New immunohistochemical markers in the differential diagnosis of nonsmall cell lung carcinoma

Background/aim: The aim of this study was to investigate Napsin-A, NTRK-1, NTRK-2, Desmoglein-3, and Desmocollin-3 in the differential diagnosis and prognosis of nonsmall cell lung cancer. Materials and methods: The expression of Napsin-A, NTRK-1, NTRK-2, and Desmoglein-3 was examined by immunohistochemistry in 50 squamous cell carcinomas and 50 adenocarcinomas. Desmocollin-3 was investigated in 29 squamous cell carcinoma and 29 adenocarcinoma cases. Associations between expression profiles of Napsin-A, NTRK-1, NTRK-2, Desmoglein-3, and Desmocollin-3 in lung cancers and clinicopathological variables were analyzed. Results: Napsin-A staining was statistically significant in detecting adenocarcinomas versus squamous cell carcinomas. The sensitivity of Napsin-A for adenocarcinomas was 96% and the specificity was 100%. NTRK-2 and Desmocollin-3 staining were statistically significant in detecting squamous cell carcinomas versus adenocarcinomas. Desmoglein-3, Napsin-A, and NTRK-2 had no effect on survival. Disease-free survival time was significantly shorter in cases that were moderately positive with NTRK-1. Conclusion: Our data suggest that Napsin-A, NTRK-2, and Desmocollin-3 are useful markers in the differentiation of nonsmall cell lung cancer. © TÜBİTAK

Use of complementary and alternative medicines by a sample of Turkish women for infertility enhancement: a descriptive study

<p>Abstract</p> <p>Background</p> <p>Infertility patients are a vulnerable group that often seeks a non-medical solution for their failure to conceive. World-wide, women use CAM for productive health, but only a limited number of studies report on CAM use to enhance fertility. Little is known about traditional and religious forms of therapies that are used in relation to conventional medicine in Turkey. We investigated the prevalence and types of complementary and alternative medicine (CAM) used by infertile Turkish women for fertility enhancement.</p> <p>Methods</p> <p>A face-to-face questionnaire inquiring demographic information and types of CAM used for fertility enhancement were completed by hundred infertility patients admitted to a primary care family planning centre in Van, Turkey between January and July 2009.</p> <p>Results</p> <p>The vast majority of infertile women had used CAM at least once for infertility. CAM use included religious interventions, herbal products and recommendations of traditional "hodja's" (faith healers). Of these women, 87.8% were abused in the last 12 months, 36.6% felt not being supported by her partner and 80.5% had never spoken with a physician about CAM.</p> <p>Conclusions</p> <p>Infertile Turkish women use complementary medicine frequently for fertility enhancement and are in need of information about CAM. Religious and traditional therapies are used as an adjunct to, rather than a substitute for, conventional medical therapy. Physicians need to approach fertility patients with sensitivity and should be able to council their patients about CAM accordingly.</p

Perceptions of second year medical school students regarding ageing and geriatric education: A qualitative study

Introduction: Existing literature on the geriatric-related attitudes of medical students reveals inconsistent results in terms of feelings for the elderly. This study aims to determine the perceptions of medical students regarding ageing and geriatric education. Materials and Method: A qualitative study was conducted with 160 second-year medical students who visited a nursing home and responded to three open-ended questions about this experience. The responses were qualitatively analysed using the constant comparative method for themes. Results: Second year medical students indicated both positive and negative impressions of ageing. Although they generally believed that ageing brings experience and maturity, happy ageing was seen as being dependent on individual characteristics and personality factors that affect the emotional aspects of ageing and, therefore, quality of life. The students indicated recognition that ageing is related to inevitable physiological changes and a belief that most illnesses in the elderly are untreatable because of the natural decline in health related to ageing. Students indicated a sense of inadequacy in communicating with the elderly and emphasised the importance of introducing geriatric psychiatry lessons into the curriculum to improve their understanding of the elderly. Conclusion: This study provides a better understanding of the opinions of future doctors about ageing and of beliefs that should be addressed to help in the making of doctors with more positive attitudes toward older people. © 2016, Geriatrics Society. All rights reserved

Waterpipe smoking, internet addiction and depression: A public health problem trio?

