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In this study, we aimed to present our tracheotomy experiences in pediatric patients in our hospital. We reviewed the data by analyzing pediatric tracheotomy retrospectively in terms of indications, follow-up and complications. Forty-six pediatric patients who underwent tracheotomy between 2014 and 2021 were included. The indications were examined under five headings according to the diagnoses that led to the tracheotomy of the patients. These were prolonged intubation, upper airway obstruction, craniofacial anomalies, neuromuscular disorders, and postoperative-traumatic sequelae. Twenty-three (50%) of these patients were girls, and 23 (50%) were boys. The mean age of the patients was 53.8±62.9 months. The youngest patient was a 1-day-old newborn, while the oldest patient was 15 years old. Pediatric tracheotomy was performed in 14 patients for prolonged intubation, 12 patients for craniofacial anomalies, 7 patients for upper airway obstruction, 7 patients for postoperative-traumatic sequelae and 6 patients for neuromuscular disorders. Preoperative or postoperative complications were seen in 10 of the patients. The intubation time of the patients who underwent elective tracheotomy was calculated as 25.7±17.1 days. Of these patients, the shortest duration of intubation was 6 days, and the longest duration was 90 days. The smallest diameter of the tracheostomy cannula inserted in the patients was 2.5 mm, while the largest was 7 mm, and the mean was 4.5 mm. In the follow-ups, it was observed that only 6 of the patients were decannulated, 11 of them died, and the remaining 29 continued their lives with tracheostomy. As a result, although pediatric tracheotomy is rare, it is a life-saving surgical procedure for the appropriate indications and can be successfully performed with manageable complications, contrary to expectations, with the appropriate surgical technique and adequate postoperative care. [Med-Science 2022; 11(1.000): 382-6]

This study was conducted to investigate the effects of Aspergillus niger strain and inoculum level on the nutritional composition of olive leaves. The experiment had a 2×3 factorial arrangement of treatments with two A. niger strains (ATCC 200345 [A] and ATCC 9142 [B]) and three inoculum levels (104, 106, and 108). Olive leaves were milled to 2 mm and fermented in solid-state by two different A. niger strains and analysed for nutritional composition. Crude protein (CP) was increased linearly as the inoculum level increased. Ether extract (EE) and crude fiber (CF) were decreased linearly in A strain or quadratically in B strain with increased inoculum levels. Crude ash and nitrogen-free extract content did not differ among groups. Strain A increased neutral detergent fiber (NDF) at higher inoculum level, whereas NDF was decreased as inoculum level increased in B strain. The lowest acid detergent fiber (ADF) was obtained from the B strain or 106 inoculum level. The results showed that the effect of two strains on CP and ADF changed similarly with increased inoculum levels. However, two strains affected EE, CF, and NDF content differently with increased inoculum levels. The optimal situations were 108 inoculum level for higher CP, A104 or B104 for higher EE, B106 for lower CF, B106 or B108 for lower NDF, 106 inoculum level or B strain for lower ADF. B strain at 106 inoculation level can be preferred to obtain an average CP and EE content and lower CF, NDF, and ADF content.

ABSTRACT: Effects of dietary Agaricus bisporus mixture or stalk or cap on growth performance, carcass components and some meat quality parameters, mesophilic aerobic bacterial counts, and intestinal histomorphology in broiler chickens were investigated. Two hundred and forty one-day-old male Ross 308 broiler chickens were divided into 4 experimental groups with 4 replicates, each including 15 birds. Chickens were fed with basal diet (C), mushroom mixture (MM, 10 g stalk+10 g cap/kg diet), mushroom stalk (MS, 20 g/kg diet) and mushroom cap (MC, 20 g/kg diet). Feed conversion ratio (FCR) was improved (P < 0.01) by dietary MS while feed intake (FI) decreased (P < 0.01) in all treatment groups compared to control. However, body weight gain (BWG) was decreased (P < 0.01) by MC inclusion. Mushroom supplemented groups had higher (P < 0.05) mesophilic aerobic bacteria in the cecum. MS inclusion increased villus height to crypt depth ratio in the jejunum (P < 0.01) and villus height in the ileum (P < 0.01) and jejunum (P < 0.05). MC increased (P < 0.01) crypt depth in the jejunum. There were no statistical differences among groups for carcass components (P > 0.05). The L* values were decreased (P < 0.01) in thigh meat but increased (P < 0.01) in breast meat by mushroom inclusion. The a* values were decreased (P < 0.01) and b* values were increased (P < 0.05) in both thigh and breast meat with mushroom addition to diet. The obtained results indicated that A. bisporus stalk meal at an inclusion level of 20 g/kg of diet had favourable effects on growth performance with higher feed efficiency, improved intestinal morphology with higher villus height and increased meat quality of broiler chickens.

