GÝRÝÞ ve AMAÇ: Saðlýklý yaþam tarzý davranýþlarý, “saðlýklý bir zihin durumunu sürdürmek ve saðlýklý aktivite davranýþlarý geliþtirmek” anlamýna gelir. Bu çalýþmanýn amacý üniversite öðrencilerinde saðlýklý yaþam tarzý davranýþlarý ile vücut kompozisyonlarý arasýndaki iliþkiyi incelemektir.
YÖNTEM ve GEREÇLER: Kesitsel tipteki bu çalýþmanýn evrenini Beslenme ve Diyetetik Bölümü'nde okuyan öðrenciler oluþturdu. Katýlýmcýlarýn demografik verileri toplandý ve “Saðlýklý Yaþam Biçimi Davranýþlarý Ölçeði-II” uygulandý.
BULGULAR: Öðrencilerin ortalama Saðlýklý Yaþam Biçimi Davranýþlarý Ölçeði II puaný 130,15±15,07 olarak belirlendi. Vücut kitle indeksine göre normal olan öðrencilerin fiziksel aktivite puanlarý, zayýf ve fazla kilolu olanlara göre istatistiksel olarak anlamlý düzeyde daha yüksekti. Vücut kitle indeksine göre normal olan öðrencilerin beslenme puanlarý zayýf olanlara göre istatistiksel olarak anlamlý derecede daha yüksekti. Vücut yað yüzdelerine göre obez olan öðrencilerin fiziksel aktivite puanlarý atlet, fit veya normal olanlara göre istatistiksel olarak anlamlý derecede düþüktü. Bel çevresine göre fazla kilolu olan öðrencilerin saðlýk sorumluluðu ve fiziksel aktivite puanlarý normal olanlara göre istatistiksel olarak anlamlý derecede düþüktü.
TARTIÞMA ve SONUÇ: Bu çalýþma, daha saðlýklý ve daha zinde bir vücuda sahip öðrencilerin beslenmelerine daha fazla önem verdiklerini, daha fazla fiziksel aktivitede bulunduklarýný ve daha yüksek saðlýk sorumluluklarýna sahip olduklarýný göstermiþtir.

INTRODUCTION: Healthy lifestyle behaviors refer to “maintaining a healthy state of mind and developing healthy activity behaviors.” The aim of this study was to investigate the relationship between healthy lifestyle behaviors and body composition in university students.
METHODS: The population for this cross-sectional study consisted of students from the Nutrition and Dietetics Department. Demographic data were collected, and the “Health Promoting Lifestyle Profile II” (HPLP-II) was administered.
RESULTS: The mean HPLP-II score of the students was 130.15 ± 15.07. The physical activity score of the students was normal according to body mass index (BMI), and it was significantly higher than that of those who were underweight and overweight. According to BMI, the nutrition scores of normal students were statistically significantly higher than those who were underweight. The physical activity scores of the students who were obese according to their body fat percentage were statistically significantly lower than those of those who were athletes, fitness, or average. According to their waist circumference, the health responsibility and physical activity scores of the overweight students were statistically significantly lower than those of those who were normal.
DISCUSSION AND CONCLUSION: In this study, it was shown that students who have healthier and fitter bodies pay greater attention to their nutrition, take part in more physical activity, and have higher levels of health responsibility.

GÝRÝÞ ve AMAÇ: Vitamin D eksikliði; artmýþ advers gebelik sonuçlarý, fetal neonatal komplikasyonlar ve anne yenidoðanýn ilerideki yaþamlarýndaki ciddi saðlýk sorunlarý ile iliþkilidir. Bununla birlikte maternal vitamin D statüsünün gestasyonel diyabet (GDM) riski ile iliþkisini araþtýran çalýþma sonuçlarý çeliþkilidir. Bu çalýþma retrospektif olarak maternal vitamin D düzeylerine göre GDM riskini deðerlendirmeyi amaçlamaktadýr.
YÖNTEM ve GEREÇLER: Dýþlama kriterleri uygulandýktan sonra 33 GDM ve 164 kontrol toplam 197 gebe kadýn çalýþmaya alýndý. Vitamin D düzeylerine gebeliðin 11-14 haftalarý arasýnda bakýldý. GDM tanýsý gebeliðin 24-28 haftalarý arasýnda 75 gram glukozla yapýlan oral glukoz tolerans testi ile kondu.
BULGULAR: GDM grubunda BMI non-GDM grubundan yüksekti (24,68 [21,72–27,64] kg/m2 vs. 22,04 [20,51–24,73] kg/m2, p = 0,004). ). Vitamin D düzeyleri GDM grubunda non-GDM grubundan anlamlý olarak daha düþük bulundu (17,2 [15,6–19,2] nmol/L vs. 33,0 [31,2–35,0] nmol/L, p <0,001). Vitamin D eksikliði prevalansý GDM grubunda % 87,88 olup, D vitamini eksikliði GDM riskini 67,06 kat arttýrmaktaydý (odds oraný 67,06, 95% güven aralýðý 20,90–215,15, p <0,001).
TARTIÞMA ve SONUÇ: Gebeliðin erken döneminde D vitamini eksikliði ile GDM geliþme riski arasýnda anlamlý bir iliþki saptanmýþtýr. Gebelik sýrasýnda özellikle de ilk prenatal vizitte D vitamini eksikliðinin rutin olarak taranmasý GDM’nin ve GDM’nin anne ve yenidoðandaki olumsuz sonuçlarýnýn daha iyi yönetilmesi bakýmýndan yararlý olacaktýr.

INTRODUCTION: Vitamin D deficiency is linked to increased risk of adverse pregnancy outcomes, fetal and neonatal complications, as well as serious health consequences later in life for both mothers and offspring. However, studies on maternal vitamin D status and risk for gestational diabetes mellitus (GDM) are controversial. This study aimed to retrospectively evaluate the risk for GDM based on maternal serum vitamin D levels.
METHODS: After applying the exclusion criteria, a total of 197 pregnant women, including 33 GDM cases and 164 controls, were enrolled in the study. Vitamin D levels were measured at 11–14 weeks of gestation. GDM was diagnosed by performing a 75-g oral glucose tolerance test between 24 and 28 weeks of gestation.
RESULTS: BMI was higher in the GDM group than in the non-GDM group (24.68 [21.72–27.64] kg/m2 vs. 22.04 [20.51–24.73] kg/m2, p = 0.004). Vitamin D levels were significantly lower in the GDM group than in the non-GDM group (17.2 [15.6–19.2] nmol/L vs. 33.0 [31.2–35.0] nmol/L, p < 0.001). The prevalence of vitamin D deficiency was as high as 87.88% in the GDM group, with a 67.062-fold higher risk for GDM (odds ratio 67.062, 95% confidence interval 20.904–215.150, p < 0.001).
DISCUSSION AND CONCLUSION: Insufficient vitamin D level in early pregnancy is significantly associated with GDM development. Routine screening for vitamin D deficiency during pregnancy, particularly at the first prenatal visit, may contribute to the identification and better management of GDM and its related adverse outcomes in mothers and offspring.

