Ege Üniversitesi Tıp Fakültesi Hastanesi

Data are limited on the safety and effectiveness of oral antivirals other than lamivudine and adefovir dipivoxil for treatment of chronic hepatitis B (CHB) in patients with decompensated liver disease. This Phase 2, double-blind study randomized 112 patients with CHB and decompensated liver disease to receive either tenofovir disoproxil fumarate (TDF; n = 45), emtricitabine (FTC)/TDF (fixed-dose combination; n = 45), or entecavir (ETV; n = 22). The primary endpoint was safety; more specifically, tolerability failure (adverse events resulting in permanent treatment discontinuation) and confirmed serum creatinine increase ≥0.5 mg/dL from baseline or confirmed serum phosphorus <2 mg/dL. Patients with insufficient viral suppression (e.g., confirmed HBV DNA ≥400 copies/mL at week 8 or 24) could begin open-label FTC/TDF but were considered failures in this interim week 48 analysis for efficacy endpoints. Tolerability failure was infrequent across arms: 6.7% TDF, 4.4% FTC/TDF, and 9.1% ETV ( P = 0.622) as were confirmed renal parameters meeting threshold 8.9%, 6.7%, and 4.5% ( P = 1.000), respectively. Six patients died (none considered related to study drug) and six received liver transplants (none had HBV recurrence). The adverse event and laboratory profiles were consistent with advanced liver disease and complications, with no unexpected safety signals. At week 48, HBV DNA was <400 copies/mL (69 IU/mL) in 70.5% (TDF), 87.8% (FTC/TDF), and 72.7% (ETV) of patients. Proportions with normal alanine aminotransferase were: 57% (TDF), 76% (FTC/TDF), and 55% (ETV). Hepatitis B e antigen (HBeAg) loss/seroconversion occurred in 21%/21% (TDF), 27%/13% (FTC/TDF), and 0%/0% (ETV). Child-Turcotte-Pugh and Modification for End-stage Liver Disease scores improved in all groups. Conclusion: All treatments were well tolerated in patients with decompensated liver disease due to CHB with improvement in virologic, biochemical, and clinical parameters. (Hepatology 2011.)

Cancer is one of the most common diseases all over the world; many people suffer from diverse types of cancer. However, currently there is no exact cure or therapy developed for cancer. On the other hand, nanoparticles are defined as microscopic particles that have dimensions less than 100 nm and they are known for their usage in health sciences and medicine, however a few harmful effects on different animal cells. Therefore, researchers began to use nanoparticles for cancer therapies and to develop new methods for much more effective therapies. Nanoparticles in cancer studies are commonly used in photodynamic therapy (PDT) and sonodynamic therapy (SDT) as a sensitising agent, in computed tomography imaging (CT) and radiation therapy as an enhancement agent, in dual-mode image contrast and enhancement therapy as an image contrast agent. Titanium dioxide nanoparticles (TiO2 NPs) are known as commonly used nanoparticles in medical applications and hence in cancer studies. They are used in PDT, SDT and drug delivery systems. As cancer continues to affect people, new therapeutics and therapies will be developed and nanotechnology for this aim will be an important approach for the researchers.

Dünya genelinde yaygın bir pandemi oluşturan COVID-19 salgını yaşamı ciddi anlamda tehdit etmeye devam etmektedir. Aslında beklenmeyen bir zamanda, Aralık 2019’da Çin’in Hubei eyaleti Wuhan kentinden başlayan bu hastalık hakkında var olan bilgiler her gün değişirken, hastalığın hızlı bulaşma şekli, hasta ve ölüm sayılarının sürekli artması sebebiyle var olan panik ve endişe bir tür korkuya dönüşmüş durumdadır. Makalemizi yazdığımız sırada geçen 4 ay içerisinde COVID-19 hakkında literatüre kazandırılan ve çoğunlukla bilimsel verilere dayandırılan makaleler, hastalık hakkında doğru bilgilenmenin sağlanmasına yardımcı olmaktadır. Bu nedenle makalenin belirtilen amaca yönelik hazırlanmasına özen gösterilmiştir. Hastalığın farklı seyreden klinik prognozu, görüldüğü yaş grupları ve yayılışı dikkate alındığında; konunun sadece tıbbi boyutla sınırla kalmayacağı, sosyokültürel, etik ve ahlâk, hukuk, eğitim, turizm, ekonomi, tarım, halk sağlığı açısından olumsuz bazı etkileri olabileceği tahmin edilebilir. Çıkış noktası burası olan bu makalede, internet üzerinden doğruluk payı fazla olan haber kaynaklarına ve bilimsel literatüre dayalı olarak, COVID-19 pandemisinin sosyal yaşam ve etik düzlemi etkileyen olumsuzluklarını inceleyen ve değerlendiren bir içeriğe yer verilmiştir. Hastalığın ilk etki dalgasındaki durumunu özetleyen bu tür makalelerin COVID-19’un ortaya çıkardığı tıbbi ve sosyal sorunların doğru algılanacağına ve yeni çalışmalara kaynak teşkil edeceğine inanıyoruz.

