The Effect of Intravitreal Bevacizumab on Apoptosis of Rat Retina Cells

Pur po se: To investigate the apoptotic effects of intravitreal bevacizumab on rat retinal cells. Ma te ri al and Met hod: Thirty-six male adult Swiss albino rats were randomly divided into two groups. The first group was applied 0.25 mg bevacizumab in 0.01 ml saline, and the second group received the same amount of saline intravitreally. Each group was divided into 3 subgroups. The animals were sacrificed and their globes were enucleated at the 3rd, 24th, and 72nd hours of the experiment. Enucleated eyes were preserved for histological analysis, immunohistochemical analysis of caspase-3, caspase-8, caspase-9, Fas/Fas L, VEGF and VEGF receptors (Flt-1, Flk-1), and TUNEL staining. Re sults: Histological evaluation showed no sign of retinal toxicity in both groups. In TUNEL staining, TUNEL(+) cells were detected in all subgroups, but the number of positive cells was relatively lower in bevacizumab treatment group that reached statistically significant level at 24 and 72 hours of treatment (p<0.001). Immunohistochemical analysis revealed that in saline-treated subgroups, immunoreactivity was more pronounced for all apoptosis-inducing proteins compared to bevacizumab-treated group. Also immunoreactivity of VEGF was prominent in saline treated group. For VEGF receptors, staining was only positive for Flt-1 at the 3rd hour in the control group. Dis cus si on: Bevacizumab did not have apoptosis-inducing potential compared to saline solution in short term, which was documented with TUNEL and immunohistochemical staining. (Turk J Ophthalmol 2013; 43: 39-44

Manisa merkez yarı kentsel bölgede bir aile sağlığı birimine kayıtlı kadınlarda bazı birinci basamak sağlık hizmet özelliklerinin değerlendirilmesi

Özet                       Amaç: Birinci basamak sağlık hizmet özellikleri kaynakça doğrultusunda bilimsel olarak ölçülebilir niteliktedir ve ilk başvuru, süreklilik, kapsayıcılık ve koordinasyon gibi temel hizmet özellikleri üzerinden değerlendirilir. Yöntem: Örnek seçiminde çok aşamalı küme örnekleme yöntemi kullanılmış, veriler yüz yüze görüşme tekniğine göre yapılandırılmış anketle toplanmıştır. Araştırma bölgesindeki toplam hane sayısı 870’tir. Küme örnekleme yöntemi ile 376 haneden 318 kadına ulaşılmıştır. Araştırmanın ulaşılabilirlik oranı % 84.6’dır. Araştırmanın bağımlı değişkenleri; İlk başvuru, Süreklilik, Kapsayıcılık ve OHS (Olağan Hizmet Sürekliliği) gibi hizmet özellikleridir. Bağımsız değişkenler ise kadının ve eşinin yaşı, kadın ve eşinin eğitimi, medeni hal, kadının çalışma durumu, sosyal sınıf (eşin işine göre), gelir algısı, bölgede yaşama yılı, göç edilen bölge, sağlık güvencesi, aile tipi, beş yaşından küçük çocuk varlığı ve hanedeki çocuk sayısı kullanılmıştır. Bulgular: Katılımcıların yaş ortalaması 38.3±15.3’tür. Bir sağlık sorunu nedeniyle aile hekimine başvurma % 61.0, ondan bir önceki sağlık sorununda AH’ne (Aile Hekimi) başvuru %55,2 oranındadır. Bu soruların her ikisine de “aynı aile hekimine başvururum” cevabını verenlerin (OHS) oranı  %40.1 olmuştur. Aile Sağlığı Birimini yakın, normal mesafe bulanların oranı %93.1’dir. Aile hekiminin ismini bilme %84, ebenin ismini bilme %36.2, her türlü sorununuzla sürekli ilgilenen bir hekim veya sağlık kuruluşuna kayıtlı olduğunu söyleyenlerin %74.5’tir. Son bir yılda evime ebe ziyareti aldım diyenler %40.6 oranındadır. Sonuç: Araştırmanın yapıldığı ASB’de geçen bir yıllık ilk AH uygulama döneminde sosyalleştirme dönemiyle karşılaştırıldığında, tedavi edici hizmet örüntüsünün değişmediği buna karşın gezici ebe hizmetlerinin azaldığı görülmüştür.Anahtar Kelimeler: Aile sağlığı birimi, ilk başvuru, süreklilik, kapsayıcılık, olağan hizmet sunucu sürekliliğiAbstractAim: The capability of primary care services can be scientifically measured and assessed via basic elements of these services such as accessibility, longitidunality, comprehensiveness and coordination. Methods: A multistage cluster sampling method was used and the data were collected by face to face interviews with a structured questionnaire. An overall 870 households which were recorded in  a Family Practice Unit (FPU) consisted of the universe of this study and 318 women were identified from a sample of 376 households by cluster sampling method. The response rate was of 84.6%. The dependent variables in the study were, the First contact care, Continuity (Usual provider continuity), Comprehensiveness; whereas independent variables were, the women’s and husband's age, the women's and husband's education, marital status, women's occupational status, family social class, perception of income, years of residency in the region, the area of emigration, health insurance status, family type, existence of children under five years of age. Results: The average age of participants was 38.3 ± 15.3. The percentage of women who preferred FPU services for their most recent health problem was 61.0%, whereas this percentage was 55.2% for the previous experienced health problem. The Usual Provider Continuity (UPC) rate was 40.1%. 93.1 percent of women stated that FPU is quite close to their house. The proportion of the women who knew the name of their family physician was 84.0% and 36.2% them knew the name of their midwife. Of the respondents, 74.5% had been registered with a PHC facility or a primary care physician.  Midwives visited 40.6% of the respondents at least once during the last year. Conclusion: This research indicates that, the pattern of therapeutic services was not changed in the new FPU system, compared to the previous socialized health organization in the Primary Care services. Besides this fact, mobile midwife services might be said to have decreased in the new FPU system.Key Words: Family health unit, the first contact, continuity, comprehensiveness, usual provider continuity.                                                 </span