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Invasive pulmonary aspergillosis evaluation in hematology patients: Three years results of tertiary hospital
Get PDFInvasive pulmonary aspergillosis (IPA) is the most frequent invasive fungal disease occurring in patients with hematological malignancies. Serum galactomannan (GM) antigen monitoring is thought to be helpful in the diagnosis of IPA. The aim of this study was to determine the role of a GM assay in serum samples for the diagnosis of IPA in patients with hematological disease. The data of 366 immunosuppressed patients that were hospitalized and followed up in the hematology clinic from January 2017 to December 2019 were retrospectively analyzed. The clinical and radiological findings of the patients and the GM results, requested twice a week, were evaluated. In this study, the incidence of probable and possible IPA was determined to be 15.3% (56/366). Of the cases detected, 28 (50.0%) were patients diagnosed with Acute Myeloid Leukemia (AML), and 34 (60.7%) patients who had compatible clinical and examination findings were started on antifungal treatment. Additionally, AUC (Area Under the Curve) values were calculated by ROC (Receiver Operating Characteristic) analysis, and it was determined that the diagnostic efficiency was more predictive when the cut-off was 0.5 in the GM test for IPA disease. The detection of GM antigen in serum is a very useful and rapid method for diagnosing IPA disease in immunosuppressed hematology patients. However, GM results should be evaluated together with clinical and radiological findings for early diagnosis, and the treatment approach should be determined accordingly
Kanser Hastalarında Uyku Sorunlarının Yönetiminde Non-Farmakolojik Yaklaşımlar
Get PDFKanser hastalarında tedavi ya da bireye özgü psikososyal distres faktörleri ile ilişkili gelişen uyku sorunları hastaların yaşam kalitesini olumsuz etkileyebilmekte ve iyileşme sürecini yavaşlatabilmektedir. Tanı konulma aşamasından tedavi bitiminden yıllar sonrasında da devam eden ve bireyden bireye göre
çeşitlilik gösteren uyku sorunları görülmektedir. Bu uyku sorunları, uykuya dalmada güçlük, sık uyanma, kabus görme, sabah yorgun kalkma ve gündüz
uykulu hissetme gibi çeşitli şekillerde ortaya çıkabilmektedir. Kanser hastalarında uyku problemleri genel popülasyona göre sıklıkla görülmekle birlikte
diğer sağlık sorunlarının yanında gözden kaçabilmektedir. Bu nedenle, kanser hastalarında uyku sorunlarının tespiti ve gerekli yaklaşımların uygulanması
gereklidir. Uyku sorunlarının yönetiminde farmakolojik yaklaşımların yanı sıra non-farmakolojik yaklaşımlardan da yararlanılmaktadır. Farmakolojik yöntemlerin olası yan etkileri nedeniyle non-farmakolojik yöntemlere daha çok başvurulmaktadır. Yapılan çalışmalar incelendiğinde kanser hastalarında uyku
sorunlarının yönetiminde uyku hijyeninin sağlanması, bilişsel-davranışsal yöntemler, manipülatif yaklaşımlar ve zihin-beden müdahalelerinden yararlanıldığı
anlaşılmaktadır. Hemşirelerin kanser hastalarında tanı aşamasından itibaren uyku sorunlarını saptamaları, hastaya uygun tedavi stratejilerinin belirlenmesi
ve non-farmakolojik yöntemler aracılığıyla bireyselleştirilmiş bir yaklaşım sunmaları önemlidir.Sleep problems that develop in relation to treatment or psychosocial distress factors in patients with cancer might negatively impact the quality of life and
slow down the recovery process. Sleep problems that persist from the diagnosis stage to years after treatment vary from person to person. These sleep
problems can manifest in various ways, such as difficulty falling asleep, frequent waking, nightmares, waking up tired in the morning, and feeling sleepy
during the day. Despite the frequency of sleep problems in individuals with cancer compared to the general population, these problems may be ignored.
