GÝRÝÞ ve AMAÇ: Koroner arter hastalýðý (KAH) tanýsý alan hastalarýn sýklýkla eþlik eden hastalýklarýnýn da olmasý nedeniyle tedavide birçok ilacýn birlikte kullanýlmasýyla hastalýðýn yönetiminde tedaviye uyum önem kazanmaktadýr. Tedaviye uyumsuzluk ilaçlarýn doz ve kullaným saatlerine uyulmamasý nedeniyle ortaya çýkabilir. Bu çalýþmada KAH tanýlý hastalarda polifarmasi ve multimorbiditenin tedavi uyum ile iliþkisinin araþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Kesitsel bir araþtýrma olan bu çalýþma; polikliniðe baþvuran KAH tanýsý almýþ ≥ 40 yaþ hastalarla gerçekleþtirilmiþtir. Araþtýrmacýlar tarafýndan hazýrlanan sosyodemografik özelliklerin, hastalýk öykülerinin, ilaç kullanýmlarýnýn sorulduðu soru formu yüz yüze görüþmelerde doldurulmuþtur. Günlük kullanýlan ilaç sayýlarý <4, 4-6 ve ≥7 ilaç olarak deðerlendirilmiþtir. Tanýmlayýcý ve analitik istatistikler ile veriler deðerlendirilmiþtir.
BULGULAR: Çalýþmaya alýnan 144 KAH tanýlý hastanýn 74’ü tedaviye uyum gösteriyordu. Tedaviye uyum göstermeyen 70 hastanýn yaþ ortalamasýnýn tedaviye uyumlu hastalardan daha düþük olduðu(p=0,001) ancak cinsiyet ve medeni durumlarý arasýnda fark olmadýðý görülmüþtür. Hipertansiyonu olan hastalarýn tedaviye daha uyumlu olduðu bulunmuþtur(p=0,032). Tedaviye uyum gösteren hastalarda, günlük ≥7 ilaç kullanýmýnýn, ilaç kullaným sürelerinin ve hastaneye yatýþ sayýsýnýn daha yüksek olduðu gözlenmiþtir (sýrasýyla; p=0,034; p=0,005; p=0,001).
TARTIÞMA ve SONUÇ: Ýlaç kullaným süresinin, günlük ilaç sayýsýnýn, hastaneye yatýþ sayýsýnýn, yaþýn ve eþlik eden hastalýklarýn KAH tanýlý hastalarda tedavi uyumunu etkilediði görülmüþtür. Kullanýlan günlük ilaç sayýsý azaldýkça tedavi uyumunun azaldýðý gözlenmiþtir; bu durumun KAH ile ilgili farkýndalýðýn yetersiz olmasýyla iliþkili olabileceðini ve günlük pratikte KAH tanýlý hastalarda tedavi uyumunun araþtýrýlmasýnýn gerekli olduðunu düþünmekteyiz.

INTRODUCTION: Patients diagnosed with coronary artery disease (CAD) often have comorbidities and many drugs are used together in treatment, so medication adherence becomes important in the management of the disease. Non-adherence to treatment may be caused by failure to comply with the dosage and hours of use of the medications. The aim of this study was to investigate the association of polypharmacy and multimorbidity with medication adherence in patients with CAD.
METHODS: This cross-sectional study was conducted with patients≥ 40 years of age who were diagnosed with CAD and admitted to the outpatient clinics. A questionnaire prepared by the researchers about sociodemographic characteristics, history of the disease, and medications that were used, during face-to-face interviews. Daily medications were evaluated as <4, 4-6, and ≥7 medications. Data were evaluated by descriptive and analytical statistics.
RESULTS: A total of 144 patients with CAD were included in the study and 74 of them were adherent to medications. The mean age of 70 nonadherent patients was lower than the adherent patients(p=0.001) but there was no difference according to gender and marital status. Hypertensive patients were more adherent to their medications(p=0.032). In patients adherent to medications, we observed that the presence of daily≥7 medications, the duration of medications, and the number of hospitalizations were higher (p=0.034; p=0.005; p=0.001; respectively).
DISCUSSION AND CONCLUSION: Medication adherence in patients with CAD was affected by the duration of medications, number of daily medications, number of hospitalizations, age, and comorbidities. Adherence decreased as the number of daily medications decreased which we think may be associated with inadequate awareness about CAD and that it is necessary to investigate medication adherence in daily practice in patients with CAD.

GÝRÝÞ ve AMAÇ: Akut apandisit sýk görülen abdominal acillerden biridir. Bu çalýþmada yetiþkin acil servis popülasyonunda basit apandisit ve komplike apandisiti ayýrmada rutin idrar tahlilinin kullanýlabilirliðini deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmaya 18 yaþ üzeri patolojik tanýsý akut apandisit olan ve acil serviste idrar analizi yapýlmýþ hastalar dahil edildi. Eksik verisi olan hastalar çalýþma dýþý býrakýldý. Patoloji raporlarýna göre, hastalar basit ve komplike apandisit olarak sýnýflandýrýldý.
BULGULAR: Basit apandisit grubu ile karþýlaþtýrýldýðýnda komplike apandisit grubunda, idrar keton cisimleri, protein ve nitrit sayýmý anlamlý olarak daha yüksekti (tüm deðerler için p <0,05). Çok deðiþkenli lojistik regresyon analizinde, keton cisimleri ve idrar nitrit pozitifliði komplike apandisit varlýðýný tahmin etmede istatistiksel olarak anlamlý bulundu (tüm deðerler için p <0,001).
TARTIÞMA ve SONUÇ: Ýdrar analizi, akut batýndan þüphelenilen hastalarda yapýlan rutin testlerden biridir. Bu nedenle, biz idrar tahlilinde idrarda keton ve nitrit pozitifliðinin komplike apandisit açýsýndan uyarýcý olabileceðini düþünüyoruz.

INTRODUCTION: Acute appendicitis is one of the common abdominal emergencies. We aimed in this study to evaluate whether routine urinalysis may use in discriminating between simple appendicitis and complicated appendicitis in the emergency department.Acute appendicitis is one of the common abdominal emergencies. We aimed in this study to evaluate whether routine urinalysis may use in discriminating between simple appendicitis and complicated appendicitis in the emergency department.Acute appendicitis is one of the common abdominal emergencies. We aimed in this study to evaluate whether routine urinalysis may use in discriminating between simple appendicitis and complicated appendicitis in the emergency department.
METHODS: Patients over 18 years of age with a pathological diagnosis of acute appendicitis and those who underwent urine analysis in the emergency department were included in the study. Patients with missing data were excluded. According to pathology reports, patients were classified as simple and complicated appendicitis.
RESULTS: Compared to simple appendicitis, the complicated appendicitis group had significantly higher urine ketone body, protein, and nitrite counts on admission (p<0.05 for all parameters). Urine ketone bodies and positive urine nitrite were found to predict statistically significant complicated appendicitis in multivariate logistic regression analysis (for all values p<0.001).
DISCUSSION AND CONCLUSION: Urine analysis is one of the routine tests performed in patients with suspected acute abdomen. Therefore, we think that especially urine ketone bodies and positive urine nitrite in urine analysis may be a warning for complicated appendicitis.

GÝRÝÞ ve AMAÇ: Diyabet hastalarýnda cinsel iþlev bozukluklarýnýn (CÝB) sýklýðýna dair çalýþmalar, cinsel psikofizyoloji çok sayýda deðiþkenden etkilenebildiði için, oldukça farklý sonuçlar üretmektedir. Bu farklý sonuçlarý konsolide edecek yöntemlerle yapýlmýþ bölgesel çalýþmalara ihtiyaç vardýr. Bu meta-analiz çalýþmasýnýn amacý diyabet hastalýðý olan kadýnlarda CÝB yaygýnlýðýný ortaya koymak ve CÝB yaygýnlýðý üzerine olasý diyabetik ve demografik deðiþkenlerin etkilerini incelemektir.
YÖNTEM ve GEREÇLER: Bu meta-analiz çalýþmasý için literatür “Google Akademik” veri tabaný ile taranmýþtýr. Ocak 2000 ile Aðustos 2020 tarihleri arasýnda Türkiye’de yapýlmýþ diyabet hastalýðý olan kadýnlarda CÝB araþtýran gözlemsel çalýþmalar dahil edilmiþtir.
BULGULAR: Diyabetik kadýnlarda CÝB yaygýnlýðý rastgele etkiler modeline göre %58,95 bulunmuþtur. Uyarýlma, istek, aðrý, doyum, lubrikasyon ve orgazm bozukluklarý ise sýrasýyla %57,75, %56,63, %45,63, %40,22, %38,61 ve %49,25 olarak saptanmýþtýr. Meta-regresyon sonuçlarýna göre CÝB üzerine HbA1c, diyabet hastalýðýnýn süresi, yaþ ve vücut kitle indeksinin etkisi saptanmamýþtýr.
TARTIÞMA ve SONUÇ: Türkiye’de diyabet hastalýðý olan kadýnlarda CÝB’in yaygýnlýðý genel popülasyondan yüksektir. Taný koymada yaþanan olasý sorunlar da dikkate alýndýðýnda bu hastalarýn mutlaka CÝB bakýmýndan sorgulanmalarý ve gerekli hastalarýn özelleþmiþ kliniklere yönlendirilmeleri gereklidir.

INTRODUCTION: Since sexual psychophysiology can be affected by many variables, studies on the frequency of sexual dysfunction (SD) in diabetic patients produce quite different results. There is a need for regional studies conducted with methods to consolidate these different results. The purpose of this meta-analysis study is to reveal the combined prevalence of SD in women with diabetes and to examine the effects of possible diabetic and demographic variables on the prevalence of SD.
METHODS: For this meta-analysis study, the literature was searched with the "Google Scholar" database. Observational studies investigating SD in women with diabetes in Turkey between January 2000 and August 2020 were included in the meta-analysis.
RESULTS: The prevalence of SD in diabetic women was 58.95% according to the random-effects model. Arousal, desire, pain, satisfaction, lubrication and orgasm disorders were found as 57.75%, 56.63%, 45.63%, 40.22%, 38.61% and 49.25%, respectively. According to meta-regression results, the effects of HbA1c, diabetes duration, age, and body mass index on SD were not determined.
DISCUSSION AND CONCLUSION: SD is higher than the general population of women with diabetes in Turkey. Considering the possible problems encountered in diagnosis, these patients should be questioned for SD and the necessary patients should be directed to specialized clinics.

GÝRÝÞ ve AMAÇ: Bu çalýþma ile T1DM’li çocuklarýn kaygý ve depresyon durumunu belirleyerek, bu durumun ebeveynlerin baþa çýkma tutumlarý ve yýlmazlýk düzeyleri ile olan iliþkisini ve glisemik kontrol üzerine olan etkilerini saptamayý amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmamýza toplam 71 hasta ve bu hastalarýn ebeveynleri alýnmýþtýr. Çocuklara, Çocuk Depresyon Ölçeði (ÇDÖ) ve Çocuklar Ýçin Anksiyete Tarama Ölçeði (ÇATÖ), ebeveynlerine Baþa Çýkma Tutumlarýný Deðerlendirme Ölçeði (BÇTDÖ) ve Aile Yýlmazlýk Ölçeði (AYÖ) uygulanmýþtýr. Tüm katýlýmcýlara kiþisel bilgi formu doldurulmuþtur. Hastalarýn glisemik kontrol düzeyleri son bir yýldaki ortalama glikolize hemoglobin (HbA1c) düzeylerine göre deðerlendirilmiþtir.
BULGULAR: Annenin yýlmazlýk düzeyi arttýkça çocuðun depresyon durumunun azaldýðý görülmüþtür. Anne ve babada en fazla sorun odaklý baþa çýkma tutumu olduðu gözlendi. Baþa çýkma tutumlarýnýn alt ölçekleri deðerlendirildiðinde; diyabet süresi ile annenin ‘zihinsel boþ verme’, babanýn ise ‘aktif baþ etme’, ‘plan yapma’ ve ‘sosyal destek kullanýmý’ arasýnda negatif iliþki saptanmýþtýr. Yine annenin baþa çýkma tutumu alt ölçeðinden ‘þakaya vurma’ ile çocuðun depresyon durumu arasýnda ve ‘aktif baþ etme’ ile çocuðun anksiyete düzeyi arasýnda pozitif iliþki saptandý.
TARTIÞMA ve SONUÇ: Kronik hastalýða sahip çocuklarý olan ebeveynler farklý baþa çýkma tutumlarý sergilemektedirler. Bu tutumlar çocuk üzerinde deðiþik etkilere neden olmaktadýr. Sonuçta ailelerin uygun baþ etme stratejilerini kullanmalarý çocuklarý üzerinde olumlu etki yaratacaktýr. Bu konuda aileleri yönlendirmek önem arz etmektedir.

INTRODUCTION: With this study, we aimed to identify the anxiety and depression status of children with T1DM and to determine its relationship with parents' coping attitudes and resilience levels and the effects on glycaemic control.


METHODS: Our study included seventy-one patients of T1DM and their parents. We applied the Children's Depression Inventory (CDI) and the Screen for Child Anxiety Related Disorders (SCARED) to the children, and the COPE Inventory and the Family Resilience Scale (FRS) to the parents. All participants filled out the personal information form was filled out. The patients' glycaemic control levels were assessed based on the average glycosylated hemoglobin (HbA1c) levels of the previous year.
RESULTS: The child's depression status decreased as the mother's resilience increased. In the mothers and fathers, the most frequently observed problem was problem-focused coping attitudes. When we evaluated the subscales of the coping attitudes, a negative statistically significant correlation was determined between the duration of diabetes and the mother's "mental disengagement," and the father's "active coping," "planning," and "using social support." Again, a positive statistically significant correlation was identified between the mother's "humor" coping attitude subscale and the child's depression status, and between "active coping" and the child's anxiety level.
DISCUSSION AND CONCLUSION: Parents with children who have a chronic disease exhibit different coping attitudes. These attitudes cause various effects on the child. In conclusion, families using appropriate coping strategies will have a positive impact on their children. It is essential to guide families in this respect.

