İstanbul Sağlık ve Teknoloji Üniversitesi Kurumsal Akademik Arşivi
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Mechanical performance of nonabsorbable monofilament suture materials tied with different suturing techniques under various knot configurations: An in vitro study
No full textThis study compared widely used nonabsorbable and monofilament suture materials tied with three different configurations and two different suture techniques. Three su ture materials (polytetrafluoroethylene, polypropylene, and nylon) were tied with either Laurell–Gottlow or the horizontal mattress suturing techniques using three different knot configurations: A (2 = 1 = 1 = 1 = 1), B (2 × 1 = 1 = 1 = 1), and C (1 × 2 = 1 = 1 = 1) on an experimental platform manufactured using a three-dimensional printer. Specimens underwent microtensile testing to determine maximum load failure and elongation rates at baseline and after 7 days of artificial saliva immersion. The Laurell–Gottlow yielded significantly lower elongation rates and higher failure load than the horizontal mattress suturing technique using nylon and polypropylene sutures at both time points (p < 0.001). Nylon had a significantly higher failure load and elongation than polypropylene and polyte trafluoroethylene at baseline for both suturing techniques and all three knot configurations (p < 0.001). Configuration C had low failure load values following immersion for all suture materials when using horizontal mattress suturing. Configuration A demonstrated superior failure load following the immersion period for all materials using both techniques. The polytetrafluoroethylene suture remained more stable over time. These findings indicate that the Laurell–Gottlow suturing technique with Configuration A provides better mechanical resistance to external forces when using nonabsorbable monofilament suture materials
Phocatalytic dye degradation activities of chitosan film modified by green synthesized tio2 from aloe vera leaf extract
No full textRecent research focuses on heterogeneous photocatalysis, an environmentally friendly and cost-effective method that uses solar energy to completely degrade pollutants without generating secondary waste. The focus is optimizing the properties of photocatalysts in terms of electronic structure, light absorption, and reduced recombination rate of photogenerated charges and easy separation of the photocatalyst from reaction media [1]. The potential for efficient, sustainable heterogeneous photocatalysis has been demonstrated by semiconductors such as TiO₂, ZnO, Fe₂O₃, CdS, CuS, and ZnS [2]. TiO₂ is regarded as one of the most effective photocatalysts. The usage of TiO₂ for the degradation of hazardous organic dyes in wastewater has significant potential. The separation of the photocatalyst from the reaction medium remains a significant challenge in photocatalytic applications. In particular, the recovery of TiO₂ after the degradation of organic dyes poses a considerable difficulty, as its fine particulate nature hampers efficient separation from the treated solution. One of the strategies in this regard is the immobilization of the photocatalyst by embedding it into a polymer matrix. This approach facilitates easier separation of the photocatalyst from the reaction medium [3]. Chitosan, a natural biopolymer widely used for its biodegradability and biocompatibility, is an attractive candidate for hydrogel development due to its functional groups that serve as cross-linking sites during hydrogel formation. It has also been combined with photocatalysts and utilized in numerous studies [4-6]. In this study, green-synthesized TiO₂-embedded chitosan films (Bio-TiO₂-CS films) prepared using aloe vera leaf extract offer the advantage of facile separation after the degradation process, as well as potential reusability following dye removal. As the goal of the study, it is believed that the obtained chitosan film hydrogels can be used as an effective bio-template material to disperse TiO2 nanostructures due to their three-dimensional porous structure and appropriate nanopore size distribution, and this feature has led us to investigate the simpler, recyclable, green approach, and biomaterial development of the use of Bio-TiO₂-CS Hydrogel Films in photocatalytic dye removal from water
