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Objective: Anxiety is a common problem before surgical procedures. The effectiveness of aromatherapy in preoperative anxiety control has been demonstrated by some studies. The aim of this study is to investigate the effects of lavender oil inhalation on anxiety levels in patients before ear surgery. Material-Method: The study was conducted in the Otorhinolaryngology clinic of a tertiary university hospital. A total of 68 patients (34 in the study group, 34 in the control group) who were scheduled for tympanoplasty operation were included in the study. Inhalation of lavender oil was used in the patients in the study group before the operation, and liquid paraffin was used in the control group. A personal information form and State-Trait Anxiety Scale (STAI) were used to collect data.Results: In the study group, the mean STAI pre-test and post-test mean scores were 44.50 ± 12.38 and 36.48 ± 10.73, respectively, and there was a statistically significant difference (p 0.05). Also, when the posttest STAI mean scores were evaluated between the study and control groups, a statistically significant difference was found (p

Data mining in education predictions are made about other groups based on the big data of education. However, the extent to which training data can be accessed is relative. A group that can be described as missing data is children living or working on the street. For this reason this study aimed to deal with children working or living on the street. Children who have to live or work on the street before they can complete their development are faced with many dangers arising from the street and may be exposed to social exclusion. In this context, the aim of this study is to examine the social dimension of the problems faced by children living or working on the street and to analyze and evaluate the limited number of data on this issue. The research is a compilation study in line with the literature analysis of the sources about children living and working on the street. Key words: Data mining in education, lost data problem, living on the streets.

Objective: The aim of our study was to assess the possible short-term effects of topical and oral eugenol on the suppression of experimentally developed myringosclerosis (MS). Methods: Four groups of seven male Wistar albino rats were used in the study. The tympanic membranes (TMs) of all subjects were myringotomized, and group 1 was given no treatment (as control group), group 2 received saline, group 3 had received topical eugenol and group 4 received oral eugenol. Results: In macroscopic evaluation the control and saline groups showed much more MS compared to the topical and oral eugenol groups which had statistically significantly less changes (p

Aim: Our aim was investigate the effect of polychlorobifenyls (PCBs) and other factors on puberty precocious (PP) in girls were diagnosed with idiopatic PP and premature thelarche (PT). Materials and Methods: The study group included 50 girls aged between 2-8 years old with PP and PT. The control group included 50 healthy girls with same age range and no puberty findings. Data was collected in terms of breast and pubic hair stages, weight, height, body mass index (BMI), standard deviation scores (SDSs), location of residence, gestational age and maternal age at menarche (AAM). Twenty-one PCB levels were evaluated in serum and urine. One-Way ANOVA test was used for comparison between the groups. For subgroup analysis, Mann-Whitney U test, multiple regression analysis were used. Results: The mean age of the study and control groups were 6.70 +/- 1.20 and 5.23 +/- 1.25 years, respectively. The studied PCBs were not detectable found in either the study or the control groups. The BMI SDSs of the patients in study and healthy groups were 0.49 +/- 1.09 and-0.12 +/- 1.28, respectively (p=0.1). Weight SDSs in the study group were found to be significantly higher than healthy group (0.72 +/- 1.35 vs-0.20 +/- 1.47, p=0.008 Maternal AAM of the patients in study group was significantly lower (p=0.006). In study group 98% of the patients were living in down town and district, whereas this ratio was 92% in control group (p=0.024). In study group 29 patients (58%) were diagnosed with PT. Basal follicle stimulating hormone and estradiol levels, bone age and uterine longest axis dimensions results were significantly different. Conclusion: We found that studied PCBs don't influence on PP in girls aged between 2-8 years old. However, weight SDS, maternal AAM, location of residence of the patients had a significant role on PP in this patient population.

The current paper aimed to identify the relation between ecological intelligence (EI) and the types of multiple intelligences (MI); and pointed out how ecological awareness could be raised through activities of MI. Data was gathered from the freshman students (N = 68) who studied at the Department of Primary Education. Four measures were used in this case study: interviews, multiple intelligence inventory (MII), ecological intelligence scale (EIS), and students' 5-min notes. Correlation analysis was used to find the relationship between the students’ ecological intelligence and the types of MI. The responses to interview questions were coded into discrete themes. Findings indicated that the intelligence type which had the most correlation with the sub-dimensions of EIS was InterP. Moreover, moderate relations were determined between the sub-dimensions of EIS and the types of MI which were Bodily/Kinesthetic (BK) and Visual/Spatial (VS). Although the students had difficulties in activities such as drama and role-playing for BK intelligence, they enjoyed, and had better motivation to learn collaboratively during the activities through visual tools. Ecological intelligence relates to various types of MI. Based on this assertion the activities of MI should be integrated in-class environmental activities for students to acquire ecological awareness and sensitivity.

Objective: This study aimed to investigate pathological lymph node involvement in selected patients and the relationship of prostate-specific antigen (PSA) progression-free survival rates between patients with and without lymph node involvement on preoperative conventional radiologic imaging. Limited data is available about local treatment outcomes in patients with prostate cancer (PCa) having clinical lymph node involvement.

Aim: In this study, we aimed to compare the effect of aerobic exercise programs on patients with Multiple Sclerosis (MS) and healthy controls, and to show that home exercise programs can be as effective as supervised exercise programs.Materials and Methods: Eighty participants were included in this study and were divided into groups as the home-exercise group (outpatient), supervised exercise group (inpatient), and healthy controls. A 6-weeks aerobic exercise program was given to all participants. Before and after the exercise program, 6-minute Walking Test (6MWT), Fatigue Severity Scale (FSS), Modified Ashworth Scale (MAS), Berg Balance Scale (BBS), Extended Disability Scale (EDSS), Cardiopulmonary Exercise Test (CPET), and MS Quality of Life (MSQoL-54) were applied to participants.Results: When 6MWT and CPET data were evaluated, it was observed that the patient and control groups benefited from the exercise program. There was a significant improvement after treatment in the 6MWT, BBS, FSS, MSQoL-54, and KPET data of both the outpatient and inpatient groups, and there was no difference between the groups when the rates of change were compared.Conclusion: We have observed that the home-based exercise program is as effective as the supervised exercise program. We think that the home program should be recommended first when planning the exercise program in PwMS in terms of cost, effectiveness, and accessibility., Amaç: Bu çalışmada, aerobik egzersiz programlarının Multipl Skleroz (MS) hastaları ve sağlıklı kontroller üzerindeki etkisini karşılaştırmayı ve ev egzersiz programlarının denetimli egzersiz programları kadar etkili olabileceğini göstermeyi amaçladık.Gereç ve Yöntem: Seksen katılımcı bu çalışmaya dahil edildi ve evde egzersiz grubu (ayaktan tedavi), denetimli egzersiz grubu (yatarak tedavi) ve sağlıklı kontroller olarak gruplara ayrıldı. Tüm katılımcılara 6 haftalık aerobik egzersiz programı verildi. Egzersiz programı öncesi ve sonrası, 6 dakikalık Yürüme Testi (6DYT), Yorgunluk Şiddet Ölçeği (YŞÖ), Modifiye Ashworth Ölçeği (MAÖ), Berg Denge Ölçeği (BDÖ), Genişletilmiş Yetersizlik Düzeyi Ölçeği (EDSS), Kardiyopulmoner Egzersiz Testi (KPET) , ve MS Yaşam Kalitesi Ölçeği (MSYKÖ-54) katılımcılara uygulandı.Bulgular: 6DYT ve KPET verileri değerlendirildiğinde hasta ve kontrol gruplarının egzersiz programından yararlandığı görüldü. Hem ayaktan hem de yatan hasta gruplarının 6DYT, BDÖ, YŞÖ, MSYKÖ-54 ve KPET verilerinde tedavi sonrası anlamlı düzelme oldu ve değişim oranları karşılaştırıldığında gruplar arasında fark yoktu.Sonuç: Ev temelli egzersiz programının denetimli egzersiz programı kadar etkili olduğunu gözlemledik. Maliyet, etkinlik ve erişilebilirlik açısından MS hastalarda egzersiz programı planlanırken öncelikle ev programının önerilmesi gerektiğini düşünüyoruz.

