Turkey AD Turkey - Supp1

Turkey AD Turkey - Supp1 tài liệu, giáo án, bài giảng , luận văn, luận án, đồ án, bài tập lớn về tất cả các lĩnh vực kin...

Int. J. Med. Sci. 2011, 8 http://www.medsci.org 339 IInntteerrnnaattiioonnaall JJoouurrnnaall ooff MMeeddiiccaall SScciieenncceess 2011; 8(4):339-344 Research Paper The Impact of a Nationwide Antibiotic Restriction Program on Antibiotic Usage and Resistance against Nosocomial Pathogens in Turkey Adalet Altunsoy1, Cenk Aypak2, Alpay Azap1, Önder Ergönül3, İsmail Balık1 1. Department of Clinical Microbiology and Infectious Disease, Ankara University, School of Medicine, Ibni Sina Hospital 06100, Ankara, Turkey 2. Department of Family Medicine, Ankara University, School of Medicine, Ibni Sina Hospital 06100, Ankara, Turkey 3. Department of Clinical Microbiology and Infectious Disease, Marmara University, School of Medicine, 34662, Istanbul, Turkey  Corresponding author: cenkaypak@gevasdh.gov.tr; Tel: +90 505 6452780; Fax: +90 312 3240328 © Ivyspring International Publisher. This is an open-access article distributed under the terms of the Creative Commons License (http://creativecommons.org/ licenses/by-nc-nd/3.0/). Reproduction is permitted for personal, noncommercial use, provided that the article is in whole, unmodified, and properly cited. Received: 2011.02.22; Accepted: 2011.05.16; Published: 2011.05.24 Abstract Purpose: Antimicrobial resistance among microorganisms is a global concern. In 2003, a nationwide antibiotic restriction program (NARP) was released in Turkey. In this study we evaluated the effect of NARP on antibiotic consumption, antimicrobial resistance, and cost. Materials and Methods: The data obtained from all of the four university hospitals, and one referral tertiary-care educational state hospital in Ankara. Antimicrobial resistance profiles of 14,233 selected microorganisms all grown in blood cultures and antibiotic consumption from 2001 to 2005 were analyzed retrospectively. Results: A negative correlation was observed between the ceftriaxone consumption and the prevalence of ceftriaxone resistant E.coli and Klebsiella spp. (rho:-0.395, p:0.332 and rho:-0.627, p:0.037, respectively). The decreased usage of carbapenems was correlated with decreased carbapenems-resistant Pseudomonas spp. and Acinetobacter spp (rho:0.155, p:0.712 and rho:0.180, p:0.668, respectively for imipenem). Methicillin resistance rates of S.aureus were decreased from 44% to 41%. After two years of NARP 5,389,155.82 USD saving occurred. Conclusion: NARP is effective in lowering the costs and antibiotic resistance. Key words: Antibiotic consumption, antimicrobial resistance surveillance, restriction policy. Introduction It is obvious that antibiotics had saved many lives since they were first introduced to medical prac-tice. However, when antibiotics are used the emer-gence of drug resistant microorganisms is inevitable. The emergence of resistant microorganisms becomes faster when antibiotic use is inappropriate [1]. As well as emergence of resistant microorganisms, increased mortality and morbidity, adverse drug reactions and excessive strain on already limited healthcare budgets are the results of inappropriate an bread a review' title='the impact of salt reduction in WORLD TRADE ORGANIZATION G/ADP/N/1/TUR/3/Suppl.2 G/SCM/N/1/TUR/3/Suppl.2 10 June 2005 (05-2377) Committee on Anti-Dumping Practices Committee on Subsidies and Countervailing Measures Original: English NOTIFICATION OF LAWS AND REGULATIONS UNDER ARTICLES 18.5 AND 32.6 OF THE AGREEMENTS TURKEY Supplement The following notification, dated June 2005, is being circulated at the request of the Delegation of Turkey _ In accordance with Article 18.5 of the Agreement on Implementation of Article VI of GATT and Article 32.6 of the Agreement on Subsidies and Countervailing Measures, Turkey hereby notifies to the WTO Secretariat that an amendment to the Regulation on the Prevention of Unfair Competition