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Most of the phenomena of various fields of applied sciences are nonlinear problems. Recently, various types of analytical approximate solution techniques were introduced and successfully applied to the nonlinear differential equations. One of the aforementioned techniques is the Homotopy analysis method (HAM). In this study, we applied HAM to find critical buckling load of a column under end load dependent on direction. We obtained the critical buckling loads and compared them with the exact analytic solutions in the literature. [ABSTRACT FROM AUTHOR]

Study design: A case report. Objectives: To present and discuss some of the difficulties in the diagnosis of brucellar spondylitis. Setting: Ankara University, Ibni Sina Hospital, Turkey. Methods: We report a patient with paraplegia, misdiagnosed as having a malignancy or tuberculosis who actually suffered from brucellar spondylitis. Diagnosis was established by her history and a compatible clinical picture together with a standard tube agglutination (Wright test) titer of ⩾ 1/160 of antibodies for brucellosis. The patient was treated with oral doxycycline, rifampicin, and ciprofloxacin combination. Results: At the end of the treatment, the blood Brucella Wright and anti-human globulin T titer levels decreased. Her lower limb weakness improved. She could walk, and climb stairs with the help of a cane. Urinary retention and fecal incontinence also resolved. Conclusion: Brucellosis is a systemic infection involving the musculoskeletal and nervous systems. Spondylitis frequently occurs in elderly patients. An early diagnosis of brucellar spondylitis can often be difficult. In endemic regions, as in the case of our country, brucellar spondylitis should always be considered in the differential diagnosis of older patients with back pain and constitutional symptoms. An early diagnosis will help to prevent the development of more severe complications such as spinal cord compression. [ABSTRACT FROM AUTHOR]

In general, there are countless types of problems encountered from different disciplines that can be represented by differential equations. These problems can be solved analytically in simpler cases; however, computational procedures are required for more complicated cases. Right at this point, the wavelet-based methods have been using to compute these kinds of equations in a more effective way. The Haar Wavelet is one of the appropriate methods that belongs to the wavelet family using to solve stiff ordinary differential equations (ODEs). In this study, The Haar Wavelet method is applied to stiff differential problems in order to demonstrate the accuracy and efficacy of this method by comparing the exact solutions. In comparison, similar to the exact solutions, the Haar wavelet method gives adequate results to stiff differential problems.

Adenocarcinomas are the most common cause of malignancy in pleura fluids. Usual primary sites include the lung, breast, gastrointestinal tract, and genitourinary tracts. Predicting the site of origin of an adenocarcinoma can be difficult due to overlapping morphologic characteristics. We investigated the use of alkaline phosphatase (AP), Cytokeratin7 (CK7) Cytokeratin8 (CK8) to distinguish adenocarcinomas of lung in 148 body cavity fluid samples. Overall results for primary lung adenocarcinomas, demonstrated CK8 reactivity in 106 (72%) of 148 cases. 95 primary lung carcinoma samples (65%) were positive for CK7. AP was expressed in 81% of primary lung adenocarcinomas. Positive immunoreactivity for AP was characterized by a red, diffusely apical cytoplasmic staining in tumor cells that ocurred singly or in groups. There was a significant difference between AP, CK 7 and CK 8 expressions in primary lung adenocarcinomas (P=0.02; Chi-squared test). The sensitivity of AP, CK8, CK7 as a marker for primary lung adenocarcinomas were 82%, 72%, 64%, respectively. Thus the AP positive staining largely confirmed the cytologic diagnosis of lung adenocarcinoma.

