bluuebunny/crossref_metadata_2025_split huggingface dataset:
Yetişkin Kadın Mağdurlarda Cinsel Saldırı Sonrası Görülen Ruhsal ve Sosyal Sorunlar
Authors: Gölge Zeynep Belma , Yavuz Mustafa Fatih , Korkut Songül , Kahveci Sevilay 
Published: May 2016

Objective: This study aimed to investigate the prevalence of psychological and social problems faced by female victims after rape and additionally the impact of also being a victim of childhood sexual abuse in Turkey, where opportunity of getting medical and psychological support for sexual assault for victims is limited and legal process lasts for years.Method: Participants consisted of 93 female rape victims who were examined by the Second Specialization Board of State Council of Forensic Medicine. An interview form, which is developed in order to investigate socio-demographic features, assault charactersitics, psychological and social problems of victim, Post Traumatic Diagnostic Scale (PTDS) and Childhood Trauma Questionnaire were applied for the investigation.Results: 61.3 % of victims were diagnosed with post traumatic stres disorder (PTSD) and 54.8% of victims had sexual dysfunctions caused by the sexual assault. 68.8 % of victims reported that they were exposed to negative social reactions. 70,3% of victims who were exposed to negative social reactions met diagnostic criteria for PTSD while only 41,4% of people who were not exposed to negative social reactions met diagnostic criteria for PTSD. Difference between groups was analyzed with chi squre method and there is significant difference between them ( X2:7.04, df:1, p<0.01). Self-mutilation and suicide attempts were high in victims of adult rape who were also sexually abused in childhood.Discussion: Considering duration between the sexual assault and interview, in our research findings the ratio of the people who have PTSD and sexual issues, is more than the other studies consequences. On the other hand, the victims which reported that incident occured more than three years ago, are fitted to the diagnosis criterias of PTSD, with the ratio of 58.8%. It’s been thought that, studying with the victims who has been sent for physical examination and the continuation of judicial process are both have impact on this conclusion.Key Words: Rape, trauma, PTSD, self mutilation
The Relationship Among Road Traffic Accidents Population Size and the Number of Motor Vehicles in Turkey
Authors: Aşırdizer Mahmut , Uluçay Tarık , Hekimoğlu Yavuz , Yılmaz İlknur , Yavuz Mehmet Sunay 
Published: May 2016

Introduction: Traffic accidents with high morbidity and mortality rates are one of the most important problems of the world. Several factors have been described for the occurrence of traffic accidents. Two of them are traffic congestion and road density which have infrequently been reported in the Turkish literature. In this study, it was aimed to evaluate the relationship between road traffic accidents, population size, and the number of motor vehicles in Turkey.Material and methods: The crude data were obtained from the web page of the Turkish Statistical Institute. They was standardized for every one million population, every one million motor vehicles, or every one thousand road traffic accidents. The system of Statistical Regions was used in the classification.Results: In Turkey, the total number of inhabitants was 74,724,269 and the number of motor vehicles was 16,089,528 in 2011. As a result of 131,845 road traffic accidents 3,835 people died and 238,074 people were injured. In the evaluation of the distribution of the number of motor vehicles for every one million population, the distribution of the number of road traffic accidents for every one million population and every one million motor vehicles, the distribution of the number of people died in road traffic accidents for every one million population, every one million motor vehicles and every one thousand road traffic accidents, and the distribution of the number of people injured in road traffic accidents for every one million population, every one million motor vehicles and every one thousand road traffic accidents were all statistically significant. Conclusion: In the traffic accidents, urban and rural society based projects for the identification of risk factors and the preventive measures are great importance. This study represents a pioneer step forward in this field in Turkey.Keywords: Road traffic accidents, traffic congestion, road density, number of motor vehicles, population.
Samsun’da Çocukluk Çağı Medikolegal Ölümler
Authors: Aydın Berna , Turla Ahmet , Mutlu Hülya 
Published: May 2016

