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Publication Metadata only A serious consequence of skin puncture by a metal nail: Lumbar epidural abscess: Case report and a brief review of literature(2003) Özgen S., Berilgen M., Konya D., Necmettin Pamir M.Epidural abscesses rarely occur in healthy persons who have no predisposing conditions. This report describes a case of lumbar epidural abscess that developed in a young healthy man after the skin of his hand was pierced by a nail.Publication Metadata only Publication Metadata only Are telemedicine/telehealth services ethical? [Internet üzerinden yapilan saǧlik hizmetlerinin etik açidan incelenmesi](2002) Kökdemir P., Görkey Ş.The devolopment rate of technolgy has affects on our daily lifes. The things we couldn't even imagine doing 10 years ago are easily done today. Especially the development rate of communication technologies has brought newer projects in the health field. One of these projects is telemedicine/telehealth services. The internet has permitted physicians, other health care professionals, patients, and other consumers to quickly access medical information in unprecedented volume. In 1994 the number of consultations done by interactive video conference system in the United States were 2500 whereas in 1995 this number increased to 7000 and a year later this number became 20.000 and in 1997 it reached 40.000. Tele-homecare systems have a capacity to enhance the delivery of home health care and thereby increase the quality of care. Some examples of how this can be accomplished are, reducing number of visits to the emergency rooms, reducing unnecessary visits to physician's offices, avoiding unnecessary costly visits by health providers, providing education of the patient in early symptom management, and monitoring vital signs on a 24-hours basis, therefore providing a potential for early intervention and/or prevention of repeat hospitalization. However there are some disadvantages such as the privacy of the personel health information. The information on the virtual world has some risks of being stolen easily. And also there might be misunderstandings through internet between the patient and his or her physician. Moreover, when a patient is getting his or her prescription, he or she might need to hear moral boosting words from the physician. World Medical Association has two statements on the topic telemedicine, one in Marbella in 1992 and one in Tel Aviv in 1999. In these statements, it tells about the accountability and responsibilities of the physicians, role of the patient, quality of care and safety in telemedicine, and recommendations about using the telemedicine system. Although telemedicine system has great offerings in the health field, it brings some problems with it. Countries who will use the telemedicine system must have laws and technological foundations. Also they must have experienced medical staff.Publication Metadata only Autonomic nervous system: Anatomy and physiology [OTONOM SINIR SISTEMI: ANATOMI VE FIZYOLOJISI](1995) Akyuz G., Canbulat N., Gozke E., Dogan N., Kayhan O., Us O.Autonomic nervous system is composed of various numbers of ganglions, plexuses and a series of cerebrospinal nuclei and nerves which are responsible of vegetative functions of the body. To understand the clinical syndromes associated with autonomic nervous system and to evaluate them the anatomy and physiology of the ANS should be well understood. Therefore it's important to know the recent advances about the central autonomic network besides the sympathetic and parasympathetic systems.Publication Metadata only Clinical usage of cardiac troponins [Kardiyak troponinler ve klinik kullanimi](2001) Akalin F.Cardiac troponins are structural proteins found in the myocardial cells and take role in activation of actin-myosin complex. Troponins have 3 subunits as tropomyosine bining subunit (Troponin T), Calcium binding subunit (Troponin C) and inhibitor subunit (Troponin I). Measurement of serum levels of cardiac troponin T and I gives sensitive and specific information about myocardial cell injury. They are proved to be superior to previously used markers such as creatine kinase (CK) and MB fraction (CK-MB) measurements in identifying high risk patients with acute chest pain, myocardial infarction and myocardial ischemia. They are not affected by skeletal muscle injuries since myocardial and skeletal muscle has different troponin molecules. Troponin measurements gives idea about extend and severity of the myocardial necrosis as well as prognosis of the patient. In pediatric age group; patients with coronary anomalies, postoperative patients