This study aims to examine the values of wisdom, tolerance, benevolence, happiness, courtesy, respect, love and responsibility in the children’s books published in the years between 2000 and 2007 and in 2014 written in Turkish for 5-6 year old children. It is designed in content analysis pattern of qualitative research. A descriptive model of quantitative research methods was used to determine the frequency of values in picture books. The sample of the study consists of 40 children’s picture books which are translated into Turkish and written in Turkish for the 5-6 age group determined by the criterion sampling strategy. The researcher developed a checklist as a data collection tool which is values checklist. As a result of the research, there are 46.80% values in the children’s picture books published between 2000 and 2007; 53.20% values published in 2014, in analyzed picture books. It is found that children’s picture books, those translated into Turkish and those written in Turkish differ in terms of inclusion of values. Regarding results of the study, it is necessary to give more importance to the value of wisdom and tolerance in the children’s picture books and to transfer the values through positive examples toward proper behavior.

Influenza related morbidity and mortality is higher in immunosuppressive patients. In this paper, four pandemic influenza cases have been described who had been hospitalized in a hematology and oncology unit. Three of the cases acquired pandemic influenza as a nosocomial infection. The sources of transmissions were an infected medical student in two of the cases. One of the cases acquired infection from a patient sharing the same room. All of the patients developed pneumonia and diagnosis of influenza was confirmed by PCR method. All of cases have been initiated to oseltamivir treatment. One of the patients died due to the uncontrolled primary disease. Oseltamivir use was terminated after five days of treatment in other cases. In patients hospitalized for the management of hematological malignancy, influenza should be considered in the differential diagnosis of neutropenic fever especially in the influenza season, and empirical antiviral therapy should be initiated in cases with influenza-like syndrome. To prevent nosocomial spread of influenza strict infection control strategies must be implemented. [ABSTRACT FROM AUTHOR]

Objective: This study aims to assess the impact of hospital-specific guidelines on the optimal utilization of carbapenems and to examine their effects on patient outcomes., Design: Quasi-experimental study., Setting: Tertiary care hospital in Turkey where infectious diseases (IDs) consultation and antibiotic approval are mandatory for carbapenem use., Participants: All inpatients ≥18 years of age who received a carbapenem for at least 24 hours during the study periods were enrolled., Intervention: Hospital-specific treatment guidelines were introduced in April 2019. The control group was the year 2018, when there were no guidelines (pre-GP). The year 2020 was analyzed as the intervention period (post-GP)., Results: A total of 678 patients were analyzed, 326 in the pre-GP period and 352 in the post-GP period. Following guideline implementation, there was a significant increase in appropriate carbapenem use (49.1% in pre-GP vs 71.9% in post-GP, P < .001). The duration of carbapenem use decreased significantly ( P = .019). However, there was no significant change in the incidence of new infection episodes within the subsequent 30 days (27.6% in pre-GP vs 28.3% in post-GP), or in the length of hospitalization [median (25%-75%) = 28 (16-46) in pre-GP, 28 (15-47.5) in post-GP, P = .678]. Mortality rates were similar at day 7 post-GP (1.7%) compared to pre-GP (0.03%) ( P = .125)., Conclusions: The implementation of guidelines increased the appropriate utilization of carbapenems, without resulting in extended hospital stays or recurrent episodes. Despite an increased number of patients admitted to the ICU during the latter period, infection-related mortality rates remained comparable., Competing Interests: All authors report no conflicts of interest relevant to this article., (© The Author(s) 2024.)

As a light-weight solution for electromagnetic shielding, this paper aims to investigate the development of electrically conductive composites that shield from electromagnetic radiation while providing sustainability by using recycled fibers in the structure of nonwoven reinforcement materials. The main novelty of this research is the conversion of waste fabrics into functional composites via a fast and inexpensive method. For this purpose, waste fabrics were recycled into fibers, and the recycled fibers were processed into needle-punched nonwovens to be used as reinforcement materials for electromagnetic shielding composites. Electrically conductive composite structures were obtained by adding copper (II) sulfate and graphite conductive particles with different ratios to polyester resin. The hand lay-up method was used for the production of composites. Electromagnetic shielding, electrical resistivity, and some mechanical properties of the composites were investigated. The results were analyzed statistically using IBM SPSS software version 18. The results have shown that up to 31.43 dB of electromagnetic shielding effectiveness was obtained in the 1-6 GHz frequency range. This result corresponds to a very good grade for general use and a moderate grade for professional use, according to FTTS-FA-003, exceeding the acceptable range for industrial and commercial applications of 20 dB. The composites developed in this research are good candidates to be used in various general and professional applications, such as plastic parts in household applications, electronic industry, building and construction industries, and other applications where light weight shielding materials are needed.