Objectives. Coronary artery bypass grafting (CABG) is the most common procedure in cardiac surgery and the great saphenous vein (GSV) are the preferred conduits. The effects of saphenous vein incision (SVI) harvesting site choice on SVI wound complications, pretibial edema, and the need for compression stockings were evaluated retrospectively in patients undergoing CABG surgery. Materials and Methods. A total of 1900 patients operated for CABG between 2003 and 2021 in our clinic were included in this study, with GSV harvest performed at below-knee level (Group-A, n:841) and above-knee level (Group-B, n:1059). SVI was made 2 cm superior and 1 cm anterior to the medial malleolus in group-A; and 3 cm superior to medial epicondyle, extending to 3 cm inferior to the inguinal ligament in group-B. Examination for edema was made with 4-5 seconds of thumb pressure at the ankle level, then the depth of the pit was measured. Results. Ankle edema (Group-A n:132, Group-B n:25), the use of compression stockings (Group-A n:97, Group-B n:13), and paresthesia (Group-A n:51, Group-B n:10) were different between the two groups and the differences were statistically significant. However, prolonged wound healing (Group-A n:11, Group-B n:38), superficial wound infection (Group-A n:6, Group-B n:11), hematoma (Group-A n:4, Group-B n:9), and lymphorrhea (Group-A n:4, Group-B n:7) incidences were not statistically different between the two groups. Conclusions. Among patients with GSV extracted using the open conventional surgery technique, pretibial edema, paresthesia, and compression stocking use were observed less frequently in patients with preoperative doppler-ultrasonography evaluation and above-knee saphenous harvest.

Актуальність. Синдром Веста характеризується картиною гіпсаритмії на електроенцефалографії, судомами спазмового типу і тріадою психомоторної регресії. Метою цього дослідження було визначення демографічних характеристик, клінічних та лабораторних показників, відповіді на лікування, впливу на формування нервової системи та факторів ризику, що розвинулися протягом тривалого спостереження пацієнтів із діагнозом синдрому Веста. Матеріали та методи. У дослідження були включені пацієнти, у яких був діагностований синдром Веста в період з липня 2011 року по грудень 2012 року на кафедрі дитячої неврології університету Ататюрка. З анамнезу кожного пацієнта були зібрані наступні дані. Були розглянуті показники загального та неврологічного досліджень, церебральної томографії та електроенцефалографії. Біохімічні аналізи проводилися за результатами лабораторних досліджень. Розвиток кожної дитини оцінювався за допомогою тесту для скринінгу на розвиток Denver 2, тесту для контролю та скринінгу розвитку Ankara. Результати. Співвідношення хлопчиків і дівчаток серед наших пацієнтів становило 2,28 : 1, а середній вік становив 8,62 ± 7,20 місяця (медіана: 8,0). 59 (85,51 %) пацієнтів були в симптоматичній групі й 10 (14,49 %) — у групі з ідіопатичним генезом захворювання. Найбільш частими факторами в симптоматичній групі були вроджені аномалії центральної нервової системи (45,7 %) і гіпоксично-ішемічна енцефалопатія (28,8 %). Спостерігалася вірогідна різниця між ідіопатичною та симптоматичною групами за частотою рецидивів, рентгенологічними даними та прогнозом (р = 0,035/р < 0,001/р < 0,001). Рецидив спостерігався в 43,5 % хворих. Серед пацієнтів, які отримували адренокортикотропний гормон, 83 % особи відповіли на лікування, у 17 % реєстрували резистентні судоми. Статистично значущої різниці між відповідями на лікування адренокортикотропним гормоном та іншими методами лікування не було (р = 0,093). У 46 з 55 дітей (83,6 %) була виявлена затримка розвитку. Висновки. Рання діагностика і лікування, надання належного й зручного лікування при синдромі Веста можуть чинити сприятливий вплив на прогноз залежно від етіології.

Signal recognition particle (SRP) promotes co-translational translocation of the proteins through or into the endoplasmic reticulum membrane and it also has elongation arrest function. SRP9 is one of the six protein subunits of SRP and functions in elongation arrest activity by forming a heterodimeric structure with SRP14. It is one of the substrates of ADAR, which has been found to have a role in breast cancer. This study was conducted to investigate the SRP9 protein expression in normal and tumor tissues of patients with breast cancer and determine its prognostic significance. A total of 32 female patients who were diagnosed as having primary breast cancer and underwent surgery were included in the study. Western Blotting was performed to detect SRP9 protein expression levels in normal and tumor tissue samples. Clinical and pathologic characteristics were analyzed to assess the prognostic significance. SRP9 protein expression was statistically higher in the breast cancer tissue samples compared to normal matched tissue, and the mean SRP9 protein expression levels of breast cancer tissue normal tissue samples were 1.019 ± 1.011 and 0.551 ± 0.456, respectively (p = 0.001). SRP9 protein expression levels in tumor tissue of patients with lymph node metastasis, tumor size > 2 cm, estrogen receptor-positive, progesterone receptor-positive, and HER-2 negative were statistically higher than in normal tissue (p

Background Congenital diarrheal disorders (CDDs) are a rare group of enteropathies that typically present in the early few months of life and pose a diagnostic challenge. We aimed to analyze the clinical findings and outcome of infants with CDDs and share experience about genetic testing. Methods Demographic, clinical and genetic findings, and outcome of the patients (n = 24) with CDDs were recorded from hospital files. Results The onset of diarrhea was within the neonatal period in 45.8% of the patients. The most frequent causes of CDDs were defects in digestion, absorption and transport of nutrients and electrolytes (DATN) (n = 11, 45.8%) and defects in intestinal immune-related homeostasis (IIH) (n = 6, 25%). Fat malabsorption (n = 6) was the leading cause of defects in DATN. Extraintestinal manifestations including neurological involvement (25%) and renal involvement (20.8%) were common among the patients. Genetic analyses were performed for 16 patients (targeted gene analysis in 9, congenital diarrhea panel in 3, immune deficiency panel in 1 and whole-exome sequencing in 3 patients). Genetic diagnosis was achieved in 14 of 16 patients (87.5%) with therapeutic consequences in 8 of 16 patients (50%). During the follow-up, 6 patients (25%) died. Conclusion The percentage of undefined etiology decreased, and treatment of the patients improved with the increased number of genetic testing in patients with CDDs.

