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

PKG’lerde hastane vaka sayıları ile mortalite ilişkisi-ACC/AHA’nın perkütan koroner girişim kılavuzlarında Asya ülkeleri için değişikliğe gerek var mı?

The relationship between hospital volume and outcome relation in percutaneous coronary intervention (PCI) is important for patients, policy makers and referring physicians. Hospital volume is the explicit criterion for health care purchasers recommended by Leapfrog group. In accordance with current American College of Cardiology/American Heart Association (ACC/AHA) percutaneous coronary intervention (PCI) clinical practice guidelines, Leapfrog has established a minimum institutional volume requirement of 400 cases per year for hospitals offering PCI (1, 2). For these reason, centralization of PCI cases in core facilities has been advocated. This volume threshold is mainly based on studies originating from USA in the 1980s and 1990s which showed increased PCI mortality for patients treated at hospitals with annual volumes <400 cases (3, 4). However, there have been many changes in recent years in PCI practice by widespread use of low profile balloons, stents, glycoprotein IIb/ IIIa inhibitors and intra-aortic balloon pumps. These changes and widespread PCI education opportunities increased interventional cardiologists’ abilities and self-confidence, which raise the possibility that currently recommended hospital PCI volume threshold of 400 cases may no longer be appropriate

An alternative malpractice system suggestion for Turkey: Patient compensation system

2015 Data Compression Conference, DCC 2015 -- 7 April 2015 through 9 April 2015 -- 113401Cocaine use has been related to the occurrence of myocardial infarction in young patients without other coronary risk factors. Acute myocardial infarction (AMI) secondary to the occlusion of the left main coronary artery (LMCA) in a cocaine user is infrequent, with sudden death being the most common form of presentation

ÖĞRETMENLERİN MESLEĞE YÖNELİK DAVRANIŞ VE YAŞANTI MODELLERİNİN BELİRLENMESİ: BARTIN İLİ ÖRNEĞİ

The purpose of this study is to determine teachers' work-related behaviour and experience patterns and to discover whether they alter according to different variables. Work-Related Behaviour and Experience Patterns (AVEM) scale is used in this study. Its target is 279 teachers who work in primary and secondary schools in Bartın province. The data collected is analyzed with frequency analysis, t-test and ANOVA analysis. According to results obtained, 39.4 percent of teachers are figured in Schonung–Heedless Attitude group and 11.8 percent of teachers are located in the group which is regarded as exhausted and the worst in terms of health. In the aftermath of analysis, it is observed that average sum of sub-dimensions of teachers’ work related behaviours significantly differs according to sex variable in dimensions of the pursuit of perfection, life satisfaction and social support experience. There is a significant difference in sub-dimensions of subjective importance of profession, professional ambition, success tendency and life satisfaction according to marital status of teachers and a significant difference in subjective importance of profession, job satisfaction and social support experience according to their ages. According to service tenure variable, points of unexperienced teachers are higher in subdimensions of give-up tendency and social support experience while experienced teachers have more points in sub-dimensions of subjective importance of profession and success tendency.Bu çalışmanın amacı öğretmenlerin mesleklerine yönelik davranış modellerinin ve yaşantı modellerinin belirlenmesi ve öğretmenlerin mesleğe yönelik davranış ve yaşantı modellerinin çeşitli değişkenlere göre farklılık gösterip göstermediğini belirlemektir. Çalışmada Schaarschmidt ve Fischer (1997) tarafından geliştirilen Mesleğe Yönelik Davranış ve Yaşantı Modelleri (MEDYAM) ölçeği kullanılmıştır. Çalışma Bartın ilindeki merkezi ilköğretim ve ortaöğretim kurumlarında çalışan 279 öğretmen üzerinde 2015 Aralık ayında gerçekleştirilmiştir. Çalışmada elde edilen verilerin analizinde betimsel analiz, t testi ve ANOVA yapılmıştır. Elde edilen sonuçlara göre öğretmenlerin, %39.4’ünün sakınmacı grupta yer aldığı, %11.8’inin ise tükenmiş olarak nitelendirilen ve sağlık açısından en kötü grup olan grupta yer aldığı görülmektedir. En sağlıklı grubun oranı ise %32.6’dır. Çalışmada yapılan analizler sonrası, öğretmenlerin mesleğe yönelik davranış boyutlarının, cinsiyet değişkenine göre mükemmeliyetçilik çabası, yaşam doyumu ve sosyal destek yaşantısı boyutlarında anlamlı bir farklılık gösterdiği görülmektedir. Öğretmenlerin medeni durumlarına göre, işin öznel önemi, mesleki hırs, başarma eğilimi ve yaşam doyumu alt boyutlarında anlamlı farklılık; yaşlarına göre işin öznel önemi, mesleki doyum ve sosyal destek yaşantısı alt boyutlarında anlamlı farklılık bulunmaktadır. Hizmet yılı değişkenine göre, pes etme eğilimi, sosyal destek yaşantısı alt boyutlarında deneyimsiz öğretmenlerin puanları istatistiki olarak daha yüksektir. İşin öznel önemi, başarma eğilimi alt boyutlarında ise deneyimli öğretmenlerin puanları daha yüksekti

