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Introduction Healthcare workers have a high risk of cross-infection during the care of Covid-19 cases. Personal protective equipment can reduce the risk. However, healthcare workers must be trained for the proper use of personal protective equipment to decrease exposure risk. This study aimed to investigate whether videos available on YouTube, presenting procedures of donning and doffing personal protective equipment, can be a useful learning resource for healthcare workers. Methods A search of YouTube was conducted using the keywords “Covid-19, personal protective equipment, donning, doffing”. Two investigators reviewed each video and collected the basic video information. Total videos were assessed independently as educationally useful and non-useful categories using a valid tool. The relationship of each video's usefulness with viewers’ preferences and the upload source were analyzed. Results A total of 300 videos were assessed; 66 (22%) fulfilled the inclusion criteria. Total video scores of educationally useful videos were higher than non-useful ones; the differences were significant. Healthcare/government agencies and hospitals mostly created educationally useful videos, e-learning platforms, and individuals mainly created non-useful videos. Significant correlations were observed between the video's usefulness and the total view and views per day. Conclusions During a pandemic, YouTube might be a resource for learning donning and doffing of personal protective equipment for healthcare workers if an appropriate selection process applied for determining educationally useful videos.

Günümüzde hızla artan nüfus ile beraber gıdaya olan talep artmakta ve ürün grubu çeşitlenmektedir. Gıda sanayisinin misyonu; gıda güvenliğini ve güvencesini temin eden, çevre dostu, tüketici odaklı, sürdürülebilir, kıtlıkla ve gıda israfıyla mücadele eden bir sanayi olmaktır. Gıda teknolojisi son yıllarda daha çok alternatif kaynaklar, mevcut kaynakların etkin kullanımı ve gıda israfını önleme üzerine yoğunlaşmıştır. Bunun yanı sıra robotik teknolojiler, modern hayatı kolaylaştıracak hızlı çözümler, gelişmiş sensör ve kameralar ile uzay gıdaları ile ilgili çalışmaları da mevcuttur. İlaveten, son yıllarda bu teknolojilerle üretilmiş gıdalar, İslam inancına göre helallik açısından da irdelenmektedir. Today, with the rapidly increasing population, the demand for food is increasing and the product group is diversifying. The mission of the food industry; is to be an industry that ensures food safety and security, environmentally friendly, provides consumer-oriented, sustainability, and combats famine and food waste. In recent years, it has been observed that the developments in the food technology have focused more on alternative sources, effective usage of existing resources and prevention of food waste. Besides, it also has studies on the use of robotic technologies, rapid solutions to facilitate modern life, advanced sensors and cameras, and space foods. In addition, in recent years, foods produced with these technologies have been examined in terms of halalness according to the Islamic belief.

Tıbbi ve aromatik bitkiler (TAB), tüketicilerin doğal beslenme ve yaşama olan ilgisinin artmasıyla birlikte son yirmi yılda ön plana çıkmıştır. Türkiye, bulunduğu coğrafi konum, sahip olduğu iklim ve bitki çeşitliliği sayesinde TAB açısından önemli bir yere sahiptir. Oldukça geniş bir varyete gösteren TAB‘ın; lezzet, koku, tat verici, antimikrobiyal, antioksidan ve terapötik gibi etkileri nedeniyle çeşitli formlarda (bütün, öğütülmüş, toz, ekstrakt, ekstre, hidrosol veya uçucu yağlar) kullanımları mevcuttur. Bileşimlerindeki sekonder metabolitlerden dolayı tıp ve eczacılık alanlarının yanı sıra fonksiyonel gıda bileşeni ve takviye edici gıda olarak kullanımları da önem taşımaktadır. Son yıllarda dünya ölçeğinde artarak yaşanan küreselleşme, kentleşme, değişen yaşam koşulları ve beslenme alışkanlarının farklılaşması ile birlikte ortaya çıkan yetersiz ve dengesiz beslenme sonucu tüketicilerin takviye edici gıdalara yönelimini artırmıştır. Takviye edici gıdalar pazarında TAB‘ın kullanımına daha fazla yer verilmesiyle bu alanda gerekli düzenlemelere gidilmiştir. Bu derlemede, TAB ile bunların takviye edici gıda üretiminde kullanımı üzerine bazı bilgilere yer verilmiştir.

Kentsel çevrenin ve yapı içindeki mekânların tüm kullanıcılar için erişilebilir olması aynı zamanda engelli bireylerin de bu yapılı çevreleri kullanımının arttırılması önemlidir. Yaş, beceri durum ve imkânların oluşturduğu farklılıklara karşın tüm bireylerin mümkün olduğu oranda eşit ve aktif kullanımlarını sağlayan çevre ya da tüm ürünlerin tasarlanması sürecindeki tasarım yaklaşımı; herkes için tasarım kavramı, bugün tüm mimari çalışmalarda ele alınmaktadır. Mekân ve çevre tasarımında kullanılabilirlik ve erişilebilirlik ele alınarak, her türlü birey için aynı kullanım özgürlüğünün sağlanması, tasarlanan yapı, çevre ve iletişimin herkes için aynı çekicilikte sunulması, kullanım yöntemlerinin kişilerin bireysel yetenek ve tercihlerine göre geniş seçenekler içermesi evrensel tasarım ilkeleri baz alınarak oluşturulabilmektedir. Bu bağlamda erişilebilirlik sosyal hayata katılmada etkili bir konudur. Toplumsal yaşamın her alanında engellilerin de yer alması, eğitim ve rehabilitasyon hizmetlerinden faydalanması, üretime ve sosyal kültürel, sportif faaliyetlere katılmasına imkan sağlayan kültür merkezleri; engellilerin kullanım ve erişebilirlik gereksinimlerini karşılayabilecek biçimde düzenlenmelidir. Bu çalışmada evrensel tasarım yaklaşımıyla engellilik ve erişebilirlik kavramları düzleminde Konya da birçok etkinliğe ve hizmete ev sahipliği yapan Mevlana Kültür Merkezi incelenmiştir. Bunun için bina çevresi ve bina içindeki erişilebilirliği sağlayan yaya geçidi, yaya yolu, otopark, rampa, merdiven, asansör, koridorlar, işaretler fotoğraflanmış ve ölçülendirilmiştir. Araştırmanın kapsamı; erişilebilir çevre standartlarının ve erişilebilir bina standartlarının alt başlıkları esas alınarak, standartların mevcut uygulamalar ile kıyaslamasını, sorun tespitini ve çözüm önerilerini içermektedir. Standartlar ve kıyaslamalar sonucu ilerdeki tasarımlar için bir rehber oluşturmak, mevcut duruma çözüm önerileri getirmek amaçlanmıştır. Sonuçlar Mevlana Kültür Merkezinin standartlara uygun olmadığı ve iyileştirme projelerinin gerekliliğini açıkça ortaya koymuştur., The accessibility of the urban environment and spaces within the building for all users, and increasing the usage of these built environments by individuals having with disabilities is important. The design approach that ensures equal and active use of all individuals as much as possible despite the differences created by age, skill, situation and opportunities (in the process of designing the environment or all products); the concept of design for everyone is addressed in all architectural works today. Considering usability and accessibility in space and environmental design, providing the same freedom of use for all kinds of individuals, presenting the designed building, environment and communication with the same attractiveness for everyone, and the usage methods include wide options according to the individual abilities and preferences of the people can be created on the basis of universal design principles. In this context, accessibility is an effective issue in participating in social life. Cultural centers that allow disabled people to take part in all areas of social life, benefit from education and rehabilitation services, participate in production, social, cultural and sports activities; It should be arranged in a way to meet the use and accessibility needs of the disabled. In this study, Mevlana Cultural Center, which hosts many activities and services in Konya in the plane of disability and accessibility concepts with a universal design approach, was examined. For this purpose, the pedestrian crossings, pedestrian paths, parking lots, ramps, stairs, elevators, corridors, signs, which provide accessibility within the building and around the building, were photographed and scaled. The scope of the research; Based on the subheadings of accessible environmental standards and accessible building standards, it includes the comparison of standards with existing practices, problem detection and solution suggestions. As a result of standards and comparisons, it is aimed to create a guide for future designs and to offer solutions to the current situation. The results clearly revealed that the Mevlana Cultural Center is not in compliance with the standards and that improvement projects are required.

