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Caffeine Use in Preterm Neonates: National Insights Into Turkish Nicu Practices
No full textUlu, Ersin/0000-0002-9798-2367Objective: Caffeine is a proven medication used for the prevention and treatment of apnea in premature infants, offering both short- and long-term benefits. International guidelines provide a range of recommendations regarding the preterm population eligible for caffeine prophylaxis, including the timing, dosage, and duration of treatment. Our national guidelines, published prior to the most recent updates of the international guidelines, recommend the use of caffeine citrate starting from the first day after delivery for preterm infants with a gestational age of 28 weeks. For infants up to 32 weeks, if positive pressure ventilation is required, the decision should be made on an individual basis. This study aims to describe the variability in caffeine usage across neonatal intensive care units in our country. Methods: An online survey was sent to neonatologist who are members of the Turkish Neonatology Society to describe the variability in caffeine usage in neonatal intensive care units in our country. Results: We collected responses from 74 units. Prophylactic caffeine usage was observed as; GA = 27(6/7): 98.6%, GA 28(0/7)-28(6/7): 89.0%, GA 29(0/7)-29(6/7): 75.3%, GA 30(0/7)-31(6/7): 53.4%. 62.2% of units reported administering loading dose within the first two hours. The initial maintenance dose was 5 mg/kg in 64.8% of units, 10 mg/kg in 32.4% of units, and intermediate dose in 5.3% of units. 47.3% of units reported no routine dose adjustment. The postmenstrual age that caffeine treatment was stopped was found to be 34 (min-max; 32-36) weeks for infants without apnea and respiratory support, 36 (min-max; 34-52) weeks for infants without apnea but any respiratory support. The time to discharge after treatment cessation was found as; 1-4 days: 37.8%, 5-7 days: 68.9%. Among the 56 units with multiple responsible physicians, 32.1% reported intra-unit variations. Conclusion: The significant differences in caffeine usage characteristics between and within units highlight the need for clear recommendations provided by standardized guidelines
Çağdaş hukuk felsefesinde doğal hukuk ve hukuki pozitivizm tartışmasına eleştirel bir bakış
No full textBu çalışmada, doğal hukuk ve hukuki pozitivizm arasındaki tartışma ve bu tartışmanın çağdaş hukuk felsefesindeki yansıması eleştirel bir bakış açısıyla incelenmiştir. Bu kapsamda, hukuki pozitivizmin temsilcileri olan Austin, Kelsen, Hart ve Raz ile doğal hukuk ekolünü savunan Fuller, Finnis ve Alexy’nin hukuk teorileri ele alınmıştır. İnceleme, hukukun özü, kaynağı ve geçerliliği sorunları çerçevesinde sınırlandırılmış ve iki ekol arasındaki tartışma bu bağlamda karşılaştırmalı olarak değerlendirilmiştir. Bu değerlendirmenin esas amacı, çağdaş hukuk felsefesinde doğal hukuk ve hukuki pozitivizm ekolleri arasındaki geleneksel karşıtlığın katı bir biçimde sürdürülmediğini, bunun yerine özellikle doğal hukukçu düşünürler tarafından bu iki ekolün uzlaştırılmasına yönelik bir yaklaşımın benimsendiğini savunmaktır. Bu amaç doğrultusunda, doğal hukuk ve hukuki pozitivizm ekollerinin temel iddiaları yeniden sorgulanmıştır. Bu sorgulama, aynı zamanda çalışmanın bir diğer amacını da ortaya çıkarmaktadır. Bu bağlamda, çalışmanın ikinci amacı, yaygın kanının aksine, doğal hukuk ekolünün hukukun olgusal boyutunu, hukuki pozitivizmin ise değer nitelikli unsurların varlığını bütünüyle reddetmediğini temellendirmeye çalışmaktır.In this study, the debate between natural law and legal positivism, and the reflection of this debate in contemporary legal philosophy, are examined from a critical perspective. In this context, the legal theories of the representatives of legal positivism including Austin, Kelsen, Hart and Raz, as well as those of Fuller, Finnis and Alexy, who advocate the natural law tradition, are analysed. This analysis is confined to the issues of the nature, source and validity of law and the debate between natural law and legal positivism is comparatively evaluated