Ufuk Universitesi Akademik Acikerisim Sistemi
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A Delphi consensus study on the treatment of slipped capital femoral epiphysis: Considerable consensus in mild and moderate slips and limited consensus in severe slips
No full textPurpose:The aim of this expert consensus study was to establish consensus on the treatment of different types of slipped capital femoral epiphysis and on the use of prophylactic screw fixation of the contralateral unaffected side. Methods:In this study, a four-round Delphi method was used. Questionnaires including all possible theoretical slip scenarios were sent online to 14 participants, experienced in the field of children's orthopedics and in the treatment of hip disorders in children. Results:In-situ fixation was considered to be the first treatment choice in all types of mild slip scenarios and in moderate, stable ones. Performing in-situ fixation was not favored in moderate, unstable, and in all severe slip scenarios. In moderate to severe, unstable slip scenarios, there was consensus on the use of gentle closed or open reduction and internal fixation. Any consensus was not established in the optimal treatment of severe, stable slips. There was also consensus on the use of prophylactic screw fixation of the contralateral side in case of co-existing endocrine disorder and younger age. Conclusions:The establishment of consensus on the treatment of all types of slipped capital femoral epiphysis even among the experienced surgeons does not seem to be possible. The severity of the slip and stability of the slip are the primary and secondary determinants of the surgeons' treatment choices, respectively. In-situ fixation is still the preferred treatment option in several slip types. Gentle capital realignment by closed or open means is recommended in displaced, unstable slips. Prophylactic screw fixation of the contralateral side is indicated under certain circumstances
Covid-19 ile Mücadelede Dijital Teknolojilerin Kullanımı
No full textCOVID-19 salgını, benzeri görülmemiş etkilerle tüm insanların yaşamlarını olumsuz yönde etkiliyor. Bu çalışma, prestijli dergi veri tabanlarındaki bilimsel çalışmalar ve hükümetlerin iyi uygulamaları incelenerek hazırlanmıştır. Pubmed ve Google'daki makale içerik analizi ve iyi uygulama analizlerinden elde edilen bilgiler ile Türk filyasyon çalışmalarından elde edilen bilgiler sonucunda dijital teknolojilerin Covid-19'daki uygulama alanları ortaya çıktı. Pandemi ile mücadelede dijital teknolojinin kullanım alanları, planlama ve izleme, temaslı takibi, enfeksiyon taraması, karantina ve kendi kendine izolasyon, klinik yönetim ve tıbbi tedarik olarak belirlenmiştir. İnceleme sonucunda, koordineli çabalar, Covid-19'u başarılı bir şekilde izole etmeye ve değişen derecelerde hafifletmeye odaklandı. COVID-19 ölüm oranlarını düşük tutan ülkeler, erken sürveyans, test, temaslı takibi ve sıkı karantinayı içeren stratejiler uyguluyor. Türkiye'de temaslı bulma, izole etme ve ölüm oranının düşüklüğü vaka tespitinin %99,9 başarı ile 10 saat içinde yapılmasına dayanmaktadır. Türk filiasyon çalışmaları ve stratejilerin başarısı dijital teknolojilerine sağlık hizmetlerine entegrasyonuna dayandığı öngörülmüştür
Molecular characterisation of colistin and carbapenem-resistant clinical isolates of Acinetobacter baumannii from Southeast Europe