An increasing number of individuals use the Internet to obtain health information. However, online health information is unregulated and highly variable. We aimed to assess the readability, understandability, and quality of online information available for “chest pain in children.” This analysis was performed in January 2020, by inputting the search term “chest pain in children” into Google. The 180 search results were evaluated/categorized. The readability was assessed using the Flesch reading ease score, the Gunning FOG readability score, the Flesch–Kincaid grade level, the Coleman–Liau score, the Simple Measure of Gobbledygook readability score, the Fry readability score, and the automated readability index (ARI). The quality was assessed through the Journal of the American Medical Association (JAMA) benchmark criteria. The understandability was evaluated by the Patient Education Materials Assessment Tool (PEMAT) for this study. Sixty-five websites were analyzed (academic and hospital websites (n = 30), physicians and health information websites (n = 35)). Among all websites, the average reading grade level was 9.99. There was no statistical difference between the two groups for the average readability level (p: 0.645). The mean PEMAT score for all websites was 65.09%. There was no statistical difference between the two groups for the average PEMAT score (p: 0.945). For both groups, the understandability score was below 70%. The average JAMA benchmark score was 2.43 ± 1.06, with a statistically significant difference between the academic and hospital websites (2.07 ± 0.91) and physician and health information websites (2.74 ± 1.09, p: 0.009). Conclusion: The readability of online materials available for patients regarding “chest pain in children” was significantly higher than the grade 6 recommended by the National Institutes of Health. The current online health information related to pediatric chest pain may be too difficult for the average reader to read. The quality and understandability were not good for both groups. Improving the readability, understandability, and quality of pediatric health–related online materials has the potential to reduce parental anxiety, improve baseline medical knowledge, and even enhance the physician–parent alliance.

Purpose: The aim of this study was to compare the effects of hyperbaric oxygen therapy (HBOT) induced hyper-oxygenation and normobaric oxygen therapy (NBOT) on myocardial repolarisation parameters in children with carbon monoxide (CO) poisoning.Materials and Methods: This prospective study included 77 girls and boys aged 0–18 years who were diagnosed and treated for CO poisoning. There were no changes in the routine clinical evaluation and treatment practices of patients. Patients who received NBOT (n=40) and HBOT (n=37) were divided into two groups. These groups were compared in terms of their demographic characteristics, carboxyhaemoglobin, lactate, troponin levels and myocardial repolarisation parameters of electrocardiography (ECG) (Tp-e interval, Tp-e dispersion, QTc and Tp-e/QTc ratio).Results: There were no significant intergroup differences in terms of carboxyhaemoglobin, lactate and troponin levels at the time of admission; admission and post-treatment Tp-e, Tp-e dispersion, corrected QTc and TPe/QTc ratio and post-treatment change rates of each ECG parameter.Conclusion: There was no intergroup difference in terms of repolarisation parameters of ECG in children with CO poisoning. The possible reason for this may be myocardial reperfusion damage due to hyper-oxygenation associated with HBOT therapy., Amaç: Bu çalışmanın amacı, karbon monoksit (CO) zehirlenmesi olan çocuklarda hiperbarik oksijen tedavisi (HBOT) ile oluşturulan hiperoksijenasyonun ve normobarik oksijen tedavisinin (NBOT) miyokardiyal repolarizasyon parametreleri üzerindeki etkilerini karşılaştırmaktı.Gereç ve Yöntem: Bu prospektif çalışmaya CO zehirlenmesi tanısı konulan ve tedavi edilen 0-18 yaş arası kız ve erkek çocuklar dahil edildi. Hastaların rutin klinik değerlendirme ve tedavi uygulamalarında değişiklik olmadı. Hastalar NBOT yapılanlar (n=40) ve HBOT yapılanlar (n=37) olarak iki gruba ayrıldı. Bu gruplar, demografik özellikler, karboksihemoglobin, laktat, troponin düzeyleri ve elektrokardiyografinin (EKG) miyokardiyal repolarizasyon parametreleri (Tp-e aralığı, Tp-e dispersiyonu, QTc ve Tp-e / QTc oranı) yönünden karşılaştırıldı.Bulgular: Gruplar arasında başvurudaki COHb, laktat, troponin düzeyleri; başvuruda ve tedavi sonrası Tpe, Tpe dağılımı, düzeltilmiş QTc ve TPe/QTc oranları ve her bir EKG parametresinin tedavi sonrası değişim oranları yönünden anlamlı bir farklılık saptanmadı.Sonuç: CO zehirlenmesi olan çocuklarda EKG repolarizasyon parametreleri açısından gruplar arasında fark yoktu. Bunun olası nedeni, HBOT tedavisi ile ilişkili hiperoksijenasyona bağlı miyokardiyal reperfüzyon hasarı olabilir.

Objectives:The pathophysiology of idiopathic chest pain remains unclear. Studies evaluating pain pressure thresholds in other idiopathic pain syndromes have revealed pain sensitivity in both affected and unaffected areas. The present study aimed to evaluate thoracic and extrathoracic pain pressure thresholds and their correlation with patients’ pain characteristics and quality of life.Methods:This cross-sectional, single-blind, controlled study included children and adolescents with idiopathic chest pain. The patients’ pain characteristics, including their symptom duration, type of pain, mean pain intensity, mean duration of painful periods, pain frequency, and Pediatric Quality of Life Inventory Child Version scores, were assessed by a paediatric cardiologist via a face-to-face interview. Pain pressure thresholds were measured using an algometer by an algologist who was blinded to the study groups.Results:There was a statistically significant difference in pain pressure thresholds in the trapezius; supraspinatus; thoracic 2, 4, and 10 areas; deltoid; and tibia between the patient and healthy control groups. In the patient group, while there was a positive correlation between the mean all-region pain pressure thresholds and age (p = 0.047, r = 0.235), there was no correlation between pain pressure thresholds and symptom duration, pain intensity, and quality of life.Conclusion:The present study is the first step towards investigating probable pain sensitivity mechanisms in children and adolescents with idiopathic chest pain. We noted lower thoracic and extrathoracic pain pressure thresholds in children and adolescents with idiopathic chest pain than in healthy controls.

