Pharmacological Treatment of the Pathogenetic Defects in Type 2 Diabetes: The randomized multicenter South Danish Diabetes Study

AbstractObjective: To determine the effect of treatment with insulin Aspart as compared to NPH insulin, together with metformin/placebo and rosiglitazone/placebo. The hypothesis was that combined correction of major pathogenetic defects in type 2 diabetes would result in optimal glycemic control. Research Design and Methods: A 2-year investigator driven, randomized, partly placebo controlled, multicenter trial in 371 patients with type 2 diabetes on at least oral antiglycemic treatment. Patients were assigned to one of eight treatment groups in a factorial design with insulin aspart at mealtimes vs. NPH insulin once daily at bedtime, metformin twice daily vs. placebo, and rosiglitazone twice daily vs placebo. Main outcome measurement: change in HbA1c. Results: HbA1c decreased more in patients treated with insulin aspart compared to NPH (-0.41 ± 0.10%,

The global distribution of fatal pesticide self-poisoning: Systematic review

<p>Abstract</p> <p>Background</p> <p>Evidence is accumulating that pesticide self-poisoning is one of the most commonly used methods of suicide worldwide, but the magnitude of the problem and the global distribution of these deaths is unknown.</p> <p>Methods</p> <p>We have systematically reviewed the worldwide literature to estimate the number of pesticide suicides in each of the World Health Organisation's six regions and the global burden of fatal self-poisoning with pesticides. We used the following data sources: Medline, EMBASE and psycINFO (1990–2007), papers cited in publications retrieved, the worldwide web (using Google) and our personal collections of papers and books. Our aim was to identify papers enabling us to estimate the proportion of a country's suicides due to pesticide self-poisoning.</p> <p>Results</p> <p>We conservatively estimate that there are 258,234 (plausible range 233,997 to 325,907) deaths from pesticide self-poisoning worldwide each year, accounting for 30% (range 27% to 37%) of suicides globally. Official data from India probably underestimate the incidence of suicides; applying evidence-based corrections to India's official data, our estimate for world suicides using pesticides increases to 371,594 (range 347,357 to 439,267). The proportion of all suicides using pesticides varies from 4% in the European Region to over 50% in the Western Pacific Region but this proportion is not concordant with the volume of pesticides sold in each region; it is the pattern of pesticide use and the toxicity of the products, not the quantity used, that influences the likelihood they will be used in acts of fatal self-harm.</p> <p>Conclusion</p> <p>Pesticide self-poisoning accounts for about one-third of the world's suicides. Epidemiological and toxicological data suggest that many of these deaths might be prevented if (a) the use of pesticides most toxic to humans was restricted, (b) pesticides could be safely stored in rural communities, and (c) the accessibility and quality of care for poisoning could be improved.</p

Business schools in crisis

Economic, political, and demographic changes, technological advances, two crashes of the economy, ethical scandals, and other developments in the business environment have strained the roles and enrollments of American universities' business schools. The b-schools have not responded adequately. Prevailing theories in many of the management disciplines have broken down, partly as a result of the same environmental changes. Again, schools and curricula have not adapted. Collegiate business education is in dire crisis. In this paper we document the crisis, note measures that have been taken - both constructive and otherwise - and make further suggestions for improving the situation

Assessing the Need for Caregiver Training on Hearing Loss

Effective communication is an important concern when working with individuals with hearing loss. This concern is apparent in the long-term elder care setting, where caregivers communicate with older adult patients every day, many of whom have hearing loss. However, there is limited training available to these caregivers working with residents with hearing loss. The purpose of this project is to establish the need and context for the development of an educational program for caregivers working with these residents with hearing loss. A total of 38 caregivers employed by three elder care facilities in Tucson, Arizona were surveyed. Results from this survey demonstrated that caregiver respondents felt they are knowledgeable and comfortable working with residents with hearing loss. However, there was an apparent gap as caregivers also reported that the presence of hearing loss among residents makes their jobs more difficult and stressful. Furthermore, they reported feeling that hearing loss impacts communication with residents and negatively effects the quality of care. Based on the findings of this survey, there is a need identified for educational opportunities for caregivers working with residents with hearing loss. The findings from this survey provide a foundation for the establishment of hearing health continuing education programs for caregivers working in long term elder care facilities. Specific recommendations regarding potential content of training programs are offered based on the survey findings. Implementation of caregiver trainings may ultimately lead to improved caregiver-resident communication and positively impact the quality of life for residents with hearing loss

