Goal: 16 - Barış, Adalet ve Güçlü Kurumlar
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 onlyAutologous 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 onlyWhich 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 onlyIs 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 onlyPrimary 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 onlyEarly 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 Metadata onlyViolence related behaviours among adolescent students and factors affecting thereto(2015-01-01T00:00:00Z) Eker, Hasan Hüseyin; Tasdemir, Mustafa; Ulger, Zekiye; ÖZDER, ACLAN; ÖZDER, ACLAN© 2015 Eker HH, et al.Background: Violence among young people is an important public health problem in society. Act of violence seen in schools is disturbing students- learning processes and inhibiting their developments generally results in emotional abuse, physical injury and death. Objectives: This study is conducted in order to find out the prevalence of and exposure to violence, which is an important public health problem, in schools and to determine the factors affecting thereto. Specific factors investigated were exposure to violence, gender, age, type of school, economic status of families and level of education of mothers. Method: This cross-sectional study was performed between March 2012 and May 2012. The population is 1575 students from 9th grade and the study is completed with 1405 students accepting to participate therein. A study questionnaire form established based on the -Youth Risk Behaviour Survey (YRBS)- prepared by CDC (Center for Disease Control and Prevention) is used as data collecting tool. Results: The ratios of each violence-related behaviour are 35.8% and 14.1%, respectively for boys whereas 20.4% and 6.4% for girls. These behaviours are statistically more common among boys than girls (p < 0.05). It was found out that there is a significant relationship between the students- family income level and getting involved in a physical fight in school (p < 0.05).Though no significant relationship is detected between mother-s educational level and getting involved in a physical fight and carrying weapons, ratios of gang membership is 6.2% for students whose a mother is illiterate and is 14.3% for student whose mother-s educational level is high school and above (p < 0.05) Conclusions: It is observed that each violence-related behaviour is more common among boys and with the increase in the mother-s education, tendency of being a member of a gang and getting involved in a physical fight accordingly increases. Publication Metadata onlyWorkplace violence against medical student- A Turkish perspective(2019-05-01T00:00:00Z) Al Ezzi, Saad Ahmed Ali; AL-EZZI, SAAD AHMED ALİBackground: Workplace violence against healthcare providers including the medical students being an important issue all over the World. The aim of this study is to survey the medical students about exposure to workplace violence (WPV) while they are doing their medical training in private tertiary hospitals. Methods: This was a cross-sectional study carried out among all medical students (4th, 5th, and 6th class) attending a teaching hospital at Bezmialem Vakif University (BVU), Istanbul, Turkey. A total of 150 students in the 2017-2018 academic year were recruited in this study. Data were collected using a modified questionnaire through a face to face interview. Data were analyzed using SPSS 16. Results: About one-third of the surveyed students (54, 36.0%) exposed to violence and 71.3% of them witnessed incidents of violence against healthcare providers at the workplace. The prevalence of physical violence and verbal abuse among medical students was reported at 5.5% and 92.6% respectively. About 81.5% were females compared to 18.5% of their counterparts. Patients (38.9%) and their relatives (61.1%) were the main sources of the violence respectively. More than half (57.0%) of students exposed to violence at outpatient services and 25.9% at the emergency room and 16.7% at inpatient wards. Few of them (22, 14.7%) thought that they will get support if they make a complaint. Conclusion: Being a medical student and has direct contact with patients and their relative is not always safe practice. Our results suggested a high prevalence of verbal and physical abuse against medical students. Health sector authorities should adopt a restrictive and clear strategy to protect medical students and other healthcare providers. Publication Metadata onlyRelationship between fetal peak systolic velocity in Middle cerebral artery and umbilical blood gas values and hemoglobin levels in diabetic pregnant women(2018-07-01T00:00:00Z) KÜTÜK, MEHMET SERDAR; DOLANBAY, MEHMET; Karasu, AYŞE FİLİZ; ÖZGÜN, MAHMUT TUNCAY; KÜTÜK, MEHMET SERDAR; GÖKMEN KARASU, AYŞE FİLİZPurposeTo assess the relationship between peak systolic velocity in the middle cerebral artery (MCA-PSV) and fetal hypoxia in diabetic pregnant women requiring insulin therapy. Publication Metadata onlyAlcohol Consumption and Views on Alcohol Research and Control Policies in Turkey: A Qualitative Study(2018-10-01T00:00:00Z) MERCAN, SÜMEYYE; Onaran, Oyku Izel; Ilbak, Ayca; Atasoy, Hakan; TELOĞLU, EMİNE ŞEYDA; TORUN, PERİHAN; Hayran, Osman; MERCAN, SÜMEYYE; TELOĞLU, EMİNE ŞEYDA; TORUN, PERİHANThis study aims to determine the culture of alcohol consumption and elicit the views of drinkers, former drinkers, and nondrinkers on alcohol consumption, alcohol research, and alcohol control policies. The data were collected through semi-structured interviews and analysed using Thematic Framework analysis. Alcohol consumption was described as a means for socialising and relaxing by the drinkers, whereas unhappiness, anxiety and depression by the non-drinkers. The participants have argued that the responses in alcohol studies are unreliable due to social characteristics and that alcohol research should be conducted by institutions, not the state. Interviewers were suggested to have come across as objective, non-judgmental, and likeable with a reassuring attitude and to have used body language appropriately. The participants support a positive approach in control policies by increasing awareness, and prohibition is not believed achievable in practice or to be an effective alcohol control policy as it instead makes drinking attractive. Therefore, the recommendation is to target the whole population by increasing facilities