within this framework. The primary aim of this evaluation is to contend that, in contemporary legal philosophy, the traditional strict dichotomy between the natural law and legal positivism schools is not maintained; rather an approach aimed at reconciling these two schools is adopted, particularly by natural law theorists. In line with this objective, the fundamental claims of the natural law and legal positivism schools have been re-questioned. This questioning, also reveals another aim of the study. The second aim of the study is to demonstrate that, contrary to common belief, the natural law school does not entirely reject the factual dimension of law, nor does legal positivism completely deny the existence of value-based elements
Thyroid Infiltration by Chronic Lymphocytic Leukemia: a Rare Case Report With Cytological and Flow Cytometry Findings
No full textPrimary and secondary involvement of the thyroid gland by CLL has been reported as extremely rare in the literature. Fine-needle aspiration cytology is one of the primary diagnostic procedures for determining the nature of suspicious thyroid nodules. Clinical information is particularly important during cytomorphological evaluation, especially in patients with a history of hematological malignancy. We report a case of a 58-year-old woman diagnosed with CLL, presenting with thyroid gland involvement 8 years after the initial diagnosis. Fine-needle aspiration cytology revealed an infiltrative cellular smear with coarse chromatin and monomorphic cells displaying a tortoise shell pattern within a colloid-containing background. Diagnostic confirmation was achieved through flow cytometric analysis of the aspirated fluid material. In patients with a history of hematologic malignancy, careful evaluation is required when a lymphocytic background is observed in aspirations, and additional methods should be employed if necessary. Distinguishing between primary and secondary lymphomas of the thyroid gland is clinically significant, as their treatment and prognosis differ substantially
Investigation of the Effect of Low Back Pain Severity on Functional Level, Quality of Life and Fear-Avoidance Behavior in Women With Hip Osteoarthritis
No full textPurpose: The objective of the this study was to investigate the effect of low back pain (LBP) severity on functional level, quality of life (QoL), and fear-avoidance behavior in patients with hip osteoarthritis (HOA). Material and methods: A cross-sectional study conducted on a total of 43 female patients diagnosed with HOA. The patients were divided into two groups according to pain intensity; Group 1 consisted of patients with moderate-to-high intensity low back pain (VAS:3.5-10 cm; n=21), Group 2 consisted of patients with mild back pain (VAS:0.5-3.49 cm; n=22) occurred. Functional level (Lumbar Spine Mobility, Harris Hip Score, Timed Up and Go Test), quality of life (Nottingham Health Profile) and kinesiophobia (Tampa Scale of Kinesiophobia) were evaluated. Results: When the groups were compared, it was found that the QoL, QoL-pain and emotional reactions sub-parameters scores of Group 1 were significantly higher than Group 2 (p=0.001, p=0.002, p=0.002). However, there was no statistically significant difference between the two groups in terms of functional level and kinesiophobia (p>0.05). Conclusion: The results of the study showed that the QoL-pain and emotional reaction sub-parameters and QoL were negatively affected in patients with moderate-high severity of LBP in HOA in comparison with mild severity of LBP. © 2025, Pamukkale University. All rights reserved
Predictive Factors for Spontaneous Dislodgement of Percutaneous Nephrostomies for Malignant Ureteral Obstruction
