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Bocavirus Viremia and Hepatitis in an Immunocompetent Child
No full textBackground: So far, many studies have shown that Human Bocavirus (HBoV) is the main pathogen of the respiratory tract. Until now, there is no study that proves the association between HBoV and hepatitis. HBoV viremia/DNAemia has been associated closely with acute primary infection and moderate-to-severe illness but, more detailed clinical data about HBoV dissemination are still unavailable.
Case Report: Here we report a 2-years-5-months-old girl suffering from respiratory distress and heptitis followed in our intensive care unit. HBoV was detected in our patients nose and throat swabs concurrent with whole blood sample by positive polymerase chain reactions. After a through investigation no causative agent other than HBoV viremia was found.
Conclusion: Human Bocavirus viremia with high viral loads may be associated with hepatitis
A Patient with Suspected Myocarditis Associated with Legionnaires' Disease: A Case Report and Review of the Literature
No full textLegionnaires' disease (LD) is a systemic infectious disease caused by Legionella species. It mainly presents with lung involvement. Herein, we present a case with suspected myocarditis associated with LD and review of the relevant literature. An 81-year-old male tourist patient with high fever, cough, imbalance while walking, and confusion presented to the emergency department. The patient was diagnosed with LD based on increased density in the left lower zone on chest x-ray and a positive Legionella urine antigen test. He was administered a combination of claritromycin and levofloxacine on the day of admission. The diagnosis of acute myocarditis was made after worsening of the cardiac functions, ST elevation and troponin I positivity. The patient's symptoms regressed with antibiotic therapy and the patient was transferred to his home country by ambulance plane ten days after admission. A search of PubMed and Web of Science using the keywords "Legionella and myocarditis" revealed 15 case reports, nine of which were in English and were reviewed. There were three female and six male patients with a mean age of 44 years (range: 32-56 years). Seven were diagnosed with LD by urine antigen testing, one by serological testing and culture, and one by direct fluorescent-antibody staining and culture. Myocarditis was diagnosed by biopsy in two patients and by clinical and laboratory findings in the rest. Myocarditis without existing pneumonia was detected in one case. Electrocardiography abnormalities such as atrial flutter, atrioventricular block, torsade de pointes, sinus tachycardia, QT prolongation, ST elevation, and T wave inversion were detected in seven patients. Ventricle dysfunction on echocardiography and cardiac marker abnormality were detected in all but one of the patients (not tested in one patient). Antimicrobial monotherapy was chosen for three of the cases. One patient died due to myocarditis. In conclusion, myocarditis may develop rarely during the course of LD. Clinical suspicion is essential for the diagnosis. Early diagnosis and appropriate treatment may be life-saving
New integer programming formulation for multiple traveling repairmen problem
No full textThe multiple traveling repairman problem (kTRP) is a generalization of the traveling repairman problem which is also known as the minimum latency problem and the deliveryman problem. In these problems, waiting time or latency of a customer is defined as the time passed from the beginning of the travel until this customer's service completed. The objective is to find a Hamiltonian Tour or a Hamiltonian Path that minimizes the total waiting time of customers so that each customer is visited by one of the repairmen. In this paper, we propose a new mixed integer linear programming formulation for the multiple traveling repairman problem where each repairman starts from the depot and finishes the journey at a given node. In order to see the performance of the proposed formulation against existing formulations, we conduct computational analysis by solving benchmark instances appeared in the literature. Computational results show that proposed model is extremely effective than the others in terms of CPU times. (C) 2016 The Authors. Published by Elsevie
Coronary flow reserve is impaired in patients with obstructive sleep apnea
No full textSTUDY OBJECTIVES: Obstructive sleep apnea (OSA) is common in adult populations. Accumulating data indicate that it is independently associated with a variety of cardiovascular diseases and has prognostic importance in affected cases. In this study, we aimed to evaluate coronary flow reserve (CFR) in patients with OSA and controls.
