Askin Keskin Kaplan

This study aimed to examine the prevalence of mobbing experiences among family medicine residents in Turkey. A cross-sectional prevalence study was conducted with 406 volunteer physicians undergoing family medicine residency training. Data were collected via an online survey including sociodemographic questions and a modified Mobbing Scale, which assessed mobbing behaviors across five sub-dimensions: lack of communication, boycott and isolation, threats and violence, reduced work commitment, and job and career barriers. Statistical analyses were performed using IBM SPSS Statistics version 25, with statistical significance set at p < 0.05. The findings revealed that 12.68% of participants experienced mobbing, while an additional 12.70% were uncertain whether they had experienced mobbing. The most frequently reported mobbing experiences occurred in the domains of reduced work commitment (34.69%) and job and career barriers (24.13%). No statistically significant differences were observed based on gender, years of professional experience, or institutional affiliation. However, mobbing related to job and career barriers was more prevalent in Turkish Health Sciences University hospitals. Additionally, a positive correlation was identified between age and job commitment, suggesting that older participants exhibited higher levels of commitment to their work. The study indicates that mobbing remains a significant issue among family medicine residents, particularly concerning job commitment and career-related obstacles. These findings highlight the need for increased awareness and the implementation of preventive strategies to mitigate mobbing in healthcare environments, especially within large and hierarchical institutions.

Transient Tachypnea of the Newborn (TTN) is a common cause of respiratory distress in term infants, associated with delayed pulmonary fluid clearance resulting from dysfunction of the epithelial sodium channel. Although generally self-limiting, TTN may increase early childhood wheezing and asthma risk. This study aimed to assess the incidence and characteristics of acute bronchiolitis in TTN infants compared to those in healthy controls within a large birth cohort. We conducted a population-based cohort study that included all live births in Istanbul from January 2016 to December 2018, utilizing the Turkish Ministry of Health's e-Nabız database. Infants diagnosed with isolated TTN (International Classification of Diseases [ICD]-10 P22.1) formed the study group. A randomly selected control group of healthy infants without respiratory diagnoses was included in the study. Both groups were followed for two years to identify episodes of acute bronchiolitis (ICD-10 J21*), excluding cases within the first month of life. The data collected included bronchiolitis incidence, recurrence, age at the time of the episode, and hospitalizations. Among 1,002,261 live births, 14,389 TTN infants and 14,500 controls were analyzed. Acute bronchiolitis occurred in 42.4% of TTN infants and 35.8% of controls (p<0.001). TTN infants had higher rates of single episodes, while controls experienced more recurrent episodes (p<0.001). Hospitalization was more frequent in the control group (p<0.001), with single hospitalizations predominating in the TTN group and multiple hospitalizations in the control group. The first episodes in TTN infants mainly occurred between 1-6 months, with controls showing more episodes early but fewer later (p<0.001). Recurrence was correlated with an earlier age of the first episode in both groups (p<0.001). TTN infants experience more bronchiolitis episodes early in life, though recurrent episodes are more common among healthy controls. Further studies are warranted to investigate the relationship between TTN and the development of wheezing and asthma.

