An Evaluation of Patient Satisfaction in Turkey with the EUROPEP Instrument

Nezih Dagdeviren,Zekeriya Akturk 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.1

Seeking to understand patient perspectives is an important step in the efforts to improve the quality of health care. Developed by the EQuiP Task Force on Patient Evaluations of General Practice Care, the EUROPEP instrument aims to collect information on patient evaluations of general practice care. In order to expose the current state of patient satisfaction and make international comparisons, a study was conducted with relevant data collected from Turkey. The Turkish version of the EUROPEP instrument was administered to 1160 patients in six different Turkish cities. Thirty-three medical practices were included in the study. In every practice, a minimum of 30 adult patients who visited the practice for a consultation were consecutively included. The results were compared with previous values from European countries. “Helping you understand the importance of following his or her advice”, “Getting through to the practice on the telephone”, and “Providing quick services for urgent health problems” were evaluated best (76.7%, 76.3%, and 76.2%, ‘good or excellent’ ratings, respectively) and “Helping to deal with emotional problems related to the health status” was rated the worst (60.2%, ‘good or excellent’). Other areas which had low ratings were: “Waiting time in the waiting room” (63.0%), “Quick relief of symptoms” (61.3%), and “Involving patients in decisions about medical care” (61.3%). Patient evaluations can help to educate medical staff about their achievements as well as their failures, assisting them to be more responsive to their patients' needs. In order to get the best benefit from EUROPEP, national benchmarking should be started to enable national and international comparisons.

Case Reports : Cutaneous Metastasis of Gallbladder Adenocarcinoma in a Patient with Chronic Lymphocytic Leukemia: A Case Report and Review of the Literature

( Ozgur Tanriverdi ),( Nezih Meydan ),( Sabri Barutca ),( Gurhan Kadikoylu ),( Gokhan Sargin ),( Canten Tataroglu ),( Nil Culhaci ) 대한피부과학회 2013 Annals of Dermatology Vol.25 No.1

Skin metastasis of primary gallbladder tumors is extremely rare with a reported incidence of 0.7∼9% and it usually involves the thorax, abdomen, the extremities, neck, head region, and scalp. Cutaneous metastasis may occur synchronously or metatochronously. In the present case, the patient had chronic lymphocytic leukemia, which was being treated with an alkylating agent (chlorambucil) when the patient developed skin metastasis from gallbladder adenocarcinoma during post- cholecystectomy follow-up. Given the fact that secondary malignancies occur in chronic lymphocytic leukemia; this clinical setting warrants attention. We aimed to discuss secondary malignancy in chronic lymphocytic leukemia patients and gallbladder adenocarcinoma with skin metastasis, based on a review of the literature and the presented case. (Ann Dermatol 25(1) 99∼103, 2013)

Evaluation of free water removal from different sludge by solar energy utilization

Zeinab Amin,Nezih Kamil Saliho?lu 대한환경공학회 2021 Environmental Engineering Research Vol.26 No.3

The purpose of this research was to provide basic information about the conditions required for the drying of three types of sludge to reduce the problems associated with sludge disposal. By designing an integrated drying system, as a simple technology with paraffin-wax (phase change material), the drying efficiency was investigated with few possibilities for waste sludge management. According to the study by providing 1,880 Wh/㎡, 1,671 Wh/㎡, and 2,051 Wh/㎡ cumulative solar radiation, within 7 h. respectively for wastewater treatment plant sludge (WWTPs.) and paint sludge, free water was released and marble sludge dried completely. The average internal temperature and moisture are the main factors for minimizing the sludge mass and volume and the heat transfer rout between the solar dryer equipment was observed. Water removal from the sludge caused the porous structure of the WWTPs. and paint sludge surface was observed using scanning electron microscopy (SEM). According to statistical analysis the goodness of the curve fit was evaluated using the R-square and root mean square error (RMSE) for all three sludge types. By solar drying a large volume of sludge water was removed for easy transporting and prepared for the subsequent waste disposal operation.

Four flap suspension technique for prevention of bottoming out after breast reduction

Yuksel Kankaya,Melike Oruc,Nezih Sungur,Ozlem Colak Aslan,Koray Gursoy,Kadri Ozer,U?ur Kocer 대한외과학회 2015 Annals of Surgical Treatment and Research(ASRT) Vol.90 No.1

Purpose: Bottoming-out deformity is accepted as the most important disadvantage of inferior pedicle breast reduction. For prevention of this deformity, different techniques are used in combination with inferior pedicle. In this study, we aimed to prevent bottoming-out deformity by producing an internal bra effect through combination of inferior pedicle technique with 2 superior and 2 inferior dermal flaps that were raised from each side of the pedicle. Methods: Thirteen patients whose medical records became available during the follow-up period at Ankara Training and Research Hospital from January 2010 to January 2015 were included in this study. We retrospectively obtained patient medical records including demographic characteristics and clinical data. Superior dermal flaps were planned on both sides of the pedicle 2 cm inferior to the lower border of areola and inferior dermal flaps were planned 6 cm inferior to the superior dermal flaps. The superior and inferior dermal flaps were secured to the periosteum of the 2nd and 4th ribs respectively with permanent sutures. Results: Preoperatively, the average distance between the inframammary fold and areola was 13.9 cm (range, 11–18 cm). The average amount of breast parenchymal resection was 745 g (range, 612–1,496 g). The average distance between the inframammary fold and the lower border of the areola was 7.9 cm (range, 7.5–9 cm) on the postoperative first-year measurements. Conclusion: In conclusion, according to our study, suspension technique to prevent bottoming-out deformity is associated with an easier technique without the need for alloplastic or allogenic materials. Since fixation is performed to the ribs instead of soft tissues like the pectoral fascia or muscle, we believe that this fixation is more long lasting and can be an effective alternative to other suspension techniques.