after arterial switch operations, cardiac transplantation, coronary lesions due to Kawasaki disease, myocardial injury due to neonatal asphyxia, trauma are potential fields of troponin T measurements. Cardiac troponins reaches their peak level 12-24 hours after myocardial injury. Troponin T is found in the serum of the patients for 14 days while Troponin I levels are found to be elevated for 5-7 days. Routine measurement of troponin levels in patients under myocardial infarction risk will provide early diagnosis and treatment of cardiac disease and decrease unnecessary hospitalization and interventions.Publication Metadata only Comparison of pharmacodynamic and pharmacokinetic properties of H2 receptor blockers: Cimetidine, ranitidine and famotidine(1991) Dedeoglu A., Onat F., Berkman K.In this article, pharmacokinetic as well as pharmacodynamic properties and side effects of cimetidine, ranitidine and famotidine, three different H2 receptor blockers, have been reviewed.Publication Metadata only Crush syndrome [Crush sendromu](2002) Kantarci G.Crush syndrome is the systemic manifestation of muscle injury caused by prolonged limb compression sustained in crush injury. It is characterized by hypovolemic shock, hyperkalemia, acute renal failure and muscule necrosis. Crush syndrome is typically encountered in wars, in earthquakes, in industrial and traffic accident. It was first descripted by Bywaters and Beal in bombing raids of London Blitz during World War II. The muscules contain the largest pool of body water, potassium and other solutes. Therefore muscule injuries may unleash extreme disturbances in plasma electrolyte concentration and body fluid compartments. Victims with massive muscule crushing, as is classically observed after earthquakes, suffer from profound hypovolemic shock. Therefore, the mainstay of management of these casualties is early massive volume replacement started preferably in the field. Mannitol and forse diuresis with the alkanization of urine are the preferred treatment for the prevention of acute renal failure (ARF). Established ARF fully recovers even after prolonged dialysis treatment.Publication Open Access Daily life of a Turkish medical oncologist(2012-05) Turhal N.S.There are many changes occurring in the Turkish health care system, including but not limited to consolidation of public hospitals and administrative takeover of some university hospitals by the Ministry of Health. Because of its unique situation, Marmara University Hospital is at the center of these changes. The adaptation process will continue for another year or so, after which it is hoped that a better health care environment will have been created for patients with cancer in Turkey. Copyright © 2012 by American Society of Clinical Oncology.Publication Metadata only Detection and sizing of telomeric repeat DNA in situ(1999) Serakinci N., Koch J.[No abstract available]Publication Metadata only Publication Metadata only Publication Metadata only Erythropoietin usage and resistance at patients with and stage renal disease [Son dönem böbrek yetersizliǧi olan hastalarda eritropoetin kullanimi ve direnci](2001) Kantarci G.Improved practices for delivering renal healthcare services have resulted in the increased and prolonged survival of dialysis patients. Anaemia affects more than 90% of patients with ESRD. Recent studies showed that anaemia represents a significant risk factor for increased morbidity and mortality. The introduction of erythropoietin into clinical practice over a decade ago has transformed the way in which renal anaemia is managed. Resistance to erythropoietin is either failure to attain the target Hb concentration while receiving more than 300IU/kg/week of erythropoietin subcutaneously, or a continued need for such dosage to maintain the target. The most cause of resistance to erythropoietin is absolute or functional iron deficiency. In the iron-repleted patient who has an inadequate response to EPO, one should first consider whether the dose is adequate and whether the injections are actually being given and, if so whether they are being sited properly under the skin. Then the following conditions should be evaluated and treated: * Chronic blood loss * Infection/inflamation * Hyperparathyroidism/osteitis fibrosa * Aluminium toxicity * Haemoglobinopathies * Folate or vitamin B12 deficiency * Multiple myeloma * Malignancies * Haemolysis * ACE inhibitors or AT1 reseptor antagonist therapy * Inadequate dialysis.Publication Metadata only Faults and reals releated to pain [Aǧriya i̇lişkin Yanilgilar ve Gerçekler](2002) Aslan F.E.Although nurses and other health care professionals are paying more