has been put into effect Paragraph (d) of Article of the Regulation on the Prevention of Unfair Competition in Imports1 has been amended as follows: "d) Any other reasonable basis, including the price actually paid or payable in Turkey for the like product or constructed value on the basis of the cost of production in Turkey for the like product, plus selling, general and administrative costs and a reasonable amount for profits." The Regulation was circulated to the Members on 17 April 2000 as the WTO document G/ADP/N/1/TUR/3 G/SCM/N/1/TUR/3 G/ADP/N/1/TUR/3/Suppl.2 G/SCM/N/1/TUR/3/Suppl.2 Page G/ADP/N/1/TUR/3/Suppl.2 G/SCM/N/1/TUR/3/Suppl.2 Page Int. J. Med. Sci. 2010, 7 http://www.medsci.org 191IInntteerrnnaattiioonnaall JJoouurrnnaall ooff MMeeddiiccaall SScciieenncceess 2010; 7(4):191-196 â Ivyspring International Publisher. All rights reserved Research Paper Efficacy of Sirolimus-Eluting Stents Compared With Paclitaxel-Eluting Stents in an Unselected Population With Coronary Artery Disease: 24-Month Outcomes of Patients in a Prospective Non-randomized Registry in South-ern Turkey Davran ầiỗek1, Hasan Pekdemir2, Nihat Kalay3 , Sỹleyman Binici4, Hakan Altay4, Haldun Mỹderrisolu5 1. Bakent University School of Medicine, Department of Cardiology, Antalya, Turkey; 2. nửnỹ University School of Medicine, Department of Cardiology, Malatya, Turkey; 3. Erciyes University School of Medicine, Department of Cardiology, Kayseri, Turkey; 4. Bakent University School of Medicine, Department of Cardiology, Adana, Turkey; 5. Bakent University School of Medicine, Department of Cardiology, Ankara, Turkey Corresponding author: Davran Cicek, Bakent University School of Medicine, Department of Cardiology, Alanya/Antalya/Turkey, Tel: +90 532 3336466, Fax: +902425115563. E-mail: davrancicek@mynet.com Received: 2010.04.27; Accepted: 2010.06.04; Published: 2010.06.10 Abstract Background: The efficacy of drug-eluting stents has been shown in randomized trials, but some controversy exists regarding which stent sirolimus-eluting or paclitaxel-eluting is more effective in unselected Turkish patients. Therefore, we investigated the clinical outcomes of patients who were treated with one type of these drug-eluting stents in the real world. Methods: We created a registry and prospectively analyzed data on a consecutive series of all patients who presented to our institution with symptomatic coronary artery disease between February 2005 and March 2007 and who were treated with the sirolimus- or the paclitaxel-eluting stent. The follow-up period after stent implantation was approximately 24 months. The primary end point was a major cardiac event, and the secondary end point was stent thrombosis. Informed consent was obtained from all subjects, and the study protocol was approved by the local ethical committee. Results: In total, 204 patients were treated with either the sirolimus-eluting stent (n = 103) or the paclitaxel-eluting stent (n = 101). The lesions in the 2 arms of the study were treated similarly by conventional technique. At 24-month follow-up, patients who received the pac-litaxel-eluting stent showed significantly higher rates of nonQ-wave myocardial infarction (1.9% vs 5.9%; P: .002), target vessel revascularization (1.9% vs 4.9%; P: .002), coronary artery bypass graft surgery (1.9% vs 6.9%; P: .001), and late stent thrombosis (1.9% vs 3.9%, P: .002). Conclusions: Patients who received the sirolimus-eluting stent showed better clinical outcomes compared with those who had the paclitaxel-eluting-stent. Key words: coronary artery disease, drug-eluting stent, major adverse cardiac event, stent throm-bosis. INTRODUCTION Because of their association with decreased in-cidents of restenosis and repeat intervention, the siro-limus-eluting stent (SES)1 and the paclitaxel-eluting stent (PES)2 have been shown to be superior to the bare-metal stent. Along with the accumulation of clinical experiences, drug-eluting stents