GÝRÝÞ ve AMAÇ: Diyabetik hastalardaki mortalite ve morbiditenin çoðundan zamanla geliþen makrovasküler ve mikrovasküler komplikasyonlar sorumludur. Ýyi glisemik kontrol ile MPV ve PDW düzeylerinin azalmasý saðlanabilir ve böylece hastalarda vasküler komplikasyonlar önlenebilir ya da geciktirilebilir. Bu çalýþmanýn amacý Tip 2 Diabetes Mellitus (DM) hastalarýnda HbA1c ve artmýþ MPV ve PDW düzeyleri iliþkisini deðerlendirmekti.
YÖNTEM ve GEREÇLER: Çalýþma, Ankara Atatürk Eðitim ve Araþtýrma Hastanesi Aile Hekimliði ve Endotem polikliniklerine Haziran 2016-Nisan 2017 tarihleri arasýnda genel saðlýk kontrolü amaçlý baþvurmuþ ve Tip 2 DM tanýsý ile takipli 18 yaþ üzeri hastalarýn demografik bilgileri ve laboratuvar kayýtlarýnýn retrospektif olarak incelenmesi ile gerçekleþtirilmiþtir.
BULGULAR: Toplamda 112 diyabetik, 33 non diyabetik kriterleri karþýlayan; biyokimyasal verileri mevcut olan 145 hasta çalýþmaya alýndý. Kontrol grubu (n=33) diyabetik hasta grubu HbA1c≤ %7 (n=46) ve HbA1c > %7 (n=66) olmak üzere 2 gruba ayrýldý. HbA1c deðerlerine göre MPV ve PDW deðerleri arasýnda istatiksel olarak anlamlý pozitif korelasyon saptanmýþtýr (sýrasýyla p1=0,001, p2=0,001ve p3=0,001).
TARTIÞMA ve SONUÇ: Mevcut glisemik disregülasyon vasküler komplikasyona neden olan MPV ve PDW gibi trombosit aktivasyon belirteçlerinin artýþýna sebep olmaktadýr. Bizim çalýþmamýzýn sonucunda MPV’nin ve PDW’nin, DM progresyonunu izlemek ve dolaylý olarak birinci basamak saðlýk hizmetlerinde vasküler komplikasyonlarýn önlenmesinde, taranmasýnda basit ve düþük maliyetli testler olarak kullanýlabileceði düþünülmektedir. Böylece erken taný ve uygun tedavi ile diyabetik vasküler komplikasyonlarýn geliþimi ve ilerlemesi geciktirilebilir.

INTRODUCTION: Macrovascular and microvascular complications are major responsible for mortality and morbidity that develop over time in diabetic patients. MPV and PDW levels can be reduced with good glycemic control and thus prevented or delayed vascular complications in patients. This study aimed to evaluate the relationship between HbA1c and increased MPV, PDW levels in Type 2 DM patients.
METHODS: The study was conducted retrospectively to demographic information and laboratory records of patients over 18 years old who were admitted to Ankara Atatürk Training and Research Hospital Family Medicine and Endotem policlinics for general health check-up and diagnosed with Type 2 DM between June 2016 and April 2017.
RESULTS: A total of 112 diabetic, 33 non-diabetic criteria are met; 145 patients with biochemical data were included in the study. The control group (n = 33) was divided into 2 groups, diabetic patient group HbA1c≤ 7% (n = 46) and HbA1c> 7% (n = 66). There was a statistically significant positive correlation was found between MPV and PDW values according to HbA1c values (p1 = 0.001, p2 = 0.001, p3 =0.001, respectively).
DISCUSSION AND CONCLUSION: Current glycemic dysregulation cause to increase in platelet activation markers such as MPV and PDW, which cause vascular complications. As a result of our study, it is thought that MPV and PDW can be used as simple and low-cost tests to monitor DM progression and thus to prevent and screen vascular complications in primary health care. Early diagnosis and appropriate treatment may delay the development and progression of diabetic vascular complications.

GÝRÝÞ ve AMAÇ: Sigara ve tütün kullanýmý olan olgularda anksiyete bozukluðu, depresyon ve diðer psikiyatrik bozukluklar daha sýk bir arada görülmektedir. Bu çalýþmada sigara býrakma polikliniðine baþvuran ve ilk deðerlendirmede psikiyatri polikliniðine konsülte edilen ve edilmeyen olgular arasýnda 1. yýl sonunda sigara býrakma açýsýndan farklýlýk olup olmadýðýný araþtýrmak amaçlandý.
YÖNTEM ve GEREÇLER: Sigara býrakma polikliniðimize 2017 yýlýnda baþvuran toplam 197 olgu çalýþmaya dahil edildi. Sigara býrakma polikliniðine baþvuran olgular içerisinde Hastane Anksiyete ve Depresyon ölçeði puanlarýna göre psikiyatri bölümüne konsülte edilen 96 olgu “grup 1” ve psikiyatri konsültasyonu yapýlmayan 101 olgu ise “grup 2” olarak sýnýflandý. Tüm olgularýn demografik verileri sigara içme tutum ve davranýþlarý, komorbid hastalýklarý, aldýklarý tedaviler ve 1. yýlda sigara býrakma durumlarý kaydedildi.
BULGULAR: Grup 1 ve grup 2 olgular karþýlaþtýrýldýðýnda 1. yýlda sigara býrakma oranlarý açýsýndan anlamlý farklýlýk yoktu [Ngrup 1 sigara býrakanlar= 22 (%22,90), Ngrup 2 sigara býrakanlar= 23 (%22,70), p=0,67]. Alt grup analizinde 1. Yýl sigara býrakan olgularda; grup 1 olgularýn grup 2 olgulara göre daha yüksek oranlarda davranýþsal tedavi ve NRT tedavisi aldýklarý görüldü (Ngrup 1 sigara býrakanlar= 33 (%44,60), Ngrup 2 sigara býrakanlar= 17 (%21,80); p=0,002). Grup 2 olgularýn ise grup 1 olgulara göre davranýþsal tedavi ve vareniklin tedavisini daha fazla aldýklarý belirlendi [Ngrup 1 sigara býrakanlar= 6 (%8,10), Ngrup 2 sigara býrakanlar= 33 (%51,10); p=0,002].
TARTIÞMA ve SONUÇ: Sigara býrakma polikliniðine baþvuran ve tarama testlerine göre psikiyatrik deðerlendirme ihtiyacý olduðu saptanan olgularýn, etkin farmakolojik ve psikiyatrik destekle anksiyete ve depresyon skoru düþük olgulara benzer oranlarda sigarayý býrakabildiði görülmüþtür. Bu nedenle olgularýn anksiyete depresyon açýsýndan deðerlendirilerek psikiyatri polikliniklerine yönlendirilmesinin ve bu hastalarýn sigara býrakma programlarýnýn psikiyatri ile eþ zamanlý yürütülmesinin önemli olduðu düþünülmüþtür.

INTRODUCTION: It is known that anxiety disorder, depression and other psychiatric disorders are more common in patients with smoking and tobacco use. In our study, it was aimed to investigate whether there was any difference in the first-year follow-up between patients who applied to the smoking cessation clinic and those who were not consulted to psychiatry at the first evaluation.
METHODS: A total of 197 cases who applied to our smoking cessation policlinic in 2017 were included in the study. Among the patients who applied to the smoking cessation outpatient clinic, 96 patients who were consulted to psychiatry were evaluated as "group 1" and 101 patients who were not consulted to psychiatry as "group 2". Demographic data and smoking attitudes and habits of all cases, comorbid diseases, treatments they received, and smoking cessation in the first year were recorded.
RESULTS: When group 1 and group 2 were compared, there was no significant difference in the cases referred to psychiatry in terms of smoking cessation rates in the first year [Ngrup 1 quitters = 22 (22.90%), Ngrup 2 quitters = 23 (22.70%), p = 0.67]. In the subgroup analysis, in cases who quit smoking in the first year; It was observed that group 1 cases received behavioral treatment and NRT treatment at higher rates than group 2 cases (Ngrup 1 quitters = 33 (44.60%), Ngrup 2 quitters = 17 (21.80%); p = 0.002). It was determined that group 2 cases received behavioral treatment and varenicline treatment more than group 1 cases [Ngrup 1 quitters = 6 (8.10%), Ngrup 2 quitters = 33 (51.10%); p = 0.002].
DISCUSSION AND CONCLUSION: It was found that the patients who were found to have a high need for psychological support who applied to the smoking cessation clinic were able to quit smoking at rates similar to those with low anxiety and depression scores with effective pharmacological and psychiatric support.

GÝRÝÞ ve AMAÇ: Metabolik sendrom (MS) kavramý, temelinde yatan insülin direnci (ÝR) ve kardiyovasküler hastalýða ait risk faktörlerinin kümelenmesi nedeni ile kritik bir öneme sahiptir. Biz bu çalýþmamýzda geleneksel kardiyovasküler risk faktörlerinin yanýnda MS kriterlerinin kardiyovasküler riski öngörmedeki deðerini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþma tanýsal amaçla koroner anjiyografi (KAG) yapýlan 264 hasta üzerinde yapýlmýþtýr. KAG sonucuna göre bir veya daha fazla koroner arterinde anlamlý daralma saptanan olgular koroner arter hastalýðý (KAH) grubu ve herhangi bir daralmanýn saptanmadýðý olgular ise kontrol grubu olarak kabul edildi. KAH ve kontrol grubu, klasik risk faktörleri ve MS kriterleri açýsýndan karþýlaþtýrýldý. Hastalarda klasik risk faktörleri ve MS parametreleri regresyon analizi ile deðerlendirilerek risk öngörüleri hesaplandý.
BULGULAR: Olgularýn 103’ü kadýn (%39,01) ve 161’i erkekti (%60,98). Kadýn olgularýn yaþ ortalamasý 57,91±9,97 ve erkek olgularýn yaþ ortalamasý 58,63±10,21 bulundu. MS kriterlerinin görülme sýklýðýna bakýldýðýnda kadýnlarda bel çevresi (BÇ) yüksekliði, erkeklerde HDL-K düþüklüðü ve her iki cinste TG yüksekliði ön planda idi. MS, KAH riskini öngörmede anlamlý deðildi ancak BÇ’deki her 1 cm lik geniþleme, her iki cinste de KAH riskinde artýþla ve kalça çevresindeki (KÇ) her 1 cm lik artýþ ise KAH riskinde azalma ile sonuçlandý.
TARTIÞMA ve SONUÇ: Çalýþmamýzda MS’un kadýnlarda yüksek BÇ ve erkeklerde ise HDL-K düþüklüðü ile birlikte ortaya çýktýðýný gözlemledik. Bu durum düþük HDL-K’nýn etnik özelliðimiz olduðu varsayýmýný desteklemekle birlikte toplumumuzda kardiyovasküler olaylarla yakýndan iliþkili MS kriterlerini belirlemek için, özellikle de HDL-K ve BÇ açýsýndan yeni çalýþmalara ihtiyaç olduðunu göstermektedir.

INTRODUCTION: The concept of metabolic syndrome (MS) is critical due to the underlying insulin resistance (IR) and included risk factors for cardiovascular disease. In this study, we aimed to investigate the value of MS criteria in predicting cardiovascular risk as well as traditional cardiovascular risk factors.
METHODS: The study was performed on 264 patients who underwent coronary angiography (CAG) for diagnostic purposes. According to the CAG result, patients with significant stenosis in one or more coronary arteries were considered the CAD (coronary artery disease) group, and cases without stenosis were accepted as the control group. CAD and control groups were compared in terms of traditional risk factors and MS criteria. The traditional risk factors and MS were evaluated for the patients by regression analysis and risk predictions were calculated.
RESULTS: There were 103(39.01%) female and 161(60.98%) male patients. The mean age was57.91±9.97 in females and 58.63±10.21 in males. Considering the incidence of MS criteria, the elevation of waist circumference(WC) in women, low HDL-C in men, and high TG in both sexes were at the forefront.MS was not significant in predicting CAD risk but every 1 cm increase in WC resulted in increased risk of CAD in both sexes and every 1 cm increase in hip circumference(HC) resulted in decreased risk of CAD.
DISCUSSION AND CONCLUSION: In our study, we observed that MS appeared with high WC in women and low HDL-C in men. While this supports the assumption that low HDL-C is a feature of our ethnicity, new studies are needed to determine MS criteria closely related to cardiovascular events in our society, especially in terms of HDL-C and WC.

GÝRÝÞ ve AMAÇ: Çalýþmamýzda kronik hastalýk durumuna göre öðrencilerin COVID-19 risk düzeylerini belirlemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Araþtýrmanýn evrenini Tekirdað ili Çorlu ilçesinde bulunan lise öðrencileri (n = 8,926) oluþturmaktadýr. Öðrencilere kronik hastalýklarý olup olmadýðý, bu kronik hastalýklar için ilaç kullanýp kullanmadýklarý ve bu kronik hastalýklarý nedeniyle bir saðlýk kuruluþuna düzenli ziyaretlerinin olup olmadýðý soruldu. Her bir katýlýmcý için COVID-19 risk seviyeleri belirlendi. Tanýmlayýcý istatistikler, baðýmsýz gruplarýn karþýlaþtýrýlmasýnda kategorik veriler için ki-kare testi ve sayýsal veriler için t testi kullanýldý. Ýstatistiksel anlamlýlýk düzeyi p <0,05 olarak kabul edildi.
BULGULAR: Katýlýmcýlarýn ortalama yaþý 15,71 ± 1,13 yýl (min14, maks18) idi. Bunlarýn %52,27'si (n=4.666) erkektir. Katýlýmcýlarýn %9.06'sýnda (n=809) en az bir kronik hastalýk vardý. Çalýþma süresince kronik bir hastalýða baðlý olarak en az bir ilacý aktif olarak kullanan öðrencilerin oraný %5,96’idi (n = 532). En az bir saðlýk kurumu tarafýndan aktif olarak takip edilenlerin oraný %3,71’idi (n=331). Kýzlarýn COVID-19 ile iliþkili riskleri erkeklere göre daha yüksekti (p=0.019). COVID-19 riski açýsýndan yaþa, okul türüne, okul kategorisine ve sýnýfa göre daðýlýmda anlamlý farklýlýk bulunmadý (p> 0.05).
TARTIÞMA ve SONUÇ: Öðrencilerde kronik hastalýk prevalansýnýn tespiti, COVID-19 hastalýðýnýn seyri üzerinde olumlu bir etkiye sahip olabilir ve bu, sýnýrlý saðlýk kaynaklarýný etkin bir þekilde kullanmayý ve eðitim sistemini buna göre doðru planlamayý mümkün kýlabilir.