This study aimed to assess awareness of Porphyria Disease among primary care physicians and investigate its diagnosis and management. This study is a cross-sectional online survey conducted with the participation of 390 primary care physicians in Turkey. Participants were recruited through online platforms, including WhatsApp and email groups. Participants who provided consent were administered an online electronic survey created using Google Forms. Data were analyzed using IBM SPSS Statistics version 21.0. Ethical approval was granted by the Clinical Research Ethics Committee. With an average of 14.13±9.56 years of medical experience, participants included 47.4% family medicine specialists, 38.5% family physicians, and 14.4% emergency medicine specialists. Only 10.5% of the total physicians reported evaluating patients with suspected Porphyria. Severe abdominal pain was the predominant symptom, cited by 78% of participants, while just 5.4% had previously been diagnosed with Porphyria. Notably, family medicine specialists exhibited a significantly higher inclination for both preliminary (p<0.001) and confirmed (p=0.041) porphyria diagnosis. 81.0% of physicians considered Familial Mediterranean Fever as part of their differential diagnosis when assessing patients with porphyria symptoms. In conclusion, our study highlights an increased awareness of Porphyria among primary care physicians, likely owing to advancements in diagnostic methods. However, the need to raise awareness remains, given its crucial role in diagnosis. Therefore, it is essential to involve primary care physicians, particularly family medicine specialists and emergency medicine specialists, in porphyria education and awareness initiatives. These efforts can ensure accurate diagnoses and better care for patients affected by this rare disease. Bu çalışma, birinci basamak hekimleri arasında Porfiri Hastalığı farkındalığını, tanı ve tedavideki yaklaşımları araştırmayı amaçlamıştır.Bu çalışma, Türkiye'deki 390 birinci basamakta görev yapan hekimin katılımıyla gerçekleştirilen kesitsel bir çevrimiçi anket çalışmasıdır. WhatsApp ve e-posta grupları gibi çevrimiçi platformlar aracılığıyla Google Forms kullanılarak hazırlanan çevrimiçi elektronik anket ile katılımcılardan alınan onay sonrasında veriler toplanmıştır. Toplanan veriler, IBM SPSS Statistics sürüm 21.0 ile analiz edilmiştir. Bu çalışmaya Klinik Araştırma Etik Komitesi tarafından etik onay sağlanmıştır. Ortalama 14,13±9,56 yıllık tıbbi deneyime sahip katılımcıların %47,4'ü aile hekimliği uzmanı, %38,5'i aile hekimi ve %14,4'ü acil tıp uzmanıydı.Toplam hekimlerin yalnızca %10,5'i ayırıcı tanıda porfiri hastalığını değerlendirdiğini bildirdi. birinci basamak hekimlerin %78'i tarafından şiddetli karın ağrısı en sık görülen semptom olarak belirtilirken daha önce porfiri tanısı koyduğunu hekimlerin %5,4'ü belirtmiştir.Özellikle Aile Hekimliğ uzmanlarının, aile hekimleri ve acil tıp uzmanlarına göre daha fazla porfiria öntanısı düşündüğü (p<0.001) ve porfiria tanısı koyduğu görüldü (p=0.041). Porfiri semptomları olan hastaları değerlendirirken hekimlerin %81,0'ı ise Ailesel Akdeniz Ateşini ayırıcı tanılarının bir parçası olarak değerlendirdi. Sonuç olarak çalışmamız, tanı yöntemlerindeki gelişmelere bağlı olarak birinci basamak hekimleri arasında porfiri konusunda farkındalığın geçmiş yıllara göre artığı ancak porfiri hastalık farkındalığının tanıdaki hayati rolü göz önüne alındığında, çalışmamızda ortaya çıkan düşük oranın arttırılmasına duyulan ihtiyacın devam etiğini düşündürtmektedir. Bu bağlamda, birinci basamak hekimlerinin, özellikle aile hekimleri, aile hekimliği uzmanları ve acil tıp uzmanlarının porfiriya hastalığına yönelik eğitim ve farkındalık programlarına dahil edilmelerinin önemli olduğu düşünülmektedir.