Introduction Nephrotoxicity is the most important adverse effect of colistin therapy. We investigated the frequency of nephrotoxicity, risk factors related to nephrotoxicity, and its relationship with mortality in patients who received intravenous colistin in intensive care units (ICUs). Materials and methods We retrospectively reviewed the data of patients who received intravenous colistin in ICUs between 2011 and 2017. Acute kidney injury (AKI) diagnosis and staging were made based on the Kidney Disease Improving Global Outcome criteria. Results There were 149 patients included in the study with 61% being male. The mean age was 58.7 ± 20.3 years. AKI was detected in 96 (64.4%) patients. There were 25 patients with AKI stage 1 (16.8%) and 71 patients with AKI stage 2 or 3 (47.7%). Advanced age (65.0 vs. 47.4 years; p

ABSTRACT: This study was conducted to investigate the effect of dietary raw sour cherry kernel (RC) or fermented sour cherry kernel (FC) on apparent digestibility, ileal morphology, and caecal microflora in broiler chickens. Raw sour cherry kernel was fermented by Aspergillus niger for 7 D. A total of 343 one-day-old Ross 308 male chicks were assigned to 7 dietary treatments consisting of 7 replicates of 7 broilers each. All birds were fed with a commercial diet or diets supplemented with 1%, 2%, or 4% RC or FC. The experimental period was 42 D. Apparent dry matter (DM), nitrogen and ash digestibilities were diminished (P < 0.05) by dietary RC inclusion, although dietary FC did not negatively affect (P > 0.05) nutrient digestibility. Dietary 1% FC increased (P < 0.01) the villus height to crypt depth ratio (VH:CD) compared with the other treatment groups, although RC4 reduced the villus height (VH, P < 0.001) and VH:CD (P < 0.01), compared with the control group. Dietary treatments had no effect (P > 0.05) on the crypt depth (CD). Birds fed 1% FC had the highest (P < 0.05) caecal Lactobacillus spp. counts among the treatment groups. Enterococcus spp. and Escherichia coli counts in cecum were not affected (P > 0.05) by dietary treatments. The results showed that the dietary inclusion of 1% FC improved ileal morphology and caecal microflora without any adverse effect on the apparent digestibility. These results indicate that FC has the potential to be a feed additive which improves intestinal health for broiler diets.

ABSTRACT: Sour cherry kernels are waste products of the fruit juice industry. Solid-state fermentation has great potential for recycling the agro-industrial residues. In the present study, the effect of raw sour cherry kernel (RC) and fermented sour cherry kernel (FC) by Aspergillus niger on growth performance, carcass traits and meat quality in broiler chickens was investigated. A total of 343 one-day-old male broilers (Ross 308) were randomly allocated to 7 treatments with 7 replicates for each treatment and 7 birds in each replicate. The chicks were fed on a basal diet (control) and basal diet supplemented with RC or FC at the 1, 2, and 4% level. Dietary RC improved (P < 0.001) the feed conversion ratio (FCR) at the 1% inclusion level although chicks fed 2 and 4% RC had lower (P < 0.01) body weight (BW), body weight gain (BWG), and feed intake (FI) from day 1 to 42, compared with that of the birds in the control group. Dietary FC with 1% inclusion level increased (P ≤ 0.05) BWG from day 22 to 42 and also enhanced (P < 0.001) the FCR from day 1 to 42. However, 4% dietary FC had an adverse effect (P < 0.01) on BW, BWG, FI, and the FCR, compared with the control group. The bursa of Fabricius weight was raised (P < 0.01) as the supplemental FC level increased. Dietary RC and FC elevated gut weight (P < 0.01) and length (P ≤ 0.05). Broilers fed on 2% FC had a higher (P ≤ 0.05) ash level and a lower (P ≤ 0.05) b* value in thigh meat, compared with the 2% RC group. The results indicate that FC can be used in broiler nutrition up to 2% level although RC can be added to broiler diets up to 1% level without a detrimental effect on growth performance. Dietary inclusion of 1% RC or FC can be recommended due to the positive effects on broiler chickens.

