The frequency and disribution of cancer cases in Hatay District in 2008

The aim of this study was to evaluate all cancer cases reported in 2008 in Hatay district.Materials and methods: Data of 465 cancer patients were collected by Hatay Cancer Early Diagnosis and Screening Centre between January 1–December 31, 2008 and evaluated.Results: Totally 465 cancer cases were collected from centre of Hatay and districts. 48,8% of these cases (227 cases) were female patients, 51,2% (238 cases) were male. The most frequently encountered cancers were skin (27,7%) and breast cancers (14,7%) when evaluated in terms of the incidence of cases.Conclusion: Due to cancer screening studies becoming widespread in the community, cases with cancer can be determined in the early stage, also studies intended for etiology and preventive medicine gradually increase. Skin and breast cancers are common in Hatay. Therefore, further studies on etiology and preventive measures for cancer are needed. J Clin Exp Invest 2011;2(2):192-

Serum SCUBE-1 levels and return of spontaneous circulation following cardiopulmonary resuscitation in adult patients

Background SCUBE 1-has been used as a biomarker for the diagnoses of myocardial infarction, stroke, mesenteric ischemia, and gastric cancer in some recent studies. In this study, we investigated the relationship between serum SCUBE-1 levels and return of spontaneous circulation (ROSC) in patients who received cardiopulmonary resuscitation (CPR). Methods Patients over 18 years of age who were not pregnant and received CPR were divided into two groups: those who achieved ROSC and those who died. There were 25 patients in each group. SCUBE-1 and other routine biochemical parameters were studied in blood samples taken at the time of admission. Results There was no significant difference between the age and gender distribution of the patients between the two groups. The SCUBE-1 value of the ROSC group was significantly higher than that of the non-survivor group ( p ˂ 0.05). At a cut-off value of 9 ng/mL, SCUBE-1 had a sensitivity of 100%, a positive predictive value of 65.8%, specificity of 48%, and a negative predictive value of 100% in predicting ROSC. Conclusions The SCUBE-1 values were found to be significantly higher in the ROSC group compared with the non-survivor group

Knowledge and attitudes towards complementary and alternative medicine among medical students in Turkey

OBJECTIVE: This study aims to examine knowledge and attitudes towards Complementary and Alternative Medicine among medical students in Turkey, and find out whether they want to be trained in Complementary and Alternative Medicine (CAM). METHODS: A cross-sectional study was carried out between October and December 2010 among medical students. Data were collected from a total of seven medical schools. FINDINGS: The study included 943 medical students. The most well known methods among the students were herbal treatment (81.2 %), acupuncture (80.8 %), hypnosis (78.8 %), body-based practices including massage (77 %) and meditation (65.2 %), respectively. Acupuncture, aromatherapy, herbal treatment and meditation were better known among female participants compared to males (p < 0.05). Females and first year students, generally had more positive attitudes. A larger proportion of female students compared to male students reported that a doctor should be knowledgeable about CAM (p = 0.001), and this knowledge would be helpful in their future professional lives (p = 0.015). Positive attitudes towards and willingness to receive training declined as the number of years spent in the faculty of medicine increased. CONCLUSIONS: Majority of the medical students were familiar with the CAM methods widely used in Turkey, while most of them had positive attitudes towards CAM as well as willingness to receive training on the subject, and they were likely to recommend CAM methods to their patients in their future professional lives. With its gradual scientific development and increasing popularity, there appears a need for a coordinated policy in integrating CAM into the medical curriculum, by taking expectations of and feedback from medical students into consideration in setting educational standards

Orak hücre anemili çocuk ve ergenlerde ebeveyn ve öğretmen bildirilerine dayalı psikiyatrik sorunlar

