İstanbul Sağlık ve Teknoloji Üniversitesi Kurumsal Akademik Arşivi
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Nefes egzersizleri ve obezite
No full textCanlılığın temel fizyolojik aktivitelerinden olan nefes, obezite ile mücadelede de stratejik bir öneme sahiptir. Obez bireyler özellikle yüksek tat algısı eşikleri, düşük metabolizma hızları, hormonal disfonksiyonları, hedonik dürtüleri ve aşırı yeme arzuları sebebiyle lezzetli yiyecekleri, normal ağırlıktaki bireylerden daha fazla tüketme eğilimindedirler. Obezitenin bir önceki basamağı olan aşırı kiloluluk durumunda ise hedonik dürtülerin kontrol altına alınmasını sağlayacak müdahalelerin, obezitenin önlenmesinde önemli rol oynayacağı düşünülmektedir. Özellikle, vagus siniri stimülasyonu üzerinden parasempatik sinir sistemi aktivasyonunu hedefleyen burun nefesi egzersizlerinin, gerek enerji alımının azaltılması gerekse enerji harcamasının artırılmasına katkı sağlayabilme potansiyeli mevcuttur. Vagal afferentler, çoğunlukla tokluk sinyallerini bağırsaktan beyne ilettikleri ve iştahı kontrol altında tutmak için önemli olduklarından dolayı aşırı kilolu ve normal ağırlıktaki bireylerde obezite gelişiminin önlenmesine yardımcıdır. Ayrıca, bu egzersizler stres yönetimine katkıları sayesinde hedonik dürtülerin ve duygusal yemenin önüne geçebilme kapasitesine sahiptir. Öte yandan, obezitenin tedavisinde birçok yöntem kullanılıyor olmasına karşın, bireyin bütüncül sağlığında kullanabilecek en kolay, ulaşılabilir ve ekonomik yöntem olarak nefes çalışmalarının potansiyelinin yeteri kadar incelenmediği görülmektedir. Bu çalışmada burnundan nefes alabilen her birey tarafından uygulanabilecek nitelikteki yöntemler açıklanmış ve nefes egzersizlerinin obezite yönetimi modülasyonundaki rolü tartışılmıştır. Böylece, Sürdürülebilir Kalkınma Hedefleri’ni destekleyecek şekilde obezitenin önüne geçebilmek adına ekonomik, herkes tarafından uygulanabilecek ve beraberinde hem fizyolojik hem psikolojik katkılar sağlayan nefes egzersizlerinin kullanımına ilişkin farkındalığa katkı sağlanacaktır
The course of the phrenic nerve in the neck region and its relationship with adjacent anatomical structures in the thoracic inlet
No full textPupose: This study aims to reveal the relationship of the phrenic nerve (PhN) with its neighboring structures in the lower neck region more comprehensively than previous studies and to minimize nerve damage by enabling invasive procedures in this region to be performed with high accuracy. Methods: Forty-one heminecks were evaluated. The relationship between the PhN and the anterior scalene muscle (ASM), internal thoracic artery (ITA), branches of subclavian artery (SA) and subclavian vein (SV) was examined. Results: It was observed that the PhN was located medial to the ASM in all cases. The distances were higher in male cadavers. The PhN was found to enter the thorax lateral to the ITA in 15/41 and medial to it in 25/41 sides. In 17/41 cases, the closest SA branch to the PhN was the thyrocervical trunk (TT) and in 24 cases the ITA. The PhN was located behind the SV in 38 cases and in front of it in 2 cases.The accessory PhN was found in 4/41 sides. There was no significant difference in morphometric findings between genders (p > 0.05). However, significant differences were observed between the parameters (p < 0.05). Conclusion: The anatomy and variations of the PhN are of great importance in surgical interventions and invasive procedures in the neck region. The study provides important information to reduce the risk of damage to the PhN in surgical procedures. In addition, knowledge of the anatomical variations of the nerve may contribute to more successful results in nerve grafting and other surgical applications
Effects of osteopathic manipulative treatment alone or in combination with respiratory training on chest wall expansion, functional mobility, and dyspnea level in patients with pulmonary arterial hypertension