Olive oil is an important part of the human diet worldwide. Its production has increased every year. Adulteration detection and labeling olive oils with a declaration of geographical origin...

Since his existence, mankind tends to arrange his environment according to his own needs. He has designed spaces that he can make use of and benefit from in nature. He has made use of the order in nature and various objects in the environment. In architectural design, the nature-based design is called as the biomorphism. Referring to the biological formation and of which point of origin is the living organism in nature, biomorphism is used in architecture by taking the functions and systems of nature as an example along with the support of the technology and biology in urban planning and structural design. In this study, Konya Tropical Butterfly Garden, an example of biomorphic design, which hosts many butterfly types has been analysed. The garden reminds a butterfly form on an overall basis. When assessing the relationship between the architecture, construct and concept of the garden, it can see that it has a pioneering perspective. Keywords: Biomorphic architecture, nature, form, concept, Konya butterfly garden.

To compare the values of neutrophil:lymphocyte ratio (NLR), platelet:lymphocyte ratio (PLR), and mean platelet volume (MPV) with carboxyhemoglobin (COHb) and lactate levels in children with acute CO intoxication. In this retrospective study, the patients were divided into two groups: mild-to-moderate carbon monoxide poisoning (COP) (COHb 10%–20%) and severe COP (COHb > 20%) according to the COHb levels in the application. All patients were compared in terms of NLR, PLR, and MPV parameters according to the severity of poisoning and the high lactate levels (≥ 2.2 mmol/L). A total of 261 children with COP were included in the study. The number of patients with mild-to-moderate COP was 183 (70.1%), and the number of patients with severe COP was 78 (29.9%). NLR [2.57 (3.27), 1.65 (1.93), (p = 0.001)] and PLR [123.0 (88.24), 92.8 (54.1), (p = 0.001)] values of mild-to-moderate COP were statistically significantly lower than the severe COP group. In the group with high lactate level, PLR values were significantly lower [120.1 (71.9), 100.2 (85.4), (p = 0.017)]. NLR and PLR values were found to be predictive of severe COP. NLR and PLR can be used for detection of clinical severity in patients with COP. PLR can be used in conjunction with lactate levels to detect tissue-level exposure in patients with COP.

Purpose: This study aimed to determine whether emotional eating (EE) and uncontrolled eating (UCE) scores affect the metabolic risk factors in obese adolescents. Methods: A sample of 100 adolescents have BMI-SDS between 1.41 and 2.83 (aged 12-17 years) was selected. EE and UCE scores were estimated using the TFEQ21. The association of EE and UCE with anthropometric data, lipid profile, glucose profile, liver enzymes, and inflammation factors was assessed in boys and girls. Results: Using Spearman rank correlation, EE scores significantly correlated with uric acid (r = 0.393 and P = 0.001), CRP (r = 0.273 and P = 0.017), TG (r = 0.317 and P = 0.001), TC (r = 0.258 and P = 0.019) and VAI (r = 0.276 and P = 0.034). Also UCE scores were showed positive correlation with CRP (r = 0.257 and P = 0.024). Conclusion: In conclusion, interrelationships tend to exist between EE and triglyceride, uric acid, visceral adiposity index, and CRP levels among obese adolescents.

Objective Smoking during pregnancy has harmful effects on the fetus and infant. Although some studies suggest that exposure to fetal-maternal smoking adversely affects both fetal growth and cardiovascular development, the mechanisms and biochemical consequences of smoking in pregnancy and newborns are not yet fully understood. We aimed to investigate whether maternal smoking during pregnancy causes fetal cardiovascular effect by measuring serum asymmetric dimethylarginine (ADMA) level and abdominal aortic intima-media thickness (aIMT). Study design This prospective study was conducted in newborns of smoking mothers and never-smoker control mothers during their pregnancies. The babies were evaluated echocardiographically on the first day following birth. In two-dimensional mode, abdominal aIMT measurements were performed. ADMA was measured in umbilical cord blood at birth. Results There were 25 mothers in the study group and 25 mothers in the control group. Serum ADMA levels were 0.459 ± 0.119 μmol/L in the study group and 0.374 ± 0.1127 μmol/L in the control group (p = 0.034). The aIMT value in the study group was 0.84 ± 0.026 mm and the aIMT value in the control group was 0.63 ± 0.011 mm (p = 0.005). Conclusion We found that both the serum ADMA and the aIMT significantly increased in the group with newborns of smoker mothers compared with the group of the newborns of never-smoker mothers. It may also be suggested that exposure to fetal-maternal smoking adversely affects cardiovascular development. Key points · It is a known fact that smoking during pregnancy has harmful effects on the development of the fetus and infant.. · We found that both the serum ADMA and aIMT were significantly higher in the group of infants of smoker mothers..

INTRODUCTION: Preoperative anxiety due to anesthesia is a common situation and decreases with preoperative evaluation. The aim of this study is to determine whether utilization of BATHE method further decreases the anxiety scores of patients who are evaluated at an anesthesia clinic for preoperative examination. METHODS: The patients were randomized into “BATHE” and “Control” groups by using the closed envelope technique. State-Trait Anxiety Inventory (STAI) scores were recorded as entrance STAI for all patients. During preoperative evaluation, BATHE method was applied to the BATHE Group whereas it was not applied to the Control Group. Post-examination, STAI scores were recorded as exit STAI and the patients were later asked questions about their contentment. RESULTS: Data of 463 patients were included in the analysis. Demographic data was similar in the groups. In both groups the exit STAI scores (BATHE: 34.27±10.30, Control: 34.90±9.54) were lower in comparison to the entrance STAI scores (BATHE: 38.21±9.86, Control: 37.09±9.93). The mean gap between the entrance STAI and exit STAI scores of the BATHE (3.94±6.05) and Control groups (2.19±6.14) were statistically significant (p

Ultrasound pretreatment with different times (0, 4, 8, 10 min) on olive paste previous malaxation of olive oil extraction along with depitting and water application procedures were studied. The effects of these procedures on oil yield, quality parameters and oxidative stability have been studied. Therefore, the olive oil yield increase with increasing time of ultrasound treatment. On the other hand, the application of ultrasound did not adversely affect the quality characteristics, as well as the antioxidant activity, when comparing with untreated paste. Furthermore, the oxidative stability data, we can conclude that ultrasound treatment can affect the olive oil oxidative stability. This study could provide useful information for industry to produce olive oil with high yield and quality. © 2020, Ministry of Higher Education and Scientific Research: 114O835 Ministry of Higher Education and Scientific Research, The Tunisian Ministry of Higher Education and Scientific Research supported this work. This study was financially supported under the international joint research project (Project no 114O835) by TÜBİTAK (Turkiye) -MHESR (Tunisia) . Useful corrections about the language by Professor Mohamed Rigane is gratefully acknowledged.

