THE PREVALENCE OF BURNOUT SYNDROME AMONG RESIDENTS OF DOKUZ EYLUL UNİVERSITY SCHOOL OF MEDICINE

Amaç: Tükenmişlik sendromu, sağlık çalışanları arasında sık görülen bir durumdur. Bununla birlikte ülkemizde, Tıpta Uzmanlık Öğrencilerinin (TUÖ) tükenmişlik düzeylerini karşılaştıran çalışmaların sayısı kısıtlıdır. Çalışmamızda Dokuz Eylül Üniversitesi Hastanesindeki temel, dahili ve cerrahi tıp bilimlerindeki tıpta uzmanlık öğrencilerinin tükenmişlik düzeyini ölçmeyi amaçladık. Yöntemler: Çalışmamızda Dokuz Eylül Üniversitesi Hastanesinde çalışan cerrahi, dahili ve temel bilimlerdeki TUÖ'lerine anket yöntemi ile Maslach Tükenmişlik Ölçeği uygulandı ve meslekleri ile ilgili düşünceleri soruldu. Farklı dallardaki TUÖ'lerinin tükenmişlik düzeyleri birbirleri ile karşılaştırıldı. Bulgular: Hastanemizde çalışan 189 TUÖ (16 temel bilim TUÖ, 126 dahili bilim TUÖ, 47 cerrahi bilim TUÖ) çalışmaya alındı. Katılımcıların %50,8' i kadın, yaş ortalaması 28,4 ± 3,1 idi. Maslach Tükenmişlik Ölçeğinde TUÖ'lerinin ortalama duygusal tükenmişlik (DT) puanı 19,17 ± 8,37, Duyasızlaşma (DYS) puanı 18,97 ± 7,73 ve Kişisel Başarı (KB) puanı 24,35 ± 6,27 olarak hesaplandı. DT ve DYS puanlarında temel bilim TUÖ'leri diğer bölümlere göre daha düşük puan alırken (her biri için p<0,001), cerrahi ve dahili bilim TUÖ'lerinin arasında fark yoktu. Dahili bilim TUÖ'leri, cerrahi bilim TUÖ'lerine göre daha yüksek KB puanına sahipti (p=0,037). Temel bilim TUÖ'leri ile cerrahi ve dahili bilim TUÖ'leri arasında KB puanı açısından fark yoktu. Sonuç: Dahili ve cerrahi bilim TUÖ'lerinin DT ve DYS puanları, temel bilim TUÖ'lerinden daha yüksektir. Dahili bilim TUÖ'leri en yüksek, temel bilim TUÖ'leri en düşük KB puanına sahiptir Objective: Burnout syndrome is common among healthcare workers. However the studies of resident physicians burnout levels measurements are limited in our country. In our study we aimed of measure the levels of burnout in different branch residents in Dokuz Eylul University hospital. Methods: In our study Maslach Burnout Scale were performed to different branch residents in Dokuz Eylul University hospital by the survey method and asked about thoughts related to their profession. Burnout levels of the residents in different branches were compared with each other. Results: 189 residents from the basic medical sciences and surgical and internal medicine departments of Dokuz Eylul University hospital were included in the study. 16 of the residents participating in the study were from basic medical sciences and 126 from internal medical departments and 47 from surgical departments. 50,8% of the residents were women and the mean age was 28.4 ± 3.1. Average Emotional Exhaustion (EE) score was 19.17 ± 8.37, Depersonalization (DP) score was 18.97 ± 7.73 and Personal Accomplishment (PA) was 24.35 ± 6.27. EE and DP scores were lowest in basic sciences residents than other branches (each of them p<0.001) altough there were no significiant difference in EE and DP scores between surgical and internal medical residents. Internal medical residents PA score higher than the surgery residents (p=0.037). There were no significiant difference in PA scores between basic sciences residents and surgical departments residents and inernal medical departments residents.  Conclusion: EE and DP scores of internal medicine and surgical departments residents are higher than basic sciences residents. Internal medicine residents have the highest and basic sciences residents have the lowest PA scor