No full textRATIONALE: While exercise training has been extensively investigated for nonpharmacologic treatment of pulmonary arterialhypertension (PAH), osteopathic manipulative treatment (OMT) has not been adequately examined. The purpose of this study wasto explore the efficacy of OMT alone or in association with respiratory training on chest wall expansion, functional mobility, anddyspnea level in patients with PAH. METHODS: 48 patients under PAH-targeted medical therapy for at least 3 months, betweenthe ages 20-74 (mean [SD] age: 48.4 [12.1] years) and with the World Health Organization functional class I to III were involved inthe study. Chest wall expansion was evaluated with a cloth tape measure at maximal inhalation and exhalation at 3 levels of the ribcage (axillary line, xiphoid process, lateral lower edge of the tenth costae) by subtracting the end-expiratory diameter from theend-inspiratory diameter. Functional mobility was assessed using 5-repetition sit-to-stand test. Dyspnea level was determinedwith the modified Medical Research Council scale. Patients were divided into OMT, combined intervention, and control groups,with 18 patients in each group. Rib raising, diaphragm release, suboccipital decompression, first rib mobilization, mediastinummobilization and thoracic inlet myofascial release techniques were applied to the OMT group twice weekly for 8 weeks. In additionto OMT, a yoga respiratory training session including nadishodhana, ujjayi, and bhramari pranayama was undertaken by thecombined intervention group. The breathing exercises were also performed once daily for the remaining days as home exercises.Control group received no additional intervention. All patients received an educational lecture. For between-group comparisonsand within-group differences of baseline with 8 weeks, one-way ANOVA with between-subject factor and the paired samples t testwere used, respectively. Pairwise multiple comparisons were conducted using Bonferroni post hoc tests.RESULTS: All outcomemeasures improved significantly in both intervention groups (p0.05). Improvements for functional mobility and all the chest wall expansion data were significantly higher in combinedintervention group than other groups, and also in OMT group than control group (p<0.05) (Table 1). Improvement for dyspnea levelwas significantly higher in both intervention groups compared with the control group (p<0.05) (Table 1). CONCLUSION: This studydemonstrated that the addition of respiratory training to OMT revealed further benefit to chest wall expansion and functionalmobility compared to OMT alone and that the OMT might be an effective therapeutic method for dyspneic patients havingdifficulties in participating cardiopulmonary rehabilitation programs
Validation of FIB-6 score in assessment of liver fibrosis in chronic hepatitis B
No full textBackground: We recently developed a simple novel index called fibrosis 6 (FIB‑6) using machine learning data analysis. We aimed to evaluate its performance in the diagnosis of liver fibrosis and cirrhosis in chronic hepatitis B (CHB). Methods: A retrospective observational analysis of data was obtained from seven countries(Egypt, Kingdom of Saudi Arabia (KSA), Turkey, Greece, Oman, Qatar, and Jordan) of CHB patients. The inclusion criteria were receiving an adequate liver biopsy and a complete biochemical and hematological data. The diagnostic performance analysis of the FIB‑6 index was conducted and compared with other non‑invasive scores. Results: A total of 603 patients were included for the analysis; the area under the receiver operating characteristic curve (AUROC) of FIB‑6 for the discrimination of patients with cirrhosis (F4), compensated advanced chronic liver disease (cACLD) (F3 and F4), and significant fibrosis (F2–F4) was 0.854, 0.812, and 0.745, respectively. The analysis using the optimal cut‑offs of FIB‑6 showed a sensitivity of 70.9%, specificity of 84.1%, positive predictive value (PPV) of 40.3%, and negative predictive value (NPV) of 95.0% for the diagnosis of cirrhosis. For the diagnosis of cACLD, the results were 71.5%, 69.3%, 40.8%, and 89.2%, respectively, while for the diagnosis of significant fibrosis, the results were 68.3%, 67.5%, 59.9%, and 75.0%, respectively. When compared to those of fibrosis 4 (FIB‑4) index, aspartate aminotransferase (AST)‑to‑platelet ratio index (APRI), and AST‑to‑alanine aminotransferase (ALT) ratio (AAR), the AUROC for the performance of FIB‑6 was higher than that of FIB‑4, APRI, and AAR in all fibrosis stages. FIB‑6 gave the highest sensitivity and NPV (89.1% and 92.4%) in ruling out cACLD and cirrhosis, as compared to FIB‑4 (63.8% and 83.0%), APRI (53.9% and 86.6%), and AAR (47.5% and 82.3%), respectively. Conclusions: The FIB‑6 index could be used in ruling out cACLD, fibrosis, and cirrhosis with good reliability
