Vitamin / mineral desteklerinin çeşitliliği ile toplum bazında kullanımı son dekatlarda giderek a... more Vitamin / mineral desteklerinin çeşitliliği ile toplum bazında kullanımı son dekatlarda giderek artmıştır. Vitamin / mineral destekleri (VMD) kullanımı vücuda fayda sağlayabilse de yanlış kullanım sonucu yüksek düzeyde VMD alımının sağlığa zararlı etkileri olabilmektedir. Bu çalışmada aile hekimliği polikliniklerine başvuran hastaların vitamin/mineral destekleri hakkında bilgi ve tutumlarının araştırılması amaçlanmıştır. Yöntem: Bu araştırma hastanemiz aile hekimliği polikliniğine başvuran ve çalışmaya katılmayı kabul eden ardışık kişiler ile iki aylık bir sürede gerçekleştirildi. Katılımcılara 13 sorudan oluşan, sosyodemografik özelliklerin, vitamin ve mineraller ile ilgili bilgi, tutum ve algılarının sorulduğu yarı yapılandırılmış bir anket uygulandı. Ankete verilen cevaplar cevaplar NCSS 2007 paket programı kullanılarak istatistiki yöntemler ile analiz edildi. Bulgular: Çalışmaya katılan 156 kişiden, anketleri eksiksiz dolduran ve yaşları 18-62 arasında değişen 54 kadın ve 75 erkek olmak üzere toplam 129 kişi analizlere dahil edildi. Katılımcıların % 76'sı en az lise mezunuydu. Fazla kilolu ve obez olan hastalar %41,8 oranında bulundu. Tüm grupta düzenli vitamin/mineral desteği alanlar (%29,5; n=38) arasında kadınlar erkeklerden anlamlı fazlaydı (p=0,021); eğitim düzeyi ve fazla kilolu veya obez olma durumu ile VMD kullanımı ilişkili bulunmadı. En sık vitamin D (%50), demir (%29), vitamin B12 (%21) ve vitamin C (%16) kullanılıyordu. Vitamin/mineral desteğinin tedavi amaçlı kullanıldığını düşünenler arasında kadınlar erkeklerden fazlaydı (p=0,029). Vitamin kullanımı için doktora danışmak gerektiğini ve kan tahlilleri yaptırmak gerektiğini düşünenler sırasıyla %90,6 ve %86,9 idi. Vitamin fazlalığının sağlığa zararlı olabileceğini düşünenler (%76,2) arasında üniversite ve lise mezunlarının fazla olduğu gözlendi (p=0,037). Katılımcılar vitamin/mineral destekleri ile ilgili bilgieri en sık sağlık personelinden (%60,5) edindiklerini belirtmiş ve sonra sırasıyla radyo/televizyon (%41,9), gazete ve dergi (%34,9), arkadaş ve akraba (%14,7) olarak belirtilmiştir. Sağlık personelinden bilgi edindiğini ifade edenler arasında ise kadınlar sayıca yüksekti (p=0,001). Sonuç: Çalışma grubumuzda VMD ile ilgili farkındalığın yüksek olduğu ve özellikle kadınlarda ve eğitim düzeyi yüksek olanlarda belirgin olduğu görülmüştür. Sağlık personelinden bilgi edindiğini ifade edenlerin kadınların erkeklerden fazla olması kadınların sağlık hizmetlerini sık kullanımına bağlı olabilir. Vitamin/ mineral destekleri kullanımı hakkında hastaların farkındalıklarının arttırılması için geniş gruplarda, kapsamlı ve çok merkezli çalışmaların yanı sıra eğitimlerin planlanmasının toplum sağlığını geliştirmek için yararlı olacağını düşünmekteyiz.
Background: Elderly people are at risk for mortality, functional decline, reattendance, and hospi... more Background: Elderly people are at risk for mortality, functional decline, reattendance, and hospitalization after an emergency department visit. Objective: The aim of this study was to evaluate the performance of Identification of Seniors at Risk tool to predict unplanned readmissions after an emergency department visit. Methods: Records of patients aged ⩾65 years, who completed Identification of Seniors at Risk tool as they were being discharged from the emergency department, were analyzed. Patients were called back at 30th, 60th, 90th, 120th, and 180th days after emergency department discharge to assess their readmission to emergency department. Descriptive statistics and receiver operating characteristic curve analysis were performed. Results: This was a single-center study conducted with elderly patients with chronic diseases in a tertiary-level hospital within a period of 10 months with the follow-up calls. During the first month, 1792 patients were admitted to emergency depart...
