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Chemical composition of forage crops (35% hungarian vetch, 35% forage peas, 10% oats, 10% triticale, 10% wheat) of different harvest times and fertilizer applications at different doses, relative feed value (RFV), relative feed quality (RFQ , energy contents (ME, NEL), in vitro digestibility parameters (TNDFD, TOMD, TDN, DMI), in vitro gas production, methane (CH4) production, fractionation factor (PF), microbial protein (MP) and microbial protein synthesis efficiency Ankom Daisy in vitro fermentation system and in vitro gas production technique were used in the research carried out to determine their effects on (MPSE) and true degree of digestion (TDD). Harvesting at different times significantly affected (P, Farklı hasat zamanı ve farklı dozlarda gübre uygulamalarının yem bitkileri karışımının (%35 macar fiği, %35 yem bezelyesi, %10 yulaf, %10 tritikale, %10 buğday) kimyasal kompozisyonu, nispi yem değeri (NYD), nispi yem kalitesi (NYK), enerji içerikleri (ME, NEL), in vitro sindirilebilirlik parametreleri (GNDFS, TOMS, TSB, KMA), in vitro gaz üretimi, metan (CH4) üretimi, taksimat faktörü (PF), mikrobiyal protein (MP) ile mikrobiyal protein sentezleme etkinliği (MPSE) ve gerçek sindirim derecesi (GSD) üzerine olan etkilerini belirlemek amacıyla yürütülen araştırmada Ankom Daisy in vitro fermentasyon sistemi ve in vitro gaz üretim tekniği kullanılmıştır. Farklı zamanlarda yapılan hasat karışımın, HP, HS, NYD, NYK, ME ile NEL, GNDFS, TOMS, TSB, KMA, GÜ, Metan (ml), GSKM ve GSD değerlerini önemli derecede (P

Fayların belirlenmesi ve özelliklerinin ortaya konulması doğal afet risklerinin belirlenmesi, güvenli şehir altyapısı, büyük mühendislik yapılarının duraylılığı, yeraltı suları ile mineral zonlarının belirlenmesi açısından büyük önem taşımaktadır. Faylar yeryüzünde belirgin çizgisel yapılar oluştururlar ve bunlar genellikle yüzeyden kolayca ayırt edilebilirler. Fayların tespit edilmesi, haritalanması ve ilgili saha çalışmaları oldukça emek yoğun çalışma gerektirmektedir. Saha çalışmalarının yoğunluğunu azaltmak ve daha geniş alandaki yapısal bütünlüğü algılamak için hava fotoğrafları, yükseklik haritaları ve uydu görüntüleri kullanılmaktadır. Arazide sadece faylar değil, karayolu, demiryolu ve insan yapımı çit vb. karşıtlık oluşturan birçok farklı çizgisel yapı bulunmaktadır. Bu çizgiselliklerin tespiti ve analizinde uzaktan algılama görüntüleri yaygın olarak kullanılmaktadır. Bu çalışmada Landsat-7 (ETM+) uydu görüntülerinden yararlanılarak filtreleme, temel bileşenler analizi (TBA), bant oranlama, FCC (False Color Composite) bant kombinasyonları görüntüleme, sonuç çizgisellik haritası ve otomatik çizgisellik çıkarımı yöntemleriyle çizgisellik analizleri yapılmıştır. Elde edilen sonuçlar arazi çalışmalarından elde edilen verilerle karşılaştırılmıştır. Yöntemlerle genel çizgisellik hatları ortak olarak belirlenebilirken, belirlenen nesne sayısında farklılık olduğu, yönteme göre çizgiselliğe ait nesne sayısının değişebildiği ve en fazla nesne sayısının otomatik çizgisellik çıkarımı yöntemi ile üretildiği belirlenmiştir.

Müfessir kimliği takdir edilmekle birlikte siyasi fikirleri, hadiste isnada yer vermemesi ve âyetleri yorumlarken İsrâiliyat türü bilgilere çokça yer vermesi gibi nedenlerle şiddetli tenkitlerin hedefi olan Mukâtil b. Süleyman, Kur’an-ı Kerim’i âyet sırasına göre başından sonuna kadar tefsir eden ilk müfessirdir. Rivayet ve dirayet yöntemini birlikte kullandığı et-Tefsîru’l-kebîr isimli eserinde, âyetleri açıklarken bir yöntem olarak esbâb-ı nüzûl rivayetlerini her zaman dikkate almıştır. Esbâb-ı nüzul, ilk devirlerden itibaren Kur’an’ı anlama konusunda ayrıcalıklı bir konuma sahip olmuştur. Bu sebeple ilk tedvin edilen Kur’an ilimleri arasında yer alan esbâb-ı nüzûlün, et-Tefsîru’l-kebîr’de nasıl ve ne şekilde ele alındığı önem arz etmektedir. Böyle bir çalışma, aynı zamanda erken dönem esbâb-ı nüzûl algısı hakkında bilgi verecektir. Bu çalışmada, öncelikle Mukâtil b. Süleyman’ın hayatı ve esbâb-ı nüzûl ilmi hakkında bilgi verilmiştir. Akabinde et-Tefsîru’l-kebîr bağlamında, Mukâtil b. Süleyman’ın esbâb-ı nüzûl rivayetlerine yaklaşımı, en önemlisi esbâb-ı nüzûlün (te‘addudü’l-esbâb ve te‘addudü’n-nüzûl gibi) problem alanlarının bu tefsirde yer alıp almadığı meselesi üzerinde durulmuştur., Muḳātil Ibn Sulaymān is the first commentator to interpret the Qur’ān from the beginning to the end according to the verse order. Although his commentator identity is appreciated, he has been the target of severe criticism for reasons such as not including isnād (chain of reporters) in the hadith, and the fact that he gives a lot of information from Israelite sources when interpreting the verses. In his work al-Tafsīr al-kabīr, in which he used the method of narration and acumen together, he always took into account the narrations of asbāb al-nuzūl (Occasions of revelation) as a method when explaining the verses. Asbāb al-nuzūl has had a privileged position in understanding the Qur’ān since the first periods. For this reason, it is important how and in what way the first teachings of the asbāb alnuzūl, which is among the Qur’ānic disciplines, are handled in al-Tafsīr al-kabīr. Such a study will also give information about the perception of early age asbāb al-nuzūl. In this study, first of all, information is given about the life of Muḳātil Ibn Sulaymān and the discipline of asbāb al-nuzūl. Subsequently, in the context of al-Tafsīr al-kabīr, Muḳātil Ibn Sulaymān's approach to asbāb al-nuzūl narrations, most importantly, the issue of whether the problem areas of asbāb al-nuzūl (plurality of reasons for the revelations and plurality of revelations etc.) are included in this commentary, is discussed.