INTRODUCTION: In our study, we aimed to identify the COVID-19 risk levels of students according to the chronic disease state.
METHODS: The study population was composed of high school students in Çorlu district of Tekirdað province (n=8,926). Students were asked if they had any chronic diseases, Ýf they use drugs for these chronic diseases, and if they have regular visits to a healthcare institution due to their chronic disease for active follow-up. COVID-19 risk levels were identified Descriptive statistics, chi-square test for categorical data in the comparison of independent groups, and t-test for numerical data was used. The statistical significance level was accepted as p<0.05.
RESULTS: The mean age of participants was 15.71±1.13 years (min14, max18). 52.27% (n=4,666) of them were male. 9.06% (n=809) of the participants have had at least one chronic disease. The rate of the students who were actively using at least one drug due to chronic disease was 5.96% (n=532) during the study. The rate of participants who have been actively followed up by at least one health institution was 3.71% (n=331). Girls had higher COVID-19 related risks compared to boys (p=0.019). In terms of COVID-19 risk, no significant difference was found in the distribution by age, school type, school category, and grade (p>0.05).
DISCUSSION AND CONCLUSION: The detecting of the prevalence of chronic diseases in students, could have a positive impact on the course of COVID-19 disease, and this could make it possible to use the limited health resources effectively and to right plan the education system accordingly.

GÝRÝÞ ve AMAÇ: 2020 Haziran itibariyle Türkiye'de baþlatýlan COVID-19 normalleþme sürecinde, hastalarýn dental uygulamalar ve koruyucu önlemlerle ilgili düþüncelerini deðerlendirmek ve bulaþ riskine yönelik düþüncelerini kurum tercihlerine göre karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: Haziran 2020 itibariyle, Aðýz ve Diþ Saðlýðý Merkezlerine (ADSM), Diþ Hekimliði Fakültelerine ve özel kliniklere baþvuran hastalara, COVID-19 ve hasta iliþkili sorularý içeren bir anket doldurtuldu. Çalýþma verileri tanýmlayýcý istatistiksel metotlar ve Ki-kare testi kullanýlarak analiz edildi. Anlamlýlýk p<0,01 ve p<0,05 düzeylerinde deðerlendirildi.
BULGULAR: Çalýþmaya toplamda 765 hasta (339 kadýn, 426 erkek) katýlmýþtýr. Katýlýmcýlarýn %69,30’unun dental tedaviler için özel klinikleri, %18,80’inin Diþ Hekimliði Fakültelerini ve %11,90’ýnýn ise ADSM’leri tercih ettiði tespit edilmiþtir. Hastalarýn COVID-19 riskine karþý kendini yeterince korunduðunu düþünme durumu, COVID-19 salgýnýnýn kontrol altýna alýndýðýný düþünme durumu ve bekleme alanýndaki kalabalýðýn endiþe yaratmasý durumu ile kurum tercihleri arasýnda istatistiksel iliþki olduðu saptanmýþtýr (p<0,05).
TARTIÞMA ve SONUÇ: Hastalara özellikle pandemi sürecinde güvenle baþvurabilecekleri bir ortamýn sunulabilmesi gereklidir. Bu nedenle en yoðun hasta baþvurusunun olduðu kurumlar olmasý dolayýsýyla, ADSM’nin ve Diþ Hekimliði Fakültelerinin, hasta beklentilerini karþýlayacak ortamý saðlayabilmesi, hastalarý bilgilendirmesi ve pandeminin en az zararla atlatýlabilmesi açýsýndan normalleþme sürecine katkýda bulunmasý oldukça kritiktir.

INTRODUCTION: To evaluate patients' opinions about dental practices and preventive measures and to compare their thoughts on transmission risk according to institutional preferences in the COVID-19 normalization process initiated in Turkey as of June 2020.
METHODS: As of June 2020, patients who applied to Oral and Dental Health Centers (ODHC), Dentistry Faculties, and private clinics filled out a questionnaire containing COVID-19 and patient-related questions. Study data were analyzed using descriptive statistical methods and the Chi-square test. Significance was evaluated at p<0.01 and p<0.05 levels.
RESULTS: A total of 765 patients (339 women, 426 men) participated in the study. It has been determined that 69.30% of the participants prefer private clinics for dental treatments, 18.80% of Dentistry Faculties, and 11.90% of ODHC. It was determined that there was a statistical relationship between the patients' state of thinking that they were adequately protected against the risk of COVID-19, the state of thinking that the COVID-19 epidemic was under control, and the state of concern by the crowd in the waiting area and institution preferences (p<0.05).
DISCUSSION AND CONCLUSION: It is necessary to provide an environment where patients can apply safely, especially during the pandemic process. For this reason, it is very critical that ODHC and Dentistry Faculties provide an environment that will meet patient expectations, inform patients and contribute to the normalization process in terms of overcoming the pandemic with the least damage since it is the institutions with the highest number of patient applications.

GÝRÝÞ ve AMAÇ: Araþtýrma bir araþtýrma hastanesinde çalýþan hemþirelerin kültürlerarasý duyarlýlýklarýnýn ve göçmen hastalar ile ilgili görüþlerinin saptanmasý amacýyla tanýmlayýcý olarak yapýlmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþma, araþtýrmaya dahil olma kriterini karþýlayan ve çalýþmaya katýlmaya gönüllü olan 200 hemþire ile yürütülmüþtür. Araþtýrma verileri, “Hemþirelerin sosyo-demografik özellikleri bilgi formu” ve “Kültürlerarasý Duyarlýlýk Ölçeði aracýlýðýyla toplanmýþtýr. Verilerin analizinde ortalama ± standart sapma ve frekans ve yüzde deðerleri, Baðýmsýz gruplar t-testi ve Tek yönlü varyans analizi (ANOVA) testi kullanýlmýþtýr.
BULGULAR: Hemþirelerin Kültürlerarasý Duyarlýlýk Ölçeði toplam puan ortalamasý 77,24±6,18 olarak bulunmuþtur. Kültürlerarasý Duyarlýlýk Ölçeði toplam puan açýsýndan deðerlendirildiðinde eðitim durumu ile ölçek puaný arasýnda istatistiksel anlamlý bir fark çýkmýþtýr (F: 1,743, p: 0,014). Kültürlerarasý duyarlýlýk ölçeðinin iletiþimde dikkatli olma alt boyutu ile iletiþim kurma þekli arasýnda anlamlý bir fark olduðu bulunmuþtur (F: 2,921 p: 0,001).
TARTIÞMA ve SONUÇ: Çalýþmada hemþirelerin kültürler arasý duyarlýlýk düzeyinin yaklaþýk orta düzeyde olduðu belirlenmiþtir. Hemþirelerin yaklaþýk %70 inin göçmen hastalarla ilgili bakým verirken bakým konusunda farklý bir his yaþamadýklarý saptanmýþtýr. Kurumlarda kültürler arasý duyarlýlýðýn geliþtirilmesi amacýyla kültürel duyarlýlýkla ilgili duygusal-biliþsel-davranýþsal eðitimlerin gibi hizmet içi eðitim programlarýnýn yer almasý ve hemþirelik eðitim müfredatýnda kültürler arasý duyarlýlýðýn geliþtirilmesine ve yabancý dil yeterliliklerini artýrmaya yönelik konulara yer verilmesi önerilmektedir.

INTRODUCTION: The current research was carried out descriptively to determine the intercultural sensitivity of nurses working in a research hospital and their views on migrant patients.
METHODS: The study was conducted with 200 nurses who met the inclusion criteria and volunteered to participate in the study. Research data were collected through “Socio-demographic characteristics information form of nurses” and “Intercultural Sensitivity Scale”. In the analysis of the data, mean ± standard deviation and frequency and percentage values, Independent groups t-test and One-way variance analysis (ANOVA) test were used.
RESULTS: The total score means of the Intercultural Sensitivity Scale of the nurses were found to be 77.24 ± 6.18. When the Intercultural Sensitivity Scale was evaluated in terms of the total score, a statistically significant difference was found between the educational status and the scale score (F: 1.743, p: 0.014). It was found that there is a significant difference between being careful in the communication sub-dimension of the intercultural sensitivity scale and the communication style (F: 2.921 p: 0.001).
DISCUSSION AND CONCLUSION: In the study, it was determined that the level of sensitivity of nurses between cultures was approximately medium. It has been determined that approximately 70% of nurses do not feel different about care while providing care to immigrant patients. It is recommended to include in-service training programs such as emotional-cognitive behavioral training related to cultural sensitivity to develop intercultural sensitivity in institutions and to include issues to improve intercultural sensitivity and increase foreign language proficiency in the nursing education curriculum.

GÝRÝÞ ve AMAÇ: Ýdrar yolu enfeksiyonlarý (ÝYE) çocukluk çaðýnda sýk görülen enfeksiyonlardýr. Enfeksiyonun seyri ve klinik takibi lokalizasyonuna göre (alt ve üst) deðiþir. C-reaktif protein (CRP) albümin oraný (CAO), son yýllarda kullanýlan enflamatuar belirteçlerden biridir. Çalýþmamýzýn amacý CAO kullanarak bu ayrýmý araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Bu çalýþma, ÝYE tanýsý almýþ 95 çocuðun hasta dosyalarý taranarak gerçekleþtirildi. Hastalar enfeksiyon bölgesine göre üst ÝYE (Ü-ÝYE) ve alt ÝYE (A-ÝYE) olarak iki gruba ayrýldý. Hastalarýn laboratuvar ve demografik özellikleri hastane kayýtlarýndan elde edilmiþ ve gruplar arasýnda karþýlaþtýrýlmýþtýr.
BULGULAR: CAR, Ü-ÝYE grubunda anlamlý olarak daha yüksekti (p <0,001). Alýcýnýn çalýþma karakteristik eðrisine göre, Ü-ÝYE tahmini için CAO'nýn optimal kesme deðeri>% 97 özgüllüðü ve% 53 duyarlýlýðý olan> 12,65 idi (AUC = 0,864; % 95 güven aralýðý CI: 0,792– 0,9363, LR: 24,40; p <0,001). Univaryant analizde anlamlý bulunan ve Ü-ÝYE ile korele olan deðiþkenlerin de alýnarak yapýldýðý çok deðiþkenli lojistik regresyon analizinde CAO (OR = 0,897,% 95 CI: 0,838-0,960, p = 0,002) ve mutlak nötrofil sayýsýnýn (OR = 0,182,% 95 CI: 0,039-0,841, p = 0,029) halen anlamlý olduðu bulundu.
TARTIÞMA ve SONUÇ: CAO, ÝYE'de Ü-ÝYE ile baðýmsýz olarak iliþkilidir ve Ü-ÝYE'yi tahmin etmek için yararlý olabilir.

INTRODUCTION: Urinary tract infections (UTI) are common infections in childhood. The course of infection and its clinical follow-up vary according to its localization (lower vs. upper). C-reactive protein (CRP) albumin ratio (CAR) is one of the inflammatory markers that have been used in recent years. The purpose of our study is to investigate this distinction by using CAR.
METHODS: This study was conducted by scanning the patient files of 95 children diagnosed with UTI. The patients were divided into two groups according to the infection site as upper UTI (UUTI) and lower UTI (LUTI). Laboratory and demographic features of the patients were obtained from the hospital records and compared between the groups.
RESULTS: CAR was significantly greater in the UUTI group (p<0.001). According to receiver operating characteristic curve, the optimal cut-off value of CAR for prediction of UUTI was >12.65, which had a specificity of 97% and sensitivity of 53% (AUC = 0.864; 95% confidence interval CI: 0.792–0.9363, LR: 24.40; p < 0.001). In the multivariate logistic regression analysis, in which variables found to be significant in univariate analysis and correlated with UUTI were also taken, CAR (OR = 0.897, 95% CI: 0.838-0.960, p = 0.002) and absolute neutrophil count (OR = 0.182, 95% CI: 0.039 -0.841, p = 0.029) was still found to be significant.
DISCUSSION AND CONCLUSION: CAR is independently related to UUTI in UTI and may be useful to predict UUTI.

GÝRÝÞ ve AMAÇ: Huzursuz bacak sendromu (HBS), ekstremitelerde anormal duyularla giden, genellikle geceleri semptomlarýn belirginleþtiði, rahatsýzlýk veren, ekstremiteleri hareket ettirme isteði uyandýran kronik bir hastalýktýr. HBS semptomlarýnýn nedenleri henüz net olarak açýklanamadýðý için tedavi de semptomlarý hafifletmeye yönelik yapýlmaktadýr. Bu çalýþmada kupa terapinin HBS üzerine etkinliðini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmamýz Ankara Þehir Hastanesi Nöroloji ve Aile Hekimliði Polikliniklerinde Ocak 2019 ve Aralýk 2019 tarihleri arasýnda yürütüldü. Huzursuz Bacak Sendromu tanýsý almýþ iki hasta grubu oluþturuldu. Birinci grup mevcut haliyle pramipeksol tedavisi alan hastalardan ikinci grup ise medikal tedavi almamýþ hastalardan oluþturuldu. Her iki gruba bir ay ara ile 2 seans kupa terapi yapýldý. Hastalara ýslak kupa terapi öncesi ve sonrasý Pittsburgh Uyku Kalite Ýndeksi (PUKÝ) ve Huzursuz Bacak Sendromu Þiddet Skalasý (HBSÞS) uygulanarak her iki grupta skorlar karþýlaþtýrýldý.
BULGULAR: Birinci grupta ýslak kupa terapi uygulamasýndan sonra dört HBSÞS alt kategorisinde (hareket etme ihtiyacý, uyku bozukluðu, þikayetlerin günlük ortalama þiddeti ve HBSÞS toplam puaný) belirgin düþme olduðu saptandý. Ýkinci grupta ise, iþlem sonrasýnda altý kategoride (HBS þikayetlerinin oraný, hareket etme ihtiyacý, uyku bozukluðu, yorgunluk ve uyku hali, HBS þikayetlerinin sýklýðý, þikayetlerin günlük ortalama þiddeti) anlamlý düþme oldu. Ýkinci grupta PUKÝ kategorilerinden uyku latansý, gündüz iþlev bozukluðu ve PUKÝ toplam puaný anlamlý oranda düzeldi (sýrasýyla p=0,041, p=0,024, p=0,025). Prosedür sonrasýnda ikinci grubun HBSÞS puanlarýnýn daha belirgin düþtüðü saptandý (p=0,012).
TARTIÞMA ve SONUÇ: Medikal tedavi almayan grupta ýslak kupa terapinin semptomlarý azaltmada daha etkin olduðu görüldü. Özellikle hafif þikayetleri olan HBS’li hastalara semptomlarý azaltmak amacýyla ýslak kupa terapisi önerilebilir. Kupa terapinin etkinliðini inceleyen ileri bilimsel çalýþmalarla, bu tedavinin etki mekanizmasýnýn netleþeceði ve daha etkin ve güvenli bir þekilde uygulanabileceði düþünülmektedir.