The purpose of this study was to contribute to research aimed at reducing preventable childhood deaths by describing the general characteristics of childhood medicolegal deaths in Samsun. Records concerning 301 medicolegal deaths in the 0-18 age group subjected to postmortem examination over a 6-year period from 2006 to 2011 in Samsun were examined. Data were analyzed with the help of SPSS (version 20.0). Males represented 66.1% of cases. Mean age was 7.7±5.7 (0-18) years, and the largest number of cases (26.6%) was in the 1-4 age group. Following forensic investigation, manner of death was determined as accidental in 78.4% of children. Of the 236 child deaths identified as due to accidents, 47.4% were the result of traffic accidents. The most common cause of death in the 34 cases assessed as natural death was infectious diseases (47.1%). Since a large part of the injury-related childhood deaths were caused by accidents, and particularly traffic accidents, we think that such deaths could be significantly reduced through simple and easily applied measures. Key words: Forensic medicine, Childhood, Medicolegal death.
Gestão pública e relação público-privada na saúde
Authors: Vieira Cesar 
Published: May 2016

Este artigo sintetiza os elementos essenciais dos sistemas de saúde em geral. Depois se agrupam os sistemas de saúde de alguns países, conforme a predominância pública ou privada no financiamento e na prestação dos serviços. Em seguida se analisam algumas características público-privadas do sistema de saúde brasileiro, antes e depois da criação do SUS e do SSS. Logo se consideram a regulação e o financiamento do sistema de saúde, dois elementos estratégicos para o seu funcionamento, também enfatizando as relações público-privadas. Finalmente, são feitas algumas conclusões preliminares, apontando possíveis tendências da evolução futura destas relações no sistema de saúde brasileiro.
O processo de humanização e a busca pela qualidade na prestação de serviços em saúde: ações e desafios enfrentados por um grupo
Authors: Abreu Arlete Aparecida de , Sete Ricardo De Souza 
Published: May 2016

Especialmente em um país como o Brasil, detentor de profundas desigualdades socioeconômicas, vários são os desafios na área de saúde. Um exemplo seria a ampliação do acesso aos serviços de saúde de maneira igualitária e com qualidade além da co-responsabilização entre trabalhadores, gestores e usuários nos processos de gerir e cuidar. A PNH (Política Nacional de Humanização) está entre uma das tentativas de ação, por parte do governo, em busca de uma prestação de serviços em saúde mais humana. Desse modo, como essa política se infiltra no ambiente hospitalar, quais são suas ações e desafios? Entender como se dá a relação entre a busca da qualidade e a política de humanização, na visão de quem dela participa é necessário, a fim de se buscar novos cursos de ação que possam contribuir para a melhoria das ações em saúde e da prestação de serviços em si. A PNH não deve ser apenas um programa pontual, sendo necessário, portanto, que cada membro dentro das instituições prestadoras de serviços em saúde se torne mais consciente de seu papel junto à busca destes objetivos. Somente assim a qualidade e a equidade poderão ser uma realidade no campo da prestação de serviços em saúde.
Adrenomedullin Expression in the Developing Human Fetal Lung
Authors: Ramos Carlos G. , Sun Xi , Johnson Eric B. , Nelson Harold E. , Gonzalez Bosc Laura V. 
Published: May 2016