Seismicity and geological data take an important place in the planning of any city. Although the planning process and the formation of cities take place on earth, it is important to determine the geological structure of the underground and the frequent changes of this structure in shallow depths in three dimensions. Evaluation of this change with geophysical (geological) information is the main factor that determines the distribution of land use above ground. Edirne province and districts earthquake zones map I. IV. It is located within the degree earthquake zone. Enez, Keşan and Ipsala, one of the districts of Edirne, are very close to the northern branch of the North Anatolian Fault Zone (NAFZ), which reaches the Aegean sea from the Saros gulf. For this reason, they are located in the 1st Degree earthquake zone and are the most affected by any earthquake that may occur in NAFZ (from Marmara sea to Saroz gulf). Therefore, considering the seismicity of Edirne province, the city plans of Keşan, Enez and Ipsala districts, which are very close to the NAFZ, have been evaluated in terms of seismicity and evaluated as sensitive to disaster. Within the framework of mitigation planning, proposals for a solution to the revision of plans were tried to be developed., Bir kentin planlanmasında depremsellik durumu ve jeolojik veriler önemli bir yer tutmaktadır. Her ne kadar planlama süreci ve kentlerin oluşumu yeryüzünde gerçekleşse de yeraltının jeolojik yapısı ve bu yapının sığ derinliklerde üç boyutta da çok sık değişiminin belirlenmesi önemlidir. Bu değişimin jeofizik (/jeolojik) bilgilerle değerlendirilmesi, yer üstündeki arazi kullanım dağılım biçimini belirleyen temel unsurdur. Edirne ili ve ilçeleri Deprem Bölgeleri Haritasında I.- IV. Derece Deprem Bölgesi içerisinde yer almaktadır. Edirne’nin ilçelerinden Enez, Keşan ve İpsala Kuzey Anadolu Fay Zonunun (KAFZ) Marmara denizinde devam ederek Saroz körfezinden Ege denizine ulaşan kuzey koluna çok yakındır. Bu nedenle 1. Derece deprem bölgesinde yer almaktadırlar ve KAFZ’da (Marmara denizinden Saroz körfezine kadar) meydana gelebilecek herhangi bir depremden en fazla etkilenecek yerleşim birimleridir. Bu nedenle Edirne ili depremsellik durumu göz önünde bulundurulduğunda KAFZ’na çok yakın olan Keşan, Enez ve İpsala ilçelerinin kent planları depremsellik açısından yeniden ele alınarak afete duyarlı olarak değerlendirilmiştir. Sakınım planlaması çerçevesinde planların revizyonuna yönelik çözüm önerileri geliştirilmeye çalışılmıştır.

Ramor 500 zırh çeliği; 2-30 mm kalınlıklara sahip, 505-590 HV sertliklerde bulunan yüksek mukavemetli bir balistik koruma çeliği olarak sınıflandırılır. Aşınma, kayma yüzeyleri arasındaki mekanik etkinin etkisiyle yüzeyler üzerinde malzemenin deformasyonuna ve kaybına neden olan bir etkileşim işlemidir. Bu çalışmada, konstrüksiyon imalat sanayisinde kullanılan Ramor 500 çeliğinin ısıl işlem sonrası mikroyapı, mikrosertlik ve abrasiv aşınma direncine etkisinin taguchi metoduyla değerlendirilmesi ve etkileri incelenmiştir. Bu amaçla Ramor 500 çeliği 900oC sıcaklıkta tavlanmış ve 3 faklı ortamda soğutulmuştur. İnceleme sonucunda mikroyapı ve mikrosertlik incelenmiştir. Ayrıca ısıl işlemsiz numunelerle kıyaslamak maksadıyla abrasiv aşınma testine tabi tutulmuştur. Elde edilen veriler Taguchi metoduyla değerlendirilip Varyans analizleriyle seviye ve parametrelerin aşınmaya olan etkileri gözlemlenmiştir.

Kur’an-ı Kerim, insan eseri olan ve konularına göre tasnif edilen kitaplardan birçok yönüyle ayrılır. Onun kendine özgü bir üslubu ve iç düzeni vardır. Kur’an’ın en küçük bölümlerine ayet, ayetlerin oluşturduğu bölümlerine de sure denir. İlk dönemlerden itibaren Kur’an sureleri (isimleri, ayet sayıları, sebeb-i nüzulü, konusu, Mekkî-Medenî özelliği, fazileti vb.) hakkında hem müstakil eserler yazılmıştır hem de tefsirlerin sure mukaddimelerinde giriş niteliğinde açıklamalar yapılmıştır. Sureyi birçok açıdan tanıtan bu tür bilgiler, surenin doğru anlaşılmasına yardım ettiği gibi okuyucunun da surenin mesaj ve muhtevasına yoğunlaşmasına katkı sağlamaktadır. Bu çalışma, klasik ve çağdaş tefsirlerin sure mukaddimelerinde yer alan sure kimlikleriyle ilgili bilgiler bağlamında, müfessirlerin sure bütünlüğüne yaklaşımlarını ele almayı, akabinde bu meselede klasik-çağdaş tefsir mukayesesi yapmayı hedeflemektedir.

WOS:000621799100001 PMID: 33631986 Aim: To assess the efficacy and tolerability of the first-line treatment options for hormone-refractory prostate cancer patients with visceral metastases. Materials and methods: The records of 191 patients diagnosed with hormone-refractory prostate cancer with visceral metastases were analyzed retrospectively. Results: Docetaxel was administered to 61.2% (n = 117), abiraterone to 14.2% (n = 27) and enzalutamide to 9.4% (n = 18) as the first-line treatment. The median survival of the patients receiving docetaxel, abiraterone and enzalutamide as the first-line treatment during the hormone-refractory period was 15 (95% Cl: 12.9-17) months, 6 (95% Cl: 1.8-10.1) months and 11 (95% Cl: 0.9-23.1) months (p = 0.038), respectively. Conclusion: The present study established a statistically significant difference in favor of docetaxel in terms of overall survival and progression-free survival. Lay abstract The optimal therapeutic option for castration-resistant prostate cancer (CRPC) patients with visceral metastases is unknown. We assessed the efficacy and tolerability of the first-line treatment options for CRPC patients with visceral metastasis. One hundred ninety-one patients diagnosed with CRPC with visceral metastases were included in the study. The present study established a statistically significant difference in favor of docetaxel in terms of overall survival and progression-free survival between first-line docetaxel, abiraterone and enzalutamide treatments in CRPC patients with visceral metastases. For patients who cannot undergo chemotherapy, enzalutamide, among novel androgen pathway inhibitors, may be the most appropriate option, given its numerical, although statistically insignificant, difference in overall survival and its fewer side effects compared with abiraterone.