Introduction: To increase, develop or maintain the knowledge and skills; to update the medical ap... more Introduction: To increase, develop or maintain the knowledge and skills; to update the medical approaches necessary for providing an effective healthcare service are aimed through continuing medical education(CME) activities.In this study,we evaluated the factors influencing attendance to CME activities along with the experiences in CME and perceptions of family physicians about the effect of CME on their routine clinical practice. Methods:A questionnaire developed by the researchers was implemented to family physicians during 3 Family Medicine CME activities held in consecutive 6 months.The questionnaire composed of multiple-choice,open-ended,Likert-type questions about sociodemographic characteristics, professional experience concerning CME. An index about perceptions of participants about the effect of CME activities on their daily clinical practice was developed and a score ≥ 20 points was considered as “positive index score”. Results: A total of 247 family physicians, consist...
Capgras's syndrome is characterized by delusions of misidentification, where a patient believes t... more Capgras's syndrome is characterized by delusions of misidentification, where a patient believes that people closely related to him or her are replaced by some similar looking impostors or persecutors. It' s a rare syndrome and is frequently considered within the concept of schizophrenia. Eight cases with Capgras's syndrome who had been diagnosed as "Schizophrenia-paranoid type" have been compared with eight Schizophrenia cases who did not have the Capgras's syndrome. Both groups of patients had been hospitalized approximately at same times within the past two months. Cases have been evaluated according to the duration of hospital stay, hospitalization frequency, duration of disease episodes, response to medication, antipsychotic dose needed to treat the disorder, the need for additional therapies and according to months they esere frequently hospitalized. CGI scale and BPRS have been used as evaluation tools. It has been concluded that patients with Capgras's Syndrome have a longer period of hospital stay and show lesssometimes inefficient-response to typical antipsychotics than patients without Capgras' s syndrome. However it has been seen that they show better improvement with atypical antipsychotics. We postulate that these findings need to be approved with additional studies and case reports. As a conclusion; answers to questions; 1)Should Capgras's syndrome be considered as an indicator of treatment resistance? 2) Can we treat Schizophrenia patients with Capgras's syndrome more effectively and faster with atypical antipsychotics? are being discussed.
Background: Methylenetetrahydrofolate reductase (MTHFR) plays a role in DNA biosynthesis, methyla... more Background: Methylenetetrahydrofolate reductase (MTHFR) plays a role in DNA biosynthesis, methylation and repair in actively dividing cells by acting on folate metabolism. A common C677T polymorphism in the gene for MTHFR leads to an enzyme with decreased activity. MTHFR polymorphisms have been studied in various cancers but not in primary brain tumors. The purpose of this case-control study was to explore a possible association between MTHFR C677T polymorphism and primary brain tumors. Materials and Methods: The MTHFR C677T genotype was determined in 74 patients with histologically-verified primary brain tumors and 98 cancer-free control subjects. Results: The MTHFR 677T variant genotype was observed in 49% of cases and 46% of controls. Although the difference was not significant (p=0.194), the homozygous TT genotype was found at a higher frequency in high-grade glioma (HGG) patients compared to controls (15.4% and 7.1%, respectively). The MTHFR genotype was not associated with men...
Every year, about 10 per 100 million people are affected by primary brain tumors which correspond... more Every year, about 10 per 100 million people are affected by primary brain tumors which correspond to about 2% of all adult primary tumors and 23% of all childhood cancers. Mortality caused by primary brain tumors is about 13,000 deaths per year and it represents 2% of adult and 25% of childhood cancer related deaths (Legler et al., 1999; DeAngelis, 2001; Wrensch et al., 2002; Furnari et al., 2007; Marie and Shinjo, 2011). Gliomas and meningiomas are the two most common primary brain tumors with approximately 50% and 20% proportion respectively. Among these two cancer types, meningiomas are mostly seen in women while gliomas are more common in men (Inskip et al., 1005; Parkin, et al., 2005; Park et al., 2009; Martinez et al., 2010). Glioblastoma multiforma (GBM) is known to be the most common and aggressive one among different primary brain tumor types (Yost et al., 2013). Primary brain tumors are mostly aggregated in families, suggesting a genetic basis for disease tendency. Thus, i...