Background Adrenomedullin (AM) is a vasodilator peptide produced by endothelial and smooth muscle cells in the systemic and pulmonary circulation. It promotes angiogenesis and alveolar growth and has protective effects in the cardiovascular and respiratory systems. Adrenomedullin's role in human pulmonary vascular and alveolar development is unknown. Objective To test the hypothesis that AM is expressed during normal human lung development and that its expression changes with advancing gestational age by investigating the messenger RNA and protein expression of AM and its receptor components, calcitonin-receptorlike receptor (CRLR), receptor activity–modifying protein (RAMP)2, and RAMP3 in human fetal lung from 10 to 24 weeks of gestation. Methods The gene expression of AM, CRLR, RAMP2, and RAMP3 was measured with real-time reverse-transcription polymerase chain reaction. Adrenomedullin protein expression was measured with Western blot. Immunohistochemical analyses of sections of lung tissue were performed. Statistical analysis was performed using linear regression and one-way analysis of variance followed by the Tukey range test. Results Adrenomedullin, CRLR, RAMP2, and RAMP3 transcripts were expressed in the midgestation human fetal lung. The gene expression of AM, CRLR, and RAMP2 increased with increasing gestational age, whereas the gene expression of RAMP3 decreased. Adrenomedullin protein expression increased with increasing gestational age. Conclusion Adrenomedullin is expressed in the midgestation human fetal lung and its gene and protein expression increased with increasing gestational age, suggesting a role for AM in human lung development. Supporting this conclusion, the AM1 receptor components CRLR and RAMP2 gene expression also increased with increasing gestational age. Conversely, the expression of RAMP3, a structural component of the AM2 receptor, decreased with increasing gestational age, suggesting different functions for the AM receptors in human fetal lung, as it has been demonstrated in animal models. This speculation requires further investigation.
A Shift in the Balance of Regulatory T and T Helper 17 Cells in Rheumatic Heart Disease
Authors: Bas Hatice Duygu , Baser Kazim , Yavuz Emine , Bolayir Hasan Ata , Yaman Belma , Unlu Serkan , Cengel Atiye , Bagriacik Emin Umit , Yalcin Ridvan 
Published: May 2016

Background Autoimmunity plays an essential role in the pathogenesis of rheumatic heart disease (RHD); however, cellular mechanisms of autoimmune response are unclear. Whereas T helper 17 (TH17) and regulatory T cells (Treg) cells share a common differentiation pathway, they play opposite roles in the immune tolerance and autoimmune diseases. Although high TH17/Treg ratio has been shown in several autoimmune diseases, no data are available in RHD. This study investigated the balance between TH17 and Treg in rheumatic mitral valve disease (MVD). Methods Forty patients with rheumatic MVD and 23 control subjects were enrolled into the study. All subjects underwent clinical, electrocardiographic, and echocardiographic evaluation. The percentages of circulating TH17 and Treg cells were analyzed by flow cytometry. Serum levels of high-sensitivity C-reactive protein (hs-CRP) and cytokines were assessed by enzyme-linked immunosorbent assay. Results As compared with control subjects, rheumatic MVD patients showed significant increase in peripheral TH17 percentage, high serum levels of TH17-related cytokine interleukin 17A, and an obvious decrease in the percentage of Treg cells. T helper 17/Treg ratio was significantly high in rheumatic MVD patients compared with control subjects ( P = 0.0001). Serum concentrations of hs-CRP in rheumatic MVD group were higher than those of the control subjects, and hs-CRP levels correlated with the TH17/Treg ratio ( r = 0.71, P = 0.0001). Serum levels of transforming growth factor β1 were increased in rheumatic MVD group compared with those of the control subjects. Conclusions The results indicated that high TH17/Treg ratio exists inrheumatic MVD. This imbalance may play a role in the pathogenesis, and TH17/Treg balance may be a promising therapeutic approach in RHD.
Tobacco Smoke–Induced Immunologic Changes May Contribute to Oral Carcinogenesis
Authors: Schierl Michael , Patel Daxesh , Ding Wanhong , Kochhar Amit , Adhami Katayun , Zhou Xi Kathy , Dannenberg Andrew J. , Granstein Richard D. 
Published: May 2016