METHODS: Sixty-one patients undergoing an overnight polysomnography were enrolled in this study. Patients with an apneauhypopnea index (AHI) 5 were accepted as OSA group (n = 45) and those with an AHI <5 were taken as controls (n = 16). Using Doppler echocardiography at baseline and following dipyridamole infusion, coronary peak flow velocities were obtained. CFR was calculated as the ratio of peak diastolic flow to baseline diastolic flow. A CFR value <2 was accepted as impaired coronary microvascular function.
RESULTS: The mean age was 50.8 10.8 years, of which 16 (26.2%) were female. Both groups had similar features with regard to demographic and clinical variables. The mean value of CFR was significantly lower in patients with OSA compared to those controls (2.24 0.46 vs. 2.74 0.62, respectively, P = 0.001). An abnormal CFR value was observed in 12 (26.7%) patients with OSA and in 1 (6.3%) participant in control group.
CONCLUSIONS: The findings of this study indicate that CFR, an indicator of coronary microvascular function, is significantly impaired in patients with OSA. Coronary microvascular function, an early sign of atherosclerosis, can be evaluated noninvasively in these patients might be used as a predictor of cardiovascular risk
Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging
No full textAims This European Association Cardiovascular Imaging (EACVI) Expert Consensus document aims at defining the main quantitative information on cardiac structure and function that needs to be included in standard echocardiographic report following recent ASE/EACVI chamber quantification, diastolic function, and heart valve disease recommendations. The document focuses on general reporting and specific pathological conditions such as heart failure, coronary artery and valvular heart disease, cardiomyopathies, and systemic diseases.
Methods and results Demographic data (age, body surface area, blood pressure, and heart rhythm and rate), type (vendor and model) of ultrasound system used and image quality need to be reported. In addition, measurements should be normalized for body size. Reference normal values, derived by ASE/EACVI recommendations, shall always be reported to differentiate normal from pathological conditions. This Expert Consensus document suggests avoiding the surveillance of specific variable using different ultrasound techniques (e.g. in echo labs with high expertise in left ventricular ejection fraction by 3D and not by 2D echocardiography). The report should be also tailored in relation with different cardiac pathologies, quality of images, and needs of the caregivers.
Conclusion The conclusion should be concise reflecting the status of left ventricular structure and function, the presence of left atrial and/or aortic dilation, right ventricular dysfunction, and pulmonary hypertension, leading to an objective communication with the patient health caregiver. Variation over time should be considered carefully, taking always into account the consistency of the parameters used for comparison
Haczedilen taşınmazların paraya çevrilmesi
No full textGünümüz hukuk sistemlerinde, kurulan bir borç ilişkisi kapsamında borcun ifa
edilmemesi sonucunda başvurulması gereken yol, devletin cebri icra organlarıdır. Cebri
icra hukuku, borçlunun iradesiyle ve zamanı geldiğinde borcunu ödememesi neticesinde,
devletin cebri icra organlarından yararlanılarak alacaklının alacağına kavuşmasını sağlayan
hukuk dalıdır.
Çalışmamız içerisinde ele alacağımız konu, haczedilen taşınmazların paraya
çevrilmesi safhası ve ihalenin sonuçları olacaktır. Alacaklının icra hukuku kuralları
çerçevesinde başlattığı icra takibinin kesinleşmesi ile birlikte, borçlunun taşınmazlarını
haczettirme ve bu taşınmazların satılarak paraya çevrilmesini talep etme hakkı
bulunmaktadır. Zira icra takibi kapsamında alacaklının tatmini, icra organları tarafından
haczedilen taşınmazların açık artırmaya çıkarılması sonucu elde edilen para ile
sağlanmaktadır. Haczedilen taşınmazların paraya çevrilmesi kural olarak açık artırma usulü
ile mümkündür. Alacaklı tarafından kanuna uygun şekilde yapılan paraya çevirme talebi
neticesinde icra müdürlüğü, açık artırmaya hazırlık işlemlerini eksiksiz şekilde yerine
getirmeli ve tarafların menfaatlerine uygun olarak artırmayı gerçekleştirmelidir.