Background: Palliative therapies have an important role in increasing the quality of healthcare a... more Background: Palliative therapies have an important role in increasing the quality of healthcare and in dealing with physical and psychosocial problems due to cancer. We here aimed to evaluate the managerial perspectives and opinions of the hospital managers and clinical directors about specialized palliative care centers. Materials and Methods: This study was conducted in two large-scale hospitals in which oncology care is given with medical directors (n:70). A questionnaire developed by the researchers asking about demographic characteristics and professional experience, opinions and suggestions of medical directors about providing and integrating palliative care into healthcare was used and responses were analyzed. Results: Potential barriers in providing palliative care (PC) and integrating PC into health systems were perceived as institutional by most of the doctors (97%) and nurses (96%). Social barriers were reported by 54% of doctors and 82% of nurses. Barriers due to interest and knowledge of health professionals about PC were reported by 76% of doctors and 75% of nurses. Among encouragement ideas to provide PC were dealing with staff educational needs (72%), improved working conditions (77%) and establishing a special PC unit (49)%. An independent PC unit was suggested by 27.7% of participants and there was no difference between the hospitals. To overcome the barriers for integration of PC into health systems, providing education for health professionals and patient relatives, raising awareness in society, financial arrangements and providing infrastructure were suggested. The necessity for planning and programming were emphasized. Conclusions: In our study, the opinions and perspectives of hospital managers and clinical directors were similar to current approaches. Managerial needs for treating cancer in efficient cancer centers, increasing the capacity of health professionals to provide care in every stage of cancer, effective education planning and patient care management were emphasized.
Alterations of cyclin D1, one of the main regulators of the cell cycle, are known to be involved ... more Alterations of cyclin D1, one of the main regulators of the cell cycle, are known to be involved in various cancers. The CCDN1 G870A polymorphism causes production of a truncated variant with a shorter half-life and thus thought to impact the regulatory effect of CCDN1. The aim of the present study was to contribute to existing results to help to determine the prognostic value of this specific gene variant and evaluate the role of CCDN1 G870A polymorphism in brain cancer susceptibility. A Turkish study group including 99 patients with primary brain tumors and 155 healthy controls were examined. Genotypes were determined by polymerase chain reactionrestriction fragment length polymorphism analysis. The CCDN1 genotype frequencies in meningioma, glioma and control cases were not significantly different (p>0.05). No significant association was detected according to clinical parameters or tumor characteristics; however, a higher frequency of AG genotype was recorded within patients with astrocytic or oligoastrocytic tumors. A significant association between AG genotype and gliobilastoma multiforme (GBM) was recorded within the patients with glial tumors (p value=0.048 OR: 1.87 CI% 1.010-3.463). According to tumor characteristics, no statistically significant difference was detected within astrocytic, oligoasltrocytic tumors and oligodentrioglias. However, patients with astrocytic astrocytic or oligoastrocytic tumors showed a higher frequency of AG genotype (50%) when compared to those with oligodendrioglial tumors (27.3%). Our results indicate a possible relation between GBM formation and CCDN1 genotype.
Methylenetetrahydrofolate reductase (MTHFR) plays a role in DNA biosynthesis, methylation and rep... more Methylenetetrahydrofolate reductase (MTHFR) plays a role in DNA biosynthesis, methylation and repair in actively dividing cells by acting on folate metabolism. A common C677T polymorphism in the gene for MTHFR leads to an enzyme with decreased activity. MTHFR polymorphisms have been studied in various cancers but not in primary brain tumors. The purpose of this case-control study was to explore a possible association between MTHFR C677T polymorphism and primary brain tumors. The MTHFR C677T genotype was determined in 74 patients with histologically-verified primary brain tumors and 98 cancer-free control subjects. The MTHFR 677T variant genotype was observed in 49% of cases and 46% of controls. Although the difference was not significant (p =0. 194), the homozygous TT genotype was found at a higher frequency in high-grade glioma (HGG) patients compared to controls (15.4% and 7.1%, respectively). The MTHFR genotype was not associated with meningioma patients. Defining patients with t...
