Impact of antimicrobial drug restrictions on doctors' behaviors

Background/aim: Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics.Materials and methods: A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician.Results: A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had 5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05).Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did

Hidden inequalities amongst the international workforce

This chapter focuses on low status expatriates who have been largely ‘hidden’ from managerial scholarship. They are ‘hidden’ because they are ignored by the migrant literature which looks at people trying to remain in their new society and gain citizenship; and ignored by the expatriation literature which is mainly concerned with high-status ‘top’ talent. These hidden expatriates are typically maids, drivers, security guards, and construction workers - low status and low paid, unable to obtain citizenship, and liable to be sent home, unemployed, at the whim of their employer. If we, as scholars, are to contribute to the betterment of society by elevating the health and well-being of those who live in it, then we must recognise the existence of and address the management issues and concerns of those at the ‘bottom of the pyramid’. We use Organisational Justice theory and draw on examples from Turkey, Singapore and the Middle East to examine the position, the concerns, and the issues of such workers and their often-unequal place in the workforce

Retroperitonal bölgede alveoler rabdomiyosarkom: 56 yaşında bir olgu sunumu

Retroperitoneal alveolar rhabdomyosarcoma is a very rare condition in adults and it is also an adverse prognostic factor. A 56 years old man was presented with a left lombar flank pain for 15 days. Radiologie examination revealed 13x10 cm retroperitoneal mass with cystic component near the lower pole of the left kidney. After explorative surgery, histopathologic examination was reported as alveolar rhabdomyosarcoma. Eight courses of adjuvant chemotherapy were performed, but in the control CT (Computed Tomography) examination a recurrent tumor with 10 cm dimension was detected. Three months after the second tumor resection surgery, patient died.Retroperitonal alveolar rabdomiyosarkom erişkinlerde oldukça nadir gözlenir ve kötü prognostik faktördür. 56 yaşında erkek hasta 15 gündür süren sol lomber bölgede flank ağrı ile başvurmuştur. Radyolojik incelemede retroperitonal bölgede sol böbrek alt pol komşuluğunda 13x10 cm. boyutlarında kistik komponentli kitle saptanmıştır. Eksploratif cerrahi sonrası, histopatolojik incelemede alveolar rabdomiyosarkom tanısı almıştır. Olguya 8 kür adjuvant kemoterapi planlanmıştır, kontrol BT (Bilgisayarlı Tomografi) ile incelemede 10 cm. çapında nüks kitle saptanmıştır. İkinci cerrahi tümör rezeksiyonu girişimden 3 ay sonra hasta kaybedilmiştir

Giant hidrocystoma of the orbit presenting with inversion and ptosis of the upper eyelid

A case of giant hidrocystoma of the orbit in a 57-year-old female causing pain, epiphora and ptosis is reported. The cystic mass was totally excised as a whole. Histopathologic examination revealed eccrine hidrocystoma of the orbit. Hidrocystoma must be considered in the differential diagnosis of patients presenting with periocular masses causing pain and ptosis. © 2017 by Turkish Ophthalmological Association

Atypia and differential diagnosis in cellular blue nevi: Clinicopathological study of 21 cases [Hücresel mavi nevuslarda atipi ve ayirici tani: 21 olgunun klinikopatolojik değerlendirilmesi]

PubMed ID: 25690862Objective: Cellular blue nevus differs from the classic blue nevus with characteristics such as large size, cellularity, intense pigmentation, and growing pattern with subcutaneous infiltration. It is a dermal melanocytic tumor that can be confused with melanoma due to the atypia it may contain. Material and Method: Hematoxylin-eosin and mIB-1 stained slides of 21 cases diagnosed between 2000-2014 were re-evaluated. In order to attract attention to this rare lesion, 21 cases are presented with the clinical and above-mentioned histopathological findings. Results: Thirteen (61.9%) cases were females and eight (38.1%) were male. The mean age was 25.4 (2-73). The most frequent localization was the sacral and gluteal region (11 cases). The mean diameter was 14.4 mm (4-60 mm). From the parameters defined to assess the atypia, ulceration was identified in four cases. Prominent cellularity and subcutaneous infiltration were seen in three and 16 cases, respectively. mitosis was seen in six tumors. Immunohistochemically, mIB-1 was present in two cases as 3% and 2% respectively, while in others it was 1% or less. Although there is no precise definition for the “a typical cellular blue nevus”, five patients were assessed as atypical cellular blue nevus (a case with infiltrative development of six cm tumor diameter, two cases with two mitosis and a mIB-1 index 3% and 2%, a case with one mitosis and confluent development and a case with one mitosis in addition to focal necrosis areas). No lymph node and/or distant metastasis was observed during follow-up. Conclusion: We think it is more important to rule out the possibility of conventional melanoma in cellular blue nevus with exaggerated morphological findings alongside low proliferative activity rather than to determine the atypia. © 2015, Federation of Turkish Pathology Societies. All Rights Reserved

Radyoterapi sonrası kutanöz anjiosarkom gelişimi

Anjiosarkom küçük kan damarlarındaki endotel hücrelerden kaynaklanan ve nadir görülen bir tümördür. Her organı etkileyebilmekle birlikte sıklıkla deri, yumuşak doku, karaciğer, dalak, kalp ve meme tutulmaktadır. İyonize radyasyon tedavisi ve sarkom gelişimi arasındaki ilişkiyi ortaya koyan çok sayıda veri mevcut ise de güncel literatürün gözden geçirilmesi sonucunda, akciğer kanseri için verilen radyoterapi sonrası anjiosarkom gelişimine rastlanmamıştır. Burada, akciğer kanseri için verilen radyoterapiden 18 yıl sonra anjiosarkom gelişen bir olgu sunulmaktadır.Angiosarcoma is a rare tumour, originated from the endothelial cells of small blood vessels. The disease may affect many organs, with the most frequently involved ones are skin, soft tissue, liver, spleen, heart and breast. Although there are lots of data to establish the relation between the ionizing radiation therapy and the development of sarcoma, a review of the recent literature did not reveal any development of angiosarcoma after radiotherapy which had been administered for lung cancer. In this report, development of cutaneous angiosarcoma 18 years after radiotherapy for lung cancer is presented