Çalışmamızda özet olarak paraya çevirme usulü, artırmaya hazırlık işlemleri ve
artırmanın yapılması ile sonuçları kapsamlı bir şekilde ele alınmıştır. Doktrindeki görüşlere
ve Yargıtay içtihatlarına da yer verilerek, uygulamada yaşanan olumlu ve olumsuz
hususlara da değinilmiştir.
In today's legal systems, the way to apply under non-fulfillment debt obligations is
state's compulsory executive bodies. Compulsory law provides to obligee when the time
comes, getting as mentioned debt using the government's compulsory executive bodies by
willing of debtor.
The subject which we will discuss in our study is the phase of the seizure of the
seized property and the result of tender. There is right to demand of obligee, follow-up of
executions initiated within the framework of compulsory laws that disposing of the
immovables registered on the debt and to convert these immovables into money for sale.
Likewise, the satisfaction of creditors in the law of compulsory is obtained by the money
which is result of the auctioning of immovable properties seized by the executive organs.
Encashment of immovable property is possible by auction procedure as a rule. Pursuant to
the request for the conversion of the money by the creditor in accordance with the law, the
executive directorate shall carry out the auctions preparation procedures in full and
increase it in accordance with the interests of the parties.
As a summary of our study, method of encashment, preparations to increase and
results of making an enhancement is examined in detail and these examines are supported
by doctrines and the Court of Cassation case-law
Türkiye’de Neoliberal – muhafazakâr politikalara kısmi rızanın serüveni: 2002- 2017
No full textTürkiye son 15 yıldır Adalet ve Kalkınma Partisi’nin (AKP) tek başına iktidarda olduğu, neoliberal politikaların hâkim olduğu ve neoliberal politikaların bir sonucu olarak, işsizlik, özelleştirme, piyasalaştırma, sendikal hak ihlalleri, güvencesizleştirme, esnekleştirme uygulamalarının yoğunlaşmaya başladığı bir dönüşüm sürecinden geçmektedir. Bu çalışma, neoliberal dönüşümün siyasi aktörü olarak AKP’nin katıldığı her seçimde oy oranını nasıl artırdığı ve bağımlı sınıfların rızasını nasıl devşirdiğini anlamayı amaçlamaktadır. Bu bağlamda birinci bölümde neoliberalizm, muhafazakarlık ve hegemonya teorileri ekseninde kuramsal çerçeve oluşturulmuştur. İkinci bölümde AKP’nin doğuşu ve iktidar oluşuna katkı sağlayan tarihsel dinamiklerden bahsedilmektedir. Üçüncü bölümde AKP hükümetinin iktidar dönemleri hegemonya sorunsalı çerçevesinde incelenmiştir. Dördüncü ve son bölümdeyse AKP’nin hegemonyasını hangi yöntemlerle yeniden ürettiğini anlamak açısından neoliberal popülizm çerçevesinde eğitim, sağlık, sosyal yardımlar ve AKP-örgütlü emek ilişkisi incelenmektedir. AKP’nin İslami öğelerle süslenmiş neoliberal popülizmi, neoliberalizmin açtığı yaraları bu politikalarla hafifletilmiş ve görünmez kılmış ve hegemonyanın tekrar üretilmesinde kilit bir işlev üstlenmiştir.
For the last 15 years Turkey has been undergoing a transformation process in which Justice and Development Party (JDP: AKP) has been in power alone, neoliberal policies dominates, and as a consequence of the neoliberal politics unemployment, privatization, marketization, violation of union rights, precarity, and flexibility of labor have begun to be intensified. The purpose of this study is to understand how AKP, as the political actor of the neoliberal transformation, has increased its votes in every election and how it has gathered the consent of dependent classes. In this context, in the first section of this study, a theoretical framework is formed on the axis of the neoliberalism, conservatism, and hegemony theories. In the second section, the origins of AKP and historical dynamics which contribute to its era are described. In the third section, the era of AK Party government is examined in the framework of hegemony problematic. In the fourth and the last section, regarding understanding how AKP has regenerated its hegemony; education, health, social policies, and AKP’s relationship with organized labor are examined in the framework of neoliberal populism. AKP’s Islamic-oriented neoliberal populism has moderated the social costs of neoliberal policies and made them invisible, so it has played a key role in the reproduction of
hegemony
Histopathological Changes of Neoadjuvant Chemoradiation and Relation with the Pre-Treatment Tumor Stage in Rectal Carcinoma
Get PDFObjective: Neoadjuvant chemoradiotherapy has considered one of the standard treatment modalities for locally advanced rectal cancers. Chemoradiotherapy has a variety of different effects and responses on tumor, tumor bed and peritumoral tissues. The purpose of the present study was to evaluate the stromal responses in tumor bed between the different treatment modalities and different clinical T stages.
