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Relation of Actinomyces with Tonsillar Hypertrophy and Antibiotic Use
No full textObjective: This study aimed to investigate the incidence of actinomyces in tonsillar tissues of patients undergoing tonsillectomy and to determine the association among tonsillar volume, preoperative antibiotic use, and presence of actinomyces in tonsil tissues.
Methods: In this study, 142 patients who underwent tonsillectomy in last four years were included. Of the total patients, 97 (66.9%) were children and 47 (33.1%) were adults. The patients' age, sex, preoperative antibiotic use, tonsillar volume, and presence of actinomyces in tonsillar tissues were recorded.
Results: Actinomyces was identified in tonsillar tissues of 16 (16.4%) pediatric and 21 (44.6%) adult patients. Of all pediatric patients positive for actinomyces, 13 were males and three were females whereas of all adult patients positive for actinomyces, 14 were males and seven were females. Tonsillar tissue volumes in both pediatric and adult patients positive for actinomyces were statistically higher than the actinomyces negative ones. Antibiotic use was higher and the incidence of actinomyces was lower in pediatric patients than in adult patients positive for actinomyces.
Conclusion: Our study results revealed that actinomyces was prominent in adult patients with tonsillar hypertrophy. In addition, the frequent use of antibiotic decreased the incidence of actinomyces in tonsillar tissues
Significance of electronic health records: A comparative study of vaccination rates in patients with sickle cell disease
No full textObjective: In this study, we investigated the influence of electronic health records (EHR) and electronic vaccination schedule applications on the vaccination status of patients who were admitted to our Center for the treatment of sickle cell disease (SCD).
Methods: The vaccination status against influenza and pneumococcus infection was determined in 93 patients who were admitted to the hematology outpatient clinic, Baskent University Adana Hospital from April 2004 to March 2009. The vaccination status was then re-evaluated following establishment of EHR and electronic vaccination schedules in 2012.
Results: Of the 93 patients with SCD 21.5% (n=20) were vaccinated against pneumococcus and 21.5% (n=20) were regularly vaccinated against influenza. When the vaccination rates of 59 of 93 patients who presented for their regular control examinations were analyzed following establishment of EHR and vaccination schedules in 2012, these rates were 49.2% (n=29) and 50.8% (n=30) for influenza and pneumococcus, respectively, after EHR; there were 23.7% (n=14) and 20.3% (n=12), respectively, before EHR. A statistically significant difference was found between the vaccination rates before and after EHR (p < 0.05).
Conclusion: Although viral and bacterial infections are life-threatening health problems in patients with SCD, the vaccination rates were low in high-risk patients. However, these rates increased after application of electronic vaccination schedules
Results of a blue code implementation at a university hospital
No full textPurpose: The blue code is an early warning system that enables the necessary interventions to be made individuals whose basic life functions are at risk or have stopped. The purpose of this study is to evaluate the blue code application in our hospital and to analyze the management of these patients.
Material and Methods: Data of 154 patients with code blue call between April 2016 and September 2016 were retrospectively analysed. Patients age, gender, code blue call time, the most call given unit, team's arrival time to unit, cardiopulmonary resuscitation (CPR) time, the initial rhythm survival and discharge rates were investigated.
Results: A total of 154 patients (97 male, 57 female) were evaluated in the study. The mean age of the patients was 62 years. 83 (53.9%) of the code blue calls occurred after hours and the most frequent calls given by internal intensive care unit. The mean time for the code blue team to arrive was 1.25 minutes and the mean duration of CPR was 27 minutes. The most frequent initial cardiac rhythm detected in patients was asystole (87%). Spontaneous circulation was provided in 24 patients and 130 died. Sixteen patient were discharged after further follow-up and treatment. When the blue code call was given from the patients who were discharged, the first cardiac rhythm detected ventricular fibrillation in 9 patient, sinus rhythm in 5 patient and asystole in 2 patient.