GÝRÝÞ ve AMAÇ: Türkiye'de 65 yaþ ve üzeri bireyler için zorunlu olarak yapýlan aþý uygulamasý olmamasý nedeniyle bu yaþ grubunun immunizasyon durumlarý hakkýnda net veriler bulunmamaktadýr. Bu nedenle hem ulusal hem uluslararasý literatüre katký saðlamak amacýyla çalýþmamýz planlanmýþtýr. Çalýþmamýzda Türkiye'de üçüncü basamak bir Üniversite Hastanesi eriþkin aþý ünitesine baþvuran 65 yaþ ve üzeri bireylerde aþýlanma durumlarýnýn deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmamýzda Hacettepe Üniversitesi Týp Fakültesi Hastanesi Enfeksiyon Hastalýklarý ve Klinik Mikrobiyoloji Anabilim Dalý bünyesinde bulunan Eriþkin Aþý Birimi’ne Haziran 2020 ile Haziran 2021 tarihleri arasýnda baþvuran 65 yaþ ve üzeri bireylerin yaþ-cinsiyet daðýlýmý ve influenza-pnömokok-tetanoz-difteri aþýlarý ile aþýlanma durumu/oranlarý deðerlendirilmiþtir.
BULGULAR: Toplamda 1194 kiþiye (kadýn %53,4) ulaþýlmýþtýr. Yaþ gruplarýna göre ikiye ayrýlan bireylerin, 830’ u (%69,5) 65-75 yaþ aralýðýnda iken; 364 ‘ü (%30,5) 75 yaþ üstünde saptanmýþtýr. Polikliniðimizde yapýlan aþýlarýn %76,72’sini Prevenar 13 oluþtururken 2. sýrada tetanoz-difteri aþýsý (%15,41), 3. sýrada ise influenza aþýsý bulunmaktadýr (%7,03).
TARTIÞMA ve SONUÇ: 65 ve üzeri eriþkinlerde geliþebilecek enfeksiyon hastalýklarý ve bunlara baðlý komplikasyonlarýn önlenmesinde, böylece morbidite ve mortalitenin azaltýlmasýnda etkin aþýlamanýn önemi tartýþýlmazdýr.

INTRODUCTION: There is no compulsory vaccination for individuals aged 65 and over in Turkey, there is no precise data about the immunization status of this age group. For this reason, our study is planned to contribute to both national and international literature. The study aimed to evaluate to vaccination status of individuals aged 65 and over who applied to the adult immunization unit of a Tertiary University Hospital in Turkey.
METHODS: In our study, age-gender distribution and vaccination status of individuals aged 65 and over who applied to the Adult Vaccination Unit within the Infectious Diseases and Clinical Microbiology Department of Hacettepe University Faculty of Medicine between June 2020 and June 2021, and vaccination status with influenza-pneumococcal-tetanus vaccines rates were evaluated.
RESULTS: A total of 1194 persons (53.4% of women) were reached. 830 (69.5%) of the individuals divided into two according to age groups were in the 65-75 age range; 364 (30.5%) of them were over 75 years old. Prevenar 13 constitutes 76.72% of the vaccines administered in our outpatient clinic, while the tetanus-diphtheria vaccine is in the second place (15.41%), and the influenza vaccine is in the third place (7.03%).
DISCUSSION AND CONCLUSION: In preventing infectious diseases and related complications in adults aged 65 and over; thus, the importance of effective vaccination in reducing morbidity and mortality is indisputable.

GÝRÝÞ ve AMAÇ: Rabdomiyoliz, çizgili kas liflerinin yýkýmý sonucu hücre içindeki toksik potansiyeli olan maddelerin sistemik dolaþýma katýlmasýyla oluþan klinik ve biyokimyasal bir durumdur. Bu çalýþmada, non-travmatik rabdomiyoliz tanýsý ile takip edilen semptomatik hastalarýn epidemiyolojik verileri morbidite, mortalite ve hastanede kalýþ süreleri açýsýndan deðerlendirildi.
YÖNTEM ve GEREÇLER: Hastanemizde non-travmatik rabdomiyoliz tanýsý konduktan sonra iç hastalýklarý kliniðine yatýrýlan ve takip edilen 18 yaþ üzeri 95 hastanýn serum kreatin kinaz (CK), miyoglobin ve kreatinin (CR) seviyeleri retrospektif olarak deðerlendirildi (retrospektif kohort çalýþmasý).
BULGULAR: Bu çalýþmamýzda, hasta grubumuzda, hastalýk etiyolojisi ile hastanede yatýþ süresi arasýnda istatistiksel olarak anlamlý bir fark saptanmadý. Hastalarýn kreatinin deðerleri ile hastanede yatýþ süresi arasýnda pozitif bir korelasyon vardý. Hastanede yatýþ süresi ile baþvuru anýnda ve yatýþtan sonra 24. saatteki kreatinin deðerleri arasýnda istatistiksel olarak anlamlý fark saptandý (p=0,043). Baþvuru anýndaki CK deðerleri ile takip ve taburculuktaki CR deðerleri arasýnda istatistiksel olarak anlamlý fark bulunmadý (p=0,594). Non-travmatik rabdomyoliz tanýsý ile yatýrýlan hastalarýn baþlangýç CK deðerinden baðýmsýz olarak uygun takip ve tedavi ile böbrek fonksiyonlarýnýn izlemde olumsuz etkilenmediði saptanmýþtýr.
TARTIÞMA ve SONUÇ: Travmatik olmayan rabdomiyoliz yaygýn olmakla birlikte olasý komplikasyonlar erken taný, uygun tedavi ve takip ile en aza indirilebilir. Serum CK ve kreatinin deðerleri hastalarýn takibinde önemli bir prognostik deðere sahip olmasýna raðmen birçok parametrenin birlikte deðerlendirilmesi ve hastalýk prognozunun deðerlendirilmesini standardize etmek için daha fazla çalýþmaya ihtiyaç vardýr.

INTRODUCTION: Rhabdomyolysis is a clinical and biochemical condition that occurs when substances that have a toxic potential inside of cells enter systemic circulation as a result of the destruction of striated muscle fibers. In this study, the epidemiological data of patients who were symptomatic and followed-up with a diagnosis of non-traumatic rhabdomyolysis were evaluated in terms of morbidity, mortality, and length of hospitalization.
METHODS: The serum creatinine kinase(CK), myoglobin, and creatinine(CR) levels of 95 patients who were over 18 years of age and had been hospitalized and followed up in the Internal Diseases ward after being diagnosed with non-traumatic rhabdomyolysis at the hospital were evaluated retrospectively.
RESULTS: In this study, no statistically significant difference was found between disease etiology and the duration of hospitalization. There was a positive correlation between the CR values and the duration of hospitalization. A statistically significant difference was found between the length of hospitalization and the CR values on admission and at 24h following admission(p=0.043). No statistically significant difference was found between the CK values on admission and the CR values at follow-up and hospital discharge (p=0.594). It was found that patients admitted with a diagnosis of non-traumatic rhabdomyolysis did not negatively affect kidney function with appropriate follow-up and treatment, regardless of the initial CK value.
DISCUSSION AND CONCLUSION: Although non-traumatic rhabdomyolysis is common, possible complications can be minimized with early diagnosis, appropriate treatment, and follow-up. Although serum CK and creatinine values have an important prognostic value in the follow-up of patients, many parameters need to be evaluated together, and more studies are needed to standardize the evaluation of disease prognosis.

