Goal: 16 - Barış, Adalet ve Güçlü Kurumlar
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Barış, Adalet ve Güçlü Kurumlar
Sürdürülebilir kalkınma için barışçıl ve kapsayıcı toplumlar tesis etmek, herkes için adalete erişimi sağlamak ve her düzeyde etkili, hesap verebilir ve kapsayıcı kurumlar oluşturmak.
Barış, istikrar, insan hakları ve hukukun üstünlüğüne dayalı etkin yönetim olmadan, sürdürülebilir kalkınma olmasını bekleyemeyiz. Gittikçe artan ölçüde bölünmüş bir dünyada yaşıyoruz. Bazı bölgelerde barış, güvenlik ve refah sürekli iken, diğer bazı bölgelerde ise bitmek bilmeyen çatışma ve şiddet sarmalı var. Ancak bu, hiçbir şekilde kaçınılmaz sonuç değildir ve mutlaka çözümlenmelidir.
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Publication Metadata only Autologous Fascia Lata Graft for Contour Restoration and Camouflage in Tertiary Rhinoplasty(2012-05-01T00:00:00Z) Karaaltin, Mehmet Veli; BATIOĞLU KARAALTIN, Ayşegül; Orhan, Kadir Serkan; Demirel, Tayfun; Guldiken, YahyaTertiary rhinoplasty is a surgical procedure to correct nasal deformities that have been developed after prior unsuccessful surgeries. Such surgery requires complicated manipulations and tissue grafting for proper restoration. In the current study, we report the use of fascia lata graft combined with cartilage grafts for contour restoring and camouflage. Twenty-three patients who had severe nasal deformities were included, of whom 14 were men and 9 were women. Their ages ranged between 24 and 34 years (mean, 29 y). All patients were twice previously operated on by surgeons other than the authors. An informed consent was obtained from all patients. After harvesting the costal cartilage, the fascia lata graft (mean size, 2-3 cm) was uniformly harvested from the right lateral thigh. Application of the fascia lata and the cartilage graft was achieved through the open rhinoplasty incision. The fascia lata was applied over the cartilage in the dorsal region in 20 patients (86.9%), applied over the reconstructed alar and dome area in the nasal tip in 8 patients (34.7%), and applied over both areas simultaneously in 4 patients (17.3%). Postoperative follow-up was between 14 and 35 months (mean, 24.5 mo); clinical evaluation, photographic documentation, and a questionnaire form related to donor-site morbidity and patient satisfaction were applied after 12 months of the follow-up period. Results showed that all patients had an improved aesthetic result, and no apparent irregularities were observed in the integument of the aesthetic lines. No complications or no requirement for revision surgery was observed later on. In conclusion, refinements of the nasal dorsum and the nasal tip in tertiary rhinoplasty are indeed important and difficult to be managed. Placing the fascia lata over the applied cartilage grafts provide a good cover that conceals the possible irregularities or distortions that may appear in the late postoperative period.Publication Metadata only Diagnostic value of electroencephalography inpatient patients: Effect on clinical decision-making Yatan hastalarda elektroensefalografinin tanısal değeri: Klinik karar verme üzerine etkisi(2020-01-01T00:00:00Z) İlgen Uslu, Ferda; Gökçal, Elif; USLU, FERDA; GÖKÇAL, ELİF© 2020, Istanbul Universitesi. All rights reserved.Objective: To evaluate the efficiency of electroencephalography (EEG) requested at the consul-tation. Methods: EEGs for which consultation was requested in one year were analyzed retrospectively. Neurology consultation notes, EEG forms, compliance with EEG findings were examined for each pa-tient. Demographic data, requested unit, pre-diagnosis, final diagnosis were recorded. EEG results were divided into 3 groups:1)normal, 2)EEG with epileptiform anomaly (EEG-EA),3)EEG with nonepilepti-form anomaly (EEG-NE). EEGs were also evaluated for their indications and contribution to diagnosis. Results: A total of 261 EEG recordings of 239 patients (133 men, average age 56.44 (18-90)) were examined. 30.5% of the registered patients had a history of neurological diseases. EEGs were requested from 36.4% intensive care units and emergency departments, 51.5% internal branches, 12.3% surgical branches. Preliminaries were seizures in 42.5%, alertness/encephalopathy in 17.2%, syncope in 5.7%, nonconvulsive status epilepticus (NCSE) in 10.3%. 