Sudden natural deaths in Edirne, Turkey, from 1984 to 2005

The aim of this study is to evaluate the characteristics of sudden natural deaths (SND) in forensic autopsy cases which were performed in Trakya University Department of Forensic Medicine, Edirne, Turkey. For each case, a complete autopsy, toxicological screening and histological examination were performed. Deaths due to unnatural causes, alcohol, drug overdose and undetermined causes (negative autopsy) were excluded from the study. Autopsy reports of 959 consecutive forensic cases performed in a 22-year period were reviewed. Two hundred and seventy-eight (278) SNDs were identified, involving 232 males (83.4%) and 46 females (16.6%). The age group of 50-59 years accounted or 21.58% of the cases. In the majority (55%) the cause of death was related to the cardiovascular system principally ischemic heart disease. The second most common cause of SND was related to the respiratory system (19.1%, especially pneumonia. Most of the SNDs occurred in the winter months. Ethyl alcohol was detected in 5.3% of cases. In conclusion, sudden natural deaths related to the cardiovascular system are shown to be a significant problem in the Trakya region of Turkey

Trakya Üniversitesi Tıp Fakültesi Hastanesi'ne 90-1992 yıllarında başvurmuş 429 kafa travması olgusunun adli tıp yönünden değerlendirilmesi

Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.Tıpta Uzmanlık65 ÖZET Bu çalışma: Trakya üniversitesi Tıp Fakültesi Nö roşirurji Ana Bilim dalında 1990-1992 tarihleri arasında kafa travması teşhisi ile yatırılan olguların içinden, adli nitelikte olanların seçilmesi ile yapılmıştır. Dünya literatürü ile uyumlu sonuçların elde edildiği çalışmamızın sonuçları özetle su şekildedir: Olguların çoğunu {%79.3) erkekler oluşturmuştur. Çalışma grubunun yas ortalaması 28.87 gibi genç bir kuşağa rastlamaktadır. Büyük bir orandaki olgu sayısı, 10-45 yas grubunda bulunmaktadır. Kafa travmalarının yıllara dağılımı birbirine yakın değerlerde olup, yaz aylarında artış göstermektedir. ölüm oranı % 10.5 olarak saptanmıştır. ölüme en sık neden olan orijin trafik kazası olarak bulunmuş olup, alkollü olgu oranı da çalışma grubuna nazaran daha yüksek bulunmuştur. 1992 yılında ölüm oranı, diğer yıllara göre daha yüksek bulunmuştur. Orijin olarak % 47.6 ile trafik kazaları, kafa travmalarının basta gelen nedeni olmuştur. Bu orijini yüksek ten ve basit düşmeler izlemiştir. Posttravmatik komplikasyon olarak en sık Amneziye rastlanmıştır. ölen olgulara otopsi yapılma oranı çok düşüktür. Trafik ve motosiklet kazalarında alkol saptanan olgu sayısı diğer orijinlere nazaran daha fazla bulunmuştur. Travma sonrası operasyon gerektirecek lezyon gelişen olgularda, ölüm oranı daha yüksek bulunmuştur. Kafa travmasına en sık, periferik ekstremite kırıkları eslik etmiştir. întrakranyal lezyon olarak en sık kontüzyon, kafa tası kırığı olarak da en sık lineer kırık saptanmıştır. Minör kafa travması olarak değerlendirilen olgular % 38.22 gibi büyük bir oranda bulunmuştur. Adli tıp ile tıbbın ilerlemesi, öğrenci eğitiminin daha nitelikli yapılması ve çok daha kaliteli ve bilgili hekimlerin yetiştirilmesi için, otopsi sayısının arttırılması gerektiği inancındayım.[Abstract Not Available