The association of exhaled nitric oxide level with respiratory muscle strength, pulmonary function, exercise capacity, sleep quality, functional status, and health-related quality of life in patients with pulmonary arterial hypertension
No full textThe Association of Exhaled Nitric Oxide Level With Respiratory Muscle Strength, Pulmonary Function, Exercise Capacity, Sleep Quality, Functional Status, and Health-Related Quality of Life in Patients With Pulmonary Arterial Hypertensio
Presence of myositis specific autoantibodies including anti synthetase antibodies predict favorable outcomes to rituximab in patients with idiopathic inflammatory myositis: Retrospective observational study
No full textBackground: Idiopathic inflammatory myositis (IIM) is a group of disorders that mainly affect skeletal muscle, joints, skin, and lungs. Objectives: This study aimed to evaluate the autoantibody profile including myositis-associated autoantibodies (MAAs) and myositis-specific autoantibodies (MSAs) and their influence on outcomes, response rates, and associated factors to Rituximab (RTX) treatment in patients with IIM who followed up in a single tertiary center. Methods: Data from the patients with IIM who follow-up between 2019 and 2023 years and met the Bohan and Peter and/or the ACR/EULAR 2017 and/or the ENMC criteria were retrospectively reviewed. RTX was initiated in patients who had an inadequate response to at least one immonomudulatory/immunosuppressive treatment (refractory group) or as a first-line treatment in patients who had critical/severe disease manifestations such as respiratory failure due to severe intertitial lung disease (ILD), respiratory muscle involvement, and dysphagia. RTX was administered at a dose of 1 g every 6 months on days 0-15, and the dose was repeated at month 6 in patients who responded to treatment. Remission was defined as the patients who met all of the following criteria during at least 6 months: i) absence of a sign of muscle inflammation by manual muscle test (normalization of muscle strength in patients without damage) alongside muscle enzymes (normalization in CK and LDH levels), ii) improvement or no progression in respiratory symptoms alongside pulmonary function tests (less than 10% decline in FVC and/or DLCO) in patients who had ILD at baseline, iii) disappearance of active skin lesions among dermatomyositis (DM) patients iv) resolution of other features attributed to several manifestations such as arthritis, heart involvement and gastrointestinal symptoms if present
Comparison of quadro‑iliac plane block and erector spinae plane block for postoperative analgesia management after single level lumbar discectomy surgery: A randomized, double‑blind, controlled, prospective, multicenter study
No full textPurpose Effective postoperative analgesia management is critical for optimizing recovery and patient satisfaction following lumbar discectomy. Erector Spinae Plane Block (ESPB) is an established regional anesthesia technique with proven efficacy, while the novel Quadro-Iliac Plane Block (QIPB) has shown promise as an alternative approach. This study compares the analgesic efficacy, opioid-sparing potential, and safety of ESPB and QIPB in single-level lumbar discectomies. Method This multicenter, prospective, randomized, double-blind study included 60 patients aged 18–65 years undergoing single-level lumbar discectomy. Patients were randomized into ESPB (n=30) and QIPB (n=30) groups. Both blocks were performed at the end of surgery, before the extubation under ultrasound guidance using 40 ml (0.25%) bupivacaine bilater ally. The primary outcome was postoperative pain assessed by the Numeric Rating Scale (NRS) at 12 h. Secondary outcomes included tramadol consumption, rescue analgesia requirements, hemodynamic parameters, and adverse events. Results The primary outcome, 12-h NRS scores, did not differ significantly between groups (p>0.05), indicating similar anal gesic efficacy. Secondary outcomes—including total tramadol consumption (54.00±49.03 mg for ESPB vs. 44.67±44.16 mg for QIPB, p=0.476), need for rescue analgesia, and incidence of nausea and vomiting—were also comparable. No motor block was observed in either group. Conclusion Although QIPB did not demonstrate superiority over ESPB, it was found to be not inferior in analgesic effect and safety outcomes. These findings suggest that QIPB may be a reliable alternative to ESPB in lumbar discectomy procedures