55% of EEGs were considered nor-mal. 37.5% were in EEG-NE, 8.4% in EEG-EA. 91.6% of patients were imaged, 52.5% were pathological. Focal imaging pathology and EEG findings were compatible in 63% of patients with pathological EEG findings. EEG was pathological in 64.5% of the 127 patients requested with appropriate indications. 80% of EEG was thought not to contribute to the definitive diagnosis. Discussion: Male and advanced elderly people with neurological disease were preferred for EEG. Appropriate indication with a desired high probability of detection of pathological EEG. It is important that the doctor who evaluates the inpatient patient makes more careful decisions in terms of unneces-sary process, resource and time wasting.Publication Metadata only Which Unicondylar Prosthesis Has Better Mid-Term Results: Fixed or Mobile?(2016-04-01T00:00:00Z) Bulbul, Ahmet Murat; KUYUCU, ERSİN; Kara, Adnan; KÜÇÜKDURMAZ, FATİH; Erdil, Mehmet; KÜÇÜKDURMAZ, FATİHObjective: Osteoarthritis, which is one of the most common causes of pain and motion loss, is an important medical disease that particularly affects elderly people. Unicondylar knee arthroplasty treatment is still a challenge for obese and/or ACL deficient patients. In addition, surgeons face a challenge of deciding whether to perform either fixed or mobile insert design prosthesis. The objective of this study was to evaluate the effect of fixed or mobile insert design prosthesis on the mid-term results of patients that we followed up for 8 years or more.Publication Metadata only Is postpartum depression a specific diagnosis? A prospective study(2012-03-01T00:00:00Z) Kirpinar, Ismet; TEPELI, Isik Ozturk; GÖZÜM, SEBAHAT; Pasinlioglu, Turkan; KIRPINAR, İSMETObjective: The studies investigating the prevalence and incidence of postpartum depression (PPD), as well as its nosologic status have controversial results. This article is part of a prospective, epidemiological study concerning postpartum depression in Erzurum City, Eastern Turkey. The present study focuses on the prevalence and incidence of PPD at sixth weeks after delivery and its diagnostic distribution according to DSM-IV. Methods: Four hundred and seventy-nine pregnant women in their third trimester were arranged to be visited by trained community midwives at 7-10 days and sixth weeks after delivery. Data were collected by use of the questionnaires on detailed sociodemographic and health information at each visit and the participitants filled out the Edinburgh Postpartum Depression Scale (EPDS) at six weeks after delivery. Finally, mothers who had PPD diagnosis according to EPDS were visited by a psychiatrist in their homes where the SCID was administered to make a DSM-IV diagnosis and determine whether the depression occurred before or after delivery. Results: The prevalence rate of PPD measured by EPDS was 14% in this population. The incidence of PPD was estimated as 6% with clinical interviews. Most of the depressed mothers (74.0%) were diagnosed as major depressive disorder according to DSM-IV, but there were some other depressive states too. Conclusion: The prevalence and incidence rates of PPD do not appear to be significantly different from those of non-childbearing women. PPD should not be seen as a specific clinical entity as far as its diagnostic distribution is concerned. (Anatolian Journal of Psychiatry 2012;13:16-23)Publication Metadata only Indirect Effect Of A Dentistry And Medical School Hospital Before And After Covid-19 On The Environment(2021-03-20T00:00:00Z) Ekinci, Esma; Armagan, Sara; KILIÇ, BANUDünya Sağlık Örgütü (WHO)’ne göre küresel ısınma tüm dünyada insanların karşılaştığı ciddi sorunlardan biridir.(WHO 2011) Gelecek nesiller için dünyanın uzun bir süre daha var olması önem taşımaktadır. Dolayısıyla bir diş hekimi olarak çevre dostu bir yöntem kullanarak doğanın ko runmasına yönelik katkı sağlamak bizim sorumluluğumuzdur. Küresel ısınmanın en önemli sebeplerinden biri de çevresel kirliliktir. Yapılan çeşitli araştırmalara göre, diş hekimliğinin çevreye etkisi değerlendirilmiştir. Birleşik Krallık Ulusal Sağlık Sistemi (NHS)’ne göre karbon ayakizine en büyük katkıyı dental servislere yapılan giriş çıkışlar ve tedarik süreci oluşturmaktadır. Diş hekimliği klinikleri, diğer sağlık kuruluşlarına kıyasla daha az atık üretiyor olsa da, son on yılda dental atıklarda önemli bir artış gözlenmektedir. Çeşitli ülkelerde yapılan akademik araştırmalarda, Covid-19 sürecinden bağımsız olarak değerlendirilen kliniklerden esinlenerek Bezmialem Vakıf Üniversitesi Diş Hekimliği ve Tıp Fakültesi Hastanelerinde bir çalışma yapılmıştır. Bu