Therefore, it is essential to identify sleep problems in individuals with cancer and implement necessary approaches. In overcoming sleep problems, both
pharmacological and non-pharmacological approaches are utilized. Due to the possible side effects of pharmacological methods, non-pharmacological
methods are more commonly applied. According to the recent studies, solutions of sleep problems in individuals with cancer involve ensuring sleep
hygiene, cognitive-behavioral methods, manipulative approaches, and mind-body interventions. It is essential for nurses to assess sleep problems in
patients who have cancer from the diagnosis stage onwards, determine appropriate treatment strategies and identify a personalized method through nonpharmacological approaches
TRESK channel activation ameliorates migraine-like pain via modulation of CGRP release from the trigeminovascular system and meningeal mast cells in experimental migraine models
No full textAims: Accumulating evidence indicates the involvement of TRESK potassium channels in migraine, however, effects of TRESK activation on migraine-related mechanisms remain unclear. We explored effects of TRESK channel modulation on migraine-related behavioral and molecular markers in in-vivo and ex-vivo rat models of migraine. Main methods: The selective TRESK activator cloxyquin at different doses, the TRESK inhibitor A2764, and the migraine drug sumatriptan were tested alone or in different combinations in nitroglycerin (NTG)-induced in-vivo model, and in ex-vivo meningeal, trigeminal ganglion and brainstem preparations in which CGRP release was induced by capsaicin. Mechanical allodynia, CGRP and c-fos levels in trigeminovascular structures and meningeal mast cells were evaluated. Key findings: Cloxyquin attenuated NTG-induced mechanical allodynia, brainstem c-fos and CGRP levels, trigeminal ganglion CGRP levels and meningeal mast cell degranulation and number, in-vivo. It also diminished capsaicin-induced CGRP release from ex-vivo meningeal, trigeminal ganglion and brainstem preparations. Specific TRESK inhibitor A2764 abolished all effects of cloxyquin in in-vivo and ex-vivo. Combining cloxyquin and sumatriptan exerted a synergistic effect ex-vivo, but not in-vivo. Significance: Our findings provide the experimental evidence for the anti-migraine effect of TRESK activation in migraine-like conditions. The modulation of TRESK channels may therefore be an attractive alternative strategy to relieve migraine pain
The Associations between Asprosine, Clusterin, Zinc Alpha-2-Glycoprotein, Nuclear Factor Kappa B, and Peroxisome Proliferator-Activated Receptor Gamma in the Development of Complications in Type 2 Diabetes Mellitus
Get PDFObjectives: The aim of this study was to investigate the circulating levels of asprosin, clusterin, zinc-alpha-2-glycoprotein (ZAG), nuclear factor-kappa B (NF-kappa B), and peroxisome proliferator-activated receptor-gamma (PPAR-gamma) in patients with T2DM in relation to microvascular and macrovascular complications. Measuring these biomarkers may provide insight into the pathophysiology of T2DM and indicate novel targets for the therapy of diabetes-related complications. Methods: A total of 260 subjects consisting of four groups: healthy controls (Group-1), T2DM patients without complications (Group-2), T2DM patients with microvascular complications (Group-3), and T2DM patients with macrovascular complications (Group-4). Results: The mean age of all subjects was 52.96 +/- 6.4, 127 of whom were male. Asprosin, clusterin, and NF-kappa B levels were significantly higher, while ZAG and PPAR-gamma levels were significantly lower in diabetic patients than healthy subjects (p < 0.01, for all). Asprosin (p < 0.01), clusterin (p < 0.01), and NF-kappa B (p: 0.002) levels were significantly higher and PPAR-gamma (p < 0.01) level was significantly lower (p < 0.001) in Group-3 than Group-2. Asprosin (p < 0.01) and NF-kappa B (p: 0.011) levels were significantly higher while ZAG (p < 0.01) level was significantly lower in Group-4 than Group-2. Serum ZAG level was found lower in Group-4 than in Group-3 (p = 0.037). Further, the biomarkers presented significant correlation with biomarkers like HbA1c and HOMA-IR. It was observed that increasing serum asprosin, clusterin, and NF-kappa B levels and decreasing serum PPAR-gamma levels were effective in the development of microvascular complications while the increased asprosin levels and decreased ZAG levels had a significant effect on the development of macrovascular complications in the binary logistic regression analysis. Conclusions: This study confirms that altered levels of asprosin, clusterin, ZAG, NF-kappa B, and PPAR-gamma are associated with T2DM and its complications. These biomarkers reflect the pathophysiological processes of metabolic disturbance and inflammation in T2DM and, therefore, have the potential for use in targeted interventions to prevent and manage diabetes-related complications
Assessment of reliability and availability of wireless sensor networks in industrial applications by considering permanent faults