In this in vitro study, we investigated the efficacy of sodium hypochlorite (NaOCl) and calcium hydroxide (Ca(OH)2) in dissolving necrotic tissue and cleaning root canals. In the first part of the study, 0.5% NaOCl solution and Ca(OH)2 paste and solution were tested with samples of necrotic bovine muscle in different treatment modes and for different periods. The necrotic tissue was weighed before and after the test and the percentage of weight change calculated. In the second part of the study, 40 extracted single-rooted human teeth were hand instrumented and then subjected to different irrigation regimens. The cleansing efficacy in root canals of 0.5% NaOCl with Ca(OH)2 pretreatments and ultrasonics was examined using scanning electron microscopy. A solution of 5% NaOCl was significantly more effective than 0.5% NaOCl as a solvent of necrotic tissue. Calcium hydroxide was an effective solvent for necrotic tissue as a paste but not as a solution. Pretreatment of necrotic tissue with Ca(OH)2 increased its solubility in 0.5% NaOCl. While 5% NaOCl plus ultrasonic irrigation produced cleaner root-canal walls at the middle and apical thirds, 0.5% NaOCl used with the same technique achieved no root-canal cleaning. However, pretreatment of root canals with Ca(OH)2 paste increased the effectiveness of 0.5% NaOCl plus ultrasonic irrigation, except in the coronal third of the root canal.

Fibrous dysplasia is a nonneoplastic developmental disease of osseous tissue. It is a lesion of unknown etiology, uncertain pathogenesis, and diverse histopathology. In this series of 16 patients with fibrous dysplasia of the craniomaxillofacial bones, the disease was generally monostotic and most commonly maxillary in location. Two patients demonstrated typical symptoms of the McCune Albright syndrome. Marked deformity or functional disturbances were the major indications for treatment. Total excision of the involved bone was the most successful form of treatment but produced the greatest functional and cosmetic deficits and long-term postoperative complications. A conservative therapeutic approach with a modest reduction in the bulk of these lesions may be sufficient to relieve signs and symptoms effectively. Periodic follow-up is indicated to detect recurrences or malignant changes in the early stages.

BACKGROUND: Hereditary recurrent fevers (HRF) are a group of rare monogenic diseases leading to recurrent inflammatory flares. A large number of variants has been described for the four genes associated with the best known HRF, namely MEFV, NLRP3, MVK, TNFRSF1A. The Infevers database ( http://fmf.igh.cnrs.fr/ISSAID/infevers ) is a large international registry collecting variants reported in these genes. However, no genotype-phenotype associations are provided, but only the clinical phenotype of the first patient(s) described for each mutation. The aim of this study is to develop a registry of genotype-phenotype associations observed in patients with HRF, enrolled and validated in the Eurofever registry. RESULTS: Genotype-phenotype associations observed in all the patients with HRF enrolled in the Eurofever registry were retrospectively analyzed. For autosomal dominant diseases (CAPS and TRAPS), all mutations were individually analyzed. For autosomal recessive diseases (FMF and MKD), homozygous and heterozygous combinations were described. Mean age of onset, disease course (recurrent or chronic), mean duration of fever episodes, clinical manifestations associated with fever episodes, atypical manifestations, complications and response to treatment were also studied. Data observed in 751 patients (346 FMF, 133 CAPS, 114 MKD, 158 TRAPS) included in the Eurofever registry and validated by experts were summarized in Tables. A total of 149 variants were described: 46 TNFRSF1A and 27 NLRP3 variants, as well as various combinations of 48 MVK and 28 MEFV variants were available. CONCLUSIONS: We provide a potentially useful tool for physicians dealing with HRF, namely a registry of genotype-phenotype associations for patients enrolled in the Eurofever registry. This tool is complementary to the Infevers database and will be available at the Eurofever and Infevers websites.