Volume CXIV, Number 4, November 7, 1996

Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population.Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014.Results: The most common karyotype was 45,X (50.7%), followed by 45,X/46,XX (10.8%), 46,X,i(Xq) (10.1%) and 45,X/46,X,i(Xq) (9.5%). Mean age at diagnosis was 10.2±4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45,X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%.Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespa

BEYİN ÖLÜMÜ KAVRAMI VE DEÜTF ANESTEZİ YOĞUN BAKIM ÜNİTESİNDEKİ OLGULARIN RETROSPEKTİF İNCELENMESİ

Bu çalışmada beyin ölümü kavramı, tarihçesi, klinik kriterleri, tanı testleri açısından değerlendirilmi

The Etiology and Clinical Features of Non-CAH Gonadotropin-Independent Precocious Puberty: A Multicenter Study

WOS: 000378819700011PubMed ID: 26964727Aim: The causes of gonadotropin-independent precocious puberty are diverse, and often have overlapping clinical and biochemical features. With the exception of congenital adrenal hyperplasia (CAH), disorders that cause gonadotropin-independent precocious puberty (GIPP) are uncommon. The literature is devoid of any large-scale studies on the etiologic distribution of GIPP. The aim of this study was to determine the frequency of each etiology in a cohort of patients with GIPP (excluding those with CAH), and to evaluate the clinical and laboratory features of these patients. Materials and Methods: This multicenter, nationwide web-based study collected data on patients who presented with non-CAH GIPP in Turkey. Results: Data were collected for 129 patients (102 girls and 27 boys) from 29 centers. Based on the data collected, the estimated prevalence of non-CAH GIPP in the studied population was 14 in 1 000 000 children. Functional ovarian cyst was the most common etiology, accounting for 37% of all cases, followed by McCune-Albright syndrome (MAS) (26%). Among the patients with MAS, 11.7% had fibrous dysplasia, 32.3% had caf-au-lait spots, and 52.9% had both. Human chorionic gonadotrophin-secreting tumors included choriocarcinoma of the liver, hepatoblastoma, and germ cell tumors of the sellar-suprasellar region and mediastinum. Patients with adrenocortical tumors presented at an earlier age than those with other etiologies. Ovarian tumors included mature cystic teratoma, dysgerminoma, juvenile granulosa tumor, and steroid cell tumor. Despite overlapping features, it was possible to identify some unique clinical and laboratory features associated with each etiology. Conclusion: This largest cohort of patients with non-CAH GIPP to date yielded an estimation of the frequency of non-CAH GIPP in the general pediatric population and showed that girls were affected at a rate 4-fold greater than that of boys owing to functional ovarian cysts and MAS, which were the two most common etiologies. The data collected also provided some unique characteristics associated with each etiology.Turkish Pediatric Endocrinology and Diabetes Society [052014]This work was supported by the Turkish Pediatric Endocrinology and Diabetes Society (No: 052014)

The Etiology and Clinical Features of Non-CAH Gonadotropin-Independent Precocious Puberty: A Multicenter Study

Aim: The causes of gonadotropin-independent precocious puberty are diverse, and often have overlapping clinical and biochemical features. With the exception of congenital adrenal hyperplasia (CAH), disorders that cause gonadotropin-independent precocious puberty (GIPP) are uncommon. The literature is devoid of any large-scale studies on the etiologic distribution of GIPP. The aim of this study was to determine the frequency of each etiology in a cohort of patients with GIPP (excluding those with CAH), and to evaluate the clinical and laboratory features of these patients

The Etiology and Clinical Features of Non-CAH Gonadotropin-Independent Precocious Puberty: A Multicenter Study

