GÝRÝÞ ve AMAÇ: Ýstenmeyen bir durum olan adölesan gebeliklerde anne ve bebek saðlýðý olumsuz etkilenebilmektedir. Bu çalýþmanýn amacý, adölesan gebeliklerin, erken neonatal dönem sonuçlar üzerine etkisini incelemektir.
YÖNTEM ve GEREÇLER: Çalýþmada üçüncü basamak bir hastanede doðum yapan adölesan yaþtaki (14-19 yaþ) ve 20 yaþ annelerin (kontrol grubu) ve bebeklerinin elektronik dosyalarý retrospektif olarak incelendi. Anne ve bebeðe ait kayýtlý demografik ve klinik veriler deðerlendirildi.
BULGULAR: Çalýþmaya 14-19 yaþ arasý 1842 (%69,82) adölesan ve 796 (%30,17) 20 yaþ anne bebeði olmak üzere toplam 2638 hasta alýndý. Adölesan gebelerin bebeklerinin ortalama gestasyonel yaþlarýnýn daha büyük ancak doðum aðýrlýklarýnýn kontrol grubuna göre anlamlý olarak daha düþük olduðu, intrauterin büyüme geriliði (ÝUBG), gebelik haftasýna göre düþük doðum aðýrlýðý (SGA) ve hipoglisemi oranlarýnýn ise anlamlý olarak daha yüksek olduðu bulundu (sýrasýyla p= 0,001, p<0,001, p=0,046, p=0,038, p=0,042). Adölesan annelerin vücut kitle indeksi (VKÝ) daha düþük, preeklampsi ve sezeryan ile doðum oranlarý ise daha fazla bulundu (sýrasýyla p<0,001, p=0,048, p<0,001). Yenidoðan yoðun bakým ünitesine yatýþ ve diðer neonatal morbidite oranlarý her iki grupta benzer oranlarda saptandý.
TARTIÞMA ve SONUÇ: Sonuç olarak adölesan gebelerde sezaryen gereksinimi daha fazla olup, olumsuz yenidoðan sonuçlarýyla iliþkili olan; preeklampsi, ÝUBG, SGA ve hipoglisemi daha fazla görülmektedir. Halen bir sorun olarak devam eden adölesan gebeliklerin önlenmesi için toplumsal bilinçlendirme saðlanmalýdýr. Adölesan gebelerin düzenli takiplerinin yapýlmasý, özellikle preeklampsi ve ÝUBG açýsýndan yakýn izlemi gereklidir. Adölesan gebelerin bebeklerinin hipoglisemi açýsýndan yakýn izlemi önemlidir.

INTRODUCTION: Adolescent pregnancies, which are undesirable situations, can adversely affect maternal and infant health. The aim of this study is to examine the effect of adolescent pregnancies on early neonatal outcomes.
METHODS: In this study, electronic files of adolescents (14-19 years old) and 20 years old mothers (control group) who gave birth and their babies in a tertiary hospital were retrospectively analyzed. Demographic and clinical data of the mother and baby were evaluated.
RESULTS: A total of 2638 patients, 1842 (69.82%) adolescents and 796 (30.17%) 20 years old mothers, were included in this study. While the birth weights of the babies of adolescent pregnant women were significantly lower than the control group; mean gestational ages, intrauterine growth retardation (IUGR), small for gestational age (SGA), and hypoglycemia rates were significantly higher (p<0.001, p=0.001, p=0.046, p=0.038, p=0.042, respectively). Adolescent mothers' body mass index was lower, preeclampsia and cesarean delivery rates were higher (p<0.001, p=0.048, p<0.001, respectively). The rates of admission to the neonatal intensive care unit and other neonatal morbidities were similar in both groups.
DISCUSSION AND CONCLUSION: Caesarean section rate is higher in adolescent pregnancies. Adolescent pregnancies are associated with negative neonatal outcomes like preeclampsia, IUGR, SGA and hypoglycemia. Social awareness should be provided to prevent adolescent pregnancies, which are still a problem. Regular follow-up of pregnant adolescents, especially in terms of preeclampsia and IUBG, is required. Close monitoring of infants of adolescent pregnant women is required for hypoglycemia is important.

GÝRÝÞ ve AMAÇ: Helicobacter pylori (HP) midede enfeksiyona neden olan gram negatif mikroaerofilik bir bakteri türüdür. Gastroözofageal Reflü Hastalýðý (GÖRH) toplumdaki en yaygýn gastrointestinal rahatsýzlýklardan biridir ve HP enfeksiyonu ile arasýndaki iliþki ise hala tartýþma konusudur. Literatürde, HP ile enfekte olan hastalarda özofajit baþlangýcýný destekleyen bazý makaleler olmasýna raðmen, GÖRH ve HP enfeksiyonu arasýnda net bir nedensel iliþki henüz kurulmamýþtýr. Bu çalýþmanýn amacý, GÖRH ile HP enfeksiyonu arasýndaki iliþkiyi deðerlendirmektir.
YÖNTEM ve GEREÇLER: Dr.Lütfi Kýrdar Kartal EAH Gastroenteroloji Ünitesinde üst GÝS endoskopisi yapýlan 1549 hastanýn dosyalarý ve gastroskopi raporlarý deðerlendirildi. Klinik özelliklerin yaný sýra endoskopik olarak GÖRH tanýsý koyulmuþ 536 hasta çalýþmaya dahil edildi. GÖRH tanýsý konulmuþ 536 hastanýn endoskopi ve patoloji raporlarý taranarak HP, özofajit ve intestinal metaplazi açýsýndan analiz edildi.
BULGULAR: GÖRH tanýsý konan 536 hastanýn 229’unda (%42,72) HP pozitifliði saptandý. HP pozitif olan hastalarýn %7,42’sinde özofajit saptandý, HP negatif olan hastalarýn ise %13,35’inde özofajit vardý. HP pozitif olanlarda özofajit sýklýðý istatiksel olarak anlamlý düþük bulundu (p=0,026).
TARTIÞMA ve SONUÇ: HP negatif olan hastalarda anlamlý derecede sýk reflü-özofajit olduðunu gördük. Bu bulgu HP ile reflü-özofajit arasýndaki zýt iliþkiyi destekleyen literatür ile uyumluydu. Literatürden edinilen bilgi birikimi ýþýðýnda GÖRH olan tüm hastalarda HP eradikasyonunun, bir grup hastada semptomlarý geriletmeyeceði belki de arttýrabileceði düþünülmektedir.