Kardiyopulmoner resüsitasyon ve acil durumlarda sık kullanılan ilaçlar
No full textYoğun bakımlarda yatan hastalarda hemodinamiğin stabil bir şekilde sürdürülmesi hedeflenir. Kardiyovasküler hastalıklar, hipovolemi, elektrolik dengesizlikleri, hipoksi, asidoz vb nedenlerden dolayı hemodinamik dengesizlik ve tedavi edilmediği takdirde kardiyaksolunum arrest meydana gelebilir. Kardiyak- solunum arreste ilişkin solunum ve dolaşımı sağlama ve hemodinamik dengeyi korumaya yönelik tıbbi araç gereçler birlikte bazı ilaçların kullanılması da gereklidir. Bu bölümde yoğun bakımda acil vakaların yönetiminde sıklıkla kullanılan ilaçlar, ilaç grupları, kullanım şekilleri, farmakokinetik-famakodinamik, etki mekanizması, endikasyonlar, kontrendikasyonlar, yan etkiler ve ilaçlara ilişkin hasta yönetiminde dikkat edilmesi gereken hususlar verilmiştir
The impact of domestic violence and sexual assault on family dynamics and child development: A comprehensive review
No full textThis review synthesizes current research on domestic violence and sexual assault, focusing on their short-term and long-term effects on family dynamics, particularly on the development and well-being of children and adolescents. The article employs a curated body of literature, including surveys, reviews, program evaluations, and international health reports, to elucidate the direct and collateral damage caused by such trauma within families. The review critically examines the intersecting consequences of abuse, including immediate psychological distress and long-term socio-economic and educational disruptions for affected youths. Additionally, the review examines structural impediments and cultural intricacies that shape reporting prac tices and access to support services. The role of civil legal aid and victim advocacy in promoting survivor safety and justice is discussed, supported by findings from service evaluation studies. The review also addresses the exacerbating effects of the Coronavirus pandemic on domes tic violence rates and service provision, noting increased occurrences of domestic abuse and decreased pursuit of urgent care and support, highlighting research conducted from the pan demic’s start through 2023. Emergent studies reveal a rise in domestic abuse occurrences and a decline in urgent care and support pursuit, emphasizing the need for adapted intervention strategies. The review offers evidence-based recommendations for policymakers, healthcare providers, and community organizations, stressing the necessity of persistent and collaborative efforts to address and prevent domestic violence. The ultimate goal is to advocate for a stron ger international response to repair harm and prevent future occurrences, ensuring a safer environment for all family members, particularly children and adolescents
Incidence and prognostic factors of isolated para-aortic lymph node metastasis in endometrial cancer: A single-center study
No full textPara-aortic lymph node metastasis (PALNM) is a key prognostic factor in endometrial cancer (EC). This study aimed to de- termine the incidence and prognostic factors of lymph node metastasis (LNM) and isolated PALNM in endometrioid-type EC patients. METHODS: EC patients treated surgically between 2000 and 2015, staged by FIGO 2009 criteria, were retrospectively analyzed. Included were patients with endometrioid histology grades I-III who underwent pelvic and PALN dissection. Excluded were those without lymph node dissec tion or with non-endometrioid histology. RESULTS: A total of 417 patients met the criteria. Of these, 246 (59%) were grade I, 117 (28.1%) grade II, and 46 (11%) grade III. Pelvic LNM (PLNM) was found in 43 (10.3%), and PALNM in 22 (5.3%). Five patients (1.19%) had isolated PALNM. PALNM was more frequent in patients with stage III, tumors >2 cm, cervical glandular/stromal involvement, deep myometrial invasion, positive peritoneal cytology, adnexal involvement, PLNM, and LVSI. Isolated PALNM was notably higher with adnexal involvement. Independent predictors of PALNM were cer vical glandular involvement and LVSI. Deep myometrial invasion, LNM, PLNM, LVSI, and adnexal involvement were linked to disease-free survival (DFS), while peritoneal cytology, PLNM, and LVSI were linked to recurrence. There was no significant difference in recurrence and DFS between PALNM and isolated PALNM. CONCLUSIONS: Isolated PALNM without PLNM is rare in EC patients but should be assessed for optimal staging and treatment