Objective The objective of this study was to determine if tobacco smoke (TS), a risk factor for cancers of the aerodigestive tract, may contribute to oral carcinogenesis, in part, by suppressing local immunity. Methods Mice were placed in Plexiglas holders in which they breathed TS through the nose and mouth for 1 hour daily for 21 days. Control mice breathed room air in the same manner. One day after the last exposure, mice were immunized by application of oxazolone to each buccal mucosa. Control mice were mock immunized by application of vehicle alone. Five days later, all mice were challenged on the ears with oxazolone, and 24-hour ear swelling assessed as contact hypersensitivity. Results Mice exposed to TS had a significantly smaller contact hypersensitivity response compared with controls. When subsequently reimmunized on the glabrous skin, mice originally primed through TS-exposed mucosa could not be fully immunized, indicating induction of immunologic tolerance by exposure to hapten through TS-perturbed mucosa. Immunocompetent mice exposed to TS in this manner and challenged by submucosal placement of a syngeneic malignant tumor had significantly increased tumor growth over time compared with controls. No difference in growth rate was observed when the experiment was performed with natural killer cell–deficient, SCID (severe combined immunodeficiency) mice. In addition, exposure of epidermal Langerhans cells in vitro to an aqueous extract of TS impaired their ability to undergo maturation and to present antigen to responsive T cells. Conclusions Immunologic changes induced in the oral cavity by exposure to TS may play a role in the development of oral cancers.
Importance of Biomarkers in Risk Stratification of Pulmonary Thromboembolism Patients
Authors: Babaoglu Elif , Hasanoglu H. Canan , Senturk Aysegul , Karalezli Aysegul , Kilic Hatice , Aykun Gokhan , Oztuna Derya 
Published: May 2016

Introduction Patients with pulmonary thromboembolism (PTE) are classified into 3 groups according to the clinical risk factors associated with mortality. High-risk patients and some of the intermediate-risk patients should be treated immediately to decrease the high mortality risk. Although clinical risk level of PTE can be determined by using echocardiography to evaluate right ventricle overload and pulmonary artery pressure findings, it may not be available in all emergency settings. Aim The purpose of the study was to define the laboratory biomarkers, which can be used in place of echocardiography for PTE risk stratification. Methods Patients (n = 98) were divided into 3 groups as high-risk (n = 13), intermediate-risk (n = 50), and low-risk (n = 35) groups, according to clinical risk factors at the first referral to hospital. Hepatic, cardiac, and renal markers were evaluated and compared among 3 groups. Results Among biomarkers examined, lactate dehydrogenase, urea, creatinine, uric acid, troponin I, N-terminal–pro–B-type natriuretic peptide, creatine kinase–MB, D-dimer, and erythrocyte sedimentation rate (ESR) levels were found different between groups. All of these biomarkers except for ESR had positive correlation, whereas ESR had negative correlation with the mortality risk. An analysis of covariance for the age difference among patient groups showed that all the biomarkers other than urea and D-dimer levels remained significantly different among risk groups. Conclusions At emergency conditions in which echocardiography assessment is not available, PTE patients who have increased levels of certain hepatic, cardiac, and renal biomarkers should cautiously be evaluated for having an increased risk for mortality. Increased levels of these biomarkers may guide the consideration for thrombolytic treatment.
Effect of Prostaglandin I2 Analogs on Macrophage Inflammatory Protein 1α in Human Monocytes via I Prostanoid Receptor and Cyclic Adenosine Monophosphate
Authors: Tsai Ming-Kai , Hsieh Chong-Chao , Kuo Hsuan-Fu , Yang San-Nan , Kuo Chang-Hung , Huang Ming-Yii , Tsai Ying-Ming , Lee Min-Sheng , Hung Chih-Hsing 
Published: May 2016

Aims Inflammation plays critical roles in atherosclerosis. Chemokines are responsible for leukocyte trafficking and involve in inflammatory diseases. Macrophage inflammatory protein 1α (MIP-1α) has been implicated in atherosclerotic lesion formation. Prostaglandin I2 (PGI2) analog, used in pulmonary hypertension, has been reported to have anti-inflammatory functions. However, little is known about its role in the MIP-1α production in human monocytes. Methods We investigated the effects of 3 conventional (iloprost, beraprost, and treprostinil) and 1 new (ONO-1301) PGI2 analogs, on the expression of MIP-1α expression in human monocytes. Human primary monocytes from control subjects and THP-1 cell line were treated with PGI2 analogs, with or without lipopolysaccharide (LPS) stimulation. Supernatants were harvested to measure MIP-1α levels by enzyme-linked immunosorbent assay. To explore which receptors involved the effects of PGI2 analogs on the expression of MIP-1α expression, I prostanoid (IP) and E prostanoid, peroxisome proliferator-activated receptor (PPAR)-α, and PPAR-r receptor antagonists were used to pretreat THP-1 cells. Forskolin, a cyclic adenosine monophosphate (cAMP) activator, was also used to further confirm the cAMP involvement on the effect of PGI2 analogs in MIP-1α production. Results Three PGI2 analogs could suppress LPS-induced MIP-1α production in THP-1 cells and human primary monocytes. ONO-1301 had a similar effect. CAY 10449, an IP receptor antagonist, could reverse the suppressive effects on MIP-1α production of iloprost. Forskolin, a cAMP activator, also suppressed MIP-1α production in THP-1 cells. Conclusions Prostaglandin I2 analogs suppressed LPS-induced MIP-1α production in human monocytes via the IP receptor and cAMP pathway. The PGI2 analog may be potential in the treatment for atherosclerosis.
The Rationale/Design of the Guimarães/Vizela Study: A Multimodal Population-Based Cohort Study to Determine Global Cardiovascular Risk and Disease
Authors: Cunha Pedro Guimarães , Cotter Jorge , Oliveira Pedro , Vila Isabel , Sousa Nuno 
Published: May 2016