Background: Waterpipe smoking and Internet addiction may result in a new public health problem globally. This study aimed to explore waterpipe use among a large group of adolescents and its association with Internet use, mental health, primarily depression and their demographic characteristics. Methods: Using a stratified random sampling method, 2054 tertiary school students aged 14-18 years were recruited in 2019. Demographical information and use of tobacco products (eg, waterpipe) were explored and compared with severity of Internet addiction and mental status. Results: A total of 288 (14.0%) adolescents had ever used waterpipe. Multivariate logistic regression analyses suggested that being male (OR = 2.55 and 95% CI = 1.98-3.30; P =.0001), being depressed (OR = 1.62 and 95% CI = 1.24-2.11) and excessive Internet use (OR = 1.94 and 95% CI = 1.50-2.52; P =.0001) were significantly associated with waterpipe use. Family income and parents’ educational status showed no relationship with waterpipe smoking. Conclusions: We suggest that adolescents who are depressed and who use the Internet excessively are at an increased risk for waterpipe use, independent of income and parenteral education. © 2020 John Wiley & Sons Lt

Intimate partner violence management and referral practices of primary care workers in a selected population in Turkey

Background: Violence against women is a significant public health problem and primary care workers (PCWs) have a crucial role in managing violence against women. However, though intimate partner violence (IPV) is frequently seen in primary care, most cases remain unreported. Aims: This study aims to investigate family physicians' (FPs') and co-working midwifes/nurses' (M/Ns') explanations about their responses to women disclosing IPV and the reasons for their actions. Methods: We conducted a cross-sectional survey via a face-to-face administered questionnaire interview involving 266 PCWs in a selected area in Turkey. We questioned the reasoning behind inappropriate responses such as not examining the patient and document findings, not recording a code of violence, and not notifying the police in the case of a disclosure of IPV. Results: We surveyed 129 FPs and 137 M/Ns. We found that the disclosure of IPV in primary care is very high, but more than one-third of physicians and half of M/Ns respond inappropriately. Reasons for inappropriate response varied. The majority believed that the victim would continue to live with her batterer, making any report ineffective. Some expressed concern for the women's and their own personal safety, citing an increase in assault cases by perpetrators in the last few years. Many indicated a lack of knowledge about management of violence cases. Conclusion: Multiple barriers challenge PCWs in helping abused women. Common behaviours, safety concerns, and a lack of knowledge seem to be the major barriers to responding appropriately to IPV. To address this issue appropriately, protective measures for both parties - PCWs and violence victims - need to be enacted and a supportive constitutional and societal organization is required. Screening and identification should lead to interventions that benefit the victims rather than harming them.C1 [Taskiran, Aysegul Catak; Ozsahin, Aysun; Edirne, Tamer] Pamukkale Univ, Dept Family Med, Denizli, Turkey

2005-2009 Yılları Arasında Van Aile Mahkemesinde Görülen Boşanma Davalarında Kadına Yönelik Şiddet Olgularının İncelenmesi

Kadına yönelik şiddet kadınların fiziksel, duygusal sağlıkları ve sosyal statüleri üzerindeki olumsuz etkileri ile önemli bir halk sağlığı sorunu olduğu gibi adli ve insan hakları ile ilgili boyutları ile de bir adli tıp sorunudur. Bu çalışmada, Van ilinde 2005- 2009 döneminde boşanma davalarmda eş şiddeti olgularının saptanması ve özelliklerinin tanımlanması amaçlanmıştır. Van Aile Mahkemesi’nde 2005-2009 döneminde sonuçlanmış boşanma davalarını incelemek üzere mahkeme arşivindeki dava dosyaları ve dava kayıt defterlerindeki bilgiler taranarak, içeriğinde şiddet unsurunun yer aldığı 193 dosya incelenmiş ve boşanma davalarından koruma kararı ile sonuçlananlar tespit edilmiştir. 193 dosya içinde, kadınların ortalama yaşı 31,39 (+8,46), ailenin çocuk sayısı 2,07 (+1,82), resmi nikahlı olarak evlilik süresi 9,27 yıl (+8,36 yıl) olarak tespit edildi. Şiddet unsuru yer alan dosyalarda adli / tıbbi raporların bulunma oranının ortalama %19,2 olduğu, tüm boşanma dosyalarında 4320 sayılı yasa gereği koruma kararı alınma oranının ise her yıl düzenli olarak arttığı ve ortalama %15,5 olduğu saptandı. Boşanma davalarmda ve her türlü aile içi şiddet olgusunda mahkeme kayıtlarının ve tıbbi raporlama işlemlerinin standardize edilmesi gereklidir. 4320 sayılı yasanın etkin kullanılması için, hakim, savcı ve avukatların bilgilendirilmelerine yönelik çalışmalar ve mahkemeler, sosyal hizmet örgütlenmesi, adli tıp birimleri ve hastane acil birimleri arasında koordinasyonun iyileştirilmesi yararlı olacaktır. Anahtar kelimeler: Aile mahkemesi, boşanma, kadına yönelik şiddet, aile içi şidde

