Türkiye’de hemşirelik lisans programlarında kültürlerarası hemşirelik

Aim: The aims of this manuscript are to examine the presence of transcultural Nursing concept and foundations in Turkey's Bachelor's Of Science In Nursing curricula.Methods: Tis study was planned as a descriptive study during the 2004-2005 academic year in Turkey's Bachelor's of Science in Nursing Curricula. The manuscript data were collected by internet, mail, fax and telephone calls. Percentage was used in the statistical evaluation.Results: According to findings none of the 66 Bachelor's of Science in Nursing curriculum programs had "transcultural Nursing" as a required course. There was only one nursing school that did have the course as an elective. However, There was courses like Socio-Anthropology, Medical Anthropology, Health Sociology and Anthropology which has the elements of transcultural nursing concept are included in BSN programs.Conclusions: Based on the findings it is recommended that Turkey's university curriculum programs in Nursing College and Health Colleges to be reevaluated for the inclusion of a transcultural Nursing Course.Amaç: Bu çalışma Türkiye'de Hemşirelik Lisans programlarında Kültürlerarası Hemşireliğin içerik ve kavramlarını kapsayan derslerin dağılımının değerlendirilmesi amacıyla yapıldı.Yöntem: Tanımlayıcı olan çalışma 2004-2005 Akademik yılında yapıldı. Çalışma iletişim ulaşılabilen 66 hemşirelik lisan programı ile yapıldı. Programlara web sayfaları, telefon, faks ve mail ile ulaşıldı. Verilerin değerlendirilmesinde yüzdelik dağılım kullanıldı. Bulgular: Hemşirelik lisans programlarının hiçbirinde kültürlerarası hemşirelik dersi yoktu. Yalnızca bir programda seçmeli ders olarak konulmuştu. Bununla beraber kültürlerarası hemşirelik dersinin içerik ve kapsamını yansıtan sosyo-antropoloji, Medikal antropoloji, Sağlık Sosyolojisi ve Antropoloji dersleri mevcuttu. Sonuç ve Öneri: Çalışma sonuçlarına göre Türkiye'de Hemşirelik Lisans Programlarında Kültürlerarası Hemşirelik dersine yer verilmemektedir. Programlardaki bu eksiliğin giderilmesine yönelik çalışmalar önerilebilir.&nbsp

The Ki-67 proliferation index predicts recurrence-free survival in patients with dermatofibrosarcoma protuberans

Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue sarcoma that originates from the dermis or subcutaneous tissue in the skin. While its prognosis is generally favorable, disease recurrence is relatively frequent. Because morbidity after repeated surgery may be significant, an optimized prediction of recurrence-free survival (RFS) has the potential to improve current management strategies. The purpose of this study was to investigate the prognostic value of the Ki-67 proliferation index with respect to RFS in patients with DFSP. We retrospectively analyzed data from 45 patients with DFSP. We calculated the Ki-67 proliferation index as the percentage of immunostained nuclei among the total number of tumor cell nuclei regardless of the intensity of immunostaining. We constructed univariate and multivariate Cox proportional hazards regression models to identify predictors of RFS. Among the 45 patients included in the study, 8 developed local recurrences and 2 had lung metastases (median follow-up: 95.0 months; range: 5.2−412.4 months). The RFS rates at 60, 120, and 240 months of follow-up were 83.8%, 76.2%, and 65.3%, respectively. The median Ki-67 proliferation index was 14%. Notably, we identified the Ki-67 proliferation index as the only independent predictor for RFS in multivariate Cox proportional hazards regression analysis (hazard ratio = 1.106, 95% confidence interval = 1.019−1.200, p = 0.016). In summary, our results highlight the potential usefulness of the Ki-67 proliferation index for facilitating the identification of patients with DFSP at higher risk of developing disease recurrences

The impact of Ki-67 index, squamous differentiation, and several clinicopathologic parameters on the recurrence of low and intermediate-risk endometrial cancer