Aim: The causes of gonadotropin-independent precocious puberty are diverse, and often have overlapping clinical and biochemical features. With the exception of congenital adrenal hyperplasia (CAH), disorders that cause gonadotropin-independent precocious puberty (GIPP) are uncommon. The literature is devoid of any large-scale studies on the etiologic distribution of GIPP. The aim of this study was to determine the frequency of each etiology in a cohort of patients with GIPP (excluding those with CAH), and to evaluate the clinical and laboratory features of these patients. Materials and Methods: This multicenter, nationwide web-based study collected data on patients who presented with non-CAH GIPP in Turkey. Results: Data were collected for 129 patients (102 girls and 27 boys) from 29 centers. Based on the data collected, the estimated prevalence of non-CAH GIPP in the studied population was 14 in 1 000 000 children. Functional ovarian cyst was the most common etiology, accounting for 37\% of all cases, followed by McCune-Albright syndrome (MAS) (26\%). Among the patients with MAS, 11.7\% had fibrous dysplasia, 32.3\% had caf-au-lait spots, and 52.9\% had both. Human chorionic gonadotrophin-secreting tumors included choriocarcinoma of the liver, hepatoblastoma, and germ cell tumors of the sellar-suprasellar region and mediastinum. Patients with adrenocortical tumors presented at an earlier age than those with other etiologies. Ovarian tumors included mature cystic teratoma, dysgerminoma, juvenile granulosa tumor, and steroid cell tumor. Despite overlapping features, it was possible to identify some unique clinical and laboratory features associated with each etiology. Conclusion: This largest cohort of patients with non-CAH GIPP to date yielded an estimation of the frequency of non-CAH GIPP in the general pediatric population and showed that girls were affected at a rate 4-fold greater than that of boys owing to functional ovarian cysts and MAS, which were the two most common etiologies. The data collected also provided some unique characteristics associated with each etiology

Clinical and genetic characteristics of a large international cohort of individuals with rare NR5A1/SF-1 variants of sex developmentResearch in context

Summary: Background: Steroidogenic factor 1 (SF-1/NR5A1) is essential for human sex development. Heterozygous NR5A1/SF-1 variants manifest with a broad range of phenotypes of differences of sex development (DSD), which remain unexplained. Methods: We conducted a retrospective analysis on the so far largest international cohort of individuals with NR5A1/SF-1 variants, identified through the I-DSD registry and a research network. Findings: Among 197 individuals with NR5A1/SF-1 variants, we confirmed diverse phenotypes. Over 70% of 46, XY individuals had a severe DSD phenotype, while 90% of 46, XX individuals had female-typical sex development. Close to 100 different novel and known NR5A1/SF-1 variants were identified, without specific hot spots. Additionally, likely disease-associated variants in other genes were reported in 32 individuals out of 128 tested (25%), particularly in those with severe or opposite sex DSD phenotypes. Interestingly, 48% of these variants were found in known DSD or SF-1 interacting genes, but no frequent gene-clusters were identified. Sex registration at birth varied, with <10% undergoing reassignment. Gonadectomy was performed in 30% and genital surgery in 58%. Associated organ anomalies were observed in 27% of individuals with a DSD, mainly concerning the spleen. Intrafamilial phenotypes also varied considerably. Interpretation: The observed phenotypic variability in individuals and families with NR5A1/SF-1 variants is large and remains unpredictable. It may often not be solely explained by the monogenic pathogenicity of the NR5A1/SF-1 variants but is likely influenced by additional genetic variants and as-yet-unknown factors. Funding: Swiss National Science Foundation (320030-197725) and Boveri Foundation Zürich, Switzerland

Growth curves for Turkish Girls with Turner Syndrome: Results of the Turkish Turner Syndrome Study Group

Objective: Children with Turner syndrome (TS) have a specific growth pattern that is quite different from that of healthy children. Many countries have population-specific growth charts for TS. Considering national and ethnic differences, we undertook this multicenter collaborative study to construct growth charts and reference values for height, weight and body mass index (BMI) from 3 years of age to adulthood for spontaneous growth of Turkish girls with TS