Conclusion: When evaluated of the code-blue calls in our hospital, the most common rhythm in cardiopulmoner arrest cases were asystoly but survival and discharged rates were more likely in patient which initial rthym is ventricular fibrillation
Ly6Chi inflammatory monocytes promote susceptibility to Leishmania donovani infection
No full textLy6Chi inflammatory monocytes (iMO) are critical for host defense against toxoplasmosis and malaria but their role in leishmaniasis is unclear. In this study, we report a detrimental role of Ly6Chi iMOs in visceral leishmaniasis (VL) caused by Leishmania donovani. We demonstrate that Ly6Chi iMOs are continuously recruited into the spleen and liver during L. donovani infection and they are preferential targets for the parasite. Using microarray-based gene expression profiling, we show that Ly6Chi iMOs isolated from the infected liver and spleen have distinct phenotypic and activation profiles. Furthermore, we demonstrate that blocking the recruitment of Ly6Chi iMOs into the liver and spleen during L. donovani infection using a CCR2 antagonist reduces the frequency of the pathogenic IFN-γ/IL10 dual producer CD4+ T cells in the spleen and leads to a significant reduction in parasite loads in the liver and spleen. Using STAT1-/- mice we show that STAT1 is critical for mediating the recruitment of Ly6Chi iMOs into organs during L. donovani infection, and adaptive transfer of wild type Ly6Chi iMOs into STAT1-/- recipients renders them susceptible to disease. Our findings reveal an unexpected pathogenic role for Ly6Chi iMOs in promoting parasite survival in VL and open the possibility of targeting this population for host-directed therapy during VL. © 2017 The Author(s)
Motivations and Barriers in Promoting Preschool Education
No full textThis study is designed to explore the reasons for sending and not sending preschool age children to preschools at an early age by exploring the motivations for and barriers towards promoting preschool education in Turkey. It aimed to determine various stakeholders' perceptions, attitudes, and knowledge related to preschool education in order to promote high-quality and comprehensive preschool education. The research was conducted with 224 participants in five cities in Turkey. Qualitative data was collected through individual and focus group interviews and interpreted by content analysis and descriptive analysis. The findings indicated that families put forward the following reasons for sending their children to preschool: preschool education prepares children for school and helps form the habit of attending school, teachers' efforts in convincing parents to send their children to preschool, providing the care for the children of working mothers with preschool teachers, and preschool helps children develop social behavior. The following factors were reasons families did not send their children to preschool: economic conditions, perceiving the child as too young, concerns over practices at school, perceptions about the mother's role, and distrust of the transportation system. The results will help decision makers develop policies and strategies to heighten the general public's awareness of the need for early education, as well as better provide early education opportunities
Efficacy of Palatal Applications on Fracture Resistance of Reattached Maxillary Central Incisors: An In Vitro Study
Get PDFThe purpose of this study was to evaluate the effects of different palatal applications on fracture strength of the fractured anterior tooth. Sixty caries-free human maxillary incisors were used. Endodontic treatments of the teeth were performed. Then, the teeth were divided randomly into five groups (n = 12). Crowns of all teeth in groups A-D were cut with diamond discs at a fixed distance of 3mm from the incisal margin in a plane normal to the buccal surface. In all groups, coronal fragments were reattached to the remaining teeth by bonding with hybrid composite resin. After then, the teeth were restored to the following; group A, bonding and palatal laminate; group B, bonding and creation of a vertical groove; group C, bonding and creation of two slot grooves; group D, bonding only; and group E, intact tooth. It was lesser in group B than in groups C and E (p = 0.007 and p = 0.006, resp.) and lesser in group D than in groups A, C, and E (p = 0.002, p < 0 001, and p < 0 001, resp.). Within the limitations of this in vitro study, it can be concluded that methods employing palatinal laminate and small grooves are clinically feasible for the reattachment of tooth fragments to incisors
Evaluation of the Relationship Between Thyroid Functions and Dry Eye Symptoms in Patients with Hashimoto Thyroiditis
Get PDFPurpose: Dry eye is the most common symptom of thyroid-associated ophthalmopathy in Hashimoto thyroiditis. Ocular surface inflammation, tear hyperosmolarity and overproduction of inflammatory cytokines are responsible for the development of this process. In this study, we aimed to investigate the relationship between thyroid functions and dry eye symptoms in patients with Hashimoto thyroiditis.
Materials and Methods: The patients, diagnosed with Hashimoto thyroiditis (n:125), were included in this monocenter cross-sectional study. The study population was divided into three groups: euthyroidism (Group-1, n: 48), subclinical hypothyroidism (Group-2, n: 38) and overt hypothyroidism (Group-3, n: 39). The groups were compared based on the presence of dry eye syndrome, Schirmer tests, OSDI scores of patients with dry eye diagnosis and tear break-up time. The results were analyzed with ANOVA and Spearman's correlation test.