Level of serum 25-OHD in healthy children aged 0-36 months in Van

Amaç: Günümüzde yapılan çalışmalarda raşitizmin ve D vitamini eksikliği görülme sıklığının iklime, toplumun sosyoekonomik düzeyine ve bölgenin sağlık hizmetlerinden faydalanma derecesine göre, yöresel değişmelere bağlı olduğu gösterilmiştir. Herhangi bir klinik belirti ortaya çıkmamış olsa bile vücut D vitamini düzeyinin en iyi göstergesi olan serum 25- hidroksi D (25-OHD) düzeyi düşük saptanabilir. Gereç ve Yöntem: Bu çalışmada normal kontrol için Van Kadın Doğum ve Çocuk Hastalıkları Hastanesi Çocuk Polikliniği’ne başvuran 0-36 ay arası sağlıklı 112 çocukta serum 25-OHD düzeyi araştırıldı. Bu amaçla annelerin ve bebeklerin beslenme tipi ve D vitamini desteği alıp almadığı, güneş ışığından yararlanma süresi değerlendirildi; Serum Ca, P, alkalen fosfataz ve 25-OHD düzeyleri çalışıldı. Sol el bilek grafileri çekildi. Serum 25-OHD düzeyi >150 ng/mL saptanan bebeklere karın ultrasonografisi yapıldı. Bulgular: Çalışmamızda raşitizmin herhangi bir klinik bulgusu olmamasına karşın ve cinsiyet farkı gözetmeksizin incelendiğinde çocukların %53,5’inde serum 25-OHD düzeyi <40 ng/mL saptandı, bu çocukların %13,3’ünde ise serum 25-OHD düzeyi <5 ng/mL olup ağır D vitamini yetersizliği vardı. Çıkarımlar: D vitamini desteği olmadan anne sütü alan bebeklerin altı aya kadar D vitamini yetersizliği lehine herhangi bir bulgu göstermedikleri, ancak serum 25-OHD düzeylerinin D vitamini desteği ile beraber anne sütü alan bebeklere göre belirgin olarak düşük olduğu saptandı.Aim: In recent studies, it has been shown that prevalence of rachitism and vitamin D deficiency depend on regional differences such as climate, socioeconomic level and changing benefits of people from health services. Even if no clinical symptom has occurred, serum 25-hydroxy D (25-OHD) level, which is the best indicator of vitamin D can be found low. Material and Method: In this study, serum 25-OHD levels of 112 healthy children, aging 0-36 months, who applied to the outpatient clinic of the Pediatrics and Gynecology Hospital for a routine control in Van, were analyzed. Nutrition style of mothers and their babies, duration of exposing to sunlight and taken vitamin supplements, were evaluated. Serum Ca, P, alkaline phosphatase and 25-OHD levels were studied and the left wrist x-rays were obtained. Abdominal ultrasonography was performed only the babies with serum 25-OHD level &gt;150 ng/mL. Results: In our study, despite no clinical symptoms of rachitism regardless of gender, 25-OHD level &lt;40 ng/mL was determined in 53.5% of the children and in %13,3 of these childrens serum level of 25-OHD was as low as &lt;5 ng/mL, and suffering from heavy vitamin D deficieny. Conclusions: The breast-fed babies with no vitamin supplement did not show any sign of vitamin deficiency, but in 25-OHD levels were significantly low compared to the breast-fed babies with vitamin supplemen