INTRODUCTION: Restless leg syndrome (RLS) is a chronic disease that goes with abnormal sensations in the extremities. Usually, the symptoms become evident at night, which causes discomfort and a desire to move. Since the causes of RLS symptoms have not been clearly explained yet, treatment is aimed at alleviating the symptoms. In this study, we aimed to investigate the effectiveness of cupping therapy on RLS.
METHODS: Our study was carried out in Ankara City Hospital Neurology and Family Medicine Polyclinics between January 2019 and December 2019. The patients with the diagnosis of Restless Leg Syndrome were divided into two groups. The first group consisted of patients who currently received pramipexole therapy, and the second group consisted of patients who received no medical treatment. Both groups received 2 sessions of cupping therapy at the one-month interval. Pittsburgh Sleep Quality Index (PSQI), and Restless Leg Syndrome Severity Scale (RLSSS) were applied to the patients before and after wet cupping therapy, and the scores were compared between groups.
RESULTS: In the first group, a significant decrease was found in four RLSS subcategories (need to move, sleep disturbance, mean daily severity of complaints, and RLSSS total score) after wet cupping therapy. In the second group, there was a significant decrease in six categories (rate of RLS complaints, need to move, sleep disturbance, fatigue and sleepiness, frequency of RLS complaints, average daily severity of complaints) after the procedure. In the second group, sleep latency, daytime dysfunction and PSQI total score among the PSQI categories improved significantly (p = 0.041, p = 0.024, p = 0.025, respectively). It was found that the RLSS scores of the second group decreased more significantly after the procedure (p = 0.012).
DISCUSSION AND CONCLUSION: It was concluded that wet cupping therapy was more effective in reducing symptoms in the group not receiving medical treatment. Wet cupping therapy can be recommended to reduce symptoms, especially to patients with RLS with mild complaints. With advanced scientific studies examining the effectiveness of cupping therapy, it is thought that the mechanism of action of this treatment will be clarified and it can be applied more effectively and safely.

GÝRÝÞ ve AMAÇ: Yaþlý bireylerin dünyada ve ülkemizde nüfuslarý giderek artmaktadýr. Birinci basamak, yaþlý kiþiler için kolay ulaþýlabilir olmasý nedeniyle daha çok tercih edilmektedir. Yaþlanma ile genellikle multimorbidite ve düþkünlük durumlarý artarken, egzersiz düzeyleri azalmaktadýr. Araþtýrmamýzda yaþlýlarda düþkünlük düzeyleri ile egzersiz yapma oranlarý arasýndaki iliþkiyi araþtýrmak amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Konya Karatay 09 Nolu Aile Saðlýðý Merkezi’nde tanýmlayýcý-kesitsel bir çalýþma yapýldý. Araþtýrmanýn örneklemini Aile Hekimliði birimine kayýtlý 65 yaþ ve üstü dönemdeki 243 kiþi oluþturdu. Bireylere yüz yüze görüþme metodu ile sosyo-demografik özellikleri, FRAIL skorlamasý ve haftalýk egzersiz süreleri soruldu.
BULGULAR: Araþtýrmaya katýlan 243 kiþinin yaþ ortancasý 72 (min=65, maks=94), %53,10’u kadýn, %63’ü 65-74 yaþ grubunda ve %69,50’si evliydi. FRAÝL düþkünlük düzeyine göre %15,60’ý düþkündü. Katýlýmcýlarýn %93,80’inin fiziksel aktivite düzeyi yetersizdir. Fiziksel aktivite düzeyine göre yaþ gruplarý arasýnda istatistiksel olarak anlamlý fark saptandý (p=0,009). Fiziksel aktivite düzeyine göre multimorbidite varlýðý ve FRAÝL düþkünlük düzeyi daðýlýmý arasýnda istatistiksel olarak anlamlý fark saptandý (her ikisinde p≤0,001).
TARTIÞMA ve SONUÇ: Düþkünlük yönetilebilen bir durumdur ve bireyler düþkünlük öncesi dönemde yakalanabilirse tedavi etme þansý o kadar fazla olacaktýr. Aile Hekimleri, baþvuru sebeplerinden baðýmsýz olarak 65 yaþ ve üzeri tüm bireylerde egzersiz ile ilgili farkýndalýk oluþturmalýdýrlar.

INTRODUCTION: The population of elderly people is increasing in the world and our country. Primary care is more preferred because it is easily accessible for elderly people. While multimorbidity and frailty status generally increase with aging, exercise levels decrease. In our study, it was aimed to investigate the relationship between the level of addiction and exercise rates in the elderly.
METHODS: A descriptive cross-sectional study was conducted in Konya Karatay No.09 Family Health Center. The study consisted of 243 people aged 65 and over registered in the Family Medicine Unit. The individuals were asked about their socio-demographic characteristics, FRAIL scoring, and weekly exercise periods using the face-to-face interview method.
RESULTS: The median age of the 243 people participating in the study was 72 (min; 65-max; 94), According to FRAIL scoring, 15.60% of them were frail. The physical activity level of 93.80% of the participants was insufficient. A significant difference was found between age groups regarding the physical activity level of the participants (p=0,009). A significant difference was found between the presence of multimorbidity and the distribution of FRAIL scoring regarding the physical activity level of the subjects (p≤0,001 for both).
DISCUSSION AND CONCLUSION: Frailty is a manageable condition, and if individuals can be caught in the pre-frailty period, the better chances of cure will be possible. Family physicians should be aware of exercise in all individuals aged 65 and over, regardless of the reasons for the application.

GÝRÝÞ ve AMAÇ: Hasta ve hekim haklarý beraber ele alýnmasý gereken unsurlardýr. Literatürde daha çok hasta haklarýyla ilgili araþtýrma makaleleri yer almaktadýr. Sadece hasta haklarýný ön plana çýkarmak, hekimin haklarýný göz ardý etmek iletiþim sorunlarýný karþýmýza çýkarýr. Çalýþmamýzda hastalarýn hekim haklarý konusundaki bilgi düzeyleri ve tutumlarýný araþtýrdýk.
YÖNTEM ve GEREÇLER: Hastanemize herhangi bir yakýnma ile müracaat eden hastalara, hekim haklarýyla ilgili araþtýrmacýlar tarafýndan hazýrlanan anket uygulanmýþtýr. Anket formunda katýlýmcýlarýn sosyodemografik özellikleri, kiþilik özelliklerini belirlemeye yönelik “Fried ve Rosenman’ýn Kiþilik Envanteri” ve hastalarýn hastalýk algýsýný belirlemeye yönelik Kýsa Hastalýk Algýsý Ölçeði yer almaktadýr. Ayrýca hekim haklarý konusundaki hastalarýn bilgi ve tutum seviyelerini ölçmeye yönelik 5’li Likert tipi ölçek kullanýlmýþtýr. Hastalarýn verdikleri cevaba göre bilgi ve tutum bölümleri 100 puan üzerinden hesaplanmýþtýr.
BULGULAR: Hastalarýn hekim haklarý konusunda bilgi seviyeleri, 100 puan üzerinden ortalama 60,65±8,53 (37-84 puan) olarak saptandý. Hastalarýn muayene esnasýnda hekim davranýþlarýna yönelik tutum puanlarý ise 41,31±6,67 (24-61 puan) olarak bulundu. Eðitim seviyeleri yüksek olan hastalarýn bilgi düzeyi puanlarý da daha yüksekti. Çalýþmamýzda “hastanýn hastalýðýyla ilgili bilgilendirme” önermesi (%91,70) en çok bilinen önerme olmuþtur. En düþük puanlar “belirli koþullar altýnda müdavi hekimin hastanýn tedavisini yarýda býrakma hakký” olarak belirlenmiþtir. Hastalarýn yaklaþýk yarýsý hekim davranýþlarýna yönelik kararsýzým þýkkýný iþaretlemeleri dikkat çeken bir bulgu idi.
TARTIÞMA ve SONUÇ: Hastalarda hekim haklarý konusunda farkýndalýk oluþturulmasý ve hasta hekim iliþkisinde karþýlýklý haklarýn varlýðýnýn kabul edilmesi, hastalarla hekim arasýndaki iletiþim problemlerinin azaltýlmasýna katký saðlayabilir.

INTRODUCTION: Patient and physician’s rights are elements that need to be handled together. In the literature, there are mostly research articles on patient rights. Only prioritizing patient rights and ignoring the rights of physicians brings up communication problems. In our study, we investigated the knowledge levels and attitudes of patients about physician rights.
METHODS: The researchers prepared a questionnaire for the patients. The questionnaire included the "Fried and Rosenman's Personality Inventory" to determine the participants' sociodemographic characteristics and personality traits and the Brief Illness Perception Questionnaire (IPQ-B) to determine the disease perception of the patients. Also, the Likert type scale was used to measure patients' knowledge and attitude levels about physician rights. The researchers calculated the information and attitude sections of the patients' answers over 100 points.
RESULTS: The patients' knowledge about physician rights was found to be 60.65 ± 8.53 (37-84 points) over 100 points. The patients' attitude scores towards physician behavior during the examination were 41.31 ± 6.67 (24-61 points). The knowledge level scores of the patients with higher education levels about patient rights were also higher. In our study, the statement "informing about the patient's disease" (91.70%) was the most well-known statements. The lowest scores were determined as "the right of the attending physician to abandon the patient's treatment under certain conditions." Almost half of the patients marked the option “I am indecisive about physician behavior”.
DISCUSSION AND CONCLUSION: Raising awareness of physician rights in patients and accepting mutual rights in the patient-physician relationship can reduce communication problems.

GÝRÝÞ ve AMAÇ: Damar içi kateterler (DÝK) günümüz týp pratiðinde sýk olarak kullanýlmaktadýr ve özellikle yoðun bakým ünitelerinde bazý durumlarda kaçýnýlmaz olarak karþýmýza çýkmaktadýr. Bu yaygýn kullaným alanlarýna baðlý olarak sebep olduklarý komplikasyonlar nedeniyle artmýþ morbidite ve mortalite ile iliþkilidirler. Bu komplikasyonlardan biri enfeksiyöz komplikasyonlardýr ve bunlar içerisinde en önemlisi kateter ile iliþkili kan dolaþýmý enfeksiyonudur (KÝKDE). Bu çalýþmamýzda hastanemiz yoðun bakým ünitesinde taný koyduðumuz KÝKDE etkenlerini ortaya koymayý amaçladýk.
YÖNTEM ve GEREÇLER: Bizim çalýþmamýza konu olan DÝK ile iliþkili kan dolaþýmý enfeksiyon (KÝKDE) etkenlerini belirlemek amacýyla Keçiören Eðitim ve Araþtýrma Hastanesi Ýç Hastalýklarý Yoðun Bakým Ünitesi’nde Ocak 2018-Aralýk 2018 tarihleri arasýnda yatmýþ olan ve eþ zamanlý kateter içi kan kültürü ve periferik kan kültürü alýnan 216 hasta retrospektif olarak deðerlendirilmiþtir. Bu hastalarýn antibiyotik duyarlýlýk testleri "Clinical and Laboratory Standards Institute (CLSI)" kriterlerine göre disk difüzyon yöntemi kullanýlarak yapýlmýþtýr. Kateterden alýnan kan ile periferik venöz kandan alýnan kan kültürleri için BACTEC 9120 (Becton Dickinson, ABD) sistemi kullanýlmýþtýr.
BULGULAR: Hastalarýn %20.3’ünde KÝKDE saptanmýþ olup bu olgularýn 6’sýnda E. faecium, 6’sýnda K. pneumonia, 6’sýnda A. baumanii, 6’sýnda S. epidermidis, 4’ünde S. capitis, 4’ünde E. faecalis ve 2’þer hastada S. aureus-P.aeroginosa-S. haemolyticus-C. albicans ve E.coli izole edilmiþtir. Çalýþmamizda KÝKDE etkeni olarak en sýk E. faecium, S. epidermidis, A. baumanii ve K. pneumoniae saptanýrken 2. en sýk etkenler S. capitis ve E. faecalistir. Çalýþmamýzý deðerlendirdiðimizde KÝKDE etkeni olarak 1. sýrada koagülaz negatif stafilokoklar karþýmýza çýkmakta 2. sýrada ise enterokoklar bulunmaktadýr.
TARTIÞMA ve SONUÇ: Hastanemiz yoðun bakým ünitesinin KÝKDE etkenlerinin daðýlým sonuçlarý Türkiye’nin ulusal hastane enfeksiyonlarý sürveyans sistemi 2012 verileri ile uyumludur.

INTRODUCTION: Intravenous catheters are frequently used in today's medical practice and are inevitable in some cases, especially in intensive care units. Due to these common areas of use, they are associated with increased morbidity and mortality due to the complications they cause. One of these complications is infectious complications, the most important of which is catheter-related bloodstream infection (CRBI). In this study, we aimed to reveal the factors of catheter-related bloodstream infection that we diagnosed in the intensive care unit of our hospital.
METHODS: In order to determine the factors and antibiotic susceptibility catheter-related bloodstream infections which were the subjects of our study, who had been hospitalized between January 2018 and December 2018 at Keçiören Training and Research Hospital Intensive Care Unit and concurrent in catheter blood culture and peripheral blood.216 patients who were cultured were evaluated retrospectively.
RESULTS: In 20.3% of the patients, catheter-related bloodstream infection was detected, in which 6 of these cases were E. faecium, 6 of them were K. pneumonia, 6 of them were A. baumanii, and 6 of them were S. epidermidis. In 4 patients we detected S. capitis and E. faecalis. S. aureus-P.aeroginosa-S.haemolyticus-C. albicans and E.coli were isolated in both 2 patients. In our study, E. faecium, S. epidermidis, A. baumanii and K. pneumoniae were the most common agents, while the second most frequent agents were S. capitis and E faecalis. When we evaluate our study, coagulase-negative staphylococci are in the first place as the cause of CRBI and enterococci are in the second place.
DISCUSSION AND CONCLUSION: The distribution results of the causes of CRBI of our hospital’s intensive care unit was compatible with Turkey's national nosocomial infections surveillance system-2012.