The Vasodilator Effect of a Cream Containing 10% Menthol and 15% Methyl Salicylate on Random- Pattern Skin Flaps in Rats

Utku Can Dölen,Nezih Sungur,Gökhan Koca,Onur Ertunç,Ayşe Tülay Bağcı Bosi,Uğur Koçer,Meliha Korkmaz 대한성형외과학회 2015 Archives of Plastic Surgery Vol.42 No.6

Background It is still difficult to prevent partial or full-thickness flap necrosis. In this study, the effects of a cream containing menthol and methyl salicylate on the viability of randompattern skin flaps were studied. Methods Forty female Sprague-Dawley rats were divided into two equal groups. Caudally based dorsal random-pattern skin flaps were elevated, including the panniculus carnosus. In the study group, 1.5 mL of a cream containing menthol and methyl salicylate was applied to the skin of the flap, and saline solution (0.9%) was used in the control group. Upon completion of the experiment, flap necrosis was analyzed with imaging software and radionuclide scintigraphy. Histopathological measurements were made of the percentage of viable flaps, the number of vessels, and the width of the panniculus carnosus muscle. Results According to the photographic analysis, the mean viable flap surface area in the study group was larger than that in the control group (P=0.004). According to the scintigrams, no change in radioactivity uptake was seen in the study group (P>0.05). However, a significant decrease was observed in the control group (P=0.006). No statistically significant differences were observed between the groups in terms of the percentage of viable flaps, the number of vessels, or the width of the panniculus carnosus muscle (P>0.05). Conclusions Based on these results, it is certain that the cream did not reduce the viability of the flaps. Due to its vasodilatory effect, it can be used as a component of the dressing in reconstructive operations where skin perfusion is compromised.

The Vasodilator Effect of a Cream Containing 10% Menthol and 15% Methyl Salicylate on Random-Pattern Skin Flaps in Rats

Dolen, Utku Can,Sungur, Nezih,Koca, Gokhan,Ertunc, Onur,Bosi, Ayse Tulay Bagci,Kocer, Ugur,Korkmaz, Meliha Korean Society of Plastic and Reconstructive Surge 2015 Archives of Plastic Surgery Vol.42 No.6

Background It is still difficult to prevent partial or full-thickness flap necrosis. In this study, the effects of a cream containing menthol and methyl salicylate on the viability of random-pattern skin flaps were studied. Methods Forty female Sprague-Dawley rats were divided into two equal groups. Caudally based dorsal random-pattern skin flaps were elevated, including the panniculus carnosus. In the study group, 1.5 mL of a cream containing menthol and methyl salicylate was applied to the skin of the flap, and saline solution (0.9%) was used in the control group. Upon completion of the experiment, flap necrosis was analyzed with imaging software and radionuclide scintigraphy. Histopathological measurements were made of the percentage of viable flaps, the number of vessels, and the width of the panniculus carnosus muscle. Results According to the photographic analysis, the mean viable flap surface area in the study group was larger than that in the control group (P=0.004). According to the scintigrams, no change in radioactivity uptake was seen in the study group (P>0.05). However, a significant decrease was observed in the control group (P=0.006). No statistically significant differences were observed between the groups in terms of the percentage of viable flaps, the number of vessels, or the width of the panniculus carnosus muscle (P>0.05). Conclusions Based on these results, it is certain that the cream did not reduce the viability of the flaps. Due to its vasodilatory effect, it can be used as a component of the dressing in reconstructive operations where skin perfusion is compromised.

Experimental and ab initio Computational Studies on Dimethyl-(4-{4-{3- methyl-3-phenyl-cyclobutyl)-thiazol-2-yl]-hydrazonomethyl}-phenyl)-amine

Çiğdem Yüksektepe,Hanife Saraçoğlu,Nezihe Çalışkan,Ibrahim Yilmaz,Alaaddin Cukurovali 대한화학회 2010 Bulletin of the Korean Chemical Society Vol.31 No.12

A new hydrazone derivative compound has been synthesized and characterized by IR, 1H-NMR, 13C-NMR and UV-vis. spectroscopy techniques, elemental analysis and single-crystal X-ray diffraction (XRD). The new compound crystallizes in monoclinic space group C2/c. In addition to the crystal structure from X-ray experiment, the molecular geometry, vibrational frequencies and frontier molecular orbitals analysis of the title compound in the ground state have been calculated by using the HF/6-31G(d, p), B3LYP/6-311G(d, p) and B3LYP/6-31G(d, p) methods. The computed vibrational frequencies are used to determine the types of molecular motions associated with each of the observed experimental bands.To determine conformational flexibility, molecular energy profile of (1) was obtained by semi-empirical (AM1) calculation with respect to a selected degree of torsional freedom, which was varied from ‒180o to +180o in steps of 10o. Molecular electrostatic potential of the compound was also performed by the theoretical method.