INTRODUCTION: Helicobacter pylori (HP) is a gram-negative, microaerophilic bacterium that causes stomach infections. Gastroesophageal Reflux Disease (GERD) is one of the most common gastrointestinal disorders in the population, and its relationship with HP infection is still controversial. Although there are some articles in the literature that support the onset of esophagitis in patients with HP, a clear causal relationship between GERD and HP infection has not yet been established. The aim of this study is to evaluate the relationship between GERD and HP infection
METHODS: The files and gastroscopy reports of 1549 patients who underwent upper GIS endoscopy in the Gastroenterology Unit were evaluated. In addition to clinical features, 536 patients endoscopically diagnosed with GERD were included in the study. Endoscopy and pathology reports of 536 patients diagnosed with GERD were evaluated and analyzed for HP, esophagitis and intestinal metaplasia.
RESULTS: HP positivity was found in 229 (42,72%) of 536 patients diagnosed with GERD. Esophagitis was detected in 7,42% of patients with HP positive, and 13,35% of patients with HP negative had esophagitis. The frequency of esophagitis was found to be statistically significantly lower in those with positive HP (p=0,026).
DISCUSSION AND CONCLUSION: We found that patients with negative HP had significantly frequent reflux-esophagitis. This finding was consistent with the literature supporting the opposite relationship between HP and reflux-esophagitis. In the light of the knowledge obtained from the literature, it is thought that HP eradication in all patients with GERD will not reduce symptoms or may increase it.

GÝRÝÞ ve AMAÇ: Bu çalýþmada obez, fazla kilolu ve normal kilolu hastalarýn obezitenin önlenmesi, risk faktörleri ve komplikasyonlarý hakkýndaki farkýndalýk düzeylerinin deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Dört aylýk süre içerisinde kliniðimize baþvuran 18 yaþ üzeri hastalar beden kitle indeksine (BKÝ) göre normal (<25 kg/m2), fazla kilolu (25-30 kg/m2) ve obez (>30 kg/m2) olarak sýnýflandýrýldý. Hastalara obezite tanýmý, sonuçlarý, risk faktörleri ve önlenmesi ile ilgili 40 sorudan oluþan bir anket uygulandý.
BULGULAR: Çalýþmaya alýnan 282 (%80,11) kadýn, 70’i (%19,89) erkek toplam 352 hastanýn yaþ ortancasý 45,00 (18-88); 51’i (%14,49) normal kilolu, 72’si (%20,45) fazla kilolu ve 229’u (%65,06) obez grubundaydý. Obezlerde eðitim düzeyi daha düþük, ailede obezite öyküsü daha yüksekti (p<0,001). Obezitenin insülin direnci, tip 2 diyabet, kardiyovasküler hastalýk, hipertansiyon, dislipidemi, yaðlý karaciðer, uyku apnesi, astým, gastrointestinal sorunlar, depresyon ve diðer ruhsal sorunlar, hareket kýsýtlýlýðý ve ölüm için risk faktörü olduðuna katýlma oraný %69,60 ile %92,61 arasýndaydý. Obezite risk faktörleri açýsýndan farkýndalýk gruplar arasýnda benzerdi. Günde 4-6 öðün yemenin ve ara öðünleri kaçýrmamanýn saðlýklý beslenme için önemli olduðunu bilenlerin oraný obez grupta en yüksekti (p=0.043).
TARTIÞMA ve SONUÇ: Çalýþmamýzda obezite iliþkili bazý komplikasyonlar hakkýnda farkýndalýk yüksek olsa da kolelitiasis, pankreatit ve kanser geliþimi gibi riskler hakkýnda farkýndalýk düþüktü. Obezitenin önlenmesi ve etkin tedavisi için hem obezitesi olan hem de olmayan hastalarda farkýndalýk düzeyinin arttýrýlmasý gereklidir.

INTRODUCTION: We aimed to determine the awareness of obese, overweight and normal-weight patients about the complications, causes and prevention of obesity.
METHODS: Patients who were admitted to our clinic during a four months period were included. Demographical features, familial histories of obesity, smoking, alcohol use, chronic diseases, medications, medical nutrition therapy and exercise habits were questioned. Patients were divided into groups as normal, overweight and obese according to the WHO criteria.
RESULTS: The median age of 352 patients was 45 (18-88), Of all, 282 (80.11%) were female, and 70 (19.89%) were male. Fifty-one patients (14.49%) were normal weight, 72 (20.45%) were overweight, and 229 (65.06%) were obese. The level of education was lower in obese patients, and the family history of obesity was higher (p<0.001). The percentage of patients who agreed that obesity was a risk factor for insulin resistance, type 2 diabetes, cardiovascular disease, hypertension, dyslipidemia, fatty liver, sleep apnea, asthma, gastrointestinal problems, depression and other mental problems, and death was changing between 65% and 92. Awareness of obesity risk factors was similar between groups. The rate of those who knew that eating 4-6 meals a day and not missing snacks was important for a healthy diet was highest in the obese group (p=0.043).
DISCUSSION AND CONCLUSION: Although awareness of some obesity-related complications was high in our study, awareness of risks such as cholelithiasis, pancreatitis and cancer development was low. For the prevention and effective treatment of obesity, it is necessary to increase the level of awareness of the disease.

GÝRÝÞ ve AMAÇ: Antenatal polikliniklerimize kaþýntý þikâyeti ile baþvuran gebelerin kaþýntý nedenlerinin ve gebelik sonuçlarýnýn deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Ankara Þehir Hastanesi, antenatal takip polikliniklerine 01.01.2020-31.12.2020 tarihleri arasýnda kaþýntý þikâyeti ile baþvuran gebelerin yaþý, gebelik haftalarý, gravida, parite, ek hastalýklarý, laboratuvar tetkik sonuçlarý ve gebelik sonuçlarýnýn incelendiði retrospektif bir çalýþma yapýlmýþtýr.
BULGULAR: Çalýþmada antenatal polikliniðimize kaþýntý ile baþvuran 223 gebenin dosyasý deðerlendirilmiþ ve tüm verilerine ulaþýlan 181 gebe dosyasý çalýþmaya dahil edilmiþtir. Kaþýntý nedenleri arasýnda en sýk klinik tanýnýn %47,51 oran ile (n=86) gebeliðe baðlý dermatozlar olduðu 80 gebede (%44,19) ise spesifik bir taný konulamadýðý görülmüþtür. Gebeliðe özgü dermatozlar içinde tüm grupta en fazla tanýnýn 46 (%25,41) gebede tespit edilen intra hepatik kolestaz (ÝHK) olduðu görülmüþtür. Gebeliðin 28 hafta ve sonrasýnda taný konulan spesifik dermatozlar içinde ÝHK oranýnýn %30,76 olduðu; 28 hafta altýnda ise en sýk karþýlaþýlan dermatozun gebeliðin atopik erupsiyonu (%36,84) olduðu sonucuna ulaþýlmýþtýr.
TARTIÞMA ve SONUÇ: Kaþýntý gebelikte sýk karþýlaþýlan bir durum olup; tanýsal deðerlendirme yapýlýrken özellikle 3.trimester gebelerde ÝHK’nýn sýklýðý gözönüne alýnarak maternal -fetal morbidite ve mortalitenin önlenebilmesi açýsýndan ayýrýcý tanýda akýlda tutulmalýdýr.