In patients with established coronary artery disease (CAD), there are different reports on gender... more In patients with established coronary artery disease (CAD), there are different reports on gender, age, dyslipidemia, and obesity according to smoking behavior. Smoking, obesity, and dyslipidemia are targets in secondary prevention. In this study, we aimed to investigate the sociodemographic differences, lipid profiles, body mass index (BMI), and cigarette smoking status in patients diagnosed with CAD. Methods: Patients with records of angiography, smoking behavior, sociodemographic information, lipid levels, and BMI present at the outpatient visits were included in the study. Patients were grouped as active smokers, nonsmokers, and former smokers. Statistical methods were used for comparison of variables and means. Results: A total of 235 patients, 167 (71.1%) men and 68 (28.9%) women, were included in the study. Nonsmokers group (31.4%) consisted of mostly women while active (22.6%) and former smoker (46%) groups consisted mostly of men (P < 0.0001). The mean age was 60.65 ± 11.55. Age was associated with the smoking status of patients, and nonsmokers consisted of geriatric patients significantly (P = 0.001). Educational status was associated with smoking history. Cessation of smoking after CAD diagnosis was achieved in 46% of patients. Active smokers had highest mean triglyceride (TG) values while nonsmokers had highest mean high-density lipoprotein-cholesterol (HDL-C) values. Active smokers had the highest mean TG values while nonsmokers had the highest mean HDL-C values. BMI was higher in nonsmokers than active smokers. Conclusion: Gender, age, and educational status are determinants of smoking behavior in patients with CAD. BMI is associated with smoking history. In nonsmokers, values of HDL were highest while TG values were lowest. To prevent reoccurring cardiovascular events, young patients and men are two groups which health professionals need to concentrate in motivating to quit smoking.
Introduction: Acute gastroenteritis(AGE) is a frequent reason of morbidity and mortality in child... more Introduction: Acute gastroenteritis(AGE) is a frequent reason of morbidity and mortality in children in both developed and underdeveloped countries. It is mostly caused by infectious agents which differ according to age groups and seasons. We aimed to review the frequency, age, gender, season of J Pediatr Inf Doi: 10.5578/ced.66368 2 admission characteristics and rate of hospitalization of rotavirus and adenovirus infections in pediatric population admitted to emergency department with AGE in which stool analysis was performed. Material and Method: The records of 5526 patients aged between 0-16 years who were admitted to pediatric emergency unit with AGE in a year and in which stool analysis were performed were reviewed. Frequency of rotavirus and adenovirus cases, gender and age distribution and hospitalization data were analyzed. Results: A total of 5526 patients with AGE, 2303 females and 3223 males, with a mean age of 5.21±3.40 were included. Adenovirus was detected in 3.1% and ...
Amac: Sigara birakma poliklinigine basvuran kisilerin sosyodemografik ve sigara icme oykusune gor... more Amac: Sigara birakma poliklinigine basvuran kisilerin sosyodemografik ve sigara icme oykusune gore anksiyete ve depresyon duzeylerini degerlendirmek, anksiyete ve depresyon ile saglikli yasam bicimi davranislari arasindaki iliskinin arastirilmasi amaclanmistir. Materyal ve Metod : Calismaya bir egitim ve arastirma hastanesindeki sigara birakma poliklinigine basvurmus, baska herhangi bir hastaligi bulunmayan, Hastane Anksiyete Depresyon Olcegi (HAD) ve Saglikli Yasam Bicimi Davranislari Olcegi II (SYBDO II) uygulanmis olan hastalar alinmis, sosyodemografik ozellikleri, Fagerstrom Nikotin Bagimlilik Testi (FNBT) ve sigara kullanimi oykusu retrospektif olarak incelenmis ve istatistiki degerlendirmeler yapilmistir. Bulgular: Calismaya alinan 73 kisinin 43’u(%58,9) erkek, 30’u(%41,1) kadindi. Ortalama HAD Anksiyete (HAD-A) puani 8,74 ± 3,55; HAD Depresyon (HAD-D) puani 7,04 ± 3,74; SYBDO II toplam skoru 125,44±20,07 olarak bulundu. HAD-A ortalama puanlari cinsiyet ve egitim durumu ile il...