Objective:Murmurs are abnormal audible heart sounds produced by turbulent blood flow. Therefore, murmurs in a child may be a source of anxiety for family members. Families often use online materials to explore possible reasons for these murmurs, given the accessibility of information on the Internet. In this study, we evaluated the quality, understandability, readability, and popularity of online materials about heart murmur.Methods:An Internet search was performed for “heart murmur” using the Google search engine. The global quality score (on a scale of 1 to 5, corresponding to poor to excellent quality) and Health on the Net code were used to measure the quality of information presented. The understandability of the web pages identified was measured using the Patient Education Materials Assessment Tool (score range from 0 to 100%, scores below 70% reflect poor performance). The readability of each web pages was assessed using four validated indices: the Flesch Reading Ease Score, the Flesch–Kincaid Grade Level, the Gunning Frequency of Gobbledygook, and the Simple Measure of Gobbledygook. The ALEXA traffic tool was used to reference domains’ popularity and visibility.Results:We identified 230 English-language patient educational materials that discussed heart murmur. After exclusion, a total of 86 web pages were evaluated for this study. The average global quality score was 4.34 (SD = 0.71; range from 3 to 5) indicating that the quality of information of most websites was good. Only 14 (16.3%) websites had Health on the Net certification. The mean understandability score for all Internet-based patient educational materials was 74.6% (SD = 12.8%; range from 31.2 to 93.7%). A score suggesting these Internet-based patient educational materials were “easy to understand”. The mean readability levels of all patient educational materials were higher than the recommended sixth-grade reading level, according to all indices applied. This means that the level of readability is difficult. The average grade level for all web pages was 10.4 ± 1.65 (range from 7.53 to 14.13). The Flesch–Kincaid Grade level was 10 ± 1.81, the Gunning Frequency of Gobbledygook level was 12.1 ± 1.85, and the Simple Measure of Gobbledygook level was 9.1 ± 1.38. The average Flesch Reading Ease Score was 55 ± 9.1 (range from 32.4 to 72.9).Conclusion:We demonstrated that web pages describing heart murmurs were understandable and high quality. However, the readability level of the websites was above the recommended sixth-grade reading level. Readability of written materials from online sources need to be improved. However, care must be taken to ensure that the information of web pages is of a high quality and understandable.

Purpose: The purpose of this study is to assess the readability of acute rheumatic fever-related Internet-based patient education materials. Materials and Methods: A total of 250 websites assessed, 50 for each of the keywords (“acute rheumatic fever,” “acute joint rheumatism’’, “rheumatic fever’’, “acute rheumatic carditis’’, “rheumatic carditis’’) on search engine Google (available at www.google.com). Sites with less information than ten sentences, chat, forum and commercial blog sites were excluded from the study. Average word count, average syllable number and words with an average syllable number of 4 and above were calculated. The average readability level was analyzed using Ateşman and Bezirci-Yilmaz readability formulas. Results: A total of 50 out of 250 websites were eligible for examination after the applying of the exclusion criteria. Of the sites reviewed, 33 created by health-care professionals and the 17 by non-health-care professionals. The readability of the web sites was moderate difficulty according to the Ateşman formula, and comprehensible to people at undergraduate level according to the Bezirci-Yılmaz formula. Conclusion: The readability level of patient educational texts related to acute rheumatic fever field on web sites was at academic literacy level. This information would be difficult to understand by the average education level in the Turkey., Amaç: Bu çalışmanın amacı akut romatizmal ateşle ilişkili internet tabanlı hasta eğitim materyallerinin okunabilirliğini değerlendirmektir.Gereç ve Yöntem: Herbir anahtar kelime (“akut romatizmal ateş”, “akut eklem romatizması”, “romatizmal ateş”, “akut romatizmal kardit '',“ romatizmal kardit '') için Google arama motorunda (www.google.com) 50 site olmak üzere toplam 250 web sitesi değerlendirildi. On cümleden daha az bilgi içeren siteler, sohbet, forum ve ticari blog siteleri çalışma dışı bırakıldı. Ortalama kelime sayısı, ortalama hece sayısı ve ortalama hece sayısı 4 ve üzerinde olan kelimeler hesaplanmıştır. Ortalama okunabilirlik seviyesi Ateşman ve Bezirci-Yılmaz okunabilirlik formülleri kullanılarak analiz edilmiştir.Bulgular: Hariç tutma ölçütleri uygulandıktan sonra 250 web sitesinin toplam 50'si araştırma için uygun bulundu. İncelenen sitelerden 33'ü sağlık uzmanları ve 17'si sağlık personeli olmayan kişiler tarafından oluşturulmuştur. Ateşman formülüne göre web sitelerinin okunabilirliği orta derecede zor, Bezirci-Yılmaz formülüne göre lisans düzeyinde insanlar tarafından anlaşılabilir bulunmuştur.Sonuç: Web sitelerindeki akut romatizmal ateş alanıyla ilgili hasta eğitimi metinlerinin okunabilirlik seviyesinin akademik okuryazarlık düzeyinde olduğu belirlenmiş ve bu bilgilerin Türkiye'deki ortalama eğitim düzeyi ile anlaşılması güç olacağı düşünülmektedir.