INTRODUCTION: We aimed to evaluate the etiologic factors and pregnancy outcomes of pregnant women who applied to our antenatal outpatient clinics with the complaint of pruritus.
METHODS: A retrospective study was conducted to examine the age, gestational weeks, gravidity, parity, comorbidities, laboratory test results and obstetric outcomes of pregnant women who applied with the complaint of pruritus to the antenatal follow-up outpatient clinics of Ankara City Hospital between 01.01.2020 and 31.12.2020.
RESULTS: Medical records of 223 pregnant women who applied to our antenatal outpatient clinic with pruritus were evaluated, and the 181 pregnant with complete accessible data were enrolled in this study. The most common clinical diagnosis was pregnancy-specific dermatoses with a rate of 47.51% (n=86), and a specific diagnosis could not be determined in 80 pregnant women (44.19 %). Intrahepatic cholestasis (IHC) was found to be the most frequent diagnosis among the pregnancy-specific dermatoses with a percent of 25.41 (n=46). The incidence of IHC among specific dermatoses diagnosed ≥ 28 weeks of pregnancy was 30.76 %, and the most common dermatosis < 28 weeks was the atopic eruption of pregnancy (36.84 %).
DISCUSSION AND CONCLUSION: Pruritus is a common condition in pregnancy; considering the frequency, especially in the third trimester, IHC should be kept in mind in the differential diagnosis to prevent maternal-fetal morbidity and mortality.

GÝRÝÞ ve AMAÇ: Son yýllarda gerek dünyada gerekse ülkemizde aþý karþýtlýðý hýzla yayýlmaktadýr. Aile Hekimleri baþta olmak üzere tüm saðlýk çalýþanlarýnýn aþý karþýtlýðý konusunda bilgi sahibi olmasý gerekmektedir. Çalýþmamýzýn amacý Aile Hekimliði kliniklerindeki asistan doktorlarýn bu konudaki görüþ, tutum ve davranýþlarýnýn deðerlendirilmesidir.
YÖNTEM ve GEREÇLER: Kesitsel tipteki çalýþma 15.06.2019-15.11.2019 tarihleri arasýnda yürütülmüþ olup Ankara’da bulunan tüm Aile Hekimliði kliniklerine ulaþýlmýþtýr. 311 hekim çalýþma grubunu oluþturmuþtur. Katýlýmcýlara veri toplama aracý olarak sosyodemografik-mesleki özelliklerinin, baðýþýklama ve aþýlar hakkýndaki bilgilerinin ve aþý karþýtlýðý ile ilgili görüþ, tutum ve davranýþlarýnýn sorgulandýðý anket formu uygulanmýþtýr. Tüm hesaplamalarda p<0,05 deðeri istatistiksel anlamlýlýk olarak kabul edilmiþtir.
BULGULAR: Aþý karþýtlýðýyla karþýlaþanlarýn oraný %59,5 (n=185) olarak saptanmýþtýr. Sözleþmeli Aile Hekimliði Uzmanlýðý (SAHU) eðitimine tabi asistanlarýn, 3 yýl ve üzeri asistanlýk yapanlarýn, birinci basamak tecrübesi olanlar daha fazla aþý karþýtlýðý vakasý yaþamýþlardýr. Bu katýlýmcýlarýn %85,4’ü (n=158) kiþileri ikna etmeye çalýþtýðýný, %12,4’ü (n=23) kiþilerin fikrine saygý duyduðunu belirtmiþtir. Katýlýmcýlarýn %94,9’u (n=295) aþý reddi fikrine, %82’si (n=255) aþý tereddütü fikrine karþýdýr. %0,3 (n=1) katýlýmcý aþý reddi fikrini desteklemektedir. Katýlýmcýlarýn %23,2’si (n=72) aþý karþýtlýðý ile ilgili eðitim almýþ olup bunlarýn %59,7’si (n=43) aldýðý eðitimi yeterli bulmaktadýr.
TARTIÞMA ve SONUÇ: Aþý tereddüdünü destekleyen veya bu konuda kararsýz olan katýlýmcýlarýn oraný azýmsanmayacak seviyededir. Asistanlarýn aþý karþýtlýðý konusunda eðitimlerinin yetersiz olduðu görülmektedir. Aþý karþýtlýðý ile mücadelenin daha etkin ve baþarýlý olmasý için eðitimler planlanmalý, gerekli hukuki düzenlemeler yapýlmalý, saðlýk okuryazarlýðý artýrýlmalýdýr.

INTRODUCTION: Recently, anti-vaccination has been rapidly spreading both around the world and in our country. Healthcare workers, including Family Physicians, must have knowledge of anti-vaccination. This study aimed to assess views, attitudes and behaviors of residents in Family Medicine clinics toward this issue.
METHODS: This cross-sectional study was performed between 15.06.2019 and 15.11.2019 and reached all Family Medicine clinics in Ankara. The study group consisted of 311 physicians. For data collection, participants received a questionnaire form questioning sociodemographic-occupational characteristics, knowledge of immunization and vaccines and views, attitudes and behaviors toward anti-vaccination. The value of p<0.05 was the cut-off point for statistical significance in all calculations.
RESULTS: The rate of those having encountered anti-vaccination was 59.50% (n=185). Residents of Contract Family Medicine (CFM) training, those who had been a resident for three years and more, and those with primary care experience had encountered more anti-vaccination cases. Of these participants, 85.40% (n=158) tried to convince individuals and 12.40% (n=23) respected their opinions. Of the participants, 94.90% (n=295) were against vaccine refusal and 82% (n=255) were against vaccine hesitancy while 0.30% (n=1) supported vaccine refusal. Of the participants, 23.20% (n=72) received training on anti-vaccination, and 59.70% (n=43) of those found the training received sufficient.
DISCUSSION AND CONCLUSION: The rate of participants supporting vaccine hesitancy or being unsure about it was considerable. Residents' training on anti-vaccination is insufficient. Therefore, training should be planned, necessary legal assessments should be performed, and health literacy should be increased to fight against anti-vaccination effectively and successfully.

GÝRÝÞ ve AMAÇ: Gebelik fiziksel, emosyonel ve sosyal açýdan sonuçlarý olan bir dönemdir. Bu sonuçlar neþe ve mutluluk gibi olumlu veya stres ve kaygý gibi olumsuz sonuçlar olabilir. Olumsuz sonuçlar doðum korkusuna neden olabilir.
YÖNTEM ve GEREÇLER: Çalýþma Samsun Eðitim ve Araþtýrma Hastanesi Kadýn Doðum ve Çocuk Hastalýklarý hizmet binasýnda yürütülmüþtür. Gebeliðin etkilerini gözlemleyebilmek için 28. Hafta ve üstü üçüncü trimesterdeki gebeler çalýþmaya dahil edilmiþtir. Demografik özellikleri sorgulayan sorular ve Wijma doðum beklentisi ölçeðini içeren anket ile elde edilen veriler SPSS paket program aracýlýðýyla yorumlanmýþtýr. Çalýþma 1 Nisan ile 15 Mayýs 2021 tarihleri arasýnda yürütülmüþtür.
BULGULAR: Çalýþma 1116 gebe ile yapýlmýþtýr. Çalýþmaya katýlan gebelerin ortalama yaþý 27,86±5,44 bulunmuþtur. Gebelik sürecinde aile hekimliðinde gebe takibi sayý ortalamasý 4,47±2,72 idi. Çalýþmaya katýlan gebelerin ortalama W-DEQ skoru 75,89±24,67 olarak bulunmuþtur. Gebelerin %33,69’u ilk defa gebe kalmýþlardý. Katýlýmcýlarýn %41,67’si daha önce normal doðum, %27,69’u sezaryenle doðum tecrübesine sahipti. Daha önce doðum yapmýþ olma, daha önce normal doðum tecrübesi olma ve daha önce sezaryenle doðum yapmýþ olma; W-DEQ skoru üzerinde istatistiksel olarak farklýlýk göstermemektedir.
TARTIÞMA ve SONUÇ: Gebeliðin planlý ve istenen bir gebelik olmasý durumunun doðum korkusu üzerinde çok anlamlý etki oluþturmasý, aile planlamasý ve gebelik zamanlamasý gibi konularýn önemini ortaya çýkarmaktadýr. Bu açýdan da ücretsiz, etkin ve kolay eriþilebilir birinci basamak hizmeti; hem danýþmanlýk hem de gebelikten korunmaya yönelik uygulamalara ait materyallerin temin edilebildiði en önemli saðlýk basamaðý olmaktadýr.