GÝRÝÞ ve AMAÇ: Bu çalýþmada Ankara Þehir Hastanesi Onkoloji Polikliniklerine baþvuran hastalarda GETAT (Geleneksel ve Tamamlayýcý Týp) hakkýnda literatür taranarak oluþturulan anket sorularýna verdikleri yanýtlar deðerlendirilerek, GETAT kullanan grubun prevalansý, sosyodemografik özellikleri, hangi kanser tanýsý ve tedavisi aldýðý, GETAT hakkýndaki tutumlarý ve bunlarý etkileyen faktörlerin saptanmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþma, 1 Kasým 2019 ile 31 Aralýk 2019 tarihleri arasýnda Ankara Þehir Hastanesi Týbbi Onkoloji Polikliniklerine baþvuran kanser tanýsýyla izlenen hastalarýn Geleneksel ve Tamamlayýcý Týp kullaným durumlarý, nedenleri, etkileyen faktörleri araþtýrmak amacýyla yapýlan tanýmlayýcý ve kesitsel bir çalýþmadýr.
BULGULAR: Çalýþmamýzda hastalarýn %57,66’sýnýn kanser tanýsý öncesi GETAT kullandýðý, %33,66’sý ise kanser tanýsý aldýktan sonra GETAT kullandýðý saptanmýþtýr. Erkeklerin kadýnlara göre daha yüksek oranda doktora gittiði bulunmuþtur(p=0,022). Hastalarýn sosyodemografik özelliklerine bakýldýðýnda; yaþ, cinsiyet, meslek, öðrenim durumu, aylýk gelir durumu, medeni hali ve aile tipi ile GETAT kullanýmý arasýnda istatistiksel olarak anlamlý iliþki saptanmamýþtýr. Hastalarýn yaþadýklarý yerleþim yeri ile GETAT yöntemlerini kullanma sýklýklarýna bakýldýðýnda il merkezinde yaþayan hastalar ilçe/köy de yaþayan hastalara göre GETAT yöntemlerine daha sýk baþvurmuþlardýr (p=0,034). Kanser tanýsý sonrasý GETAT yöntemleri arasýnda en sýk baþvurulan yöntem fitoterapi (%90,90), ikinci sýrada hacamat uygulamasý (%5,45), üçüncü sýrada ise sülük uygulamasý (%3,63) gelmektedir. Fitoterapinin içinde ilk sýrada bitkisel çaylar (%52), ikinci sýrada ise ýsýrgan otu (%30) yer almaktadýr.
TARTIÞMA ve SONUÇ: Hastalarýn GETAT hakkýndaki bilgi düzeylerinin yetersiz olduðu görülmüþtür. GETAT yöntemleri hakkýnda hastalarýn bilgi ve farkýndalýklarýný artýrmaya yönelik çalýþmalar yapýlmasý faydalý olacaktýr.

INTRODUCTION: This study aims at determining the prevalence, socio-demographic features, the type and treatment of cancer, the attitudes towards the T&CM (Traditional and Complementary Medicine), and the factors influencing these attitudes of the patients at Ankara City Hospital, Oncology Polyclinics.
METHODS: This is a descriptive and cross-sectional study aiming at the research on the use of, the rationale for and the influential factors leading to the utilization of T&CM on cancer patients at Ankara City Hospital, Oncology Polyclinics between the periods of November 1, 2019, and December 31, 2019.
RESULTS: The study had found that 57.66% of the patients used T&CM before diagnosis, while 33.66% begun using them after the diagnosis. Male patients have sought the doctor’s help more than female patients (p=0,022). As for socio-demographic findings, there was no significant statistical correlation between the use of T&CM and age, gender, occupation, educational background, monthly income, marital status, or family type. In terms of location, the patients residing in city centers utilized T&CM more than those living in smaller regions such as counties or villages (p=0,034). Among the post-diagnosis T&CM practices, phytotherapy was the most popularly applied (90.90%), followed by phlebotomy (5.45%), and leech therapy (3.63%). Amongst phytotherapy were the consumption of herbal teas (52%) and the use of Urtica urens (30%).
DISCUSSION AND CONCLUSION: It was observed that the knowledge level of the patients about T&CM was insufficient. It would be beneficial to carry out studies to increase the knowledge and awareness of patients about T&CM methods.

GÝRÝÞ ve AMAÇ: SARS-CoV-2 enfeksiyonunda bir hiperkoagulasyon durumu rapor edilmiþtir. Trombositler geleneksel rollerinin yaný sýra baðýþýklýk hücreleri olarak da adlandýrýlýr. Çalýþmanýn amacý, COVID-19'da trombosit aktivasyonunu ve agregasyonunu incelemekti.
YÖNTEM ve GEREÇLER: Bu vaka-kontrol çalýþmasý SARS-CoV-2 enfeksiyonu olan 61 hasta ve 18 saðlýklý bireyden oluþmuþtur. Hastalar yoðun bakým ünitesinde (YBÜ) tedavi ihtiyacýna göre gruplara ayrýldý. Tüm gruplarda CD41, CD61, CD42a ve CD42b saptandý ve trombosit agregasyon testleri incelendi.
BULGULAR: Trombosit CD41, CD61, CD42a ve CD42b ekspresyonlarý, YBÜ hastalarýnda saðlýklý donörlere YBÜ olmayan hastalara kýyasla önemli ölçüde yüksekti. YBÜ grubundaki hastalar, YBÜ olmayan hastalar ve kontrollere göre trombosit agregasyonlarýnda artýþa sahipti. Ek olarak, trombosit aktivasyonu ve trombosit fonksiyon testleri, C-reaktif protein, interlökin-6, nötrofil-lenfosit oraný, trombosit-lenfosit oraný, monosit-lenfosit oraný, D-dimer ve fibrinojeni içeren inflamatuar ve pýhtýlaþma belirteçleri ile korelasyon göstermiþtir
TARTIÞMA ve SONUÇ: YBÜ COVID-19 hastalarýnda artmýþ trombosit aktivitesi ve daha hýzlý trombosit agregasyonu gözlendi. Trombosit hiperreaktivitesinin SARS-CoV-2 enfeksiyonunun ilerlemesine katkýda bulunmasý olasýdýr. Trombosit aktivasyon ve fonksiyon testlerinin inflamatuar ve pýhtýlaþma belirteçleri ile arasýndaki iliþkiler, sistemik inflamasyonun ve sitokinlerin YBÜ'deki COVID-19 hastalarýnda hiperkoagulasyonu tetikleyebileceðini veya hiperaktif trombositlerin inflamasyonu artýrabileceðini göstermektedir.