Methods: Fifty-seven consecutive patients with median age of 62.4 years were treated for rectal adenocarcinoma between January 2005 and July 2012 in Uludag University Medical Faculty. Twenty-three of the patients were treated with neoadjuvant chemoradiation therapy and following surgery, 34 patients treated with surgery only.
Results: When we compared the stromal responses in the tumor bed between the two different treatment modalities, the amount of fibrosis and intensity of inflammatory cell infiltration were found considerably marked. The existence of calcification, hemosiderin-laden macrophages and mucin lakes were found also significant marked. There was no difference found in between the patients with different clinical stages which were received neoadjuvant CRT.
Conclusion: The stromal response in the tumor bed increases with the neoadjuvant chemoradiotherapy but the excess of the response doesn't have any relation with the clinical T stage
Protective effect of Nigella sativa oil on acoustic trauma induced hearing loss in rats
Get PDFAcoustic trauma is a common reason for hearing loss. Different agents are used to prevent the harmful effect of acoustic trauma on hearing. The aim of this study was to evaluate the potential preventive effect of Nigella sativa (black cumin) oil in acoustic trauma. Our experimental study was conducted with 20 Sprague Downey female rats (mean age, 12 months; mean weight 250 g). All of the procedures were held under general anesthesia. Following otoscopic examinations, baseline-hearing thresholds were obtained using auditory brainstem responses (ABR). To create acoustic trauma, the rats were then exposed to white band noise of 4 kHz with an intensity level of 107 dB in a soundproof testing room. On Day 1 following acoustic trauma, hearing threshold measurements were repeated. The rats were divided into two groups as the study group (n: 10) and the controls (n: 10). 2 mL/kg/day of Nigella sativa oil was given to the rats in the study group orally. On Day 4 following acoustic trauma, ABR measurements were repeated again. There was no difference between the baseline hearing thresholds of the rats before acoustic trauma (P>0.005). After the acoustic trauma, hearing thresholds were increased and there was no significant statistically difference between the hearing thresholds of the study and control groups (P=0.979). At the 4th day following acoustic trauma, hearing thresholds of the rats in control group were found to be higher than those in the study group (P=0.03). Our results suggest that Nigella sativa oil has a protective effect against acoustic trauma in early period. This finding should be supported with additional experimental and clinical studies, especially to determine the optimal dose, duration and frequency of potential Nigella sativa oil therapy
Can Sleep Apnea be Detected by Heart Sounds?
Get PDFObjective: It has previously been shown that there are morphological changes in hearth sounds during respiration and holding breath. In this study, for the first time in the literature, it was investigated whether sleep apnea could be detected automatically from heart sounds by teaching various classifiers of time and frequency plane parameters which are thought to be able to characterize the morphological changes seen in heart sounds during apnea.
Materials and Methods: For this purpose, heart sounds were recorded simultaneously with full polysomnography records from 17 people. Classification studies were performed by assigning feature vectors obtained from heart sounds to K nearest neighbors and support vector machines.
Results: The best result with K nearest neighbor classifier was 48% accuracy, 100% selectivity level. With support vector machines classifier, 82% accuracy and 42% selectivity values were reached.
Conclusion: According to these values, it is concluded that the parameters of the heart sound used in this study do not make it possible to diagnose the sleep apnea from the heart sounds