Objective: Classical Bartter syndrome (cBS) and Gitelman syndrome (GS) are genotypically distinct, but there is a phenotypic overlapamong these two diseases, which can complicate the accurate diagnosis without genetic analysis. This study aimed to evaluate thecorrelation between clinical and genetic diagnoses among patients who have genetically defined cBS and GS.Patients and Methods: The study included 18 patients with homozygous/compound heterozygous CLCNKB (NM_000085) (n:10/18)and SLC12A3 (NM_000339) (n:8/18) mutations. Biochemical, clinical and radiological data were collected at presentation and at thelast visit.Results: In cBS group age at diagnosis, median plasma potassium and chloride concentrations were significantly lower and medianplasma HCO3 and blood pH values were significantly higher. Patients with GS had significantly lower median plasma magnesiumconcentrations and urinary calcium/creatinine ratio. One child with GS had normocalciuria, two children with cBS had hypocalciuriaand hypomagnesemia. Low estimated glomerular filtration rate (eGFR) (ml/dk/1.73m2) and growth failure were more evident in cBSgroup. In patients with cBS, nine different CLCNKB gene mutations were detected, five of them were novel. Novel mutations were:one nonsense (c.66G>A, p.Trp22*), one missense (c.499G>A, p.Gly167Ser) and three splice-site (c.867-2delA; c.499-2insG; c.1930-2A>C) mutations. In patients with GS, six different SLC12A3 gene mutations were found.Conclusions: It may not always be possible to clinically distinguish cBS from GS. We suggest to perform a genotypic classification ifgenetic analysis is possible.

Background/aim We evaluated the feasibility of producing splints with 3D printer technology to prevent contractures in burned children in our clinical prospective study. Materials and methods After approvals, children with burns greater than 2nd degree were included in the study. Age, sex, burn percentages, printing time, filament types, number of filament trials, splint suitability, patient and doctor comments, preclinical trials’ significances and financial impact were evaluated statistically. Results Seventy-six trials were conducted on 18 patients. Fourteen of the patients were male and 4 are female. Average ages of boys and girls were 5 and 3, respectively. Burn percentage was 36.9 ± 13. Polylactic acid (PLAFlex), polyurethane (PolyFlex), semiflexible copolyester (nGenFlex), and thermoplastic polyurethane (TPU) were the main filaments that were used in the study. Printing time differed from 4 to 29 h according to body regions. Splints were suitable for 81.25% in upper extremity, for 66.7% in lower extremity, and for 100% in mouth. Burn percentage was significantly correlated with total number of filament (p = 0.049). Other statistical evaluations were insignificant. Conclusion The 3D printer seems to be useful in children with burns. However, difficulties caused by some reasons like production must be overcome. By increasing clinical experience, this emerging custom-made technology may become standard, and documented problems can be solved.

AMAÇ: Tüberküloz (TB), Mycobacterium tuberculosis kompleks (MTBK) grubuna ait mikroorganizmaların neden olduğu kronik gidişatlı, bir enfeksiyon hastalığıdır. Anti tüberküloz ilaçlar ile tedavi edilmekte ve kontrol altına alınmakta olan bu hastalık; bazen ilaçlara yanıt vermeyebilir. Tüberkülozda ilaç direnç araştırması yapılması tüberküloz kontrol ve tedavi programlarının temelini oluşturmaktadır.GEREÇ VE YÖNTEM: Çalışmamızda, laboratuvarımızda izole edilen MTBK izolatlarının primer anti tüberküloz ilaçlara duyarlılıklarının araştırılması ve direnç paternlerinin belirlenmesi amaçlanmıştır. Kliniğimizde 2011 - 2019 yılları arasında tüberküloz şüphesi ile mikrobiyoloji laboratuvarına gönderilen 8804 klinik örnek değerlendirmeye alınmıştır.BULGULAR: Çalışmaya alınan örneklerden 126’sında tüberküloz kültürü pozitif gelmiştir. 126 örneğe (%1.4) anti-tüberküloz duyarlılık testi uygulanmıştır. 28 (%22.3) izolat ise test edilen anti tüberküloz ilaçlardan en az birine dirençli olarak tespit edilmiştir. Çok ilaca direnç ise %2,38 oranında bulunmuştur.SONUÇ: Tüberküloz tedavisinde direnç gelişimini önlemek ve tedavinin sağlıklı bir şekilde yapılabilmesi için her hastaya kültür ve antibiyotik duyarlılık testlerinin çalışılması, verilerin elde edilmesi gerekmektedir.

Coronary thrombus causes reduced blood flow in patients with acute myocardial infarction. Our aim was to to contribute to the understanding of the mechanisms of coronary occlusion caused by thrombus, evaluating the histopathological characteristics of thrombi in three cases. Cases were diagnosed with ST elevation type of myocardial infarction by coronary angiography. Histopathological analysis of thrombi as well as immunohistochemical staining with PTX3 (pentraxin 3, an acute phase protein) and CD68 (a cytokine released from monocyte and macrophages) were performed. Blood levels of troponin and PTX3 were also evaluated. The PTX3 immunostaining score was high in all cases but it was not consistent with its blood level. The high PTX3 staining intensity in the case with normal PTX3 blood level may be the result of rapid local release of PTX3. Case with highest PTX3 blood level had another inflammatory disease that could have driven this increase. We suggest that PTX3 and CD68 immunostainings can be used as a marker in the histopathological evaluation of coronary thrombus.

Renal parenchymal fibrosis is the most important determinant of kidney disease progression and it is determined via biopsy. The aim of this study is to evaluate the renal stiffness noninvasively by magnetic resonance elastography (MRE) and to compare it with clinicopathologic parameters in glomerulonephritis and AA amyloidosis patients. Thirty-four patients with glomerular filtration rate (GFR) over 20 ml/min/1.73m2 had non-contrast MRE prospectively. Kidney stiffness values were obtained from whole kidney, cortex, and medulla. Values were correlated with GFR, albuminuria, proteinuria, and degree of fibrosis that are assessed via renal biopsy. Patients were grouped clinicopathologically to assess the relation between stiffness and chronicity. Mean whole kidney, cortex, and medulla stiffnesses were 3.78 (± 1.26), 3.63 (± 1.25), and 4.77 (± 2.03) kPa, respectively. Mean global glomerulosclerosis was 22% (± 18%) and median segmental glomerulosclerosis was 4% (min–max: 0%–100%). Extent of tubulointerstitial fibrosis was less than 25% in 26 of the patients (76.5%), 25%–50% in 6 of the patients (17.6%), and higher than 50% in 2 of the patients (5.9%). Fourteen patients were defined to have chronic renal parenchymal injury. MRE-derived stiffness values correlated negatively with parameters of fibrosis. Lower stiffness values were observed in patients with chronic renal injury compared to those without (P

Copyright protection for works of applied art poses certain challenges, primarily due to the functional aspects that they often incorporate. The approach to this predominant attribute, i.e. function, has shaped legal initiatives for copyright protection to works of applied art. In some countries, such as France, the design industry was colored by the prevalence of rather ornamental creations, with an eye toward fidelity to the craft tradition. Copyright law in these countries was able to embrace the applied arts more easily, elevating them to the level of fine arts and reviving the old unity of craft/art. On the other hand, some countries where function and standardization have been paramount, i.e. Germany in particular, have constructed their national strategy, and correspondingly copyright protection, within the framework of another form of unity. Instead of adhering to the old craft tradition, these countries opted for a unity between art, function and industry. This latter form of unity and the predominance of function and industry stamped the modern design to a far greater degree than the former one did. Against this historical-factual background, this article attempts to formulate rough guidelines for the application of a functionality doctrine, which has gradually emerged from the case law of the Court of Justice of the European Union. In line with the unity of art, function and industry, the article suggests to take what is termed a holistic approach to functionality and industry, arguing that a contrary approach would clash with the modern design.