Endometrial endometrioid carcinoma (EEC) represents approximately 75-80% of endometrial carcinoma cases. Three hundred and thirty-six patients with EEC followed-up in the authors’ medical center between 2010 and 2018 were included in our study. Two hundred and seventy-two low and intermediate EEC patients were identified using the European Society for Medical Oncology criteria and confirmed by histopathological examination. Recurrence was reported in 17 of these patients. The study group consisted of patients with relapse. A control group of 51 patients was formed at a ratio of 3:1 according to age, stage, and grade, similar to that in the study group. Of the 17 patients with recurrent disease, 13 patients (76.5%) were Stage 1A, and 4 patients (23.5%) were Stage 1B. No significant difference was found in age, stage, and grade between the case and control groups (p > 0.05). Body mass index, parity, tumor size, lower uterine segment involvement, SqD, and Ki-67 index with p<0.25 in the univariate logistic regression analysis were included in the multivariate analysis. Ki-67 was statistically significant in multivariate analysis (p = 0.018); however, there was no statistical significance in SqD and other parameters. Our data suggest that the Ki-67 index rather than SqD needs to be assessed for recurrence in patients with low- and intermediate-risk EEC

The Perspective of Jehovah’s Witnesses to the Blood Transfusion and Organ Transplantation

Yehova Şahitleri, inanışları gereği kan naklini reddetmektedir. Şahitlerin bu tür bir inanışa sahip olmalarını ve karşı olum tutumu geliştirmelerini “Kutsal Kitabın” Tekvin 9:3; Levililer 17:10-11 ve Elçilerin İşleri 15:22-29 ayetlerinden çıkardıkları yorumlar desteklemektedir. Yehova Şahitlerine göre bu ayetler, kanın bir kutsallık içerdiğini ve hayatın özünü oluşturduğunu bildirmektedir. Kan nakline hangi koşullarda olursa olsun karşı çıkan Yehova Şahitleri, bu uygulamayı yapan üyelerine de “müşareketten kesme” adı verilen cemaatten çıkarma yaptırımını uygulamaktadır. Şahitler bu tutum ve davranışlarını, “kan istemiyorum” ifadesinin yer aldığı özel bir belge ile yazılı hale getirip, “hastane irtibat heyetleri” ile işbirliği içerisinde bulunarak tedavi süreçlerini kendi inanışları doğrultusunda etkilemek ve yönlendirmek amacındadır. Yehova şahitleri, hastane irtibat heyetlerinin önerileri doğrultusunda kan nakline alternatif tıbbi çözümler ile tedavi olmayı kabul etmektedir. Bunun yanı sıra, inanışlarına aykırı olduğu gerekçesiyle başlangıçta organ nakline karşı olumsuz bir tavır sergilerken daha sonraki süreçte organ nakli uygulamasını kişisel kararlara bırakmışlardır. Bazı ülkelerde olduğu gibi Türkiye’de de organ nakli gerçekleştirilen Yehova Şahitleri olduğu bilinmektedir. Bu çalışma Yehova Şahitlerinin, kan ve organ nakline karşı oluşlarını ve bunu hangi ayetlere dayandırdıklarını ortaya koymak amacıyla yapılmıştır

Aortic stiffness, flow-mediated dilatation and carotid intima-media thickness in obstructive sleep apnea: Non-invasive indicators of atherosclerosis

Background and Objective: Obstructive sleep apnea (OSA) has a critical association with cardiovascular mortality and morbidity. Carotid intima-media thickness (IMT), flow-mediated dilatation (FMD) and aortic stiffness are early signs of atherosclerosis. The presence of subclinical atherosclerosis was assessed in OSA patients using these parameters. Methods: 40 patients with OSA showing an apnea-hypopnea index (AHI) ≥5 (mean age 51.3 ± 9 years, 32 males) and 24 controls (AHI &lt; 5, mean age 51.9 ± 5.2 years, 19 males) were enrolled in the study. In all subjects, polysomnographic examination and recordings were performed during sleep. IMT of the carotid artery, endothelium-dependent/-independent vasodilation of the brachial artery and aortic elastic parameters were investigated using high-resolution Doppler echocardiography. Results: The demographic data of the patients with OSA and controls were not significantly different. Subjects with OSA demonstrated higher values of aortic stiffness (7.1 ± 1.88 vs. 6.42 ± 1.56, respectively) and IMT (0.85 ± 0.13 vs. 0.63 ± 0.11 mm, p = 0.0001, respectively) but lower distensibility (9.47 ± 1.33 vs. 11.8 ± 3.36 cm2/dyn/106) and FMD (4.57 ± 1.3 vs. 6.34 ± 0.83%, p = 0.0001, respectively) than the controls. The respiratory disturbance index correlated positively with aortic stiffness and IMT and negatively with distensibility and FMD. Conclusion: We observed blunted endothelium-dependent dilatation, increased carotid IMT and aortic stiffness in patients with OSA compared with matched control subjects. This is evident in the absence of other diseases, suggesting that OSA is an independent cause of atherosclerosis. These simple and non-invasive methods help to detect subclinical atherosclerosis in OSA. Copyright © 2006 S. Karger AG