No full textUtebey, Ayse Ruksan/0000-0003-3885-2551; Aslan, Halil Serdar/0000-0002-5255-8618PurposeTo investigate the etiology of spontaneous percutaneous nephrostomy (PCN) catheter dislodgements and evaluate factors potentially associated with these dislodgements, including muscle-to-fat composition and tissue characteristics of catheter traces.Materials and methodsData from 92 patients (63 males, 29 females; mean age 63.9 +/- 11.4 years, range 28-88) undergoing 151 PCN catheter replacements between January 2016 and June 2021 were analyzed. Patients were divided into Group 1 (prophylactic replacements every 3 months, n = 41) and Group 2 (at least one spontaneous dislodgement, n = 51). Associations were evaluated for factors including intraabdominal visceral adipose tissue index (IAVATI), subcutaneous adipose tissue index (SATI), and abdominal perimeter. Other variables assessed were Eastern Cooperative Oncology Group (ECOG) performance status scores, psoas muscle index (PMI), renal size, renal parenchymal thickness, renal cortex-to-skin distance, posterolateral abdominal wall muscle thickness, and PCN replacement frequency.ResultsNo significant differences were identified between Group 1 and Group 2 in IAVATI, SATI, or abdominal perimeter values (p = 0.210-0.412). A significant difference in ECOG performance status scores (p = 0.0001), PMI (p = 0.04) and lower renal size, renal parenchymal thickness, renal cortex-to-skin distance, and posterolateral abdominal muscle thickness (p = 0.0001-0.039) were observed in Group 2. PCN replacements were significantly more frequent in Group 2 (p = 0.0001). Multivariate regression identified renal parenchymal thickness and abdominal wall muscle thickness as significant independent predictors (p = 0.0001, p = 0.02). ROC analysis yielded an AUC of 0.843 (95% CI: 0.769-0.917) for renal parenchymal thickness and 0.694 (95% CI: 0.610-0.778) for abdominal wall muscle thickness. Sensitivity and specificity rates were 73.1% and 96.4% for a 16 mm cutoff in renal parenchymal thickness, and 50.7% and 79.8% for an 8 mm cutoff in abdominal wall muscle thickness.ConclusionA significant association was identified between spontaneous PCN catheter dislodgement and both the psoas muscle index and ECOG performance status scores, while no notable relationship was observed with abdominal visceral or subcutaneous fat tissue volumes or abdominal perimeter. The risk of dislodgement was found to increase with reduced renal parenchymal and abdominal wall muscle thickness, as well as with more frequent nephrostomy replacements, suggesting these parameters may serve as useful markers for identifying patients at higher risk.Scientific and Technological Research Council of Turkiye (TUBIdot;TAK)Open access funding provided by the Scientific and Technological Research Council of Turkiye (TUB ; Idot;TAK). This study was conducted without any funding or financial support from external institutions. The authors did not receive support from any organization for the submitted work
Sedimentology and Isotope Geochemistry of Early Pliocene Shallow Lacustrine Dolomitic Succession in the Baklan Basin, Southwestern Türkiye
No full textA multiproxy study of the lower Pliocene (Zanclean) shallow lacustrine succession in the southwestern margin of the Baklan Basin (southwestern Anatolia, T ; uuml;rkiye) provides new insights into the paleoclimatic and paleohydrologic evolution of an extensional basin located at the top of the western Taurides mountain range in the southeastern Mediterranean region. Detailed petrographic, sedimentological, palynological and stable isotope analyses on Mg-rich carbonates were carried out on the dolomitic succession in the Sapaca locality in the basin, indicating a vegetated, quiet to slow-moving, low-gradient, perennial, alkaline shallow lake environment under warm and arid climate conditions. The stable isotopic analysis of the dolomitic carbonates exhibits a narrow range of values (-1.318(18)O+5.82 parts per thousand and-7.108(13)C-2.10 parts per thousand) and the 8(18)O-8(13)C correlation (r=0.70) indicates a hydrologically closed lake. Two types of dolomite are identified in the studied section. Type-1 crystals formed mainly as a result of primary precipitation of dolomite in the shallow lake, whereas type-2 crystals probably indicate microbially controlled dolomite precipitation. The palynological record from Sapaca reveals that the early Pliocene paleoenvironment was dominated by steppe and open vegetation with some isolated shrubs. Similar