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Bazı Aile Sağlığı Merkezlerine Başvuranların Geleneksel ve Tamamlayıcı Tıp Uygulamaları ile İlgili Bazı Bilgi ve Tutumları
No full textThe relationship between isokinetic knee flexion and extension muscle strength, jump performance, dynamic balance and injury risk in female volleyball players
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The Effect of Cerium Oxide on Lung Tissue in Lower Extremity Ischemia Reperfusion Injury in Sevoflurane Administered Rats
No full textIntroduction: We aimed to investigate the effects of cerium oxide,
applied before the sevoflurane anesthesia, on lung tissue in rats with
lower extremity ischemia-reperfusion (IR).
Materials and Methods: A total of 30 rats were randomly divided into
five groups as; control (C), IR, cerium oxide-IR (CO-IR), IR-sevoflurane
(IRS), and cerium oxide-IR-sevoflurane (CO-IRS). In the CO-IR group, 30
minutes after the injection of cerium oxide (0.5 mg/kg, intraperitoneal
(i.p)), an atraumatic microvascular clamp was placed on the infrarenal
abdominal aorta for 120 minutes. Then, the clamp was removed and
reperfused for 120 minutes. Sevoflurane was applied in 100\% oxygen at a
rate of 2.3\% at 4 L/min during IR. The blood samples were taken for
biochemical analysis and the lung tissue samples were taken for
histological analysis.
Results: Neutrophil infiltration/aggregation was significantly higher in
the IR group than in the C and CO-IRS groups. The alveolar wall
thickness and total lung injury scores were significantly higher in the
IR group than in the C, IRS, CO-IR and CO-IRS groups.
Discussion: We determined that the administration of 0.5 mg/kg dose of
cerium oxide with sevoflurane reduces the oxidative stress and corrects
IR-related damage in lung tissue. Our results show that the
administration of cerium oxide before IR and the administration of
sevoflurane during IR have a protective effect in rats
Change Of Maternal Vıtamın D Levels Between Trımesters, Obstetrıc And Neonatal Outcomes In Vıtamın D Defıcıency
No full textVitamin D, diyetle alınabilen, temelde ultraviolet ışınları etkisi altında sentezlenebilen, kolesterolden derive prohormondur. Vitamin D eksikliği tüm dünyada yaygın bir problemdir. Vitamin D; plasental implantasyon, immun fonksiyonlar, inflamatuar yanıt ve glukoz homeostazı üzerine etkilidir. Plazma 25(OH)D, vitamin D eksikliğini, endojen vitamin sentezini ve vitamin D takviyesini en iyi gösteren biyomarkerdır. D vitamininin yeterli seviyelerinin cut off değerlerini tanımlamak için kullanılan çalışmaların çoğunda farklılıklar vardır. Gebelikte optimal vitamin D düzeyleri belirlenmemiştir ve bu konu araştırma alanı olmaya devam etmektedir.
Gazi Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği’nde Ocak 2016-Aralık 2017 tarihleri arasında takip edilip, her üç trimesterde D vitamin düzeyi değerlendirilen ve doğum yapan 179 hasta çalışmaya dahil edildi. Veriler, arşiv bilgilerinden ve elektronik data analizlerinden edinilerek kaydedildi. Hastaların tamamı Sağlık Bakanlığı Ana Çocuk Sağlığı ve Aile Planlaması Genel Müdürlüğü tarafından ‘Gebelere D Vitamini Destek Programı’ kapsamında 12. gebelik haftasından itibaren günde tek doz 1200 IU (9 damla) D vitamini desteği almaktaydı. Vitamin D düzeyleri; 20 ng/ml üzerinde olanlar yeterli, 20 ng/ml altında olanlar eksik olarak tanımlandı. Bu iki grup arasında doğum şekli, gestasyonel diyabet eşlik etmesi, preeklampsi gelişmesi, preterm doğum, SGA, düşük doğum ağırlığı, bebek doğum kilosu ve boyu gibi antenatal ve neonatal sonuçlar arasında fark olup olmadığının değerlendirilmesi planlandı. Eş zamanlı
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kord kanı D vitamin düzeyi değerlendirilen hastalarda, D vitamin eksikliğinin yenidoğan üzerindeki etkisi hakkında da değerlendirme yapılması planlanmıştır.
