Pınar Erkekoğlu, Belma Giray, Orhan Derman

Fitalat teması ile plazma amilaz ve lipaz düzeyleri arasındaki ilişkinin pubertal jinekomasti hastalarında değerlendirilmesi Özgün Araştırma

Özet Amaç: Bu çalışmanın amacı endokrin bozucu etkileri bilinen di 2 etilhekzil fitalat DEHP ve metaboliti mono 2 etilhekzil fitalat nbsp; MEHP plazma düzeylerinin yüksek olduğu belirlenen pubertal jinekomasti hastalarında plazma fitalat düzeyleri ile pankreatik lipaz ve a amilaz düzeyleri arasındaki ilişkinin incelenmesi ve fitalatların pankreas üzerindeki olası etkilerinin değerlendirilmesidir Gereç ve Yöntem: Çalışma grubu 40 pubertal jinekomasti hastasından oluşmaktadır Plazma fitalat düzeyleri DEHP ve MEHP mono 2 etikhekzil Yüksek basınçlı sıvı kromatografisi high pressure liquid chromatography kullanılarak belirlenmiştir Lipaz ve a amilaz düzeyleri enzimatik kolorimetrik yöntemle ölçülmüştür İncelenen değişkenler arasındaki ilişki ilişki katsayısı saptanarak incelenmiştir Bulgular: Jinekomasti hastalarındaki plazma DEHP ve MEHP düzeyleri kontrol grubuna oranla önemli düzeyde yüksek bulunmuştur Alfa amilaz ve MEHP düzeyleri arasında jinekomasti hastalarında r= 0 388 p lt;0 05 ve tüm çalışma grubunda r= 0 353 p lt;0 05 negatif ilişki saptanmıştır DEHP ve a amilaz düzeyleri arasında da tüm çalışma grubunda önemli düzeyde negatif ilişki r= 0 323 p lt;0 05 saptanmıştır Çıkarımlar: Sonuçlar fitalat varlığının a amilaz salgılanmasında belirgin azalmalara neden olabileceğine işaret etmektedir Gözlenen bu ters ilişki fitalatların PPARg peroxisome proliferator activated receptor gamma etkinliği ile açıklanabilir nbsp; Türk Ped Arş 2010; 45: 366 70 Anahtar sözcükler: a amilaz di 2 etilhekzil fitalat jinekomasti lipaz mono 2 etilhekzil fitalat nbsp;

Anahtar Kelimeler:

α-amilaz, di (2-etilhekzil) fitalat, jinekomasti, lipaz, mono (2-etilhekzil) fitalat

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Malpractice has gained an alarming dimension especially along with the introduction of compulsory professional liability insurance On the other hand it is quite difficult to say that malpractice is discussed by considering all responsible determinants According to individual focused approach the error is caused by single individual so the solution can be achieved by punishing the individual It is known that this approach does not reduce errors and adversely affect services due to high compensations and increased insurance premiums In Turkey malpractice is simply considered in the customer seller relationship context and individual focused approach is adopted However it is well established that this ldquo;blame culture rdquo; has negative effects on service provided social perception of the profession and job satisfaction Beside recognizing individual professional responsibilities basically it should be stressed that declaring healthcare workers as mainly responsible would not be fair In addition it violates right to health because of increasing the preventable errors and harms Turk Arch Ped 2011; 46: 6 11

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