Get PDFWireless Sensor Networks (WSNs) are critical for communication within a mile radius and industrial applications. These networks are very prone to failure due to their enormous number of nodes and their unique hardware and software restrictions. To make sure network performance, a lot of study needs to be done to improve failure tolerance and stability. This study looks at how to judge the availability and dependability of WSNs that have long-term issues. The suggested method checks how well a network works in various failure cases by using fault trees and Markov chain analysis. Such methods help us find and study possible failure scenarios and how they might impact the network's dependability in a planned way. The results show that WSNs have major flaws and give useful suggestions for making the systems work better. The findings show that using these evaluation methods may greatly enhance the ability to handle faults, lower the risk of damage, and allow developers of WSNs to make smart choices
Aircraft type selection using fuzzy trigonometric based OPA and RAFSI model
Get PDFThe availability of numerous types of aircraft and their technical capabilities are offering a wide range of alternatives. As customers have different expectations, aircraft type selection is a business strategy for the airline companies. The choice on carriers should be made in accordance with disparate dimensions such as customers' expectations, profit of the company, capacity limitations and market conditions. This study formulates aircraft type selection as a Multi Criteria Decision Making (MCDM) problem and proposes a novel model that incorporates fuzzy trigonometric norms to solve. Being differentiated from the existing models in the literature, a two-stage model is identified. In the first stage, a fuzzy trigonometric-based Ordinal Priority Approach (OPA) determines the criteria weights. In the second stage, RAFSI (Ranking of Alternatives through Functional Mapping of Criteria Subintervals into Single Intervals) is integrated to determine the optimal aircraft type. The model simulated for a case of Turkish Airline company. Sensitivity tests justify robustness of the model. Results show that among the four options, medium-scale highqualified but not luxury aircraft is the best option
6-8.11 yaş arası çocuklarda dil ve bilişsel gelişimin matematik performansına etkisi / The effect of language and cognitive development on mathematical performance in children aged 6-8.11
No full textDil bozukluğu görülen bireylerde matematiksel güçlük görülebileceği gibi matematik becerilerinde zorlanan bireylerde bazı dilsel ve bilişsel problemler görülebilir. Bu araştırmanın amacı; 6-8.11 yaş arası çocuklarda dil ve bilişsel gelişimin matematik performansına etkisini incelemektir. Araştırmaya 37 erkek, 15 kız toplam 52 birey dahil edilmiştir. 52 katılımcıdan sosyodemogrofik bilgileri alındıktan sonra katılımcılara sırasıyla TODİL (Türkçe Okul Çağı Dil Gelişim Testi), TAST (Türkçe Anlamsız Sözcük Tekrarı Testi), LİTMUS-TR (Türkçe Cümle Tekrarı Testi), WISC-R (Wechsler Çocuklar İçin Zeka Ölçeği) ve yaş düzeyine göre rutin olmayan matematiksel problemler sunulmuştur. Araştırmadan elde edilen bulgulara göre TODİL dil bilgisi bileşke puanı ile matematik performansı arasında yüksek pozitif bir korelasyon olduğu gözlemlenmiştir. WISC-R benzerlik, sözel puan, küplerle desen ve tüm puan ile yüksek pozitif ilişki gözlemlenmiştir. LİTMUS-TR ile matematik performansı arasına da yüksek pozitif bir korelasyon gözlemlenmiştir. Bulguların sonucuna göre dil ve matematik arasında anlamlı ilişki olduğu gözlemlenmiş, dil seviyesi düşük olan çocuklarda matematik performansının düşük olduğu aksine dil seviyesi yüksek olan çocuklarda ise matematik performansının yüksek olduğu görülmüştür. Biliş ile matematik arasında da anlamlı bir ilişki olduğu gözlemlenmiştir. Bu araştırmada da dil ve bilişin matematik performansını etkilediği görülmüştür. Bu nedenle okul öncesi ve okul çağı çocuklarda matematik performansını arttırmak için dil becerilerini arttırmak ve bilişsel becerilerini desteklemek gerekmektedir. Anahtar kelimeler: Dil, biliş, matematik, rutin olmayan problemler
Konuşma sesi bozukluğu olan çocukların anlatı becerileri ve çalışma belleği performanslarının incelenmesi / Examination of narrative skills and working memory performance in children with speech sound disorders