Iliac artery perforation and treatment during lumbar disc surgery by simple balloon tamponade

WOS: 000319150300010PubMed ID: 22805757Introduction Although vascular injury during lumbar disc surgery is quite rare, it may be life threatening if not recognized and treated immediately. Case We report the case of a woman who had a left common iliac artery laceration during spinal surgery and was treated by endovascular therapy. In the past, open surgery was the only way to repair a vascular injury, but thanks to the advance of new endovascular techniques and devices, endovascular therapy has become a strong alternative. Conclusion This case differs from those published in the literature as we used a single balloon inflation and subtotal occlusion without the need for a covered stent

Determination of work-related behavior and experience patternsmodel of secondary and high school teachers: the case of Bartin province

Bu çalışmanın amacı öğretmenlerin mesleklerine yönelik davranış modellerinin ve yaşantı modellerinin belirlenmesi ve öğretmenlerin mesleğe yönelik davranış ve yaşantı modellerinin çeşitli değişkenlere göre farklılık gösterip göstermediğini belirlemektir. ÇalışmadaSchaarschmidt ve Fischer (1997) tarafından geliştirilenMesleğe Yönelik Davranış ve Yaşantı Modelleri(MEDYAM) ölçeği kullanılmıştır. Çalışma Bartın ilindeki merkezi ilköğretim ve ortaöğretim kurumlarında çalışan 279 öğretmen üzerinde 2015 Aralık ayında gerçekleştirilmiştir. Çalışmada elde edilen verilerin analizindebetimsel analiz, t testi ve ANOVA yapılmıştır. Elde edilen sonuçlara göre öğretmenlerin, %39.4’ünün sakınmacı grupta yer aldığı, %11.8’inin ise tükenmiş olarak nitelendirilen ve sağlıkaçısından en kötü grup olan grupta yer aldığı görülmektedir. En sağlıklı grubun oranı ise %32.6’dır. Çalışmada yapılan analizler sonrası, öğretmenlerin mesleğe yönelik davranış boyutlarının, cinsiyet değişkenine göre mükemmeliyetçilik çabası, yaşam doyumuve sosyal destek yaşantısı boyutlarında anlamlı bir farklılık gösterdiği görülmektedir. Öğretmenlerin medeni durumlarına göre, işin öznel önemi, mesleki hırs, başarma eğilimi ve yaşam doyumu alt boyutlarında anlamlı farklılık;yaşlarına göre işin öznel önemi, mesleki doyum ve sosyal destek yaşantısı alt boyutlarında anlamlı farklılık bulunmaktadır. Hizmet yılı değişkenine göre, pes etme eğilimi, sosyal destek yaşantısı alt boyutlarında deneyimsiz öğretmenlerin puanlarıistatistiki olarak daha yüksektir. İşin öznel önemi, başarma eğilimi alt boyutlarında ise deneyimli öğretmenlerin puanları daha yüksektir.The purpose of this study is to determine teachers' work-related behaviour and experience patterns and to discover whether they alter according to different variables. Work-Related Behaviour and Experience Patterns (AVEM) scale is used in this study. Its target is 279 teachers who workin primary and secondary schools in Bartın province. The data collected is analyzedwith frequency analysis, t-test and ANOVA analysis. According to results obtained, 39.4 percent of teachers are figured in Schonung–Heedless Attitude group and 11.8 percent of teachers are located in the group which is regarded as exhausted and the worst in terms of health. In the aftermath of analysis, it is observed that average sum of sub-dimensions of teachers’ work related behaviours significantly differs according to sex variable in dimensions of the pursuit of perfection, life satisfaction and social support experience. There is a significant difference in sub-dimensions of subjective importance of profession, professional ambition, success tendency and life satisfaction according to marital status of teachers and a significant difference in subjective importance of profession, job satisfaction and social support experience according to their ages. According to service tenure variable, points of unexperienced teachers are higher in sub-dimensions of give-up tendency and social support experience while experienced teachers have more points in sub-dimensions of subjective importance of profession and success tendency

Konjenital inferior vena kava agenezi olan hastada atriyoventrikülernodal reentran taşikardisinin başarılı kateter ablasyonu

A 50-year-old womanadmitted with recurrent palpitations due tosupraventricular tachycardia previously documented by ECG. Shewas referred for electrophysiological studyand catheter ablationinitiated by introducingthe venous sheath viathe right femoral vein.However, the ablationcatheter could not be advanced through the inferior vena cava (IVC) due to resistance