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Role of preoperative C-reactive protein value and neutrophil ratio in the determination of conversion from laparoscopic appendectomy to open appendectomy
Get PDFBACKGROUND: In this study, we aimed to investigate the factors causing conversion from laparoscopic appendectomy (LA) to open appendectomy (OA) in patients with acute appendicitis and to investigate the role of preoperative C reactive protein (CRP) and neutrophil ratio in this conversion and determine a cut-off point for these parameters.
METHODS: Records of patients who underwent LA due to acute appendicitis at our general surgery department between January 2011 and January 2017 were retrospectively evaluated. The preoperative American Society of Anesthesiology (ASA) scores, Alvarado scores, white blood cell count, C-reactive protein level, and neutrophil ratio were evaluated.
RESULTS: LA was performed in 394 patients with an initial diagnosis of acute appendicitis. A conversion to OA (cOA) was performed in 17 patients (4.31%). A CRP value of >= 108.5 mg/L and a neutrophil ratio of >= 81.5% were found to be statistically significant for the cOA (p<0.001).
CONCLUSION: Our study results showed that male gender, age, elevated neutrophil ratio, and CRP value were the main risk factors for cOA in patients who were scheduled for LA due to acute appendicitis
Bacterial detection using bacteriophages and gold nanorods by following time-dependent changes in Raman spectral signals
No full textThis study attemps to develop bacterial detection strategies using bacteriophages and gold nanorods (GNRs) by Raman spectral analysis. Escherichia coli was selected as the target and its specific phage was used as the bioprobe. Target bacteria and phages were propagated/purified by traditional techniques. GNRs were synthesized by using hexadecyltrimethyl ammonium bromide (CTAB) as stabilizer. A two-step detection strategy was applied: Firstly, the target bacteria were interacted with GNRs in suspensions, and then they were dropped onto silica substrates for detection. It was possible to obtain clear surface-enchanced Raman spectroscopy (SERS) peaks of the target bacteria, even without using phages. In the second step, the phage nanoemulsions were droped onto the bacterial–GNRs complexes on those surfaces and time-dependent changes in the Raman spectra were monitored at different time intervals upto 40 min. These results demonstrated that how one can apply phages with plasmonic nanoparticles for detection of pathogenic bacteria very effectively in a quite simple test. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group
Association between leptin and weight gain in patients receiving iron treatment
No full textPurpose: The aim of this study was to evaluate the relationship between leptin and weight gain in patients receiving iron treatment.
Materials and Methods: A total of 42 female patients who were diagnosed with IDA were included in the study. Whole blood count, serum iron, serum unsaturated iron binding capacity (UIBC), serum ferritin level were measured at the time of diagnosis and on month one after treatment; serum hepcidin level and serum leptin level were measured at the time of diagnosis and 96 hours after commencement of parenteral therapy; body weight and appetite alterations were recorded at the time of diagnosis and on month one.
Results: A statistically significant difference was not found between hepcidin and leptin values at the time of diagnosis and after treatment. Increased appetite was detected in 22 (52.4%) patients on month one after treatment. While mean weight of all patients was 69.6 +/- 17.9 kg at the time of diagnosis, it was 70.7 +/- 17.5 kg on month one after treatment and there was a statistically significant difference between two values.
Conclusion: Our study revealed that appetite and body weight increased following iron therapy, consistently with our observations and hypothesis. However no significant relationship was found with leptin levels and weight increase
Solitary Fibrous Tumor of the Vagina with Potentially Malignant Features: A Case Report and Review of the Literature
No full textExtrapleural solitary fibrous tumors are being increasingly reported. The retroperitoneum, deep soft tissues of the proximal extremities, abdominal cavity, trunk, head and neck are among the most common extraserosal locations reported. A recurrent solitary fibrous tumor involving the vagina of a 25-year-old woman is reported. Microscopically, the tumor was hypercellular and composed of mitotically active spindle cells. Immunohistochemically, the tumor cells were positive for vimentin, CD34, and bcl-2. Four cases of solitary fibrous tumors involving the vagina have been reported previously. To the best of our knowledge, this is the first case with clinical and histological features suggestive of a malignant behavior
The Mediating Role of Self-Concept and Coping Strategies on the Relationship Between Attachment Styles and Perceived Stress
No full textThe aim of this study was to examine the role of attachment style, self-concept, and coping strategies, in order to explain the differences in perceived stress factors and stress symptoms, in a mediation model. Participants were 515 university students (302 female and 213 male) aged 17-28 years. The assessment instruments were: Social Comparison Scale, Ways of Coping Scale, Experiences in Close Relationships Scale-II, Brief Symptom Inventory and University Students Stress Factors Scale. The results indicated that the effect of anxious attachment on perceived stress factors and stress symptoms was partially mediated by self-concept and coping styles. Our findings revealed that the level of anxious attachment is an important factor to explain perceived stress and stress-related variables
Retinal detachment in albinism
No full textPurpose: To report the visual and anatomic outcomes of albino retinal detachment (ARD) repair.