Geçmişte yaşamış farklı medeniyetler inşa ettikleri anıtsal yapılarla günümüze önemli kültürel miraslar bırakmışlardır. Bu yapıların en ihtişamlıları ve döneminin özelliklerini yansıtan; kilise, cami gibi önemli dini yapılar genellikle yerleşim yerlerinin merkezinde inşa edilmiştir. Sonrasında gelen toplum bu yapıları kendi inançları doğrultusunda kullanarak şekillendirmişlerdir. Estetik görünüşlerinin yanında birçok medeniyetin kültürel hafızasını günümüze taşıyan tarihi yapıların korunması ve gelecek nesillere aktarılması insanlığın görevlerindendir. Doğu Karadeniz Bölgesi’nde yer alan Artvin ili ve çevresi zengin tarihe sahip olmakla birlikte farklı uygarlıklara da ev sahipliği yaptığı bilinmektedir. Bu çalışmada Tbeti (Cevizli) kilisesinin yapısal durumunun belirlenmesi, onarım ve güçlendirme için deplasman ölçümleri ele alınmıştır. Deplasman ölçümleri tek periyot olarak tasarlanmıştır. Duvarların üst kısımlarında oluşan hasarlar zemine yakın duvarlar baz alınarak incelenmiştir. Fotogrametrik olarak elde edilen veriler robust regresyon ve polinomal eğri uydurma yöntemleriyle değerlendirilmiştir. Değerlendirme sonucunda yapının kuzey kesiminde bulunan duvarlarda 5 cm’ye varan deplasmanlar tespit edilmiştir. Örnek bir çalışma olarak yığma yapım sistemiyle inşa edilen Tbeti kilisesinde meydana gelen deplasmanlar sunulmuştur. Çalışma sonucunda tek periyotluk ölçüler ile kilise ve diğer yapılarda duvarlar boyunca meydana gelen sapmaların düşeysel olarak tespit edilebileceği kanısına varılmıştır. The different civilizations that live in the past have left important cultural heritage to the present day with the monumental structures they built. The most magnificent of these structures and reflect the characteristics of their era; important religious buildings such as churches and mosques were usually built in the center of settlements. The later societies shaped these structures in line with their own beliefs. In addition to the aesthetic aspects, the preservation of historical buildings carrying the cultural memory of many civilizations to the present and transferring them to the next generations is one of the duties of humanity. Artvin province, located in the Eastern Black Sea Region, has a rich history and is known to host different civilizations. In this study, determination of structural status of Tbeti (Cevizli) church and displacement measurements for repair and strengthening are discussed. Displacement measurements are designed as a single period. The damages on the upper parts of the walls were examined with reference to the parts close to the ground. Photogrammetric data were evaluated by robust regression and polynomial curve fitting methods. As a result of the evaluation, displacements up to 5 cm were found on the walls in the northern part of the building. As an example study, displacements occurred in Tbeti church which was built with masonry construction system are presented. As a result of the study, it was concluded that the deviations occurring along the walls in churches and other buildings can be detected vertically with single period measurements

Bu çalışmanın amacı, ortaöğretimde öğrenim görenöğrencilerin atom kavramını anlama seviyelerini tespit edebilmektir. Bu araştırmada betimsel yöntem kullanılmıştır. Çalışmaverileri, yedi devlet lisesinden toplam 271 son sınıf öğrencisine geliştirilen12 maddelik bir testin uygulanması ve 10 öğrenci ile olaylarla ilgili yapılan mülakatlardan(interview-about-events)elde edilmiştir. Testtin güvenirlik katsayısı 0,72 dir. Veriler frekans veyüzde olarak verilerek analiz edilmiştir. Elde edilen bulgularda ortaöğretimöğrencilerinin dörtte üçüne yakınının atom kavramını anladıkları görülmüştür.Öğrencilerin yaklaşık % 42’nin atom kavramını anlamadıkları ve bu konuda yanlışanlamalarının olduğu görülmüştür. Öğrencilerin atom kavramı ile ilgili yanlışanlaması “Atom, maddenin parçalara ayrılamayan en küçük yapı taşıdır”yargısıdır. Öğrencilerin çoğunluğunun atomun yapısını kısmen anladığı veyaklaşık % 20’sinin anlamadıkları ve bu konuda yanlış anlamalarının olduğugörülmüştür. Öğrencilerin atomun yapısı ile ilgili yanlış anlamaları; ”Atom,küre şeklindedir”, ”Atomun çekirdeği bir küreşeklindedir”, ”Elektronlaratomda belli yörüngelerde hareket ederler.” ve ”Atom, çekirdek, elektron veyörüngelerden oluşur” şeklindeki ifadelerdir. Ortaöğretimöğrencilerinin atom kavramını anlama seviyelerinin yüksek olmasına rağmen,çoğunun atomun yapısını kısmen anladıkları ve her iki alanda da bazı yanlışanlamalarının olduğu tespit edilmiştir. Öğrencilerinyarısından fazlasının atom altı kuark, lepton, gluon, müon vebenzeri gibi parçacıklardan haberdar olmadıklarıbelirlenmiştir. Çalışma sonunda, atomkavramı ve yapısı ile ilgili sorunların giderilmesine yönelik önerilere yerverilmiştir., The aim of this study is assessing high schoolstudents’ levels of understanding of the atom concept. The descriptive research method was used in this study. The datafor the study has been obtained from a total of 271 senior class students fromseven state high schools by applying a 12 item test and a further interview-about-events interview of 10students. The reliability coefficient has been found as 0,72. The data has beenanalyzed as frequencies and percentages. The findings showed that nearly threequarters of secondary education students comprehended the atom concept. Nearly42 % of them did not understood the atom concept and related misconceptionshave been determined. The first misconception was the statement that “The Atomis the smallest particle of matter that is indivisible into it’s particles”. Ithas been further found that most students partially understood the constitutionof the atom and that 20 % did not understand, and misconceptions in this issuehave been noted. The misconceptions were that “the atom was in the shape of asphere”, “the nucleus of the atom was sphere shaped”, “the electrons moved onparticular trajectories” and “the atom consists of a nucleus, electrons andtrajectories”. Although the understanding levels of high school studentsof the atom concept was found as high, most of them understood the structure ofthe atom incomplete and some misconceptions on both issues existed. It has beenfound that half of the students were unaware of sub-atom particles as quarks,leptons, gluons, muons and similar particles. The conclusion of the studyinvolved suggestions aimed at the resolution of the misconceptions and deficits

Introduction: Bloodstream infection (BSI) caused by Enterobacteriaceae is associated with mortality in cancer patients receiving chemotherapy. The aim of this study is to identify the risk factors and outcomes related to BSIs caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in cancer patients. Methodology: Hematology/oncology patients, who were diagnosed with BSIs caused by Enterobacteriaceae by positive blood cultures were evaluated retrospectively. Patients were divided into two groups by ESBL-positive and ESBL-negative Enterobacteriaceae bacteremia. Patients' demographic features, underlying conditions, comorbidity, neutrophil count, duration of neutropenia, antibiotic use in the previous three months before infection, mechanical ventilation, steroid use, central venous catheter implementation, total parenteral nutrition (TPN), hospitalization in the past three months, stay in intensive care unit, quinolone prophylaxis, and history of infection with ESBL-producing Enterobactericeae were evaluated. Risk factors related to BSIs caused by ESBL-producing Enterobacteriaceae and mortality were assessed. Results: A total of 122 patients were evaluated retrospectively. Quinolone propyhlaxis, TPN, infection with Extended Spectrum Beta-Lactamase positive ESBL-P Enterobacteriaceae during the previous three months, treatment with piperasillin-tazobactam or carbapenems in the previous three months were found to be independent risk factors for ESBL-P BSIs. Longer duration of neutropenia before BSI and complication at the beginning of BSI were found to be independent risk factors for mortality related to infection. Conclusions: ESBL-producing Enterobacteriacea should be treated with an appropriate antibiotic that is associated with better outcomes in hematology/oncology patients with BSIs. History of broad-spectrum antibiotic use and stay in hospital in the previous three months should be taken into consideration upon commencing antibiotic therapy.