INTRODUCTION: Pregnancy is a period with physical, emotional and social consequences. These results can be positive, such as joy and happiness, or negative, such as stress and anxiety. Negative consequences can cause fear of childbirth.
METHODS: The study was carried out in Samsun Education and Research Hospital, Gynecology and Pediatrics service building. In order to observe the effects of pregnancy, pregnant women at the 28th week and above in the third trimester were included in the study. The data obtained with the questionnaire, including questions questioning demographic characteristics and the Wijma birth expectancy scale, were interpreted through the SPSS package program. The study was conducted from April 1 to June 15, 2021.
RESULTS: The study was conducted with 1116 pregnant women. The mean age of the pregnant women participating in the study was found to be 27,86±5,44. The mean number of pregnant follow-ups in family medicine during pregnancy was 4,47±2,72. The mean W-DEQ score of the pregnant women participating in the study was found to be 75.89±24,67. Of the pregnant women, 33.69% were pregnant for the first time, 41.67% of the participants had previous experience of normal delivery, and 27.69% of them had previous cesarean delivery experience. In terms of having given birth before, having experienced normal birth before, and having had a previous cesarean delivery, the W-DEQ score does not differ statistically.
DISCUSSION AND CONCLUSION: The fact that pregnancy is a planned and desired pregnancy has a very significant effect on fear of childbirth reveals the importance of issues such as family planning and pregnancy timing. In this respect, free, effective and easily accessible primary care service; is the most important health step where materials for both counseling and contraception can be obtained.

GÝRÝÞ ve AMAÇ: Bu çalýþmada COVID-19 enfeksiyonunda baþ aðrýsý sýklýðýný ve hastalýða özgü olup olmadýðýný belirlemek amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Kesitsel tanýmlayýcý araþtýrmaya COVID Polikliniðine baþvuran 18 yaþ üstü tüm hastalar dahil edilmiþtir. Hastalardan baþ aðrýsý þikayeti varlýðý ve özelliklerine yönelik 18 soru yanýtlamalarý istenmiþtir. Bað aðrýsý taný gruplarýný ayýrmak için ID MIGREN ölçeði ve Uluslararasý Baþ Aðrýsý Cemiyeti taný kriterleri, aðrý yoðunluðu için Vizüel Aðrý Skalasý kullanýlmýþtýr.
BULGULAR: Çalýþma 440 katýlýmcýdan 208’i (%47,27) kadýndý. 273 ilk baþvuru hastasýndan 44’ünde (%16,12) pozitif RT-PCR sonucu alýnmýþtý. Baþvurularý herhangi bir þikayete dayalý olan 301 hastadan 179’unun (%59,47) baþ aðrýsý þikayetleri bulunuyordu. VAS’a göre aðrý yoðunluðu 5,86 ± 2,72 idi. Baþ aðrýsý bulunma oranlarý ya da aðrý yoðunluðu RT-PCR test sonuçlarý açýsýndan anlamlý farklýlýk göstermiyordu. Baþ aðrýsý taný gruplarý açýsýndan RT-PCR test sonuçlarýna göre anlamlý farklýlýk yoktu.
TARTIÞMA ve SONUÇ: Baþ aðrýsý COVID-19 hastalarýnda en sýk yakýnmalardan biridir. Çalýþmamýzda COVID-19 polikliniðine hastalýk þüphesi ile baþvuran hastalardan RT-PCR testi ile taný alan ve almayan hastalar arasýnda baþ aðrýsý þikayetinin sýklýk ve özelliklerinde farklýlýk yoktur.

INTRODUCTION: This study aimed to determine the frequency of headaches in COVID-19 related hospital admissions and whether they are specific to the disease.
METHODS: All patients over the age of 18 who applied to the COVID Outpatient Clinic were included in the cross-sectional descriptive study. Patients were asked to answer an 18-item questionnaire about the presence and characteristics of headache complaints. The ID Migraine scale and International Headache Society diagnostic criteria were used for classification, and the visual Pain Scale was used for pain intensity.
RESULTS: Of the 440 participants, 208 (47.27%) were women. Of the 273 first applicant patients, 44 (16.12%) had positive RT-PCR results. Of the 301 patients whose applications were based on any complaint, 179 (59.47%) had headaches. According to VAS, the pain intensity was 5.86 ± 2.72. Rates of headache presence or pain intensity did not differ in terms of RT-PCR test results. There was no significant difference in headache diagnostic groups according to RT-PCR test results.
DISCUSSION AND CONCLUSION: The headache is one of the most common complaints in COVID-19 patients. In our study, there was no difference in the frequency and characteristics of headaches according to RT-PCR test among patients who applied to the COVID-19 outpatient clinic with suspicion of the illness.

GÝRÝÞ ve AMAÇ: COVID-19 salgýný sýrasýnda son dönem akciðer hastalýðý olan bireylerin kaygý düzeylerinin belirlenmesi amaçlanmýþtýr.

YÖNTEM ve GEREÇLER: Çalýþmaya altta yatan akciðer hastalýðý nedeni ile solunum yetmezliði olan ve uzun süreli oksijen tedavisi kullanan eriþkinler dahil edildi. Katýlýmcýlarda durumluk ve sürekli kaygý düzeyleri sýrasý ile STAI-1 ve STAI-2 skorlarýna göre belirlendi.