No full textObjectives: To characterise 11 colistin-and carbapenem-resistant Acinetobacter baumannii isolates recently emerging in hospital settings.Methods: A. baumannii isolates were collected from hospitalised patients under colistin treatment in three countries of Southeast Europe: Turkey, Croatia, and Bosnia and Herzegovina. Isolates were identified using molecular methods.Results: Isolates from Turkey and Croatia belong to the sequence types ST195 or ST281 of the clone lineage 2, while the single isolate from Bosnia and Herzegovina belongs to the ST231 of clone lineage 1. All isolates turned out to be highly resistant to colistin (MIC >= 16 mg/L) and have point mutations in pmrCAB operon genes. The colistin-resistant isolate from Bosnia and Herzegovina had a unique P170L point mutation in the pmrB gene and the R125H point mutation in the pmrC gene. The L20S mutation in the pmrA gene was detected only in isolates from Croatia and has never been reported before in isolates from this country.Conclusion: Colistin resistance in A. baumannii in hospitalised patients receiving colistin treatment is a result of chromosomal mutations. The pattern of point mutations in pmrCAB genes suggests a spread of specific colistin-resistant isolates within the hospital.(c) 2023 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.This is an open access article under the CC BY-NC-ND license( http://creativecommons.org/licenses/by-nc-nd/4.0/
Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery
No full textObjective: The hemodynamic effects and the renal outcome of patients undergoing elective cesarian section with Oxytocin and carbetocin for postpartum haemorrhage prophylaxis are evaluated. Methods: One hundred patients without risk factors for postpartum haemorrhage undergoing elective cesarean delivery, under spinal anaesthesia, were randomly allocated to receive either a single dose of carbetocin (100?g/3 mL) (n = 50) or Oxytocin intravenous injection (3 IU/3 mL) (n=50). The primary outcome was blood loss and hemodynamic effects. The secondary parameter evaluated was the renal effects of drugs. Results: Regarding the hemodynamic effects, intraoperative (243±116.91 ml vs 311.30±130.23 ml, p=0.002) and second-hour postoperative blood loss (24.72 ± 9.43 ml vs 35.54 ± 19.4 ml, p=0.003) were significantly lower in the carbetocin group. At two hours postoperatively, urine osmolality (322.66±211.67 vs 401.45±218.08, p=0.028) was significantly higher in the oxytocin group. Conversely, postoperative urine sodium was higher in the carbetocin group at the twenty four hours in the carbetocin group (51.90±36.74 vs 42.42±41.63, p = 0.004). Conclusion: Carbetocin is easy to use with lower blood loss and less requirement of additional uterotonics compared to Oxytocin. Both drugs cause minimal changes in renal parameters at physiological limits. The renal effects might be far more different with higher doses of both drugs that necessitate further research
ETView SL versus Macintosh Direct Laryngoscope for Endotracheal Intubation Amid Simulated COVID-19 Cardiac Arrest: A Randomized Crossover Study
No full textAirway management procedures, such as endotracheal intubation (ETI), pose a significant risk of aerosol generation, requiring robust personal protective equipment (PPE) against aerosol-generating procedures (AGP). This study aimed to assess the impact of PPE-AGP on intubation success rates, time to intubation, and glottic visualization using ETView and a standard Macintosh laryngoscope (MAC). A total of 52 physicians participated in this prospective, observational, randomized crossover study conducted in a medical simulation setting. Participants included COVID-19 patients with cardiac arrest scenarios with and without PPE-AGP who were intubated with ETView and MAC. During intubation without PPE-AGP, ETView showed a similar first-pass success rate (FPS) but had a shorter intubation time and better glottal hydration compared to MAC. In scenario B (with PPE-AGP), ETView outperformed MAC in FPS, initiation time, and glottic visualization. The use of PPE-AGP had little impact on ETView's performance. However, it negatively affected the Macintosh laryngoscope, reducing FPS and glottic visibility. Participants found intubation with ETView easier in both scenarios. In conclusion, as compared to the Macintosh laryngoscope, ETView demonstrated higher performance under the circumstances of the simulation, especially when PPE-AGP was used