Çürük yönetiminde nanoteknoloji yaklaşımları: Bir pedodontist bakış açısı
No full textThis review evaluates the potential contributions of nanotechnology-based materials in caries prevention and management, taking into account the limitations of traditional approaches. Nanomaterials, with their antibacterial, remineralizing, and diagnostic properties, offer an innovative perspective to caries management strategies especially in pediatric dentistry. While the efficacy of dental materials modified with nanotechnology is enhanced, pH-responsive and targeted smart drug carrier systems along with theranostic approaches can optimize the treatment process via minimally invasive methods, thus increasing success rates. These innovative strategies are expected to play a critical role in updating caries management protocols and providing long-term solutions in pediatric dentistry.Bu derleme, geleneksel çürük yönetimindeki sınırlamaları göz önüne alarak, nanoteknoloji odaklı materyallerin çürük önleme ve yönetimindeki potansiyel katkılarını değerlendirmektedir. Nanomalzemeler, antibakteriyel, remineralize edici ve tanısal özellikleri sayesinde, özellikle çocuk diş hekimliğinde çürük yönetim stratejilerine yenilikçi bir bakış açısı kazandırmaktadır. Nanoteknoloji ile modifiye edilmiş dental materyallerin etkinliği artarken, pH-duyarlı ve hedefe yönelik akıllı ilaç taşıyıcı sistemler ile teranostik yaklaşımlar, minimal invaziv yöntemlerle tedavi sürecini optimize ederek başarıyı arttırabilir. Bu yenilikçi stratejilerin, çürük yönetim protokollerinin güncellenmesinde ve çocuk diş hekimliğinde uzun vadeli çözümler sunmasında kritik rol oynayacağı öngörülmektedir
Cartoon-assisted visual/auditory distraction usage in paediatric dental care, assessment of effects on patient anxiety, pain, and behaviour: A randomised crossover clinical trial
No full textObjectives This randomized crossover clinical trial designed to evaluate the impact of visual and auditory distraction techniques on pediatric patients’ anxiety, pain perception, and behavior during dental treatment. The study specifically focuses on children, aiming to determine whether distraction methods can effectively reduce anxiety levels, alleviate pain experiences, and improve cooperative behavior in a clinical setting. Method and materials Children aged 4 to 9 years receiving routine dental care at the Pediatric Dentistry Clinic, Istanbul Medipol University, were randomly assigned to Group 1 (distraction first, then tell-show-do) or Group 2 (tell-show-do first, then distraction), with a two-week washout period before switching interventions. Anxiety was assessed using the Venham Picture Test and pulse rate, pain perception with the Sounds, Eyes, and Motor Scale during local anesthesia and the Wong-Baker FACES Pain Rating Scale during treatment, while cooperation and behavior were evaluated using the Houpt Scale. Statistical analysis was conducted using Mann-Whitney U, Student’s t-test, Paired t-test, and Wilcoxon test, with the significance level set at 0.025 using the Bonferroni correction. Results Sixty-eight patients (37 female, 31 male) with a mean age of 6.69±1.08 years completed the study (Group 1: n=32, Group 2: n=36). The cartoon-assisted distraction technique did not significantly reduce anxiety compared to the tell-show-do method. A non-significant reduction in pain perception was observed during local anesthesia with distraction. However, this technique significantly reduced self-reported pain during treatment (p<0.025) and improved child cooperation and behavior. Conclusion Cartoon-assisted visual and auditory distraction can alleviate pain perception and improve behavior during pediatric dental procedures. However, it does not appear to reduce dental anxiety or pain perception during local anesthesia. Integrating this technique with the traditional tell-show-do approach may enhance the pediatric dental experience