INTRODUCTION: A hypercoagulability status has been reported in SARS-CoV-2 infection. Beside their traditional roles, platelets are referred to as immune cells. The purpose of the study was to examine platelet activation and aggregation in COVID-19.
METHODS: This case-control study comprised 61 patients with SARS-CoV-2 infection and 18 healthy individuals. The patients were separated into groups with respect to the need for treatment in the intensive care unit (ICU). CD41, CD61, CD42a, and CD42b were determined as platelet activation markers, and platelet aggregation tests were analyzed in all groups.
RESULTS: Platelet CD41, CD61, CD42a, and CD42b expressions were significantly elevated in ICU patients compared to non-ICU patients and healthy donors. Patients in the ICU group had increased platelet aggregations than those in non-ICU patients and controls. Additionally, platelet activation and platelet function tests correlated with inflammatory and coagulation markers involving C‐reactive protein, Interleukin-6, neutrophil-to-lymphocyte ratio, platelet‐to‐lymphocyte ratio, monocyte to lymphocyte ratio, D-dimer, and fibrinogen concentrations.
DISCUSSION AND CONCLUSION: Enhanced platelet activity and faster platelet aggregation were observed in ICU COVID-19 patients. It is possible that platelet hyperreactivity may contribute to the progression of SARS-CoV-2 infection. The relationships between platelet activation and functions tests with inflammatory and coagulation markers show that systemic inflammation and cytokines may trigger the hypercoagulability in COVID-19 patients in ICU, or hyperactivated platelets could augment the inflammation.

GÝRÝÞ ve AMAÇ: Son yýllarda Geleneksel ve Tamamlayýcý Týp (GETAT) uygulamalarýna ilgi tüm dünyada ve ülkemizde artýþ göstermektedir. Bu çalýþmada Samsun ilindeki aile hekimlerinin GETAT ile ilgili bilgi düzeylerini ve tutumlarýný araþtýrmak amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Tanýmlayýcý, kesitsel türde tasarlanan bu çalýþmaya Ocak 2021- Mart 2021 tarihleri arasýndaki 3 aylýk süre içerisinde, Samsun Ýl Saðlýk Müdürlüðü’ne baðlý aile saðlýðý merkezinde çalýþan hekimler katýlmýþtýr. Hekimlere literatürden faydalanýlarak hazýrlanan GETAT ile ilgili bilgi düzeyi ve tutumlarýný içeren bir veri toplama formu uygulanmýþtýr. Ýstatistiksel analizler SPSS 17.0 paket programý yardýmýyla gerçekleþtirilmiþtir.
BULGULAR: Toplamda 213 hekim katýlmýþtýr, yaþ ortalamasý 45,54±7,68’dir. Hekimlerin en sýk duyum ya da bilgisi olduðu uygulama hipnozdur (%89,67). Kendilerine en sýk kupa terapisi yaptýrdýklarý görülmüþtür (%8,92). Hekimler hastalarýna en sýk ozon terapisi tavsiye etmektedir (%27,23). Hastalarýna uyguladýklarý ve sertifikasyona sahip olduklarý en sýk uygulama ise kupa terapisidir (sýrasýyla %2,35, %1,41). GETAT uygulamalarýnýn faydalý olduðunu ve klasik týp ile tamamlayýcý týbbýn bir bütünün parçalarý olduðunu düþünenler çoðunluktadýr. Hekimler GETAT ile ilgili bilgileri %77 oranýnda sosyal çevre ve medyadan öðrendiklerini belirtmiþtir.
TARTIÞMA ve SONUÇ: Birinci basamak hekimlerinin GETAT hakkýndaki bilgi düzeyinin yeterli olmadýðý görülmektedir. Kanýta dayalý bilimsel çalýþmalarýn artýrýlmasýyla GETAT bilinirliði ve doðru kullanýmý da yaygýnlaþacaktýr.

INTRODUCTION: In recent years, interest in Traditional and Complementary Medicine (T&CM) applications has increased all over the world and in our country. This study, it was aimed to investigate the knowledge levels and attitudes of family physicians in Samsun province about T&CM.
METHODS: Physicians working in the family health center of Samsun Provincial Health Directorate participated in this descriptive, cross-sectional study. A data collection form including the level of knowledge and opinions about T&CM was applied to the physicians using the literature. Statistical analyzes were carried out with the help of the SPSS 17.0 package program.
RESULTS: A total of 213 physicians participated, the average age was 45.54 ± 7.68. Hypnosis is the most common practice that physicians know about (89.67%). It was observed that they mostly applied cupping therapy (8.92%). Physicians most often recommend ozone therapy for their patients (27.23%). The most common practice they apply to their patients and have certification is cupping therapy (2.35%, 1.41%, respectively). Those who think that GETAT applications are beneficial and that classical medicine and complementary medicine are parts of a whole are in the majority. Physicians stated that they learned about T&CM from the social environment and media at a rate of 77%.
DISCUSSION AND CONCLUSION: It is observed that the knowledge level of primary care physicians about T&CM is not sufficient. With increasing evidence-based scientific studies, T&CM awareness and correct use will also increase.

GÝRÝÞ ve AMAÇ: Türkiye’nin de dahil birçok ülkede birinci basamakta kariyer yapmayý düþünen öðrenci sayýsý az olmakla birlikte, birinci basamak hekimine duyulan ihtiyaç artmaktadýr. Türkiye'de bu konuda yapýlan çalýþmalar sýnýrlýdýr. Bu çalýþmanýn amacý, öðrencilerin aile hekimliði hakkýndaki bilgi ve tutumlarýný deðerlendirmek ve aile hekimliði uzmanlýðý tercihi ile düþüncelerini incelemektir.
YÖNTEM ve GEREÇLER: Tanýmlayýcý kesitsel çalýþma 2020 Kasým ayýnda yapýlmýþtýr. Veriler çevrimiçi bir anket yoluyla toplanmýþtýr
BULGULAR: Toplam 225 öðrenci anketi tamamladý (Cevap oraný: %82,72; kadýn oraný: % 58,66; ortalama yaþ: % 24,43 yýl). Uzmanlýk eðitimi yapmadan pratisyen aile hekimi olarak çalýþmayý isteyenler %17,77 (n=40), geçici bir süre pratisyen aile hekimi olarak çalýþabileceðini belirtenler %49,33 (n=111) olarak bulundu. Aile hekimliði uzmanlýðýný kariyer tercihleri arasýnda planlayanlarýn oraný %27,55 (n=62) olarak saptandý. Öðrencilerin büyük çoðunluðu aile hekimlerinin iþ-yaþam dengesinin diðer hekimlere göre daha iyi olduðunu (%92,88), aile hekimliðinin tedavinin yanýnda hastalýktan korunmaya da odaklandýðýný (%92), aile hekimliðinde uzun süreli hekim hasta iliþkisi olduðunu (%88,00), aile hekimliðinin týbba önemli katký saðladýðýný (%85,77) onayladý. “Aile hekimliðindeki saðlýk hizmetleri diðer uzmanlýk alanlarý kadar heyecan vericidir” (%16,44) ve “aile hekimlerine toplumda gereken saygý gösterilir” (%27,55) ez az onaylanan ifadelerdi. “Aile hekimleri diðer uzmanlardan daha az kazanýr”, “aile hekimliði teþhis açýsýndan zordur” en yaygýn kararsýz kalýnan ifadeler olarak saptandý.
TARTIÞMA ve SONUÇ: Öðrencilerin büyük çoðunluðunun aile hekimliðini koruyucu hekimlik, uzun süreli hekim hasta iliþkisi ve týbba önemli katký saðlama özelliklerini bilmesine raðmen üçte birisinden daha azýnýn aile hekimliði uzmanlýðýna ilgisi olduðu bulundu. Aile hekimliðindeki saðlýk hizmetlerinin heyecan verici olmadýðý ve toplumda gereken saygý gösterilmemesi en yaygýn olumsuz düþüncelerdi.