Background Cardiovascular disease and dementia are growing medical and social problems in aging societies. Appropriate knowledge of cardiovascular disease and cognitive decline risk factors (RFs) are critical for global CVR health preventive intervention. Many epidemiological studies use case definition based on data collected/measured in a single visit, a fact that can overestimate prevalence rates and distant from clinical practice demanding criteria. Portugal displays an elevated stroke mortality rate. However, population's global CV risk characterization is limited, namely, considering traditional/nontraditional RF and new intermediate phenotypes of CV and renal disease. Association of hemodynamic variables (pulse wave velocity and central blood pressure) with global CVR stratification, cognitive performance, and kidney disease are practically inexistent at a dwelling population level. Study Design and Methods After reviewing published data, we designed a population-based cohort study to analyze the prevalence of these cardiovascular RFs and intermediate phenotypes, using random sampling of adult dwellers living in 2 adjacent cities. Strict definition of phenotypes was planned: subjects were observed twice, and several hemodynamic and other biological variables measured at least 3 months apart. Results Three thousand thirty-eight subjects were enrolled, and extensive data collection (including central and peripheral blood pressure, pulse wave velocity), sample processing, and biobank edification were carried out. One thousand forty-seven cognitive evaluations were performed. Conclusions Seeking for CV risk reclassification, early identification of subjects at risk, and evidence of early vascular aging and cognitive and renal function decline, using the strict daily clinical practice criteria, will lead to better resource allocation in preventive measures at a population level.
Are Human Adenovirus-5 and 36 Associated with Obesity in Children?
Authors: Cakmakliogullari Elcin Kal , Sanlidag Tamer , Ersoy Betul , Akcali Sinem , Var Ahmet , Cicek Candan 
Published: May 2016

Objectives The aims of this study were to determine the association between adenovirus-5– and adenovirus-36–specific antibodies and obesity in children and to investigate their relationship with serum lipid and leptin levels. Methods A cross-sectional study was performed on a total of 120 children who were divided into subgroups according to body mass index percentile as obese (≥95th percentile) or nonobese (<95th percentile). The presence of adenovirus-36 and adenovirus-5–neutralizing antibodies was investigated by using the serum neutralization assay. Serum leptin levels were determined by microenzyme immonoassay; high-density lipoprotein, low-density lipoprotein, triglyceride, and cholesterol levels were measured by chemiluminescence method. Results The presence of adenovirus-5–specific antibodies was 28.3% and 6.6% in the obese children and in non–obese children, respectively ( P = 0.02). The frequency of adenovirus-36–specific antibodies was significantly greater ( P = 0.018) in the obese children (26.6%) than in the non–obese children (10.0%). Serum leptin level of the obese group were significantly higher than that of the non–obese group ( P = 0.000). Conclusions Our data support the association between obesity and the presence of specific antibodies to adenovirus-36 and adenovirus-5 in children. Our research has the feature of being the first national study to indicate the relationship between adenovirus-36 and human obesity as well as the first international study to indicate the relationship between adenovirus-5 and human obesity.