Evaluation of the Development of Psychosomatic Medicine in a Large University Hospital in Turkey

The purpose of this study was to evaluate the development of psychosomatic medicine at our university hospital in Istanbul, which has an inpatient capacity of 3.000. Changing patterns of utilization of psychiatric service were analyzed in two 1-year surveys five-year intervals (1998, n=888) – (2003, n=1609). Psychiatric referrals were analyzed with regard to rate of consultation, demographic characteristics, departments making referrals, reasons for referral, psychiatric diagnoses and patterns of psychiatric intervention. Psychiatric consultation request, consultation reply and medical psychiatric examination forms were used. In evaluating the data, consultation rate was seen to have doubled over the five intervening years. Significant changes were also noted in the demographic characteristics of patients (e.g., more men, older mean age). The most prevalent disorders in both groups were depressive disorder and adjustment disorders. Alcohol and substance abuse remained as a small group. The gradual increase in the utilization of psychiatric services can be attributed to service and education-related variables

Yaşla Beraber Ön Segment Parametrelerindeki Değişimin Dual Scheimpflug Topografi ile Değerlendirilmesi

Objective: The aim of this study was to investigate the changes according to age in anterior segment parameters measured by Galilei Dual Scheimpflug Analyzer. Material and Methods: Healthy subjects were recruited and classified into seven groups according to age. Group 1 consisted of subjects whose ages ranged between 5 and 10 years. Group 2, 3, 4, 5, 6, 7 consisted of subjects who were in their second, third, forth, fifth, sixth and seventh decades, respectively. After a detailed examination, anterior segment parameters were assessed by using Galilei Dual Scheimpflug Analyzer. The following parameters were obtained from topographic and pachymetric maps for analysis: anterior chamber angle (ACA), anterior chamber depth (ACD), anterior chamber volume (ACV), central corneal thickness (CCT), pupil diameter (PD) and corneal horizontal diameter (CHD). Statistical analysis was performed by using SPSS for Windows version 23.0. Results: The age of subjects ranged between 5 and 67 years. Of 229 subjects, 152 (66.4%) were female and 77 (33.6%) were male. The decrease in CCT, CHD, PD, ACD and ACA with age was statistically significant and a negative correlation was present (p=0.000). Except Group 1, the decline in ACV by increasing age was statistically significant and a negative correlation was present [r (458) =-0.34. p=0.000]. Conclusion: All anterior segment parameters except mean ACV measured by Galilei Dual Scheimpflug Analyzer were found to decline with age and mean ACD achieved to adult size till the beginning of the second decadeAmaç: Yaşla beraber ön segment parametrelerindeki değişimin Galilei Dual Scheimpflug Topografi ile değerlendirilmesi. Gereç ve Yöntemler: Çalışmaya sağlıklı denekler alınarak yaşlarına göre 7 gruba ayrıldı. Grup 1’deki deneklerin yaşları 5 ile 10 arasında idi. Grup 2, 3, 4, 5, 6 ve 7 ise yaşları sırasıyla ikinci, üçüncü, dördüncü, beşinci, altıncı ve yedinci on yıllarında olan deneklerden oluşturuldu. Detaylı göz muayenesinden sonra Galilei Dual Scheimpflug Topografi ile ön segment parametreleri değerlendirildi. Ön kamara açısı (ÖKA), ön kamara derinliği (ÖKD), ön kamara hacmi (ÖKH), merkezi kornea kalınlığı (MKK), pupilla çapı (PÇ) ve horizontal kornea çapı (KÇ) değerleri topografik ve pakimetrik haritalar incelenerek değerlendirildi. İstatistiksel analiz SPSS 23,0 programı ile yapıldı. Bulgular: Çalışmaya katılan 229 deneğin yaşları 5 ile 67 arasında değişmekte ve 152’si (%66,4) kadın, 77’si (%33,6) ise erkekti. Analiz sonucunda MKK, KÇ,PÇ, ÖKD ve ÖKA yaşla beraber azalmakta ve yaş ile bu değerler arasında istatistiksel olarak negatif korelasyon mevcuttu (p=0,000). ÖKH’de ise Grup 1 hariç diğer gruplar arasında yaşla beraber düşme olduğu gözlenmiş ve istatistiksel olarak negatif korelasyon bulunmuştur [r (458) =-0,34. p=0,000]. Sonuç: Galilei Dual Scheimpflug topografi ile ortalama ÖKH hariç tüm ön segment parametreleri yaşla birlikte azalmıştır. ÖKD’nin ikinci on yıldan itibaren erişkin boyutuna ulaştığı gözlenmiştir