AIMS: Sufficient myocardial recovery with the subsequent explantation of a left ventricular assist device (LVAD) occurs in approximately 1-2% of the cases. However, follow-up data about this condition are scarcely available in the literature. This study aimed to report the long-term outcomes and clinical management following LVAD explantation. METHODS AND RESULTS: An analysis of the European Registry for Patients with Mechanical Circulatory Support was performed to identify all adult patients with myocardial recovery and successful explantation. Pre-implant characteristics were retrieved and compared with the non-recovery patients. The follow-up data after explantation were collected via a questionnaire. A Kaplan-Meier analysis for freedom of the composite endpoint of death, heart transplantation, LVAD reimplantion, or heart failure (HF) relapse was conducted. A total of 45 (1.4%) cases with myocardial recovery resulting in successful LVAD explantation were identified. Compared with those who did not experience myocardial recovery, the explanted patients were younger (44 vs. 56 years, P < 0.001), had a shorter duration of cardiac disease (P < 0.001), and were less likely to have ischaemic cardiomyopathy (9% vs. 41.8%, P < 0.001). Follow-up after explantation could be acquired in 28 (62%) cases. The median age at LVAD implantation was 43 years (inter-quartile range: 29-52), and 23 (82%) were male. Baseline left ventricular ejection fraction was 18% (inter-quartile range: 10-20%), and 60.7% of the patients had Interagency Registry for Mechanically Assisted Circulatory Support Profile 1 or 2. Aetiologies of HF were dilated cardiomyopathy in 36%, myocarditis in 32%, and ischaemic in 14% of the patients, and 18% had miscellaneous aetiologies. The devices implanted were HeartMate II in 14 (50%), HVAD in 11 (39%), HeartMate 3 in 2 (7%), and 1 unknown with a median duration of support of 410 days (range: 59-1286). The median follow-up after explantation was 26 months (range 0.3-73 months), and 82% of the patients were in New York Heart Association Class I or II. Beta-blockers were prescribed to 85%, angiotensin-converting enzyme inhibitors to 71%, and loop diuretics to 50% of the patients, respectively. Freedom from the composite endpoint was 100% after 30 days and 88% after 2 years. CONCLUSIONS: The survival after LVAD explantation is excellent without the need for heart transplantation or LVAD reimplantation. Only a minority of the patients suffer from a relapse of significant HF.