INTRODUCTION: In many countries, including Turkey, the number of students considering a career in primary care is low, although the need for primary physicians increases. Studies on this subject in Turkey are scarce. The aim of this study was to evaluate students’ knowledge and attitudes about family medicine (FM) and to examine their intentions to enter the FM specialty.
METHODS: The descriptive cross-sectional study was conducted in November 2020. The data was collected via an online questionnaire.
RESULTS: A total of the 225 students (response rate: 82.72%; female rate: 58.66%; mean age: 24.43 years) completed the survey. It was found that 27.55% (26 males, 36 females) of the students would include FM specialty among their specialty preferences. The most important factors for the specialization choice of these students were comfort/work-life balance and personal interest. There was no significant relationship between gender, income, place of residence, and preferring FM specialty (p> 0.05). The majority of students approved that the work-life balance of family physicians was better than that of other physicians (92.88%), that FM had protective properties besides treatment (92.00%), that long-term physician-patient relationship (88.00%). “FM is as exciting as other specialties” (16.44%) and “family physicians are given the necessary respect in society” (27.55%) were the least approved statements.
DISCUSSION AND CONCLUSION: Less than a third of students were found to have an interest in an FM specialty. The most common negative thoughts about FM are that FM is not exciting and is not properly respected in society.

GÝRÝÞ ve AMAÇ: Hipoprodüktif (örn: AA, AML, ALL, MDS) ve hiperdestrüktif trombositopeninin (örn: ITP) ayrýmýnda en geçerli taný yöntemi kemik iliði incelemesidir. Ancak kemik iliði incelemesi oldukça invaziv bir yöntem olup ITP gibi hiperdestrüktif trombositopeninin tanýsýnda yapýlmasý bazý çalýþmalarda önerilmemektedir. Son yýllarda yapýlan bazý çalýþmalarda MPV, PCT ve PDW gibi platelet parametrelerin trombositopeninin ayýrýcý tanýsýnda kullanýlabileceði ileri sürülmüþtür. Bu çalýþmada amacýmýz, bu parametrelerin trombositopeninin ayýrýcý tanýsýndaki etkinliðini araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Çalýþmaya trombositopenisi olan 164 hasta dahil edildi. Hastalar tanýsýna göre hiperdestrüktif (75 ITP) ve hipodestrüktif(25 AA, 25 MDS, 24AML, 15 ALL) trombositopeni olarak iki gruba ayrýldý. Hastalarýn tanýsý güncel hematoloji, patoloji rehberleri ve kromozom analizleri kullanýldý. K3EDTA’lý tüplere alýnan kan örnekleri Beckman-Coulter otomatik cihazlarda çalýþýldý.

BULGULAR: Trombosit sayýsý açýsýndan iki grup arasýnda herhangi bir farklýlýk yoktu. Cinsiyet, yaþ ve PDW açýsýndan iki grup arasýnda herhangi bir farklýlýk izlenmedi. Bununla birlikte MPV, hiperdestrüktif grupta hipodestrüktif gruptakilere göre belirgin olarak daha yüksekti. Bunun aksine PCT deðeri hiperdestrüktif grupta hipodestrüktif gruba göre önemli ölçüde daha düþüktü.
TARTIÞMA ve SONUÇ: Bu çalýþmada; trombosit parametrelerinin kullanýmýnýn, ITP hastalarýnýn tanýsýný güçlendirebileceði, diðer klinik ve laboratuvar testleri ile birlikte faydalý olabileceði saptandý.

INTRODUCTION: Bone Marrow (BM) examination is the gold-standard test in discriminating between hyperdestructive thrombocytopenia and hypoproductive thrombocytopenia. However, BM examination is an invasive, time-consuming, and expensive approach. Therefore, BM study is not recommended as the first-line method. Recent studies showed that platelet parameters such as mean platelet volume (MPV), plateletcrit (PCT), platelet size deviation width (PDW) could be used for differential diagnosis of thrombocytopenia. In the present study, accordingly, we aimed to investigate the significance of these parameters in the differential diagnosis of thrombocytopenia.
METHODS: One hundred sixty-four (164) patients with thrombocytopenia were included in the present study. The patients were divided into two groups according to the time of the diagnosis of thrombocytopenia: hyperdestructive (75 ITP) and hypoproductive (25 AA, 25 MDS, 24 AML, 15 ALL). The diagnosis was made based on hematological, pathological, and chromosomal analyses and guidelines. Samples for complete blood counts were collected in K3EDTA tubes and analyzed with an automated hematology analyzer, Beckman-Coulter.
RESULTS: The platelet count was similar in both groups. The present results showed that there were no statistically significant differences between the groups in terms of age, gender and PDW. However, MPV was significantly higher in the hyperdestructive group than the hypoproductive group. By contrast, PCT was considerably lower in the hyperdestructive group than the hypoproductive group.
DISCUSSION AND CONCLUSION: The results of the present study indicated that these platelet parameters might provide additional contributions to strengthen the diagnosis in patients diagnosed with ITP and would be beneficial to consider the thrombocyte parameters as well as the clinical and other laboratory tests of the patient.

GÝRÝÞ ve AMAÇ: Oksidatif stres, hücresel savunma mekanizmalarýyla (antioksidanlar) elimine edilenden daha fazla reaktif oksijen türü (ROS) oluþumunu ifade eder. Bu çalýþmanýn amacý, CO zehirlenmesinde geliþen oksidatif stresi belirlemek, oksidan ve antioksidan parametreleri ölçmek ve normobarik oksijen (NBO9 ve hiperbarik oksijen (HBO) tedavilerinin bu parametreler üzerindeki etkilerini incelemektir.
YÖNTEM ve GEREÇLER: Acil servise baþvuruda ve oksijen tedavisi sonrasý 24. saatin sonunda toplam oksidan durum (TOS) oksidatif stres parametresi, total antioksidan durum (TAS), paraoksonaz (PON), serum paraoksonaz (SPON), arilesteraz (ARES) ve tiol (TTL) seviyeleri, antioksidan kapasite göstergesi olarak ölçüldü.
BULGULAR: Hasta grubunda kontrol grubuna göre TAS, TTL ve ARES düzeyleri anlamlý olarak düþük bulundu. Hiperbarik tedavi ve normobarik tedavi alan hastalar arasýnda oksidatif stres parametrelerinin hem baþlangýç hem de 24. saat düzeylerinde farklýlýk yoktu.
TARTIÞMA ve SONUÇ: TAS, PON, SPON, ARES ve TTL'de devam eden düþüþ, antioksidan kapasitenin henüz deðiþtirilmemiþ olmasýndan veya reperfüzyon iskemisinin tedaviden kaynaklanmasýndan kaynaklanýyor olabilir. Çalýþmamýzýn sonuçlarý CO zehirlenmesi vakalarýnda oksidatif dengenin antioksidanlara ters döndüðünü desteklemektedir.