Anatomical features of posterior cerebral arteries and basilar artery in 170 anatolian fresh cadavers: Implications for surgical planning and intervention
No full textBackground The posterior cerebral arteries (PCAs) are terminal branches of basilar artery (BA) and are responsible for the primary supply of the occipital lobe. Saccular aneurysm is most commonly seen close to the bifurcation of the BA.Various surgical interventions are performed for aneurysms.Therefore, the anatomy and localization of the BA and PCA are crucial.The aim of this study is to determine the characteristics of these arteries in a large Anatolian population. Methods A total of 170 fresh cadavers from Department of Morgue, the Council of Forensic Medicine, Istanbul, Turkey were included in the study.The diameters of the BA and PCA were measured. Correlations according to gender and age groups were analyzed. The Q1, Q2 and Q3 angles between the right and left PCA, between the right PCA and BA and between the left PCA and BA, respectively, were measured.The location of the PCA relative to the SP was also evaluated. Results It was noted that the diameter of the artery increased with age and was higher in males than in females.Q1 and Q2 diameters were higher in males while Q3 angle was higher in females.The Q1 angle between the right and left PCAs was found to be higher in 40-59 years old with a mean of 87.33±17.91mm.Finally, the bifurcation point of the PCA was most frequently located above the SP and least frequently located on SP. Conclusion We believe that the findings of our study will contribute to the planning of surgical approaches, the development of endovascular devices, the success of invasive procedures and the reduction of complications
Tendencias de las publicaciones sobre humanismo en enfermería: un análisis bibliométrico
No full textHumanism has significantly shaped modern nursing practices by emphasizing on the crucial value of providing patient-centered care and acknowledging the innate worth of human dignity. That is why this paper aims to explore and assess the existing framework of knowledge within publications that address humanism in nursing, as well as trace its evolutionary trajectory. The present document shows the results of a descriptive bibliometric study based on a data retrieval conducted from the Web of Science (WoS) Core Collection database and its subsequent analysis made using Excel and VOSviewer. The study encompassed 135 documents published from 1993 to 2021 in 82 journals, authored by 390 researchers from 33 countries. Notably, 79.3% of these works were classified as original articles, 53.3% belonged to the nursing category, and 86.7% were published in English. The existence of a strong connection between humanism, ethics, care, and nursing education was observed in all the works analyzed.El humanismo ha influido de manera significativa y moldeado las prácticas de enfermería contemporá-neas al resaltar el valor crucial de brindar atención centrada en el paciente y reconocer la dignidad inheren-te del ser humano. Este artículo tiene como objetivo explorar y evaluar el marco de conocimiento existente de las publicaciones que abordan el humanismo en enfermería, así como rastrear su trayectoria evolutiva. Realizado como un estudio bibliométrico descriptivo, la recopilación de datos se llevó a cabo el 17 de diciembre de 2022, a partir de la base de datos Web of Science (WoS) Core Collection, y el análisis subsi-guiente se realizó con programas como Excel y VOSviewer. El estudio abarcó 135 artículos escritos por 390 investigadores, abarcando el período de publicación desde 1993 hasta 2021. Notablemente, el 79.3% de estos trabajos se clasificaron como artículos originales, con un 53.3% perteneciente a la categoría de enfermería, y un 86.7% publicado en inglés. Los estudios fueron publicados en un conjunto variado de 82 revistas y contaron con la participación de investigadores de 33 países diferentes. Se observó la existencia de una fuerte conexión entre el humanismo, la ética, la atención y la educación en enfermería
Effect of heat treatment on corrosion behavior of S275 mild steel using accelerated DC voltage, LPR, and EIS
