýk belgeleri için baþvuran kiþilere hizmet veren birinci basamak saðlýk kurumlarýdýr. Pandemi varlýðýnda aile hekimleri, ASM’lere baþvuran kiþiler arasýnda virüs iletimini kýsýtlamak zorundadýr. Bu nedenle triaj yapýlmasý yüksek riskli hastalarý mümkün olan en kýsa sürede saptamak için gereklidir. ASM’lere baþvuran tüm hastalar bu þekilde korunabilir. Filyasyon yapýldýktan sonra, þüpheli vakalar veya COVID-19 ile temas eden vakalar aile hekimleri tarafýndan klinik durumlarýnýn takip edilmesi ve izolasyon koþullarýnýn kontrol edilmesi amacýyla günlük olarak takip edilmektedir. Tüm bu nedenlerden ötürü, COVID-19 ile mücadele eden aile saðlýðý merkezlerini incelemeyi amaçladýk.

The coronaviruses are a large family of viruses infecting animals or humans and causing diseases, including Middle East Respiratory Syndrome(MERS, MERS-CoV) and Severe Acute Respiratory Syndrome(SARS, SARS-CoV). The novel coronavirus SARS-CoV-2 emerged in December 2019 at city of Wuhan, affecting respiratory system leading to pneumonia, pulmonary edema, Acute Respiratory Distress Syndrome, multiorgan failure and death. Treatment studies are still ongoing but hydroxychloroquine, azithromycin, oseltamivir, favipravir with some other anti-virals and convolescent plasma therapy are prominent. Mortality rate of disease is 3,8% in the world, infesting many countries. Legal regulations have been made for public to reduce transmission. Family health centers are providing healthcare services to every individual, for example; children, pregnants, patients with chronic diseases, patients with any complaint and individuals applied for health papers. In such a pandemic family physicians also have to restrain the transmission of virus between those people who applied. Therefore triage is needed to determine the high risk patients as soon as possible. Both them and other patients are protected in that way. After the filiation is done, suspected case or COVID-19 contacted cases are kept in touch by family phyisicians to follow up their clinical status and check for isolation conditions. For all these reasons, we aimed to examine the family health centers coping with COVID-19.

Bu yazýda, halen görülmeye devam eden 21. Yüzyýlýn en büyük pandemisinde geçmiþten bugüne yapýlan hazýrlýklar ve bu hazýrlýklarýn yeni corona virüs salgýný (Covid19) üzerine etkilerini Dünya ve Türkiye genelinde yapýlan çalýþmalar üzerinden derlemeyi amaçladýk. Pandemiler yüzyýllardýr milyonlarca insanýn ölmesine sakat kalmasýna ve hastalanmasýna neden olmuþlardýr. Toplumu saðlýk, sosyal ve ekonomik olarak derinden etkilemektedirler. Pandeminin, etkilerinin azaltýlmasýna yönelik geçmiþten ders çýkarýlmalýdýr. Hazýrlýklar planlandýðý gibi gitmeyebilir. Ön görülemeyen durumlara yönelik çaresizlikler oluþabilir. Bu çaresizliklere raðmen pandemi ile mücadelede temel ilkeler yanýnda, uygulamada katký saðlayabilecek araçlar mutlaka vardýr. Covid-19 pandemisi her salgýn gibi bir gün mutlaka sonlanacaktýr. Salgýn sonrasýnda yapýlanlar ve yapýlmayanlar deðerlendirildiðinde ortak akýl ve kanýta dayalý uygulamalar kazanacak ve paylaþýlanlar hatýrda kalacaktýr.

In this article, we aimed to review the preparations that made from the past to present, and the effects of these preparations on the novel coronavirus outbreak, which is the greatest and ongoing pandemic of the 21st century, in the light of the studies done across the world and Turkey. Pandemics have caused millions of people to die and become ill for centuries. They affect society profoundly, socially, and economically. Lessons should be drawn from the past to reduce the effects of a pandemic. Preparations may not go as planned. Desperation may occur for unforeseen situations. Despite these despair, besides the basic principles in combating pandemic, there are definitely tools that can contribute to practice. Covid-19 pandemics will definitely end one day like all epidemics. When the things that done and the things not done after the epidemic are evaluated, common mind and evidence-based practices will win and those shared will be remembered.

Yeni tip Corona virus (COVID-19), 2019 yýlý sonunda Çin Wuhan kentinden dünyaya yayýlan, çok sayýda insana bulaþan ve ölümcül bir pandemi olarak tanýmlanmýþtýr. Diðer Coronavirüs enfeksiyonlarýna kýyasla bulaþýcýlýðý yüksek, ölüm oraný düþük olan bu enfeksiyon en fazla 30-79 yaþ arasýnda görülse de 80 yaþ üzeri populasyonda mortalitesi çok yüksektir. Gebelerde hastalýðýn seyri ve fetal-neonatal etkiler açýsýndan elimizde sýnýrlý veri olmasýna raðmen anne ve bebek saðlýðýný koruma açýsýndan dikkat edilmesi gereken bazý hususlar vardýr. Bu derleme yeni tip Corona virüs enfeksiyonu hakkýnda genel bilgiler içermektedir.

The new type of Corona virus (COVID-19) has been identified as a deadly pandemic, infected to a lot of people spread from Wuhan city in China at the end of 2019. Although this infection, which has a high spread from people to people and low mortality rate than the other coronavirus infections, is common between 30-79 years of age, the mortality rate is very high in the population over 80 years of age. Although we have limited data in terms of the consequences of the disease in pregnant women and its fetal-neonatal effects there are some issues to be considered in terms of protecting the health of the mother and baby. This review includes general information about the new type of Corona virus infection.