INTRODUCTION: Oxidative stress refers to formation of more reactive oxygen species (ROS) than that are eliminated by cellular defense mechanisms (antioxidants). The aim of this study is to determine oxidative stress developed in CO poisoning, to measure oxidant and antioxidant parameters and to study the effects of the NBO and HBO treatments on these parameters.
METHODS: On admission to emergency department and at the end of 24th hour after the oxygen therapy, total oxidant status (TOS) was measured as an oxidative stress parameter, total antioxidant status (TAS), paraoxonase (PON), serum paraoxonase (SPON), arylesterase (ARES), and thiol (TTL) levels were measured as indicators of antioxidant capacity.
RESULTS: TAS, TTL and ARES levels were found to be significantly lower in the patient group when compared to control group. There were no differences in both inital and 24th hour levels of oxidative stress parameters between the patients who received hyperbaric therapy and normobaric therapy.
DISCUSSION AND CONCLUSION: Continuing decrease of TAS, PON, SPON, ARES, and TTL may be because the antioxidant capacity has not yet been replaced or reperfusion ischemia is caused by treatment. The results of our study support that oxidative balance turns against antioxidants in cases of CO poisoning.

GÝRÝÞ ve AMAÇ: Adölesan idiopatik skolyoz’un (AIS) cerrahi tedavisinde standart yaklaþýmý posterior enstrümentasyon ve füzyon (PEF) oluþturur. Tedaviye alternatif, füzyonsuz cerrahi yöntem olan vertebra cisim gerdirme (VBT) ise giderek daha sýk kullanýlmaktadýr. Bu çalýþmayla, PEF ve VBT yöntemleri ile ameliyat edilmiþ AIS hastalarýnýn düzelme miktarlarý ve yaþam kalitelerinin karþýlaþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Eþleþmiþ kohortlar, 2 yýl takipli 40⁰-70⁰ eðriliði olan AIS hastalarý incelenerek elde edildi. Lomber eðriliðin cerrahiye dahil edildiði hastalar çalýþmadan çýkartýldý. Hastalarýn demografik verileri, perioperatif ve takip radyografik ölçümleri ve hasta tarafýndan bildirilen SRS-22 skorlarý karþýlaþtýrýldý.
BULGULAR: Çalýþmaya, 16 PEF ve 18 VBT hastasý (30K, 4E) dahil edildi. Kohortun ortalama yaþý 13,4 (10-17) yýl ve takip süresi 25,7 (24–32) aydý. Gruplarýn preoperatif üst torasik, ana torasik (MT) ve torakolomber (TL) skolyoz açýlarý benzerdi. PEF grubunda MT eðrilikte cerrahi düzelme oraný daha fazla (%84–%53, p<0,001) iken, 2. yýlda toplam düzelme oranlarý gruplarda benzerdi (%80–%76, p=0,616). 2. yýlda PEF ve VBT gruplarýnda kendi imaj/görüþünde ve ara toplamda anlamlý iyileþme olduðu saptandý (p<0,001–p=0,037 ve p<0,001–p=0,016). PEF grubunda, fonksiyon/ aktivite alt baþlýðýndaki skorlar 6. ayda ve 2. yýlda (p=0,027) ve aðrý, ara-toplam skorlarý 2. yýlda, VBT grubuna göre düþüktü (p=0,020, p=0,036).
TARTIÞMA ve SONUÇ: PEF ve VBT cerrahisi takibinde MT ve TL eðriliklerde 2. yýlda benzer oranda düzelme görülmektedir. SRS22 skorlarýnda iki cerrahi ile benzer iyileþme elde edilirken, VBT’de bu iyileþme dinamik olarak seyretmektedir. Ýki grup arasýnda fonksiyon/aktivite, ara-toplam ve aðrý skorlarýnýn VBT grubunda erken dönem ve takipte füzyona kýyasla daha iyi olmasý, daha uzun takipli geniþ hasta serilerinde incelenmelidir.

INTRODUCTION: Posterior instrumentation and fusion (PEF) is the standard surgical approach and vertebral body tethering (VBT) emerged as an alternative non-fusion technique in the treatment of idiopathic scoliosis. The aim of this study was to compare the correction and health-related life quality of the patients who have undergone PEF and VBT.
METHODS: Matched cohorts were obtained among patients whose curves ranged between 40⁰-70⁰ who had >2 years follow-up. Patients with a lumbar curve included in surgery were excluded. Patients' demographic data, perioperative and follow-up radiographic measurements, and SRS-22 scores were compared.
RESULTS: 16 PEF and 18 VBT patients (30F, 4M) were included. The mean age and follow-up were 13.4 (10-17) years and 25.7 (24–32) months. Preoperative upper thoracic, main thoracic (MT), and thoracolumbar (TL) curves were similar among groups. The surgical correction percentage in the MT curve was greater in the PEF group (84%–53%, p<0.001), while the overall correction percentage at two years was similar (80–76%, p=0.616). There was an improvement in self-image and subtotal scores at two years in PEF and VBT groups (p<0.001–p=0.037 and p<0.001–p=0.016). In the PEF group, function scores at six months and two years (p=0.027), pain and sub-total scores at two years (p=0.020, p=0.036) were found to be lower compared to VBT.
DISCUSSION AND CONCLUSION: Following PEF and VBT surgeries, a similar improvement was observed in MT and TL curves. While similar improvement is achieved in SRS22 scores, this improvement is dynamically progressed in VBT. Whether SRS22 scores are better in the VBT group should be examined in larger patient series with longer follow-up.