Amaç: Bu araştırma, yapay zeka ve sağlıkta yapay zekanın kullanımına yönelik sağlık bilimleri fakültesi öğrencilerinin görüşlerinin belirlenmesi amacı ile yapılmıştır. Materyal-Metot: Tanımlayıcı tipteki bu araştırma, Mayıs-Temmuz 2020 tarihleri arasında, İzmir ilinde yer alan bir üniversitenin Sağlık Bilimleri Fakültesi hemşirelik (n=182), fizyoteretapi ve rehabilitasyon (n=191) ve beslenme ve diyetetik (n=32) bölümünde öğrenim gören 405 sağlık bilimleri öğrencisinin katılımı ile gerçekleştirilmiştir. Araştırma verileri, Yapay Zeka Farkındalık Anketi ile toplanmıştır. Nitel veriler tematik içeriz analizi yöntemiyle değerlendirilirken, niceliksel verilerin analizinde tanımlayıcı istatistikler kullanılmıştır. Bulgular: Araştırma bulguları; öğrencilerin yarıya yakın kısmı (%47,9, n=194) sağlıkta yapay zeka kavramı ve çoğunluğunun (%75,6, n=306) günlük hayatta yapay zeka ile desteklenen programlar hakkında bilgi sahibi olduklarını, yarısından fazlasının sağlıkta yapay zeka kullanımı hakkında bilgi sahibi olduklarını (%55,8, n=226) ve büyük çoğunluğunun (%92, n=372) bilgiye sosyal medyadan ulaştıklarını gösterdi. Öğrenciler sağlıkta yapay zeka kullanımı ile ilgili görüşlerini sağlıkta yapay zeka kullanımına yönelik olumlu görüşler, olumsuz görüşler, endişeler ve bilgi eksikliği temaları ile ifade etti. Öğrenciler sağlıkta yapay zeka kullanımına yönelik uygulama önerileri arasında; tıbbi hataların önlenmesine yönelik uygulamalar, klinik karar vermeyi kolaylaştıracak uygulamalar, sağlık profesyonellerinin iş yükünü azaltmaya yardımcı uygulamalar ve robotik uygulamalar yer aldı. Sonuç: Araştırma sonucunda Sağlık Bilimleri Fakültesi öğrencilerinin yapay zeka ve sağlıkta yapay zeka kullanımının farkında oldukları ve yapay zeka araçlarının kullanmak istedikleri ancak bu konuda endişelerinin ve bilgi eksikliğinin olduğu görülmüştür. Geleceğin sağlık profesyonellerini, yapay zeka teknolojilerine hazırlamak için eğitim müfredatında yapay zeka ile ilgili içeriklerin dahil edilmesinin önemli olduğu düşünülmektedir.

Articular cartilage is a highly specialized tissue composed of chondrocytes which regulate the metabolism of extracellular matrix molecules responsible for maintaining cartilage function. Chondrocytes and synoviocytes are metabolically highly active cells and respond to various factors such as hormones, cytokines, growth factors, and mechanical stresses. Under normal physiological conditions, degradation and synthesis of extracellular matrix molecules are maintained in a state of balance. Any disruption of this balance results in degenerative cartilage diseases such as osteoarthritis and rheumatoid arthritis. Currently, diagnoses of both diseases are based on the assessment of a combination of clinical symptoms and radiological findings. However, degenerative changes in the articular cartilage occurs long before radiological changes are observed. Therefore, new laboratory tools are required to detect cartilage degradation in the early phase of the disease, to show the progression of cartilage destruction, and to assess response to treatment. In recent years, there has been an increase in the use of some biochemical markers derived from bone and cartilage for the diagnosis and follow-up of cartilage diseases. In this paper, the utility of these markers for early diagnosis and follow-up of cartilage injury is discussed in the light of the current literature.

OBJECTIVES: A second paediatric report has been generated from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS). The purpose of EUROMACS, which is operated by the European Association for Cardio-Thoracic Surgery, is to gather data related to durable mechanical circulatory support for scientific purposes and to publish reports with respect to the course of mechanical circulatory support therapy. Since the first report issued, efforts to increase compliance and participation have been extended. Additionally, the data provided the opportunity to analyse patients of younger age and lower weight. METHODS: Participating hospitals contributed pre-, peri- and long-term postoperative data on mechanical circulatory support implants to the registry. Data for all implants in paediatric patients (≤19 years of age) performed from 1 January 2000 to 1 July 2019 were analysed. This report includes updates of patient characteristics, implant frequency, outcome (including mortality rates, transplants and recovery rates) as well as adverse events including neurological dysfunction, device malfunction, major infection and bleeding. RESULTS: Twenty-nine hospitals contributed 398 registered implants in 353 patients (150 female, 203 male) to the registry. The most frequent aetiology of heart failure was any form of cardiomyopathy (61%), followed by congenital heart disease and myocarditis (16.4% and 16.1%, respectively). Competing outcomes analysis revealed that a total of 80% survived to transplant or recovery or are ongoing; at the 2-year follow-up examination, 20% died while on support. At 12 months, 46.7% received transplants, 8.7% were weaned from their device and 18.5% died. The 3-month adverse events rate was 1.69 per patient-year for device malfunction including pump exchange, 0.48 for major bleeding, 0.64 for major infection and 0.78 for neurological events. CONCLUSIONS: The overall survival rate was 81.5% at 12 months following ventricular assist device implant. The comparison of survival rates of the early and later eras shows no significant difference. A focus on specific subgroups showed that survival was less in patients of younger age (<1 year of age) (P = 0.01) and lower weight (<20 kg) (P = 0.015). Transplant rates at 6 months continue to be low (33.2%) The fact that the EUROMACS registry is embedded within the European Association for Cardio-Thoracic Surgery Quality Improvement Programme offers opportunities to focus on improving outcomes.