increasingly have been used for more complex Asian Pacic Journal of Cancer Prevention, Vol 13, 2012 21 DOI:http://dx.doi.org/10.7314/APJCP.2012.13.1.021 Complementary and Alternative Medicine Use by Gynecologic Oncology Patients in Turkey Asian Pacic J Cancer Prev, 13, 21-25 Introduction Cancer is a major disease burden worldwide and most people perceive it as a frightening and untreatable disease that implies death. Each year, tens of millions of people are diagnosed with cancer around the world, and it is estimated that in 2020, this number will reach 15 million (Turgay et al., 2008; Ma and Yu, 2006). Use of CAM is growing rapidly recent years among cancer patients. Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine (NCCAM 2011). Complementary/alternative medicine has been described as ‘diagnosis, treatmentand/or prevention which complements mainstream medicine by contributing to a common whole, satisfying a demand not met by orthodoxy, or diversifying the conceptual frameworks of medicine (Ades and Yarbro, 2000). An unknown number of patients with cancer in Turkey are using complementary and alternative medicine (CAM) products or practices. There have been fewer studies conducted with patients with gynecologic cancer in Turkey. Those studies that have been conducted over the past decade indicate that a variety of CAM therapies 1 Obstetric and Gynecologic Nursing, Department of Nursing, Adana Health School, Çukurova University, 2 Department of Obstetrics and Gynecolog, Adana Numune Education Hospital, Adana, Turkey *For correspondence: eceevsen_61@hotmail.com Abstract The use of complementary and alternative medicines (CAM) among women with gynecologic cancer is becoming increasingly popular. Therefore, it is important to gain insight into the prevalence and factors related to the use of CAM. The aim of this study was to assess the use of CAM in women with gynecologic cancer. This is a descriptive cross-sectional study. Data were obtained from 67 gynecological cancer patients at gynecologic oncology clinic of a hospital in Turkey between October 2009 to December 2010 using a questionnaire developed specically for this study. The instrument included questions on socio-demographic information, disease specics and complementary and alternative medicine usage. On the basis of women’s responses, all participants were divided into 2 groups: CAM users and nonusers. The ndings indicated that 61.2% of the women reported the use of 1 or more CAM therapies. There were no signicant differences in the sociodemographic and clinical characteristics between CAM users and nonusers (P <0.05). The most frequently used CAM method was herbal therapy (90.2%) and the second was prayer (41.5%). The main sources of information about CAM were informal (friends/ family members). A considerable proportion (56.1%) of CAM users had discussed their CAM use with their physicians or nurses. Turkish women with gynecologic cancer frequently use CAM in addition to standard medical therapy. Nurses/ oncologists caring for women with gynecologic cancer should i KERKENES SPECIAL STUDIES 1 SCULPTURE AND INSCRIPTIONS FROM THE MONUMENTAL ENTRANCE TO THE PALATIAL COMPLEX AT KERKENES DA, TURKEY oi.uchicago.edu ii   oi.uchicago.edu iii KERKENES SPECIAL STUDIES 1 SCULPTURE AND INSCRIPTIONS FROM THE MONUMENTAL ENTRANCE TO THE PALATIAL COMPLEX AT KERKENES DA, TURKEY by  and  with contribution by CLAUDE BRIXHE and Turkish summary translated by KE YAZICIOLU   oi.uchicago.edu iv      The Oriental Institute, Chicago    Series Editors  and  with the assistance of  Series Editors’ Acknowledgments   Spine Illustration  Printed by Edwards Brothers, Ann Arbor, Michigan    oi.uchicago.edu v TABLE OF CONTENTS  vii LIST OF PLATES  PREFACE  ACKNOWLEDGMENTS  BIBLIOGRAPHY   Geoffrey D. Summers 1 CATALOG SC UL PT U R E (CA T . NO S. 1–10Catherine M. Draycott                                         ...Page G/ADP/N/1/TUR/3/Suppl.2 G/SCM/N/1/TUR/3/Suppl.2 Page