Amaç: Deli bal zehirlenmesi; Rhododendron çiçeklerinden üretilen ve içinde Grayanotoxin (GTX) bulunan balın tüketilmesi sonucunda oluşur. Oldukça nadir görülmesine ragmen hayatı tehdit eden bulgulara sebep olabilir. Bu çalışmada hastanemize başvuran 38 deli bal zehirlenmesi vakasının demografik ve biyokimyasal kan gazı paremetreleri ışığında organlar üzerindeki etkilerinin retrospektif olarak literatür eşliğinde tartışılması amaçlanmıştır.Gereç ve Yöntemler: Çalışmaya 2010-2012 yılları arasında acil servise herhangi bir şikayetle başvurmuş ve 'Deli Bal Zehirlenmesi' tanısı almış toplam 38 hastanın retrospektif dataları dahil edildi.Bulgular: Olguların 23 (%60.5)'i erkek, 15 (%39.5)'i bayandı. Olgularımız 29 ile 86 yaşları arasındaydı. Olgularımızın yaş ortalamaları 55.42±12.63 yıl olarak belirlendi. Olguların bal alımı sonrası semptomların başlama süresi ortalama 92.82±30.09 dak olarak belirlendi. Olgularda hastaneye başvurudaki kalp atım hız ortalaması 49.74±11.41 atım/dak, ortalama sistolik kan basıncı değeri 72.16±16.92 mmHg ve ortalama diyastolik kan basıncı 43.79±10.58 mmHg olarak bulundu. Hastaların ortalama 0.76±0.55 mg atropin ve 1336.84±935.31 ml kristaloid sıvı ile tedavi edildiği bulundu. Ritm problemleri dışında gastrointestinal, solunum ve kardiyovasküler sistem bulguları normal sınırlardaydı. Olguların bal tüketim miktarları ile, semptomların başlama süresi arasında bir korelasyon ilişkisi belirlenemedi Sonuç: Deli Bal Zehirlenmesi en sık kardiyovasküler sistemi etkilemektedir. Bu hastalarda en sık hipotansiyon ve bradikardiye rastlanmaktadır. Tedavide sıklıkla yeterli sıvı resüsitasyonu ve 1-2 mg İntravenöz Atropin tedavisi yeterli olmaktadır, Objective: Mad honey intoxication results from consuming honey which is produced from rhododendron flowers and containing Grayanotoxin (GTX). This intoxication is seen rarely, however it may lead some life-threatening signs. In this study, it was aimed to retrospectively discuss the effects of 38 mad honey intoxication cases on the organs in the light of demographic and biochemical blood gas parameters.Material and Methods: We enrolled 38 patients diagnosed with “mad honey intoxication” retrospectively, who were admitted to our emergency department between January 2010 to December 2012. Results: Of cases, 23 (60.5%) were male and 15 (39.5%) were female. Our cases were between the ages of 29 and 86 years. The mean age of cases was 55.42±12.63 years. The mean onset of symptoms after honey intake was determined to be 92.82±30.09 minutes. The mean heart rate when cases applied to hospital was found to be 49.74±11.41 beats/min. and the mean systolic and diastolic blood pressures were found to be 72.16±16.92 mmHg and 43.79±10.58 mmHg, respectively. The mean amount of atropine treatment given to the patient was found to be 0.76±0.55 mg and the mean crystalloid fluid given was 1336.84±935.31 mL. Except the rhythm problems, gastrointestinal, respiratory and cardiovascular system findings were in normal range. There was no correlation found between the amount of honey consumed and the onset of symptoms in the cases. Conclusion: Mad honey intoxication most often affects the cardiovascular system. Hypotension and bradycardia are the most common signs in these patients. Sufficient fluid hydration and 1-2 mg intravenous atropine are often adequate for the treatment

WOS: 000406446700005, PubMed: 28077344, Objective: This study aimed to measure the serum levels of heart-type fatty acid binding protein (H-FABP) in patients presenting with diabetic ketoacidosis (DKA) and diabetic ketosis (DK) and to determine its role in identifying early-period cardiac ischemia. Methods: This prospective study included 35 patients diagnosed with DKA, 20 patients diagnosed with DK, and 20 control subjects. H-FABP, creatine kinase-MB (CK-MB), and troponin I levels were investigated at presentation in patients with DKA and DK and in the control group. H-FABP values were measured again after acidosis correction in the DKA patients. Results: No statistically significant differences were found with respect to troponin I and CK-MB within the groups. The H-FABP values of DKA patients at presentation were found to be significantly higher than those of DK patients and the control group (p = 0.015). The H-FABP value of the DKA group was also found to be significantly higher than the value at hour 36 after acidosis correction (p = 0.0001). Conclusion: We would like to propose H-FABP as a potential marker for indicating myocardial ischemia., Selcuk UniversitySelcuk University [13102033], Selcuk University Scientific Research Project Coordinator-Project No: 13102033.

Autoimmune hematological disorders may be the initial indicator of an underlying Hodgkin lymphoma (HL). Immune thrombocytopenia (ITP) can manifest before, during, or after the diagnosis of HL, and concurrent thrombocytopenia can complicate the diagnosis and initial treatment of the malignancy. Various autoimmune disorders have been described in patients with HL, including ITP, autoimmune hemolytic anemia, autoimmune neutropenia, systemic lupus erythematosus, and scleroderma. An underlying HL should be considered in the differential diagnosis of a pediatric patient with ITP. In this report, we present the case of a 5-year-old boy who had thrombocytopenia and fever at the time of his HL diagnosis. Based on bone marrow aspiration and evaluation, we diagnosed immune thrombocytopenia and administered treatment with intravenous gammaglobulin. The platelet count normalized within a few days of treatment

Objective The aim of this study was to evaluate the importance of growth-differentiation factor-15 level and tissue Doppler imaging in the detection of cardiomyopathy in children who have type 1 diabetes mellitus. Materials and Methods Thirty-eight patients (11 males and 27 females) with type 1 diabetes mellitus were included in this study. The control group consisted of 40 age- and gender-matched healthy volunteers. All children underwent a detailed echocardiography, which contained an m-mode, pulse Doppler and tissue Doppler imaging; and growth-differentiation factor-15 level was measured. Results In this study, there were significant differences between diastolic function parameters of the heart. The mitral isovolumic contraction time, contraction time, and isovolumic relaxation time values were different in the patients than in the controls (p Conclusion The follow-up of children with type 1 diabetes mellitus in terms of cardiomyopathy and the use of tissue Doppler imaging and growth differentiation factor-15 levels may be useful.

Subclinical hypothyroidism, defined as increased TSH serum levels and normal serum free T4 concentrations, has been associated with an increased risk of heart disease in adults. But, data in children and adolescents are scanty and treatment of subclinical hypothyroidism is controversial. Growth differentiation factor-15 (GDF-15) is a promising biomarker of cardiac remodeling. This study aimed to evaluate the cardiovascular risk factors in children with subclinical hypothyroidism, measured with tissue Doppler echocardiography (TDE), and conventional echocardiography and GDF-15 level. The study comprised a total of 41 pediatric patients with subclinical hypothyroidism (SH) (mean age 9.6 ± 4.7 years) and 31 healthy children (mean age 11.2 ± 3.4 years) as the control group. Subclinical hypothyroidism was defined as a thyroid-stimulating hormone level higher than 4 mIU/l and a normal free-thyroxine level (0.6–1.8 ng/dl). Tissue Doppler echocardiography was performed to all individuals in the control group and patient group at the beginning of the study. Global systolic function as assessed by left ventricular ejection fraction was compared between groups. The serum GDF-15 level was measured. There were no significant differences in demographic parameters between the SH and control groups. The left ventricular internal diameter end systole, interventricular septal end diastole, left ventricular posterior wall end diastole, and tricuspid annular plane systolic excursion values were significantly different between the SH and control groups (p = 0.038, 0.028, 0.005, and 0.000, respectively). The mean mitral isovolumic relaxation time value of the SH group was 57.2 ± 9.3 ms, compared to 44.5 ± 5.6 ms for the control group (p = 0.000). The mean tricuspid isovolumic contraction time value of the SH group was 58.7 ± 9.4 ms, and that of the control group was 45.1 ± 5.3 ms (p = 0.000). The mean tricuspid isovolumic relaxation time value of the SH group was 58.03 ± 9.5 ms, and that of the control group was 45.1 ± 5.3 ms (p = 0.000). There were no significant differences in the other m-mode or pulse Doppler echocardiography values between two groups. The GDF-15 value of the SH group was 382.6 ± 268.2 pg/mL, and that of the control group was 473.6 ± 337.9 pg/mL; this difference was not significant. Patients with subclinical hypothyroidism versus healthy individuals had some changes in echocardiographic parameters that indicate involvement of diastolic function of the left ventricle. They were significantly different when compared SH group and the control group. This study demonstrated ventricle diastolic dysfunction in pediatric patients with hypothyroidism. The results of our study suggest that cardiac follow-up may be useful in patients with subclinical hypothyroidism and clinical trials are needed to explore therapeutic effects of T4 and T3 administration in this patients.