WOS: 000425633300017, PubMed ID: 28707314, Nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL) is a rare subtype of Hodgkin's lymphoma. In this study, we aimed to investigate the clinical features and therapeutic outcomes of patients with NLPHL who were diagnosed at different institutes in Turkey. We retrospectively reviewed the records of the patients diagnosed with NLPHL. Adult patients who were diagnosed after 2005 with histological confirmation were selected for the study. Forty-three patients were included in the study. Median age of patients was 37.5years (18-70) at the time of diagnosis. About 60.5% patients were diagnosed as stage I and II NLPHL, and remaining 39.5% had stage III and IV disease. Median follow-up was 46months. During follow-up, none of the patients died. Seven patients relapsed or progressed after initial therapy at a median of 12months. Five of 7 relapsed/refractory patients (71.4%) were salvaged with chemotherapy only (DHAP, ICE), and the remaining 2 (28.6%) were salvaged with chemoimmunotherapy. All of relapsed/refractory patients were able to achieve complete remission after salvage therapy. Lactate dehydrogenase levels were significantly higher in patients with progressive disease compared with nonprogressive disease. Our study showed an excellent outcome with all patients alive at last contact with a median follow up of 46months despite a wide range of different therapeutic approaches. All relapsed and refractory patients were successfully salvaged despite a low frequency of patients received immunotherapy in conjunction with chemotherapy. Our results suggest that immunotherapy may be reserved for further relapses.

Background: Haematopoietic stem cell transplantation is a curative treatment option for many haematological disorders. Infection following haematopoietic stem cell transplantation is one of the major causes of mortality. Aims: To investigate the outcomes of early cessation of empirical antibiotic treatment per protocol in febrile neutropenia patients who have undergone haematopoietic stem cell transplantation at our clinic. Study Design: Descriptive study. Methods: The present study retrospectively evaluated febrile neutropenia attacks in haematopoietic stem cell transplantation recipients during the period June 2014 - January 2015 at our haematopoietic stem cell transplantation clinic. Results: A total of 72 febrile neutropenia attacks were evaluated in 53 patients. In 46 febrile neutropenia attacks, microbiologic cultures revealed positive results. In culture-positive febrile neutropenia episodes a single bacterium was isolated in 32 cases and multiple strains were isolated in 14. In 15 patients, empirical antibiotic therapy was discontinued after 72 hours. These patients were clinically stable, without evident focus of infection and had negative culture results. Only 4 recurrent episodes were observed (27%) after cessation of antibiotherapy. No patient died as a result of recurrent infection. The 30-day and 100-day post-transplantation mortality rates of patients with febrile neutropenia episodes were 11.3% (6/53) and 3.8% (2/53), respectively. Infection-related 30-day and 100-day mortality rates were 7.5% (4/53) and 0% (0/53), respectively. Conclusion: The main message of our study is that early cessation of empirical antibiotherapy seems to be feasible in eligible patients without increasing febrile neutropenia mortality rates.

Objective: The aim of this study was to identify regional, familial, socioeconomic and economic characteristics of intoxications and investigate the factors that may facilitate such intoxications. Method: 318 poisoning cases aged between 1 month-17 years (44±18 months on average) who were taken to the Pediatric Emergency Service of Cumhuriyet University Faculty of Medicine were evaluated retrospectively. Results: The ratio of poisoning cases to all pediatric emergency admissions was 5.1%. 65.1% of the cases were males, and the ratio of males to females was 1.8:1. Of the poisoning agents, 66% (n: 210) were pharmacologic and 34% (n: 108) were non-pharmacologic agents. The highest rate of poisoning was in the 25 months-5 years of age group (75.2%), and the most common poisoning agents were drugs. When evaluated by seasons, 40.3% of the patients referred to the hospital in the summer, 25.2% in the spring, 18.2% in the winter and 16.4% in the autumn. It was determined that 66.2% of the poisoning cases occurred at home and 33.8% occurred outside home. Of the poisoning cases, 7.9% were due to suicide, %11.3 were due to ignorance, %69.2 were accidental, %0.6 were iatrogenic, %0.6 were due to addiction, %0.3 were due to exposure, %1.6 due to adverse effects and %6.3 were due to other reasons . It was determined that accidental intake of drugs was the most common poisoning agent in our region. Conclusion: This study will contribute significantly in determining the poisoning profile of the region, raising awareness of healthcare personnel and the society and taking preventive measures.

WOS: 000327912900006, PubMed ID: 24270136, The aim of the present study was to evaluate renal involvement in children with Crimean-Congo hemorrhagic fever (CCHF). Forty-four children infected with CCHF virus and 30 controls were enrolled in the study. Urine neutrophil gelatinase-associated lipocalin (uNGAL) and urine protein levels were measured in the patient and control groups. Clinical and laboratory findings of the patient and control groups were compared. uNGAL levels were higher in the patient group than that in the control group (P < 0.001). Of the 44 patients, 26 (59.1%) were proteinuric. uNGAL levels in proteinuric patients were higher than those in non-proteinuric patients (P = 0.035). There was a positive correlation between uNGAL and urine protein levels in the patient group. (R = 0.614, P < 0.001). Due to renal involvement, increased proteinuria and increased uNGAL levels were observed in children with CCHF. In these children, measuring urine total protein and uNGAL levels can be useful to monitor renal involvement due to CCHF.

WOS: 000371909200007, PubMed ID: 26928096, Aim The aim of the study is to discuss clinical effects, treatments, and outcomes of pediatric colchicine poisoning. Method This study was designed as an observational case series study. The medical records of children aged between 0 and 18 years, who were hospitalized for colchicine poisoning at the Department of Pediatric Intensive Care Unit, Cumhuriyet University Faculty of Medicine, between January 2010 and January 2012, were retrospectively evaluated. Results We presented 17 children with colchicine poisoning. The mean (SD, range) age of patients was 71.5 (69.19, 18-204) months. The period to apply to the hospital after taking the medications was 7.3 hours (7.97, 30 minutes-26 hours) on average. The use of colchicine was due to diagnosis of Familial Mediterranean fever (FMF) in the families of 8 patients, diagnosis of Behcet disease in 1 patient's father, diagnosis of Behcet disease in 1 patient herself, and diagnosis of FMF in 6 patients themselves. Thirteen patients had taken colchicine at the dose of less than 0.5 mg/kg known as subtoxic and 1 patient had taken colchicine at the dose of greater than 0.8 mg/kg, and doses taken by 3 patients were not known. Fourteen patients (82.4%) had involuntary drug intake. Fifty percent of them were symptomatic at the moment of application and all had gastrointestinal complaints. All patients were observed in intensive care unit upon first admission and received supportive care. One of patients showed total alopecia, one showed leucocytosis, and another one showed acute abdomen picture. None of the patients showed mortality. Conclusions Mortality of colchicine toxicity is high and quick assessment is absolutely required. In regions where FMF is common and the use of colchicine is high, clinicians should pay attention to symptoms and findings related to colchicine intoxication and keep them in mind in differential diagnosis.