The world population is aging rapidly. Some of the elderly live alone and it is observed that the elderly who live with their families frequently have to stay at home alone, especially during the working hours of adult members of the family. Falling while alone at home often results in fatal injuries and even death in elderly individuals. Fall detection systems detect falls and provide emergency healthcare services quickly. In this study, a two-step fall detection and fall direction detection system has been developed by using a public dataset and by testing 5 different machine learning algorithms comparatively. If a fall is detected in the first stage, the second stage is started and the direction of the fall is determined. In this way, the fall direction of the elderly individual can be determined for use in future researches, and a system that enables necessary measures such as opening an airbag in the direction of the fall is developed. Thus, a gradual fall detection and fall direction detection system has been developed by determining the best classifying algorithms. As a result, it has been determined that Ensemble Subspace k-NN classifier performs a little more successful classification compared to other classifiers. The classification via the test data corresponding to 30% of the total data, which was never used during the training phase, has been performed with 99.4% accuracy, and then 97.2% success has been achieved in determining the direction of falling.

Objective This study aimed to establish the prevalence and patterns of nonsyndromic tooth agenesis in patients referred to a tertiary health care facility. Methods The intraoral records and panoramic radiographs of 9,874 patients aged 12–22 years were evaluated. The study group included 716 patients (371 male, 345 female) with non-syndromic agenesis of at least one tooth (except the third molars). The study data were assessed using descriptive statistics, chi-square test, and Mann–Whitney U test, while patterns were evaluated using a tooth agenesis code (TAC) tool. Results A total of 1,627 congenitally missing teeth, were found in patients with non-syndromic tooth agenesis, with an average of 2.27 missing teeth per patient. The prevalence of tooth agenesis was 7.25%, and the most commonly missing teeth were the left mandibular second premolars (10.17%). The age group comparison revealed no significant difference in the median number of missing teeth per patient according to the cutoff values for ages between 12 and 22 years. When the missing teeth were examined separately according to quadrants, 114 different tooth agenesis patterns (upper right quadrant = 28, upper left quadrant = 27, lower left quadrant = 31, and lower right quadrant = 28) were identified, and 81 of these patterns appeared only once. Conclusions This study highlights the benefits of applying the TAC tool in a large sample population. The application of the TAC tool in such studies will enable the development of template treatment plans by determining homogenous patterns of tooth agenesis in certain populations.

Introduction: Obstructive sleep apnea (OSA) is a disease characterized by recurrent complete (apnea) or partial (hypopnea) upper respiratory tract obstructions episodes during sleep and often a decrease in blood oxygen saturation. The knowledge and attitude of physicians about OSA is very important as it influences the level of clinical suspicion of OSA which can lead to diagnose. Therefore, aim of this study was to evaluate the knowledge of and attitude to OSA of physicians. Material and Method: This descriptive, cross-sectional survey study included 105 physicians in a university hospital. Participants completed the Obstructive Sleep Apnea Knowledge and Attitudes (OSAKA) questionnaire through the face-to-face interview method. Results:The study respondents comprised 55 (52.8%) males and 50 (47.6%) females with a mean age of 34.4±7.3 years (range, 23-59 years). The years of experience was mean 10.45±7.37 years (range, 1–35 years). The knowledge level of physicians was mean score of 11.56±2.70 (64.1%). Attitude section, the mean score was 16.34±2.47 from a possible maximum of 25. A positive correlation was determined between the knowledge and the attitude scores of the physicians (r: 0.467 p

Paul Schrader’s Mishima: A Life in Four Chapters (1985) is one of the most comprehensive biographical representations of Yukio Mishima’s literature and life, which were retroactively overshadowed by his sensational death. In this film with a multi-layered and complex temporal structure oscillating between documentary and fiction, Schrader concisely adapts The Temple of the Golden Pavilion (1956), Kyōko’s House (1959), and Runaway Horses (1969), as well as some anecdotal episodes of Mishima, for cinema. The story centres on Mishima’s bizarre act of terror which he executed with his four young soldiers from his militia force, the Shield Society, on November 25, 1970, at the headquarters of the Japan Self-Defence Forces. He committed suicide by seppukku when his call for “Shōwa Restoration” was ignored. Hence, as this biographical film focuses on Mishima’s “death” and his anecdotes connected with his “death wish” rather than on his “life-story,” its genre should be renamed as a “death-story.” On the other hand, Schrader consciously transformed Benjamin’s “shock effect” theory into a method. According to Benjamin, the “shock effect” is caused by the constant and sudden change of images in cinema which subverts the viewer’s consciousness. However, in this way, the spectator, who is forced to re-establish her/his consciousness by taking a productive stance, comprehends the film more efficiently. Our goal is to reveal how Schrader utilised Benjamin’s “shock effect” in his film. To this end, we analysed the above-mentioned literary works and their film adaptations comparatively, with a particular focus on the “death-story” of Mishima.

Amaç: Sedoanaljezi eşliğinde entübasyon olmadan video yardımlı torakoskopik cerrahi (VATS) son on yılda minimal invaziv prosedürler için giderek daha popüler bir cerrahi teknik haline gelmiştir. Bu çalışmada ise, sedasyon veya torasik epidural anestezi kullanılamayan hastalarda sadece lokal anestezi ile uygulanan video yardımlı torakoskopi tekniğinin sunulması amaçlanmıştır. Gereç ve Yöntemler: 2009-2019 yılları arasında, genel anestezi riski yüksek olarak sınıflandırılarak uyanık halde video yardımlı torakoskopik cerrahi yapılan 43 hasta retrospektif olarak incelendi. 10 ml izotonik ile sulandırılan 10 ml %0,5 bupivakain, cilt altına ve kas içine uygulandı. 15 dakika sonra 10 mm 0 derece videotorakoskop için toraksa tek bir port insizyonunu takiben VATS uygulandı. Yaş, cinsiyet, başvuru yakınmaları, lateralite, efüzyon tipi, sitoloji sonuçları, hastaların komorbiditeleri, hastanede kalış süresi, efüzyon miktarı, ameliyat süresi ve patoloji sonuçları retrospektif olarak değerlendirildi. Bulgular: Yaş ortalaması 67,32 (45-85) olan kırk üç hastanın 23’ü erkek, 20’si kadındı. En sık yakınma (n = 40) dispne idi. 22 sol ve 21 sağ hemitoraksa VATS uygulandı. 39 hidrotoraks, 4 pnömotoraks olgusu vardı. Hidrotoraks tanılı olgulardan drene edilen ortalama sıvı miktarı 1311 ml (400-4000 ml) idi. Bül nedeniyle pnömotoraks gelişen 2 olguya wedge rezeksiyon yapıldı. Hiçbir hastaya kas gevşetici veya sedasyon verilmedi. Sonuç: Uyanık VATS seçilmiş hastalarda, kas gevşetici ve sedoanaljezi gerektirmediğinden güvenli bir tekniktir.

Objective: Methotrexate (MTX) is a commonly used chemotherapeutic agent in clinical oncology practice and in treatment of autoimmune diseases. The major side effect during treatment is mucositis. Recently published studies reported that this effect may be due to direct intestinal epithelial injury and disturbance of intestinal microbiota. In this study, we aimed to characterize the intestinal histological changes caused by MTX and to investigate the effects and safety of Sildenafil and probiotic Bacillus clausii on intestinal mucositis in a rat model. Materials and Methods: The rats were divided in 4 groups; Group1(n=8) received MTX + B. clausii, Group 2 (n=8) received only MTX, Group3 (n=8) received MTX + Sildenafil and Group 4 (n=7) was served as control (received no treatment). Results: The rate of villus atrophy, villous fusion and erosion in the MTX + B. clausii group were found to be statistically significantly lower than in the MTX group and the MTX + Sildenafil group. Conclusion: The study demonstrated the effect of B. clausii on repairing of intestinal mucosa after MTX-treatment. The better understanding of the effects of probiotics on intestinal mucosal protection may lead to new therapeutic approaches in chemotherapy-induced mucositis.