Background: Varicose veins commonly occur on the legs and cause discomfort, pain, and aesthetic issues. Varicose vein surgery has an significant impact on sleep disorders such as Restless Leg Syndrome (RLS), daytime sleepiness (DS), and sleep quality (SQ). We intended to determine if preoperative and postoperative sleep quality, excessive daytime sleepiness, and RLS severity impacted in those who had varicose vein surgery., Materials and Methods: The research included 160 patients who presented to the Cardiovascular Surgery outpatient clinic with symptoms of leg pain and cramping and were diagnosed with venous insufficiency. The Restless Legs Syndrome Study Group Rating Scale (RLSS), Epworth Sleepiness Scale (ESS), and Pittsburgh Sleep Quality Index (PSQI) tests were performed on patients. The patients' scores on the scales were compared preoperatively and postoperatively., Results: The mean age of the 160 patients was calculated to be 48.7 ± 10.6 years. There were 109 female (68.1%) and 51 male (31.9%). The mean ferritin level of the patients was calculated as 61.4 mL/ng (4.3-421 mL/ng). After varicose vein surgery 63% reported improved sleep quality. Individuals with increased DS had lower postoperative RLSS scores and higher SQ. There was a decrease in postoperative RLSS scores and an increase in postoperative SQ in patients with normal DS ( p  < 0.001). Postoperative RLSS and DS scores were lower in patients with good SQ ( p  < 0.001)., Conclusion: Patients had a lower RLSS score, a lower DS score, and a higher SQ after varicose vein surgery. Surgical treatment is critical to improving the quality of life and sleep comfort of patients with varicose veins and sleep disorders., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Acir, Okudan Atay, Atay and Yayla.)

Purpose The aim of this study is to investigate the relationship of trochlear dysplasia (TD) and patella type with bipartite patella (BP). Materials and methods A total of 5,081 knee MRIs taken in our institution were reviewed retrospectively. Patients with a history of knee surgery, previous or recent trauma, and rheumatologic involvement were excluded from the study. The MRIs of 49 patients with bipartite/multipartite patella were detected. Three patients were excluded: two patients had a tripartite variant, and one had multiple osseous dysplastic findings. Overall, 46 patients with BP were included in the study. BPs were classified as type I, II, and III. Patients were divided into symptomatic and asymptomatic groups according to the presence of edema within the bipartite fragment and adjacent patella. Patients were examined in terms of patella type, trochlear dysplasia, tuberosity-trochlear groove (TT-TG) difference, sulcus angle, and sulcus depth. Results There were 46 patients with BP (28 males and 18 females) (mean age: 33±9.5 years, range: 18-54). Thirty-eight bipartite fragments (82.6%) were type III and eight (17.4%) were type II. There was no type I BP. Seventeen (36.9%) were symptomatic, and 29 (63.1%) were asymptomatic. Seven of the type II (87.5%) and 10 of the type III (26.3%) bipartite fragments were symptomatic. The frequency and degree of trochlear dysplasia (p=0.007 and p=0.041, respectively) were found to be higher in symptomatic patients. The trochlear sulcus angle was higher (p=0.007) and the trochlear depth was lower (p=0.006) in the symptomatic group. No statistically significant difference was found (p=0.247) in terms of TT-TG difference. Type III and type IV patella were more common in the symptomatic group. Conclusion The current study shows that patellofemoral instability and patella type are associated with symptomatic BP. Patients with trochlear dysplasia, type II BP, and disproportionate patellar facet may have a significantly increased risk of symptomatic BP., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Atay et al.)