GÝRÝÞ ve AMAÇ: Çocuklarýn büyüme ve geliþmelerinin takibi önemli bir konudur. Nitekim aile saðlýðý merkezlerinde ilgili protokol ve mevzuatlarda öðrencilerin aile hekimleri tarafýndan her yýl periyodik muayene /izlemlerinin yapýlmasý gerektiði belirtilmektedir. Bu çalýþmada, öðrenci izlemlerini deðerlendirmek amacýyla Okulda Saðlýðýn Korunmasý ve Geliþtirilmesi Programý’nýn uygulandýðý bir aile saðlýðý birimindeki okul çaðý izlemlerinin sonuçlarý analiz edilmiþtir.
YÖNTEM ve GEREÇLER: Çalýþmamýz retrospektif tanýmlayýcý tipte bir gözlemsel çalýþmadýr. Ankara Keçiören’de bir aile hekimliði birimine 1 Ocak - 1 Haziran 2019 tarihleri arasýnda “Okulda Saðlýðýn Korunmasý ve Geliþtirilmesi Programý” kapsamýnda okullardan yönlendirilerek baþvuru yapan tüm öðrencilerin izlem verileri ilgili aile hekimliði bilgi sistemi (AHBS) üzerinden derlenerek deðerlendirilmiþtir.
BULGULAR: Çalýþmaya 5 aylýk süreçte takipleri yapýlan 230’u erkek, 231’i kýz toplam 461 çocuðun izlem verileri dâhil edildi. Çalýþmaya dâhil edilen çocuk ve gençlerin yaþ ortalamasý 11,87±3,33 olarak hesaplandý. Yaþa ve cinsiyete göre vücut kitle indeksi hesaplandýðýnda %48,15’inin (n: 222) normal deðerler haricinde olduðu tespit edildi. Öðrencilerin %27,33’ünde (n: 126) diþ çürüðü, %13,66’sýnda (n: 63) görme bozukluðu, %10,19’unda (n: 47) obezite, %4,72’sinde (n: 22) hiperlipidemi ve %3,25’inde (n: 15) anemi tespit edildi. Tansiyonu ölçülen 4 çocukta pre-hipertansiyon, 2 çocukta Evre 1 hipertansiyon tespit edilirken iþitme testi sonucu 1 öðrencide çift taraflý iþitme kaybý, 2 öðrencide tek taraflý iþitme kaybý olduðu görüldü.
TARTIÞMA ve SONUÇ: Çalýþmanýn yapýldýðý aile hekimliði biriminde geçmiþ dönemlere kýyasla ilgili programýn da katkýsý ile okul çaðý çocuk/genç izlem sayýsýnýn 5 aylýk süreçte %3’ten %45’e yükseldiði görüldü. Bu tür protokollerin uygulanmasý ile okul çaðý çocuk/genç izlem sayýlarý artacak ve büyüme ve geliþme anormallikleri, hipertansiyon, dislipidemi, görme ve iþitme bozukluklarý ile aðýz diþ saðlýðý problemleri gibi birçok hastalýða erken tanýnýn koyulmasý ve/veya risk yönetimi ile önlenmesi çalýþmamýzda olduðu gibi saðlanabilecektir.

INTRODUCTION: Monitoring the growth and development of children is an important issue. As a matter of fact, in family health centers, it is stated in the relevant protocols and regulations that the students should be examined periodically by their family physicians every year. In this study, the results of school-age follow-ups in a family medicine unit were examined.
METHODS: Our study is a retrospective descriptive observational study. The follow-up data of all students who applied to a family medicine unit in Ankara between January 1- June 1, 2019, by referring from schools within the scope of the "Program for the Protection and Improvement of Health at School" were compiled and evaluated through the relevant family medicine information system.
RESULTS: 461 children were included in the study (230 of whom were boys and the mean of age was 11.87±3.33). The body mass index of children was found out of normal (48.15%(n: 222)). Dental caries in 27.33%(n: 126) of the students, visual impairment in 13.66%(n: 63), obesity in 10.19%(n: 47), hyperlipidemia in 4.72%(n: 22) and anemia in 3.25%(n: 15) were detected. Prehypertension was detected in 4 children whose blood pressure was measured, stage 1 hypertension was detected in 2 children while hearing test result was found to have hearing loss in 3 students.
DISCUSSION AND CONCLUSION: In the family medicine unit where the study was conducted, it was observed that the number of school-age follow-up of children increased from 3% to 45% in 5 months with the contribution of the relevant program compared to previous periods. By applying such protocols, the number of school-age follow-ups will increase and many diseases such as growth and development abnormalities, hypertension, dyslipidemia, visual and hearing disorders, and oral and dental health problems will be diagnosed early and/or prevented by risk management like in our study.

GÝRÝÞ ve AMAÇ: Ýnfertilite, sýklýðýnýn yüksek olmasý ve infertil kiþilerin yaþadýðý problemler nedeniyle ülkemiz için önemli bir halk saðlýðý sorunudur. Çalýþmamýzýn amacý, hastanemiz Týbbi Genetik polikliniðine baþvuran infertil olgularý Hamilton Anksiyete Deðerlendirme Ölçeði (HAM-A) ile deðerlendirmek ve HAM-A’nýn sosyo-demografik özelliklerle iliþkisini saptamaktýr.
YÖNTEM ve GEREÇLER: 01.03.2020-01.07.2020 tarihleri arasýnda hastanemiz Týbbi Genetik Polikliniði’ne açýklanamayan infertilite nedeniyle baþvuran, üreme çaðýndaki, 120 infertil olgu çalýþmaya alýndý. Etik kurul onayý alýndýktan sonra, aydýnlatýlmýþ onamý alýnan olgulara sosyo-demografik verileri içeren anket ve HAM-A uygulandý. 0-5 puan anksiyetenin olmadýðýný, 6-14 puan minör anksiyeteyi, 15 puan ve üzeri majör anksiyeteyi göstermektedir. Verilerin analizi için SPSS 22.0 paket programý kullanýldý. Veriler, tanýmlayýcý istatistiklerin yaný sýra, Pearson ki-kare ve Mann-Whitney U testi ile deðerlendirildi. p<0,05 istatistiksel olarak anlamlý kabul edildi.
BULGULAR: Týbbi Genetik Polikliniði’mize baþvuran 120 infertil olgunun yaþ ortalamasý 33,94±9,89 yýl idi. Olgularýn %55,83’ü kadýndý. Ýnfertil olgularýn ortalama infertil süreleri 5,27±3,64 yýl idi. Kadýnlarda HAM-A puan ortalamasý 20,13±9,98, erkeklerde HAM-A puan ortalamasý 18,25±8,80 tespit edildi. Total ölçek puan ortalamasý 19,44±9,85 idi. Çalýþmaya katýlan kadýnlarda, 40-45 yaþ aralýðýnda olanlarda, daha önce infertilite tedavisi alanlarda, eðitim düzeyi düþük olanlarda, kronik hastalýðý olanlarda anksiyete toplam puanlarý olumsuz yönde yüksek bulunmuþtur (sýrayla p=0,002, p=0,000, p=0,023, p=0,001, p=0,003).
TARTIÞMA ve SONUÇ: Týbbi Genetik Polikliniðine baþvuran infertil olgularda çok þiddetli anksiyete tespit edildi. Týbbi Genetik Polikliniði’ne baþvuran infertil olgular anksiyete yönünden deðerlendirilmeli, anksiyete tespit edilenlere gerekli bilgi, danýþmanlýk ve rehberlik saðlanmalýdýr.

INTRODUCTION: Infertility is an important public health problem for our country due to its high frequency and problems experienced by infertile couples. The aim of our study is to evaluate the infertile patients with the Hamilton Anxiety Rating Scale (HAM-A) who attended to Medical Genetic Outpatient Clinic of our hospital and to determine the relationship of the HAM-A with the socio-demographic characteristics.
METHODS: 120 infertile patients of reproductive age who attended our hospital between 01.03.2020-01.07.2020 with unexplained infertility were included in the study. After the ethical committee approval, HAM-A, and a questionnaire containing socio-demographic data were applied to the patients whose informed consent was obtained. The point scale used for the study was shown as follows; 0-5 points for anxiety, 6-14 points for minor anxiety, 15 points, and above for major anxiety. SPSS 22.0 package program was used for analyzing the data. The data were evaluated with descriptive statistics as well as by Pearson chi-square and Mann-Whitney U test. p<0.05 was considered statistically significant.
RESULTS: The mean age of 120 infertile patients was 33.94±9.89 years. 55.83% of the patients were women. The mean infertile duration of the patients was 5.27±3.64 years. The mean HAM-A score was detected at 20.13±9.98 in women whereas 18.25±8.80 in men. The mean score of the total scale was 19.44±9.85. The total anxiety score was found to be higher in women with those who received infertility treatment previously, with forty years and older, low level of education, with chronic illnesses (in order p=0.002, p=0.000, p=0.023, p=0.001, p=0.003).
DISCUSSION AND CONCLUSION: Severe anxiety was detected in infertile patients. All infertile cases attended to Outpatient Clinic should be evaluated with anxiety scales and optimum counseling and guidance should be provided to them.

GÝRÝÞ ve AMAÇ: Covid-19 nedeniyle hastanede yatarak tedavi gören hastalarýn bulaþýn önlenmesi için tek kiþilik odalarda ve yanýnda refakatçi olmadan tedavileri saðlanmaktadýr. Bu hastalara hizmet veren gerek saðlýk gerek destek personelleri kiþisel koruyucu ekipman ile hastalarla temas etmektedir. Bu deðiþen koþullarýn bireylerin psikolojileri üzerindeki etkisini deðerlendirmeyi planladýk.
YÖNTEM ve GEREÇLER: Araþtýrma Göðüs Hastalýklarý, Enfeksiyon Hastalýklarý ve Ýç Hastalýklarý servislerine yatan 300 hasta (115 kadýn, 185 erkek) ile yapýldý. Veriler, araþtýrmacý tarafýndan hazýrlanan ve hastalarýn tanýtýcý özelliklerini içeren kiþisel bilgi formu ve Hastane Anksiyete ve Depresyon Ölçeði (HAD) ile toplandý. Ölçeðin ülkemizde geçerliliði daha önce araþtýrýlmýþ ve anksiyete ve depresyon için yararlý ve duyarlý bir tarama aracý olduðu gösterilmiþtir.
BULGULAR: Hasta grubunun ortanca yaþý 42 (min-maks: 18-90) olup, hastalarýn %61,70'i erkek, %46,30'u ilköðretim mezunu, %78,30’u evli, %24'ü ev hanýmý, %10,30’u emekli idi. Tüm vakalar arasýnda %8.30 (n: 25) klinik olarak ciddi depresyon ve %24 (n: 72) hafif depresyon ve %7,70 (n: 23) klinik olarak ciddi anksiyete ve %16 (n: 48) hafif anksiyete vardý. HAD-anksiyete puanýnýn þiddetine göre iki cinsiyet arasýnda istatistiksel olarak anlamlý fark vardý ve kadýnlarda anksiyete puanlarý daha yüksekti (p <0,001).
TARTIÞMA ve SONUÇ: Bulgularýmýz, Covid-19 nedeniyle hastanede yatarak tedavi gören bireylerde anksiyete ve depresyon düzeylerinin arttýðýný göstermiþtir. Pandeminin önümüzdeki süreçte devam etmesi beklenmektedir. Bu nedenle hastalarýn anksiyete depresyon düzeylerinin azaltýlmasýna yönelik giriþimlerinin planlanmasýnýn ve gerekli destek programlarýnýn oluþturulmasýnýn gerekli olduðu düþünülmektedir.

INTRODUCTION: Patients who are hospitalized for Covid-19 are treated in single rooms and without an attendant to prevent contamination. Both health and support personnel serving these patients come into contact with patients with personal protective equipment. We planned to evaluate the impact of these changing conditions on individuals' psychology.
METHODS: The study was conducted with 300 patients (115 females, 185 males) hospitalized in Chest Diseases, Infectious Diseases, and Internal Diseases services. The data were collected using the personal information form prepared by the researcher and containing the descriptive characteristics of the patients and the Hospital Anxiety and Depression Scale (HAD).
RESULTS: The median age of the patient group was 42 (min-max: 18-90), 61.70% of the patients were male, 46,30% were primary education graduates, 78.30% were married and 24% were housewives, 10.30% were retired. Among all cases, there were 8.30% (n: 25) clinically serious depression and 24% (n: 72) mild depression, and 7.70% (n: 23) clinically serious anxiety and 16% (n: 48) mild anxiety. There was a statistically significant difference when compared between two genders according to the severity of HAD-anxiety score, and anxiety scores were higher in women (p<0.001).
DISCUSSION AND CONCLUSION: Our findings showed that anxiety and depression levels increased in individuals hospitalized for Covid-19. The pandemic is expected to continue in the upcoming period. For this reason, it is thought that it is necessary to plan the interventions of patients to reduce their anxiety and depression levels and to create the necessary support programs.

GÝRÝÞ ve AMAÇ: Bu çalýþmada yaþamýnýn herhangi bir döneminde Ýdrar yolu enfeksiyonu (ÝYE) geçirme ile genital hijyen davranýþlarý arasý iliþkiyi deðerlendirme amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþma tek merkezli, tanýmlayýcý niteliktedir. Þiþli Hamidiye Etfal Araþtýrma Hastanesi Aile Hekimliði Polikliniði’ne baþvuran kadýn hastalardan katýlmayý kabul edenler alýnmýþtýr. Katýlýmcýlarýn sosyodemografik özellikleri ve genital hijyen davranýþlarýný sorgulayan 36 sorudan oluþan bir anket yüz yüze uygulanmýþtýr.
BULGULAR: Çalýþmaya 142 hasta dahil edilmiþtir. Yaþ ortalamasý 38,5±14,2 (min=8, maks=70). Herhangi bir zamanda ÝYE geçiren 104 (%73,2) kiþi idi. Yaþamýnýn herhangi bir döneminde ÝYE geçirme ile sosyodemografik özellikler arasýndaki iliþki saptanmamýþtýr(p≥0,05). Kadýn Hastalýklarý ve doðum bilgileri sorgulanmasýnda ise gebelik sayýsý, doðum sayýsý, en son yaptýðý doðum þekli ve þu an menopozda olma ile herhangi bir zamanda ÝYE geçirme arasýnda iliþki saptanmazken(p≥0,05); jinekolojik operasyon geçirme ile iliþki saptanmýþtýr(p=0,038). Genital bölge temizliðini arkadan öne yapmak ile herhangi bir döneminde ÝYE geçirme arasýnda anlamlý iliþkili saptandý (p=0,041).
TARTIÞMA ve SONUÇ: Sonuç olarak; genital bölge temizliðini arkadan öne yapmak, jinekolojik operasyon geçirmiþ olmak yaþamýnýn herhangi bir döneminde ÝYE arasýnda iliþki saptanmýþtýr. Doðru hijyen eðitiminin düzenlenmesi ve toplumun bilinçlendirilmesinin ÝYE'yi azaltacaðýný düþünüyoruz.