Objectives The aim of this study is to investigate the outcomes of coronavirus disease 2019 (COVID-19) in our cohort of Behçet’s disease (BD) patients and to reveal the rate of BD exacerbations due to COVID-19. Methods Patients who have been followed with a diagnosis of BD were retrospectively investigated for a positive severe acute respiratory syndrome–coronavirus 2 polymerized chain reaction (PCR) test. Data regarding demographics, clinical features and COVID-19 outcomes were collected from medical records for patients with a positive PCR. PCR-positive patients were reached via phone numbers, and ‘Behçet’s Disease Current Activity Form’ (BDCAF) scores for pre- and post-COVID-19 BD symptoms were calculated. Results Out of a total 648 BD patients, 59 were detected to have a positive PCR test. Three of the 59 patients (5.0%) were found to be hospitalized, none of them was admitted to the ICU or died. An increasing trend in the frequency of comorbid diseases and older age was observed in hospitalized patients. 32.2% of BD patients suffered from exacerbation of at least one symptom related to BD. Conclusions We observed no ICU admission or mortality with COVID-19 in our BD patient cohort. A substantial number of patients suffered from exacerbation of BD symptoms.

The aim was to define the clinical and histopathologic findings of infants who underwent muscle biopsy and identify the diagnostic yield of muscle biopsy in this cohort. Infants who underwent muscle biopsy from January 2010 to March 2017 at a tertiary hospital were included in the study (N = 87; 64 boys (73.6%), 23 girls (26.4%); age range 0 - 2 years; mean age 9.73 ± 7.04 months). Clinical and histopathologic data were obtained from medical records. Developmental delay (64.4%) and hypotonia (59.8%) were the most frequent clinical findings, and mitochondrial disease (61%) was the most frequent clinical diagnosis, followed by muscular dystrophy (15.9%) and congenital myopathy (11.5%). Creatine kinase level was normal in 65.9% and > 1,000 U/L in 17.1%. Specific pathologic findings were identified from 38 biopsies (43.7%). The most frequent pathologic findings were features compatible with mitochondrial/metabolic myopathy (14 patients, 16.1%) and muscular dystrophy (12 patients, 13.8%). Myopathic changes were present in 7 biopsy samples (8.0%) and neurogenic changes in 5 (5.7%). The clinical and pathologic diagnoses were compatible in 24 patients (63.2%). The diagnostic yield of muscle biopsy remains significant, especially in this age group. Mitochondrial disease is a major diagnostic challenge, and muscle biopsy helps to support the clinical diagnosis and guide further studies.

The global pandemic forced educational institutions worldwide to adapt to a new, fully online concept of education and a rapid digitalization to keep providing their services to learners. This paper reports on the digitalization process of the Independent Learning Center (ILC) and the Learning Advisory Program (LAP) unit at Ankara Yildirim Beyazit University (AYBU), Turkey. The interrelated digitalization stories of the two units include the provision of learning resources and activities to learners with digital tools and their responses to the new format. Despite the challenges involved, the ILC has offered a considerably higher number of extracurricular activities than in face-to-face education days and reached a higher number of learners in the 2020-2021 academic year. As for the LAP, the participants’ reflections showed how opportunities for offering engaging activities in the LAP created a cascading impact of affordances for both the individual learners and the members of the larger community.

Objective: The Hamilton Depression Rating Scale (HDRS-17) and the Hamilton Anxiety Rating Scale (HARS-14) have been acknowledged as gold standards in evaluating the severity of depression and anxiety. The specificity and sensitivity of these scales in predicting somatic complaints of depression and anxiety are issues in both clinical and research areas. The present study proposes a new model to enhance the sensitivity and specificity of HDRS-17 and HARS-14 for predicting symptoms of insomnia, inappetence, and loss of libido in psychiatric patients. Methods: This study included 1507 patients diagnosed with bipolar disorder, depression, panic disorder, obsessive-compulsive disorder, and generalized anxiety disorder. The HDRS-17 and the HARS-14 were utilized as predictive scales for the prediction of patients' sleep, appetite, and libido. The sensitivity and specificity were computed using the receiver operating characteristic (ROC). Logistic regression was performed to enhance the predictive values. The predictive value of the logistic regression model was not satisfactory, and a conversion table was therefore designed for each symptom-diagnosis subgroup. The new joint ROC model was then used to recalculate the sensitivity and specificity of the 2 scales for each symptom-diagnosis subgroup. The outcome is a prediction table, presented for use by clinicians. Results: It was observed that the new statistical model, the joint ROC, increased the sensitivity and specificity of the HDRS-17 and the HARS-14. Conclusion: Based on the results of the evaluations with the HDRS and the HARS, the joint ROC method was developed to better predict the presence of symptoms.

Aim: This study aimed to investigate the effect of blood groups on the risk and prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the infected/source cases and contact individuals. Material and Method: This study was designed as a descriptive and retrospective study. The individuals who were in contact with the SARS-CoV-2main/source cases and followed at home were included in the study.The distribution of the participants according to their blood groups was assessed. Patients were divided into three groups as group 1 including source/main cases, group 2 including SARS-CoV-2contacts who were living in the same house with the source case and followed up, and group 3 including contacts who were followed up in the same house but did not develop SARS-CoV-2 during the follow-up.Results: While the rate of Non-O blood group was the highest (n=365, 39.4%) in group 2the rate of O blood group was the highest (n=190, 42.8%) in group 3 (p:0.028). While the rate of Rh positive blood group was high in group 1 that of Rh negative blood group was higher in group 3 (p:0.000). For other variables, the presence of a chronic disease was more in group 1 (p:0.000). Rh (+) blood group (OR:0.464, p:0.010, %95 Cl: 0.306 ~ 0.703) was among the factors affecting the development of the infection. Conclusion: Patients infected with SARS-CoV-2 mostly had A, Non-O blood group and Rh positivity. Having Rh (+) blood group may have increased the rate of infection development in high-risk household contacts. After patients in this blood group were detected as contacts a closer follow-up may be necessary to decrease morbidity.

Planning ability is one of the core abilities and playing an essential role in problem-solving and decision-making process. Mainly, it is critical in childhood managing school-related demands and carrying out daily activities in older ages. This study aims to develop a computerized version of the 4-disc Tower of London (TOL) test. Method: The research was conducted by three studies, including children, adults, and combined samples. The research consisted of children and adults who were 5-53 years. Nonparametric tests were used, thereby that the research data had a non-normally distributed pattern. Research results show significant relationships between age and planning ability, the number of problems solved on the first trial, and the number of problems solved within three trials. Results show that increasing planning ability and the number of problems solved on the first trial was associated with increasing age. The increasing number of problems solved within three trials was associated with decreasing age. There was no significant relationship between age and planning time. Research results show that gender has an effect on planning time in the adult group. Reliability and validity results showed that the computerized version of 4-disc TOL was a reliable and valid measure as the original version. This study was conducted by healthy participants, so there is a need for psychometric study for clinical use in Turkish literature.