Çalışmamızda vitamin D yetersizliği, ilk trimesterde %59, ikinci trimesterde %72, üçüncü trimesterde %62 olarak saptanmıştır. Üçüncü trimesterde ölçülen ortanca vitamin D düzeyi, birinci ve ikinci trimestere göre belirgin olarak yüksek saptanmıştır (p<0,001). Bebek kord kanı vitamin D düzeyi ile üçüncü trimester maternal vitamin D düzeyi arasında pozitif yönde orta düzeyde bir korelasyon saptanmıştır (p<0,001 / R:0,694). Ayrıca kord kanı D vitamin düzeyi yetersiz olan grupta bebek doğum kilosu ve doğum haftası anlamlı olarak düşük saptanmıştır. Maternal vitamin D düzeyi yetersiz olan grup ile GDM, preeklampsi, doğum şekli, doğum zamanı arasında ilişki saptanmamıştır. Çalışmamızda, üçüncü trimester D vitamin düzeyi <20 ng/ml olan grupta SGA bebek oranı yüksek saptanmıştır (p:0,045). Bebek doğum kilosu 2500 gr altında olan düşük doğum ağırlıklı grupta preterm doğum oranı yüksek gözlenmiştir (p:0,025). Düşük doğum ağırlığı olan grupta üçüncü trimester 25(OH)D vitamin düzeyleri yetersiz saptanmıştır (p:0,045).
Çalışmadan elde edilen bulgular ışığında; D vitamini desteği verilen gebelerde 25(OH)D düzeyi ilk trimesterden gebeliğin sonuna kadar anlamlı olarak yükselse bile ortanca değerin istenilen düzeylere ulaşmadığı gözlenmiştir. Bu durum verilen dozların hastalar tarafından düzenli kullanılmaması ile, verilen dozun yetersizliği ile, ilacın veriliş şeklinin farklılığıyla ilgili olabilir. Bu nedenle öncelikle gebeler bilinçlendirilmelidir. Oral damla, intranasal ya da intramuskuler kullanım yolları da denenebilir. Maternal serum D vitamin düzeyi kord kanı ile koreledir ve yetersizliğinde düşük doğum ağırlıklı bebeklerin sıklığı artmaktadır.
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Prematüritenin getirdiği komplikasyonlardan kaçınılması için D vitamini durumu daha sıkı takip edilmelidirVitamin D is a cholesterol-derived, prohormone that can be taken on a diet and can be synthesized under the influence of ultraviolet rays. Vitamin D deficiency is a common problem all over the world. Vitamin D, is effective on placental implantation, immune functions, inflammatory response and glucose homeostasis. Plasma 25(OH)D is a biomarker that best demonstrates vitamin D deficiency, endogenous vitamin synthesis and vitamin D supplementation.There are differences in most of the studies used to define the cut off values of adequate levels of vitamin D. Optimal vitamin D levels were not determined during pregnancy and this topic remains a research area. The study included 179 patients who were followed-up between January 2016-December 2017 at the Gazi University Faculty of Medicine, Department of Obstetrics and Gynecology, who had been evaluated for vitamin D levels in all three trimesters and delivered in our clinic. Data were obtained from archival information and electronic data analysis. All of the patients received a single dose of 1200 IU (9 drops/day) vitamin D daily from the 12th gestational week within the scope of the Vitamin D Support to Pregnant Women Program by the General Directorate of Maternal and Child Health and Family Planning. Vitamin D levels; those who were above 20 ng/ml were identified as adequate, and those below 20 ng/ml were defined as deficiency. It was planned to evaluate whether there were any differences between antenatal and neonatal outcomes such as delivery type, gestational diabetes, preeclampsia development, preterm delivery, SGA, low birth weight, infant birth weight and height. It was planned to evaluate the effect of
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vitamin D deficiency on neonates in patients with concurrent cord blood vitamin D levels. In our study, vitamin D deficiency was found as 59% in the first trimester, 72% in the second trimester and 62% in the third trimester. The median vitamin D level measured in the third trimester was significantly higher than the first and second trimesters (p <0,001). A moderate positive correlation was found between the level of maternal vitamin D in third trimester and baby cord blood (p <0,001 / R: 0,694). In addition, in the group with inadequate cord blood vitamin D levels, birth weight and birth week were significantly lower. There was no relationship between the group with inadequate maternal vitamin D levels and GDM, preeclampsia, type of delivery and delivery time. In our study, SGA infant rate was found to be high in the group with a vitamin D level <20 ng / ml in the third trimester (p: 0,045). Preterm delivery rate was found to be high in the low birth weight group with a birth weight below 2500 g (p: 0,025). In the low birth weight group, 25(OH)D vitamin levels were found to be insufficient in the third trimester (p: 0,045). In the light of the findings obtained from the study; although 25(OH)D levels increased significantly from the first trimester to the end of the pregnancy, it was observed that the median value did not reach the desired levels in the pregnants who were given vitamin D supplementation. This may be related to the lack of regular use of the given doses by the patients, the insufficiency of the given dose and the difference in the mode of administration of the drug. Therefore, pregnant women should be informed firstly. Oral drops, intranasal or intramuscular routes of administration can also be tried. The maternal serum vitamin D level is correlated with cord blood, and the incidence of low birth
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weight infants is increasing. Vitamin D status should be followed more strictly in order to avoid complications caused by prematurity
Higher Risk of Loosening for a Four-Pegged TKA Tibial Baseplate Than for a Stemmed One: A Register-based Study
No full textBackground Modern modular implants allow surgeons to mix different
combinations of components within the same brand. From 1999 to 2012, the
NexGen (R)-CR Option femoral component, together with a NexGen (R)
Option Stemmed tibial plate (stemmed baseplate), which uses a short
central stem, was the most-frequently used NexGen (R) combination in the
Swedish Knee Arthroplasty Register. However, from 1999 to 2012, the same
femoral component was also used along with the NexGen (R) Precoat
four-pegged tibial baseplate (pegged baseplate). Considering the
difference in the fixation concepts for these two tibial baseplates, we
wanted to study whether their revision rates differed.