This study aimed to investigate the effect of beta-blocker therapy on blood pressure in patients with subclinical hyperthyroidism and to elucidate the potential benefits of this treatment approach. This retrospective observational cohort study included 56 hypertensive patients with subclinical hyperthyroidism who received beta-blocker therapy. Patient data, including demographic characteristics, thyroid function tests, and blood pressure measurements, were collected from medical records and evaluated using statistical analysis with SPSS Statistics software. The cohort of hypertensive patients included 35 patients with uncontrolled blood pressure and 21 newly diagnosed patients, with a total average age of 55 and 73.2% of them being female. In newly diagnosed and uncontrolled hypertensive patients, TSH levels were below the average, and T3 levels were high (p<0.001). Significant reductions in systolic and diastolic blood pressure were observed in both groups after beta-blocker therapy (p<0.001). The most significant decrease in blood pressure in beta-blocker therapy occurred in newly diagnosed hypertensive patients, with an average decrease of 37.85 mmHg. Additionally, a significant reduction in the number of antihypertensive medications was observed in patients receiving beta-blocker therapy (p<0.001). In conclusion, our study demonstrates the positive effects of beta-blocker therapy on blood pressure control in patients with subclinical hyperthyroidism. Particularly, the significant decrease in blood pressure in newly diagnosed hypertensive patients indicates the potential of beta-blockers as a preferred treatment option. This study highlights the necessity of a causal approach in treating hypertension with thyroid disorders. However, considering the limitations of the study design, further comprehensive research is needed to confirm these findings. Bu çalışma, subklinik hipertiroidizmi olan hastalarda beta-bloker tedavisinin kan basıncı üzerindeki etkisini araştırmayı ve bu tedavi yaklaşımının potansiyel faydalarını ortaya koymayı amaçlamıştır. Bu retrospektif gözlemsel kohort çalışmaya subklinik hipertiroidizmi olan ve beta-bloker tedavisi alan 56 hipertansif hasta dahil edildi. Hastaların demografik özellikleri, tiroid fonksiyon testleri ve kan basıncı ölçümlerini içeren hasta verileri, tıbbi hasta kayıtlarından toplanarak SPSS Statistics yazılımı kullanılarak istatistiksel analizle değerlendirildi. Çalışmaya dahil edilen kan basıncı kontrol altında olmayan 35 ve yeni teşhis konmuş 21, toplam 56 hipertansif hastanın kohortunda ortalama yaş 55 ve %73,2 si kadınlar hastalardan oluşmaktaydı. Yeni teşhis edilen ve kan basıncı kontrol altında olmayan hipertansif hastalarda, TSH düzeylerinin ortalamanın altında olduğu ve T3 düzeylerinin ise yüksek olduğu görüldü (p<0,001). Her iki grupta da beta-bloker tedavisi sonrasında sistolik ve diyastolik kan basıncında anlamlı düşüşler gözlenmiştir (p<0,001). Beta-bloker tedavisinde en büyük kan basıncı düşüşü, yeni teşhis edilen hipertansiyonlu hastalarda ortalama 37,85 mmHg azalma olarak ortaya çıkmıştır. Ek olarak, beta bloker tedavisi alan hastalarda antihipertansif ilaç kullanımı sayısında anlamlı azalma görülmüştür (p<0,001). Sonuç olarak çalışmamızda, beta-bloker tedavisinin subklinik hipertiroidizmli hastalarda kan basıncı kontrolüne olumlu etkileri olduğunu gösterilmektedir. Özellikle yeni tanılı hipertansiyonlu hastalarda belirgin kan basıncı azalması, beta-blokerlerin tercih edilen bir tedavi seçeneği olarak potansiyelini göstermektedir. Bu çalışma, tiroid bozuklukları ile ilişkili hipertansiyon tedavisinde nedene yönelik bir yaklaşımın gerekliliğini vurgulamaktadır. Bununla birlikte, çalışmanın tasarım kısıtlamaları göz önüne alındığında, bu bulguların doğrulanması için daha kapsamlı araştırmalara ihtiyaç duyulmaktadır.