Olanzapine is an atypical antipsychotic drug, commonly used in the management of psychotic symptoms in patients with schizoprenia and bipolar affective disorder. Deep venous thrombosis is a manifestation of venous thromboembolism. It is very well known that use of antipsychotic drugs increase the risk of thrombosis in a patient with schizophrenia. It has been reported in many studies the effects of olanzapine on thrombosis but there isn’t any report about the effect of olanzapine on international normalized ratio (INR). in the medical literature. In this paper, a patient with schizophrenia and also family history of deep venous thrombosis who emerged deep venous thrombosis after being started on olanzapine treatment and effect of olanzapine treatment on INR has been reported., Olanzapin psikotik belirtilerin tedavisinde kullanılan, psikotik bozuklukların ve duygudurum bozukluklarının tedavisinde başarılı, etki gücü yüksek (potent) bir ikinci kuşak antipsikotiktir. Derin ven trombozu bir venöz tromboemboli kliniği olup, antipsikotik tedavi alan hastalarda tromboz riskinin arttığı bilinmektedir. Olanzapin tedavisinin venöztromboz üzerine olan etkileri raporlanmış olmasına rağmen, literatürde olanzapin tedavisinin “international normalized ratio” (INR) üzerine etkileri hakkında bir çalışma bulunmamaktadır. Bu olgu bildiriminde derin ven trombozu aile öyküsü olup, olanzapin tedavisi altında derin ven trombozu atağı geçiren ve antikoagülan tedavisi alan şizofreni tanılı bir hastada olanzapinin INR üzerine etkilerinin ele alınması amaçlanmıştır.

Prostate cancer is one ofthe most common types of cancer among males as well as causing the most deaths.Early diagnosis of prostate cancer plays an important role in the treatment ofthe disease. Therefore, microarray technology is widely used in the diagnosisof inherited diseases such as prostate cancer. With this technology, it ispossible to obtain more knowledge about cancer by analyzing thousands of geneexpressions. However, it is quite difficult to analyze complex relationshipsamong thousands of genes in microarray data. For this reason, high performanceartificial intelligence-based classification methods are needed in recentyears. In this study, a hybrid method has been proposed for optimizing theparameters of Adaptive Neuro Fuzzy Inference System (ANFIS) with GeneticAlgorithm (GA) in order to classify prostate cancer gene expression profiles.The performance of the proposed method is compared with those of ANFIS modelstrained by different learning algorithms. According to obtained results, theproposed method is more successful than the other methods, with the accuracy of90.32%., Prostate cancer is one of the most common types of cancer among males as well as causing the most deaths. Early diagnosis of prostate cancer plays an important role in the treatment of the disease. Therefore, microarray technology is widely used in the diagnosis of inherited diseases such as prostate cancer. With this technology, it is possible to obtain more knowledge about cancer by analyzing thousands of gene expressions. However, it is quite difficult to analyze complex relationships among thousands of genes in microarray data. For this reason, high performance artificial intelligence-based classification methods are needed in recent years. In this study, a hybrid method has been proposed for optimizing the parameters of Adaptive Neuro Fuzzy Inference System (ANFIS) with Genetic Algorithm (GA) in order to classify prostate cancer gene expression profiles. The performance of the proposed method is compared with those of ANFIS models trained by different learning algorithms. According to obtained results, the proposed method is more successful than the other methods, with the accuracy of 90.32%.

Cancer in pregnancy is a rare occasion affecting less than 0.1% of all pregnancies. Either primary or secondary metastatic thoracic tumors during pregnancy account even a small portion of them. However, any lung tumor of a term pregnant has devastating potential influence during the anesthesia for childbirth. Due to extreme scarcity of these cases, there are no well-established anesthesia methods to overcome the problems encountered in this particular patient population. Data and information in this field are derived mainly from occasional case reports and mini reviews. The aim of this chapter is to give a structured information and to discuss the possible challenges that the anesthesiologist may come across.

Environmental problems appear due to rapid population growth, uncontrolled urbanization, rapid exhaustion of natural sources, global warming and climate changes. With an aim to find solutions to these problems and to ensure that next generations can live on this planet, the concepts of sustainable architecture and sustainable buildings gained importance. Sustainable architecture is a contemporary and interdisciplinary approach to architecture that works in compliance with environmental systems. It builds on using energy and scanty sources consciously and economically. Sustainable construction design requires the integration of ecologic, economic and socio-cultural sustainability components into the design procedure in a balanced manner. Educational buildings that serve next generations are crucial in the context of sustainable design with their contributions to social awareness and the economy in the country. In this respect, first basic criteria that constitute the sustainability in education structure design, and samples of “sustainable education buildings” chosen from different climate regions around the world have been evaluated according to the defined criteria in the present study. The evaluations have indicated that parameters such as “environmental factors, climate features, land choice, material and construction technology used” are effective in sustainable education buildings designs. The results also underline the need for different designs in the light of the data gathered.

Asymmetric dimethylarginine (ADMA) is an analogue of l -arginine, a naturally occurring product of metabolism found in human circulation. It is an endogenous inhibitor of nitric oxide production. Acute rheumatic fever (ARF) is a delayed immunologically mediated autoimmune sequel of throat infection by group A β-hemolytic streptococci. As serum ADMA levels have not previously been assessed in patients with ARF, we aimed to investigate ADMA levels in patients with ARF during the acute stage and after anti-inflammatory treatment and compared results with healthy control subjects. The study population consisted of 34 children with ARF (30 patients with carditis and 4 patients without carditis) and 31 healthy control subjects. Erythrocyte sedimentation rate and C-reactive protein values were significantly higher and serum ADMA values were lower, but not statistically significant in patients with ARF during the acute stage when compared with controls. Serum C-reactive protein and erythrocyte sedimentation rate values were significantly decreased in patients with ARF after the treatment when compared with baseline and ADMA levels were increased after the treatment compared with baseline, but this change was not statistically significant. Our study has demonstrated that resolution of acute inflammation in patients with ARF may lead to a mild increase in serum concentration of ADMA. Comprehensive prospective and observational studies are required to confirm our findings and to assess potential interactions between ARF and ADMA levels.

WOS: 000411505100010, PubMed: 28694400, Carpenter syndrome (acrocephalopolysyndactyly type 2, OMIM 201000) is a rarely seen autosomal recessive disorder. In addition to abnormalities such as acrocephaly, craniosynostosis, facial asymmetry, polydactyly and syndactyly, obesity, hypogonadism, mental retardation, and corneal opacity, it may frequently be accompanied by congenital heart diseases such as ventricular septal defect, patent ductus arteriosus and pulmonary stenosis. Double outlet right ventricle is a defect in which both major arter-ies originate in the morphological right ventricle. To the best of our knowledge, this is the first report in the literature of double outlet right ventricle disease in combination with Carpenter syndrome.