Methods: Collaborative retrospective analysis of ARD. Outcome measures were number of surgical interventions, final retinal reattachment, and best corrected visual acuity (BCVA) at last follow-up.
Results: Seventeen eyes of 16 patients (12 males; mean age =37.8 years) had the following complications at presentation: macula off (14), total (7) or inferior detachment (5), proliferative vitreoretinopathy (5), detectable break (16), lattice (5), horseshoe tears (9), and giant tear or dialysis (4). Mean number of interventions was 1.8 (range = 1-5) and included cryopexy (15) with scleral buckle (11), and/or vitrectomy (8). Mean initial BCVA was counting finger (CF) 1 m and at last follow-up (mean 77 months) CF4m with mean improvement of 4.5 lines (early treatment diabetic retinopathy study) (P=0.05). Intraoperative choroidal hemorrhage occurred in three eyes. The retina was finally attached in 14 eyes, with residual inferior detachment in three eyes with silicone oil in situ. Silicone oil was kept in six of seven eyes because of residual inferior detachment (3) and removal of silicone oil, which led to redetachment (1) or fear of redetachment (2).
Conclusion: Repair of ARD may require several interventions, with the need to keep silicone oil in several cases due to nystagmus and reduced melanin pigment
The influence of adjunctive caudal epidural steroid injection on the therapeutic effect of transforaminal epidural steroid injection
No full textBackground: Epidural steroid injection is widely used to treat the short and long-term symptoms of low back and radicular pain. To the best of our knowledge, the influence of transforaminal epidural steroid injection (TFSI) combined with caudal epidural steroid injection (CESI) on pain intensity, patient satisfaction, and quality of life in lumbar radiculopathy has not been examined.
Aim: To evaluate the short and long-term efficacy of TFSI, and TFSI combined with CESI (TFSI + CESI) in patients with lumbar radiculopathy.
Materials and Methods: We retrospectively examined the records of 104 patients with lumbar radicular pain and L4/5 and/or L5/S1 intervertebral disc disease who underwent TFSI or TFSI + CESI. We compared the pain intensity using a Visual Numeric Scale (VNS), North American Spine Society (NASS) pain satisfaction index, and EuroQol five dimensions (EQ-5D) quality of life scores before intervention, and after 1, 6 and 12 months.
Results: In the TFSI group, the mean pre-treatment VNS score was 9.2, which improved to 4.9 after 1 month and to 7.2 after 12 months. In the TFSI + CESI group, the mean pre-treatment VNS score was 9.4, which improved to 2.6 and 4.6 after 1 and 12 months, respectively. Improvement in the VNS scores was significantly higher in the TFSI + CESI group (P < 0.0001 for each). Mean EQ-5D quality of life index in the TFSI group improved from 0.59 in the pre-treatment phase to 0.76 after 12 months of intervention, while it improved from 0.62 in the pre-treatment phase to 0.84 at 12 months of intervention in the TFSI + CESI group. The EQ-5D scores were significantly better in the TFSI + CESI group at 1, 6, and 12 months after the procedure (P = 0.004, 0.036, and 0.042, for 1, 6, and 12 months, respectively). The NASS scores were significantly better in the TFSI + CESI group at 6 and 12 months after the intervention (P = 0.025 and 0.001 for 6 months and 12 months, respectively).
Conclusion: In patients with lower lumbar radiculopathy, a combined TFSI + CESI technique offers superior short and long-term pain relief, quality of life, and long-term patient satisfaction, than when TFSI is performed alone
Kanun yoluna başvurmanın ilâmların icrasına etkisi
No full textToplum içerisinde borçlunun borcunu zamanında ve gereği gibi ifa etmesi beklenmektedir. Ancak bu süreç içerisinde yaşanılan bir aksaklığa karşı alacaklının haklarının korunması adına Devlet alacaklıya kendisine başvurma hakkı tanımıştır. İcra ve İflas Kanunu’nda ilâmlı icra takibi, alacaklının hakkına ulaşabilmek için başvuracağı bir yol olarak belirlenmiştir.
Hukukumuzda belirli istisnalar hariç ilâmların icraya konulabilmesi için kesinleşme şartı aranmamaktadır. Kanun yoluna başvuru kararın icrasını etkilemez. Hâlbuki kanun yoluna başvurunun erteleyici ve aktarıcı olmak üzere iki temel özelliği vardır. Kurallar çerçevesinde belirlenmiş istisnalar dışında kalan ilâmlı icra takibinin durması için borçlu tarafından “icranın geri bırakılması kararı” alınması gerekmektedir.
Çalışmamız bir kanun yolu olan kanun yolu müessesesin ilamların icrasına etkisine ilişkindir. Bu çerçevede çalışmamızın ilk bölümünde, istinaf başvurusunun cebri icraya etkisi üzerinde durulacaktır. İkinci bölümde ise istinaf yoluna başvurulmasıyla erteleyici etkinin kendiliğinden doğduğu ilâmlar incelenecek olup üçüncü ve son bölümde istinaf yoluna başvurulmasıyla erteleyici etkinin doğmasının geciktirici şarta bağlı olduğu ilâmlar üzerinde durulacaktır.