Objective: To evaluate the outcomes of radiofrequency ablation (RFA) therapy performed on patients with great saphenous vein insufficiency., Study Design: Descriptive study., Place and Duration of Study: Bahcelievler State Hospital, Istanbul, Turkey, between January 2018 and May 2021 Methodology: A total of 709 patients (382 females, 327 males), who were treated with radiofrequency ablation (RFA) in the clinic, were included in the study. The demographic, anthropometric, clinical, laboratory, and radiological data of the patients were obtained retrospectively from the medical records. Pre and post treatment clinical, etiologic, anatomical, pathophysiologic (CEAP) scores, the venous clinical severity score (VCSS), and the visual analog scale (VAS) were evaluated., Results: The median age of the patients was 48 (19-65) years, and the median follow-up period was 36 (6-53) months. At follow-up, after treatment, 673 (94.9%) of the patients had a CEAP clinical score of C0. Postoperative complications were recorded in 56 (7.9%) patients. Significant improvement was observed in the patients' CEAP, VAS, and VCSS scores at the follow-up (p<0.001)., Conclusion: There was a high success rate in achieving short- and long-term venous occlusion in varicose vein treatment with RFA. Characterized by a fast recovery, good perioperative and postoperative outcomes, and a low frequency of side effects, RFA is effective and safe in the treatment of varicose veins., Key Words: Chronic venous insufficiency, Radiofrequency ablation, Patient-reported outcomes.

Purpose: One subset of peripheral arterial disease is aortoiliac occlusive diseases (AIOD). AIOD is the term for all arterial lesions between the infrarenal distal aorta and common femoral artery. Implantation of kissing stents (KS) with covered stents (CS), bare-metal stents (BMS) is one of the endovascular treatment (ET) modalities for AIOD involving aortic bifurcation. In this study, we report the outcomes of the KS technique in infrarenal AIOD., Methods: Between January 2014 and September 2017, 31 patients who underwent ET were treated with KS technique either with balloon-expandable BMS or balloon-expandable CS. Technical details, clinical success, complications, and patency at follow-up were documented., Results: The majority of patients were male (77.4%), and the median age was 62 years (range, 45-78 years). All patients were classified according to the TASC II criteria. Eight patients (25.8%) were classified as TASC B. Fifteen patients (48.4%) were classified as TASC C, and 8 patients (25.8%) were classified as TASC D. These 23 patients were classified as complex AIOD group. BMS was used in 17 patients (54.8%), and CS was used in 14 patients (45.2%). Technical and clinical success was achieved in 100% of treated cases. The median follow-up was 24 months (range, 24-34 months). Primary patency rates at 12, 18, and 24 months after ET were 100%, 96.8%, and 90.3%, respectively., Conclusion: We found that the KS technique has satisfying 24-month results, even in complex AIOD lesions, with high technical success and acceptable midterm patency. Key Words: Aorta, Arterial occlusive diseases, Endovascular procedures, Iliac artery, Stents., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported., (Copyright © 2021, the Korean Surgical Society.)

Objectives: This study aims to identify the factors affecting the activities of daily living, balance, and prosthesis satisfaction in patients with non-traumatic lower limb amputation (LLA)., Patients and Methods: This cross-sectional study included a total of 195 patients (120 males, 75 females; mean age 65.9±11.6 years; range, 40 to 90 years) who underwent LLA between January 2009 and April 2017. All patients were evaluated in terms of age, sex, amputation etiology, side, level, comorbidity, length of hospital stay, prosthesis adjustment, ambulation level, functional outcome, and complications. Prosthesis adjustment, physical balance ability, and daily living activities were assessed using the Turkish versions of the Trinity Amputation and Prosthesis Experience Scales (TAPES), Berg Balance Scale (BBS), and Nottingham Extended Activities of Daily Living Scale (NEADLS), respectively., Results: There was no significant difference between male and female patients in terms of prosthesis and amputation adaptation, physical balance, and activities of daily living. The BBS, TAPES, and NEADLS scores were lower in the patients aged over 65 years (p<0.001, p<0.001, and p<0.001, respectively). Prosthesis and amputation adaptation, physical balance, and daily living activities were also worse in this age group. Transfemoral amputees had lower BBS, TAPES, and NEADLS scores than the transtibial amputees (p=0.009, p=0.020, and p=0.004, respectively). Prosthesis and amputation adaptation, physical balance, and daily living activities were worse in the transfemoral amputees., Conclusion: Age and amputation level affect physical balance, prosthesis satisfaction, and daily living activities after non-traumatic LLA. Therefore, orthopedic surgeons and physical therapists should conduct a multidisciplinary evaluation, particularly in patients aged over 65 years and in transfemoral amputees to improve outcomes., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2020, Turkish Society of Physical Medicine and Rehabilitation.)

