{"title":"Cinsiyet Eşitsizliği, Kadına Yönelik Şiddet ve Sağlık Çalışanlarının Yaklaşımı","authors":"Selma Dağci, B. Ören","doi":"10.16948/ZKTIPB.452219","DOIUrl":"https://doi.org/10.16948/ZKTIPB.452219","url":null,"abstract":"Bu derlemede cinsiyet esitsizligi, Turkiye ve dunyada kadina yonelik siddetin gorunumu, siddetin nedenleri ve cozum onerilerinin sunulmasi amaclanmistir. Şiddet tanimlanmasi ve girisimde bulunulmasi zor bir durum olmakla birlikte, siddet sonrasi magdura yonelik koruma, tedavi ve iyilestirme hizmetlerin daha etkili bicimde sunulmasi ve gerektigi kadar surekliginin saglanmasi cok buyuk onem tasimaktadir. Toplumsal cinsiyet; toplumun kadin ve erkeklere verdigi roller, gorevler ve sorumluluklardir. Kadina yonelik siddet; cinsiyete dayali olarak gerceklesen ve kadinlarda fiziksel, cinsel, psikolojik herhangi bir zarar ve uzuntu sonucunu doguran veya bu sonucu dogurmaya yonelik ozel veya kamu yasaminda gerceklesebilen her turlu davranis, tehdit, baski veya ozgurlugun keyfi olarak engellenmesidir. Kadina yonelik siddet prekonsepsiyonel oncesi donemden baslamakta, dogumu takiben de kiz bebeklerin oldurulmesi, yetiskinlik ve yaslilik doneminde de daha cok cinsel istismara ugrama ve dayak olarak kendini surdurmektedir. Dunya Saglik Orgutu’nun 2005 yilinda 11 ulkede 24.000 kadin uzerinde yaptigi calismada, kadinlarin; %13-61’inin fiziksel, %6-59’unun cinsel, %15-71’inin hem fiziksel hem de cinsel, %20-75’inin ise duygusal siddete maruz kaldigi bildirilmektedir . Kadina yonelik siddeti onlemek ve azaltmak amaciyla birey, aile, toplum ve saglik calisanlari olarak her grubun uzerine dusen bazi sorumluluklar vardir. Bu baglamda; hukumet tarafindan yasal duzenlemeler yapilarak; cocuklari, magdurlari, cinsel tacizden koruyacak yasal uygulamalar desteklenmeli ve guclendirilmelidir. Saglik calisanlarinin calisma ortamlarinda hastalari ile yakin iliski kurmalari, siddetin saptanmasi ve girisimi acisindan anahtar rol oynamaktadir. Sonuc olarak, saglik calisanlari siddet belirti, bulgu ve girisimleri konusunda egitilmelidirler.","PeriodicalId":249483,"journal":{"name":"Zeynep Kamil Tıp Bülteni","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130006787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Demir eksikliği olan okul öncesi ve okul çağındaki çocukların serum çinko seviyelerinin değerlendirilmesi: Kesitsel vaka kontrol çalışması","authors":"Ömer Kartal, Orhan Gürsel","doi":"10.16948/ZKTIPB.532853","DOIUrl":"https://doi.org/10.16948/ZKTIPB.532853","url":null,"abstract":"Amac: Dunyada hala ek sik gozlenen nutrisyonel eksiklikler demir ve cinko eksiklikleridir. Gunumuzde bu nutrisyonel eksiklikler sadece gelismekte olan ulkelerin degil tum dunyanin onemli bir problemidir. Bu calismanin amaci, okul oncesi ve okul caginda demir eksikligi olan cocuklarda serum cinko seviyelerini karsilastirmak ve eritrosit indekslerine olan etkilerini degerlendirmektir. Gerec ve Yontemler: Calismaya Ocak 2011 ile Agustos 2017 tarihleri arasinda Gulhane Egitim ve Arastirma Hastanesi cocuk hematolojisi poliklinigine basvuran, serum cinko ve demir duzeyleri bakilmis cocuklar dahil edildi. Hastalar okul oncesi (2-5 yas) ve okul cagi (6-12 yas) olarak 2 gruba ayrildi ve gruplarin serum demir ve cinko duzeyleri degerlendirildi. Bulgular: Demir eksikligi anemisi olan gruplarda serum cinko duzeyleri, kontrol gruplarina gore istatistiksel olarak anlamli bir sekilde dusuk bulundu (p<0.05). Yapilan korelasyon analizinde serum cinko duzeyi ile hemoglobin duzeyi arasinda istatistiksel olarak anlamli ve pozitif