Objective To determine the potential predictors of antegrade ureteral stenting (AUS) failure in patients with malignant and benign ureteral obstruction. Method We retrospectively evaluated 116 AUS procedures performed in 80 patients for ureteral obstruction due to malignant and benign causes. Variables such as etiology for obstruction, ureter shape, previous treatment regimen, history of ileal loop diversion, and presence of percutaneous nephrostomy were recorded. Univariate and multivariate logistic regression methods were used between these variables and stent failure. Results Antegrade ureteral stenting was performed as single stage in 24 procedures (n: 24/116, 21%) and performed as a two-step approach after percutaneous nephrostomy in 92 procedures (n: 92/116, 79%). Ureteral stent was successfully deployed in 112 AUS procedures (n: 112/116, 96.5%). In 35 of these successful procedures, the patients were referred to our department due to prior failed retrograde ureteral stenting (RUS). Subsequent stent failure occurred in 40 procedures after a median interval of 39 days. Pre-stenting percutaneous nephrostomy (PN) was a statistically significant risk factor for stent failure (p: 0.041), and age showed an inverse relationship with stent failure (p: 0.008). Complications in early (within the first 30 days after procedure) and late stage occurred in a total of 17 procedures. Early complications included urinary tract infection (n: 11), stent migration (n: 3), and malposition (n: 1). Late complications (after 30 days) were urinary tract infection (n: 1) and stent migration (n: 1). Conclusion This study suggests that AUS can be performed effectively in both benign and malignant ureteral obstructions including cases with prior failed RUS. Two-step AUS after percutaneous nephrostomy was found to be a significant risk factor for subsequent stent failure in our study cohort.

Objectives:Even though multiple sclerosis (MS) is not considered to be a painful disease, painful symptoms are frequently encountered in patients with MS. The objective of this study was to investigate various types of pain and clinical features associated with these pains in patients with MS.Materials and Methods:Seventy consecutive patients followed up with relapsing remitting MS were included in the study. Besides demographic and clinical characteristics of patients, expanded disability status scale (EDSS) scores, cranial and spinal demyelinating lesions were recorded. Patients were investigated for migraine, tension-type headache (TTH), treatment-related headache, Lhermitte sign, neuropathic limb pain, painful tonic spasms, low back pain, and mechanical limb pain, and also evaluated for associated fatigue, depression and anxiety symptoms.Results:Of the 70 patients (54 females, 16 males, mean age 36.2±7.9) 64 had one or more painful disorders (91.4%). Low back pain was the most common painful symptom (48.6%) followed by migraine (38.6%) and treatment-related headache (31.1%). Fatigue, depression and anxiety were found to be more frequently in patients with migraine than in those without migraine (p=0.027, p=0.01 and p=0.016, respectively). The duration of MS was longer in patients with neuropathic pain (p=0.018). Patients with neuropathic limb pain, Lhermitte sign, and low back pain had higher EDSS scores (p

Objectives The goal of treatment in essential thrombocytosis (ET) is to prevent vascular complications such as thrombosis and hemorrhage. This study aimed to evaluate the risk of cerebrovascular microembolism in ET patients due to detection of microembolic signals (MES) and measure cerebral blood flow velocity (CBFV) by Transcranial Doppler (TCD) ultrasonography. Material and Methods In this prospective case-control study, forty patients with diagnosed ET and age and sex-matched forty healthy controls were examined by the TCD sonography. Results The ET group had a higher rate of MES (8/40) in the right MCA than that in the control group (none), as measured by TCD. Five patients had MES at the left MCA compared to that in no subjects in the control group. The comparison of the ET and control groups in terms of CBFV parameters showed significantly lower end-diastolic FV at the right MCA in the ET group compared to that in the control group (p < 0.05). On the other hand; both pulsatility and resistance indices in the right and left MCA and the ratios of systolic to diastolic blood flow rates in the right and left MCA were significantly higher in the ET group than that in the control group. Discussion This study revealed that MES seems to be more common in patients with ET despite treatment. We could suggest that ET patients should be monitored more closely to address the potential risk of developing a cerebrovascular disease, which can be estimated by detection MES and raised CBFV, combine antiplatelet therapies to standard treatments. Bezmiâlem Vakıf Üniversitesi

The association of carotid atherosclerosis with silent brain infarcts (SBIs) and white matter lesions (WMLs) currently remains unknown. This study aims to compare SBIs, deep white matter lesions (DWMLs), and periventricular white matter lesions (PWMLs) in ipsilateral and contralateral hemispheres to internal carotid artery (ICA) stenosis, and investigate their association with stenosis grade in patients with asymptomatic ≥ 50% unilateral extracranial ICA stenosis. Patients without previous history of stroke and/or transient ischemic attack who had ≥ 50% stenosis in unilateral ICA on carotid color Doppler ultrasound were enrolled in the study. Patient demographics, vascular risk factors and ICA stenosis grades; number, location, and size of SBIs, DWMLs, and PWMLs in ICA territory were evaluated in both hemispheres using magnetic resonance imaging of the brain. Of the 69 patients, 53 had 50-69% (76.8%) and 16 had ≥ 70% (23.2%) unilateral ICA stenosis. There was no statistically significant difference in SBIs between ipsilateral and contralateral hemispheres to ≥ 50% ICA stenosis. Comparison of ICA stenoses as 50-69% and ≥ 70% revealed a greater number of patients with SBI in ipsilateral hemisphere to ≥ 70% stenosis compared to contralateral (p = 0.025). The number of SBIs was also higher in ipsilateral hemisphere to ≥ 70% stenosis compared to contralateral (p = 0.022). While DWMLs and PWMLs did not differ between hemispheres, frequency of Fazekas grade 1 DWMLs was lower in ipsilateral hemisphere to either 50-69% or ≥ 70% ICA stenosis compared to contralateral (p = 0.035 and p = 0.025, respectively). Results of the present study indicate that stenosis grade may be relevant in the association between asymptomatic carotid stenosis and SBIs, and ≥ 70% stenosis may pose a risk of SBI development.

WOS:000564506100008 Objective: Adrenocortical cancer (ACC) is one of the rare endocrine system cancers that are aggressive. Despite surgical treatment, the mortality rate is quite high. This study aimed to examine prognostic factors affecting survival in patients with ACC, the role of dehydroepiandrosterone sulfate (DHEA-S), and the maximum standard uptake (SUVmax) values on predicting mortality through the single-center data. Material and Methods: A total of 21 patients who were diagnosed with adrenal cancer and followed from a single center were included in the study. Patients who survived follow-ups were included in the survived group (n=6), and those who died were included in the dead group (n=15). The demographic, anatomical, pathological, and clinical characteristics of the patients were analyzed. Positron emission tomography- computerized tomography imaging and SUVmax values of adrenal masses were compared. The effect of all these data on survival was examined. Results: The mortality rate among patients with ACC was 71%. According to the Kaplan-Meier survival analysis, the average life expectancy was 23.66±2.79 (95% CI=18.18-29.13) months. The mass size of the survived and dead groups was 9.2±3.82 cm and 10.84±4.74 cm, respectively. The production rate of adrenal hormone was higher in the dead group (p

Diffuse Large B-cell lymphoma is a subgroup of nonHodgkin's lymphoma. Lymphoma with endobronchial pulmonary involvement is a rarely reported condition. A 64-year-old male patient was admitted to our clinic with complaints of swellings in the neck and in the bilateral upper limbs, along with shortness of breath. A computed tomography of the thorax revealed diffuse mediastinal enlargement with a superior vena cava obstruction, and a huge right hilar mass formation obliterating the anterior segment of the right upper lobe. A diagnostic fiberoptic bronchoscopy showed mucosal irregularity and an endobronchial lesion on the anterior segment of the right upper lobe. A diagnosis of endobronchial lymphoma was made following bronchial biopsies. Diffüz büyük B hücreli lenfomalar non-Hodgkin lenfomaların subtipini oluştururlar. Lenfomaların endobronşial invazyonu oldukça nadirdir. Nefes darlığı, boyun ve üst ekstremitede şişlik şikayeti olan 64 yaşında erkek hasta kliniğimize başvurdu. Toraks tomografisinde üst mediastende büyümüş lenf nodları, vena cava süperiorda daralma ve sağ hiler büyümüş lenf nodları izlendi. Fiberoptik bronkoskopisinde sağ akciğer üst lob anterior segmentte endobronşiyal lezyon izlendi. Fiberoptik bronkoskopik biyopsi ile endobronşiyal lenfoma tanısı doğrulandı.