Reconsideration of Clinical and Histopathological Prognostic Factors in Breast Cancer Patients: A Single Center Experience

Tanriverdi, Ozgur,Meydan, Nezih,Barutca, Sabri Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.2

Background: The clinical course of the neoplasm may vary due to both patient and tumor cell characteristics. Aim: The aim of this study was to research the influence of certain clinical and pathological features on the prognosis of early stage breast cancer. Materials and Methods: This study included 117 women that were treated and followed-up in between the years 2001-2011. The demographic, clinical and histopathological features of the cases were reviewed retrospectively. Statistical analysis: In categorical comparisons between groups, cross-tab statistics were provided and significance levels were estimated using chi-square test. Cox regression analysis, Pearson and Spearman correlation tests, and the Kaplan-Meier test were also used. Results: With an average of 35-months follow-up, the mean disease-free survival of patients was 91 months and the mean overall survival time was 132 months. In the whole study group, the disease-free survival rates were 88, 84, 83 and 52%, while the overall survival rates 95, 94, 83, and 83% within the first, third, fifth and tenth years, respectively. The disease-free and overall survival rates were decreased with increasing tumor grades, though this was not statistically significant. The presence of lymphovascular invasion, positive staining with Ki67 and postmenopausal status were associated with shorter disease-free and overall survival times. In multivariate analysis, only age and Her2/neu receptor status influenced the prognosis significantly. Conclusions: In parallel to clinical, histopathological, and immunohistochemical prognostic features in breast cancer, in this study positive Her2/neu receptor status, a previously accepted poor prognostic factor, was found to have positive influence after trastuzumab treatment.

Experimental and ab initio Computational Studies on Dimethyl-(4-{4-{3-methyl-3-phenyl-cyclobutyl)-thiazol-2-yl]-hydrazonomethyl}-phenyl)-amine

Yuksektepe, Cigdem,Saracoglu, Hanife,Caliskan, Nezihe,Yilmaz, Ibrahim,Cukurovali, Alaaddin Korean Chemical Society 2010 Bulletin of the Korean Chemical Society Vol.31 No.12

A new hydrazone derivative compound has been synthesized and characterized by IR, $^1H$-NMR, $^{13}C$-NMR and UV-vis. spectroscopy techniques, elemental analysis and single-crystal X-ray diffraction (XRD). The new compound crystallizes in monoclinic space group C2/c. In addition to the crystal structure from X-ray experiment, the molecular geometry, vibrational frequencies and frontier molecular orbitals analysis of the title compound in the ground state have been calculated by using the HF/6-31G(d, p), B3LYP/6-311G(d, p) and B3LYP/6-31G(d, p) methods. The computed vibrational frequencies are used to determine the types of molecular motions associated with each of the observed experimental bands. To determine conformational flexibility, molecular energy profile of (1) was obtained by semi-empirical (AM1) calculation with respect to a selected degree of torsional freedom, which was varied from $-180^{\circ}$ to $+180^{\circ}$ in steps of $10^{\circ}$. Molecular electrostatic potential of the compound was also performed by the theoretical method.

Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis

Özlem Çolak Aslan,Yüksel Kankaya,Nezih Sungur,Kadri Özer,Koray Gürsoy,Kemal Şerbetçi,Uğur Koçer 대한성형외과학회 2019 Archives of Plastic Surgery Vol.46 No.3

Background The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols. However, there is no consensus on the ideal suture material and technique. This study was conducted to compare the tensile strength, repair time, and characteristics of 4-strand cruciate, modified Kessler, and 4-strand horizontal intrafiber barbed sutures for flexor tenorrhaphy with a 12-mm suture purchase length in an animal model. Methods The right third deep flexors of 60 adult Leghorn chicken feet were isolated and repaired with a 12-mm suture purchase length. The tendons were randomly assigned to three groups of equal number (n=20 each). Groups 1 and 2 received 4-strand cruciate and modified Kessler repair with conventional suture materials, respectively. A 4-strand horizontal intrafiber barbed suture technique was used in group 3. The repaired tendons were biomechanically tested for tensile strength, 2-mm gap resistance, and mode of failure. Repair times were also recorded. Results The maximum tensile strength until failure was 44.6±4.3 N in group 1, 35.7±5.2 N in group 2, and 56.7±17.3 N in group 3. The barbed sutures were superior to the other sutures in terms of the load needed for 2-mm gap formation (P<0.05). Furthermore, the barbed sutures showed the shortest repair time (P<0.05). Conclusions This study found that 4-strand horizontal intrafiber barbed suture repair with a 12-mm purchase length in a chicken flexor tendon injury model showed promising biomechanical properties and took less time to perform than other options.