Conference of the Asian-Pacific-Association-for-the-Study-of-the-Liver (APASL) -- MAR 12-15, 2014 -- Brisbane, AUSTRALIA, WOS: 000370967500005, PubMed: 26966614, Background: Before the introduction of direct-acting antivirals in the treatment of chronic hepatitis C patients, the combination of peginterferon alpha and ribavirin was the standard therapy. Observational studies that investigated sustained virological response (SVR) rates by these drugs yielded different outcomes. Aims: The goal of the study was to demonstrate real life data concerning SVR rate achieved by peginterferon alpha plus ribavirin in patients who were treatment-naive. Study Design: A multicenter, retrospective observational study. Methods: The study was conducted retrospectively on 1214 treatment naive-patients, being treated with peginterferon alpha-2a or 2b plus ribavirin in respect of the current guidelines between 2005 and 2013. The patients' data were collected from 22 centers via a standard form, which has been prepared for this study. The data included demographic and clinical characteristics (gender, age, body weight, initial Hepatitis C virus RNA (HCV RNA) level, disease staging) as well as course of treatment (duration of treatment, outcomes, discontinuations and adverse events). Renal insufficiency, decompensated liver disease, history of transplantation, immunosuppressive therapy or autoimmune liver disease were exclusion criteria for the study. Treatment efficacy was assessed according to the patient's demographic characteristics, baseline viral load, genotype, and fibrosis scores. Results: The mean age of the patients was 50.74 (+/- 0.64) years. Most of them were infected with genotype 1 (91.8%). SVR was achieved in 761 (62.7%) patients. SVR rate was 59.1% in genotype 1, 89.4% in genotype 2, 93.8% in genotype 3, and 33.3% in genotype 4 patients. Patients with lower viral load yielded higher SVR (65.8% vs. 58.4%, p=0.09). SVR rates according to histologic severity were found to be 69.3%, 66.3%, 59.9%, 47.3%, and 45.5% in patients with fibrosis stage 0, 1, 2, 3 and 4, respectively. The predictors of SVR were male gender, genotype 2/3, age less than 45 years, low fibrosis stage, low baseline viral load and presence of early virological response. SVR rates to each peginterferon were found to be similar in genotype 1/4 although SVR rates were found to be higher for peginterferon alpha-2b in patients with genotype 2/3. The number of patients who failed to complete treatment due to adverse effects was 33 (2.7%). The number of patients failed to complete treatment due to adverse effects was 33 (2.7%). Conclusion: Our findings showed that the rate of SVR to dual therapy was higher in treatment-naive Turkish patients than that reported in randomized controlled trials. Also peginterferon alpha-2a and alpha-2b were found to be similar in terms of SVR in genotype 1 patients., Asian Pacific Assoc Study Liver

Results: The maternal 36th week serum calcium and 25(OH)D levels were significantly lower than those of 24th week and the control group. The maternal 36th week serum glucagon and calcitonin levels were significantly higher than those of 24th week and control group. Serum calcium levels of the newborn at 24th and 48th hour were lower than those of the cord blood (p

Key Clinical Message Multiple myeloma is a plasma cell disease, whereas CLL (Chronic Lymphocytic Leukemia) affects mature B-cell lymphocytes. Even though the coexistence of those two conditions is extremely rare, as both cell types differentiate from the same multipotent stem cells, the clinician should evaluate patients carefully not to misdiagnose such a concomitancy.

WOS: 000291794100002, PubMed ID: 21511509, Background: Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease with a high mortality rate, and is one of the viral hemorrhagic fever syndromes. The average mortality rate of CCHF is 3-30%. Research indicates that the longest incubation period after a tick bite is 12 days in CCHF disease. However, in clinical practice, we encounter patients with CCHF as a result of tick bites with much longer incubation periods (max. 53 days) than those reported in the literature. We present herein CCHF cases presumably infected through tick bites and having incubation periods longer than the upper limit reported in the literature. Methods: We analyzed the cases of the 825 CCHF patients admitted to our hospital from 2007 to 2010 and found that 312 of them had undoubtedly been bitten by a tick. We searched the patient records for information on the incubation period and found that 12 patients had experienced an incubation period of over 12 days, which is the longest incubation period stated in the literature for patients definitely bitten by a tick. Results: A total of 12 patients (eight males and four females, with a mean age of 45 years) were recruited into this study. Five (41.7%) of the 12 patients had positive CCHF virus-specific IgM antibodies, three (25%) had a positive reverse transcription polymerase chain reaction test for CCHF virus, and four (33.3%) had positive results in both tests during the acute and/or convalescent phase of the disease. In these cases, the interval between tick bite and the onset of symptoms was a mean of 23.6 days (range 13-53 days). Conclusion: Physicians serving in endemic regions should be aware of these longer incubation periods after a tick bite. It is suggested that they perform more follow-ups on clinically and serologically highly suspected patients than they currently do. (C) 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Summary Background We performed a prospective observational cohort study to evaluate the causative bacteria and to identify risk factors for mortality in febrile neutropenic (FN) patients with blood stream infection (BSI). Material/Methods We conducted a prospective data collection on all patients with bacteremia or fungemia. The patients were assigned into low-risk and high-risk groups in accordance with the Multinational Association for Supportive Care in Cancer (MASCC) Risk Index. Results Throughout the study period, the patients developed 420 FN episodes. Out of 420 episodes, only 90 (21.4%) were found to have bloodstream infection. The mean age of the patients was 45.6±18.4 years and 55.6% of the patients were male. A total of 98 isolates were recovered from the cases of BSI. Coagulase-negative Staphylococcus spp (CoNS) were the most common isolates overall (33.7%). There was a significant increase in the rate of gram-negative bacteria throughout the study period (p=0.028). Overall mortality was 33%. Multivariate analyses showed that MASCC risk scores (p=0.0001, OR=15.1, CI%95 4.5–50.7), ICU wards (p=0.0002, OR= 8.6, Cl%95 1.101–68,157) and CoNS (p=0.004, OR=12.12, CI%95 2.3–64.7) were independent risk factors associated with mortality. BSI due to CoNS was associated with lower mortality; however, MASCC high risk score and ICU stay were associated with higher mortality. Conclusions The MASCC risk-index score and emergence of CoNS in positive blood cultures are valuable tools in the management of FN.

Direct current (DC) resistivity, self potential (SP) and very low frequency electromagnetic (VLF-EM) measurements are carried out to detect the spread of groundwater contamination and to locate possible pathways of leachate plumes, that resulted from an open waste disposal site of Canakkale municipality. There is no proper management of the waste disposal site in which industrial and domestic wastes were improperly dumped. Furthermore, because of the dumpsite is being located at the catchment area borders of a small creek and is being topographically at a high elevation relative to the urban area, the groundwater is expected to be hazardously contaminated. Interpretations of DC resistivity geoelectrical data showed a low resistivity zone (

In this study, the effect of clarithromycin on the destruction of bacterial biofilm in Pseudomonas aeruginosa osteomyelitis was investigated. Foreign body-related osteomyelitis caused by ceftazidime-sensitive Pseudomonas aeruginosa was produced in the tibias of 26 rats. After osteomyelitis was verified on Day 14, 10 rats had ceftazidime (1500 mg/kg/day) given subcutaneously, and 10 rats had ceftazidime given subcutaneously and clarithromycin (100 mg/kg/day, two 50-mg/kg doses every 12 hours) given orally; three rats formed the control group. After a treatment period of 20 days, the tibias and the foreign bodies were removed, cultured, and examined by electron microscopy. The number of microorganisms growing on the bone tissue in the group receiving combined treatment was significantly lower than in the other groups. The number of microorganisms growing on the foreign body in the group receiving only ceftazidime was significantly higher than that of the group receiving combined treatment. Electron microscope examination revealed that the biofilm layer was eradicated in the group that had combined therapy; however, biofilm formation was evident on the foreign body in the group receiving only ceftazidime. Clarithromycin enhanced the activity of concomitantly used bactericidal agents by destroying biofilm on the surface of the materials.