INTRODUCTION: In this study, it is aimed to evaluate the relationship between urinary tract infection [UTI] and genital hygiene behaviors in any period of life.
METHODS: The study is single-center and descriptive. All women agreed to participate in the study from the patients admitted to the Health Sciences University Þiþli Hamidiye Etfal Research Hospital Family Practice Clinic any reason is planned to be included in the survey. A questionnaire consisting of 36 questions questioning the participants' socio-demographic and genital hygiene behaviors was applied face to face.
RESULTS: 142 patients were included in the study. The average age is 38.5 ± 14.2 (min=18, max=70). It was 104 (%73,2) people who had UTI at any time. There was no relation between socio-demographic features and UTI at any time (p≥0.05). In the questioning of Obstetrics and Gynecology information, there was no relationship between the number of pregnancies, the number of births, the most recent birth type, and currently being in menopause and UTI at any time (p≥0.05), but a relationship with the gynecological operation was found (p=0.038). There was a significant correlation between performing genital area cleaning from the back to the front and transmitting UTI in any period (p=0.041).
DISCUSSION AND CONCLUSION: As a result, a relationship was found between performing genital area cleaning from the back to the front, having a gynecological operation, and transmitting UTI at any time in life. We think that organizing the right hygiene education and increase the awareness of society will decrease UTI.

GÝRÝÞ ve AMAÇ: Ülkemizde tularemi ilk olarak 1936 yýlýnda bildirilmiþ olup günümüzde daha çok Marmara, Batý-Orta Karadeniz, Ýç Anadolu bölgelerinde; kýrsal kesimlerde ve içme-kullanma sularýnýn sanitasyonunun yetersiz olduðu bölgelerde görülmektedir. Bu çalýþmada hastanemizde tularemi tanýsý ile izlenen hastalarýn klinik ve laboratuvar bulgularý retrospektif olarak deðerlendirilmiþtir.
YÖNTEM ve GEREÇLER: Ocak 2010- Ocak 2019 tarihleri arasýnda hastanemize baþvuran mikrobiyolojik veya serolojik olarak doðrulanmýþ tularemi hastalarý çalýþmaya dahil edildi. Hastalarýn demografik özellikleri, klinik ve laboratuvar bulgularý olgu bildirim formlarýndan ve hastalarýn takip çizelgelerinden elde edildi.
BULGULAR: Hastalarýmýzýn ortalama yaþý 43’tü ve hastalarýn çoðunluðu (%66) kadýn cinsiyete sahipti. Hastalarýn %52’si kuyu suyu kullanmaktaydý. Baþvuruda en yaygýn þikayetler boyunda þiþlik (%92), halsizlikti (%90), ateþ (%76) ve boðaz aðrýsý (%72) idi. Hastalarýn semptom baþlangýcýndan hastaneye baþvurusuna kadar geçen ortalama süre 22 gündü. Lenfadenopati (%94) ve konjonktivit (%24) ise en sýk saptanan klinik bulgular iken, 1 (%2) hastada splenomegali mevcuttu. Lenfadenopati ile baþvuran hastalarýn çoðunda (%65) servikal lenf nodlarý tutulmuþtu. Hastalarýn tanýsý mikroaglütinasyon testi ile doðrulandý ve antikor titreleri 1/160- 1/1280 arasýnda deðiþmekteydi. Altý (%12) hastanýn aspirasyon materyalinde Francisella tularensis polimeraz zincir reaksiyonu pozitifliði gösterilirken, 2 (%4) hastada ise kültürde mikroorganizma üretildi.
TARTIÞMA ve SONUÇ: Ülkemizde özellikle beta-laktam grubu antibiyotik tedavisine yanýt vermeyen boyunda þiþlik, boðaz aðrýsý ve ateþ yüksekliði ile baþvuran hastalarýn ayýrýcý tanýsýnda tularemi mutlaka akýlda bulundurulmalýdýr.

INTRODUCTION: In our country, tularemia was first reported in 1936, and today it is mostly seen in Marmara, West-Central Black Sea, and Central Anatolia regions; and in rural areas where sanitation of water is insufficient. In this study, clinical and laboratory findings of patients who were followed up with a diagnosis of tularemia were evaluated retrospectively.
METHODS: Microbiologically or serologically confirmed tularemia patients admitted to our hospital between January 2010 and January 2019 were included in the study. Demographic characteristics, clinical and laboratory findings of the patients were obtained from case report forms, and follow-up charts of the patients.
RESULTS: Mean age of the patients was 43 years, and the majority (66%) of the patients were female. Fifty-two percent of the patients were using well water. The most common complaints on admission were neck swelling (92%), weakness (90%), fever (76%), and sore throat (72%). The average time from the onset of symptoms to admission to the hospital was 22 days. While lymphadenopathy (94%) and conjunctivitis (24%) were the most common clinical findings, 1(2%) patient had splenomegaly. Cervical lymph nodes were involved in most of the patients (65%) presenting with lymphadenopathy. Diagnosis of patients was confirmed by microagglutination test and antibody titers ranged between 1/160 and 1/1280. Francisella tularensis polymerase chain reaction positivity was shown in 6(12%) patients’ aspiration specimen, while the microorganism was grown in culture in 2(4%) patients.
DISCUSSION AND CONCLUSION: In our country, tularemia should be kept in mind as a differential diagnosis, especially in patients who present with swelling in the neck, sore throat, high fever, and does not respond to beta-lactam group antibiotic treatment.

GÝRÝÞ ve AMAÇ: Ülkemizde ilk COVID-19 vakasý görülmesinden itibaren alýnan bir dizi önlemin içinde, pandemide hassas rolleri olan saðlýk personelinin korunmasýna yönelik önlemler de mevcuttur. Bu baðlamda, ülke çapýnda alýnan tedbirlerin 1. basamak saðlýk çalýþanlarý özelinde ve kiþisel koruyucu ekipmanlar (KKE) aðýrlýklý olarak incelemesi yapýlacaktýr.
YÖNTEM ve GEREÇLER: Ýlimizdeki Aile Saðlýðý Merkezleri'nde (ASM) çalýþan toplam 3.996 personele ve ilçelerde (Ýlçe Saðlýk Müdürlüðü/Toplum Saðlýðý Merkezi/Entegre Devlet Hastanesi) çalýþan toplam 2.380 personele çalýþmanýn yapýldýðý tarih aralýðýnda belli aralýklarla ve ihtiyaca yönelik olarak KKE (cerrahi maske, N95 maske, gözlük, eldiven, tulum, dezenfektan, siperlik) daðýtýlmýþtýr. Ayrýca birinci basamak saðlýk personelinin çalýþma yeri ve kurum bazýnda COVID-19 pozitiflik daðýlýmý ile ASM'lerde çalýþan personele yapýlan Hýzlý Taný Testi sonuçlarýyla aralarýndan pozitif çýkan vakalara yapýlan PCR testi sonuçlarýnýn karþýlaþtýrmasý da yapýlmýþtýr.
BULGULAR: Ýlimizdeki ASM'lere ve ilçelere toplamda 1.023.850 cerrahi maske, 96.627 N95 maske, 8.439 gözlük, 1.995.230 adet eldiven, 62.805 tulum, 11.961 L dezenfektan, 2.961 siperlik daðýtýmý yapýlmýþtýr. 53.124 saðlýk çalýþaný arasýnda tespit edilen 691 adet COVID-19 (+) vakanýn sadece 14’ünü 1. basamak saðlýk çalýþanlarý oluþturmaktadýr. Bunlarýn daðýlýmýna bakýldýðýnda; 1.568 aile hekiminde 7; 1.531 aile saðlýðý çalýþanýnda 2; 897 grup gereði çalýþan personelde 3 ve 2.380 Ýlçe Saðlýk Müdürlüðü/Toplum Saðlýðý Merkezi/Entegre Devlet Hastanesi personelinde ise 2 adet pozitif vaka izlenmiþtir. Bir kereye mahsus ilçelerde hýzlý taný testi ile test edilen 4.156 adet ASM çalýþaný arasýnda, testi pozitif gelen 27 personelde (%0,65) doðrulama için PCR testi yapýlmýþ, sadece 2 adedi PCR (+) olarak saptanmýþtýr.
TARTIÞMA ve SONUÇ: Ankara ili genelinde, COVID-19 ile mücadelede, birinci basamak saðlýk çalýþanlarýný güçlü kýlmak ve alýnan koruyucu tedbirlerin etkin uygulayabilmek adýna lojistik desteðe önem verilmiþtir.

INTRODUCTION: Protective measures for health workers, who have delicate roles throughout the pandemic, have been a part of the precautions taken since the onset of the first COVID-19 case in our country. In this context, countrywide precautions taken specifically to primary health care workers would be examined with a predominance on personal protective equipment (PPE).
METHODS: In our study, the details of PPE delivery (surgical mask, N95 mask, eye wears, gloves, surgical overalls, disinfectant, face-shield) to 3996 personnel in 25 family health centers of Ankara and 2380 personnel working for District Health Directorates/Public Health Centers/Integrated State Hospitals during the study interval were given. The distribution of COVID-19 positivity among primary health care workers based on the place and institute worked and the comparison of PCR test results for family health center personnel formerly tested positive by Rapid Antigen Test was compared.
RESULTS: In our city, 1,023,850 surgical masks, 96,627 N95 masks, 8,439 eye wears, 1,995,230 gloves, 62,805 surgical overalls, 11,961 L disinfectant, and 2,961 face-shields were distributed to the family health center and district personnel. 14 out of the 691 COVID-19 (+) cases amongst 53,124 health workers were primary health care workers. In 1,568 family physicians; 1,531 family healthcare personnel; 897 group personnel and 2,380 District Health Directorates/Public Health Centers/Integrated State Hospital personnel; 7,2,3 and 2 positive cases were observed, respectively. PCR testing was performed for the 27 family health center personnel (0.65%) out of 4,156 who tested positive by the formerly applied Rapid Antigen Test and only 2 came as PCR (+).
DISCUSSION AND CONCLUSION: In Ankara, logistical support is prioritized to enforce primary healthcare staff and to effectively implement the preventive measures during the COVID-19 struggle.

GÝRÝÞ ve AMAÇ: Osteoartrit (OA), dünyada en yaygýn görülen eklem hastalýðýdýr, en sýk alt ekstremitede görülür ve kronik kas iskelet sistemi aðrýlarýnýn en önemli nedenidir. OA tedavisi ve yönetimi amacýyla yayýnlanan tüm kýlavuzlarda önerilen en uygun tedavi yöntemi farmakolojik ve nonfarmakolojik tedavinin birlikte kullanýlmasýdýr. Bu çalýþmada, Ankara’daki Aile Hekimliði Kliniklerinde çalýþan hekimlerin OA tedavisindeki nonfarmakolojik yöntemler hakkýndaki farkýndalýklarýnýn ve yaklaþýmlarýnýn deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Araþtýrmamýz tanýmlayýcý, kesitsel tipte bir araþtýrmadýr. 2019 yýlý itibari ile Ankara’daki Aile Hekimliði Kliniklerinde çalýþan çeþitli unvanlara sahip tüm aile hekimleri çalýþma evrenimizi oluþturmaktadýr. Katýlmaya gönüllü olan aile hekimlerine, anket yüz yüze anket uygulama yöntemiyle uygulanmýþtýr. Nonfarmakolojik tedavi yaklaþýmlarýna dair hem kendi yetkinlik kanaati puanlarý hem de toplam yaklaþým puanlarý hesaplanmýþtýr. Ýstatistiki anlamlýlýk düzeyi p<0.05 olarak alýnmýþtýr.
BULGULAR: Çalýþmamýza 234 aile hekimi dahil edilmiþtir. Hekimlerin %54,71’u daha önce OA tedavi yaklaþýmlarý konusunda herhangi bir eðitim almadýklarýný belirtmiþtir. Eðitim alan ve bu eðitimin yeterli olduðunu düþünen hekimlerin hem nonfarmakolojik toplam yaklaþým puaný hem de kendilerine verdikleri yetkinlik puanlarý anlamlý olarak daha yüksek olarak saptanmýþtýr.
TARTIÞMA ve SONUÇ: OA tedavi yaklaþýmlarý konusunda genel olarak bir eðitim eksikliði saptanmýþ ve bu konuda daha önce eðitim alýp bu eðitimi yeterli bulan aile hekimlerinin ise bu eðitimlerden faydalandýðý bu çalýþmada görülmüþtür. Maliyet etkin ve uygulamasý kolay olan, hastalýðýn progresyonunu yavaþlatan, engelliliði azaltan nonfarmakolojik tedavi yöntemlerinin aile hekimleri tarafýndan daha sýk kullanýlmasý gerekmektedir.

INTRODUCTION: Osteoarthritis (OA) is the most common joint disease in the world, most common in the lower extremities, and the leading cause of chronic musculoskeletal pain. In all guidelines published on the treatment of OA, the most suitable method of treatment is the combination of pharmacological and nonpharmacological treatment. The aim of this study is to evaluate the awareness and approaches of nonpharmacological methods of OA treatment of physicians who working in Family Medicine Clinics in Ankara.
METHODS: This research is descriptive and cross-sectional. As of 2019, all family physicians working in Family Medicine Clinics in Ankara constitute the study population. Family physicians who volunteered to participate in the study were accepted to this study by using face to face survey methods. Both self-efficacy scores and total approach scores for non-pharmacological treatment were calculated. The significance level was taken p<0.05.
RESULTS: 234 family physicians participated to the study. 54.71% of physicians stated that they had not received a training on OA treatment approaches before. Physicians who received training and thought that this training was sufficient, both the non-pharmacological approach score and the competence scores they gave themselves were found to be significantly higher.
DISCUSSION AND CONCLUSION: A lack of education on OA treatment approaches was detected and it was seen in this study that family physicians who had received training on this subject and found this training sufficient benefited from these trainings. This study showed that nonpharmacological treatment methods should be used more frequently by family physicians because of easy to apply, low cost and reduce disease progression and disability.