with social activities and encouraging social life. In conclusion, the study has provided valuable hints for planning alcohol research and control policies, and it is especially useful for understanding the background of alcohol consumption culture in Turkey. Publication Metadata onlyRELATIONSHIP BETWEEN SUICIDAL PATIENTS AND VITAMIN D(2019-04-25T00:00:00Z) Atik, Dilek; Taşlıdere, Bahadır; TAŞLIDERE, BAHADIRNTRODUCTION: When a person end their life consciously and intentionally, it is called suicide. Suicide is not a random and nonpurposeful movement, but it is a way of getting rid of the crisis or problem that cause a big trouble and can not be overcome (1,2).The person who committed suicide carries out this action with the thoughts of despair and the lack of people around to help. Suicide is related to ongoing stress factors and narrowing of options before the individual (1,2). The most commonly used method for suicide is multiple drug intake and suicide probability is high among people who have previously attempted suicide, people from families with suicidal individuals (3,4). One of the most investigated issues related to suicide is mental disorders. Numerous studies have reported high rates of mental disorders in individuals who attempt suicide or who die from suicide (5,6). In a study conducted on 100 people who had attempted suicide, 70% of them had depression, 15% had alcoholism, 3% had schizophrenia and 5% had other disorders (7). The most important of the sterols belonging to the vitamin D family is cholecalciferol (vitamin D3). Cholecalciferol is composed of 7- dehydrocholesterol in the skin with the effect of ultraviolet rays (8). The aim of this study was to investigate the vitamin D levels in patients admitted to our emergency department due to suicid intervention and to contribute to the treatment of clinical applications according to the results. METHOD: This study is conducted prospectively in patients presented with suicide in Istanbul Sağlık Bilimleri University Kanuni Sultan Suleyman Training and Research Hospital Emergency Medicine Clinic between 01.12.2018-01.02.2019 with the approval of Kanuni Sultan Süleyman Training and Research Hospital Ethics Committee by the protocol numbered 2018/11/47. The study included 59 individuals with suicidal attempt and 42 subjects with control group. Blood taken from the patients was taken as disposable 10 ml, vacuumed, nonanticoagulanted, in biochemistry tubes for 5-7 ml and centrifuged at 2500 rpm for 10 minutes and their serum was separated within half an hour. Separated serums were stored at -80°C until examined. Each serum was only dissolved once on the day of the study. All variables were tested for conformity to normal distribution, Kolmogorov Smirnov test and compliance with parametric test criteria. The data obtained by the study carried out within the scope of clinical research are statistically nonparametric. For this reason, Mann Whitney U tests were used for statistical evaluations based on categorical (nominal or ordinal) and binary variables. Spearman rank correlation in non-parametric data and Pearson correlation in parametric data were used as correlation methods. FINDINGS: A total of 59 patients and 42 control groups were included in our study. 70.3% (n = 71) of the participants were female and 29.7% (n = 30) were male. The mean age of the participants was 30.7 and the minimum and maximum ages were 18 and 53 years. When the final results of the patients were evaluated; 50.8% (n = 31) were discharged with health, 29.5% (n = 18) were hospitalized and 7.1% (n = 12) were admitted to intensive care unit. When the presence of psychiatric disease was evaluated inthe patients with suicidal attempt, 42.3% (n = 25) had psychiatric disease and 57.6% (n = 34) did not have a diagnosis of psychiatric disease. In patients with suicidal interventions, a positive, high level relationship was detected with the presence of psychiatric disease (r: 0.860, p=0.000). Hastaların The relationship between vitamin D levels and the presence of psychiatric disease was statistically significant (r: 0.276, p = 0.005). Laboratory parameters of vitamin D minimum 4.4 maximum 33 values were found, the effect of vitamin D on suicidal interference is negative, a significant relationship is found (z:-3.630, p=0.000). ). When the relationship between vitamin D levels and previous suicide attempts was found to be significant (z: -2.260, p = 0.024) DISCUSSION: It has been reported that vitamin D has an important role in the treatment of many chronic diseases in recent years (9,10). The risk of suicide is different in every psychiatric disorder. Psychiatric disorder most commonly associated with increased risk of suicide is major depression (11,12,13). The identification of vitamin D receptors in brain regions affecting depression has strengthened the relationship between vitamin D and depression. In human and animal studies, vitamin D receptors and 1-α-hydroxylase enzyme are found in the brain and the role of vitamin D in central nervous system functions have been shown (14,15). According to the results of our study, vitamin D levels was detected low in cases with sucidal attempts. There is increasing evidence that there is a relationship between depressive symptoms and low serum/plasma 25 (OH) D levels. Cross-sectional studies and prospective data also support that low vitamin D levels are associated with an increased risk of depression (16,17). In a study showing that vitamin D deficiency and mood disorders were very common among the elderly, the quality of life of the elderly women with low vitamin D (<400 IU / day) was found to be lower than those with higher vitamin D. In order to improve the quality of life in the elderly, it was emphasized that the recommended daily intake of vitamin D (≥400 IU / day) is important (18). In our study, the relationship between the presence of psychiatric disease in patients with suicidal attempt is indirectly similar to other studies. Low vitamin D levels were found to be a factor in suicidal intervention. CONCLUSION: Suicidal intervention is a condition with high mortality and morbidity. According to the results of our study, considering the low level of vitamin D in patients with suicidal interventions and underlying psychiatric disorders, it was thought that D vitamin replacement can be taken into treatment protocols and suicidal interventions could be reduced.