No full textThis study used an external DC voltage of 1.5 V to accelerate corrosion in heat-treated S275 mild steel samples at different time intervals. LPR and EIS were used to study the corrosion behavior of original and quenched steel samples. There was only a negligible difference in the corrosion rate (CR) for the original and the quenched samples up to 30 min of voltage application in a 3.5% NaCl electrolyte media. When the exposure time increased to 60 min, the original sample showed seven times higher CR than the quenched samples. The pits on the surface of the original samples acted as cathodes, enhancing the reaction rate on the surface and increasing its CR dramatically. This led to bimodal corrosion, where the first part is led by concentration and diffusion; while, the second part is led by localized corrosion. The smaller pits on the original surface samples served as cathodic reaction centers, exacerbating corrosion. The corrosion rate of the original samples ranged from 0.8 to 7.8 mmpy; whereas, the corrosion rate of the quenched samples remained consistently around 0.8 mmpy. This trend can be observed in long-term corrosion in different metals. The uniformly oriented martensitic microstructure and the quenched samples’ small grain size prevented the enhanced ion penetration due to applied voltage. This study analyses the long-term stability of structural steel samples in marine environments by accelerating the corrosion rate by an applied external DC voltage
Comparison of packaging and online nutritional labels of baby biscuits and puries on sale in Turkey
No full textAmaç: Bu çalışmada Türkiye’de satışta olan bebek bisküvileri ve pürelerinin çevrimiçi ve ambalaj etiket bilgilerindeki besinsel içerikler arasındaki tutarlılığın değerlendirilmesi amaçlanmıştır. Ayrıca, bu ürünlerin etiket yönetmeliğine uygunluğu da incelenmiştir. Gereç ve Yöntem: Bu kapsamda, Türkiye’deki alışveriş sitelerinde satışa sunulan bebek bisküvileri (n=18) ve pürelerinin (n=41) web sitelerinde ve ambalajlarındaki etiket bilgileri edinilmiştir. Daha sonra, 100 gram ürüne karşılık gelen enerji, karbonhidrat, şeker, yağ, doymuş yağ, protein ve tuz miktarları ile etiket yönetmeliğinin gerektirdiği hususlar kaydedilmiştir. Tüm veriler SPSS 26.0 programına aktarılarak, istatistiksel analizler gerçekleştirilmiştir. Bulgular: Bebek bisküvilerinin çevrimiçi ve ambalaj etiketlerinde yer alan besinsel içeriğin ortalamalar arasındaki farkı istatistiksel olarak anlamlı bulunmazken; bebek pürelerinin çevrimiçi ve ambalajlardaki enerji ve karbonhidrat içeriklerindeki fark istatistiksel olarak anlamlıdır (p<0,05). Ayrıca, bebek bisküvilerinde “6. ayından önce kullanılan ürünlerde gluten içerir/içermez” ve bebek pürelerinde "İlgili sağlık profesyonelinin tavsiyesi ile kullanılmalıdır" ifadeleri bakımından ambalaj ve çevrimiçi etiket bilgileri arasında zayıf uyum (0,00-0,20 arası Kappa) değerleri hesaplanmıştır. Sonuç: Türkiye’de satışa sunulan bebek ek gıdalarının özellikle şeker içeriğinin bilimsel literatürdeki benzer çalışmalara kıyasla çok daha yüksek olması kronik hastalıklar açısından halk sağlığını tehdit ettiğini göstermektedir. Ayrıca, internet üzerinde alışverişin yoğun olarak yapıldığı bebek ürünlerindeki etiket bilgilerinin yasal mevzuata uygunluğunda eksiklikler saptanmış olup, ilgili otoritelerce gerekli takip ve düzenlemelerin yapılması elzemdir.Aim: In this study, it is aimed that the evaluation of consistency between the nutritional contents of online and package label information of baby biscuits and purees sold in Turkey. In addition, the compliance of these products with the labeling regulations was also examined. Method: In this context, the labeling information on the websites and packaging of baby biscuits and purees offered for sale on shopping websites in Turkey was obtained. Afterward, the amounts of energy, carbohydrates, sugar, fat, saturated fat, protein, and salt corresponding to 100 grams of product and the issues required by the labeling regulation were recorded. All data were transferred to the SPSS 22.0 program, and statistical analyses were performed. Results: While the difference between the averages of the nutritional content on the online and packaging labels of baby biscuits was not found to be statistically significant, the difference in the energy and carbohydrate contents of baby purees online and in packaging is statistically significant (p<0.05). In addition, poor