WOS: 000419796200002, Objective: Hypernatraemia has serious complications such as brain injury, brain oedema and seizure. In this study, the incidence among children hospitalized hypernatremia, causes, development time, clinical features, and morbidity, and aimed to reveal the effect on mortality. Method: In this retrospective study, clinical and laboratory data from patients with hypernatremic were recorded. The study period was 33 months. The groups were separated into two groups; group I: Hypernatremia was present at hospital admission, group II: Hypernatremia was acquared after the hospitalization. Results: Overall incidence of hypernatraemia was 1.3% of all hospitalised children. While 42% of patients were from group I, 58% of patients had acquired hypernatremia during hospital stay. In group I, 61% of patients had infections on hospital admission. The most common cause of hypernatraemia in group II was neurological disorders (53%). The mortality rate was 30.5% (11/36) in patients with hypernatraemia on admission, 67.3% (33/49) in those with hospital-acquired hypernatraemia (P0.05. Conclusion: Hypernatraemia in pediatric age is associated with mortality and morbidity, and should be closely monitored in pediatric patients hospitalized for any reason in order to prevent complication.

2nd International Conference on Green Energy Technology (ICGET) -- JUL 18-20, 2017 -- SAPIENZA Univ Rome, Rome, ITALY, WOS: 000439410300022, Shear walled (SW) reinforced concrete (RC) buildings are considered to be a type of high seismic safety building. Although this structural system has an important seismic advantage, it also has some disadvantages, especially in acoustic and thermal comfort. In this study, experimental studies have been conducted on RC members produced with plastic material having circular sections to determine structural performance. RC members have been produced with and without 6 cm diameter balls to analyze the structural behaviour under loading and to investigate the thermal performance and sound absorption behaviour of the members. In the study, structural parameters have been determined for RC members such as slabs and SWs produced with and without balls to discover the feasibility of the research and discuss the findings comparatively. The results obtained from the experimental studies show that PB used in RC with suitable positions do not significantly decrease strength but improve the thermal and acoustic features. It has been also seen that using plastic balls reduce the total concrete materials.

Anthracyclines have led to an increased risk of cardiac morbidity and mortality. Late cardiac complications in cancer survivors may develop from subclinical myocardial damage. Tissue Doppler imaging (TDI) also has potential as a clinically useful technique for the assessment of myocardial function. Biochemical markers may be used to detect cardiac damage growth-differentiation factor-15 (GDF-15) and are emerging as a biomarker of cardiac dysfunction. The aim of this study is to assess the value of the plasma levels of GDF-15 and TDI in detecting late myocardial dysfunction in childhood cancer survivors (CCS) who were treated with anthracyclines.Thirty-eight CCS who had completed chemotherapy treatment with anthracyclines were included in this study. Control group consisted of 32 age- and gender-matched healthy volunteers. All children underwent a detailed echocardiography, which contained an M-mode, pulse Doppler and tissue Doppler imaging. However, GDF-15 and cardiac troponin-I (cTnI) were measured.Although, systolic function of the left ventricular was similar in all groups, there were significant differences between parameters of diastolic function of the heart. The mitral valve E wave, E/A ratio, left ventricular E'm wave, and E'm/A'm ratio were different in the patients than in the controls (p = 0.049, p = 0.037, p0.0001, p = 0.001, respectively). The tricuspid valve E/A ratio, right ventricular E't wave, and E't/A't ratio in the patients were also different from those of the controls (p = 0.031, p0.0001, p0.0001, respectively). Mean plasma GDF-15 was significantly higher in patients than healthy controls (p = 0.027). There were no significant differences in cTnI between both groups.Growth-differentiation factor-15 level may be used as a biomarker of anthracycline-induced cardiovascular disease severity in the CCS.

WOS: 000319781500007, PubMed: 23438803, Background and objectives: Initiation of epidural anesthesia with long-lasting local anesthetics consumes a significant amount of time, which could be problematic in busy obstetric anesthesia suites. We have hypothesized that a combination of articaine and ropivacaine provides faster onset and even an early recovery of sensory-motor block characteristics. Methods: Sixty term parturients scheduled to have elective cesarean section were randomly allocated into three groups to receive either 20 mL 2% articaine (Group A), 10 mL 2% articaine + 10 mL 0.75% ropivacaine (Group AR) or 20 mL 0.75% ropivacaine (Group R) via lumbar epidural catheter. The onset time of sensory block to T-10, T-6 and maximum sensory block level, time to two segments regression from maximum sensory block level, onset time and duration of motor block were all recorded. Intraoperative and postoperative additional analgesic requirements were also recorded. Results: Demographic data were similar. The onset times of sensorial block to T-10 and T-6 were significantly shorter in Groups A and AR in comparison with Group R (p < 0.05). The onset times of motor block were similar in all groups, but a more intense motor block was observed in Group R (p < 0.05). Two segments regression time and motor block durations were significantly shorter in Groups A and AR in comparison with Group R (p < 0.05). Intraoperative supplementary analgesic requirements were higher in Group A than in the other two groups (p < 0.05). Conclusion: A combination of 2% articaine and 0.75% ropivacaine for epidural anesthesia in a cesarean section should be preferred over epidural 0.75% ropivacaine alone. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

WOS: 000378646700028, PubMed: 27513415, Background/aim: Persistent upper airway obstruction may lead to increased pulmonary arterial pressure (PAP). The aim of this study was to evaluate N-terminal pro brain natriuretic peptide (NT-proBNP) concentrations and PAP values in children with allergic rhinitis. Materials and methods: Sixty-six patients with allergic rhinitis and 22 healthy children were prospectively enrolled in this study. Plasma NT-proBNP levels were measured at first admission and after treatment. Simultaneously, echocardiography was done to assess pulmonary arterial hypertension, and rhinitis symptom scores were recorded. Results: The median age of the study group was 9.0 (5.0. 17.0) years; 26 were female. PAP was found to be normal in all the patients. There was a negative correlation between age and NT-proBNP levels (r = -0.452, P < 0.01). Nasal blockage levels affected NT-proBNP levels mildly (P = 0.067). No significant difference between before and after nasal steroid treatment was observed in NT-proBNP levels. Conclusion: These results suggest that NT-proBNP level and PAP may not be affected in children with allergic rhinitis, and primarily this influence may be associated with the severity of nasal obstruction.