Purpose: The frequency of iatrogenic femoral artery pseudoaneurysm (FAP) diagnoses has recently increased due to the growing use of diagnostic and interventional procedures involving large diameter sheaths, as well as more potent anticoagulation procedures. In this study, we aimed to present our experience with ultrasound-guided thrombin injection (UGTI) in patients with iatrogenic FAP., Methods: We studied patients with FAP who were under anticoagulant or antiplatelet therapies preoperatively, or who had received a loading dose during an interventional procedure. The outcomes of patients with FAP treated with UGTI were compared with those of patients who underwent open surgical repair for pseudoaneurysms., Results: Among the 55 patients included in this study, 24 had UGTI while 31 had open surgery. The success rate was 95.8% when taking into consideration primary and secondary attempts. The mean duration of the procedure was shorter in patients with UGTI (10.1 ± 3.54 minutes) when compared with those who underwent open surgery (76.55 ± 26.74 minutes, P ≤ 0.001). In addition, the total complication frequency was significantly higher in the open surgery group (P = 0.005), as was their length of hospital stay (P < 0.001). Cost analysis showed significant differences between UGTI ($227.50 ± $82.90) and open surgery ($471.20 ± $437.60, P = 0.01)., Conclusion: We have found that UGTI is the safer and more effective choice of treatment in appropriate patients with FAP, as opposed to surgery., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported., (Copyright © 2020, the Korean Surgical Society.)

Background: While acute pancreatitis (AP) resolves spontaneously with supportive treatment in most patients, it may be life-threatening. Predicting the disease severity at onset dictates the management strategy. We aimed to define the patients with mild pancreatitis who may be considered for outpatient management with significant cost-savings., Materials and Methods: This prospective observational study included 180 patients with mild AP according to the harmless acute pancreatitis score (HAPS) and Imrie score. The relationships of biochemical parameters with the changes in the Balthazar score and clinical course were examined., Results: The study included 180 patients (111 females, 69 males; mean age: 53.9 ± 17.2 years; range: 17-92 years). The etiology was biliary in 118 (65%) patients and remained undetermined in 38 (21.1%) patients. Computed tomography (CT) performed within the first 12 h revealed mild and moderate AP in 159 (88.3%) and 21 (11.7%) patients, respectively. CT repeated at 72 h revealed mild, moderate, and severe AP in 155 (86.1%), 24 (13.3%), and 1 (0.6%) patients, respectively. Comparisons between stages A + B + C and D + E showed significant differences in the amylase levels on day 1 and 3, and in C-reactive protein on day 3. Also, in stage D and E disease, narcotic analgesic intake, oral intake onset time, and pain were significantly higher., Conclusion: There were no significant changes in the CT findings of patients with mild AP at 12 and 72 h. Most patients ( n = 179; 99.4%) recovered uneventfully. Patients with mild pancreatitis according to the HAPS and Imrie scores can be considered for outpatient management. The recovery is longer in stage D and E disease., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper.