Validation of tracheal intubation of wire-reinforced endotracheal tube with ultrasonography

Objective. Te use of ultrasonography (US) is a new method for verifying the location of the endotracheal tube. Design. Our study was designed as a paired-data and investigator-blind clinical study for evaluating the efectiveness of US for verifcation of wire-reinforced endotracheal tube (WR-ETT) placement compared with capnography. Setting. Tis study was conducted on 56 patients scheduled for elective surgery under general anesthesia. Patients. Fify patients completed the study as 6 were excluded for various reasons. Intervention. Two diferent investigators performed the ultrasonography and intubation independently from one another. While investigator 1 attempted to verify the location of the WR-ETT with a portable ultrasonography with sagittal trans-tracheal view, investigator 2 intubated the patient and verifed the location of the ETT using capnography. Measurements. Time for verifying the location of the ETT using both US and capnography was recorded. Main Results. When the ultrasonography method was compared with capnography for verifcation of the WR-ETT placement, the results showed 95.75% sensitivity and 100% specifcity. Te average verifcation times for endotracheal intubation were 12.78 ± 7.46 s. and 24.44 ± 1.45 s. with US and capnography, respectively (p=0.003). Conclusion. Our results suggest that ultrasound identifcation of a WR-ETT within the trachea is a rapid and accurate method for confrmation of tracheal placement. Larger studies are needed before widespread use of this technique

Revisiting weighted-rankit method by a hypothetical data set

Bitki gen kaynaklarının morfolojik karekterizasyonu ve değişik bölgeler için çeşit adaptasyonları Türkiye’deki bahçe bitkileri araştırmalarının önemli bir kısmını oluşturmaktadır. Her iki alan da değişik önem seviyelerinde birçok bahçe bitkileri özelliğinin çok sayıda genotip için değerlendirmesini gerektirmektedir. Bu tip denemelerde sıklıkla tartılı derecelendirme yöntemi bir istatistiksel yöntem olarak kullanılmaktadır. Tartılı derecelendirme ile ilgili yapılan kaynak taramasında, halen uygulanmakta olan yöntemin bahçe bitkileri araştırmaları için ilk olarak önerilen yöntemden önemli ölçüde farklı olduğu görülmüştür. Bu çalışmada, yapay bir veri dosyası kullanarak, orijinal yöntemle Türkiye’deki çalışmalarda kullanılan tartılı derecelendirme yönteminin aynı veri seti için değişik sonuçlar verebileceğini gösterdik. Önem testi içermeyen mevcut yöntem, test edilen genotiplerin toplam puanları arasında, istatistiksel olarak önemli olup olmadığı belirlenememektedir. Ancak bu yöntemdeki hiçbir sonuç istatistiksel olarak desteklenmemektedir. Bu yüzden bahçe bitkilerindeki çok-değişken içeren araştırmalarda ya “asıl” tartılı derecelendirme yönteminin titizlikle takip edilmesini ya da diğer çok-değişkenli analiz yöntemlerinin kullanılmasını önerilmektedir.Morphological characterization of plant genetic resources and variety trials in various ecological regions are important parts of horticultural research in Turkey. Both topics require evaluation of many horticultural traits with different weights for a large number of genotypes. Weighted-rankit (WR) method is a tool commonly used in statistical analyses of these experiments. Our survey on the WR indicated that the common interpretation of the method significantly deviates from the original method suggested for horticultural research in the literature. In this study, using a hypothetical data set, we demonstrated that interpretations as made in both Turkish and original horticultural research may suggest different conclusions for the same data set. Not having a significance test, the current version of interpretations commonly found in horticultural studies in Turkey may be erroneous as it recovers variability among the total scores of the entities tested without considerations of whether or not those are statistically different. However, in this method, conclusions would not be supported by a valid statistical test. Therefore, we suggest either strictly following the “original“ WR method or using other valid multivariate methods for analyzing multi-traits studies in horticultural research