Kısa etkili inhale beta 2 mimetik bir ilaç olan salbutamol, bronkospazm ve solunum sıkıntısı durumlarında çok sık kullanılmaktadır ama ülkemizde intihar amaçlı alımı nadir görülen bir durumdur. Salbutamole bağlı komplikasyonlar iyi bilinmektedir ve terapotik dozlarda da ortaya çıkabilir. İlaca bağlı toksikasyon geliştiğinde hiperaktivite, tremor, konvülzyon, hiperglisemi, hipokalemi, hipomagnezemi, laktik asidoz, hipotansiyon, hipertansiyon, konjestif kalp yetmezliği, miyokard iskemisi, atriyal ve ventriküler ektopik atımlar, atriyal aritmiler, QT uzaması ve ventriküler taşikardi gibi aritmiler ile ani kardiyak ölüm ortaya çıkabilir. Bu makalede, intihar amaçlı olarak salbutamolün tablet formundan 200 mgr kullanan 15 yaşındaki bir hasta sunuldu ve literatür bilgileri eşliğinde çocuklarda salbutamol zehirlenmesine yaklaşım tartışıldı., Salbutamol, a drug with short-acting inhaled beta 2 mimetic effect, is very frequently used in cases of bronchospasm and respiratory distress; however, its intake for suicide purposes is rare in Turkey. Salbutamol-induced complications are well established and may be seen at therapeutic doses. When drug-related intoxication develops, hyperactivity, tremor, convulsion, hyperglycemia, hypokalemia, hypomagnesemia, lactic acidosis, hypotension, hypertension, congestive heart failure, myocardial ischemia, atrial and ventricular ectopic heart beats, atrial arrhythmias, QT prolongation and arrhythmias such as ventricular tachycardia and sudden cardiac death may occur. This paper presents a 15-year-old patient who used 200 mg salbutamol in tablet form for suicide purposes and discusses the approach to salbutamol intoxication with a review of the literature information

Intravenous lipid emulsion eliminates the toxicity-related symptoms of several drugs. We hypothesized that intravenous lipid emulsion prolongs the survival time in digoxin-intoxicated rats.Electrocardiograms of 14 anesthesized Wistar rats were monitored. All of the rats received digoxin infusion at a rate of 12 mL/h (0.25 mg/mL). Five minutes after the start of digoxin infusion, animals were treated either with 12.4 mL/kg intravenous lipid emulsion (group L) or saline (group C). The primary outcome variable was time elapsed until asystole development. Cumulative dose of digoxin required to induce asystole was also recorded.Mean time until asystole development in groups C and L were 21.28 ± 8.61 and 32.00 ± 5.41 minutes, respectively (P.05). The mean lethal doses of digoxin in the groups C and L were 3.97 ± 1.54 and 6.09 ± 0.96 mg/kg, respectively (P.05).Intravenous lipid emulsion prolonged the time until asystole development and increased cumulative lethal dose in rats intoxicated with digoxin.

The main objective of this study is to evaluate general anesthesia or propofol-based sedation methods at gastric endoscopic submucosal dissection (ESD) procedures. The anesthetic method administered to cases undergoing upper gastrointestinal ESD between 2013 and 2015 was retrospectively investigated. Procedure time, lesion size, dissection speed, anesthesia time, adverse effects such as gag reflex, nausea, vomiting, cough, number of desaturation episodes (SpO2

Operative decision in American Society of Anesthesiology Physical Status (ASA-PS) V patient is difficult as this group of patients expected to have high mortality rate. Another risk scoring system in this ASA-PS V subset of patients can aid to ease this decision. Data of ASA-PS V classified patients between 2011 and 2013 years in a single hospital were analyzed in this study. Predicted mortality of these patients was determined with acute physiology and chronic health evaluations (APACHE) II, simplified acute physiology score (SAPS II), Charlson comorbidity index (CCI), Porthsmouth physiological and operative severity score for enumeration of mortality and morbidity (P-POSSUM), Surgical apgar score (SAS), and Goldman cardiac risk index (GCRI) scores. Observed and predicted mortality rates according to the risk indexes in these patients were compared at survivor and nonsurvivor group of patients. Risk stratification was made with receiver operator characteristic (ROC) curve analysis. Data of 89 patients were included in the analyses. Predicted mortality rates generated by APACHE II and SAPS II scoring systems were significantly different between survivor and nonsurvivor group of patients. Risk stratification with ROC analysis revealed that area under curve was 0.784 and 0.681 for SAPS II and APACHE II scoring systems, respectively. Highest sensitivity (77.3) is reached with SAPS II score. APACHE II and SAPS II are better predictive tools of mortality in ASA-PS V classified subset of patients. Discrimination power of SAPS II score is the best among the compared risk stratification scores. SAPS II can be suggested as an additional risk scoring system for ASA-PS V patients.

OBJECTIVES The aim of this study was to evaluate the importance of growth-differentiation factor-15 (GDF-15) levels and tissue Doppler imaging (TDI) in the early detection of anthracycline-induced cardiomyopathy during the treatment of childhood cancers. PATIENTS AND METHODS Twenty patients (13 males and 7 females) newly diagnosed with childhood cancer whose treatment protocol included anthracycline were included in the study. Echocardiography, including M-mode, pulse Doppler, and TDI, was performed after the first anthracycline treatment at cumulative doses of 100, 200, and 300 mg/m and at least 6 months after the last treatment. GDF-15 and troponin-I were also measured at these time points. RESULTS The median age of the patients was 14 years (range, 3 to 18 y). The median cumulative anthracycline dose was 220 mg/m (range, 60 to 400 mg/m). Conventional pulse wave and pulse wave tissue Doppler methods revealed significant differences in the right ventricular myocardial performance indices of the patients who received cumulative anthracycline doses of 300 mg/m compared with their indices at least 6 months after the last treatment. The serum GDF-15 levels after the cumulative anthracycline dose of 200 mg/m were also higher than the patients' pretreatment levels. CONCLUSIONS Doppler/TDI and GDF-15 levels may be used in the early determination of anthracycline-induced cardiomyopathy during the treatment of childhood cancers.

WOS: 000376566800024, Coronary arteriovenous fistula is an incidental finding in 0.1% to 0.2% of coronary angiograms. A 15-year-old famale patient presented with a three years history of chest pain on exertion. Echocardiography was performed previously and a small muscular ventricular septal defect was detected. The electrocardiogram was normal sinus rhythm together with normal axis. On echocardiography, left ventricular function was normal and there was continuous flow into the right ventricle. Therefore, coronary angiography was performed for considering the coronary artery fistula. Coronary artery fistula was observed between the first septal perforating branch of the left anterior descending coronary artery with right ventricle. The patient's clinical follow-up was decided since a significant shunt could not be identified.

Hemitruncus arteriosus (HA) is an uncommon congenital cardiac malformation in which one pulmonary artery branch originates from the ascending aorta. A 2-month-old male was referred to our hospital for failure to thrive, cyanosis, and tachypnea. A chest radiograph demonstrated moderate cardiomegaly and peribronchial thickening. Echocardiography demonstrated right atrial and ventricular enlargement and increased gradient (25 mm Hg) in the right pulmonary artery. Cardiac magnetic resonance angiography was performed and clearly revealed typical imaging findings of a right HA which had complex cardiac and vascular anatomy. This case report presents cardiac magnetic resonance angiography findings of HA.