paleoclimatic and paleovegetational conditions are observed in other Anatolian basins and in the southern Mediterranean region. Therefore, the results of this study demonstrate that the shallow lacustrine system of the Baklan Basin serves as a good analogue for understanding early Pliocene warmth and aridity in this region.Scientific and Technological Research Council of Turkiye (TUEBITAK) [105Y280]This study was financially supported by The Scientific and Technological Research Council of Turkiye (TUEBITAK research grants CAYDAG 105Y280) . The authors would like to thank Dr. Thomas Denk (Swedish Museum of Natural History, Sweden) for literature and valueable discussion concerning the interpretation of the palynological signal and Niluefer Ayd ; imath;nl ; imath;k (Pamukkale University) for SEM studies. The authors express their gratitude to the editors and two anonymous reviewers for their valuable comments and suggestions
Comparative Evaluation of Superb Microvascular Imaging and Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Differentiating Benign and Malignant Breast Masses
No full textYitik, Ahmet Yasin/0000-0002-1793-7911Objectives Our study aims to compare the diagnostic performance of superb microvascular imaging (SMI) and dynamic contrast-enhanced magnetic resonance imaging (MRI) in differentiating benign from malignant breast masses, using histopathological findings as the reference standard. Methods This prospective study was conducted from April 2022 to March 2024. A total of 112 breast lesions from 110 patients were evaluated using gray-scale ultrasonography, SMI, and dynamic contrast-enhanced MRI. The vascular index (VI) obtained during SMI examination and kinetic curve patterns from MRI were analyzed. Results Histopathological analysis revealed 62 benign and 50 malignant lesions. The VI showed a statistically significant difference between benign and malignant lesions, with a mean VI of 5.12 +/- 4.66 in benign masses and 10.13 +/- 5.48 in malignant masses (P .001). The ROC analysis demonstrated an AUC of 0.79 for SMI with a VI cut-off value of 4.15, yielding a sensitivity of 92%, specificity of 60%, and accuracy of 74%. A statistically significant correlation was found between VI values and MRI contrast enhancement kinetic curve types (P .05). MRI demonstrated superior diagnostic performance, with an AUC of 0.89 and sensitivity, specificity, and accuracy of 98, 80.65, and 88.39%, respectively. Conclusions SMI, when used in conjunction with conventional ultrasonography and MRI, provides significant diagnostic value in differentiating benign from malignant breast masses. The study supports the potential integration of SMI into routine breast cancer diagnostic workflows, particularly in settings where MRI is less accessible
Hacımeter – Tekman (Erzurum) bakır-altın cevherleşmesinde sıvı kapanım incelemeleri
No full textBu tez çalışması PAU Bilimsel Araştırma Projeleri Koordinasyon Birimi tarafından 2023FEBE0034 nolu proje ile desteklenmiştir.Erzurum-Tekman bölgesindeki inceleme alanında en yaşlı birim olarak Karataştepe Metamorftitleri oluşturmakta olup üzerinde Şahvelet Ofiyolitlerine ait birimler yüzeylemektedir. Tekman bölgesindeki bakırlı oluşumlar genellikle bölgede yaygın olarak gözlenen ofiyolitik kayaçlarla birlikte gözlenen meta-volkanik kayaçlar içerisinde mercekler şeklinde gözlenmektedir. Cevher minerali olarak en yaygın pirit,manyetit, kalkopirit gözlenirken, gang minerali olarak kuvars gözlenmektedir. Sıvı kapanım çalışmalarında kuvarslardaki birincil kapanımların sıcaklıklarının (150-183°C) ve tuzluluklarının 0.00 - 4.182 %NaCl olduğu belirlenmiştir. Cevherleşmeye ait elde edilen veriler Erzurum-Tekman cevherleşmesinin Kıbrıs tipi yatakların tipik örneklerinden birisi olduğuna işaret etmektedir.In the Erzurum-Tekman region, the oldest unit in the study area is represented by the Karataştepe Metamorphics, which are overlain by units belonging to the Şahvelet Ophiolites. Copper mineralizations in the Tekman area are generally observed as lenses within metavolcanic rocks, which are commonly associated with the region's widespread ophiolitic rocks. The most common ore minerals identified are pyrite, magnetite, and chalcopyrite, while quartz is the predominant gangue mineral. Fluid inclusion studies have determined that the primary inclusions in quartz have temperatures ranging from 150 to 183°C and salinities between 0.00 and 4.182 wt% NaCl. The data obtained regarding the mineralization indicate that the Erzurum-Tekman mineralization is a typical example of Cyprus-type deposits