İNTİHAR AMAÇLI KULLANILAN BAKLOFEN VE ENTOKSİKASYONU: OLGU SUNUMU

Baklofen, merkezi sinir sisteminde bir inhibitör transmitter olan, lipofilik GABA (gamma-aminobutirik asit) analoğudur. Yüksek doz baklofen alımı, beyin ölümünü taklit eden derin koma tablosuna neden olabilir. İlacın plazma düzeylerinin belirlenmesi her zaman mümkün olamayacağı gibi tanı konulmasını da güçleştirebilir. Klinik değerlendirme ve destekleyici tedavilerin önemi büyüktür. Baklofen ile akut zehirlenen hastaların tedavisinde tam donanımlı hastanelerde solunum desteği gerektiğinde verilebilmelidir. Bununla birlikte, olgumuzda da görüldüğü gibi ciddi vakalarda bile prognoz iyi seyreder.ABSTRACTBaclofen is a lipophilic analogue of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in central nervous system. Baclofen toxicity can be a cause of profound coma with brainstem dysfunction mimicking brain death. Measuring plasma levels is not always possible and may be misleading. It’s important to be careful in clinical evaluation and provide full supportive care. Treatment of patients with acute baclofen intoxication should take place in hospitals appropriately equipped which can provide artificial respiration. However, as demonstrated in our case, the prognosis can be good even in severe cases

Assessment on risk and stress of resident doctors during the COVID-19 pandemic

INTRODUCTION: It has been noted that post-traumatic stress disorder symptoms could be common in physicians who have experienced a traumatic event. The aim of this study was to determine the prevalence of post-traumatic stress disorder and contributing risk factors among resident doctors working in a tertiary care hospital during the COVID-19 pandemic. METHODOLOGY: A cross-sectional study was conducted via an online survey from May to July 2020. Sociodemographic characteristics, exposure to the coronavirus, application of personal hygiene rules, presence and use of personal protective equipment, anxiety and prevalence of post-traumatic stress disorder were investigated. RESULTS: In total, 17.8% (n = 40) of 225 resident doctors who participated in the study had post-traumatic stress disorder. Working at a department serving to COVID-19 patients increased the risk of post-traumatic stress disorder by 2.9 times (OR = 2.936, p = 0.003) while contacting positive patients increased this risk by 2.6 times (OR = 2.607, p = 0.023) and lack of personal protective equipment by 3.6 times (OR = 3.656, p = 0.018). Anxiety scores were statistically significantly higher in women, married and those living with their parents or spouses and children (p = 0.049; p = 0.011; p = 0.004, respectively). CONCLUSIONS: Working in a department serving to COVID-19 patients, contact with positive patients and lack of personal protective equipment were risk factors in the emergence of post-traumatic stress disorder in resident doctors. Anxiety was also found to be greater in women, married and those living with their families

DİSCUS İNHALER CİHAZI KULLANIMINA BAĞLI GELİŞEN LATEX ALLERJİSİ: OLGU SUNUMU

Lateks allerjisi, lateks allerjenleri ile yüksek oranda karşılaşan sağlık çalışanları ve kronik hastalarda sık gözlenen, son zamanlarda epidemik olarak rastlanan yeni bir hastalıktır. Lateks’e bağlı anafilaktik  reaksiyonlara ise sporadik olarak rastlamaktayız. Lateks alerjisi, lateks proteinine karşı tip 1 aşırı duyarlılık reaksiyonu olup kontak ürtikerden, astım ve anafilaksiye kadar değişik klinik tablolarla karşımıza çıkabilmektedir. Olgu sunumuzda “Astım İnhalasyon Cihazı” olarak diskus formu kullanan erkek hastada diskusun dudaklara değmesinden 5 dakika kadar sonra her iki dudak mukozasında gelişen anjioödemi (tip 1 lateks alerjisi) sunmaktayız. Lateks alerjisi konusunda atopik bünyeli hastaların iyi irdelenip, lateks pozitif bulunan bireylerde kullandıkları lateks içeren her türlü malzemenin hastalara iyi bildirilmesi önemli bir koruyucu hekimlik görevidir.ABSTRACTNatural rubber latex allergy is a new illness whose prevalence has reached epidemic proportions in highly exposed populations such as health care workers and who has chronic illness. After anaphylactic type reactions due to latex has been shown as case reports. Latex allergy generally refers to a type 1 reaction to natural rubber latex proteins with clinical manifestations ranging from contact urticaria to asthma and anaphylaxis. In this report, we discuss latex allergy with discus form of inhalation drug of asthma after contact of discus form to lips. Still, latex allergy is an important problem in patients with latex allergy. We must inform all patients about latex allergy and all latex containing devices