BULGULAR: STAI-1 deðerlendirmesine göre olgularýn 64’ünde (28,57%) hafif, 142’sinde (63,39%) orta, 18’inde (8,03%) aðýr düzeyde anksiyete, STAI-2 deðerlendirmesine göre 44’ünde (19,64%) hafif, 164’sinde (73,21%) orta, 16’inde (7,14%) aðýr düzeyde anksiyete mevcuttu. STAI-2 deðerlendirmesine göre kadýnlarda (medyan; min-max: 50; 38-67) erkeklere (42; 26-75) göre kaygý düzeyi daha yüksekti (p<0,001). Hem STAI-1 hem de STAI-2 skorlarý psikiyatrik hastalýðý olanlarda (52,5; 42-61 ve 52,5; 43-66, sýrasýyla) psikiyatrik hastalýðý olmayanlara (47; 21-67 ve 43; 26-75, sýrasýyla) göre daha yüksekti (p= 0,015 ve p= 0,002, sýrasýyla). STAI-2 skorlarý COVID-19 geçirmeyen bireylerde (44; 34-75) geçirenlere (40; 34-75) göre daha yüksekti (p<0,001). STAI-1 ve STAI-2 skorlarý salgýna karþý alýnan toplumsal önlemleri yeterli bulmayanlarda (50,5; 30-67 ve 45,5; 34-75, sýrasýyla) yeterli bulanlara (45; 21-60 ve 43; 26-62, sýrasýyla) kýyasla daha yüksekti (p<0,001 ve p=0,008, sýrasýyla).
TARTIÞMA ve SONUÇ: Son dönem akciðer hastalýðý tanýsý olan bireylerde kaygýnýn mevcut olduðu görülmüþtür.

INTRODUCTION: With this study, it was aimed to determine the anxiety levels of individuals with end-stage lung disease during the COVID-19 outbreak.
METHODS: Adults with respiratory failure due to underlying lung disease and using long-term oxygen therapy were included in the study. State and trait anxiety levels of the participants were determined according to the STAI-1 and STAI-2 scores.
RESULTS: According to the STAI-1 evaluation, 64 (28,57) of the cases had mild, 142 (63,39) moderate, and 18 (8,03) severe anxiety, and according to the STAI-2 evaluation, 44 (19,64) had mild, 164 (73,21) moderate, and 16 (7.14) had severe anxiety. According to the STAI-2 evaluation, the anxiety level was statistically significantly higher in women (median; min-max: 50; 38-67) compared to men (42; 26-75) (p <0.001). Both STAI-1 and STAI-2 scores were higher in patients with psychiatric disease (52.5; 42-61 and 52.5; 43-66, respectively) than those without psychiatric disease (47; 21-67 and 43; 26-75, respectively) (p = 0.015 and p = 0.002, respectively). STAI-2 scores were higher in individuals who haven’t contracted COVID-19 (44; 34-75) than those who did (40; 34-75) (p <0.001). STAI-1 and STAI-2 scores were higher in participants who think that social measures taken against the epidemic are sufficient (50.5; 30-67 and 45.5; 34-75, respectively) compared to those who think insufficient (45; 21-60 and 43; 26-62, respectively) (p <0.001 and p = 0.008, respectively).
DISCUSSION AND CONCLUSION: Anxiety is observed in individuals with a diagnosis of end-stage lung disease.

GÝRÝÞ ve AMAÇ: Önemli bir halk saðlýðý sorunu ve hastalýk yükü belirleyicisi olan depresyon, özellikle yaþlý popülasyonda en sýk görülen ruhsal bozukluklardan biridir. Bu çalýþmada aile hekimliði polikliniðine baþvuran yaþlýlarda geriatrik depresyon prevalansýnýn ve depresyon ile iliþkili faktörlerin araþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: 60 yaþýn üzerinde ki toplam 195 gönüllü çalýþmaya dahil edilmiþtir. Katýlýmcýlarýn, depresyon ile iliþkili olabilecek demografik özellikleri, týbbi geçmiþleri, psikososyal faktörler ve bireylerin fiziksel saðlýk durumlarý anket formu ile elde edildi. Depresif belirtiler 30 maddelik Geriatrik Depresyon Ölçeði (GDS) kullanýlarak deðerlendirilmiþtir
BULGULAR: Çalýþmaya dahil edilen 166 katýlýmcýnýn %49,09'unda (n=81) depresyon yoktu, %4,24'ünde (n =7) olasý depresyon ve %46,67'sinde (n =77) depresyon vardý. 75 yaþ ve üstü katýlýmcýlarýn depresyon anketi puanlarý diðer yaþ gruplarýndan istatistiksel olarak daha yüksekti (p=0,001). Kendi günlük iþini yapamama (OR: 19,78, Cl: 1,23-317,83, p=0,035), iþitme problemi olma (OR: 2,74, CI: 1,20-6,27 p=0,017) ve orta uyku kalitesi (OR: 10,62, Cl: 2,37-42,70, p=0,002) veya kötü uyku kalitesi (OR: 4,24, Cl: 1,78-10,06, p=0,001) depresyon durumunu etkileyen baðýmsýz risk faktörleriydi.
TARTIÞMA ve SONUÇ: Bu çalýþma, saðlýk çalýþanlarýna ve Aile hekimlerine geriatrik depresyonun yüksek prevalansý konusunda endiþe verici bir sinyal vermektedir. Geriatrik depresyonun yaþlý popülasyonda hane halký geliri, eðitim düzeyi, fiziksel saðlýk, iþitme sorunu, uyku durumu ve düþme öyküsü ile iliþkili olduðu saptanmýþtýr.

INTRODUCTION: Depression, which is an important public health problem and a determinant of disease burden, is one of the most common mental disorders, especially in the elderly population. The current study was aimed to investigate the prevalence of geriatric depression and associated factors among elderly people who admitted to the family medicine outpatient clinic.
METHODS: A total of 195 elderly participants aged 60 years have enrolled in this study. Demographic characteristics, medical history, psychosocial factors, and physical health status of individuals that may be associated with depression were obtained with a questionnaire. Depressive symptoms were assessed using the 30-item Geriatric Depression Scale (GDS).
RESULTS: Total of the 166 participants included in the study, 49.09% (n=81) had no depression, 4.24% (n=7) had probable depression, and 46.67% (n=77) had depression. Depression questionnaire scores of participants 75 years and over-aged were statistically higher than other age groups (p=0.001). Ability to make own daily work (OR: 19.78, Cl: 1.23-317.83, p=0.035), have a hearing problem (OR: 2.74, CI: 1: 20 - 6: 27 p=0.017) and fair sleep quality (OR: 10.62, Cl: 2.37-42.70, p=0.002) or poor sleep quality (OR: 4.24, Cl: 1.78-10.06, p=0.001) were independent risk factors that affecting the depression status.
DISCUSSION AND CONCLUSION: This study provides an alarming signal for health professionals and family physicians about the high prevalence of geriatric depression. We found that geriatric depression is associated with household income, education level, physical health, hearing problem, sleep status and history of falls in the elderly population.