No full textKonuşma Sesi Bozukluğu (KSB) olan çocuklarda çalışma belleği kapasitesinin tipik gelişen akranlarına göre daha düşük olduğu çeşitli araştırma sonuçlarında ortaya konmuştur. Spontan konuşma esnasında iletişimsel amacın dinleyiciye aktarımı ve mesajın içeriği ile ilgili mantıksal bütünlüğün sağlanabilmesi, çalışma belleği kapasitesi ile bağlantılıdır. Bu amaçla bu araştırmada 8;0 yaş ve 8;11 yaş arası KSB+dil bozukluğu olan ve tipik gelişim (TG) gösteren çocukların anlatı becerileri ve çalışma belleği performansları karşılaştırmalı olarak incelenmiştir. Araştırmanın katılımcılarını KSB+dil bozukluğu olan 20 çocuk (10 erkek-10 kız) ve TG gösteren 20 çocuk (10 erkek-10 kız) oluşturmaktadır. Bu çalışmada veri toplama aracı olarak Türkçe Sesletim-Sesbilgisi Testi (SST), Çalışma Belleği Ölçeği ve çocukların anlatı becerilerini öyküleme bağlamında değerlendirmek amacıyla Mercer Mayer tarafından oluşturulan "Kurbağa Neredesin?'' (Frog Where Are You?) isimli resimli yazısız kitap; çocukların anlatılarının analizi için ise Işıtan tarafından geliştirilen "Öykü Anlatma Değerlendirme Formu" kullanılmıştır. Bu çalışmaya ait verilerin analizi SPSS 25.0 istatistik paket programı kullanılarak analiz edilmiştir. Analiz sonuçlarına göre; KSB +dil bozukluğu olan katılımcıların anlatı toplam puanı ile çalışma belleği toplam puanı arasında istatistiksel açıdan anlamlı ilişki bulunamamıştır (r= -336; p= 0,148) ancak çalışma belleği performanslarında ve anlatı becerilerinde KSB+dil bozukluğu olan grup ile TG gösteren grup arasında anlamlı bir şekilde farklılık olduğu belirlenmiştir (p=0,000). Dolayısıyla KSB+dil bozukluğu olan grubun TG gösteren gruba göre daha zayıf performans sergilediği görülmüştür. Bu sonuçlar, konuşma terapistlerinin KSB' yi sadece konuşma seslerinin üretiminde bir sorun olarak görmeden KSB' li çocukların çalışma belleği ve anlatı becerilerini de değerlendirmeleri gerektiğini düşündürmektedir.Various studies have shown that children with Speech Sound Disorder (SSD) have lower working memory capacity compared to their typically developing peers. The ability to convey communicative intent and maintain logical coherence in message content during spontaneous speech is related to working memory capacity. This study aims to compare the narrative skills and working memory performance of children with SSD+language disorders and typically developing (TD) children aged between 8;0 and 8;11 years. The participants included 20 children with SSD+language disorders (10 boys and 10 girls) and 20 TD children (10 boys and 10 girls). Data collection tools used in this study were the Turkish Articulation and Phonology Test (SST), Working Memory Scale, and the picture book "Frog Where Are You?" by Mercer Mayer, which was used to assess the children's narrative skills in the context of storytelling. For the analysis of the children's narratives, the "Storytelling Assessment Form" developed by Işıtan was employed. Data analysis was performed using SPSS 25.0 statistical software. The analysis revealed no statistically significant relationship between the total narrative scores and total working memory scores of the children with SSD+language disorders (r =-0.336; p = 0.148). However, significant differences were found between the SSD+language disorders group and the TD group in terms of working memory performance and narrative skills (p = 0.000). Therefore, it was observed that the SSD+language disorders group exhibited weaker performance compared to the TD group. These results suggest that speech therapists should not view SSD solely as an issue of speech sound production but should also evaluate the working memory and narrative skills of children with SSD
Temporal microbiome changes in axolotl limb regeneration: Stage-specific restructuring of bacterial and fungal communities with a Flavobacterium bloom during blastema proliferation
No full textThe intricate relationship between regeneration and microbiota has recently gained attention, spanning diverse model organisms. Axolotl (Ambystoma mexicanum) is a critically endangered salamander species and a model organism for regenerative and developmental biology. Despite its significance, a noticeable gap exists in understanding the interplay between axolotl regeneration and its microbiome. Here, we analyse in depth bacterial 16S rRNA amplicon dataset that we reported before as data resource and profile fungal community by sequencing ITS amplicons at the critical stages of limb regeneration (0-1-4-7-30-60 days post amputation, 'dpa'). Results reveal a decline in richness and evenness in the course of limb regeneration, with bacterial community richness recovering beyond 30 dpa unlike fungi community. Beta diversity analysis reveals precise restructuring of the bacterial community along the three phases of limb regeneration, contrasting with less congruent changes in the fungal community. Temporal dynamics of the bacterial community highlight prevalent anaerobic bacteria in initiation phase and Flavobacterium bloom in the early phase correlating with limb blastema proliferation. Predicted functional analysis mirrors these shifts, emphasising a transition from amino acid metabolism to lipid metabolism control. Fungal communities shift from Blastomycota to Ascomycota dominance in the late regeneration stage. Our findings provide ecologically relevant insights into stage specific role of microbiome contributions to axolotl limb regeneration
Genç Erkek Hastalarda Spinal Blok Sırasında Gelişen Vazovagal Senkopa Midazolam Premedikasyonunu Etkisi: Retrospektif Bir Çalışma
Get PDFAmaç: Vazovagal senkop arteriyel kan basıncının ve serebral kan akışının azalmasından kaynaklanan ani bilinç kaybıdır.
