ÖZETCeza ve tazminat davalarında son yıllarda ciddi artış yaşanan önemli ve çok boyutlu bir kavram olan malpraktis, sağlık personelinin kasıt, kusur ya da ihmal ile uygun giriş imde bulunmamas ı, yanlış tedavi uygulanması ve tedavisinin verilmemesi ile oluşan zarar meydana getiren fiil ve durumlar olarak tanımlanır. Hemşirelik bakımı sırasında da gerçekleşebilen malpraktis olgularında, hemşireler etik ilkelerden vücut bütünlüğüne zarar vermeme ilkesine ters düşen uygulamaları nedeniyle ceza uygulamalarıyla karşı karşıya kalmaktadırlar.Bu çalışmada çeşitli hemşirelikte malpraktis olguları literatür ışığında tartışılarak hatalar ve nedenlerine, ayrıca hataların önlenmesinde uygun yaklaşımın önemine dikkat çekmek amaçlanmıştır.Anahtar Kelimeler: Malpraktis, hemşire, ilaç uygulamaları. ABSTRACTThe issue malpractice, which is an important and multi-dimensional concept, has been debated in recent years and as a result, an increase of penalty and compensation cases are states that will be harmful to a patient by not giving treatment, by not applying standard medical applications with intent, fault, or negligence by the health staff, and by wrong treatment applications. In malpractice cases may occur during nursing care, nurses are faced with penalty applications for being contrary to ethic principle is no damage his/her body integrity of ethical principles.In this study, cases of nursing malpractice were discussed with literature and it was aimed to draw attention errors and their reasons, importance of suitable approach for prevention K e y Wo r d s : M a l p r a c t i c e , N u r s i n g , D r u g Applications. GİRİŞ ve AMAÇCeza ve tazminat davalarında son yıllarda ciddi artış yaşanan önemli ve çok boyutlu bir kavram olan malpraktis, hukuk dilinde sözlük anlamı ile itinasızca veya yanlış tedavi, vazifede ihmal veya suistimal, görevi kötüye kullanma olarak açıklanmaktadır (1,2,3). Tıbbi uygulama hataları ise sağlık personelinin kasıt ya da ihmal ile standart tıbbi uygulamayı yapmaması, yanlış tedaviyi uygulaması veya hastaya tedaviyi vermemesi ile oluşan kişide zarar meydana getiren fiil ve durum olarak tanımlanmaktadır (4).Sağlık bakım sisteminde yer alan hemşireler birey, aile ve toplumun sağlığının sürdürülmesi, geliştirilmesi ve hastalık varlığında iyileştirmeye yönelik çabaların tümünde yer almaktadırlar. Hemşirelik bakımı sırasında st
Purpose Diabetes and dyslipidemia are leading causes of mortality and morbidity. According to international guidelines, statins are the cornerstone of treatment in patients with diabetes and/or dyslipidemia. However, statins and antidiabetic agents have opposite pharmacological effects, because statins, particularly atorvastatin and rosuvastatin, impair glucose homeostasis, increasing the risk of new-onset diabetes, whereas antidiabetic drugs improve glycemic homeostasis. The aim of this study was to investigate the effect of atorvastatin, rosuvastatin, and pitavastatin on glucose homeostasis in patients with type 2 diabetes mellitus (T2DM) and dyslipidemia during stable treatment with hypoglycemic drugs. Materials and Methods The study was conducted as a pilot, prospective, randomized, open label, parallel group with blinded-endpoints (PROBE) study. Of 180 recruited patients with T2DM and dyslipidemia, 131 were randomized to atorvastatin (n=44), rosuvastatin (n=45), and pitavastatin (n=42) and treated for 6 months. Results Fasting plasma glucose (FPG) marginally decreased in patients assigned to atorvastatin (-3.5 mg/dL, p =0.42) and rosuvastatin (-6.5 mg/dL, p =0.17), while it decreased much more in patients treated with pitavastatin (-19.0 mg/dL, p <0.001). Mean glycated hemoglobin A1c (HbA1c ) values remained unchanged during treatment with atorvastatin (-0.10%, p =0.53) and rosuvastatin (0.20%, p =0.40), but were significantly reduced with pitavastatin (-0.75%, p =0.01). Atorvastatin, rosuvastatin, and pitavastatin significantly lowered ( p <0.001) plasma levels of total cholesterol, low-density lipoprotein-cholesterol, and triglycerides, while high-density lipoprotein-cholesterol (HDL-C) levels increased significantly ( p =0.04) only in the pitavastatin group. Conclusion The results of the present study suggest that pitavastatin affects FPG and HbA1c less than atorvastatin and rosuvastatin in patients with T2DM and concomitant dyslipidemia. Lipid-lowering efficacies were not significantly different among the three statins, with the exception of HDL-C, which increased significantly with pitavastatin. Although the pharmacological mechanism of pitavastatin on glucose homeostasis in patients with T2DM during stable antidiabetic therapy is not known, it can be assumed that pitavastatin has less drug interaction with hypoglycemic agents or that it increases plasma levels of adiponectin.
Background: Benign prostatic hyperplasia is a compilation of irritative voiding and obstructive symptoms which are consistent with reduced emptying of urine from and defective storage of urine in the bladder. Medications are a common method of treatment to delay complications and reduce symptoms. Silodosin is a highly selective alpha-1A adrenoceptor blocker that has 162 times more affinity for alpha-1a than alpha 1b, thus resulting in high uroselectivity and decreased side effects. Aim:In this review article our aim was to elucidate the clinical effects, safety and tolerability profile of silodosin in the treatment of benign prostatic hyperplasia.Method: Literatures were retrieved by a PubMed search, using different combinations of pertinent keywords (e.g., silodosin, hypotension, benign prostatic hyperplasia), without any limitations in terms of publication date and language. Papers which assessed the therapeutic efficacy and tolerability of silodosin were selected for inclusion according to their relevance for the topic, as judged by the authors. Overvıew of clinical data:Silodosin is indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia. It has a rapid onset of effect in men with lower urinary tract symptoms and improvements were seen in voiding and storage symptoms, maximum urinary flow rate and health-related quality of life. The efficacy of silodosin was maintained in several controlled studies and also non-interventional real-world setting. Silodosin was generally well tolerated. Conclusion:Silodosin is the most uroselective α-blocker. Silodosin has been emphasized in the 2021 European Association of Urology Conservative treatment of non-neurogenic male LUTS guidelines and it has been reported that the hypotensive effect of silodosin is comparable with placebo and has favorable safety and tolerability profile. Dosing of silodosin does not need to be adjusted according to age, concurrent medication with antihypertensives and phosphodiesterase type 5 inhibitors.
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