GÝRÝÞ ve AMAÇ: Bu çalýþma, kas-iskelet sistemi tutulumlu romatizmal hastalýklarý (RH) olan hastalarda covid-19 pnömonisinin radyolojik þiddetini vurgulamayý amaçlamaktadýr.
YÖNTEM ve GEREÇLER: Toplam 342 Polimeraz Zincir Reaksiyonu (PCR) pozitif hasta geriye dönük olarak incelendi. Hastalar RH varlýðý açýsýndan iki gruba ayrýldý. Akciðer bilgisayarlý tomografi (BT) þiddet skorlarý, demografik özellikler, hastaneye yatýþ, yoðun bakým ünitesi (YBÜ) gereksinimi, hastanede kalýþ süresi RH ve RH olmayan grup arasýnda karþýlaþtýrýldý. BT görüntülerinde tipik ve atipik bulgular, her iki hasta grubundaki görülme sýklýklarý ile birlikte tanýmlandý.
BULGULAR: : Yaþ ve kadýn cinsiyet, RH grubunda RH olmayan gruba göre anlamlý olarak daha yüksekti (p=0,001, p=0,041). BT-þiddet skorunun ortalamasý RH grubunda RH olmayan gruba göre daha yüksekti, ancak fark istatistiksel olarak anlamlý deðildi (p=0,081). YBÜ'ye nakil ve ölüm oranlarý RH grubunda RH olmayan gruba göre daha yüksek bulunurken, hastanede yatýþ oranlarý ve kalýþ süreleri arasýnda fark saptanmadý (p=0,002, p=0,036, p=0,280, p=0,168). Her iki grupta da buzlu cam opasiteleri, üst üste bindirilmiþ konsolidasyon ve kaldýrým desenleri en yaygýn tipik bulgulardý. Covid-19 pnömonisi için atipik BT bulgularý, RH grubunda RH olmayan gruba göre daha yüksek bulundu.
TARTIÞMA ve SONUÇ: Kronik inflamasyon ve immünosupresif ilaçlarýn kullanýmý RH hastalarýnda enfeksiyonlara karþý hassasiyete neden olmaktadýr. Bu çalýþmada, RH'li hastalarda mortalite ve YBÜ gereksinimlerinin daha yüksek olduðu bulundu. Benzer þekilde, RH grubunda atipik akciðer BT bulgularýnýn daha yaygýn görülmesi, bu hasta grubunda covid-19 pnömonisinin taný ve ayýrýcý tanýsýnda özellikle önemli olabilir.

INTRODUCTION: This study aims to focus on the radiological severity of covid-19 pneumonia in patients with rheumatic musculoskeletal diseases (RMD).
METHODS: A total of 342 Polymerase Chain Reaction positive patients were retrospectively reviewed. The patients were divided into two groups in terms of the presence of RMD. Chest Computed Tomography (CT) severity scores, demographic characteristics, hospitalization, intensive care unit (ICU) requirement, length of stay at the hospital were compared between RMD and non-RMD groups. Typical and atypical findings on CT images were identified with their incidence in both groups of patients.
RESULTS: Age and female gender were significantly higher in the RMD group (p=0.001, p=0.041). The average CT-severity score was higher in the RMD group, but the difference was not statistically significant (p=0.081). ICU transfer and mortality rates were higher in the RMD, whereas no difference was found in hospitalization rates and length of stay (p=0.002, p=0.036, p=0.280, p=0.168). Ground glass opacities, superimposed consolidation, and crazy paving patterns were the most common typical findings seen on both groups. Atypical CT findings for covid-19 pneumonia were found to be higher in the RMD group than in the non-RMD group.
DISCUSSION AND CONCLUSION: Chronic inflammation and the use of immunosuppressive drugs constitute a vulnerability to infections in RMD patients. In this study, mortality and ICU requirements were found to be higher in patients with RMD. Similarly, the higher rate of atypical chest CT findings in the RMD group may be of particular importance in the diagnosis and differential diagnosis of covid-19 pneumonia in this patient group.

GÝRÝÞ ve AMAÇ: Bozulmuþ glukoz toleransý (BGT) olan hastalarda manyetik rezonans görüntüleme (MRG) ile MRG-perfüzyon ile miyokardiyal kan akýmý deðerlendirildi. Mikrovasküler obstrüksiyon varlýðý ve iskemik kalp hastalýðý sýklýðý araþtýrýldý.
YÖNTEM ve GEREÇLER: Çalýþmamýza IGT'li 20, tip 2 diabetes mellituslu (DM) 16 hasta ve normal MR bulgularý olan 15 hasta dahil edildi. Tüm hastalar supin pozisyonda 1.5 Tesla MR ile vücut koili kullanýlarak muayene edildi. Ýlk olarak, duvar hareketlerini görmek, duvar kütlesini ve sol ventrikül ejeksiyon fraksiyonunu hesaplamak için B-TFE sine sekanslarý elde edildi. Daha sonra diðer kardiyak miyokard hastalýklarýný dýþlamak için "siyah kan" T2 aðýrlýklý ve STIR sekanslarý alýndý. Ýlk geçiþ perfüzyonunu deðerlendirmek için 0.2 mmol/kg Gd-DTPA'nýn intravenöz uygulanmasýyla bazal, midventriküler ve apikal kýsa aks sekanslarý elde edildi. Ardýndan "inversiyon recovery GRE" sekansý ile enjeksiyondan 10 dakika sonra geç opaklanma bulgularý elde edildi.
BULGULAR: Miyokard dokusunda ilk geçiþ perfüzyonunda tepe kontrastlanma ve birikmiþ kontrastlanma araþtýrýldýðýnda, BGT ve tip 2 DM'li olgularda benzerlik saptandý. Ancak saðlýklý kontrol grubuna göre anlamlý farklýlýklar tespit edildi. Ýlk geçiþ perfüzyonunda; kontrast madde gelme zamaný ile miyokard dokusunda kontrast madde artýþýnýn tepe noktasý karþýlaþtýrýldýðýnda, bu gruplar arasýnda fark görülmedi. Ayrýca sol ve sað ventrikül sistolik fonksiyonlarý gruplar arasýnda benzerdi.
TARTIÞMA ve SONUÇ: BGT'li olgularda miyokardiyal mikrovasküler dolaþým bozukluklarý koroner arter hastalýðý olmaksýzýn erken evrelerde ortaya çýkabilir. Bu tür vakalarda kardiyak MRG önemli bir seçim olabilir.

INTRODUCTION: Myocardial blood flow was evaluated with magnetic resonance (MR) perfusion in the patients with impaired glucose tolerance (IGT), and the existence of microvascular obstruction and risk for cardiac diseases were researched. In addition, the wall motion, wall mass (gram), and viability of the left ventricle, and the systolic function of both ventricles were evaluated.
METHODS: Twenty patients with IGT, 16 patients with type 2 diabetes mellitus (DM) and 15 patients with normal MR findings were included in our study. All patients were examined in the supine position using a body coil with 1.5 Tesla MR. Firstly, images B-TFE cine sequences to see the wall motions, calculate the wall mass and the left ventricular ejection fraction. "Black blood" T2-weighted and STIR sequences were then taken to exclude other cardiac myocardial diseases. Basal, midventricular, and apical short-axis sequences were obtained by intravenous administration of 0.2 mmol/kg Gd-DTPA to evaluate first-pass perfusion. And late opacification findings were obtained 10 minutes after the injection with the "inversion recovery GRE" sequence.
RESULTS: When peak enhancement and accumulated enhancement in the first pass perfusion of myocardial tissue were investigated, the similarity was found in cases with IGT and type-2 DM. However, significant differences were found compared to the healthy control group. In the first pass perfusion; When contrast agent arrival time and the peak of contrast agent increase in myocardial tissue were compared, no difference was observed between these groups. In addition, left and right ventricular systolic functions were similar between groups.
DISCUSSION AND CONCLUSION: In the cases with IGT, myocardial microvascular circulation disorders can emerge in early phases without the presence of coronary artery disease. In these kinds of cases, cardiac MRI can be an important choice.