In recent years, intensive care units have been using advanced technology that provides significantly improved results in clinical treatment and care practices. However, this results in intensive care patients experiencing pain and anxiety. This pain and anxiety is generally brought under control with various pharmacological preparations. When a pharmacological approach is not used or is ineffective, doctors and nurses also use non-pharmacological approaches such as music to control pain and anxiety. Research has found music therapy to be an effective method of reducing pain intensity and anxiety levels in intensive care patients. Therefore, the use of music therapy is important for intensive care patients. This article will deal with the effects of music therapy on pain and anxiety management in intensive care patients.

Abstract OBJECTIVES A second paediatric report has been generated from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS). The purpose of EUROMACS, which is operated by the European Association for Cardio-Thoracic Surgery, is to gather data related to durable mechanical circulatory support for scientific purposes and to publish reports with respect to the course of mechanical circulatory support therapy. Since the first report issued, efforts to increase compliance and participation have been extended. Additionally, the data provided the opportunity to analyse patients of younger age and lower weight. METHODS Participating hospitals contributed pre-, peri- and long-term postoperative data on mechanical circulatory support implants to the registry. Data for all implants in paediatric patients (≤19 years of age) performed from 1 January 2000 to 1 July 2019 were analysed. This report includes updates of patient characteristics, implant frequency, outcome (including mortality rates, transplants and recovery rates) as well as adverse events including neurological dysfunction, device malfunction, major infection and bleeding. RESULTS Twenty-nine hospitals contributed 398 registered implants in 353 patients (150 female, 203 male) to the registry. The most frequent aetiology of heart failure was any form of cardiomyopathy (61%), followed by congenital heart disease and myocarditis (16.4% and 16.1%, respectively). Competing outcomes analysis revealed that a total of 80% survived to transplant or recovery or are ongoing; at the 2-year follow-up examination, 20% died while on support. At 12 months, 46.7% received transplants, 8.7% were weaned from their device and 18.5% died. The 3-month adverse events rate was 1.69 per patient-year for device malfunction including pump exchange, 0.48 for major bleeding, 0.64 for major infection and 0.78 for neurological events. CONCLUSIONS The overall survival rate was 81.5% at 12 months following ventricular assist device implant. The comparison of survival rates of the early and later eras shows no significant difference. A focus on specific subgroups showed that survival was less in patients of younger age (&amp;lt;1 year of age) (P = 0.01) and lower weight (&amp;lt;20 kg) (P = 0.015). Transplant rates at 6 months continue to be low (33.2%) The fact that the EUROMACS registry is embedded within the European Association for Cardio-Thoracic Surgery Quality Improvement Programme offers opportunities to focus on improving outcomes.

The aim of this study was to observe the course of the marginal mandibular branch of the facial nerve (MMBFN) in relation to the inferior border of the mandible and parotid gland and its relevance to surgical procedures such as rhytidectomy and parotid gland surgery. In this study, 50 specimens were dissected. The relationships between the MMBFN and the inferior border of the mandible were recorded and analyzed. We found that posterior to the facial artery, the MMBFN ran above the inferior border of the mandible in 37 (74%) of the specimens. In 11 (22%) specimens, below the inferior border of the mandible it was divided into two branches at the crossing point with the facial artery. In 2 (4%) specimens the MMBFN divided into two branches at the point of emergence from the parotid gland. There were no statistical differences between the left and right sides, and both sexes. The MMBFN is one of the most vulnerable branches to surgical injury because of its location. For this reason, the surgeons who are willing to operate on this area, especially for the rhytidectomies, should have a true knowledge about the anatomy of this branch.