GÝRÝÞ ve AMAÇ: Kronik kalp hastalýðý (KKH) olan hastalar birçok kýlavuzda influenza aþýsý için öncelikli gruplardan biri olarak tanýmlanmýþtýr. Bu çalýþmanýn amacý, KKH'li hastalarda influenza aþýlama oranlarýný ve iliþkili faktörleri deðerlendirmektir.
YÖNTEM ve GEREÇLER: Bu kesitsel anket çalýþmasý Mayýs-Aðustos 2019 tarihleri arasýnda yapýlmýþtýr. Ankette sosyo-demografik özellikler, 2018-19 influenza sezonunda aþýlanma durumu, influenza aþýsýnýn önerilip önerilmediði ve aþý kabul veya ret nedenleri incelenmiþtir.
BULGULAR: Çalýþmaya katýlan 389 KKH hastasýnýn %62,21'i erkek, %45,24'ü ≥65 yaþýndaydý. Ýnfluenza aþýsý olma oraný %11,31 idi. Ýleri yaþ, hekim tarafýndan aþý önerisi, KKH hastalarý ile yaþayan aile bireylerinin daha önce aþýlanmýþ olmasý, kalp hastalýðý veya solunum yolu hastalýðý nedeniyle acil yatýþ ve grip aþýsýnýn ücretsiz olduðunun bilinmesi aþý kabulünü artýran faktörlerdi.
TARTIÞMA ve SONUÇ: Bu çalýþmada KKH hastalarýnda influenza aþýlama oraný beklenen düzeyin oldukça altýndadýr. Özellikle doktorlar veya diðer saðlýk çalýþanlarý tarafýndan influenza aþýsýnýn tavsiye edilmemesi veya yeterince teþvik edilmemesi, KKH hastalarý arasýnda influenza aþýlamasýnýn önündeki en büyük engel olarak görünmektedir.

INTRODUCTION: Patients with chronic heart disease (CHD) have been defined in many guidelines as one of the priority groups for influenza vaccination. The purpose of this study was to evaluate influenza vaccination rates and related factors in patients with CHD.
METHODS: This cross-sectional survey study was conducted between May and August 2019. The questionnaire investigated socio-demographic characteristics, vaccination status in the 2018-19 influenza season, whether the influenza vaccine had been recommended, and vaccine acceptance or refusal reasons.
RESULTS: Of the 389 CHD patients participating in the study, 62.21% were male, and 45.24% were aged ≥65. The influenza vaccine uptake rate was 11.31%. Advanced age, vaccination recommendation by a physician, family members living with CHD patients having been previously vaccinated, emergency hospitalization for heart disease or respiratory disease, and knowing that the influenza vaccine was free of charge were factors that increased vaccination acceptance.
DISCUSSION AND CONCLUSION: The influenza vaccination rate among the CHD patients in this study was well below the expected level. The influenza vaccine not being recommended or not sufficiently encouraged, especially by physicians or other healthcare workers, seems to represent the greatest obstacle to influenza vaccination among CHD patients.

GÝRÝÞ ve AMAÇ: Tiyol-disülfid(TDH) homeostazý birçok hastalýkta araþtýrýlmýþtýr. Bu çalýþmanýn amacý, týkanma sarýlýðý tanýsý konan hastalarda dinamik tiyol-disülfid homeostazýný araþtýrmak ve dinamik tiyol-disülfid homeostazýný iskemi modifiye albümin ile karþýlaþtýrmaktýr
YÖNTEM ve GEREÇLER: Acil servise baþvuran 69 hasta ve 77 saðlýklý gönüllüden oluþan toplam 146 katýlýmcý çalýþmaya dahil edildi. Hastalardan baþvuru anýnda detaylý kan örnekleri alýndý.
Týkanma sarýlýðý tanýsý konulan hastalarda, baþvuru sýrasýnda Erel ve Neselioðlu tarafýndan geliþtirilen yepyeni bir yöntemle tiyol/disülfit düzeylerine bakýldý. Veriler bilgisayar sisteminde deðerlendirildi.

BULGULAR: Týkanma sarýlýðý olan hastada total tiyol (p=0,025) ve nativ tiyol (p=0,023) düzeyleri kontrol grubuna göre istatistiksel olarak anlamlý derecede düþüktü. Nativ tiyol düzeyleri ile ALP (r =-0,262, p<0,01), üre (r =-0,313, p<0,01), total bilirubin (r =-0,388, p) arasýnda anlamlý negatif korelasyon olduðu gözlendi. <0,01), direkt bilirubin (r =-0,351, p<0,01) seviyeleri. Ayný zamanda, disülfit düzeyi (p = 0,235) hasta grubunda kontrol grubuna göre daha düþüktü ancak istatistiksel olarak anlamlý deðildi. Kontrol grubunda iskemi modifiye albümin (ÝMA) deðerlerinin týkanma sarýlýðý grubuna göre daha düþük olduðu bulundu (p=0,03).
TARTIÞMA ve SONUÇ: Týkanma sarýlýðý patogenezinde total tiyol ve nativ tiyol seviyeleri azalmaktadýr. Tiyol-disülfit homeostazý, týkanma sarýlýðýnda oksidatif stresin yeni bir biyobelirteç olabilir

INTRODUCTION: The thiol-disulphide (TDH) homeostasis was investigated in a number of disorders. The aim of the present study is to investigate the dynamic thiol-disulphide homeostasis in patients diagnosed with obstructive jaundice and to compare the dynamic thiol-disulphide homeostasis with ischemia-modified albumin.
METHODS: A total of 146 participants who were admitted to the emergency department and who consisted of 69 patients and 77 healthy volunteers were included in the study. Detailed blood samples were obtained from the patients at the time of admission. Thiol/disulphide levels were examined using a brand-new method developed by Erel and Neselioglu on the patients diagnosed with obstructive jaundice during the admission. Data were evaluated in the computer system.

RESULTS: The levels of total thiol (p =0.025) and native thiol (p =0.023) were statistically significantly lower in the patient with obstructive jaundice than in the control group. It was observed that there was a significant negative correlation between the native thiol levels and the ALP (r =-0.262, p<0.01), urea (r =-0.313, p<0.01), total bilirubin (r =-0.388, p<0.01), direct bilirubin (r =-0.351, p<0.01) levels. At the same time, the level of disulphide (p = 0.235) was lower in the patient group than in the control group but not statistically significant. It was found that the ischemia modified albumin (IMA) values were lower in the control group than the obstructive jaundice group (p = 0.03).
DISCUSSION AND CONCLUSION: Total thiol and native thiol levels decrease in obstructive jaundice pathogenesis. Thiol-disulphide homeostasis may be a new biomarker of oxidative stress in obstructive jaundice.