INTRODUCTION: The aim of this study is to investigate the parameters that may contribute to the prediction of in-hospital mortality in patients who were admitted to the emergency department with non-variceal upper gastrointestinal system (GI) bleeding and underwent endoscopy.
METHODS: Patients with non-variceal upper GI bleeding who were admitted to the emergency department of our hospital between March 2019 and June 2021 were evaluated retrospectively. Surviving and deceased patients were compared. To predict mortality independently, logistic regression analysis was performed with parameters that were significant.
RESULTS: It was shown that there was a relationship between low albumin and T score, older age, high LDH and higher white blood cell count, and mortality. In the ROC analysis, where the diagnostic accuracy of these five factors in predicting mortality was evaluated, the area under the curve was calculated as 0.84.
DISCUSSION AND CONCLUSION: The evaluation of albumin, age, T score, white blood cell and LDH together may be helpful in predicting the in-hospital mortality of patients with non-variceal upper GI bleeding.

GÝRÝÞ ve AMAÇ: Bu çalýþmada, Tip 2 Diabetes Mellitus’ta (T2DM) tamamlayýcý ve alternatif týp (TAT) kullanýmýný ve bunun uzun süreli medikal tedaviye uyum ile iliþkisini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Araþtýrma, tanýmlayýcý tipte bir çalýþma olarak tasarlandý. En az 1 yýldýr oral antidiyabetik kullanan 100 hasta çalýþmaya dahil edildi. Katýlýmcýlara, sosyodemografik özellikleri ve TAT kullanýmýný sorgulayan bir anket; tedaviye uyumu ölçmek için 6 soruluk Türkçe Modifiye Morisky Ölçeði uygulandý.
BULGULAR: Hastalarýn %55’i en az bir TAT yöntemi kullanmýþtý. En sýk kullanýlan yöntem bitkisel ilaçlar (%80(n=44)) idi. TAT yöntemleri baþlýca, þikayetleri azaltmak ve tedaviyi destekleyici amaçlý kullanýlmýþ ve hastalarýn %85,5’i (n=47) bu yöntemlerin kullanýmý konusunda doktora danýþmamýþtý. Bu hastalarýn %89,4’ü (n=42) danýþmama nedenini, ‘doktorun olumsuz tepkisinden çekinme’ olarak belirtti. TAT kullanýmý ile tedaviye uyum arasýnda istatistiksel olarak anlamlý iliþki bulunmadý.
TARTIÞMA ve SONUÇ: Hastalarýn TAT yöntemlerini kullanýrken doktora danýþmamalarý, ilaç-bitki etkileþimlerine baðlý toksikasyonlara ve doz yetersizliklerine karþý dikkatli olmamýz gerektiðini göstermektedir. Hekimler hastalarýnýn ilaç öyküsü yanýnda bu yöntemlerin kullanýmýný da etkin bir þekilde sorgulamalýdýr. Bu baðlamda, tüm hekimler TAT yöntemleri hakkýnda temel bilgiye sahip olmalý ve bu tedaviler hakkýnda kanýta dayalý bilgiye nasýl ulaþýlabileceklerini de öðrenmelidir.

INTRODUCTION: In this study, we aimed to investigate complementary and alternative medicine (CAM) use and its relationship with adherence to long-term medical therapy in Type 2 Diabetes Mellitus (T2DM).
METHODS: The research was designed as a descriptive study. 100 (a hundred) patients who were using oral antidiabetic for at least one year were included in the study. A questionnaire to determine sociodemographic characteristics and CAM use and a six-item Turkish Modified Morisky Scale for the measure of medication adherence were applied to the participants.
RESULTS: 55% of patients (n=55) used at least one CAM practice. The most commonly used practice was herbal medicine [80% (n = 44)]. The main reasons for using CAM were to relieve complaints and support their conventional treatment, and 85.5% (n=47) of patients did not consult their physicians about the use of these practices. There was no statistically significant relationship between CAM use and medication adherence.
DISCUSSION AND CONCLUSION: The fact that patients do not consult a doctor while using CAM shows that we need to be careful about toxicities and dose insufficiency due to drug-herb interactions. Physicians should effectively investigate the use of these therapies in addition to the drug history of their patients. Therefore, all physicians should have at least basic knowledge of CAM and learn how to access evidence-based information about these practices.

Geriatrik hastalar çok sayýda hastalýða sahip olmaya ve yüksek ilaç yükü altýnda kalmaya yatkýndýr. Aile saðlýðý merkezleri, yaþlýlarýn muayene ve reçete ihtiyaçlarý için hastanelere kýyasla daha ulaþýlabilir yerlerdir. Kýrsal bölgelerde, aile saðlýðý merkezlerinin bu uygunluðu daha da önemli hale gelir. Bu durumda, aile hekimleri kýrsal bölgede yaþayan yaþlýlarýn yaþadýklarý problemleri tespit edecek ve ilaçlarýný düzeltip doðru ilaç kullanýmýný saðlayacak tek doktorlar olmaktadýr. Bu makalede, kýrsal bir bölge olan Bala’da, aile hekimini ziyaret eden üç geriatrik hasta olasý uygunsuz ilaç kullanýmý yönünden ele alýnmýþtýr.

Geriatric patients tend to have multiple diseases and a high burden of medication. Primary care centers are more accessible for the elderly to meet their examination and prescription needs compared to hospitals. In rural places, the convenience of primary care centers is far more important. Therefore, family physicians may be the only doctors in rural places to correct and/or supply proper medications as well as detecting ongoing problems of the elderly. In this article, three geriatric patients who visited their family physician in a rural town, Bala, were evaluated in terms of potentially inappropriate drug use.

SARS-CoV-2 virüsünün neden olduðu COVID 19 hastalýðý günümüzün en önemli halk saðlýðý sorunudur. Bu virüsün oluþturduðu pandemi tüm dünyadaki yaþam biçimini köklü olarak deðiþtirdi. Bu virüse karþý geliþtirilen aþýlar ise elimizdeki en önemli savunma aracýmýz. Olgumuz iki doz aþýlanmasýna raðmen varyant COVID 19 hastalýðýna yakalan bir hastadýr. Bu vaka üzerinden aþýlanmanýn önemi kadar kiþisel ve sosyal önlemlere bir süre daha uymanýn gereði vurgulanacaktýr.

COVID 19 disease caused by the SARS-CoV-2 virus is the most important public health problem of today. The pandemic caused by this virus has radically changed the way of life all over the world. Vaccines developed against this virus are our most important defense tool. Our case is a patient with variant COVID 19 disease, despite two doses of vaccination. In this case, the importance of adhering to personal and social precautions for a while will be emphasized as well as the importance of vaccination.