ÖZET Amaç: Toplumda tanı konmamış Metabolik Sendrom vakalarının tespiti, giderek salgın hale gelen obezite ve tip 2 diyabetle mücadelede önemli bir adım olacaktır. Bu nedenle çalışmamızda bir büyükşehir aile sağlığı merkezine kayıtlı bireylerde obezite ve metabolik sendrom sıklığını ve ilgili faktörleri araştırmayı amaçladık. Materyal ve Metotlar: Bu kesitsel araştırma, bir Aile Sağlığı Merkezine kayıtlı 18 yaş ve üzeri bireyler arasında yapılmıştır. Değerlendirmeler Türk Endokrinoloji ve Metabolizma Derneği tarafından Metabolik Sendrom Tanı Kriterlerine göre yapılarak boy, kilo, bel çevresi ve arteriyel kan basıncı değerleri, vücut kitle indeksii açlık kan şekeri, trigliserit ve HDL düzeyleri kaydedildi. Bulgular: Kadın ve erkeklerde Metabolik Sendrom sıklığı sırasıyla %32.97 (n:31) ve %32.43 (n:24) idi. Metabolik sendrom sıklığı cinsiyetler arasında farklılık göstermezken eğitim düzeyi düşük olanlarda ve çalışmayanlarda Metabolik sendrom sıklığı daha sık görüldü. Sonuç: Çalışmamız Metabolik Sendrom ile toplumdaki eğitim düzeyi arasında ters bir ilişki saptamıştır. Ayrıca, Metabolik Sendrom’lu bireyler genellikle fazla kilolarının farkındadır ve çare arayışındadırlar. Bu bulgular metabolik sendromun yükünü azaltmak için bireylerin her zaman kolayca erişim sağlayabilecekleri birinci basamak sağlık merkezlerinde erken teşhis ve eğitim programlarının uygulanmasını desteklemektedir.

Introduction: In recent years, there has been a surge in research focusing on the link between smoking and insulin resistance in the context of obesity and diabetes. In this study, our objective was to investigate the relationship between smoking and insulin resistance. Materials and Methods: This is a case-control study. The case and control groups were formed using the hospital patient information database and clinically randomized using data obtained, including age, gender, height, and weight. The case group for this study consisted of smokers, whereas the control group consisted of non-smokers. Chi-square tests were used to compare numbers and rates, and independent sample t-tests were used for the averages. Binary logistic regression analysis was performed between the case and control groups. Results: According to logistic regression analysis, the odds ratio for non-smokers was 0.59 (0.31-1.14). The risk of insulin resistance is decreased by 41% non-significantly in non-smokers. The odds ratio for age was 1.03 (1.01-1.05). When the age variable increases by one unit, the risk of insulin resistance increase by 1.03 times. Conclusion: Our study found no significant relationship between smoking and insulin resistance in healthy individuals. The relationship between smoking and insulin resistance, as reported in the scientific literature, may be suggestive of an association in which smoking exacerbates insulin resistance as a result of other contributing factors rather than serving as a direct causal factor. Further studies are warranted to elucidate the potential mechanisms underlying this association fully.

Background/Aim: Although hemodialysis provides prolonged survival, patients face major challenges, including conflicts about life decisions, limited physical, mental, and lifestyle activities, psychological distress, high prevalence of anxiety and depression symptoms, and compromised health-related quality of life. This study aimed to compare anxiety-depression levels and coping strategies between renal transplant waitlisted and non-waitlisted hemodialysis patients. Methods: A total of 75 hemodialysis patients were enrolled in this case-control analytical study, including renal transplant waitlisted (n = 35) and non-waitlisted (n = 40) patients. Patients were asked to fill out a questionnaire including socio-demographic characteristics, duration of hemodialysis, the Hospital Anxiety and Depression Scale, and the Ways of Coping Questionnaire. Comparative analyses were performed via Student's t-test and Pearson Correlation test. Results: The mean age was 57.1 (15.3) years; 56% were males, and being under hemodialysis treatment was 7.3 (5.9) years. Waitlisted and non-waitlisted patients were matched. Overall, 28 patients (37.3%) had anxiety, and 34 patients (45.3%) had depression. There was no significant difference between the two groups regarding depression scores. Anxiety was more common among non-waitlisted than waitlisted patients (P = 0.043). The fatalistic approach was the most common coping strategy applied, and there was a significant negative correlation between anxiety scores and the problem-solving approach (P = 0.034) and a significant positive correlation between depression scores and the helplessness approach (r = 0.234, P = 0.043). Conclusion: Both waitlisted and non-waitlisted hemodialysis patients have significantly higher levels of depression, with anxiety being higher in non-waitlisted patients. Since coping strategies differed concerning anxiety and depression but not transplant candidacy, psychiatric evaluation and counseling would be essential in hemodialysis patients to control the stressors.