Kemoterapiye Bağlı Bulantı-Kusmada Kullanılan Alternatif Tıp Uygulamaları

Kemoterapiye bağlı bulantı- kusma hastaların yaşam kalitesini azaltan önemli bir sorundur. Hastaların bulantı-kusma ile baş edebilmek için kullandıkları farmakolojik yöntemler dışında etkisi bilinen bazı non-farmakolojik yöntemler bulunmaktadır. Uluslararası Onkoloji Hemşireliği Derneğinin, kanıta dayalı uygulamalardan geliştirdiği rehberde, düş kurma, müzik terapisi, progresif kas gevşeme, psiko-eğitimsel ve psiko-sosyal bakım, akupunktur ve akupresür gibi non-farmakolojik yöntemlerin kemoterapiye bağlı bulantı kusmanın önlenmesinde ve azaltılmasında yararlı olduğunu belirtmiştir. Bunların dışında bulantı kusmayı önlemede hastalara diyet ve çevre düzenlenmesi, dikkati başka yöne çekme, hipnoz, masaj yöntemleri de önerilmektedir. Bitkisel tedavi olarak dünya genelinde zencefil ön planda bulunmakla birlikte Türkiye genelinde halk arasında nane-limon karışımının yaygın olarak kullanıldığı bilinmektedir. Bu çalışma kemoterapiye bağlı bulantı-kusmada kullanılabilecek alternatif tıp uygulamaları ele alınmıştı

Gaucher disease: two case

Gaucher hastalığı beta glukoserobrozidaz genindeki mutasyon sonucunda gelişen, otozomal resesif kalıtımla geçen, lipit depo hastalığıdır. Mutasyon sonucunda enzim aktivitesindeki azalma sonucunda retikuloendotelial sistemde makrofajlarda glukoserobrozid birikimi olur. Nörolojik komponenti olup (tip 2 ve 3) olmamasına (tip 1) göre klinik üç subtipi vardır. Hastalar sıklıkla hepatosplenomegali, anemi, trombositopeni ve kemik ağrıları vardır. Biz birinde siroz gelişmiş iki tip 1 Gaucher hastasını sunduk.Gaucher's disease is an autosomal recessive glycolipid storage disorder caused by mutations in the beta glucocerebrosidase gene. This defect leads to reduced enzyme activity with accumulation of glucocerebroside in the macrophages of the reticuloendothelial system. Three clinical subtypes of Gaucher's disease have been described on the basis of the absence (type I) or presence (types II and III) of a neurological component. Type I is the more common subtype. Common presenting features include hepatosplenomegaly, anemia, thrombocytopenia, and often bone pains. We present two cases with Gaucher disease type 1, one of whom also had cirrhosis

Capillary Bedside Blood Glucose Measurement in Neonates: Missing a Diagnosis of Galactosemia

A number of factors may lead to inaccuracy in measurement of capillary blood glucose with a glucometer. Measurement of other carbohydrate molecules such as galactose and fructose along with glucose can potentially be a cause of error. We report a newborn patient who was referred to our hospital with conjugated bilirubinemia, hepatomegaly and high capillary blood glucose levels measured with a glucometer. Simultaneous biochemical measurements revealed normal blood glucose levels. Further investigation led to a diagnosis of classical galactosemia. Capillary blood glucose level measured with glucometer also dropped to normal values following cessation of breastfeeding and initiation of feeding with a lactose-free formula.WoSScopusPubMe