Vitamin / mineral desteklerinin çeşitliliği ile toplum bazında kullanımı son dekatlarda giderek a... more Vitamin / mineral desteklerinin çeşitliliği ile toplum bazında kullanımı son dekatlarda giderek artmıştır. Vitamin / mineral destekleri (VMD) kullanımı vücuda fayda sağlayabilse de yanlış kullanım sonucu yüksek düzeyde VMD alımının sağlığa zararlı etkileri olabilmektedir. Bu çalışmada aile hekimliği polikliniklerine başvuran hastaların vitamin/mineral destekleri hakkında bilgi ve tutumlarının araştırılması amaçlanmıştır. Yöntem: Bu araştırma hastanemiz aile hekimliği polikliniğine başvuran ve çalışmaya katılmayı kabul eden ardışık kişiler ile iki aylık bir sürede gerçekleştirildi. Katılımcılara 13 sorudan oluşan, sosyodemografik özelliklerin, vitamin ve mineraller ile ilgili bilgi, tutum ve algılarının sorulduğu yarı yapılandırılmış bir anket uygulandı. Ankete verilen cevaplar cevaplar NCSS 2007 paket programı kullanılarak istatistiki yöntemler ile analiz edildi. Bulgular: Çalışmaya katılan 156 kişiden, anketleri eksiksiz dolduran ve yaşları 18-62 arasında değişen 54 kadın ve 75 erkek olmak üzere toplam 129 kişi analizlere dahil edildi. Katılımcıların % 76'sı en az lise mezunuydu. Fazla kilolu ve obez olan hastalar %41,8 oranında bulundu. Tüm grupta düzenli vitamin/mineral desteği alanlar (%29,5; n=38) arasında kadınlar erkeklerden anlamlı fazlaydı (p=0,021); eğitim düzeyi ve fazla kilolu veya obez olma durumu ile VMD kullanımı ilişkili bulunmadı. En sık vitamin D (%50), demir (%29), vitamin B12 (%21) ve vitamin C (%16) kullanılıyordu. Vitamin/mineral desteğinin tedavi amaçlı kullanıldığını düşünenler arasında kadınlar erkeklerden fazlaydı (p=0,029). Vitamin kullanımı için doktora danışmak gerektiğini ve kan tahlilleri yaptırmak gerektiğini düşünenler sırasıyla %90,6 ve %86,9 idi. Vitamin fazlalığının sağlığa zararlı olabileceğini düşünenler (%76,2) arasında üniversite ve lise mezunlarının fazla olduğu gözlendi (p=0,037). Katılımcılar vitamin/mineral destekleri ile ilgili bilgieri en sık sağlık personelinden (%60,5) edindiklerini belirtmiş ve sonra sırasıyla radyo/televizyon (%41,9), gazete ve dergi (%34,9), arkadaş ve akraba (%14,7) olarak belirtilmiştir. Sağlık personelinden bilgi edindiğini ifade edenler arasında ise kadınlar sayıca yüksekti (p=0,001). Sonuç: Çalışma grubumuzda VMD ile ilgili farkındalığın yüksek olduğu ve özellikle kadınlarda ve eğitim düzeyi yüksek olanlarda belirgin olduğu görülmüştür. Sağlık personelinden bilgi edindiğini ifade edenlerin kadınların erkeklerden fazla olması kadınların sağlık hizmetlerini sık kullanımına bağlı olabilir. Vitamin/ mineral destekleri kullanımı hakkında hastaların farkındalıklarının arttırılması için geniş gruplarda, kapsamlı ve çok merkezli çalışmaların yanı sıra eğitimlerin planlanmasının toplum sağlığını geliştirmek için yararlı olacağını düşünmekteyiz.
Background: Elderly people are at risk for mortality, functional decline, reattendance, and hospi... more Background: Elderly people are at risk for mortality, functional decline, reattendance, and hospitalization after an emergency department visit. Objective: The aim of this study was to evaluate the performance of Identification of Seniors at Risk tool to predict unplanned readmissions after an emergency department visit. Methods: Records of patients aged ⩾65 years, who completed Identification of Seniors at Risk tool as they were being discharged from the emergency department, were analyzed. Patients were called back at 30th, 60th, 90th, 120th, and 180th days after emergency department discharge to assess their readmission to emergency department. Descriptive statistics and receiver operating characteristic curve analysis were performed. Results: This was a single-center study conducted with elderly patients with chronic diseases in a tertiary-level hospital within a period of 10 months with the follow-up calls. During the first month, 1792 patients were admitted to emergency depart...