All suspected congenital abnormalities of the nose require further evaluation. The nasal dermoid sinus cyst (NDSC) is one of the many midline nasal masses that often pose diagnostic and treatment dilemmas for the plastic and reconstructive surgeon. NDSCs are distinct from other facial dermoids in their potential for involving deeper contiguous structures, and intracranial extension. Accurate diagnosis and effective treatment are essential to avoid craniofacial skeletal deformation, cyst rupture, and infection that could cause cutaneous, ocular, or intracranial complications. A comprehensive discussion of the embryogenesis, pathogenesis, diagnosis, and surgical management of the NDSC is presented to delineate the role of open rhinoplasty in optimizing the management of this congenital nasal deformity.

In Brief In this current study, the clinical data and postoperative follow-up findings of 118 patients with a primary lower lip carcinoma who were treated between 1983 and 1999 in the Department of Plastic and Reconstructive Surgery are presented. Medical records were reviewed retrospectively and data were collected concerning age, gender, followup period, location of lesion on the lip, cervical metastasis at presentation, preoperative biopsy results, histological grade, initial treatment, reconstruction type, pathological outcome, local recurrence, regional lymph node metastasis, treatment of local recurrence and regional lymph node metastasis, and postoperative treatment. The prognostic value of clinical stages in relation with recurrence and mortality from disease was investigated. The overall rate of recurrence was calculated as being 39.8%, and the determinate survival rate was found to be 72.9% at 5-year follow-up. The data concerning the above-mentioned parameters, together with risk factors that might play a role in the development of lip cancer, are discussed in light of the current literature. A review of 118 primary lower lip carcinomas, 43% presenting as stage IV, demonstrated a 39.8% recurrence rate and a 72.9% determinate 5-year survival rate.

BACKGROUND: Basal cell carcinoma (BCC) in central facial locations and tumors with positive margins are at a higher risk of recurrence. The most effective treatment is total excision, which includes an adequate pathological margin. OBJECTIVE: To evaluate the outcome of the patients who underwent surgery for BCCs of the head and neck and of those who had positive surgical margins where Mohs surgery is not available. METHODS: This study was conducted at Ege University Medical School between 2004 and 2014. One hundred thirty patients with 154 BCC who underwent surgical excision were included. In the histopathologic report, the existence of positive margin, BCC subtype, localization of the tumor, and distance of margins to the tumor were evaluated. RESULTS: Twenty-three lesions (14.9%) of 22 patients revealed positive surgical margins. Six patients (26.1%) had recurrences on the surgical site. The BCC subtypes of recurrent patients were reported to be multifocal superficial in 2 (33.3%), infiltrative (16.7%) in 1, and micronodular (50%) in 3. CONCLUSION: Patients with superficial multifocal or micronodular tumors should undergo reoperation because of high recurrence rates.

OBJECTIVES: 1. To investigate the life-time prevalence of spousal physical abuse, history of childhood physical abuse, and child physical abuse among female outpatients and the relationship between the three; 2. To investigate the characteristics of physical abuse; 3. To investigate the socio-demographic and cultural features of physical abuse. METHOD: Domestic violence and its features were investigated for 3 generations in 100 female psychiatric outpatients using standard semi-structured interviews. SCID-I was used for psychiatric diagnoses. Clinical, socio-demographic, and family structure features were compared in abused and non-abused groups. FINDINGS: Lifetime prevalence of spousal physical abuse was 62%, 63% of the patients were physically abused in their homes during childhood, and 51% reported that they physically abused their children. The spouse-abused and non-abused groups did not differ in education level, occupation, family income, age at marriage, form of marriage, and history of childhood domestic violence. Age, extended family, and an alcohol-consuming husband were significantly correlated with spousal physical abuse. Perpetrating child abuse was significantly correlated with history of childhood physical abuse and spousal physical abuse. CONCLUSIONS: Domestic violence is a common problem among female psychiatric patients. Child abuse, spousal abuse, and history of childhood abuse are correlated.

A case of unilateral salpingitis caused by Enterobius vermicularis presenting as a painful adnexal mass in a 28-year-old woman is reported.

