Introduction: Restricted or enhanced intrauterine growth is associated with elevated risks of early and late metabolic problems in humans. Metabolomics based on amino acid and carnitine/acylcarnitine profile may have a role in fetal and early postnatal energy metabolism. In this study, the relationship between intrauterine growth status and early metabolomics profile was evaluated.Materials and Methods: A single-center retrospective cohort study was conducted. Three hundred and sixty-one newborn infants were enrolled into the study, and they were grouped according to their birth weight percentile as small for gestational age (SGA, n = 69), appropriate for gestational age (AGA, n = 168), and large for gestational age (LGA, n = 124) infants. In all infants, amino acid and carnitine/acylcarnitine profiles with liquid chromatography-tandem mass spectrometry (LC-MS/MS) were recorded and compared between groups.Results: LGA infants had higher levels of glutamic acid and lower levels of ornithine, alanine, and glycine (p < 0.05) when compared with AGA infants. SGA infants had higher levels of alanine and glycine levels when compared with AGA and LGA infants. Total carnitine, C0, C2, C4, C5, C10:1, C18:1, C18:2, C14-OH, and C18:2-OH levels were significantly higher and C3 and C6-DC levels were lower in SGA infants (p < 0.05). LGA infants had higher C3 and C5:1 levels and lower C18:2 and C16:1-OH levels (p < 0.05). There were positive correlations between free carnitine and phenylalanine, arginine, methionine, alanine, and glycine levels (p < 0.05). Also, a positive correlation between ponderal index and C3, C5-DC, C14, and C14:1 and a negative correlation between ponderal index and ornithine, alanine, glycine, C16:1-OH, and C18:2 were shown.Conclusion: We demonstrated differences in metabolomics possibly reflecting the energy metabolism in newborn infants with intrauterine growth problems in the early postnatal period. These differences might be the footprints of metabolic disturbances in future adulthood.

Sigara içme durumuna göre PMS yaygınlığı karşılaştırıldığında gruplar arasında anlamlı bir fark olduğu bulunmuştur (p<0.05). Yaşamında hiç sigara denemeyenlerde PMS yaygınlığı en düşük düzeyde (%28,7) iken sigara içenlerde bu oran %52,9'dur. Öğrencilerin PMSÖ puan ortalaması 98,15 (SD=35,83) olup, sigara içme durumuna göre PMSÖ toplam ve alt boyut puan ortalamaları arasındaki fark incelendiğinde hiç sigara denemeyenlerin puan ortalamasının, sigarayı bırakanlar ve halen içenlerden anlamlı düzeyde düşük olduğu bulunmuştur (p<0.05). Halen sigara içenlerin FNTT puanları ile PMSÖ puanları arasındaki ilişkinin anlamsız olduğu saptanmıştır (p>0.05). Sonuç: Çalışmada sigarayı denemiş olmanın PMS yaygınlığını etkilediği belirlendiğinden, sigaranın hiç denenmemesine yönelik eğitim ve danışmanlık programlarının yapılması, konuya yönelik basılı görsel araçların geliştirilmesi önerilir.

Aim: Although many pregnancies and birth processes have passed without any problems, all pregnancies have various risks. The main purpose should be to control risky situations in pregnancy without threatening the health of mother and baby. Our study was carried out in order to investigate the complications related to the risks determined by the risk assessments of women who were followed during pregnancy and puerperants in a family health centre. Methods: Women who were registered in the family medicine unit and whose pregnancy and puerperium were followed were scanned through the automation system during the study period. During the pregnancy periods, risk factors and time of birth were examined. Patients with any risk factor were considered as risky pregnant and examined whether a pathological condition developed during pregnancy or during the postpartum period. Results: It was determined that during pregnancy period 10 pregnant women had at least one risk factor of 81 pregnant women whose risk assessments were examined. The distribution of risk factors was as follow; 3 with grand-multiparity story, 3 with preterm delivery, 2 with pregnancy over 35, 2 with Rh incompatibility, 1 with cardiovascular disease, 1 with multiple pregnancy, 1 with preterm labor, and under 18 years of age in 1 pregnant women was determined. It was found statistically significant that the risk of having a risk factor was higher than that of non-risk patients at 38 weeks (p<0.01). Among the risk factors, when the patients with preterm delivery and preterm delivery were excluded, it was also found that the preterm delivery risk increased significantly (p=0.012). Conclusions: In pregnancies with risk factors, complications may occur much more than normal pregnancies. Therefore, it is very important for women to communicate with family physicians while planning pregnancy; if their risks are identified and appropriate approach protocols are used to ensure that both the mother and baby survive and maintain a healthy life.