Introduction: To increase, develop or maintain the knowledge and skills; to update the medical ap... more Introduction: To increase, develop or maintain the knowledge and skills; to update the medical approaches necessary for providing an effective healthcare service are aimed through continuing medical education(CME) activities.In this study,we evaluated the factors influencing attendance to CME activities along with the experiences in CME and perceptions of family physicians about the effect of CME on their routine clinical practice. Methods:A questionnaire developed by the researchers was implemented to family physicians during 3 Family Medicine CME activities held in consecutive 6 months.The questionnaire composed of multiple-choice,open-ended,Likert-type questions about sociodemographic characteristics, professional experience concerning CME. An index about perceptions of participants about the effect of CME activities on their daily clinical practice was developed and a score ≥ 20 points was considered as “positive index score”. Results: A total of 247 family physicians, consist...
Capgras's syndrome is characterized by delusions of misidentification, where a patient believes t... more Capgras's syndrome is characterized by delusions of misidentification, where a patient believes that people closely related to him or her are replaced by some similar looking impostors or persecutors. It' s a rare syndrome and is frequently considered within the concept of schizophrenia. Eight cases with Capgras's syndrome who had been diagnosed as "Schizophrenia-paranoid type" have been compared with eight Schizophrenia cases who did not have the Capgras's syndrome. Both groups of patients had been hospitalized approximately at same times within the past two months. Cases have been evaluated according to the duration of hospital stay, hospitalization frequency, duration of disease episodes, response to medication, antipsychotic dose needed to treat the disorder, the need for additional therapies and according to months they esere frequently hospitalized. CGI scale and BPRS have been used as evaluation tools. It has been concluded that patients with Capgras's Syndrome have a longer period of hospital stay and show lesssometimes inefficient-response to typical antipsychotics than patients without Capgras' s syndrome. However it has been seen that they show better improvement with atypical antipsychotics. We postulate that these findings need to be approved with additional studies and case reports. As a conclusion; answers to questions; 1)Should Capgras's syndrome be considered as an indicator of treatment resistance? 2) Can we treat Schizophrenia patients with Capgras's syndrome more effectively and faster with atypical antipsychotics? are being discussed.
Background: Methylenetetrahydrofolate reductase (MTHFR) plays a role in DNA biosynthesis, methyla... more Background: Methylenetetrahydrofolate reductase (MTHFR) plays a role in DNA biosynthesis, methylation and repair in actively dividing cells by acting on folate metabolism. A common C677T polymorphism in the gene for MTHFR leads to an enzyme with decreased activity. MTHFR polymorphisms have been studied in various cancers but not in primary brain tumors. The purpose of this case-control study was to explore a possible association between MTHFR C677T polymorphism and primary brain tumors. Materials and Methods: The MTHFR C677T genotype was determined in 74 patients with histologically-verified primary brain tumors and 98 cancer-free control subjects. Results: The MTHFR 677T variant genotype was observed in 49% of cases and 46% of controls. Although the difference was not significant (p=0.194), the homozygous TT genotype was found at a higher frequency in high-grade glioma (HGG) patients compared to controls (15.4% and 7.1%, respectively). The MTHFR genotype was not associated with men...
Every year, about 10 per 100 million people are affected by primary brain tumors which correspond... more Every year, about 10 per 100 million people are affected by primary brain tumors which correspond to about 2% of all adult primary tumors and 23% of all childhood cancers. Mortality caused by primary brain tumors is about 13,000 deaths per year and it represents 2% of adult and 25% of childhood cancer related deaths (Legler et al., 1999; DeAngelis, 2001; Wrensch et al., 2002; Furnari et al., 2007; Marie and Shinjo, 2011). Gliomas and meningiomas are the two most common primary brain tumors with approximately 50% and 20% proportion respectively. Among these two cancer types, meningiomas are mostly seen in women while gliomas are more common in men (Inskip et al., 1005; Parkin, et al., 2005; Park et al., 2009; Martinez et al., 2010). Glioblastoma multiforma (GBM) is known to be the most common and aggressive one among different primary brain tumor types (Yost et al., 2013). Primary brain tumors are mostly aggregated in families, suggesting a genetic basis for disease tendency. Thus, i...