The research about the effects of world trade organization?s agricultural agreement and negotiations on moment turkey?s agriculture

Her ülke kendi tarımını destekleyerek, tarımsal üretimini ülke menfaatleri doğrultusunda yönlendirdiği için uluslararası alanda tarım politikası yürütücüsünün veya yürütücülerinin olması düşünülemez. Ancak Dünya’daki birçok ülkenin tarımsal alanda belirli kurallar çerçevesinde işbirliği yaptığı da bilinen bir gerçektir. Bu işbirliği daha çok tarım ürünleri ticareti konusunda olmaktadır. Tarımsal dış ticaretin yanında tarımsal üretimde yetersiz olan ülkelere yapılan yardımları da yönlendiren kuruluşlar bulunmaktadır. Bu kuruluşlardan birisi de Dünya Ticaret Örgütüdür. DTÖ, birçok üründe olduğu gibi tarım ürünlerinin dış ticaretinde de birtakım kuralların uygulanmasına çalışmaktadır. Bu çalışmada Dünya ülkelerinin çoğunun (160’a yakın ülke) uymak zorunda mutabık kaldığı “tarım anlaşması” koşullarının ve görüşmelerin Türkiye tarımına olası etkileri ayrıntılı bir biçimde incelenmiştir. Çalışmada ağırlıklı olarak Dünya tarımsal ticaretine yön veren Dünya Ticaret Örgütünün tarımsal dış ticarette ülkelerin uymayı taahhüt ettiği kuralların Dünya ticaretini nasıl etkilediği ve özel olarak Türkiye tarımının söz konusu anlaşmadan nasıl etkilendiği ve etkileneceğini değerlendirilmiştir.It cant be thought that agricultural policy executor or executors who are directed for the benefit of the country for agricultural production as each country supported own agricultural production. However, the certain rules as known is cooperation within the framework of many countries in the world's agricultural area. This cooperation is about more than trade in agricultural products. There are leading organizations for to aid agricultural production in poor countries besides the foreign trade of agriculturel. World Trade Organization is one of these organizations. Studied the implementation of certain rules as with many product in the foreign trade of agricultural products by WTO In this study is shown the possible effects that most of the world's countries ( closed 160 countries ) have to comply with the agreement that the "contractfarming" conditions and negotiations on Turkey’s agriculture. In this research study, mainly in agricultural foreign trade is the World Trade Organization rules, countries have undertaken to comply with, and how it affects the world trade agreement, in particular how these are affected, and affected by agriculture in Turkey are evaluated

Sudden natural deaths in Edirne, Turkey, from 1984 to 2005

The aim of this study is to evaluate the characteristics of sudden natural deaths (SND) in forensic autopsy cases which were performed in Trakya University Department of Forensic Medicine, Edirne, Turkey. For each case, a complete autopsy, toxicological screening and histological examination were performed. Deaths due to unnatural causes, alcohol, drug overdose and undetermined causes (negative autopsy) were excluded from the study. Autopsy reports of 959 consecutive forensic cases performed in a 22-year period were reviewed. Two hundred and seventy-eight (278) SNDs were identified, involving 232 males (83.4%) and 46 females (16.6%). The age group of 50-59 years accounted for 21.58% of the cases. In the majority (55%) the cause of death was related to the cardiovascular system – principally ischemic heart disease. The second most common cause of SND was related to the respiratory system (19.1%), especially pneumonia. Most of the SNDs occurred in the winter months. Ethyl alcohol was detected in 5.3% of cases. In conclusion, sudden natural deaths related to the cardiovascular system are shown to be a significant problem in the Trakya region of Turkey. </jats:p