Amaç: Bu çalışma Orak Hücre Anemisi (OHA) tanılı çocuk ve ergenlerde psikiyatrik sorunların varlığını incelemeyi amaçlamıştır. Gereç ve Yöntemler: 4-18 yaş arası için Çocuk Davranış Kontrol Listesi (ÇDKL/4-18), Conners Ebeveyn Derecelendirme Ölçeği (CEDÖ), Conners Öğretmen Derecelendirme Ölçeği (CÖDÖ-R) ve Turgay DSM-IV’e dayalı Çocuk ve Ergen Davranış Bozuklukları Tarama ve Derecelendirme Ölçeği, klinisyen ve ebeveyn formları (T-DSM-IV-Ö) 7-18 yaş arası OHA tanılı 31 çocuğun ve 34 yaş olarak eşlenmiş demir eksikliği anemisi tanılı kontrol grubunun bakım vericileri ve öğretmenlerine verildi. Bulgular: OHA tanılı çocuk ve ergenler her 4 ölçekte de daha yüksek puanlar aldılar. Ölçek alt puanlarında içe atım sorunları ve dikkat sorunları öne çıkıyordu. Sonuç: OHA tanılı çocuk ve ergenlerin psikiyatrik sorunlar açısından yüksek riskte olduğu görünmektedir. Olgulara düzenli psikolojik değerlendirme yapılması ve çocuk ve ergen psikiyatri kliniklerine refere edilmesi risk altında olan olguların zamanında tanısı ve etkin tedavisine katkı sağlayabilir.Objective: This study aimed to investigate the occurrence of psychiatric problems in children and adolescents with sickle cell disease (SCD). Material and Methods: The Child Behavior Checklist for ages 4-18 years (CBCL/4-18), Conners&amp;#8217; Parent Rating Scale (CPRS), Conners&amp;#8217; Teacher Rating Scale (CTRS-R), and The Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale, clinician and parent forms (T-DSM-IV-S) were given to the caregivers and teachers of 31 children with SCD aged between 7-18 years and the caregivers and teachers of 34 age matched controls with iron- deficiency anemia. Results: The SCD patients had higher scores on all 4 of scales. Among the subscales, internalizing problems, and attention problems were more prominent in the SCD patients. Conclusion: Children and adolescents with SCD appear to have an increased risk for psychiatric problems. Regular psychological evaluation and referral to child and adolescent psychiatry clinics may facilitate timely diagnosis and effective treatment of at-risk children and adolescents

Hatay ilinde kronik hastalığı bulunan bireylerin cepten yaptıkları sağlık harcamalarının kronik hastalık bakımlarına etkisi

Amaç: Çalışmamızda, kronik hastalığı bulunan bireylerin sağlık harcamalarının, kronik hastalık bakım memnuniyetine etkisinin değerlendirilmesi amaçlanmıştır. Yöntem: Kesitsel tanımlayıcı tasarıma sahip bu çalışma, Haziran 2017–Ekim 2017 ayları arasında, Hatay’da (Antakya) dört aile sağlığı merkezinde yürütülmüştür. Belirlenen aile sağlığı merkezlerine başvuran 18 yaş ve üzeri, en az bir yıldır kronik hastalığı bulunan bireyler dahil edilmiştir. Kronik hastalığa sahip bireylerin; sosyodemografik özelliklerini, hastalıklarının özelliklerini, aldıkları sağlık hizmetlerini, yaptığı sağlık harcamalarını etkileyen faktörleri kapsayan bir anket uygulanmıştır. Ayrıca hastalara, aldıkları bakımı kendilerinin değerlendirmesine olanak veren Kronik Hastalık Bakımını Değerlendirme Ölçeği-Hasta formu (Modifiye PACIC) çalışma yürütücüsü tarafından uygulanmıştır. Bulgular: Anketi değerlendirmeye alınan 47,11 ± 15,20 yaş ortalamasına sahip 790 katılımcının 400 (%50,6)’ü kadın, 390 (%49,4)’si erkek hastaydı. Katılımcılarımızın, Modifiye PACIC puan ortalaması toplam ölçek için 3,29 ± 0,7 olarak hesaplanmıştır. Hastaların gelir düzeyi arttıkça, sağlık hizmet alımının etkilendiği görülmüştür(Cramer’s V=0,263; p=0,001). Aterosklerotik kalp hastalığı olanlarda, kronik hastalık memnuniyet puan ortalaması 3,0±0,6 ile diğer hastalıklara göre daha düşük bulunmuştur (p=0,005). Hastaların gelir düzeyi kategorilerine göre kronik hastalık bakım memnuniyet puanları arasında fark görülmemiştir (p=0,853).Sonuç: Cepten yapılan sağlık harcamalarının, hizmet alımını etkilemediğini belirten hastaların Modifiye PACIC alt ölçek skorları genel olarak daha yüksek bulunmuştur. Ayrıca hastaların gelir düzeyinin kronik hastalık bakımlarını etkilediği sonucuna ulaşılmıştır.Aim: To evaluate the effect of healthcare expenditure of the patients who have chronic disease on chronic disease care satisfaction. Method: This cross sectional design study was conducted at four primary care clinics in Antakya, the central city of Hatay. The adult patients with a chronic disease at least for one year who visit the primary care centers from June to October 2017 were included in the study. A questionnaire including questions about the chronic disease, the healthcare they receive, and the factors that effect their healthcare expenditure were applied to the subjects. Also the subjects filled a chronic disease care evaluation scale- patient form (modified PACIC) to evaluate the healthcare they receive. P value<0,05 is considered as significant. Results: Of the 790 patients 400 (50,6%) were female, while 390 (49,4%) were male. The average age of the participants was 47,1 ±15,2. Average Modified PACIC score was calculated as 3,29 ±0,7. It was observed that healthcare intake was affected as the income level of the patients increased (Cramer’s V = 0,263; p = 0,001). In patients with atherosclerotic heart disease, the chronic disease satisfaction score was found to be lower with 3.0 ± 0.6 compared to other diseases (p = 0.005). There was no difference between the chronic disease care satisfaction scores according to the income level categories of the patients (p = 0.853). Conclusion: Modified PACIC subscale scores of the patients who stated that their out-of-pocket health spending did not affect their service purchases were generally higher. In addition, it was concluded that the income level of the patients affected chronic disease care