In this study, the removal of UV254, phenol, and calcium from paper industry wastewater by persulfate oxidation was investigated. Fe2+ addition and heat application methods were used for persulfate...

Amaç İlk olarak Aralık 2019’da Çin’in Wuhan kentinde ortaya çıkan ve Dünya Sağlık Örgütü tarafından SARS-CoV-2 olarak adlandırılan yeni koronavirüs, Covid-19 hastalığına neden oldu ve küresel ölçekte bir pandemi başlattı. Başlangıçta hipoksik solunum yetmezliği ile kendini gösteren hastalık, vücuttaki tüm sistemleri de etkileyerek multiorgan yetmezliğine ve ölüme sebebiyet veren progresif bir gelişim gösterdi. Özellikle şiddetli progresyon gösteren Covid-19 olgularında kontrolsüz sitokin üretimi gözlenmekte ve bu durumun artmış mortalitenin nedenlerinden biri olduğu düşünülmektedir. Covid-19 hastalığı nedeniyle yoğun bakımımızda yatmakta olan ve SARS-CoV-2 virüsünün tetiklediği kontrolsüz sitokin üretimi sonrası sitokin salınım sendromu ve/veya sitokin fırtınası geliştiğini düşündüğümüz hastalara Coupled Plasma Filtration Adsorption(CPFA) ve Tosilizumab tedavileri uyguladık. Çalışmamızda bu tedavilerin etkinliklerini, geriye dönük dosya ve arşiv taraması üzerinden değerlendirmeyi amaçladık. Materyal ve Metod Çalışmamızın etik kurul onayı, Sağlık Bilimleri Üniversitesi Hamidiye Klinik Araştırmalar Etik Kurulu’ndan 17/06/2020-18521 sayılı yazı ile alınmıştır. Çalışmamıza Covid-19 hastalığı sebebiyle Şubat-Haziran 2020 tarihleri arasında yoğun bakım ünitemizde yatmış, sitokin salınım sendromu ve/veya sitokin fırtınası geliştiği düşünülmüş ve tedavi amacıyla CPFA veya Tosilizumab uygulanmış hastalar dahil edildi. Çalışmamız her tedavi grubundan 20’şer hastanın verileri retrospektif olarak taranarak planlandı. CPFA uygulamaları, her seans 10 saat olacak şekilde ve 12 saat ara verilmek suretiyle 2 seans olarak yapılmıştır. Tosilizumab uygulaması 8 mg/kg dozdan, maksimum 800 mg olacak şekilde, 1 saatlik sürede intravenöz yoldan yapılmıştır. CPFA ve Tosilizumab uygulamaları başlamadan hemen önce, uygulamalar sonrası 24. saat, 48. saat ve 7. gün ölçülen ve hesaplanan SOFA skorları, Horowitz index değerleri (PaO2/FiO2), ateş değerleri, inotrop varlığı, SpO2 ve ilgili birtakım laboratuvar değerleri(IL-6, Lenfosit sayısı, CRP, D-dimer) dosyalarından ve sistemsel verilerden temin edildi. Bulgular CPFA ve Tosilizumab tedavileri sonrası ateş ve IL-6 değerlerinde düşme, SpO2 ve lenfosit değerlerinde artış, Horowitz ve SOFA skorlarında artış, CRP ve D dimer değerlerinde azalma izlenmiştir. SpO2 ve Horowitz skoru değerlerinde artış CPFA grubunda anlamlı olarak daha yüksekti. 7. günün sonunda ateş değerlerinde düşme ve SOFA skorlarında artış ile CRP - D dimer değerlerinde düşme CPFA grubunda anlamlı olarak daha belirgindi. İnotrop desteğinde azalma CPFA grubunda izlendi. Sonuç Covid-19 hastalığında bağışıklık sisteminin etkilenmesi sonrası gelişen sitokin salınım sendromu ve/veya sitokin fırtınası ile hastalık daha ağır seyretmektedir. CPFA ve Tosilizumab tedavileri ile inflamatuar sitokin üretimi kontrol altına alınarak, hastaların oksijenizasyonunda ve klinik bulgularında düzelmeler sağlanmıştır.

The primary aim of this study was to compare the 25(OH)D level between patients with COVID-19 and the reference population. The secondary aim was to determine the association of 25(OH)D level with COVID-19-related in-hospital mortality.The COVID-19-positive group comprised 520 hospitalized patients and the reference population comprised 15,789 COVID-19-negative patients. The 25(OH)D level was categorized as vitamin D deficiency (25[OH]D 20 ng/mL) and severe vitamin D deficiency (25[OH]D 12 ng/mL).While the incidence of vitamin D deficiency was similar in both groups, the incidence of severe vitamin D deficiency was higher in patients with COVID-19 than in the reference population (68.3% [Severe vitamin D deficiency is more common in patients with COVID-19 and may play a significant role in worsening the prognosis of these patients. However, the 25(OH)D level was not observed to effect COVID-19-related in-hospital mortality.

The pandemic caused by the COVID-19 epidemic, which is effective worldwide and continues to show its negative effects in every field, has also shown its negative effects in higher education and an urgent transition to distance education has been experienced. With distance education, teacher candidates in education faculties started to see applied courses in a theoretical way. Continuing education and training activities, including the teaching practice, which is based on practice, are carried out online, and the positive or negative aspects of this progress on students could not be evaluated due to the rapid and unpreparedness of the process. With this research, it was aimed to obtain and evaluate the opinions of teacher candidates regarding distance education and teaching practices during the pandemic process. The case study, which is one of the qualitative method patterns, was used in the research. The collected data were analyzed with content analysis technique, and the MAXQDA 2020 package program was used in data analysis. The study group of the research consists of teacher candidates who are studying at Canakkale Onsekiz Mart University Faculty of Education and who also take the course of distance education and teaching practice. In line with the findings, it was concluded that the pre-service teachers found distance education inadequate due to the way the lessons were taught and internet problems, and that the continuation of the teaching practice with distance education would create a lack in terms of experience. In the research, there are also the results that distance education has deficiencies in terms of communication and distance from the classroom environment, and the instructors are deemed sufficient in this process.

BACKGROUND: Critical diseases usually cause hypercortisolemia via activation of the hypothalamic-pituitary-adrenal axis. OBJECTIVES: To investigate the relationship between serum total cortisol level and mortality among coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU), at the time of their admission. DESIGN AND SETTING: Prospective study developed in a pandemic hospital in the city of Şırnak, Turkey. METHODS: We compared the serum total cortisol levels of 285 patients (141 COVID-19-negative patients and 144 COVID-19-positive patients) followed up in the ICU. RESULTS: The median cortisol level of COVID-19-positive patients was higher than that of COVID-19 negative patients (21.84 μg/dl versus 16.47 μg/dl; P < 0.001). In multivariate logistic regression analysis, mortality was associated with higher cortisol level (odds ratio: 1.20; 95% confidence interval: 1.08-1.35; P = 0.001). The cortisol cutoff point was 31 μg/dl (855 nmol/l) for predicting mortality among COVID-19-positive patients (area under the curve 0.932; sensitivity 59%; and specificity 95%). Among the COVID-19 positive patients with cortisol level ≤ 31 μg/dl (79%; 114 patients), the median survival was higher than among those with cortisol level > 31 μg/dl (21%; 30 patients) (32 days versus 19 days; log-rank test P < 0.001). CONCLUSION: Very high cortisol levels are associated with severe illness and increased risk of death, among COVID-19 patients in the ICU.