Several studies have shown that serum procalcitonin levels increase conspicuously in acute and systemic inflammatory diseases. However, there is insufficient information concerning its activity in chronic infectious diseases such as tuberculosis. In this study, we aimed to assess serum level of procalcitonin in patients with active pulmonary tuberculosis and in medical staff at high risk due to close patient contact (high-risk staff).For this purpose, 30 patients (6 female, 24 male) and 20 staff (8 female, 12 male) were evaluated. Twenty eight healthy blood donors (9 female, 19 male) made up the control group.Serum procalcitonin level in patients with tuberculosis was 0.76 +/- 0.20 ng/mL. Procalcitonin levels in active tuberculosis patients and staff were not significantly different (p=0.381); however, differences between active tuberculosis patients and control group were significant (p0.001). In addition, serum procalcitonin levels were also different in staff and control groups (p0.001).This study showed that procalcitonin levels increased both in patients with pulmonary tuberculosis and in the staff. This result considered that procalcitonin could be a good indicator of inflammation in patients with chronic diseases and in persons exposed to long-lasting infections.

WOS: 000301220600013, PubMed ID: 22227121, Objective: The aim of this study was to investigate cochlear functions in children with Familial Mediterranean Fever (FMF). Methods: Fifty-six FMF patients (112 ears) and 30 healthy control subjects (60 ears) were included in the study. Transient evoked otoacoustic emission (TEOAE) was investigated. Numerical measurements of TEOAE, except the correlation percentage (%), included response amplitude (dB) and signal/noise (SN) ratio. Results: There was no statistically significant difference in age and sex in the two groups. Mean TEOAE correlation percentage, signal/noise ratio, TEOAE amplitudes in 1, 1.5, 2, 3 and 4 Hz frequency values were not different between the two groups (p > 0.05). Conclusions: In this study using the TEOAE test, we found that FMF did not cause outer cell hair damage in children. In the literature, there is no study on outer cell hair damage in children or adults with FMF, so this is the first investigational study. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

WOS: 000291506300024, PubMed ID: 21524804, Objective: The aim of this study was to investigate cochlear involvement in child patients with Crimean-Congo hemorrhagic fever (CCHF) disease. Methods: Twenty-eight CCHF disease patients (56 ears) and 26 sex- and age-matched healthy control subjects (52 ears) were included in the study. Pure-tone audiometry at frequencies 0.25, 0.5, 1, 2, 4, and 6 kHz, immittance measures including tympanometry and acoustic reflex testing, and transient evoked otoacoustic emission (TEOAE) testing were performed in the patients and controls. Results: The proportion with a result of 'fail' for the TEOAE test in the CCHF patients was not statistically significant from the control group (p > 0.05). Conclusions: CCHF disease does not impair cochlear function in children. The clinical course of CCHF among children seems to be milder than in adults. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

WOS: 000360090300003, PubMed ID: 25504688, Proinflammatory and anti-inflammatory cytokines have an important role in the pathogenesis of febrile seizures (FS). Adipocytokines like interleukin 6 (IL-6), leptin, and adiponectin released from adipose tissue play a role in inflammation. This study aimed to assess the probable role of adipose tissue in children with FS. We measured serum IL-6, leptin, and adiponectin levels and evaluated clinical and laboratory findings in children with FS (n = 32) and compared the results with the values of children of the same age with febrile illness without seizures (febrile control, FC; n = 26) and healthy control group (HC; n = 29). The serum levels of white blood cells, C-reactive protein, IL-6, leptin, and adiponectin were found to be significantly higher, while serum hemoglobin (Hb) levels were found to be significantly lower in FS and FC groups than in the HC group (p < 0.001). When we compared the FS with the FC group, the serum Hb levels were significantly lower in the FS group than those in the FC group (p = 0.001). There was no significant difference between the FS and FC group with regard to the serum levels of these adipocytokines (p > 0.05). Our data showed that elevated levels of these adipocytokines as acute phase reactants in FS and FC groups did not contribute to the development of FS.

Fibromatosis colli (FC) is a rare form of infantile fibromatosis occurring in the sternocleidomastoid muscle, occurring in the 1st to 8th weeks of life with a history of a non-tender neck mass and torticollis. We present a case of FC in a 6-week-old female baby presented with right neck mass and torticollis, diagnosed with ultrasonography.Keywords: Fibromatosis colli, sternocleidomastoid muscle, ultrasonographyÖzetFibromatozis kolli bebeklerde görülen fibromatozisin sternokleidomastoid kasta görülen nadir bir formudur, yaşamın ilk 1-8 haftasında görülen, ağrılı olmayan ve tortikolise neden olan bir boyun kitlesidir. Ultrasonografi ile fibromatozis kolli tanı konulan, sağ boyun kitlesi ve tortikolis ile başvuran 6 haftalık bir kız bebek olgusu sunulmaktadır.Anahtar sözcükler: Fibromatozis kolli, sternokleidomastoid kas, ultrasonografi, Fibromatozis kolli bebeklerde görülen fibromatozisin sternokleidomastoid kasta görülen nadir bir formudur, yaşamın ilk 1-8 haftasında görülen, ağrılı olmayan ve tortikolise neden olan bir boyun kitlesidir. Ultrasonografi ile fibromatozis kolli tanı konulan, sağ boyun kitlesi ve tortikolis ile başvuran 6 haftalık bir kız bebek olgusu sunulmaktadır.

WOS: 000330751500005, PubMed ID: 24451097, In this study, we investigated the pro- and antioxidant status of patients with a pathogenesis of Crimean-Congo hemorrhagic fever (CCHF) in terms of their role in its pathogenesis. During the study period, 34 children and 41 adults were diagnosed with CCHF. The control group consisted of healthy age- and gender-matched children and adults. Serum levels of the total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), and plasma total thiol (TTL) were evaluated and compared between groups. The difference in mean TAC values between CCHF patients and healthy controls was not statistically significant (P > 0.05). Mean TOS, OSI, and TTL values were significantly lower in CCHF patients than in healthy controls (P < 0.001). Comparisons between the 2 groups revealed that mean TOS and OSI values were significantly lower in adults with CCHF than in their healthy counterparts (P < 0.001). Similarly, mean TTL levels were lower in both children and adults with CCHF when compared separately with healthy controls (P < 0.05). There was no significant difference in the mean serum TTL levels between children and adults with CCHF (P > 0.05). Our results suggest that TTL may play a more important role in CCHF pathogenesis than the other parameters investigated. The mean TOS and OSI values were higher in the control group than in CCHF patients.

WOS: 000338030400010, PubMed ID: 24320760, We aimed to assess the association between serum levels of soluble IL-2 receptor (sIL-2r) and endothelin-1 and severe infection in children with Crimean-Congo hemorrhagic fever (CCHF). Fifty-two patients under 18 years of age with a laboratory-confirmed diagnosis of CCHF and 38 healthy controls were enrolled in the study. Patients were classified into two groups based on disease severity (severe group and non-severe group). The sIL-2r and endothelin-1 levels were observed to be significantly higher in patients with severe CCHF compared with those with non-severe CCHF and the control group (p < 0.05). In addition, those with non-severe CCHF were also found to have a significantly higher sIL-2r level relative to the control group (p < 0.001). Although there was a positive correlation between sIL-2r and endothelin-1 levels, serum levels of both sIL-2r and endothelin-1 were negatively correlated with the platelets count. In children with CCHF, serum levels of sIL-2r and endothelin-1 were increased, and this increase is related to the severity of the disease. In this study, we concluded through prognosis that serum levels of sIL-2r and endothelin-1 might be related, and that hemophagocytic lymphohistiocytosis and endothelial injury might contribute to a pathogenesis of the disease., Research Foundation Council of Cumhuriyet University [T-539], The Research Foundation Council of Cumhuriyet University partly supported this study (Project No. T-539).