Background: Palliative therapies have an important role in increasing the quality of healthcare a... more Background: Palliative therapies have an important role in increasing the quality of healthcare and in dealing with physical and psychosocial problems due to cancer. We here aimed to evaluate the managerial perspectives and opinions of the hospital managers and clinical directors about specialized palliative care centers. Materials and Methods: This study was conducted in two large-scale hospitals in which oncology care is given with medical directors (n:70). A questionnaire developed by the researchers asking about demographic characteristics and professional experience, opinions and suggestions of medical directors about providing and integrating palliative care into healthcare was used and responses were analyzed. Results: Potential barriers in providing palliative care (PC) and integrating PC into health systems were perceived as institutional by most of the doctors (97%) and nurses (96%). Social barriers were reported by 54% of doctors and 82% of nurses. Barriers due to interest and knowledge of health professionals about PC were reported by 76% of doctors and 75% of nurses. Among encouragement ideas to provide PC were dealing with staff educational needs (72%), improved working conditions (77%) and establishing a special PC unit (49)%. An independent PC unit was suggested by 27.7% of participants and there was no difference between the hospitals. To overcome the barriers for integration of PC into health systems, providing education for health professionals and patient relatives, raising awareness in society, financial arrangements and providing infrastructure were suggested. The necessity for planning and programming were emphasized. Conclusions: In our study, the opinions and perspectives of hospital managers and clinical directors were similar to current approaches. Managerial needs for treating cancer in efficient cancer centers, increasing the capacity of health professionals to provide care in every stage of cancer, effective education planning and patient care management were emphasized.
Alterations of cyclin D1, one of the main regulators of the cell cycle, are known to be involved ... more Alterations of cyclin D1, one of the main regulators of the cell cycle, are known to be involved in various cancers. The CCDN1 G870A polymorphism causes production of a truncated variant with a shorter half-life and thus thought to impact the regulatory effect of CCDN1. The aim of the present study was to contribute to existing results to help to determine the prognostic value of this specific gene variant and evaluate the role of CCDN1 G870A polymorphism in brain cancer susceptibility. A Turkish study group including 99 patients with primary brain tumors and 155 healthy controls were examined. Genotypes were determined by polymerase chain reactionrestriction fragment length polymorphism analysis. The CCDN1 genotype frequencies in meningioma, glioma and control cases were not significantly different (p>0.05). No significant association was detected according to clinical parameters or tumor characteristics; however, a higher frequency of AG genotype was recorded within patients with astrocytic or oligoastrocytic tumors. A significant association between AG genotype and gliobilastoma multiforme (GBM) was recorded within the patients with glial tumors (p value=0.048 OR: 1.87 CI% 1.010-3.463). According to tumor characteristics, no statistically significant difference was detected within astrocytic, oligoasltrocytic tumors and oligodentrioglias. However, patients with astrocytic astrocytic or oligoastrocytic tumors showed a higher frequency of AG genotype (50%) when compared to those with oligodendrioglial tumors (27.3%). Our results indicate a possible relation between GBM formation and CCDN1 genotype.
Methylenetetrahydrofolate reductase (MTHFR) plays a role in DNA biosynthesis, methylation and rep... more Methylenetetrahydrofolate reductase (MTHFR) plays a role in DNA biosynthesis, methylation and repair in actively dividing cells by acting on folate metabolism. A common C677T polymorphism in the gene for MTHFR leads to an enzyme with decreased activity. MTHFR polymorphisms have been studied in various cancers but not in primary brain tumors. The purpose of this case-control study was to explore a possible association between MTHFR C677T polymorphism and primary brain tumors. The MTHFR C677T genotype was determined in 74 patients with histologically-verified primary brain tumors and 98 cancer-free control subjects. The MTHFR 677T variant genotype was observed in 49% of cases and 46% of controls. Although the difference was not significant (p =0. 194), the homozygous TT genotype was found at a higher frequency in high-grade glioma (HGG) patients compared to controls (15.4% and 7.1%, respectively). The MTHFR genotype was not associated with meningioma patients. Defining patients with t...
