Several clinical observations and animal experiments have led to speculation concerning the possible effects of pregnancy and pregnancy-associated sex steroids on gastrointestinal function. It was reported that estrogen increases intestinal contractile activity, while progesterone or the combination of estrogen and progesterone decreases it. In order to measure gastric emptying, a methylcellulose test meal was given orally into the stomach of conscious rats. In progesterone-treated rats, at the dose of 0.2 mg/kg, gastric emptying was not significantly different from that of the control, but it was found to be significantly delayed at the dose of 10 mg/kg (P < 0.05). Estrogen treatment at doses of 20 micrograms/kg and 600 micrograms/kg significantly delayed gastric emptying, when compared with controls (P < 0.001). Combined therapy of estrogen and progesterone induced a significant delay in gastric emptying rate compared with the control group (P < 0.001). In the animals with pseudopregnancy treatment (100 micrograms/kg estrogen+ 15 mg/kg progesterone; 7-12 days) the gastric emptying rate was significantly different from that of the control (P < 0.05). We conclude that both estrogen and progesterone exert inhibitory effects on gastric emptying, and this may account for the disturbances in gastrointestinal function that pregnant women frequently experience.

Bir palyatif bakım merkezinde yatan hastaların klinik özelliklerini incelemek ve uzun yatış süresi, hastaneden taburculuk durumu ile ilişkili faktörleri araştırmaktır. Gereç ve Yöntem: Kesitsel ve retrospektif bir çalışmadır. Palyatif bakım merkezinde 1 Ağustos 2015-30 Temmuz 2017 tarihleri arasında yatan hastaların dosyaları incelendi. Tüm hastaların demografik özellikleri, komorbid durumları, ilaç sayıları, yatış şikayetleri, ilk yatışındaki nutrisyon, bası yarası ve ağrı durumları değerlendirildi. Hastaların uzun yatış süresi (≥ 15 gün) ve taburculuk durumları (eve taburcu, ileri yoğun bakım merkezine sevk ve ölüm) ile ilişkili faktörler için değişkenler Spearman korelasyon testi ile analiz edildi. Bulgular: Çalışmaya alınan 319 hastanın (%55 Erkek, %45 Kadın) ortalama yaşı 71±15,8 ve ortalama yatış süresi 15,4±15,7 gündü. En sık üç komorbid hastalık malnütrisyon %59, malignite %44 ve enfeksiyon hastalığı %33 idi. En sık yatış şikayetleri oral alım bozukluğu %35, genel durum bozukluğu %19 ve ateş %17 idi. Uzun yatış süresi ile ilişkili pozitif faktörler ileri evre bası yarası (r=0,366; p<0,001), serebrovasküler hastalık (r=0,175; p=0,002), hipertansiyon (r=0,158; p=0,005) ve diabetes mellitusdur (r=0,129; p=0,021). Taburculuk durumu (ileri yoğun bakıma sevk ve/veya ölüm) ile ilişkili pozitif faktörler ise, malignite (r=0,234; p<0,001), opioid kullanımı (r=0,204; p<0,001), parenteral beslenme tipi (r=0,20; p<0,001) ve halsizlikyorgunluk semptomudur (r=0,115; p=0,041). Sonuç: İleri evre bası yarası hastanede yatış süresini uzatan en önemli faktördür. Hastaların taburculuk durumu için en etkili faktörler ise malignite, opioid kullanımı, parenteral beslenme tipi ve halsizlik-yorgunluk semptomunun varlığıdır.

Summary Background To our knowledge, the early effect of the fear caused by terrorism on human health, especially its effect on the number of visits to medical emergency departments (EDs), has not yet been studied. Objectives To observe the effect of fear from terrorist alerts on the use of EDs and on the rate of cardiovascular (CV) and/or cerebrovascular events. Setting In Istanbul, Turkey, there was a terror alert on the weekend of 19 and 20 March 2016. In this multicenter retrospective study, we compared the data of patients from that weekend with those from the preceding and following weekends. Patients A total of 12 324 adult patients' records were included in this study: 4562 patients in the first weekend, 3627 patients in the second, terror alert weekend, and 4135 patients in the third weekend. Measurements The ED, CV, and cerebrovascular incidence rates of the above three groups were compared. Results The rate of ED use was the least in the weekend of the terror alert; the highest rate occurred during the weekend prior to it (female applications decreased more [P = 0.03]). The medical center that was the farthest from the crowded central places of the city and from the place where suicide bombing occurred was less affected by the decrease in use. Conclusions Fear associated with terrorism may affect human health indirectly by preventing patients from reaching the necessary emergency healthcare facilities. This finding may be a pathfinder to decision‐makers in such extraordinary emergency conditions. Further studies are needed in this field.

Effective treatment and follow-up for type 1 diabetics have resulted significant increase in the number of adult type 1 diabetic patients. Psychological adaptation problem and impairment in glycemic control have been observed Type 1 diabetic patients that have been referred from pediatric endocrinology clinics to adult endocrinology clinics. Type 1 and Type 2 diabetes are clinically different from each other in terms of age of onset, ketosis tendencies, family history and metabolic differences. We investigated whether there was a difference between glycemic controls of type 1 and type 2 diabetic patients who were referred to our hospital endocrinology and diabetes outpatient clinics, and probable causes for his condition. 17,985 patients who applied to our hospital for the last 5 years were included. Age, sex, glucose, A1C, triglyceride, total cholesterol, LDL, HDL and TSH levels of all patients were recorded retrospectively. Patients were divided into two groups, Type 1 and Type 2 diabetes. Glucose (p=0.0001) and A1C (p=0.0001) values were found to be statistically higher in type 1 diabetic patients. In Type 2 diabetic patients total cholesterol, LDL cholesterol and triglycerides (TG) levels were significantly higher, while there was no statistically significant difference in HDL and TSH levels. Oral anti-diabetic use rather than frequent insulin injections in our Type 2 diabetes group may be one of the factors that increase treatment compliance. Relative high incidence of hypoglycemia due to absolute insulin deficiency in type 1 diabetics may lead to weight problems and increase in A1C as the dose of insulin may be skipped. In type 1 diabetics, prolonged duration of the disease may be one of the factors that leads to impaired glycemic control and increased diabetic complications