Minero-Petrographic, Geochemical, and Multiisotopic Characterization of the Ancient Banded Travertine Quarries of the Lycus Valley (Denizli, Türkiye)
No full textThe Lycus Valley in Western Anatolia has been the site of numerous civilizations since ancient times due to historical, geopolitical, and climatological characteristics. Banded travertine is a ubiquitous architectural stone observed in ancient settlements in the Lycus Valley. Banded travertines referred to as “Alabastro Fiorito,” “Alabastro Listato,” and “Alabastro Rossa” in archaeological bibliographies have been extracted from the ancient quarries of Çukurbağ, Hierapolis, Develi-Akköy, Gölemezli, and Tripolis in the Lycus Valley and are characterized by white, yellow, brown, red, and red-burgundy colored bands with thicknesses ranging from a few millimeters to centimeters. The banded travertines have similar mineral compositions and consist of carbonate minerals (calcite, aragonite, and ±dolomite). However, the colored bands have a goethite and hematite composition, with X-ray diffraction and confocal Raman spectrometry studies supporting these results. They have a distinctive colloform texture (partially balloon-like structure), a radial dendritic texture, and a micritic laminated texture. The Lycus Valley travertines have characteristically high Sr contents and are geochemically similar to travertines of thermogenic origin. Compared to the North American Shale Composite (NASC) and Average Phanerozoic Limestones (APL), they show significant depletion in the concentrations of Al, Ca, Fe, Ti, Cr, Ni, Ba, Rb, Sr, Zn, Pb, Ce, La, and Nd. The δ13CV-PDB and δ18OV-PDB values of the Lycus Valley travertines range from 5.41‰ to 6.68‰ and from –16.05‰ to –12.09‰ in Çukurbağ, from 5.09‰ to 5.63‰ and from –14.85‰ to –9.18‰ in Hierapolis, from 4.69‰ to 5.16‰ and from –14.98‰ to –11.62‰ in Develi-Akköy, from 4.21‰ to 4.51‰ and from –15.29‰ to –13.76‰ in Gölemezli, and from 2.99‰ to 3.99‰ and from –15.93‰ to –13.01‰ in Tripolis. The geological ages of the banded travertines from the Çukurbağ, Hierapolis, Develi-Akköy, Gölemezli, and Tripolis quarries were determined to be 24.11 ± 0.13 to 91.1 ± 1.4 ka, 55.10 ± 0.22 to 158.3 ± 4.8 ka, 55.59 ± 0.23 to 74.92 ± 0.32 ka, 303.0 ± 20 to 408.0 ± 15 ka, and 2.09 ± 59 to 351.01 ± 8.12 ka, respectively. © TÜBİTAK.Ankara University YEBİM Laboratories; Scientific Research Projects Unit of Pamukkale University, (2017 ARKE003
Spor Manşetlerindeki Metaforlar Bize Ne Demek İstiyor? Dijital Spor Haberleri Üzerine Bir Araştırma
No full textToplumun takip ettiği en önemli alanlardan biri olan spor haberleridir. Hem evrensel bir yapıya bürünmesi hem de insanların yoğun ilgisini kazanmış olan spor, toplumsal yaşantımızın bir parçası haline gelmiş olması nedeniyle de çok yakından takip edilen bir kitle etkinliği olarak gündemdeki yerini almaktadır. Dijitalleşme ile birlikte spor medyası da bundan payını alarak basılı geleneksel yayınlardan ziyade dijital gazetelerden takip edilir duruma gelmiş bulunmaktadır. Tüm bu gelişmeler ışığında çalışmamızın konusu da tıklama, takip edilme açısından yüksek bilinirliği bulunan Fotomaç ve Fanatik spor gazetelerinin dijital yayınlarındaki manşetler olmuştur. Çalışmanın deseni nitel araştırmadır. Analiz yöntemi olarak ise içerik analiz yöntemi kullanılmıştır. Gündem yaratan manşetlerin ilgi çekiciliğinin artırılması için metaforik terimlerin ne oranda ve ne şekilde kullanıldığı araştırılmıştır. Bu amaç doğrultusunda elde edilen bulgular ise spor manşetlerin de kullanılan metaforların %50’nin üzerinde kısmının olumlu metaforlardan oluştuğu ve spor branşları arasında en çok futbol branşından yoğunlaştığı gözlemlenmiştir