GÝRÝÞ ve AMAÇ: Aile Hekimliði müfredatý, temeli ve hakemli dergileri olan bir akademik disiplindir. Bilimsel dergilerin içeriklerinin takibi ve deðerlendirilmesi, sürekli artan yayýn sayýsý göz önünde bulundurulduðunda zor hale gelmektedir. Bu sebeple akademik verilerin takibinde yardýmcý olmak amacýyla ‘Birinci Basamak Saðlýk Hizmeti’(PHC) ile ilgili bilimsel dergileri deðerlendirdik.
YÖNTEM ve GEREÇLER: 09/11/2021 tarihinde Web of Science (WoS) veri tabanýnda ‘PHC’ kategorisinde bulunan 27 dergi deðerlendirildi. Makale Ýþlem Ücretleri (APC), Açýk Eriþim (OA) durumlarý, menþeileri, yýllýk yayýn sayýlarý, frekanslarý ve türleri, yayýn dilleri, Dergi Atýf Göstergeleri (JCI), SCImago Dergi Sýralamalarý (SJR), Publons verileri, H-ýndex ’leri ve yayýn baþlýðýnda ‘COVID-19’ terminolojisine yer verme durumlarý incelendi. p<0.05 anlamlý kabul edildi. Spearman korelasyon analizi kullanýldý.
BULGULAR: WoS’da PHC kapsamýnda 18 adet SCIE (Science Citation Index Expanded) ve 9 adet ESCI (Emerging Sources Citation Index) dergi olduðu görüldü. APC’ nin 0-4545 Amerikan Dolarý, yýllýk dergi sayýsýnýn 1-24, H-Index’in 8-120, SJR’nin 0,17-1,92 aralýðýnda deðiþtiði, ESCI dergilerin tamamýnýn, toplamda 20 derginin OA olduðu görüldü. SCIE dergilerin JCI, H-Index ve SJR deðerlerinin daha yüksek olduðu saptandý. Baþlýðýnda ‘COVID-19’ terminolojisi içeren yayýn sayýsý ile dergi etki faktörlerinin ters orantýlý olduðu saptandý.
TARTIÞMA ve SONUÇ: SCIE-ESCI dergileri arasýnda geçerli olan genel farklýlýklarýn PHC kategorisindeki dergilerde de olduðu, bu durumun H-Index, SJR 2020, JCI 2019 ve 2020 gibi göstergelere yansýdýðý görülmektedir. ESCI dergilerin tamamýnýn OA oluþu dikkat çekmektedir. PHC dergilerinin alanlarý itibariyle ‘COVID-19’ ile ilgili içeriklerden kaçýndýðý düþünülmektedir.

INTRODUCTION: Family Medicine is an academic discipline with a curriculum, foundation and peer-reviewed journals. The monitoring and evaluation of the contents of the scientific journal become difficult considering the increasing publication's number. So, we evaluated scientific journals about 'Primary Health Care' (PHC) to help in the follow-up of academic data.
METHODS: On 09/11/2021, we evaluated 27 journals on the Web of Science (WoS) database in the 'PHC' category. Article Processing Charges (APC), Open Access (OA) states, origins, annual publication numbers, frequencies and types, publication languages, Journal Citation Indicators (JCI), SCImago Journal Rankings (SJR), Publons data, were examined as H-indexes including the terminology 'COVID-19'. p<0.05 was significant. Spearman correlation analysis was used.
RESULTS: In WoS, there were 18 SCIE (Science Citation Index Expanded) and 9 ESCI (Emerging Sources Citation Index) journals within PHC. Also seen that APCs ranged from 0-4545 USD, the annual number of journals ranged from 1-24, H-Index ranged from 8-120, SJR ranged between 0.17-1.92, all ESCI journals, as Twenty, were found to be OA. It was determined that the JCI, H-Index and SJR values of SCIE journals were higher. The number of publications containing the terminology "COVID-19" in the title and the impact factors of the journal was inversely proportional.
DISCUSSION AND CONCLUSION: The differences between SCIE-ESCI journals are in the journals in the PHC category, and this situation is reflected as H-Index, SJR 2020, JCI 2019 and 2020. It is noteworthy that all ESCI journals are OA. It is thought that PHC journals avoid 'COVID-19' related content in terms of their fields.

GÝRÝÞ ve AMAÇ: Bu çalýþma insülin kullanan diyabetli hastalarda hipoglisemi sýklýðý, þiddeti ve hipoglisemiyi etkileyen faktörleri belirlemek amacýyla yapýlmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþma kliniðimizde tedavi olan veya Polikliniðe ayaktan baþvuran, 18 yaþ üzeri insülin kullanan diyabet tanýlý 1038 hasta ile yapýlmýþtýr.
BULGULAR: Araþtýrma bulgularýna göre çalýþmaya alýnan bireylerin yaþ ortalamalarýnýn (53,50±9,44 yýl) yüksek ve çoðunluðunun kadýn olduðu tespit edilmiþtir. Olgularýn çoðunluðunun; ilköðretim mezunu, þehir merkezinde yaþayan, sosyal güvencesi olan, ev hanýmlarýndan oluþan, sigara ve alkol kullanmayan, T2DM (Tip 2 Diyabet)’li, ek hastalýk olarak da en çok hipertansiyon ve hiperlipidemi görülen bireyler olduðu belirlenmiþtir. Diyabet taný süresi yüksek olan olgularýn çoðunluðu diyabet ve insülin eðitimi almýþ, diyet ve egzersiz yapmayan, son iki yýlda insülin baþlanmýþ, karýþým insülin tedavisi alan bireylerden oluþmaktadýr. Hipoglisemi deneyimleme oraný yüksek olup hipoglisemilerin nadir ve hafif yaþandýðý görülmüþtür. Olgularýn tamamýna yakýnýnýn glukometresinin bulunduðu, ölçüm yaptýðý, insülin enjeksiyonunu kendisinin uyguladýðý, enjeksiyonlarda 8 mm iðne ucu kullandýðý ve bölge deðiþtirdiði tespit edilmiþtir. Metabolik ölçümlerde BKÝ, AKÞ ve TKÞ’ler, bel çevreleri ve HbA1c’lerin yüksek olduðu belirlenmiþtir.
TARTIÞMA ve SONUÇ: Araþtýrmada yapýlan analizlerde meslek, diyabet tipi, insülin tipi, retinopati, glukoz takibi, diyabet süresi, insülin kullanma süresinin hipoglisemi varlýðý açýsýndan; yaþ ve insülin kullanma süresinin hipoglisemi sýklýðý açýsýndan; insülin kullanma süresinin hipoglisemi þiddeti açýsýndan anlamlý olduðu tespit edilmiþtir.

INTRODUCTION: This study was conducted in order to determine the frequency and severity of hypoglycemia and factors affecting hypoglycemia in diabetic patients.
METHODS: The patients hospitalized in the endocrinology ward or admitted to our outpatient clinics were included. All patients were above 18 years of age and had diabetes who were receiving insulin treatment. A total of 1038 patients were enrolled.
RESULTS: According to our findings, the patients in the study group were mostly female and relatively older. Most patients had low education levels and social status, and they were mostly living in the city suburbs. Most female patients in that group were housewives, and the most common accompanying comorbidities were hypertension and hyperlipidemia. The patients had a long duration of diabetes history and had received "diabetes and insulin education" before. Despite education, they didn't make the appropriate lifestyle changes such as diet and exercise. The mean insulin usage time was two years, and premixed insulins were the most common ones that were being used. Although hypoglycemia was frequent, the rate of severe attacks was low. Almost all cases had glucometer at home and were making self blood glucose monitoring. Moreover, almost all patients were injecting insulin to themselves, and the most common needle diameter was 8 mm. In our study, the enrolled patients' mean BMI, FPG, PPG were above the target range.
DISCUSSION AND CONCLUSION: In the analysis made in the research, occupation, diabetes type, insulin type, retinopathy, glucose follow-up, duration of diabetes, the duration of insulin treatment were found to be significant in terms of the presence of hypoglycemia; age and duration of insulin treatment were found to be significant in terms of frequency of hypoglycemia; duration of insulin treatment was significant in terms of severity of hypoglycemia.