In patients with established coronary artery disease (CAD), there are different reports on gender... more In patients with established coronary artery disease (CAD), there are different reports on gender, age, dyslipidemia, and obesity according to smoking behavior. Smoking, obesity, and dyslipidemia are targets in secondary prevention. In this study, we aimed to investigate the sociodemographic differences, lipid profiles, body mass index (BMI), and cigarette smoking status in patients diagnosed with CAD. Methods: Patients with records of angiography, smoking behavior, sociodemographic information, lipid levels, and BMI present at the outpatient visits were included in the study. Patients were grouped as active smokers, nonsmokers, and former smokers. Statistical methods were used for comparison of variables and means. Results: A total of 235 patients, 167 (71.1%) men and 68 (28.9%) women, were included in the study. Nonsmokers group (31.4%) consisted of mostly women while active (22.6%) and former smoker (46%) groups consisted mostly of men (P < 0.0001). The mean age was 60.65 ± 11.55. Age was associated with the smoking status of patients, and nonsmokers consisted of geriatric patients significantly (P = 0.001). Educational status was associated with smoking history. Cessation of smoking after CAD diagnosis was achieved in 46% of patients. Active smokers had highest mean triglyceride (TG) values while nonsmokers had highest mean high-density lipoprotein-cholesterol (HDL-C) values. Active smokers had the highest mean TG values while nonsmokers had the highest mean HDL-C values. BMI was higher in nonsmokers than active smokers. Conclusion: Gender, age, and educational status are determinants of smoking behavior in patients with CAD. BMI is associated with smoking history. In nonsmokers, values of HDL were highest while TG values were lowest. To prevent reoccurring cardiovascular events, young patients and men are two groups which health professionals need to concentrate in motivating to quit smoking.
Introduction: Acute gastroenteritis(AGE) is a frequent reason of morbidity and mortality in child... more Introduction: Acute gastroenteritis(AGE) is a frequent reason of morbidity and mortality in children in both developed and underdeveloped countries. It is mostly caused by infectious agents which differ according to age groups and seasons. We aimed to review the frequency, age, gender, season of J Pediatr Inf Doi: 10.5578/ced.66368 2 admission characteristics and rate of hospitalization of rotavirus and adenovirus infections in pediatric population admitted to emergency department with AGE in which stool analysis was performed. Material and Method: The records of 5526 patients aged between 0-16 years who were admitted to pediatric emergency unit with AGE in a year and in which stool analysis were performed were reviewed. Frequency of rotavirus and adenovirus cases, gender and age distribution and hospitalization data were analyzed. Results: A total of 5526 patients with AGE, 2303 females and 3223 males, with a mean age of 5.21±3.40 were included. Adenovirus was detected in 3.1% and ...
Amac: Sigara birakma poliklinigine basvuran kisilerin sosyodemografik ve sigara icme oykusune gor... more Amac: Sigara birakma poliklinigine basvuran kisilerin sosyodemografik ve sigara icme oykusune gore anksiyete ve depresyon duzeylerini degerlendirmek, anksiyete ve depresyon ile saglikli yasam bicimi davranislari arasindaki iliskinin arastirilmasi amaclanmistir. Materyal ve Metod : Calismaya bir egitim ve arastirma hastanesindeki sigara birakma poliklinigine basvurmus, baska herhangi bir hastaligi bulunmayan, Hastane Anksiyete Depresyon Olcegi (HAD) ve Saglikli Yasam Bicimi Davranislari Olcegi II (SYBDO II) uygulanmis olan hastalar alinmis, sosyodemografik ozellikleri, Fagerstrom Nikotin Bagimlilik Testi (FNBT) ve sigara kullanimi oykusu retrospektif olarak incelenmis ve istatistiki degerlendirmeler yapilmistir. Bulgular: Calismaya alinan 73 kisinin 43’u(%58,9) erkek, 30’u(%41,1) kadindi. Ortalama HAD Anksiyete (HAD-A) puani 8,74 ± 3,55; HAD Depresyon (HAD-D) puani 7,04 ± 3,74; SYBDO II toplam skoru 125,44±20,07 olarak bulundu. HAD-A ortalama puanlari cinsiyet ve egitim durumu ile il...
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