yonlu bir korelasyon saptandi ( p <0.05 ). Sonuc: Calisma sonucunda e lde ettigimiz veriler cinkonun anemi icin bagimsiz bir risk faktoru oldugu yonundedir. Demir eksikligi anemisi olan cocuklarda demir tedavisine ragmen duzelmeyen anemi varliginda cinko destegi dusunulmelidir.","PeriodicalId":249483,"journal":{"name":"Zeynep Kamil Tıp Bülteni","volume":"9 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123630021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Kabuki Make-Up Sendromu: Nadir Bir Olgu","authors":"Ali Karaman","doi":"10.16948/ZKTIPB.458645","DOIUrl":"https://doi.org/10.16948/ZKTIPB.458645","url":null,"abstract":"Kabuki make-up sendromu , multipl konjenital anomaliler, tipik yuz gorunumu, iskelet anomalisi, dermatoglifik degisiklikler, postnatal buyume geriligi ve mental retardasyonla karakterize nadir bir sendromdur. Kabuki make-up sendromu, genellikle sporadik olusan MLL2 ve KDM6A genindeki degisime bagli dogumsal bir bozukluktur. Kabuki tipi yuz gorunumu, gelisim geriligi, mental retardasyon, fetal parmak yastikciklari olan Kabuki make-up Sendromlu bir olgu literature katki amaciyla sunuldu.","PeriodicalId":249483,"journal":{"name":"Zeynep Kamil Tıp Bülteni","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127219532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bahar Özcabı, Feride Tahmiscioglu Bucak, Esma Şengenç, E. Sunamak, Ibrahim Adaletli, Sebuh Kuruğoğlu, Oya Ercan, O. Evliyaoğlu
{"title":"Ergen kızlarda polikistik over sendromu: klinik, endokrin ve metabolik bulgular","authors":"Bahar Özcabı, Feride Tahmiscioglu Bucak, Esma Şengenç, E. Sunamak, Ibrahim Adaletli, Sebuh Kuruğoğlu, Oya Ercan, O. Evliyaoğlu","doi":"10.16948/ZKTIPB.499708","DOIUrl":"https://doi.org/10.16948/ZKTIPB.499708","url":null,"abstract":"Amac: Polikistik over sendromu tanisi alan ergen kizlarin basvurudaki klinik, metabolik ve endokrin bulgularini degerlendirmeyi amacladik. Gerec-Yontemler : Ocak 2008-Aralik 2012 tarihleri arasinda Rotterdam tani olcutlerine gore tanilandirilan 53 olgunun yakinmalari, adet duzenleri, fizik baki bulgulari (antropometrik olcumler, Ferriman Gallwey skoru, akantozis nigrikans varligi), bazal/uyarilmis adrenal androjen, aclik glukoz/insulin degerleri, kan yag ve lipoprotein duzeyleri, pelvik ultrasonografi bulgulari kaydedildi. Yasa gore vucut kitle indeksi (VKI) %95 ve uzeri olgular sisman olarak tanimlandi. Oligo/amenore, hiperandrojenizm ve ultrasonografide polikistik over bulgularinin hepsinin bulundugu hastalar klasik grup olarak adlandirildi. Kan trigliserit duzeyi yasa gore %97 degerinden fazla ise yuksek olarak nitelendirildi; HOMA-IR degeri ≥ 3,82 olgularda insulin direnci var kabul edildi. Bulgular: Ortalama basvuru yasi 15±1,5 yildi. En sik yakinma adet duzensizligiydi (%49,1). Adet duzeni ayrintili sorgulandigindaysa olgularin %60,4’unde oligo/amenore oldugu goruldu. Olgularin %43,4’u sismandi. Akantozis nigrikans (%37,7) olan olgularda sismanlik daha sikti (p=0.010). Hirsutizm %41,5 olguda orta-agir (Ferriman Gallwey skoru≥16) olarak belirlendi: orta-agir olgularda oligo/amenore daha sikti (p=0,007). Insulin direnci %39,6 olguda (%81 obez) vardi ve akantozis nigrikans saptananlarda daha sikti (p=0,001). Trigliserit yuksekligi 49 olgudan 7’sinde saptandi; bu olgularin hepsinde insulin direnci de mevcuttu (p=0,033). Serum trigliserit duzeyi ile HOMA-IR degeri arasinda korelasyon saptandi (r:0,415). Polikistik over bulgusu olgularin % 96,2’sinde belirlendi. Klasik grupta diger gruba gore oligo/amenore, hirsutizm, akantozis nigrikans, trigliserit