Metoklopramide bağlı akut distonik reaksiyon : İki olgu sunumu

Metoclopramide is a widely used antiemetic agent in paediatric population with the primary side-effect of extrapyramidal reactions. Incidence is 0.5-1% in children while incidence in young adults and elders is 25%. Patients can be misdiagnosed as meningitis, encephalitis, hypocalcemia, seizure and tetanus. We report two cases, 8-month-and 10-year-old boys referred to our hospital with a presumptive diagnosis of encephalitis and diagnosed as metoclopramide induced acute dystonic reaction, to stress this side-effect of metoclopramide.Metoklopramid, çocukluk çağında yaygın olarak kullanılan antiemetik bir ajan olup, en sık görülen yan etkisi ekstrapiramidal reaksiyonlardır. Çocuklarda insidansı % 0.5-1 iken, adölesan ve yaşlılarda % 25 civarındadır. Hastalar, meninjit, ensefalit, hipokalsemi, nöbet ve tetanoz şeklinde yanlış tanı alabilmektedir. Biz de ensefalit ön tanısı ile hastanemize sevk edilen 8 aylık ve 10 yaşında iki erkek hastada, metoklopramide bağlı akut distonik reaksiyon gelişen iki vaka saptadık

The effect of vitamin D supplementation on balance and quality of life in older women