Gereç ve Yöntem: ASA I-II, 18-45 yaş aralığında, elektif şartlarda spinal anestezi uygulanan 133 erkek hastanın anestezi kayıtları retrospektif olarak incelendi. Premedikasyon uygulanan ve uygulanmayan hastaların anestezi kayıtlarında yer alan hemodinamik veriler ve spinal anesteziye bağlı gelişen baygınlık hissi, hipotansiyon,
senkop ve asistoli kayıtları incelendi ve iki grup hastanın verileri istatistiksel olarak karşılaştırıldı. Verilerin analizinde bağımsız örneklem T test, Mann-Whitney U,
Ki-Kare Test, Ki-Kare Test koşulları sağlanmadığında Fischer Test kullanıldı.
Bulgular: Spinal anestezi öncesi midazolam kullanan grupta anksiyete oranı midazolam kullanmayan gruptan anlamlı olarak daha yüksekti (p<0,05). Midazolam
kullanan ve kullanmayan gruplar arasında spinal sırasında ve spinal öncesi hemodinamik verilerde anlamlı farklılık görülmedi (p>0,05). Midazolam kullanılmayan
grupta bradikardi, senkop, baygınlık hissi oranı midazolam kullanılan gruptan anlamlı (p<0,05) olarak daha yüksekti. Midazolam kullanılan grupta yatar pozisyon oranı
midazolam kullanmayan gruptan anlamlı olarak daha düşüktü (p<0,05). Midazolam kullanan ve kullanmayan gruplar arasında efedrin ve atropin kullanımı benzer
bulundu (p>0,05).
Sonuç: Sonuçlarımız spinal anestezi öncesi uygulanan midazolam sedasyonunun genç erkek hastalarda spinal blok sırasında görülen bradikardi, baygınlık hissi ve
senkopu önlemede etkin olabildiğini göstermektedir.Aim: Vasovagal syncope is a sudden loss of consciousness caused by decreased arterial blood pressure and cerebral blood flow.
Materials and Methods: The anesthesia records of 133 ASA I-II male patients aged 18-45 years who underwent spinal anesthesia under elective conditions were
retrospectively analyzed. The hemodynamic data in the anesthesia records of the premedicated and non-premedicated patients and the records of feeling of unconsciousness, hypotension, syncope and asystole due to spinal anesthesia were examined and the data of the two groups of patients were statistically compared.
Independent sample T test, Mann-Whitney U, Chi-Square Test and Fischer Test were used to analyze of the data.
Results: Anxiety rate was significantly higher in the group using midazolam before spinal anesthesia than in the group not using midazolam (p<0.05). There was no
significant difference in hemodynamic data during and before spinal anesthesia between midazolam and non-midazolam groups (p>0.05). The rate of bradycardia,
syncope and collapse was significantly (p<0.05) higher in the non-midazolam group than in the midazolam group. The rate of supine position was significantly
lower in the midazolam group than in the non-midazolam group (p<0.05).The use of ephedrine and atropine was similar between the midazolam and non-midazolam
groups (p>0.05).
Conclusion: Our results suggest that midazolam sedation before spinal anesthesia may be effective in preventing bradycardia, syncope and syncope during spinal
block in young male patients