GÝRÝÞ ve AMAÇ: Evde Saðlýk Birimi’ne kayýtlý 65 yaþ ve üstü hastalarda çoklu ilaç kullanýmýnýn tespit edilmesi, ilaçlarýn 2015 ve 2019 AGS Beers Kriterleri kriterlerine göre uygun olup olmadýðýnýn belirlenmesi, iki versiyon arasýnda klinik açýdan anlamlý farklýlýk olup olmadýðýnýn araþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Retrospektif tanýmlayýcý tarzdaki çalýþmamýzda, kayýtlý 659 hasta dosyasý tarandý. Verilerine ulaþýlan 493 hastanýn ilaç kullaným verileri 2015 ve 2019 AGS Beers kriterlerine göre analiz edildi.
BULGULAR: Çalýþmaya 354’ü (%71,81) kadýn 493 hasta dahil edildi. Hastalarýn taný almýþ hastalýk sayýsý ortancasý 6 (min: 1, maks: 10) olup en sýk görülen hastalýklar, hipertansiyon, yaygýn anksiyete bozukluðu, diabetes mellitus idi. 490 hastanýn kullandýðý en az bir ilacý olup ilaç sayýsý ortancasý 7 (min: 0, maks: 16) idi. Hastalarýn 306’sýnda (%62,45) polifarmasi, 91’inde (%18,57) aþýrý polifarmasi saptandý. Potansiyel UÝK durumu 2015 ve 2019 Beers kriterlerine göre 211 hastada saptandý. 2015 Beers Kriterlerine göre 358, 2019 Beers Kriterlerine göre 383 etken maddede uygunsuz ilaç kullanýmý (UÝK) belirlendi. Polifarmasi görülen hastalarda her iki versiyona göre de UÝK sýklýðý daha fazlaydý.
TARTIÞMA ve SONUÇ: Polifarmasi saptanan hastalarda UÝK durumunun da önemli oranda fazla olduðu görüldü. 2015 ve 2019 AGS Beers kriterlerinin UÝK tespit durumu kýyaslandýðýnda, 2019 versiyonunda daha fazla etken maddede uygunsuzluk saptandý.

INTRODUCTION: It is aimed to determine the use of multiple drugs in patients aged 65 and over who are registered in the Home Health Unit, to determine whether the drugs are suitable according to the 2015 and 2019 AGS Beers Criteria, and to investigate whether there is a clinically significant difference between the two versions.
METHODS: In our retrospective descriptive study, 659 patient files were scanned. The drug usage data of 493 patients, whose data were eligible, were analyzed according to the 2015 and 2019 AGS Beers criteria.
RESULTS: The study included 493 patients, 354 (71.81%) of whom were female. The median number of diagnosed diseases was 6 (min: 1, max: 10), and the most common diseases were hypertension, generalized anxiety disorder, and diabetes mellitus. At least one drug used by 490 patients and the median number of drugs was 7 (min: 0, max: 16). Polypharmacy was detected in 306 (62.45%) patients and excessive polypharmacy in 91 (18.57%) patients. Potential Inappropriate Medication (PIM) status was determined in 211 patients according to 2015 and 2019 Beers criteria. PIM status was determined in 358 active substances according to the 2015 Beers Criteria and 383 active substances according to the 2019 Beers Criteria. The frequency of PIM was higher in patients with polypharmacy compared to both versions.
DISCUSSION AND CONCLUSION: PIM status was observed to be significantly higher in patients with polypharmacy. When the PIM detection status of the 2015 and 2019 AGS Beers criteria was compared, inappropriateness was found in more active ingredients in the 2019 version.

GÝRÝÞ ve AMAÇ: Prostat kanserli hastalarda kemik metastaz taramasýnda lumbopelvik SPECT/BT görüntülemenin TVKS’ye katkýsýný belirlemek ve tedavi yöntemine etkisini araþtýrmaktý.
YÖNTEM ve GEREÇLER: 184 hastanýn verileri geriye dönük olarak incelendi. TVKS, lumbopelvik SPECT/BT ve her ikisinin birlikte deðerlendirilmesiyle tüm hastalar normal, benign, þüpheli ve metastatik olarak yorumlandý. Her metodun kemik metastazýný belirlemedeki tanýsal parametreleri hesaplandý. Ayrýca lumbopelvik SPECT/BT’nin hasta bazýnda tanýya katkýsý ve tedavi yönetimine etkisi belirlendi.
BULGULAR: TVKS ile hastalarýn %22,82’si metastaz açýsýndan þüpheli olarak deðerlendirilmiþ olup bu oran lumbopelvik SPECT/BT’nin eklenmesiyle belirgin olarak düþmüþtür (%22,82 ve %7,61; p<0,001). Lumbopelvik bölge özelinde deðerlendirildiðinde SPECT/BT ile net yorum yapýlamayan hasta oraný planar görüntülemeye göre belirgin olarak düþük bulunmuþtur (%4,89 ve %21,73; p<0,001). TVKS+lumbopelvik SPECT/BT’nin duyarlýlýk ve özgüllük deðerleri %100 ve %97,61 olarak bulunmuþtur. Lumbopelvik SPECT/BT ile hastalarýn %23,36’sýnda metastaz tanýsý kesinleþmiþ veya deðiþmiþ, diðer bazý hastalarda ise tedavi yönetimini etkileyecek metastaz yaygýnlýðý veya semptomatik benign patolojiler saptanmýþtýr. Sonuçta hastalarýn %41,84’ünde lumbopelvik SPECT/BT’nin tedavi yönetimine katkýsý olmuþtur.

TARTIÞMA ve SONUÇ: Lumbopelvik SPECT/BT, prostat kanserinde kemik metastaz taramasýnda þüpheli yorumlarý azaltýr ve tedavi yönetimine belirgin katký saðlar. Bu nedenle ileri evre ve semptomatik hastalarýn metastaz taramasýnda TVKS ile birlikte rutin lumbopelvik SPECT/BT görüntülemeyi öneriyoruz.

INTRODUCTION: The study aimed to determine the contribution of lumbopelvic SPECT/CT and investigate its effect on management of therapy.
METHODS: The data of 184 patients were analyzed retrospectively. All patients were interpreted as normal, benign, suspicious, and metastatic by evaluating WBS, lumbopelvic SPECT/CT, and both. Each method's diagnostic parameters and the contribution of lumbopelvic SPECT/CT to diagnosis and therapy management were determined on a patient basis.
RESULTS: With WBS, %22.82 of the patients were evaluated as suspicious for metastasis, and this rate decreased significantly with the addition of lumbopelvic SPECT/CT (%22.82 and %7.61; p <0.001). When evaluated specifically for the lumbopelvic region, the rate of suspicious findings with SPECT/CT was found to be significantly lower than planar imaging (%4.89 vs. %21.73; p <0.001). The sensitivity and specificity values of WBS + lumbopelvic SPECT/CT were found to be 100% and %97.61. With lumbopelvic SPECT/CT, the metastasis diagnosis was confirmed or changed in %23.36 of the patients. Besides, the extent of metastasis was changed, or symptomatic benign pathologies were determined in some patients. As a result, lumbopelvic SPECT/CT contributed to the therapy management in %41.84 of the patients.
DISCUSSION AND CONCLUSION: Lumbopelvic SPECT/CT reduces suspicious comments in screening for bone metastases in prostate cancer and significantly contributes to treatment management. For this reason, we recommend routine lumbopelvic SPECT / CT imaging together with WBS for metastasis screening in an advanced stage and symptomatic patients.

GÝRÝÞ ve AMAÇ: Beyin ölümü kavramý klinik olarak uyarýlara tam cevapsýzlýk hali, solunum ve motor cevabýn olmamasý, beyin sapý reflekslerinin yokluðu ve koma tablosunun mevcudiyeti ile tüm beyin fonksiyonlarýnýn tam ve geri dönüþümsüz olarak kaybý ile karakterize bir klinik tablo olarak tanýmlanmaktadýr. Türkiye'de sýnýrlý donör kaynaklarý ve yüksek aile reddi nedeniyle beyin ölümü ve potansiyel baðýþçýlarýn belirlenmesi büyük önem arz etmektedir. Burada üçüncü basamak eriþkin yoðun bakým ünitesinde beyin ölümü geliþen hastalarý ve kadavra donörlerini geriye dönük olarak deðerlendirmeyi hedefliyoruz.
YÖNTEM ve GEREÇLER: 2008-2019 yýllarý arasýnda beyin ölümü tanýsý alan hastalarýn týbbi kayýtlarý geriye dönük olarak deðerlendirildi. Hastalarýn demografik özelliklerini, klinik tanýlarýný ve baðýþ oranlarýný kaydedildi.
BULGULAR: 2008-2019 yýllarý arasýnda yoðun bakým ünitesinde toplam 102 beyin ölümü hastasý teþhis edildi. Hastalarýn ortalama yaþý 49 (16-84, min-maks), %55,88'i erkek ve %44,11'i kadýndý. Klinik tanýlar spontan intrakraniyal kanama (%50), travmatik intrakraniyal kanama (%28,43), kardiyak arrest (%12,74) ve serebral infarkt (%7,84) idi.19 (%18,62) hastada organ baðýþý onaylanýrken 83 hastada reddedildi. Yoðun bakýma baþvuru ile apne testi arasýnda geçen süre ortalama 3,56 gün olarak belirlendi.
TARTIÞMA ve SONUÇ: Bu çalýþmada, beyin ölümü taný oranlarýnýn arttýðýný, ancak kadavra donörden organ baðýþý oranlarýnda deðiþiklik olmadýðýný tespit ettik. Saðlýk çalýþanlarý, organ baðýþý oranlarýný artýrmak için organ baðýþý ve organ baðýþý gönüllülüðü konusundaki farkýndalýðý arttýrmaya odaklanmalýdýr.

INTRODUCTION: The concept of brain death is clinically defined as the absence of spontaneous respiration, brain stem reflexes, and motor responses, presence of coma, and irreversible cessation of brain function, including the cerebral and brain stem functions completely. Because of limited donor sources and high family refusal in Turkey, to determine brain death and potential donors is very important. Here we aim to evaluate the brain-dead patients and cadaver donors in a tertiary level adult intensive care unit, retrospectively.
METHODS: We evaluated the medical records of brain-dead patients diagnosed between the years 2008-2019, retrospectively. We recorded the demographics of the patients, clinical diagnosis, and donation rates.
RESULTS: A total of 102 brain dead patients were diagnosed in the intensive care unit between the years 2008-2019. The median age of the patients was 49.16 (16-84, min-max), 55.88% was male and 44.11% was female. The clinical diagnoses were spontaneous intracranial hemorrhage (50%), traumatic intracranial hemorrhage (28.43%), cardiac arrest (12.74%), and cerebral infarct (7.84%). Organ donation was approved in 19 (18.62%) patients and refused in 83 patients. The time between admission to the intensive care unit and apnea test was determined as a mean of 3.56 days.
DISCUSSION AND CONCLUSION: In the present study, we recognized the increased rates of brain death diagnosis, but there was no change in donation rates of cadaver donors. Health professionals should focus on promoting awareness of organ donation and volunteering to donate in order to increase donation rates.

GÝRÝÞ ve AMAÇ: COVID-19 hastalarýnda yaþýn, toraks bilgisayarlý tomografi (BT) bulgularý ve hastalýk þiddeti üzerindeki etkisini analiz etmek.
YÖNTEM ve GEREÇLER: Çalýþma, 1 Nisan 2020-1 Haziran 2020 tarihleri arasýndaki 367 COVID-19 hastasýnýn toraks BT görüntülerini içeriyordu. Hastalar dört yaþ grubuna ayrýldý: Grup A (≤19 yaþ), grup B (20-39 yaþ), grup C (40-59 yaþ) ve grup D (≥60 yaþ). BT'de lateralite, tutulan loblar, lezyon sayýsý, lezyon tipleri ve lezyon daðýlýmý deðerlendirildi ve karþýlaþtýrýldý.
BULGULAR: Çalýþma popülasyonu 367 hastadan (210 erkek, 157 kadýn, ortalama yaþ 47.50, aralýk 12-92 yaþ) oluþmaktaydý. Yaþ gruplarý arasýnda cinsiyet farký yoktu. Tüm yaþ gruplarýnda en sýk görülen BT bulgusu buzlu cam opasitesiydi. Lezyon sayýsýnýn da daha fazla olduðu yaþlý hastalarda konsolidasyonlar, kaldýrým taþý manzarasý ve hava bronkogramlarý daha yaygýndý. Yaþlý hastalarda üst loblar ve sað orta lob daha sýk etkilenmiþti. Grup A ve B'de mortalite saptanmazken, grup C ve D’de yoðun bakým ihtiyacý ve ölüm oranlarý daha yüksekti. ROC eðrisi analizi, kötü prognoz açýsýndan 55 yaþýn optimal kesim deðeri olduðunu ortaya koydu.
TARTIÞMA ve SONUÇ: COVID-19 hastalarýnýn toraks BT bulgularý yaþa göre deðiþiklik göstermektedir. Bilateral, multiple ve yaygýn infiltrasyonlar, konsolidasyon, hava bronkogramý, kaldýrým taþý manzarasý ile üst loblarýn tutulumu ve ileri yaþ kötü prognoz iþareti olarak düþünülmelidir.

INTRODUCTION: To analyze the effect of age on chest computed tomography (CT) features and disease severity in COVID-19.
METHODS: The study included the chest CT images of 367 patients with COVID-19 between April 1, 2020, and June 1, 2020. The patients were divided into four age groups: Group A (≤19 years), group B (20-39 years), Group C (40-59 years), and Group D (≥60 years). On chest CT, laterality, involved lobes, number of lesions, lesion types, and lesion distribution were evaluated and compared.
RESULTS: The study population consisted of 367 patients (210 male and 157 female, mean age 47.50 years, range 12-92 years). There was no significant gender difference between the age groups. The most common CT finding in all age groups was ground-glass opacity. Consolidations, crazy-paving patterns, and air bronchograms were more common in elderly patients, in which the number of lesions was also higher. The upper lobes and the right middle lobe were affected more frequently in elderly patients. While no mortality was found in groups A and B, the rates of intensive care admission and mortality were higher in groups C and D. The ROC curve analysis revealed that 55 years of age was the optimal cut-off value to predict a worse outcome.
DISCUSSION AND CONCLUSION: The CT findings of COVID-19 patients vary in different age groups. Bilateral, multiple and diffuse infiltrations, consolidation, air bronchogram, and crazy-paving patterns, upper lobe involvement, and older age should be considered as an indicator for worse outcomes.