Background: Unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) are being used for preoperative management of critical coronary artery disease. However, preoperative UFH therapy may cause a reduction in antithrombin concentrations, leading to various degrees of heparin resistance (HR). The main purpose of this study is to investigate the effects of preoperative LMWH on HR during cardiopulmonary bypass (CPB)., Methods: Data were retrospectively reviewed from adult patients that underwent on-pump coronary artery bypass graft (CABG) surgery. Four hundred fifty-seven patients underwent CABG, and 139 of them, who had isolated on-pump CABG, were included in the study. The heparin sensitivity index was calculated if activated clotting time levels were discovered below 400 seconds. Values less than 1.3 were accepted as HR., Results: Of 139 patients who underwent on-pump CABG, preoperative LMWH was administered in 59 patients (56.8%). Intraoperative HR occurred in 29 patients (20.9%). Patients who received preoperative LMWH had an increased risk of developing HR compared with patients who did not receive LMWH (odds ratio 4.8 and 95% confidence interval 1.7-13.5). CPB duration and aortic clamp duration were significantly longer in patients who developed intraoperative HR when compared to those in patients who did not develop HR., Conclusion: Preoperative treatment with LMWH may cause intraoperative HR. Corrective and preventive arrangements with close follow-up should be performed in this group of patients.

Pseudoaneurysm of the deep femoral artery (FAP) due to penetrating trauma is less common and can be a challenging condition for surgeons. The conventional treatment strategy for FAP due to penetrating trauma is open surgical repair. With emerging technologies, less invasive techniques are being used in these patients. We report a 37-year-old male patient with delayed presentation of FAP secondary to a stab wound and treated successfully with ultrasound-guided thrombin injection.

Today there is a widespread use of endovascular treatment (EVT) for traumatic vascular injuries in adults, but there is lack of evidence of its use in adolescent patients with vascular injuries. With this case, we present successful EVT of 14-year-old adolescent with a right subclavian artery pseudoaneurysm (SAP) due to war injury. SAP was successfully excluded with deployment of 6 × 50 mm flexible, self-expanding covered nitinol stent graft (The GORE® VIABAHN® Endoprosthesis (W.L. Gore & Associates, Flagstaff, AZ)). Patient was discharged from hospital 2 days after the procedure with dual antiplatelet therapy (clopidogrel and aspirin). 3 months after discharge control DUS showed patent stent graft without any residual lesions. As a result, EVT is an alternative approach to treatment of SAP. It is safe, effective, and less invasive therapy for SAP in adults as well as in adolescents. We aim to contribute to the literature with this first case report.

Objective: BLES (Intact Breast lesion Excision System) is a new defined system which can remove the lesion completely. We aimed to evaluate and compare the results of BLES used for breast lesions requiring histological verification with other percutaneous biopsy methods in the literature., Methods: Patients with breast lesions smaller than 20mm and for whom biopsy was indicated were involved in the study. 18(1 male, 17 female, mean age: 41. 83, age range: 26-72) patients were included the study. BLES is applied with a single insertion. Radiofrequency is used to excise the breast tissue after the insertion. Around the lesion, tissue capture basket is moved back and forth. Once captured, the basket and the probe is removed from the incision area., Results: All of the lesions were excised en-bloc. The only complication occured was subdermal hematoma in one case (5.5%) which resolved spontenously. Pathological analysis of the specimens revealed 9 fibroadenoma, 3 fibroadenomatosis hyperplasia, 3 complicated and calcified cysts, 1 ductal epithelial hyperplasia, 1 carcinoma in situ with intraductal papillary carcinoma focus and 1 ductal carcinoma in situ with 2 mm invasive carcinoma focus. The last two cases underwent resectıon and sentınal lymph node procedure., Conclusion: BLES is a is non-invasive method which has no need for additional initiatives in benign cases, provide sufficient samples for pathological diagnosis and remove the lesion in one piece. BLES method can be applied in selected cases., Key Words: Breast Lesion Excision System, Breast, Biopsy, Radiofrequency, Lesion.