yuksekligi anlamli (p<0.005), total testosteron duzeyi anlamliliga yakin yuksekti (p=0.056). Sonuc: Polikistik over sendromu tanisinda adet duzeni ayrintili olarak sorgulanmalidir. Akantozis nigrikans saptanan olgular insulin direnci acisindan irdelenmeli, insulin direnci varliginda trigliserit yuksekligi arastirilmalidir.","PeriodicalId":249483,"journal":{"name":"Zeynep Kamil Tıp Bülteni","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126613593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"HCG uygulamasından 36 saat ile 42 saat sonra yapılan intrauterin inseminasyonların klinik sonuçlarının karşılaştırılması","authors":"Samettin Çelik, Banu Şahin, Aysemin Gürçeğlar, Canan Soyer, Şafak Hatırnaz","doi":"10.16948/zktipb.566761","DOIUrl":"https://doi.org/10.16948/zktipb.566761","url":null,"abstract":"Aim: Intrauterine insemination (IUI) is a commonly used procedure to increase the chance of pregnancy in infertile couples. The planned IUI timing after hCG (human chorionic gonadotropin) trigger was practically determined as at 36th hour. However, this timing may be delayed due to clinical traffic. In our study, we aimed to compare the clinical results of patients who underwent IUIs at 36th hour versus at 42nd hour. Method: The records of 450 patients who were admitted to Samsun Training and Research Hospital due to unexplained infertility and were performed IUI after gonadotropin treatment, were retrospectively analyzed. Demographic information, hormone levels, endometrial thickness, total follicle numbers, β-hCG test positivity, live birth rates, and spontaneous abortion rates of patients with 6 hours delay (42 hours) in IUI timing after hCG trigger due to the traffic in the clinic, and patients with on the time (36 hours) IUI performation were evaluated. Student's t-test and Chi-square test were used for comparisons between groups. Results: IUI procedures were applied to 348 patients at the 36th hour and 102 patients at the 42nd hour after the hCG triggers. No difference was observed between the groups in terms of ages, infertility durations, basal hormone levels and endometrial thicknesses (p <0.05) (Table 1). When the effects of IUI treatments on pregnancy outcomes were examined, there was no difference between groups in terms of dominant follicle numbers obtained after ovulation induction, β-hCG test positivity, livebirth rates and spontaneous abortion rates. (p=0.34, p=0.12, p=0.31, p=0.25) (Table 2). Conclusion: The clinical pregnancy rates of patients with IUI timing after ovulation induced by hCG injection does not change with delaying to 42nd hour versus 36th hour.","PeriodicalId":249483,"journal":{"name":"Zeynep Kamil Tıp Bülteni","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123818586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yeliz Doğan Merih, A. Alioğullari, Meryem Yaşar Kocabey, Çiğdem Gülşen, Aytül Sezer
{"title":"HEMŞİRELİKTE İNOVASYON KÜLTÜRÜ OLUŞTURMA; BİR BAŞARI ÖYKÜSÜ","authors":"Yeliz Doğan Merih, A. Alioğullari, Meryem Yaşar Kocabey, Çiğdem Gülşen, Aytül Sezer","doi":"10.16948/ZKTIPB.559616","DOIUrl":"https://doi.org/10.16948/ZKTIPB.559616","url":null,"abstract":"Aim: Nurses should keep up with constant change and integrate innovation into their services in order to obtain effective and desirable results in their service provision activation of the process of innovation in nursing services reduces the cost of care and increases the quality of care . Material and Method: In order to activate the process of innovation in nursing services provided