Aim: Urinary tract infection is one of the most common serious bacterial infections in children. Due to regional differences and past infections, the use of antibiotics has problems such as variability in microorganisms and antibiotic susceptibility. In this study, we aimed to determine the microorganisms detected in urinary tract infections in children and their antibiotic resistance status. Methods: A retrospective observational study was planned. Demographic data, urine microscopy and urine culture results of patients who were hospitalized with urinary tract infection diagnosis in our pediatric clinic at hospital were recorded retrospectively through hospital automation system. The first culture results of the patients were used in the evaluation of the data. Results: In the study group of 112 patients, Escherichia coli (E. coli) and Klebsiella were the most identified microorganisms in patients with urinary culture. Under 2 years old, Klebsiella was more frequent, and at 2 years of age there was a noticeable increase in the frequency of E. coli. The most common resistance of both microorganisms was found to be ampicillin. Conclusion: Regional infectious agents and antibiotic resistance should be revised at regular intervals, appropriate empiric therapy should be considered. Thus, is predicted that the chance of success in treatment will increase and the speed of resistance development will decrease. ÖzAmaç:İdrar yolu enfeksiyonu çocuklarda sık görülen ciddi bakteriyel enfeksiyonların başında gelir. Bölgesel farklılıklar ve geçirilmiş enfeksiyonlar nedeniyle antibiyotik kullanımı beraberinde mikroorganizmalarda ve antibiyotik duyarlılığında değişkenlikler gibi sorunlar taşımaktadır. Bu çalışmada çocuklarda idrar yolu enfeksiyonlarında saptanan mikroorganizmaların ve bunların antibiyotik direnç durumlarının belirlenmesi amaçlanmıştır. Gereç ve yöntem:Retrospektif gözlemsel bir çalışma planlandı. Hastanemiz çocuk kliniğinde 2013 yılında idrar yolu enfeksiyonu tanısı ile yatarak tedavi gören hastaların demografik verileri, idrar mikroskopileri ve idrar kültür sonuçları, retrospektif olarak hastane otomasyon sistemi üzerinden taranarak kayıt altına alındı. Verilerin değerlendirilmesinde hastaların ilk kültür sonuçları kullanıldı. Bulgular:112 hastadan oluşan çalışma grubunda, idrar kültüründe üreme olan hastalarda en sık tespit edilen mikroorganizmalar Escherichia coli (E. coli) ve Klebsiella oldu. 2 yaş altında Klebsiella daha sık görülürken 2 yaş üstünde belirgin oranda E-coli sıklığı göze çarpmaktaydı. Her iki mikroorganizmanın da en sık direnç geliştirdiği antibiyotiğin ise ampisilin olduğu tespit edildi. Sonuç:Bölgesel enfeksiyon etkenleri ve antibiyotik dirençleri belli aralıklarla gözden geçirilmeli, uygun ampirik tedaviler değerlendirilmelidir. Böylece tedavide başarı şansının artacağı ve direnç gelişim hızının azalacağı ön görülmektedir. Anahtar kelimeler: Antibiyotik Direnci, İdrar Kültürü, İdrar Yolu Enfeksiyonu J Surg Med 2017;1(1):9-11. Urinary track infections in children P a g e / S a y f a | 10

Toplumda anne sütü ve emzirme ile ilgili var olan yaygın inanışlar özellikle yaşamın ilk altı ayında tam emzirmenin önündeki engellerden biridir. Bu çalışma doğum yapan kadınların anne sütü ve emzirme ile ilgili mitlere inanma durumlarını belirlemek amacıyla tanımlayıcı olarak yapılmıştır. Yöntem: Çalışmanın örneklemini bir üniversite hastanesinde doğum yapan 282 kadın oluşturmuştur. Veriler araştırmacılar tarafından geliştirilen "Bireysel Özellikler Formu" ve "Anne Sütü ve Emzirme Mitleri Formu" ile toplanmıştır. Anne Sütü ve Emzirme Mitleri Formu toplumda anne sütü ve emzirme ile ilgili sık karşılaşılan yanlış inanışları ifade eden maddelerden oluşmakta ve her bir madde "katılıyorum", "kararsızım", "katılmıyorum" olmak üzere üçlü likert tipinde yanıtlanmaktadır. Formlar doğum yapan kadınlar taburcu olmadan önce uygulanmıştır. Veriler bilgisayarda SPSS (14.0) programında değerlendirilmiş, istatistiksel analizde ki-kare testi kullanılmıştır. Bulgular: Araştırma kapsamında yer alan kadınların yaş ortalaması 29,48±6,11 olup, %26,2'si ortaokul mezunudur, %82,3'ü çalışmamakta ve %53,5'i il merkezinde yaşamaktadır. Kadınların %62,1'inin daha önce emzirme deneyimi vardır. Kadınların %67'si bu gebeliklerinde sağlık personelinden anne sütü ve emzirme ile ilgili bilgi almışlardır. Kadınların en fazla inandıkları mitler "Yetersiz besin ve sıvı alımı süt miktarını azaltır" (%92,9), Bebek sürekli ağlıyorsa anne sütü yetmiyordur" (%65,6), "Emzirmenin iki yıldan uzun süre devam etmesi çocukta anneye bağımlılık geliştirir" (%64,2) "Bazı annelerin sütleri bebeklerine yaramaz" (%64,9), "Bebek sık emmek istiyorsa bu anne sütünün yetersiz olduğunu gösterir" (%60,3), dir. Eğitim durumu ilköğretim ve altı olan kadınların 49 mit ifadesinin 28'ine katılma yüzdesinin, ortaöğretim ve üzeri öğrenime sahip kadınlardan anlamlı düzeyde yüksek olduğu bulunmuştur (p<0,05). Ayrıca emzirme deneyimi olan kadınların 7 mit ifadesine katılma yüzdesinin, emzirme deneyimi olmayan kadınlardan anlamlı düzeyde yüksek olduğu bulunmuştur (p<0,05). Kadınların gebeliklerinde sağlık personelinden anne sütü ve emzirmeye yönelik bilgi alma durumuna göre mitlere katılma yüzdeleri arasında dört madde hariç anlamlı bir fark olmadığı belirlenmiştir (p>0,05). Sonuç: Bu çalışmadan elde edilen sonuçlar doğum yapan kadınlar arasında anne sütü ve emzirme ile ilgili mitlerin yaygın olduğunu göstermiştir. Düşük eğitim düzeyine sahip ve emzirme deneyimi olan kadınlar arasında bu mitlere inanma oranı daha yüksektir. Sağlık personelinden bilgi alma durumu ise mitlere katılma düzeyini etkilememiştir. Bu nedenle emzirme eğitimi ve danışmanlığında mitler üzerinde durulmalı ve eğitim içerikleri güncel kanıtlar çerçevesinde şekillendirilmelidir.