PSYCHOLOGICAL REACTIONS TO SURGICAL TREATMENT IN BREAST CANCER

Breast cancer is a disease that threats not only the life but also sexuality and womenhood of the person. Surgical operation effects detrimentaly the patient's body image, self-esteem, psychological status, sexual life and interrelationship with the environment. The determining factors in the response to the operation are the subjective meaning of breast lost, the personal experience and perception of the breast in the person's ego and womenhood concept. Even the thought and probability of the loss of the breast effect the person severely in a sociaty that equals or attribute the breast a symbol of womenhood and sexuality. Depending on how the breast is perceived and the personality feature of the patient, a variety of psychological reaction develop among which the primary ones can be defined as the following: Shock, denial, hostilite, depression, projection, psychological regression, hopelessnes-helplessnes, exhaustion and pathological dependency. Anxiety and depression are the most frequently devoloping psychiatric situations. The perception of the illness, the information level and what is unknown effects psychological state of the patient. Thus the psychological preparation of the patient in the preoperative phase and providing psychological support decreases medical and behavioral complications and helps in the psyhosocial adjustment of the patient during the post-operative phase. It is of vital importance to provide psychological support starting from the pre-operative phase continuing in the post-operative phase and until a new body image, a new functional ego and new perceptive style, new productive relation with the world is constructed

Revisiting weighted-rankit method by a hypothetical data set

Bitki gen kaynaklarının morfolojik karekterizasyonu ve değişik bölgeler için çeşit adaptasyonları Türkiye’deki bahçe bitkileri araştırmalarının önemli bir kısmını oluşturmaktadır. Her iki alan da değişik önem seviyelerinde birçok bahçe bitkileri özelliğinin çok sayıda genotip için değerlendirmesini gerektirmektedir. Bu tip denemelerde sıklıkla tartılı derecelendirme yöntemi bir istatistiksel yöntem olarak kullanılmaktadır. Tartılı derecelendirme ile ilgili yapılan kaynak taramasında, halen uygulanmakta olan yöntemin bahçe bitkileri araştırmaları için ilk olarak önerilen yöntemden önemli ölçüde farklı olduğu görülmüştür. Bu çalışmada, yapay bir veri dosyası kullanarak, orijinal yöntemle Türkiye’deki çalışmalarda kullanılan tartılı derecelendirme yönteminin aynı veri seti için değişik sonuçlar verebileceğini gösterdik. Önem testi içermeyen mevcut yöntem, test edilen genotiplerin toplam puanları arasında, istatistiksel olarak önemli olup olmadığı belirlenememektedir. Ancak bu yöntemdeki hiçbir sonuç istatistiksel olarak desteklenmemektedir. Bu yüzden bahçe bitkilerindeki çok-değişken içeren araştırmalarda ya “asıl” tartılı derecelendirme yönteminin titizlikle takip edilmesini ya da diğer çok-değişkenli analiz yöntemlerinin kullanılmasını önerilmektedir.Morphological characterization of plant genetic resources and variety trials in various ecological regions are important parts of horticultural research in Turkey. Both topics require evaluation of many horticultural traits with different weights for a large number of genotypes. Weighted-rankit (WR) method is a tool commonly used in statistical analyses of these experiments. Our survey on the WR indicated that the common interpretation of the method significantly deviates from the original method suggested for horticultural research in the literature. In this study, using a hypothetical data set, we demonstrated that interpretations as made in both Turkish and original horticultural research may suggest different conclusions for the same data set. Not having a significance test, the current version of interpretations commonly found in horticultural studies in Turkey may be erroneous as it recovers variability among the total scores of the entities tested without considerations of whether or not those are statistically different. However, in this method, conclusions would not be supported by a valid statistical test. Therefore, we suggest either strictly following the “original” WR method or using other valid multivariate methods for analyzing multi-traits studies in horticultural research