Yılmaz Sezgin, Aşkın Keskin Kaplan. J Pharmacopuncture 2021;24:54-8. https://doi.org/10.3831/KPI.2021.24.2.54

Antecedentes / objetivo : La muerte celular autofágica y la apoptosis de células tumorales se ha convertido en uno de los principales objetivos en el tratamiento del cáncer, mientras que las líneas celulares tumorales se utilizan principalmente en estudios para proporcionar datos importantes para la evaluación de posibles sustancias anticancerígenas. En este estudio, nuestro objetivo fue evaluar los cambios morfológicos y bioquímicos, incluida la tasa de apoptosis y los niveles de alfa fetoproteína (AFP) a diferentes concentraciones de ácido carnósico (CA) en células de carcinoma hepatocelular humano HepG2. Materiales y métodos : Carcinoma hepatocelular humano (células HepG2 de séptimo pase) .Las líneas celulares se cultivaron en cubreobjetos de vidrio Schott D263M de 11 µM colocados en placas de 12 pocillos y se trataron con DMSO, concentraciones de CA 1, 2,5, 5 y 10 µM durante 24 horas. 48 y 72 horas. Los datos morfológicos y bioquímicos se registraron diariamente, incluidas las tasas de apoptosis demostradas por Caspasa 3, las expresiones de Anexina V bajo luz invertida y microscopía de inmunofluorescencia, luego se analizaron los datos para determinar la significación estadística. Los niveles de AFP, albúmina y proteínas totales se analizaron espectrofotométricamente para evaluación bioquímica. Resultados : Nuestros resultados mostraron que CA inhibió significativamente la proliferación de células HepG2 de una manera dependiente de la dosis y el tiempo y causó significativamente la formación de vacuolas autofágicas comenzando desde 5 µM y alcanzando significancia a concentraciones de 10 µM. Se observó una disminución significativa en la AFP cuando se examinaron las expresiones de 48 y 72 horas, alcanzando el nivel más bajo a las 72 horas en el grupo de CA 10 µM. Además, el aumento en los niveles de albúmina alcanzó significación solo en el grupo de 48 h, mientras que también se observaron aumentos no significativos en los grupos de 24 hy 72 h. Conclusión: Nuestro estudio actual demuestra un aumento significativo en las tasas de apoptosis por el ácido carnósico principalmente a concentraciones de 10 µM, lo que respalda su efecto anticancerígeno en las células HepG2. Estos hallazgos también están respaldados por cambios en los análisis bioquímicos de los niveles de albúmina y AFP a concentraciones de 10 µM.

Introduction While discussions on the effectiveness of COVID‐19 vaccines continue, healthcare professionals' attitudes and their growing fear and anxiety during the pandemic process are not yet fully known. In this study, we aimed to investigate the COVID‐19 vaccine acceptance and affecting factors in healthcare professionals. Methods This was a cross‐sectional online survey conducted in 1574 healthcare professionals consisting of physicians, nurses, dentists, pharmacists, and healthcare personnel in Turkey in December 2020. Demographic, attitudinal, and Fear of COVID‐19 Scale scores of healthcare professionals were investigated in this survey. Results About 84.6% of healthcare professionals declared willingness to accept the COVID‐19 vaccine whenever possible. Most physicians (90.4%) stated to receive the COVID‐19 vaccine, while 66.5% of nurses, 73.9% of healthcare personnel, also preferred to have it as soon as the vaccine was available. Factors affecting the willingness to accept the COVID‐19 vaccine were found to be advanced age, male gender, working in a primary health care center, living with family, having a child, having a chronic disease, having high Fear of COVID‐19 Scale (FC‐19S) scores. While the group with the highest vaccine rejection rate was nurses with 33.5%, FC‐19S scores were significantly higher in nurses who wanted to be vaccinated. In multivariate regression analyses, factors related to the acceptance of the COVID‐19 vaccine were identified as advanced age, routine adult vaccination, no history of COVID‐19, and recommendation of the COVID‐19 vaccine. Conclusion A high proportion of healthcare professionals declared their willingness to accept the COVID‐19 vaccine, and hence, this will play a leading role in optimizing the vaccination rate of the entire population while combating the pandemic.