çalışma, Covid-19 öncesi ve sonrası bir diş hekimliği ve tıp fakültesi hastanesinin kullandığı ve harcadığı materyallerin (2019-2020 yıllarının Haziran-Aralık ayları arasındaki dezen-fektan, sabun, kağıt, hasta sayısı, doğalgaz, elektrik ve geri dönüşüm atıkları) derlenmesiyle sağlık sektörünün karbon ayakizinin bu süreçte hangi yönlerde değişime uğradığını belirtmektedir. Matery-allerin belirlenen süreçlerdeki hem yıllık değişimi hem de hasta başına düşen birim değişimi dikkate alınmıştır. Sağlık sektöründeki bireyler olarak bu süreci nasıl değerlendirmiş olduğumuzu gösteren bu çalışma, gelecekte benzer pandemilerin yaşanması durumunda öngörülecek durumları ve dikkat edilmesi gereken noktaları göz önüne sermiştirPublication Metadata only Primary Retroperitoneal Mucinous Cystadenocarcinoma: 5th Male Case in the Literature(2015-02-01T00:00:00Z) Kos, F. Tugba; Ozkan, Fuat; Bakaris, Sevgi; Bulbuloglu, ERTAN; Gurbuz, Esma; Ozer, Nazmi; BÜLBÜLOĞLU, ERTANRetroperitoneal primary mucinous tumor is an extremely rare malignancy. To date, only 52 cases of primary retroperitoneal mucinous cystadenocarcinoma (PRMC) have been reported in the literature, with the majority being women. Our patient is the 5th known male case. A 57-year-old male patient presented with a two year history of an undefined abdominal pain. Computed tomography demonstrated a 12 x 9.5 cm cystic mass lesion extending superiorly from right iliac fossa, while localizing below the abdominal wall and close to the psoas muscle. According to the laparotomy, iliopsoas muscle was infiltrated by the mass in the retroperitoneal region. Pathological diagnosis was mucinous cystadenocarcinoma. The asymptomatic patient was followed up without applying an adjuvant chemotherapy, since the clinical course of the tumor is known to be slow and postoperative therapy is not recognized as a standardized treatment. The clinical course of PRMC is generally indolent, however, it may manifest an aggressive course, as well. It has no definitive and clear pathogenesis. The treatment is contentious, as well. Diagnosis and treatment require surgical excision but data on adjuvant chemotherapy is limited.Publication Metadata only Inflammation, Frailty and Cardiovascular Disease(2020-01-01T00:00:00Z) SOYSAL, PINAR; Arik, Ferhat; Smith, Lee; Jackson, Sarah E.; IŞIK, AHMET TURAN; SOYSAL, PINARChronic inflammation, which is called -inflamm-aging-, is characterized by an increased level of inflammatory cytokines in response to physiological and environmental stressors, and causes the immune system to function consistently at a low level, even though it is not effective. Possible causes of inflammaging include genetic susceptibility, visceral obesity, changes in gut microbiota and permeability, chronic infections and cellular senescence. Inflammation has a role in the development of many age-related diseases, such as frailty. Low grade chronic inflammation can also increase the risk of atherosclerosis and insulin resistance which are the leading mechanisms in the development of cardiovascular diseases (CVD). As it is well known that the risk of CVD is higher in older people with frailty and the risk of frailty is higher in patients with CVD, there may be relationship between inflammation and the development of CVD and frailty. Therefore, this important issue will be discussed in this chapter.Publication Metadata only Early Left Atrial Mechanics and Volume Abnormalities in Subjects with Prehypertension: A Real Time Three-Dimensional Echocardiography Study(2012-11-01T00:00:00Z) Acikgoz, Nusret; Akturk, Erdal; ERMİŞ, NECİP; Yagmur, Julide; Kurtoglu, Ertugrul; CANSEL, MEHMET; Eyupkoca, Ferhat; PEKDEMİR, HASAN; ÖZDEMİR, Ramazan; AÇIKGÖZ, NUSRET; ÖZDEMİR, RAMAZANThe aim of this study was to evaluate left atrial (LA) volume and mechanical functions by real time three-dimensional echocardiography (RT3DE) in prehypertensive subjects. The study included 54 (34 male and 20 female) prehypertensive subjects and 36 (14 male and 22 female) healthy control subjects. Transthoracic echocardiography and RT3DE were performed in all patients. Interventricular septum thickness and isovolumetric relaxation time were significantly higher in prehypertensives than in controls (10.7 +/- 0.7 vs. 10.1 +/- 0.8 P = 0.001 and 89.9 +/- 10 vs. 82.4 +/- 11 P = 0.002, respectively). LA maximum volume, volume before atrial contraction, total and active stroke volume, total and active emptying fractions, expansion