How to cite / Atıf için : Öksüz A, Atadağ Y, Aydın A, Kaya D.The frequency of analgesic drug use in 65 years and above diseases and their causes; an experience of family medicine unit.

Introduction: The exact definition of small-for-gestational-age (SGA) infant is still controversial among clinicians. In this study, we aimed to understand which definition is better in terms of establishing both early postnatal problems and growth. In this way, we compared early neonatal problems and infancy growth of term infants with birth weight (BW) &lt; -2 SDS and with BW between 10th percentile (−1.28 SDS) and −2 SDS.Methods: A single center retrospective cohort study was conducted. Preterm infants, multiple gestations and newborns with any congenital anomalies were excluded from the study. Study group was defined as Group 1 (n = 37), infants BW &lt; −2.00 SDS; Group 2 (n = 129), between −1.28 and −2.00 SDS; and Group 3 (n = 137), randomly selected newborns with optimal-for-gestational-age (BW between −0.67 and +0.67 SDS) as a control group.Results: The incidence of severe hypoglycemia was highest in Group 1 (%10.8) and Group 2 and 3 had similar rates of severe hypoglycemia (0.8 and 0.7%, respectively). The incidence of polycythemia was 5.4% in Group 1 and was significantly higher than Group 3 (0.0%) while it was 2.3% in Group 2. Short stature (length &lt; −2 SDS) ratio at the age of 1 and 2 years were similar in each group. Overweight/obesity ratio at the age of 1 were 9.5, 20.8 and 16.7% in each group, respectively (p = 0.509).Conclusion: This study was planned as a pilot study to determine potential differences in the problems of hypoglycemia, polycythemia, and growth according to the differences in definition. Short term disturbances such as hypoglycemia and polycythemia are found to be higher in infants with a BW SDS below −2. From this point of view, of course, it will not be possible to change the routine applications immediately, however this study will be an initiative for discussions by making long-term studies.

PurposeFear of birth may cause perinatal complication, increased risk of intervention and need for analgesia, delayed mother–infant attachment process and deterioration of spouse relationship. The purpose of this study was to determine the affecting factors and childbirth fears of Turkish pregnant women.Design/methodology/approachThis is a descriptive research type. The sample of this study consisted of 78 pregnant women who met the inclusion criteria and agreed to participate in this study. This study was carried out in a family health center and university hospital in a city in Turkey. Data were collected with Personal Information Form and Wijma Expectancy/Experience Scale-A Version (W-DEQ A).FindingsThe mean scores of pregnant women from W-DEQ A version were 75.60 ± 9.48. In 65.4% of pregnant women, fear of severe birth, 20.5% fear of clinical birth and 14.1% of children had a fear of moderate birth. W-DEQ A version, the third trimester, unplanned pregnancies, lack of knowledge of the level of inadequate birth and more than eight pregnancies in pregnancy, the total score of pregnant women was found to be higher (p < 0.05).Research limitations/implicationsThe limitation of this study is its small sample size. Further studies with larger sample sizes are needed.Practical implicationsIt was determined that one-fifth of the sample group experienced birth fear at the clinical level and childbirth fear level is associated with unplanned pregnancies, lack of knowledge. In antenatal period, the pregnant woman should be encouraged to express her feelings and thoughts about the labor and give information about the labor.Social implicationsCognitive and behavioral education programs can be structured to cope with fear of birth for pregnant women at risk.Originality/valueThis research is original. This study presents data on Turkish women. The data can also be used to evaluate intercultural differences.