Cerrahi Tekniğin Uterin Fibroidlerin Psödokapsülü Üzeindeki Etkisi: Ön Sonuçlar
No full textAmaç: Leiomyomlar kadın genital sisteminin en sık görülen iyi huylu tümörleridir. Myomektomi, fertiliteyi korumak için iyi bir seçenektir. Myomektomi, hem laparotomi (LT) hem de laparoskopi (LS) ile yapılabilmektedir. LS’de LT’ye göre psödokapsül liflerinin daha iyi korunduğu düşünülmektedir. Psö- dokapsülün korunması myometriumun sonraki fonksiyonelli ği için önemlidir. Bu çal ışmada LS ve LT myomektomi yap ılmış olgularda, myomektomi spesmenlerinin myom psödokapsül kalınlıklarını karşılaştırmayı amaçladık. Gereç ve Yöntemler: Ufuk Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği’nde Ocak 2018 ve Aral ık 2018 tarihleri arasında myomektomi yapılmış olan 121 hasta kaydından 34’ü zarf yöntemiyle seçilerek retros- pektif olarak incelenmiştir. Kayıtlar; hastaların yaşları, vücut kitle indeksleri (VKİ), myomektomi endikasyonları, myom sayıları, myom çapları ve geçi- rilmiş abdominal cerrahi için tarand ı. Laparoskopik ve laparotomik myomektomi gruplar ı psödokapsül kalınlığı açısından karşılaştırıldı. Bulgular: Çalışmaya toplam 34 hasta dahil edildi. Bu hastalar ın 20’sine LT myomektomi (%58.8), 14’üne LS myomektomi (41.1%) yap ılmıştı. LT ve LS myo- mektomi grupları arasında hasta ya şı, VKİ bakımından istatistiksel aç ıdan anlamlı fark izlenmedi. Myomektomi endikasyonlar ının dağılımı da gruplar arasında benzerdi. Geçirilmiş abdominal cerrahisi olan hastaların oranı LT myomektomi grubunda, LS grubuna göre yüksekti (40.0% vs 7.1%; p:0.049, sırasıyla). Psödokapsül kalınlıkları, LT grubunda LS grubuna göre anlamlı olarak yüksekti (1.2 vs 0.75, p:0.013).Sonuç: Bu çalışma LT myomektomi yön- teminde eksize edilen psödokapül kalınlığının LS’ye göre artmış olduğunu ve laparoskopide psödokapsülün daha yüksek oranda korunduğunu göstermiş- tir. Psödokapsülün korunmasının, post-operatif myometrial iyileşme ve bütünlük üzerindeki olumlu etkilerini doğrulayan daha geniş örneklem büyüklüğüne sahip prospektif çalışmalar gerekmektedir
Experiences and results with a cementless femoral stem design: SL-PLUS MIA
No full textAim: To evaluate the outcomes of the SL-PLUS® MIA cementless femoral stem (Smith & Nephew Orthopedics AG, Switzerland) application using the modified lateral approach. Method: Demographic and clinical data, in addition to the operational outcomes of 42 patients who underwent total hip arthroplasty (THA) and partial hip arthroplasty (PHA) using the MIA cementless femoral stem with the modified lateral approach, between November 2015 and June 2017, were collected. Harris Hip Scores were calculated preoperatively and at 6 weeks, and 3 and 6 months, and 1 and 3 years postoperatively (a total of 6 times) in the THA group and at 6 weeks, and 3 and 6 months, and 1 and 3 years postoperatively (a total of 5 times) in the PHA group. Results: Data from 24 THA patients with a diagnosis of primary or secondary coxarthrosis and 18 PHA patients with a diagnosis of isolated collum femoris fracture were collected. The average patient (26 females, 16 males, mean age 68.1 ± 13.1 years) follow-up period was 46.7 ± 1.4 months. There were no intraoperative or postoperative trochanteric fractures. No patients displayed the trendelenburg sign. The Harris Hip Scores of all of the patients increased postoperatively, proportional to the duration of follow-up. Conclusions: In hip arthroplasties performed using the modified lateral approach, femoral preparation with a MIA femoral stem, which has a proximal lateral slope, reduced the tension in the trochanteric region. This was believed to lower the risk of trochanteric fractures. Additionally, this type of femoral component may help to avoid the trendelenburg sign postoperatively by protecting more gluteal muscle during the femoral preparation stage due to its proximal design
