Bilindiği üzere 31 Aralık 2019’da Çin’in Wuhan şehrinden bir deniz ürünleri ve canlı hayvan pazarı ile ilişkili olabilecek etyolojisi açıklanamayan 44 pnöm

Amber necklaces have been used frequently to reduce the complaints of babies during teething. In this study, the knowledge and experience of families regarding the use of amber necklaces investigated. The structured questionnaire was applied face-to-face to parents with a 4–24 month old baby who applied to the paediatric outpatient clinic. One hundred one families participating in the study reported that they used the amber necklace most frequently for restlessness (n = 72, 71.3%). Eighty- three% of families reported that the amber necklace was beneficial. It determined that 2% of the babies had suffocation and 2% had problems dispersing the grains. Although the parents think that the use of amber necklaces is effective during the teething period, they are not aware of the risks. It is important for healthcare professionals to inform their families about teething and especially the risks of using amber necklaces.

Objectives: Breastfeeding, which is the ideal feeding method for babies, has many benefits for both babies and mothers. However, nipple problems during breastfeeding can cause early weaning. One of the methods used for nipple care is the use of silver nipple cups. In this study, we aimed to evaluate the experiences of breastfeeding mothers using silver cups for nipple care. Methods: Mothers contacted via social media were asked to participate in a structured survey consisting of 33 questions related to breastfeeding, nipple care and silver cups use. Results: A total number of 298 women were assessed with a structured questionnaire. There was no significant difference between mothers using and not using silver cups regarding their demographic features, breastfeeding starting time, frequency, duration and pumping. Ninthy three percent (n=290) of mothers used at least one method for nipple care. The first three commonly used methods for nipple care were lanoline (52,2%), breastmilk (51,2%) and silver cups (49,8%). It was reported by 36,6% (n=109) of mothers that they have not experienced any nipple problems. Among the 147 mothers who had used silver cups 89,9% (132) claimed that this method was effective for them. There was no difference between the frequency of nipple fissures in mothers using silver cups when compared to mothers who did not use it. Conclusion: Nipple fissure is one of the most common causes of early cessation of breastfeeding. Mothers use many methods for nipple care. Silver cups is one of the methods preferred by mothers in the prevention of nipple fissures and it is reported to be beneficial.

Background: Dermatological diseases account for a substantial share of primary-care visits, yet many are referred to secondary or tertiary services. A notable proportion of dermatology outpatient visits may instead be manageable within primary care. We evaluated whether patients assessed at the tertiary level could have been managed in primary care, in order to inform referral optimization. Methods: In this retrospective, cross-sectional study, the records of 400 patients who presented to the dermatology outpatient clinic of a city hospital in Istanbul between May, and July 2025 were analyzed. Each case was independently classified by three multidisciplinary commissions; each commission comprised a dermatologist, a family medicine specialist, and a general practitioner. Each commission produced a single panel-level management decision per case, and inter-commission agreement across the three commissions was assessed with Fleiss’ kappa. Results: Of the 400 patients, 58.8% were female and the mean age was 31.0 ± 17.6 years; 27.5% (n = 110) were pediatric (aged 0–18 years). Overall, 51.5% of cases were judged manageable in primary care (27.5% by a family physician directly and 24.0% with teledermatology support); this was 55.5% in pediatric and 50.0% in adult patients. Only 17.8% of patients had consulted a family physician in the 7 days before attendance. The most frequent diagnoses were acne, dermatitis, and superficial fungal infections. Inter-commission agreement was moderate overall (κ = 0.430; p < 0.001) and lower in pediatric (κ = 0.312) than adult (κ = 0.471) cases. Conclusions: A substantial proportion of tertiary dermatology visits could plausibly be managed in primary care. Realizing this potential depends primarily on strengthening primary-care dermatology capacity, with teledermatology serving as one structured, supportive pathway.

Background: Frequent and short-term repeat visits place significant pressure on primary care-centered health systems, particularly in large metropolitan areas. Istanbul, with its high population density and heterogeneous sociodemographic profile, presents a unique context for understanding short-interval healthcare utilization dynamics. Objective: To examine short-term repeat healthcare utilization following an index primary care visit and to explore how district-level population and socioeconomic characteristics shape early post-visit care-seeking dynamics in a large metropolitan setting. Methods: This retrospective cohort study analyzed protocol records from 225 randomly selected FMUs across Istanbul. A total of 11,101 individuals who presented on 7 July 2025 were followed for 21 days, during which 26,743 healthcare contacts (index family medicine unit visits, recurrent FMU visits, and secondary/tertiary care visits) were captured. FMU repeat visits, higher-level utilization, district-level population density, and socioeconomic development level (SEGE-2022) were analyzed using descriptive statistics and district-level comparative analyses. Results: During the 21-day follow-up period, participants generated a total of 26,743 healthcare contacts. Across the full cohort, the median number of recurrent FMU visits was 0 (IQR 0–1), and the median number of secondary/tertiary visits was 0 (IQR 0–1). Among individuals who had repeat contacts, the median number of recurrent FMU visits was 1 (IQR 1–2), and the median number of secondary/tertiary visits was 1 (IQR 1–2). Repeat visits clustered in the first 7 days, whereas higher-level visits increased between days 10–21. Districts with lower SEGE status and high population density (e.g., Esenyurt, Bağcılar, Pendik, Küçükçekmece, Ümraniye) exhibited markedly higher repeat visit intensity. Spatial patterns indicated substantial clustering in western and socioeconomically disadvantaged districts. Multivariable regression analysis showed that visitor patient status was associated with higher secondary/tertiary care utilization (OR = 1.14, 95% CI 1.04–1.24), while higher SEGE scores were modestly associated with increased repeat FMU visits. Conclusions: Short-term repeat visits in Istanbul appear to be influenced not only by clinical needs but also by broader contextual factors such as socioeconomic disadvantage, population density, and health system organization. These findings suggest potential structural pressures within Türkiye’s primary care-centered system and highlight the potential value of district-specific interventions.

Background Amber necklaces have been used frequently to reduce the complaints of babies during teething. In this study, the knowledge and experience of families regarding the use of amber necklaces investigated. Methods The structured questionnaire was applied face-to-face to parents with a 4–24 month old baby who applied to the paediatric outpatient clinic. Results One hundred one families participating in the study reported that they used the amber necklace most frequently for restlessness (n = 72, 71.3%). Eighty- three percent of families reported that the amber necklace was beneficial. It determined that 2% of the babies had suffocation and 2% had problems dispersing the grains. Conclusion Although the parents think that the use of amber necklaces is effective during the teething period, they are not aware of the risks. It is important for healthcare professionals to inform their families about teething and especially the risks of using amber necklaces.