attention to pain control than over before, too many patients still suffer needlessly. The one reason is that health care professionals don't know enough about relieving it and don't team work; another is that many patients underreport pain. In this article is discussed faults and reals related to unrelieving pain.Publication Metadata only Publication Metadata only Publication Metadata only Hepatitis G virus; Structure, epidemiology and clinical significance(1998) Avsar E., Tozun N.Hepatitis G virus is a new member of hepatotropic virus belonging to the family of Flaviviridae. Its genome consists of 2900 amino acids. This new virus which has been identified two years ago is a positive stranded RNA virus and causes both acute and chronic hepatic disease. The structure, epidemiology and clinical importance of hepatitis G virus will be discussed in this article.Publication Metadata only Is Alzheimer's disease genetically transmissable? New insights to the biogenesis of the disease(1998) Tekin S., Aktan S.Alzheimer's disease (AD) is the most common cause of dementia in the elderly. The disease affects 1% to 6% of people over 65 years of age and 10% to 20% of those over the age of 80. AD is a slowly progressive dementia, in which memory failure, in the presence of normal alertness is the first and most notable complaint. As the disease advances, problems with language, calculation, visuospatial functions and praxis become apparent. Behavioural alterations such as depression, agitation, delusions and hallucinations become evident at any time during the course of the illness. The frequency of seizures, usually of generalised onset is about 10% and very rarely seizures may be an initial feature. The neurologic examination in AD is usually normal. Common findings are primitive reflexes and impaired graphestesia. Less common features include, extrapyramidal signs, gait disturbances and myoclonus. A definite diagnosis of AD requires pathologic confirmation on autopsy, but with suitable laboratory and diagnostic studies, 80-90% accuracy of clinical diagnosis can be achieved.Publication Metadata only Publication Metadata only Management of animal bites and rabies prophylaxis [Hayvan isiriklarina yaklaşim ve kuduz profilaksisi](2002) Sönmezoǧlu M.Animal bites have been characterized as an "unrecognized epidemic" because of their frequency, preventability, and potential severity. Bite wounds are common and often mistakenly considered innocuous by both patients and physicians. Most data on the incidence of infection, bacteriology, and various medical and surgical methods of treatment come from small studies. Bite wounds consist of lacerations, evulsions, punctures, and scratches. Although 80% of patients never seek and do not need medical care, awareness of the magnitude of the infectious complication from bites in growing.Publication Metadata only Microsomal metabolism of N-benzyl-N-ethylaniline and N-benzyl-N-ethyl-p-toluidine(Walter de Gruyter GmbH, 1997) Ulgen M., Ozer U., Kucukguzel I., Gorrod J.W.The in vitro hepatic microsomal metabolism of two tertiary anilines, N-benzyl-N-ethylaniline (NBNEA) and N-benzyl-N-ethyl-toluidine (NBNEPT), was examined in order to determine whether these compounds produce amide derivatives (benzoyl or acetyl) in addition to N-dealkylation and N-oxidation products as metabolites. The preparation of these tertiary anilines and their corresponding potential metabolites was undertaken. The amines and metabolites were separated using TLC and HPLC. Incubations were performed using hamster microsomal preparations fortified with NADPH. The substrates and their potential metabolites were extracted into dichloromethane and examined by TLC and HPLC. The metabolic process of particular interest was the formation of amides from NBNEA and NBNEPT. The results from these experiments indicated that neither tertiary aniline (NBNEA and NBNEPT) produced amide (acetyl or benzoyl) or N-oxide metabolites. These substrates were dealkylated to the corresponding secondary amines via debenzylation and de-ethylation. Uncharacterised metabolites observed with substrates are proposed to be phenolic (for NBNEA) and hydroxymethyl (for NBNEPT). These findings support the concept that: nitrones are essential intermediates for the formation of amides from secondary aromatic amines (chemical rearrangement to amide via an oxaziridine intermediate); carbinolamines produced by NBNEA and NBNEPT are not stable enough to allow further oxidation to amides and therefore these intermediates are broken down to dealkylated products. The results are discussed in relation to the mechanism of metabolic amide formation from amines.