Meclisin Açılma Sürecinde Mustafa Kemal Paşa (Nuh) ile Çanakkale Mevki Müstahkem Kumandanı Miralay Şevket Galatalı (İsa) Arasında Yapılan Gizli Yazışma Örnekleri
No full textMillî Mücadele döneminde Mondros’la başlayan işgallere karşı çıkan Mustafa Kemal Paşa ve Temsil Heyeti üyeleri direnişe geçme kararı almış ve bu harekatın başarıya ulaşabilmesi için en büyük görevi Türk Subayları üstlenmiştir. “Galatalı” lakabıyla tanınan, İstanbul Boğaz’ından sorumlu Çanakkale Mevki Müstahkem Kumandanı Miralay Şevket Bey’de bu subaylar arasındadır. Şevket Bey cephedeki başarılarının yanı sıra siyasi bağlantıların kurulması hususunda Millî Mücadele dönemi kahramanları arasında yerini almıştır. Ayrıca yabancı istihbarat örgütleri tarafından faaliyetleri yakından takip edilen “Karakol Cemiyeti” kurucuları arasındadır. Karakol Cemiyeti’nin diğer kurucularından Kara Vasıf Bey ile yürüttüğü örgüt liderliği ile Millî Mücadele döneminde özellikle İstanbul Hükümeti ve Sivas karargâhı arasında istihbaratın sağlanmasında kilit isim olmuştur. Bu çalışmada meclisin açılmasına kadar geçen sürede Şevket Bey ve Mustafa Kemal Paşa arasında yapılan gizli görüşmeler arşiv belgeleri ışığında ele alınmaya çalışılmıştır
The Role of Ischemia-modified Albumin and Ischemia-Modified Albumin to Albumin Ratios in Patients with Alopecia Areata
No full textIntroduction: Objective: To investigate the role of ischemia-modified albumin (IMA) and IMA/albumin levels in patients with AA. Methods: The present prospective crossectional study includes patients & GE;18 who were admitted to the Dermatology and Venerology Department of Hitit University Hospital between April 1, 2021, and September 30, 2021. 70 patients participated in the study (n=34 for the study group and n=36 for the control group). Demographic features, clinical characteristics, IMA, and IMA/albumin levels were compared between the groups. The study group was divided into subgroups based on the number of patches, disease duration, and the number of disease attacks. IMA and IMA/albumin levels were compared between each subgroup. Results: The study and control groups were similar with regard to demographic features and clinical characteristics. Significant differences were observed between the mean IMA and IMA/albumin ratio (p=0.004 and 0.012, respectively). The study subgroups were comparable in the number of patches, disease duration, and number of disease attacks. Conclusion: Although oxidative stress is an important component in the etiology of AA, IMA and IMA/albumin may not be useful in the prediction of disease severity in patients with AA
Mass attenuation coefficient, stopping power, and penetrating distance calculations via Monte Carlo simulations for cell membranes
No full textThe Monte Carlo (MC) method is a computer simulation that is widely used in different disciplines including physics, biology, biophysics, medical imaging, biomedical engineering, etc. In addition, MC method is often used to simulate the interaction of radiation with cells, tissues, and the environment. In the present study, mass attenuation coefficient, stopping power, and penetrating distance calculations were performed for cell membranes having an approximately 60-100 angstrom thickness. These calculations have been done for lipid bilayer structure of cell membrane via MC techniques employing two of the most known computer-aided calculation and simulation software which are MC methods such as SRIM-2013 (The Stopping and Range of Ions in Matter) and MCNPv6 (Monte Carlo N-Particle) with XCOM software. Stopping power and penetrating distance calculations were obtained using SRIM-2013. Also, both XCOM software and MCNPv6 simulation code were used to obtain photon interaction parameters within the energy range of 0.01 - 10000keV. Obtained all results from different codes have been visualized by graphing for evaluation