Covid-19 olarak tanýmladýðýmýz SARS-CoV-2 enfeksiyonu 2021 yýlý sonuna kadar (2 yýl) dünyada yaklaþýk 5,2 milyon kiþinin hayatýný kaybetmesine sebep olmuþtur. Hastalýðýn çeþitli varyantlarla yayýlýmý ve öldürücülüðü devam etmektedir. Obstetrik açýdan hastalýðýn önemi gebelerde kliniðin gebe olmayan kadýnlara göre daha aðýr seyretmesi ve ek hastalýklar varlýðýnda morbidite ve ölüm oranlarýnýn gebelerde daha yüksek olmasýndan kaynaklanýr. Tüm salgýnlarda olduðu gibi hastalýða global çözüm bulmanýn yolu aþýdan geçmektedir. Fakat salgýnýn tüm dünyayý kasýp kavurmasý, sosyal ve ekonomik hayatý yerle bir etmesi 10 yýlý aþan aþý geliþtirme çalýþmalarýnýn bazý basamaklarýnýn atlanmasýný zorunlu kýlmýþtýr. Modern tekniklerin de devreye girmesi ile geliþtirilmeye çalýþýlan onlarca aþýdan birkaçý Aralýk 2020’den itibaren global saðlýk örgütleri tarafýndan acil kullaným onayý almýþtýr. Aþýlarýn toplumlar arasý ufak farklýlýklarla beraber eriþkin popülasyonda yüksek oranda baðýþýklýk saðladýðý gösterilmiþtir. Hiçbir aþý çalýþmasýnýn ayrýca bir gebe kolu olmamasýnýn yanýnda gebe hayvanlardan elde edilen ve raporlanan sonuçlar da sýnýrlýdýr. Dolayýsý ile gebeler aþý yapýlýp yapýlmayacaðý konusu ulusal ve uluslararasý kuruluþlarýn önerileri ile saðlýk hizmeti sunanlarýn bilgilendirmesi ve gebenin gönüllü olmasý esasýna dayanmaktadýr. Bu makalenin amacý Covid-19 aþýlarýnýn genel özellikleri ve gebelere ait dünyada ve ülkemizdeki son veriler ve önerilerin bugünkü halinin saðlýk hizmeti sunucularýna topluca aktarýlmasýdýr.

SARS-Cov-2 infection, which we define as Covid-19, caused the death of almost 5,2 million people in the world until the end of 2021. The spread and lethality of the disease through various variants continue. The importance of the disease in obstetrics is due to the more severe clinical course in pregnant women compared to non-pregnant women and the higher morbidity/mortality rates in pregnant women in the presence of additional diseases. As in all epidemics, the way to find a global solution to the disease is through the vaccine. However, the fact that the epidemic deeply affected the whole world made it necessary to skip some steps of vaccine development studies that normally exceed ten years. A few of the dozens of vaccines that are tried to be developed with the introduction of modern techniques have been approved for emergency use by global health organizations since December 2020. Vaccines have been shown to provide high immunity in adults with slight differences between populations. In addition to the fact that no vaccine study also had a pregnant arm, reported results from pregnant animals are also limited. Therefore, the issue of whether pregnant women will be vaccinated is based on the recommendations of national and international organizations and the volunteers of the pregnant woman who is informed by health care providers. The purpose of this article is to present the general characteristics of Covid-19 vaccines and the latest data and recommendations regarding pregnant women in the world and in our country to health care providers.

Akut veya kronik hastalýklarda görülen tiroid hormon deðiþimlerinin her ne kadar patofizyolojisi net anlaþýlmasa da vücudun metabolik olarak verdiði adaptif cevap olduðu yaklaþýk son 50 yýldýr bilinmektedir. Öte yandan primer altta yatan hastalýðýn prognozu ile ilgili çýkarýmlar yaptýrabileceði de birçok çalýþmada gösterilmiþtir. Nontiroidal hastalýk olarak tanýmlanan bu tiroid hormon deðiþim paterninin en bilinenleri düþük triiyodotironin (T3) ve artmýþ revers T3 (rT3) seviyeleridir. Birçok patogenetik mekanizmanýn bu deðiþimlere yol açtýðý düþünülse de en bilinenleri deiyodinaz aktivitesindeki, tirotropin (TSH) salgýlanmasýndaki ve serum taþýyýcý proteinlerinde ve/veya hücresel taþýyýcý reseptörlerindeki deðiþikliklerdir. Tiroid hormonlarýndaki deðiþimler primer altta yatan hastalýðýn farklý evrelerinde deðiþkenlik gösterebilir. Ayrýca farklý klinik durum ya da patolojilerde tiroid hormonlarý farklý þekillerde etkilenerek ayýrýcý taný güçlüðüne neden olabilir. Klinikte kullanýlan birçok ilacýn da tiroid hormonlarýný farklý düzeylerde ve yönlerde etkilediði bilinmektedir. Deðerlendirme yapýlýrken mevcut durumlar göz önünde bulundurulmalý ve mümkünse serbest tiroksin (sT4) ile TSH baþta olmak üzere tam tiroid hormon paneli görülmelidir. Tedavi gerekliliðine, laboratuvar bulgularý yanýnda hastanýn klinik prezentasyonu ve öyküsü de dikkate alýnarak karar verilmelidir. Yapýlan çok sayýda çalýþmada rutin tiroid hormon replasmaný, olumlu veya olumsuz yönde net sonuç vermediðinden önerilmemektedir.

Although the pathophysiology of thyroid hormone changes observed in acute or chronic diseases is not clearly understood, it has been known for about the last 50 years that the body has an adaptive metabolic response. On the other hand, it has also been shown in many studies that it can make inferences about the prognosis of the primary underlying disease. The most known of this thyroid hormone change pattern, defined as a non-thyroid disease, are low triiodothyronine (T3) and increased reverse T3 (rT3) levels. Although many pathogenetic mechanisms are thought to lead to these changes, the most known are changes in deiodinase activity, thyrotropin (TSH) secretion, and serum carrier proteins and/or cellular carrier receptors. Changes in thyroid hormones can vary at different stages of the primary underlying disease. In addition, in different clinical conditions or pathologies, thyroid hormones are affected in different ways, causing difficulty in the differential diagnosis. Many drugs used in the clinic are also known to affect thyroid hormones at different levels and directions. Current conditions should be taken into account when evaluating, and if possible, a full panel of thyroid hormones, especially TSH with free thyroxine (sT4), should be seen. The need for treatment should be decided by taking into account laboratory findings as well as the patient's clinical presentation and history. In many studies, routine thyroid hormone replacement is not recommended, as it does not give a positive or negative net result.