In social life, a debtor is expected to perform their debt duly and as required. However, in order to protect the creditor’s rights in the case of any problems throughout this process, the creditor is granted by the State the right to pursue legal proceedings. In the Debt Enforcement and Bankruptcy Law, enforcement proceeding with judgment is established as a legal procedure to be pursued by a creditor to secure their rights.
In Turkish Law, with a few exceptions, res judicata is not necessary for a judgment to be enforced. The pursuit of legal proceedings will not affect the enforcement of a verdict. However, the pursuit of legal proceedings has two basic characteristics: suspension and transference. In order to suspend an enforcement proceeding with judgment other than legally stipulated exceptions, a debtor must obtain an “enforcement suspension verdict”.
The present study is concerned with the effect of appeals, which refer to a form of legal proceeding, on the enforcement of judgments. Within this framework, the first section will focus on the effect of the request for appeal on the compulsory enforcement. The second section will investigate those judgments envisaging an automatic suspensive effect upon the request for appeal, and the third and last section will discuss those judgments in which the suspensive effect to arise upon the request for appeals depends on a suspensive condition
Sürdürülebilir çimento sektörü eğilimlerine dayalı performans kriterlerinin belirlenmesi ve karşılaştırılması
No full textBu çalışmada; uluslararası alanda “Cement Sustainability Initiative (CSI)” girişimine üye olan, ayrıca “Global Reporting Initiative (GRI)” bünyesindeki “Sustainability Disclosure Database” veri tabanında yer alan çimento firmaları başta olmak üzere, çimento sektöründe uygulanan üretim yaklaşımları analiz edilmiştir. Analiz 1990 ve 2013 yılları için yapılmıştır. Kyoto protokolünün etkilerini, hedeflere ulaşmak için belirlenmiş olan kriterlerin, uygulamaların sonuçlarının ve farklı yaklaşımların karşılaştırmalı olarak analiz etmek amacıyla, çok kriterli endeksler geliştirilmiştir. Endeks iki ayrı değerlendirmeye göre oluşturulmuş olup, birinci endeks Enerji ve çevresel performans ayrımlarına göre yapılmıştır. İkinci endeks klinker fırın tiplerine göre yapılmış olup. Çıkan sonuçlar soğutma havasının geri kazanımının önemine işaret etmiş ve Akılcı Ekserji Yönetimi Modelinin uyarlanması ile en faydalı uygulamalara yön vereceği anlaşılmıştır.
In this study, the production approaches applied by the cement producing companies which are members of the "Cement Sustainability Initiative" in the international scale and in the "Sustainability Disclosure Database" within the "Global Reporting Initiative" have been analyzed.
The analysis has been carried out for the years between 1990 and 2013. Multi-criteria indices were developed in order to competitively analyze the impacts of the Kyoto protocol, in terms of the criteria, that were set for achieving the objectives, the results of the applications and the different approaches. Two different indices were developed according to two separate evaluation headings. The first index is based energy and environmental performance. The second index was made according to clinker kiln types. The results have shown the importance of the heat recovery of cooling air and it has been understood that the adaptation of the Rational Exergy Management Model (REMM) will guide us to the most beneficial applications
Skryabin'in evreninde teozofi ve sembolizm
No full text20. yy’ın ilk çeyreği Rusya’da sanat hayatı için çok verimli bir dönem olmuştur. Rus
şiiri “Gümüş Çağı” nı yaşamaktayken diğer sanat dalları da bu dönemin etkileriyle
değişmektedir. Bu döneme damgasını vuran en önemli akım ise sembolizm olmuştur. Rus
şiiri sembolizm akımı etrafında şekillenirken Rus müziğinde de bu etkinin yansımaları
hissedilmiştir.
Aleksandr Skryabin Rus müziğinde sembolizm akımının en önemli temsilcilerinden
biridir. Müziğinde kullandığı sembolist ögeler üslubunun ayrılmaz bir parçası olmuştur.
Teozofi doktrinine duyduğu ilgi düşünce dünyasını şekillendirmiştir. Teozofik fikirleri
müziğinde kullandığı simgelerin de kaynağı olmuştur. Bu tezin amacı, Skryabin’in teozofik
ve sembolist hareket etrafında şekillenmiş olan düşünce dünyasının eserlerine nasıl
yansıdığını araştırmaktır.
First quarter of the 20th century has been quite prolific period for art life in Russia.
While Russian poetry was living its “Silver Age”, other constituents of arts were changing
under the influence of this period. The most important current that marked this period was
symbolism. As Russian poetry was being shaped around the symbolism movement, the
reflection of this effect was also felt in Russian music.
Alexander Skryabin is one of the most important figures of the symbolism movement
in Russian music. The symbolist elements he used in his music have become an integral part
of his style. His interest in the theosophy doctrine has shaped his thought-world. Skryabin’s
theosophical ideas are also the source of the symbols he used in his music. The purpose of
this dissertation is to investigate how Skryabin’s thought-world, which was shaped around
theosophical and symbolist movement, reflects on his works