index, and LA max volume index were significantly higher in prehypertensives when compared with controls (P < 0.0001 for all). However, the passive emptying fraction was significantly lower in prehypertensives than controls (45.7 +/- 5.6 vs. 48.6 +/- 4.1, P = 0.006), and the minimum LA volume between the two groups was similar. The main finding of this study was that although LA volume and LA active systolic functions were significantly increased in prehypertensive people, there was a reduction in passive LA systolic functions. These parameters may be important in showing hemodynamic and structural changes in cardiac tissue caused by prehypertension. (Echocardiography 2012;29:1211-1217)Publication Open Access State and trait anxiety among medical staff during the first month of COVID-19 pandemic: A sample from Turkey(2021-08-01T00:00:00Z) ŞAHAN, EBRU; TANGİLNTİZ, AİSE; ŞAHAN, EBRU; TANGİLNTİZ, AİSEObjectives During the COVID-19 pandemic, excessive workload, a rapidly changing workplace environment, the danger of carrying the virus and transmitting the disease to their families, relatives and those they live with creates stress for the medical workers. In our study, we aimed to evaluate the state and trait anxiety levels of healthcare professionals who encounter patients with suspected COVID-19 infection and related factors. Method Data were collected from healthcare professionals working with patients diagnosed or suspected with COVID-19 via online self-report questionnaire between 9-19 April 2020. The state (STAI-S) and trait anxiety (STAI-T) scale was used to measure anxiety. Results A total of 291 healthcare professionals, 216 women and 75 men, participated in the study. Women-s state and trait anxiety were significantly higher than men-s. 11 participants without any lifetime psychiatric illness experienced psychiatric symptoms and consulted to a psychiatrist. The state anxiety of those who have children, nurses and those working in branches directly related to the pandemic (Infectious Diseases, Respiratory Diseases, Emergency Medicine, Internal Medicine, Radiology, Anesthesiology and Reanimation) was higher than others. The state anxiety of those who thought they were not protected with personal protective equipment and those who did not stay in their own home was higher than others. Conclusions At the forefront of the fight against COVID-19, there are medical personnel who pay a serious psychological cost. Especially in terms of anxiety, we should pay attention to women, workers with children, nurses and people working in branches that are directly related to pandemics.Publication Open Access Discordance between Serum Neutralizing Antibody Titers and the Recovery from COVID-19(2020-09-25T00:00:00Z) Koç, Mm; Kalkan, Yazıcı; Çetin, Nesibe Selma; Doymaz, Mz; Sümbül, B; Durdu, B; YAZICI, MERVE; MERİÇ KOÇ, MELİHA; ÇETİN, NESİBE SELMA; KARAASLAN, ELİF; OKAY, GÜLAY; DURDU, BÜLENT; SÜMBÜL, BİLGE; DOYMAZ, MEHMET ZIYAThe recent pandemic of COVID-19 has caused a tremendous alarm around the world. Details of the infection process in the host have significant bearings on both recovery from the disease and on the correlates of the protection from the future exposures. One of these factors is the presence and titers of neutralizing Abs (NAbs) in infected people. In the current study, we set out to investigate NAbs in the recovered subjects discharged from the hospital in full health. Serum samples from a total of 49 documented consecutive COVID-19 subjects were included in the study. All the subjects were adults, and serum samples collected during the discharge were tested in viral neutralization, enzyme immunoassay (EIA), and Western immunoblot tests against viral Ags. Even though a majority of the recovered subjects had raised significant NAb titers, there is a substantial number of recovered patients (10 out of 49) with no or low titers of NAbs against the virus. In these cohorts as well as in patients with high NAb titers, viral Ag binding Abs were detectable in EIA tests. Both NAb titers and EIA detectable Abs are increased in patients experiencing a severe form of the disease, and in older patients the Ab titers were heightened. The main conclusion is that the recovery from SARS-CoV-2 infection is not solely dependent on high NAb titers in affected subjects, and this recovery process is probably produced by a complex interplay between many factors, including immune response, age of the subjects, and viral pathology.