Objectives: Scaphoid nonunion still creates a big challenge for hand surgeons due to high failure rates after surgery, particularly in proximal pole fractures. The pedicled vascularized bone graft (VBG) is a valuable option to achieve union and good outcomes. This study aimed to analyze the clinical and radiological results of patients who underwent scaphoid fixation with pedicled VBG due to non-union of a scaphoid fracture. Methods: The patients who were operated due to scaphoid non-union and underwent fixation with pedicled VBG between 2017 and 2018 were reviewed retrospectively. The patients were evaluated both preoperatively and postoperatively. The clinical assessments included; the range of motion, grip strength, Mayo wrist score, and visual analogue scale (VAS) pain score. The presence of bony union was evaluated with direct radiographs. Results: Eight patients were included in the final analysis. Four patients who had waist non-union were reconstructed with volar pedicled VBG, while the other four patients with proximal non-union were reconstructed with dorsal 1,2 ICSRA pedicled VBG. The average age was 28.7 and the average follow-up was 12.3 months. The bony union was achieved in 7 patients at average 3.1 months with gain of both range of motion and grip strength. The average VAS pain score was improved from 6.8 to 2. The average Mayo wrist score was improved from 52.2 to 80.4. Conclusion: The application of pedicled VBGs harvested from the distal radius provides good clinical and radiological outcomes in the treatment of scaphoid non-unions. [Hand Microsurg 2021; 10(2.000): 104-109]

We report the case of a 54-year-old woman who presented to the ear, nose, and throat (ENT) outpatient clinic with hearing loss, tinnitus, and fullness in her right ear. In the first clinical examination, a pouch hanging in the anterior upper quadrant was detected in the tympanic membrane of the right ear. A tick larva was found in the cyctic lesion located on the tympanic membrane. Our case was unique due to this unexpected diagnosis.

BACKGROUND: In many studies, vitamin D has been found to be low in COVID-19 patients. In this study, we aimed to investigate the relationship between clinical course and inhospital mortality with parenteral administration of high-dose vitamin D3 within the first 24 h of admission to patients who were hospitalized in the intensive care unit (ICU) because of COVID-19 with vitamin D deficiency. METHODS: This study included 175 COVID-19 patients with vitamin D deficiency [25(OH) D

OBJECTIVE Maternal mood disorders such as postpartum depression (PPD) can negatively affect the lives not only of mothers but also of partners. The purpose of this study investigates emotional behavior and hippocampal apoptosis alterations of the male live with a postpartum depressed female. METHODS Pregnant rats in the stress group were exposed to restraint stress (RS). The male rats who shared the same cages were not exposed to RS. To explain the consequences of depressive-like behavior and anxiety, animals were exposed to the forced swim test (FST), open-field test (OFT), and elevated plus maze (EPM). The apoptotic cell number was detected by terminal deoxynucleotidyl transferase (Tdt)-mediated dUTP biotin nick-end labeling (TUNEL) staining. RESULTS According to FST, PPD caused more immobility, reduced swimming, and climbing compared to control groups in the stressed female and male (p

The level of development throughout the world is explained on the basis of various criteria population are some of these development indicators. For many countries, the rural population and the characteristics of this population are accepted as an important indicator of development. Also, in Turkey, focusing the rural population particularly on the issue of rehabilitation since the founding of the Republic remained on the agenda. Indeed, the rural population in Turkey since the first years of the Republic showed a great change and transformation in terms of both quantitative and qualitative. The continuous contraction of the share of the rural population in the face of the urban population, the change in the rural labor force and finally some changes in the administrative sense, led to the situation of addressing the rural population and especially the female population from a significantly different perspective. Finally, in 2012, in accordance with Law No. 6360, Metropolitan Municipality 30 Metropolitan Municipalities organized in Turkey, rural population in these cities was adopted as 0 (zero). In addition to the many disadvantages of this situation, there are drawbacks to criticism in terms of ignoring the presence of women, which constitutes the largest part of the informal labor force in rural areas. It is debatable that rural women, who are deprived of their social rights and have a low level of awareness and quality of life, are inaccessible with the relevant law in comparison with the relatively urban women. In this study, the state of the overall presence of women in rural areas as a result of administrative arrangements with the relevant distribution in Turkey explained the outlines of the female population in the metropolitan municipalities in rural areas was discussed.

Amac: Okult Hepatit B Virus (HBV) enfeksiyonu (Occult HBV infection; OBI) mevcut serolojik testler ile HBV yuzey antijeni (Surface antigen; HBsAg) negatif tespit edilen bireylerin karacigerinde HBV genomunun uzun sureli persistan varligi ile karakterizedir. Bu calismada OBI tanili hastalardan elde edilen HBV’lerin genotip, subgenotip ve subtip profillerinin karakteristiginin irdelenmesi amaclanmistir. Gerec ve Yontem: Calismaya HBsAg negatif farkli klinik endikasyonlar nedeniyle karaciger parankim biyopsisi gerceklestirilen hastalarin karaciger biyopsi orneklerinde Nested PCR yontemiyle HBV DNA varligi tanimlanan 32 OBI tanili hasta ile 17 kronik hepatit B hastasi dahil edildi. HBV S gen MHR bolgesini hedefleyen DNA fragmanlari nested PCR kullanilarak amplifiye edildi. HBV’nin genotip, subgenotip ve subtip/serotiplerinin belirlemek icin Sanger sekans metodu kullanildi. Bulgular: Bu calismada OBI ve kronik hepatit B hastalarindan izo le edilen HBV’lerin tumununun genotipi D, subgenotipler sirasiyla HBV/D1 (%75,5), HBV/D2 (%6,1) ve HBV/D3 (%18,4) serotipler sirasiyla ayw2 (%73,5) ve ayw3 (%26,5) olarak belirlenmistir. OBI’li hastalarin %28,1’nin subgenotipi HBV/D3 olarak belirlenmesine karsin kronik hepatit B hastalarinin hic birinde HBV/D3 subgenotipi saptanmamistir. Sonuc: Subgenotip HBV/D3’un viral biyogenezin dinamigi uze rindeki potansiyel etkileri HBsAg negatifligi ve dusuk replikasyon yetkinligi ile karakterize OBI ile iliskili olabilir.

Hyperferritinemia may develop due to various reasons such as inflammation, infection, or malignancy. The purpose of the study to explore the prevalence and to figure out the causes of general hyperferritinemia and extreme hyperferritinemia as detected through the ferritin measurements requested by the rheumatology department. Adult patients at the age of 18 years and older with at least one serum ferritin level measurement at or above 500 ng/mL as requested by the rheumatology department between January 2010 and December 2019 were evaluated retrospectively. Hyperferritinemia was detected in 4.7% of 11,498 serum ferritin tests. The mean age of 242 patients found to have hyperferritinemia was 53.7 ± 17.1 years; of the patients, 63.2% were female, and the mean serum ferritin value was 2820 ± 5080 ng/mL. The most common cause of hyperferritinemia was rheumatological diseases with a ratio of 59.1%, which was followed by infections, iron overload, and solid malignancy. Among the rheumatologic diseases, adult-onset Still’s disease (AOSD), rheumatoid arthritis, and vasculitis were the cause accounting for hyperferritinemia. Ferritin levels were significantly higher in the AOSD group compared to the other rheumatologic disease groups (p