GÝRÝÞ ve AMAÇ: Çalýþmanýn amacý varfarin tedavisi alýrken acil serviste (AS) International Normalized Ratio (INR) yüksekliði tespit edilen ve tedavide Protrombin Kompleks Konsantresi (PCC) kullanýlan olgularý uygulama sonuçlarý ile birlikte deðerlendirmektir.
YÖNTEM ve GEREÇLER: Çalýþma 01.01.2013-31.07.2019 arasýnda Eskiþehir Osmangazi Üniversitesi Týp Fakültesi Hastanesi Acil Servis’inde geriye dönük olarak yapýldý. Varfarin tedavisi alýrken AS’de INR yüksekliði saptanan, PCC uygulama endikasyonu olan 18 yaþ ve üstü hastalar çalýþmaya dahil edildi. Demografik veriler, INR deðerleri ve bunlarýn mortalite ile iliþkileri deðerlendirildi. Hedef INR deðeri 1,5 olarak belirlendi.
BULGULAR: Deðerlendirmeye alýnan 106 olgunun yaþ ortalamasý 71 (28-97 aralýðýnda) ve 59’u (%55,70) kadýndý. Varfarin kullaným nedeni 42 (%39,60) olgu ile en sýk atriyal fibrilasyondu. En sýk PCC kullaným nedeni ise 48 (%45,30) olgu ile intrakraniyal kanama idi. Baþvuru INR ortanca deðeri 8,96 (Q-Q3: 5,06-15) idi. Baþvuru INR deðerleri ile PCC kullanma nedenleri arasýnda istatistiksel anlamlý iliþki saptanmadý (p= 0,93). PCC uygulamasý sonrasý kontrol INR ortanca deðeri 1,43 (Q1-Q3: 1,26-1,91) bulundu. Olgularýn 49’unda (%46,00) hedef INR’ye ulaþýldýðý görüldü. Olgularýn INR azalma oranlarýnýn ortanca deðeri 81 (Q1-Q3: 67-89) olarak belirlendi. 24 saatlik mortalite %1,97 iken 30 günlük mortalite %20,7 olarak saptandý. Baþvuru ve kontrol INR deðerleri ile mortalite arasýnda istatistiksel iliþki saptanmadý (p deðerleri sýrasýyla; 0,06-0,09). Tromboembolik olaya rastlanmadý.
TARTIÞMA ve SONUÇ: Varfarin doz aþýmýna baðlý kanamasý veya kanama riski olan hastalarda kanamanýn ciddiyeti dikkate alýnarak tedavi verilmelidir. Varfarin kullanýmýna baðlý hayatý tehdit eden kanamalarda ve acil giriþimlerde PCC kullanýmý INR azalmasýnda etkin rol oynamaktadýr.

INTRODUCTION: The aim of the study is to evaluate the cases with warfarin therapy in which elevated International Normalized Ratio (INR) was detected and Prothrombin Complex Concentrate (PCC) was used for treatment at the Emergency Department (ED), and their treatment outcomes.
METHODS: The study was conducted retrospectively at the ED of Eskisehir Osmangazi University Medical School between 01.01.2013-31.07.2019. Patients 18 years and older having Warfarin therapy who had elevated INR and PCC indication at the ED were included in the study. Demographics, INR levels, and their relationship with mortality were evaluated. The target INR was set as 1.5. The study was conducted retrospectively at the ED of Eskisehir Osmangazi University Medical School between 01.01.2013-31.07.2019. Patients 18 years and older having Warfarin therapy who had elevated INR and PCC indication at the ED were included in the study. Demographics, INR levels, and their relationship with mortality were evaluated. The target INR was set as 1.5. The study was conducted retrospectively at the ED of Eskisehir Osmangazi University Medical School between 01.01.2013-31.07.2019. Patients 18 years and older having Warfarin therapy who had elevated INR and PCC indication at the ED were included in the study. Demographics, INR levels, and their relationship with mortality were evaluated. The target INR was set as 1.5.
RESULTS: The average age in 106 evaluated cases was 71 (range, 28-97) and 59 (55.70%) were female. The most common reason for warfarin use was atrial fibrillation (42 cases-39.60%). The most common reason for PCC use was intracranial hemorrhage (48 cases-45.30%). The initial median INR was 8.96 (Q1-Q3: 5.06-15). There was no statistically significant relation between initial INR and the reasons for PCC use (p=0.93). The control median INR was 1.43 (Q1-Q3: 1.26-1.91). Target INR was achieved in 49 cases (49.00%). The median drop levels in INR was 81(Q1-Q3: 67-89). 24-hour mortality was 1.97% and 30-day mortality was 20.7%. There was no statistically significant relation between initial INR and mortality (p=0.06-0.09, respectively). No thromboembolic incident was encountered.
DISCUSSION AND CONCLUSION: In patients, who have hemorrhage or hemorrhage risk due to warfarin overdose, treatment should be implemented considering hemorrhage. In life-threatening hemorrhages and emergency interventions related to warfarin, PCC has an efficient role in INR reduction.

32 yaþýnda, 17 haftalýk gebe hasta, üst solunum yolu enfeksiyonu sonrasýnda boynunun sað tarafýnda aðrýlý bir kitle fark edip aile hekimliði polikliniðine baþvurdu. Fizik muayenede vitalleri stabildi. Farinksinin hiperemik olduðu, sað servikal bölgede en büyüðü 1 cm olan birkaç adet lastik kývamýnda, sert, fikse, aðrýlý lenfadenopatisi olduðu saptandý. Hastaya aile hekimi tarafýndan üst solunum yolu enfeksiyonu tanýsý ile ampirik antibioterapi baþlanýp kontrole çaðrýldý. Lenf bezlerindeki hýzlý büyüme ve boyutlarýnýn 1 cm’in üzerinde olmasý nedeni ile malignite ön tanýsý ile kulak burun boðaz polikliniðine sevk edildi. Alýnan eksizyonel biyopsi sonucunda Diffüz Büyük B Hücreli Lenfoma tanýsý aldý. Kemoterapi planlanan hastaya gebelik terminasyonu önerildi ancak hasta reddetti. Gebeliðin 32. haftasýnda fetal distres nedeni ile 1500 gr kýz bebeðin sezaryen ile canlý olarak doðumu gerçekleþtirildi. Gebelikle baðlantýlý olmasý ve seyrek görülmesi, malignite gibi hayati bir hastalýkta aile hekiminin erken teþhiste rol almasý nedeniyle olgunun literatür eþliðinde sunulmasý uygun görülmüþtür.

A 32-year-old, 17-week pregnant patient visited her family physician because of painful lymphadenopathy on the right side of her neck after an upper respiratory tract infection. On physical examination, her vital signs were stable. A few elastic, firm, fixed, and painful lymphadenopathies, the largest of which was 1 cm were detected in the right cervical region, and the pharynx of the patient was hyperemic. Empirical antibiotherapy treatment was initiated by the family physician with the diagnosis of upper respiratory tract infection and the patient was called for control follow-up. Due to the rapid growth of lymph nodes and their size over 1 cm, she was referred to the otorhinolaryngology outpatient clinic with a preliminary diagnosis of malignancy. She was diagnosed with Diffuse Large B Cell Lymphoma. Pregnancy termination was recommended to the patient whose chemotherapy was scheduled, but the patient refused. At the 32nd week of pregnancy, the pregnancy was terminated due to fetal distress and a 1500-gram live baby girl was born. Since it is associated with pregnancy and rare, and that the family physician plays a role in early diagnosis of a important disease such as malignancy, it is deemed appropriate to present the case with literature.

Arteriyovenöz malformasyon (AVM); arter ile ven arasýnda kapiller baðlantý olmaksýzýn birbiriyle doðrudan iliþkili olduðu sýklýkla intrakraniyal yerleþimli anormal damarsal oluþumlardýr. Lezyon baþ boyun bölgesinde sýk görülmesine raðmen özellikle aurikulada nadir görülür. Aile saðlýðý merkezine kulak kepçesinde kanamalý kitle ve tinnitus þikayeti ile baþvuran 64 yaþýndaki erkek hasta bu þikayetleri üzerine kulak burun boðaz bölümüne yönlendirildi. Burada kitle eksizyonu yapýldý ve primer sütürle kapatýldý. Patoloji bölümümüze polipoid görünümde 1,7x0,7x0,7 cm boyutlarýnda ince bir sapý bulunan kesit yüzeyi kirli beyaz renkli, kanamalý bir materyal geldi. Histopatolojik incelemede düzgün sýnýrlý, kalýn duvarlý, çeþitli büyüklüklerde ve çaplarda arter ve ven yapýlarýndan oluþan bir lezyon izlendi. Olguya yapýlan immünhistokimyasal boyamalarda CD31 ve CD34 (+) Podoplanin (-) tespit edildi. Histokimyasal boyamada damar duvarlarýnda MTK (Masson's Trichrome boyamasý ) ile boyanma saptandý. Tüm bu bulgularla olguya aurikulaya sýnýrlý bir AVM tanýsý konuldu. Olgu nadir görülmesi nedeniyle literatür tartýþmasý eþliðinde sunuldu.

Arteriovenous malformation (AVM) refers to the abnormal venous formations, which are generally localized to intracranial region and directly related with each other without a capillary connection between artery and vein. The lesion is frequently seen in the head-neck region but rarely in auricula. A 64-year-old male patient, who applied to the family health center with the complaints of tinnitus and hemorrhagic mass in the auricula, was referred to the otolaryngology department. The mass was excised there and then closed using primary suture. A hemorrhagic material with 1.7x0.7x0.7cm dimensions and, having a thin stem and off-white colored surface, and polypoid appearance was brought to our pathology department. In the histopathological examination, a well-circumscribed lesion consisting of arteries and vessels having different sizes and radii and thick walls was observed. In immunohistochemical staining, the case was found to be CD31 and CD34 (+) and Podoplanin (-). In histochemical staining, the staining with MTK (Masson's Trichrome Stain) was observed in vessel walls. In the all these findings, the diagnosis of AVM limited to auricula was made. Since this case is rarely seen, it is presented together with a literature discussion.

COVID-19 Hastalýðý, asemptomatik enfeksiyondan kritik hastalýða kadar geniþ bir klinik yelpazeye sahiptir, az sayýda COVID-19 hastasý ölümle sonuçlanabilecek ciddi hastalýklar yaþar. Literatürde COVID-19 hastalýðýnda kutanöz lezyonlarla ilgili daha az bilgi mevcuttur. 42 yaþýnda, bilinen hastalýðý olmayan erkek hasta, 3 gün önce baþlayan ateþ, kuru öksürük, halsizlik, kýzarýklýk ve baþ aðrýsý þikayetlerinden sonra acil servisimize geldi. Bu yazýda, COVID-19 enfeksiyonunun zona zoster gibi diðer hastalýklarda da görülebileceði konusunda farkýndalýk yaratmayý amaçladýk.

COVID-19 Disease has a wide clinical spectrum from asymptomatic infection to critically ill, a small number of COVID-19 patients experience a severe illness that can result in death. Less information is available in the literature regarding cutaneous lesions in COVID-19 disease. A 42-year-old male patient with no known disease came to our emergency department after fever, dry cough, weakness, rashes, and headache complaints that started 3 days ago. In this article, we aimed to report this case to raise awareness that COVID-19 infection can be accompanied by other diseases such as zona zoster.

Kýrýlganlýk sendromu, yaþlanan nüfusun en önemli sorunlarýndan biridir. Ýnflamatuar süreçlerin düzensizliði, oksidatif stres, mitokondriyal iþlev bozukluðu ve hücresel yaþlanma dahil olmak üzere çeþitli patofizyolojik etkenler, sendromun patofizyolojisini oluþturur. Sosyodemografik özellikler, psikolojik durumlar, beslenme durumu, fiziksel aktivite eksikliði ve mevcut komorbiditeler kýrýlganlýðý etkileyen faktörlerdir. Omega-3 çoklu doymamýþ yað asidinin (ÇDYA) akut veya kronik hastalýðý olan yaþlýlarda anti-inflamatuar etkisi sayesinde yararlý etkilerinin olduðu bilinmektedir. Bu derlemenin amacý, diyet kaynaklý veya destek olarak verilen omega-3 ÇDYA'nýn yaþlý bireylerde kas kütlesi ve kas gücü, inflamatuar biyobelirteçler ve fonksiyonel kapasitedeki rolüne iliþkin kanýtlarý incelemek ve deðerlendirmektir. Yapýlan araþtýrmalar, omega-3 ÇDYA'nýn pre-kýrýlganlýk dönemde olan yaþlý bireylerde sendromun seyrini iyileþtirici etki gösterebileceðini desteklemektedir. Kýrýlganlýk evresinde olan yaþlýlarda diyet kaynaklý veya destek olarak verilen omega-3 ÇDYA'nýn etkileri tartýþmalýdýr. Tüm araþtýrmalar, sarkopeni ve kýrýlganlýk geliþimini önlemek için rutin olarak beslenme durumunun kontrol edilmesi ve gerekli diyet müdahalelerinin yapýlmasýnýn önemini vurgulamaktadýr.

Frailty syndrome is one of the most important problems of the aging population. Various pathophysiological factors constitute the pathophysiology of the syndrome, including dysregulation of inflammatory processes, oxidative stress, mitochondrial dysfunction, and cellular aging. Sociodemographic characteristics, psychological conditions, nutritional status, lack of physical activity, and existing comorbidities are factors that affect frailty. Omega-3 polyunsaturated fatty acid (PUFA) is known to have beneficial effects in the elderly with acute or chronic diseases due to its anti-inflammatory effect. The purpose of this review is to examine and evaluate the evidence for the role of dietary or supplemental omega-3 PUFA in muscle mass and muscle strength, inflammatory biomarkers, and functional capacity in elderly individuals. Studies support that omega-3 PUFA may improve the course of the syndrome in pre-frailty older adults. The effects of dietary or supplemental omega-3 PUFA in frail elderly are controversial. All studies emphasize the importance of routinely controlling nutritional status and making the necessary dietary interventions to prevent the development of sarcopenia and frailty.