Questions/purposes To investigate the difference in (1) all-cause
revision and (2) the risk of revision for aseptic loosening between the
NexGen (R) pegged and stemmed baseplates when used with the NG-CR Option
femoral component and the same two types of inserts. Methods The Swedish
Knee Arthroplasty Register provided data. The register, which was
started in 1975, has since 1999 registered part numbers for individual
implant components, allowing it to assess the combinations of components
used in each patient. It has been shown to have high completeness (97\%)
and validity {[}12, 15]. The inclusion period was 1999 to 2012; during
that time, 137,143 primary knee arthroplasties were registered, of which
125,094 were TKAs. Only TKAs performed for osteoarthritis and without
patellar resurfacing were included, since not resurfacing the patella is
the standard procedure in Sweden. This left 15,287 knees with the
stemmed baseplate and 2479 with the pegged baseplate, or 12\% and 2\% of
the total number of TKAs, respectively. Two general hospitals used the
pegged baseplate exclusively during that period. Thus, specific patients
were not selected for having the pegged plate. The mean age, mortality,
and length of followup were similar for the two groups. We used the
Kaplan-Meier statistics to calculate the cumulative revision rate (CRR)
and Cox regression to compare risk ratios after adjusting for age and
sex. The end point was a knee revision for respective all causes or
aseptic loosening. The study ended on December 31, 2016. Due to the free
healthcare system in Sweden it is highly unusual for patients to seek
elective revision abroad, and by use of the extensive Swedish census
register, we estimate the level of followup approximately 97\%. Results
Knees with the pegged baseplate had a higher risk for all-cause revision
than did those with the stemmed baseplate (5.8\% {[}95\% confidence
interval \{CI\}, 4-8.3] and 3\% {[}95\% CI, 2.6-3.5] at 15 years; p =
0.003). After controlling for age and sex, the aseptic loosening risk in
the pegged baseplate group was still higher than that in the stemmed
group (relative risk, 5.40; 95\% CI, 3.64-8.02; p < 0.001). Conclusions
In this Swedish registry study, we observed a higher loosening risk with
the pegged baseplate than the stemmed one, even after controlling for
age and sex. Because this was only a comparison of implants from one
vendor, and because there may have been other between-group differences
for which we could not fully control, this concerning finding should be
explored using data from other registries
High-sensitive troponin T increase after hemodialysis is associated with left ventricular global longitudinal strain and ultrafiltration rate
No full textImmunomagnetic separation and Listeria monocytogenes detection with surface-enhanced Raman scattering
No full textBackground/aim: We aimed to develop a rapid method to enumerate Listeria
monocytogenes (L. monocytogenes) utilizing magnetic nanoparticle based
preconcentration and surface-enhanced Raman spectroscopy measurements.
Materials and methods: Biological activities of magnetic
Au-nanoparticles have been observed to have the high biocompatibility,
and a sample immunosensor model has been designed to use avidin attached
Au-nanoparticles for L. monocytogenes detection. Staphylococcus aureus
(S. aureus) and Salmonella typhimurium (S. typhimurium) bacteria
cultures were chosen for control studies. Antimicrobial activity studies
have been done to identify bio-compatibility and bio-characterization of
the Au-nanoparticles in our previous study and capturing efficiencies to
bacterial surfaces have been also investigated.
Results: We constructed the calibration graphs in various population
density of L. monocytogenes as 2.2 x 10(1) to 2.2 x 10(6) cfu/mL and the
capture efficiency was found to be 75\%. After the optimization
procedures, population density of L. monocytogenes and Raman signal
intensity showed a good linear correlation (12 2 - 0.991) between 10(2)
to 10(6) cfu/ml, L. monocylogenes. The presented sandwich assay provides
low detection limits and limit of quantification as 12 cfu/mL and 37
cfu/mL, respectively. We also compared the experimental results with
reference plate-counting methods and the practical utility of the
proposed assay is demonstrated using milk samples.
Conclusion: It is focused on the enumeration of L. monocytogenes in milk
samples and the comparision of results of milk analysis obtained by the
proposed SERS method and by plate counting method stay in food
agreement. In the present study, all parameters were optimized to select
SERS-based immunoassay method for L. monocytogenes bacteria to ensure
LOD, selectivity, precision and repeatablity