Results: No significant difference was found in the frequency of dry eye syndrome between the groups (p = 0.1). There was no difference in the Schirmer scores and tear break-up time measurements (p = 0.6 and 0.2). The severity of OSDI scores was significantly milder in the patients with dry eye diagnosis, in the euthyroid group (p = 0.03). Serum fT3 levels positively correlated with tear break up time measurements (p = 0.004, r = 0.302) and negatively correlated with presence of dry eye syndrome (p = 0.03, r = -0.981).
Discussion: Although dry eye symptoms tend to be milder in euthyroid patients, the frequency of dry eye syndrome is similar in patients with Hashimoto thyroiditis, independent of thyroid function status
High Levels of Circulating Endothelial Progenitor Cells Are Associated with Acrotism in Patients with Takayasu Arteritis
Get PDFObjectives: To investigate the association between endothelial progenitor cells (EPCs) and Takayasu arteritis (TA). Subjects and Methods: A total of 39 subjects were included in this study: 12 subjects had been diagnosed with active TA, 11 had active Behcet disease (BD), and 16 were healthy controls. The EPCs, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels of all the subjects were measured. MedCalc 15.8 software (MedCalc, Belgium) was used for all statistical analyses. Results: The level of EPCs was higher in TA patients (4.25 +/- 2.56) than in the BD group (2.27 +/- 2.0) and the healthy controls (2.12 +/- 1.2) (p = 0.015). TA patients with acrotism (n = 4) had higher levels of EPCs compared to TA patients without acrotism (n = 8) (6.50 +/- 1.73 vs. 3.12 +/- 2.16, p = 0.02). A positive correlation was found between EPCs and the ESR (r = 0.723, p = 0.0079) and between EPCs and CRP in patients with TA (r = 0.769, p < 0.0034). Conclusion: High levels of circulating EPCs were correlated with the CRP level and the ESR in patients with TA. These cells could be a marker for acrotism and inflammation in patients with TA. (C) 2016 S. Karger AG, Base
Anesthesia management for laparoscopic bariatric surgery: retrospective analysis of 62 patients
Get PDFPurpose: The aim of this study was to present our experience in patients who underwent laparoscopic bariatric surgery and to discuss the current literature on the perioperative management
Material and Methods: Sixty two patients with ASA risk classification II-III were evaluated retrospectively who underwent obesity surgery in our hospital. Demographic characteristics of the patients, surgical time, complications that seen in the perioperative period and the length of hospital stay were recorded
Results: The age of the patients ranged from 19 to 59 years and 75.9% of them were female. Mean operation time was 167 minutes and the length of hospital stay was 5 days. Complications seen during intraoperative period were tachycardia, hypertension and arrhythmia. In the following days, 6 (9.7%) patients were re-operated and there was no mortality
Conclusion: The prevention of complications that may occur in laparoscopic obesity surgery is required with a equipped team and teamwork, a good preoperative preparation, thromboembolism prophylaxis, tight hemodynamics and blood gas monitoring for safe anesthesi
Enhancing an International Perspective in Public Health Teaching through Formalized University Partnerships
No full textTeaching in the field of public health needs to employ a global perspective to account for the fact that public health problems and solutions have global determinants and implications as well. International university partnerships can promote such a perspective through the strengthening of cooperation, exchange, and communication between academic institutions across national boundaries. As an example for such an academic network in the field of public health, we introduce the International Public Health Partnership-a collaboration between a university in Germany and universities in India, Turkey, and Nigeria. Formed in 2005, it facilitated the exchange of information, fostered discussion about the transferability of public health concepts, contributed to the structural development of the universities involved, and promoted an intercultural dialog through a combination of local and distance learning activities. Although well accepted by students and staff, different obstacles were encountered; these included limited external funding, scarce own financial, time and personnel resources, and diverging regulations and structures of degree programs at the partnership sites. In the present article, we share several lessons that we learned during our joint collaboration and provide recommendations for other universities that are involved in partnerships with institutions of higher education or are interested to initiate such collaborations