Pandemilerde genelde saðlýk sistemleri, özelde ise saðlýk profesyonelleri için çalýþma yükü ve stresi belirgin derecede artar. Uzun mesai saatleri, aðýrlaþan çalýþma ortamý koþullarý, hasta sayýsýyla birlikte toplumun beklenti ve kaygýlarýndaki çoðalma ve de çalýþanlarýn kendilerinin hastalanma riskleri bir bütün olarak saðlýk çalýþanlarýnýn genel psikososyal iþlevselliðine ve dayanýklýlýðýna etkide bulunur. Bu dönemlerde psikolojik incinebilirlik riski artan çalýþanlara yönelik destekleyici psikososyal hizmet ve programlarýn sunulabilmesi için koruyucu faktörler ve risk faktörleri üzerinde çalýþma ihtiyacý doðmaktadýr. Bu derlemenin amacý, pandemi dönemlerinde saðlýk çalýþanlarýnýn psikososyal saðlýðýný etkileyen koruyucu faktörlerin ve risk faktörlerinin, yakýn dönem salgýnlarla ilgili (SARS, MERS–CoV ve çoðunlukla Covid–19 örneklerinde) literatür bilgilerine dayalý olarak gözden geçirilmesidir. Ýnceleme, psikososyal deðiþkenlerin deðerlendirildiði araþtýrmalarla sýnýrlandýrýlarak yapýlmýþtýr. Saðlýk çalýþanlarý pandemilerde, anksiyete, depresyon, travma sonrasý stres bozukluðu gibi psikiyatrik bozukluklarý ve tükenmiþlik gibi belirtileri toplumun geneline göre daha yüksek düzeyde gösterebilmektedir. Pandemilerin psikososyal yönlerini inceleyen çalýþmalara göre, kadýnlar ve hemþireler daha fazla etkilenmektedirler. Hijyen koþullarýnýn uygunluðu, koruyucu ekipmanlara yeterli eriþim, dengeli çalýþma–dinlenme saatleri, pandemi ekip üyeleri arasýndaki sosyal ve duygusal destek iliþkileri ve yönetim birimlerinden saðlanan destekleyici hizmetler koruyucu faktörler arasýndadýr. Saðlýk çalýþanlarýnýn stigmatizasyona karþý korunmasý ve toplumsal olarak desteklenmesi psikososyal saðlýklarýný korumada etkili olacaktýr.

In pandemics, work load and stress levels increase significantly for healthcare systems in general and healthcare professionals in particular. Long working hours, difficult working environment conditions, the increase in the expectations and concerns of the society together with the number of patients, and the risks of getting infected themselves affect the overall psychosocial functionality and resilience of healthcare workers. In these periods, there is a need to work on protective and risk factors in order to provide supportive psychosocial services and programs for healthcare workers considering their increased risk of vulnerability levels. This review aims to review the protective and risk factors affecting the psychosocial health of healthcare workers during pandemics, based on literature information about recent outbreaks (SARS, MERS-CoV and mostly Covid-19 examples). The examination was limited to studies in which psychosocial variables were evaluated. Healthcare professionals may show the symptoms of psychiatric diorders such as anxiety, depression, post-traumatic stress disorder and burnout at a higher level in pandemics than the general population. Studies examining the psychosocial aspects of pandemics have shown that women and nurses are more affected. Adequate hygienic conditions, access to protective equipment, balanced working–resting hours, social and emotional support relationships between work teams and supportive services from management units are among the protective factors. In order to protect the psychosocial health of healthcare workers, they should be protected against stigmatization and socially supported.

Günümüzde saðlýk alanýnda yapýlan çalýþmalarýn artmasý sonucu diþ hekimliði literatürü hýzla geniþlemektedir. Literatürde yer alan tüm geliþmeleri takip etmenin zorluklarý nedeniyle araþtýrma sonuçlarý ve klinik uygulamalar arasýnda kopukluklar meydana gelmektedir. Bu sebeple, bireysel klinik deneyime dayanan karar verme süreci, yerini kanýta dayalý uygulamalara býrakmaya baþlamýþtýr. Kanýta dayalý diþ hekimliði, mevcut en iyi tedaviyi saðlamak için bilimsel kanýtlarýn ve hastayla ilgili faktörlerin bir bütün olarak deðerlendirilmesine dayanmaktadýr. Kanýta dayalý diþ hekimliði uygulamalarýnýn en önemli amacý tedavi hizmetlerini geliþtirmektir. Ancak, çok hýzlý bilgi akýþý sonucu doðru kanýta ulaþma ve kanýtlarý deðerlendirme noktasýnda bazý zorluklarla karþýlaþýlmaktadýr. Kanýta dayalý karar verme sürecinde, kanýta dayalý diþ hekimliðinin klinik uygulamalarý klinisyenlerin deneyimlerini, modern araþtýrmalara entegre etmesini saðlayarak mümkün olan en iyi saðlýk hizmetine ulaþýlmasýný saðlamaktadýr. Bu derlemede, kanýta dayalý diþ hekimliði ve çocuk diþ hekimliðindeki uygulamalar yer almaktadýr.

As a result of increasing number of studies in the field of health, the dental literature is expanding rapidly. Due to the difficulties of following all the developments in the literature, inconsistencies occur between the research results and clinical applications. For this reason, decision process depending on the individual experience has been replaced by evidence-based practice. Evidence-based dentistry is based on the entire evaluation of scientific evidences and patient-related factors to provide the best treatment. The most important goal of evidence-based dentistry practices is to improve treatment services. However, due to very fast flow of information, problems about reaching and evaluating evidence can be encountered. In the evidence-based decision-making process, clinical practice of evidence-based dentistry ensures reaching the best possible healthcare by enabling clinicians to integrate their experience into modern research. In this review, evidence-based dentistry and applications in pediatric dentistry are included.