Giriş: Bu araştırmada yaşlı kadınlarda vitamin D kullanımının denge ve yaşam kalitesi üzerine etkisinin saptanması amaçlanmıştır. Gereç ve Yöntem: Fiziksel tıp ve rehabilitasyon polikliniğine başvuran 60 yaş üzerindeki kadın hastalar çalışmaya alındı. Hastaların denge durumunu değerlendirmede, The Performance-Oriented Mobility Assessment (TPOMA), yaşam kalitesini değerlendirmede, Short Form Health Survey (SF-36) kullanıldı. SF-36'nın fiziksel sağlık (FS) ve mental sağlık (MS) olmak üzere 2 komponenti üzerinden toplam skorlar hesaplandı. Calcitriol: 0.25-0.50 mcg/gün veya alfacalcidol 0.5-1 mcg/gün alınması aktif D vitamini kullanımı olarak tanımlandı ve cholecalciferol: 800 IU/gün alınması D vitamini kullanımı olarak tanımlandı. Bulgular: Toplam 180 hastanın 47'si (%26.1) vitamin D kullanırken 28'si (%15.6) aktif vitamin D kullanıyordu. 105 (%58.3)hasta vitamin D tedavisi almıyordu. 3 grup arasında; yaş, Vücut Kitle İndeksi (VKİ), FS, MS, TPOMA total değer, TPOMA kategorisi ve denge bozukluğu açısından istatistiksel olarak anlamlı fark yoktu. Hastaların 75'i (%41.7) aktif vitamin D veya vitamin D kullanıyordu. Vitamin D kullananlar ve çalışmadaki diğer hastalar arasında da; yaş, VKİ, FS, MS, TPOMA total değer, TPOMA kategorisi ve denge bozukluğu açısından anlamlı fark bulunamadı. Sonuç: Yaşlı kadınlarda vitamin D kullanımı ile denge ve yaşam kalitesi arasında ilişki bulunmamıştır. Vitamin D kullanımı ile bu parametreler arasındaki ilişkiyi araştırmak için ileri çalışmalar gereklidir.Introduction: In this study it was aimed to investigate the effect of vitamin D supplementation on balance and quality of life in older women. Materials and Method: Female patients older than 60 years were enrolled. Participants' fall risk was assessed using The Performance-Oriented Mobility Assessment (TPOMA) and, health status using Short Form Health Survey(SF-36). Active vitamin D supplementation was described as usage of calcitriol:0.25-0.50mcg/daily or alfacalcidol:0.5-1mcg/daily, and vitamin D was described as usage of cholecalciferol:800IU/daily. Results: Of 180 patients 28 (15.6%) were using active vitamin D when 47(26.1%) were using vitamin D. One hundred and five patients (58.3%) received no vitamin D supplementation. There was no statistically significant difference between three groups according to age, body mass index(BMI), Physical Component Score(PCS), Mental Component Score(MCS), TPOMA total score, category of TPOMA, and presence of balance disorder. Of all patients 75(41.7%) were using either active vitamin D or vitamin D. There was also no significant difference between vitamin D users and the rest of the study patients according to age, BMI, PCS, MCS, TPOMA total score, category of TPOMA, and presence of balance disorder. Conclusion: We found no association between vitamin D supplementation and balance and quality of life in older women adults. Further studies are necessary to investigate the relationship between vitamin D supplementation and these parameters

The Effects of Elimination of Gate-Keeping on Tertiary Care and the Social Insurance System

The aim was to investigate the effects of elimination of gatekeeping on a university hospital and Social Insurance Institute (SII). Electronic records of 2006-2007 were analyzed. The mean outpatient visits was 273.8±69.9 before the gate-keeping elimination, it was 471.8±114.7 after the gate-keeping elimination (p<0.001). The increased rate of visits were in the department of cardiology (95.4%) followed by respiratory medicine (33.3%), orthopedics (22.6%), neurology (16.1%) and gynecology (11.4%). Also the most frequent diagnoses changed in these departments. The most frequent diagnoses before and after elimination were as follows; hypertension in comparison to anxiety disorders after elimination in cardiology, chronic obstructive lung disease compared to myalgia in respiratory medicine, fracture follow up compared to joint pain in orthopaedics, epilepsy compared to dizziness in neurology and infertility compared to vaginitis in gynecology. SII has paid 10.67 fold higher dues after elimination for these 7 departments and diagnoses. Consequently; elimination of the gate-keeping can easily be applied to tertiary care and can increase health expenditures

Osteoporosis Medication and Quality of Life in Older Women - Original Investigation

Aim: We aimed to investigate the effect of drug therapy on quality of life in older women with osteoporosis. Material and Methods: One hundred seventy seven women over 65 years were enrolled in this study. Quality of life was evaluated by Short-Form-36 (SF-36). Participants’ quality of life was compared according to their medication use for osteoporosis by comparing Physical Component Summary (PCS) and Mental Component Summary (MCS) score of SF-36 between groups. Results: While one hundred twenty two(68.9%) of the participants had not used any drug, 20 (11.3%) women had used only vitamin D-calcium and, 35 (19.8%) women had used antiresorptive agents plus vitamin D-calcium. There were no statistically difference between groups in respect to age and bone mineral density (p>0.05). The mean values of PCS were 34.80±11.24, 30.33±9.49, and 31.56±7.28 respectively in the groups 1, 2 and 3. The mean values of MCS were 44.91±9, 44.15±11.93, and 44.42±12.09 respectively in the groups 1, 2 and 3. There were no significant differences between the PCS and MCS values (p>0.05, p>0.05). Conclusion: The findings of this study were considered that vitamin D plus calcium and antiresorptive agents were not sufficient to improve the quality of life in the older women with osteoporosis. (From the World of Osteoporosis 2008;14:7-11