Low prevalence of erosive esophagitis and Barrett esophagus in a tertiary referral center in Turkey

PubMed ID: 19115148Background/aims: The purpose of upper gastrointestinal endoscopy in gastroesophageal reflux disease is to detect the complications; both Barrett esophagus and erosive esophagitis are common in developed countries. We aimed to investigate the ratio of esophageal complications in gastroesophageal reflux disease and the relationship between reflux symptoms and erosive esophagitis. Methods: Six hundred forty-five consecutive adult patients presenting to the Reflux Outpatient Clinic were evaluated prospectively. One hundred sixty patients who underwent upper gastrointestinal endoscopy and who complained of heartburn or regurgitation occurring at least weekly were selected. The complaints and general features of patients were queried via a detailed questionnaire. Results: Twenty-seven patients (17%) had endoscopic evidence of erosive esophagitis. Barrett esophagus was found in 3 patients (2%). Neither esophageal stricture nor adenocarcinoma was found. Esophagitis was low grade (grades A and B) in 25 of the 27 (92%) with erosive esophagitis. Patients with erosive esophagitis consumed less alcohol than patients with non-erosive reflux disease. No difference was found between the severity of symptoms in patients with erosive esophagitis and non-erosive reflux disease. Conclusions: Barrett esophagus and erosive esophagitis were less common compared to the literature although the study was conducted in a tertiary reference center for gastroesophageal reflux disease. The presence of severe symptoms in gastroesophageal reflux disease is not an indication for upper gastrointestinal endoscopy. No impact of Helicobacter pylori on the severity of esophagitis or symptoms was shown

A guide for pediatric intensive care units: Propositions from pediatric emergency medicine and intensive care society [Çocuk yogun bakim birimleri için kilavuz: Çocuk acil tip ve yogun bakim dernegi önerileri]

The importance of pediatric intensive care medicine is being more generally accepted in our country as services become more widely available. Indeed, important developments occurred in this field in recent years. The aim of these guidelines is to provide a reference point as new units are established or old ones undergo reconstruction, raising the quality of services to state of the art level. Representing the view of the Pediatric Emergency Medicine and Intensive Care Society, various aspects of pediatric intensive care services are discussed in this guideline, including organizational and administrative issues, hospital and unit facilities, personnel, and equipment requirements

Ottoman forestry: socio-economic aspect and its influence today Otomano florestal: aspecto socioeconômico e sua influência hoje

Forestry is an important subject because it supplies wood and timber for direct human consumption, in addition to its positive effects on global warming and on bio-diversity, with a history dating back to antiquity. As a labor-intensive sector in developing countries, it maintains interactions with natural resources management, public relations and socio-economic structure. It can affect the prosperity of countries either positively or negatively. Hence, an analysis of the history of forestry bears importance because it not only sheds light on its past and present condition, but also explains the improvements for the protection of forests. Accordingly, in the first section of this study, general information on the Ottoman Land System and Ottoman Forestry Organization will be given. In the second section, we will treat 19th century westernization movements, as well as socio-cultural and economic changes. The third section will include significant regulations on forestry, forest management, and administration in the Ottoman Empire; as well as the influence of Ottoman forestry on the actual socio-economic structure. In the final section, under the title discussion and conclusion, Ottoman forestry will be examined regarding its consequences in terms of policy, economy and law.<br>A silvicultura é um assunto importante, pois o suprimento de madeira em geral e madeira para consumo humano direto, além de seus efeitos positivos sobre o aquecimento global e sobre a diversidade biológica, trata de uma história que remonta à antiguidade. Como um setor de trabalho intensivo nos países em desenvolvimento, mantém interações com a gestão dos recursos naturais, relações públicas e estrutura socioeconômica. Ela pode afetar a prosperidade dos países, seja positiva ou negativamente. Assim, uma análise da história da silvicultura tem importância, porque não só lança luz sobre a sua condição passada e presente, mas também explica as melhorias para a proteção das florestas. Assim, na primeira parte deste estudo, serão dadas informações gerais sobre o Sistema de Terras e Florestas e Organização Otomano. Na segunda seção, serão tratados movimentos da ocidentalização do século 19, bem como alterações socioculturais e econômicas. A terceira seção irá incluir regulamentos significativos na silvicultura, manejo florestal e administração no Império Otomano, bem como a influência da silvicultura Otomano na atual estrutura socioeconômica. Na seção final, no âmbito da discussão do título e conclusão, a silvicultura Otomano será analisada em relação as suas consequências em termos de economia, política e direito