Dünyamızda 1900’lü yıllardan günümüze kadar dil öğretiminde çeşitli metinler kullanılmıştır. Bunlar “ edebi metinler, üretilmiş metinler, özgün ve özel metinler ” başlıkları altında toplanmıştır. Metinlerin seçimi dil öğretim yaklaşım ve yöntemlerine göre değişmektedir. Her yaklaşım kendine özgü metin kullanmıştır. Geleneksel yaklaşımda dil bilgisi kuralları, atasözleri, edebiyat, genel kültür gibi konuların öğretimine ağırlık verildiğinden edebi metinler kullanılmıştır. Davranışçı yaklaşımda dil davranış olarak ele alınmış, tekrar, taklit ve ezberleme yoluyla öğretilmiştir. Bu yaklaşımda edebi metinler yerine üretilmiş metinler kullanılmıştır. Bilişsel yaklaşımda “dil iletişim aracıdır” görüşü yayılmış ve özgün metinler kullanılmaya başlanmıştır. Günümüzde ise yapılandırıcı yaklaşımdan hareketle “Dil, sosyal etkileşim aracıdır.” anlayışı gündeme gelmiştir. Bu yaklaşımda özgün ve özel metinler kullanılmaya başlanmıştır. Böylece dil öğretiminde edebi metinlerden üretilmiş metinlere ardından da özgün ve özel metinlere geçilmiştir. Dünyamızdaki bu gelişmeler Türkçe öğretiminde de görülmektedir. Eskiden edebi metinlerle Türkçe öğretimi yapılırken yeni Türkçe öğretim programlarda özgün ve özel metinlerden yaralanılmakta, öyküleyici, bilgilendirici ve şiire yer verilmektedir.

Amaç: Öğrenme yaklaşımlarının belirlenmesi tıp eğitimi alanında önemli bir konudur. Böyle bir değerlendirme için iyi bilinen bir ölçeğin kültürel ve dilsel uyarlamasının yapılması, yeni bir ölçek hazırlanmasından daha etkin ve güvenli bir yoldur. Bu araştırma ile Biggsin Gözden Geçirilmiş İki Faktörlü Öğrenme Yaklaşımları Ölçeğinin Türkçe uyarlamasının geçerlilik ve güvenilirliğinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Araştırma Türkiyedeki üç tıp fakültesinde dönem I ve II öğrencilerine uygulanmıştır (n= 1027). Ölçek, test-tekrar test güvenirliği için öğrencilere uygulanmış ve tüm maddeleri yanıtlayan öğrenciler (n= 993) analizlere dahil edilmiştir. Geçerlilik çalışması olarak yapı geçerliği incelenerek doğrulayıcı faktör analizi yapılmıştır. Ölçeğin güvenirlilik analizinde her bir alt boyutun Cronbach Alfa değerleri belirlenmiş ve test-retest güvenirlilik katsayıları hesaplanmıştır. Bulgular: Ölçeğin yeni formunun yapı geçerliği incelenirken orijinal çalışmada doğrulayıcı faktör analizi için seçilen uyum indeksleri Türkçe uyarlamasında da seçilmiş ve değerlendirilmiştir. Tüm alt boyutlarda Karşılaştırmalı Uyum İndeksi (CFI) > 0.9 Standardize Ortalama Hataların Karekökü (SRMR) ve Yaklaşık Hataların Ortalama Karekökü (RMSEA) < 0.08 olarak bulunmuştur. Cronbach Alfa değeri Derin Yaklaşım için 0.772 ve Yüzeysel Yaklaşım için 0.800 olarak hesaplanmış ve kabul edilebilir düzeyde bulunmuştur. Test-tekrar test analizinde elde edilen sonuçlar arasındaki korelasyon katsayılarının ölçeğin derin yaklaşım boyutu için 0.687 ve yüzeysel yaklaşım boyutu için 0.604 (p< 0.01) olduğu görülmüştür. Sonuç: Bu sonuçlara göre ölçeğin araştırmalarda kullanılabilecek geçerli ve güvenilir bir ölçme aracı olduğu söylenebilir.