WOS: 000330078200019, PubMed ID: 23714976, Objectives: Crimean-Congo hemorrhagic fever (CCHF), like other viral infections, may prolong mucociliary clearance time and increase nasal resistance in children. The aim of the present prospective case-control study was to study, using saccharin and anterior rhinomanometry tests, whether CCHF infections caused any change in nasal physiology. Methods: Overall, 40 subjects, 20 of whom had CCHF (group 1) and 20 of whom were healthy controls (group 2), were enrolled in this study. The definitive diagnosis of CCHF infection was made based on typical clinical and epidemiological findings and detection of CCHF virus-specific IgM by ELISA or of genomic segments of the CCHF virus by reverse transcription-polymerase chain reaction. Anterior rhinomanometry was performed in all participants according to current recommendations of the Committee Report on Standardization of Rhinomanometry. A saccharin test was used to evaluate mucociliary clearance, and nasal mucociliary clearance time was assessed with the saccharin test as described previously. Results: In our patients, the mean time from the application of saccharin crystals to the first feeling of a sweet taste was 6.77 +/- 3.25 minutes (range 2-16 min). In terms of the mean time from the application of saccharin crystals to the first feeling of a sweet taste, there was no difference between two groups. The mean total air flow was 637.60 +/- 76.18 mL/s (range 490-760 mL/s). The mean total nasal airway resistance was 0.24 +/- 0.03 Pa/mL s (range 0.20-0.31 Pa/mL s). In terms of the degree of nasal air flow and nasal airway resistance and the total air flow and total nasal airway resistance of each nostril, there was no difference between the 2 groups. Conclusions: The results obtained in anterior rhinomanometry and saccharin test showed that there was no statistically significant difference between CCHF (+) patients and controls. These results suggest us that CCHF virus infection does not affect nasal physiology. However, this is the first study performed on this issue and further studies on larger series need to be performed.

This article describes an outbreak of meningitis caused by Serratia marcescens in patients who had undergone spinal anaesthesia for caesarean section. Bacterial meningitis was diagnosed in 12 of the 46 patients who underwent a caesarean section under spinal anaesthesia in a 75-bed private hospital between 6(th) and 14(th) March 2011. S. marcescens was isolated from samples taken from four prefilled syringes and one bag containing 5% dextrose with norepinephrine, suggesting that medications used in spinal anaesthesia were contaminated extrinsically. Strategies for prevention of anaesthesia-associated infections in operating theatres are discussed.

UNAL, SERHAT/0000-0003-1184-4711; Yalcin, Ata Nevzat/0000-0002-7243-7354; Dursun, Oguz/0000-0001-5482-3780; Geyik, Mehmet Faruk/0000-0002-0906-0902; Leblebicioglu, Hakan/0000-0002-6033-8543; dursun, oguz/0000-0001-5482-3780; Topeli, Arzu/0000-0002-5874-9087 WOS: 000316641000020 PubMed: 23355330 Purpose To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 11 intensive care units (ICUs), from 10 hospitals, members of the INICC, in 10 cities of Turkey. Methods A prospective active before-after surveillance study was conducted to determine the effect of the INICC multidimensional approach in the VAP rate. The study was divided into two phases. In phase 1, active prospective surveillance of VAP was conducted using the definitions of the Centers for Disease Control and Prevention National Health Safety Network, and the INICC methods. In phase 2, we implemented the multidimensional approach for VAP. The INICC multidimensional approach included the following measures: (1) bundle of infection control interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of VAP rates, and (6) performance feedback of infection control practices. We compared the rates of VAP obtained in each phase. A time series analysis was performed to assess the impact of our approach. Results In phase 1, we recorded 2,376 mechanical ventilator (MV)-days, and in phase 2, after implementing the multidimensional approach, we recorded 28,181 MV-days. The rate of VAP was 31.14 per 1,000 MV-days during phase 1, and 16.82 per 1,000 MV-days during phase 2, amounting to a 46 % VAP rate reduction (RR, 0.54; 95 % CI, 0.42-0.7; P value, 0.0001.) Conclusions The INICC multidimensional approach was associated with a significant reduction in the VAP rate in these adult ICUs of Turkey. Foundation to Fight against Nosocomial Infections The authors thank the many health care professionals at each member hospital who assisted with the conduct of surveillance in their hospital, including the surveillance nurses, clinical microbiology laboratory personnel, and the physicians and nurses providing care for the patients during the study; without their cooperation and generous assistance this INICC would not be possible; Mariano Vilar, Debora Lopez Burgardt, Santiago Suarez, Cecilia Cappelini, Denise Brito, Eugenia Manfredi, Luciana Soken, Dario Pizzuto, Yuan Ding, Katie Saunders, and Isaac Kelmeszes who work at INICC headquarters in Buenos Aires, for their hard work and commitment to achieve INICC goals; the INICC country coordinators (Altaf Ahmed, Carlos A. Alvarez Moreno, Anucha Apisarnthanarak, Luis E. Cuellar, Bijie Hu, Hakan Leblebicioglu, Eduardo A. Medeiros, Yatin Mehta, Lul Raka, Namita Jaggi, and Toshihiro Mitsuda); the INICC Advisory Board (Carla J. Alvarado, Gary L. French, Nicholas Graves, William R. Jarvis, Patricia Lynch, Dennis Maki, Russell N. Olmsted, Didier Pittet, Wing Hong Seto, Syed Sattar, and William Rutala), who have so generously supported this unique international infection control network; and specially to Patricia Lynch, who inspired and supported us to follow our dreams despite obstacles. The funding for the activities carried out at INICC head quarters were provided by the corresponding author, Victor D. Rosenthal, and Foundation to Fight against Nosocomial Infections.

Background: We retrospectively evaluated the efficacy and toxicity of paclitaxel plus doxorubicin as a second-line treatment in patients with urothelial carcinoma, who had not responded to a prior platinum plus gemcitabine combination. Patients and Methods: All patients received intravenous infusions of paclitaxel (175 mg/m(2)/h) and doxorubicin (50 mg/m(2)/30 min) on day 1. Chemotherapy courses were repeated every 21 days. Results: The median follow-up duration was 13.5 months (range 2.8-22.4 months). Complete and partial responses were observed in 2 (5.6%) and 10 (27.8%) patients, respectively. Median overall survival was 8.9 months (95% confidence interval (CI): 6.2-11.6). Median time to progression was 3.8 months (95% CI: 2.7-4.8). The most common hematologic toxicities were neutropenia (n = 21, 58.3%), thrombocytopenia (n = 10, 27.8%), and anemia (n = 9, 25%). The most common non-hematologic toxicities consisted of fatigue (n = 15, 41.7%), nausea/vomiting (n = 13, 36.1%), peripheral neuropathy (n = 11, 30.6%), and mucositis (n = 6, 16.7%). Dose reductions by 25-35% were performed in 6 (16.7%) patients because of grade 3/4 toxicity. Anthracycline-related heart failure did not occur. Conclusion: 3-weekly courses of cyclic paclitaxel plus doxorubicin were found to be effective and tolerable in patients with urothelial carcinoma, who had not responded to prior platinum- and gemcitabine-based chemotherapy.

Brucellosis is a zoonotic systemic infectious disease, and multiorgan involvement is commonly seen, but involvement of the neck is a rare presentation of brucellosis. Granulomatous infections of the parotid gland are extremely rare. Warthin tumor is a well-known benign neoplasm of the salivary glands. In this report, we describe a Warthin tumor associated with Brucella melitensis in the same parotid gland.