at our hospital, a number of steps were completed. In the first step, nurses’ level of knowledge was improved through regular training, individual counseling was initiated using the coaching system, competitions were organized for making the process more interesting, and participation rate was increased with rewards. These implementations produced an innvoation culture. Results: During the process of activating innovation at our hospital, which was initiated in 2012, competitions and symposiums were held. In the 7 year period, nurses wurking at our hospital completed 376 innovative projects. Each of these projects had an inventive quality and through these projects, the nurses were able to support novel and creative activities which increased the quality of care. The patenting process of 50 innovative projects was completed and studies were activated for producing new inventions. Conclusion: Regular training, role modeling, and scientific activities that introduce the process, make the process more interesting, and guide nurses are crucial for activating the innovation process in nursing .","PeriodicalId":249483,"journal":{"name":"Zeynep Kamil Tıp Bülteni","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122338639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medikal tedavi verilen ektopik gebeliklerin başlangıç B-hCG değeri ve 4. gün B-hCG değerindeki değişikliğe göre başarı durumunu öngörme: 183 olgu içeren retrospektif bir çalışma","authors":"Ramazan Deni̇zli̇, Önder Sakin, Nayif Çiçekli, A.Doğukan Angin, Muzaffer Seyhan Çıkman, Zehra Meltem Pirimoğlu","doi":"10.16948/ZKTIPB.458145","DOIUrl":"https://doi.org/10.16948/ZKTIPB.458145","url":null,"abstract":"INTRODUCTION: we aimed to predict treatment success with comparing B-hcg values on first and fourth days of methotrexate injection METHODS: we research the informations of ectopic pregnancy, retrospectively, between years 2009 and 2017 in Kartal Dr.Lutfi Kirdar Training and Research Hospital which treated with single dose MTX. 183 patients included into the study. RESULTS: In our study; 77,6% of patients treated with single dose MTX injection. With inclusion of second dose injected patients, success rate is rising to 91,8%. When we look at the prior B-hcg values, patients,those have less than 2000 mIU/mL values, have higher treatment success rate with single dose MTX injection. When we look at the patients, who needed second MTX dose, we have seen 95,95% success rate on patients’ B-hcg values less than 4000 mIU/mL. More than 10 percent decrease of Patients’ B-hcg value between first and fourth days of treatment showed 94,6% success rate. As patients’ treatment,whose B-hcg values decreased less than 10%, showed 48,6% success rate. DISCUSSION AND CONCLUSION: Despite treatment success rate as initial B-hcg levels rises, we have to keep in mind that even patients with higher than 5000 mIU/mL B-hCG, there is a 72% treatment success rate. If there is no contraindication, still MTX treatment considered as a good choice of treatment. More than 10 percent decrease on patients’ fourth day of treatment B-hcg values seems to be a good parameter for treatment success prediction. But there is 48,6% of negative predictive value, and this is a disadvantage about prediction of MTX injection treatment success.","PeriodicalId":249483,"journal":{"name":"Zeynep Kamil Tıp Bülteni","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122509670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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