agreement values (Kappa between 0.00-0.20) were calculated between the packaging and online label information in terms of the statements of "contains/does not contain gluten in products before the sixth month in the baby biscuits" and "should be used with the advice of the relevant health professional" in baby purees. Conclusion: The fact that the sugar content of infant supplementary foods offered for sale in Turkey is much higher compared to similar studies in the scientific literature, indicates threatens public health in terms of chronic diseases. In addition, deficiencies have been detected in compliance with the legal legislation of the labeling information on baby products, which are intensively shopped for on the internet, and the relevant authorities must make the necessary follow-up and arrangements
Assessment of nutritional composition of Turkish Red crescent menus after the M7.8 and M7.6 earthquakes in Kahramanmaraş, Türkiye
No full textObjective: This study aims to evaluate the nutritional content and quality of the Turkish Red Crescent (TRC) menus delivered to earthquake victims after the 2023 earthquakes in Kahramanmaraş, Türkiye. Methods: The menus of general, search-rescue, diabetes, and celiac were obtained from the TRC following the magnitudes of 7.8 and 7.6 Kahramanmaraş earthquakes. The nutrient content of the menus was evaluated with the Nutrient Rich Food (NRF20.3) score. In addition, the menus’ energy, macronutrient, and micronutrient contents were compared with the dietary reference intake values of the Türkiye Dietary Guideline—2022, European Food Safety Authority, and Food and Drug Administration. Results: The general menu was insufficient to meet the daily requirements of vitamin D, vitamin K, vitamin C, calcium, and potassium for earthquake victims. The sodium, phosphorous, and omega-6/omega-3 ratios were much higher than the recommended intakes. The NRF20.3 score of the diabetes menu was significantly higher than the search-rescue and celiac menus (P < 0.05). The energy content of the search-rescue menu was significantly higher than that of other menus (P < 0.05). Conclusion: The several nutritional risks were determined in TRC menus for earthquake victims who suffered from the Kahramanmaraş earthquakes. Several supplementation programs can be applied to the earthquake regions to obtain strength immunity and effectively challenge posttraumatic stress symptoms
Liver stiffness and steatosis measurements with iLivTouch and FibroScan: A comparative study
No full textBackground/Aims: The presence of liver fibrosis is the most important indicator of progression to cirrhosis. Noninvasive measurement of liver stiffness is crucial for detecting fibrosis. Vibration-controlled transient elastography is one of the most useful methods for this pur%02pose. We aimed to compare the liver stiffness and steatosis measurements with iLivTouch© and the FibroScan© elastography devices Materials and Methods: Two hundred thirty-seven consecutive adult patients with chronic hepatitis were included in the study. The liver stiffness and steatosis were measured with iLivTouch and FibroScan on the same day. Thirty-one patients had liver biopsies on the same day with elastography procedures. The diagnostic performances of iLivTouch and FibroScan were compared to aspartate aminotrans%02ferase to platelet ratio index (APRI), Fibrosis-4 (FIB-4), and nonalcoholic fatty liver disease fibrosis score (NFS). Results: The liver stiffness measurements obtained using iLivTouch and FibroScan had median value of 10.3 (ranging from 2.9 to 46.3) and 7.2 (ranging from 2.5 to 75), respectively. The mean steatosis measurements using ultrasound attenuation parameter with iLiv%02Touch were 245.51 ± 45.79, while the mean controlled attenuation parameter measurements using FibroScan were 259.37 ± 75.0. In subgroup analysis, the AUC of iLivTouch on detecting signiicant fibrosis [0.83, (P = .002)] was minimally higher than other noninvasive methods [0.82 for NFS (P = .003), 0.80 for FibroScan (P = .006), 0.68 for FIB-4 (P = .089), and 0.53 for APRI (P = .76)]. Conclusion: The stiffness and steatosis measurements with iLivTouch and FibroScan were not similar. The accuracy of iLivTouch in detecting significant and advanced fibrosis was minimally higher. Large clinical trials are necessary to support these findings