WOS: 000297247000020, PubMed ID: 21941213, Objective: The objective of the study was to evaluate hypoxia-inducible factor 1 (HIF-1), which plays a major role in the stimulation of angiogenesis in placental tissues, by using immunohistochemical staining in preeclampsia model of rats, developed by N-nitro-L-arginine methyl ester (L-NAME) Methods: Thirty pregnant rats were randomized into 2 groups (n = 15 in each group) on day 10 of gestation. L-NAME was given to rats in the study group by gavage. On days 0, 10, and 20 of gestation, rats were weighted, and urine protein values and blood pressures were measured. Hypoxia-inducible factor 1 expressions were assessed with immunohistochemical staining by using avidin-biotin peroxidase via selecting preparation. Results: Systolic and diastolic blood pressures and urine protein value of L-NAME group on day 20 of gestation were found to be significantly higher than those obtained on days 0 and 10 of gestation in the same group and those obtained on day 20 of gestation in the sham group (P < 0.05). Maternal weight, number of fetuses, and mean fetal weight of rats in L-NAME group on day 20 of gestation were found to be significantly lower than those obtained from rats in the sham group (P < 0.05). Regarding HIF-1 expression of placental tissues, mild immunohistochemical staining was found in 2 rats (13.4%) and moderate in 13 rats (86.6%) in the L-NAME group. A significant difference was found in terms of HIF-1 positivity in the maternal placentas of both groups (P < 0.05). Conclusions: L-NAME preeclampsia model of pregnant rats is consistent with human preeclampsia in terms of hypertension, proteinuria, and intrauterine growth retardation; in addition, it also shows evidence of placental hypoxia findings.

WOS: 000293140200008, PubMed ID: 21709631, Background: Tularemia is a zoonotic infection, and the causative agent is Francisella tularensis. A first-line therapy for treating tularemia is aminoglycosides (streptomycin or, more commonly, gentamicin), and treatment duration is typically 7 to 10 days, with longer courses for more severe cases. Material/Methods: We evaluated 11 patients retrospectively. Failure of the therapy was defined by persistent or recurrent fever, increased size or appearance of new lymphadenopathies and persistence of the constitutional syndrome with elevation of the levels of the proteins associated with the acute phase of infection. Results: We observed fluctuating size of lymph nodes of 4 patients who were on the 7(th) day of empirical therapy. The therapy was switched to streptomycin alone and continued for 14 days. The other 7 patients, who had no complications, were on cefazolin and gentamycin therapy until the serologic diagnosis. Then we evaluated them again and observed that none of their lymph nodes regressed. We also switched their therapy to 14 days of streptomycin. After the 14 days on streptomycin therapy, we observed all the lymph nodes had recovered or regressed. During a follow-up 3 weeks later, we observed that all their lymph nodes had regressed to the clinically non-significant dimensions (< 1 cm). Conclusions: All patients were first treated with gentamicin, but were than given streptomycin after failure of gentamicin. This treatment was successful in all patients. The results of our study suggest that streptomycin is an effective choice of first-line treatment for pediatric oropharyngeal tularemia patients.

WOS: 000295899700014, PubMed ID: 21804465, Background: Crimean-Congo hemorrhagic fever (CCHF) involves the multi-organ systems. The involvement of the heart in adult patients has been described previously. We investigated the electrocardiographic and echocardiographic findings of pediatric patients with CCHF. Material/Methods: Patients younger than 16 years of age diagnosed with CCHF were enrolled in the study. The diagnosis of CCHF infection was based upon typical clinical and epidemiological Findings and serological tests. All patients underwent a thorough cardiologic evaluation. A standard 12-lead electrocardiography and echocardiography were performed. Results: Twenty-three consecutive patients who were hospitalized with diagnosis of CCHF were enrolled in the study (mean age: 12 2 years, 6 female). All electrocardiographic parameters were within normal ranges according to age. Seven patients (30%) had minimal (

We aimed to determine the risk factors for healthcare-associated infections (HCAI) caused by multidrug-resistant (MDR) bacteria in patients with solid tumours.This retrospective study was performed in the Department of Clinical Microbiology and Infectious Diseases, Mersin Teaching and Research Medical Centre, between January 2004 and December 2008. SPSS version 11.5 program package was used for the statistical analyses.A total of 145 patients who had an HCAI were analyzed; 62% of the patients were male and their median age was 57.7 ± 16 y and median Charlson co-morbidity score was 4.94 ± 1.2. During the study period, 83 MDR bacteria were isolated from HCAIs that developed in 70 (48.3%) patients. In multiple binary logistic regression analysis, duration of hospital stay (odds ratio (OR) 1.041, 95% confidence interval (CI) 1.007-1.077; p = 0.019), surgery (OR 3.115, 95% CI 1.288-7.535; p = 0.012), use of glycopeptides (OR 5.394, 95% CI 1.960-14.850; p = 0.001), and use of third-generation cephalosporins (OR 5.521, 95% CI 2.017-15.110; p = 0.001) were found to be independent risk factors for the development of an MDR infection.Among hospitalized patients with a solid tumour, HCAIs caused by MDR bacteria occurred more frequently in patients undergoing surgery, receiving third-generation cephalosporins and glycopeptide antibiotics, and having a prolonged hospital stay.

A case of neurobrucellosis complicated by optic, abducens and vestibulocochlear nerve palsies is reported. Brucella melitensis was isolated in the cerebrospinal fluid, and the patient was diagnosed with retrobulbar neuritis. Despite medical treatment, the patient developed optic atrophy. Multiple cranial nerve involvement should be kept in mind in patients presenting with blurred vision and double vision, especially in regions where brucellosis is endemic.

Dandy-Walker variant is a rare anomaly of the central nervous system that is characterized by partial agenesis of vermis and results in persistence of the 4. ventricule and cisterna magna. Firstly, in 1988 Kohyama et al. [10] reported the coexistence of Dandy-Walker variant and tetralogy of Fallot. Afterwards, it is reported as several case reports in the literature. In this case report, we report a 2 days-old male patient with Dandy-Walker variant and pentalogy of Fallot., ÖzetDandy-Walker varyasyonu, 4. ventrikül ve sisterna magna arasındaki devamlılıkla sonuçlanan vermisin parsiyel agenezisi ile karakterize santral sinir sisteminin nadir bir anomalisidir. Literatürde ilk kez 1988’de Kohyama ve arkadaşları tarafından bildirilen Dandy-Walker varyasyonu ve Fallot Tetralojisi birlikteliği daha sonraki yıllarda birkaç vaka sunumu şeklinde bildirilmiştir. Biz bu yazıda, Dandy-Walker varyasyonu ve Fallot Pentalojisi olan 2 günlük bir erkek hastayı bildiriyoruz.Anahtar sözcükler: Dandy-Walker varyasyonu, Fallot Pentalojisi AbstractDandy-Walker variant is a rare anomaly of the central nervous system that is characterized by partial agenesis of vermis and results in persistence of the 4. ventricule and cisterna magna. Firstly, in 1988 Kohyama et al. reported the coexistence of Dandy-Walker variant and tetralogy of Fallot. Afterwards, it is reported as several case reports in the literature. In this case report, we report a 2 days-old male patient with Dandy-Walker variant and pentalogy of Fallot.Keywords: Dandy-Walker variant, pentalogy of Fallot