The study was aimed to improve the nutritional composition of nettle (Utrica dioica L.) having positive effects on animals by solid-state fermentation. Aspergillus niger was used as a inoculant in fermentation of nettle. Before and after fermentation, crude protein (CP), ash, ether extract (EE), nitrogen-free extract (NFE), crude fiber (CF), hemicellulose (HC), neutral detergent fiber (NDF), acid detergent fiber (ADF) and acid detergent lignin (ADL) contents of nettle were determined. The ash, NFE and HC content of nettle were increased by fermentation. However, A. niger decreased the CF and EE in nettle. The results showed that solid-state fermentation with A. niger can be used to improve the nutritional composition of nettle.

This study aimed to investigate the effect of solid-state fermentation on the nutritional composition of cottonseed meal (CSM), sunflower meal (SFM) and hazelnut kernel meal (HKM). In this study, each feedstuff was divided into two treatment groups (unfermented and fermented) with five replicates. Nutritional changes in the feedstuffs were determined by analyzing crude protein, ether extract, ash, crude fiber, neutral detergent fiber, acid detergent fiber contents. Solid-state fermentation had effects on the nutritional composition in all feedstuffs. The best improvement in nutritional quality was obtained from the HKM with increasing the crude protein and decreasing the structural carbohydrates content. Fermented HKM can be considered as an alternative protein feed for soybean meal considering the nutritional composition.

INTRODUCTION: The prevalence of SCI is higher in the ICUthan in other units of the hospital because of frequent central venous catheters, urinary catheters, mechanical ventilation and long-term hospitalizations. In addition, the use of broad spectrum antibiotics frequently causes colonization and infections with resistant microorganisms in patients in these units. This study was undertaken to describe the impact of various risk factors and the antibiotic resistance of breeding microorganisms in the SBIE epidemiology acquired in the ICU METHODS: A retrospective study was carried out on prospectively collected data of 62 patients who applied internally at tertiary ICU between January 2014 and December 2017. The SBIH was diagnosed according to the Centers for Disease and Control definitions. All patients' data were obtained from hospital information management system and infection control committee patient follow-up forms. RESULTS: 36 (58.1%) of the cases were male and 26 (41.9%) were female. The causative agent of infection is primarily A. baumannii, K. pneumoniae and E. coli. The most common infection was found as urinary tract infection with 34%. Ventilator-associated pneumonia and bloodstream infection were more frequent in patients who were mechanically ventilated, and this was statistically significant In our study, all A. baumannii strains were carbapenem resistant. TMethicillin resistance was present in all of the coagulase (-) staphylococci. DISCUSSION AND CONCLUSION: It is also evident that a larger scale of work with a larger number of patients are needed, although each hospital considers that such studies are important in terms of knowing the infection frequency, factors and resistance profile in their unit.

Introduction: After the United States, The Food and Drug Administration approved the use of the first generic of the original tacrolimus in 2009, generic tacrolimus was preferred in many countries for cost-reducing reasons. This is the first study about the conversion of original to generic tacrolimus, reported from Turkey. Methods: The inclusion criteria of this single-center, retrospective study were (1) being ≥18 years old, (2) passing at least three months after kidney transplantation, (3) conversion from reference tacrolimus (PrografⓇ) to generic tacrolimus (AdoportⓇ). The endpoints were acute rejection, an increase in serum creatinine, decreases in e-GFR, tacrolimus level, tacrolimus concentration/dose ratio. We applied the paired T-test to analyze the pre-conversion and final visit laboratory values. Results: Thirty-six patients who agreed to use generic tacrolimus evaluated. The mean age was 39.8 years (± 11.6),% 52,7 were female,% 86,1 were living donor transplants. The patients followed up for 12 months [3-41]. There was no increase in serum creatinine value, no decreases in e-GFR and tacrolimus concentration/dose ratio. We observed a decrease in tacrolimus level (p = 0,037). There were 9 patients with positive BK-DNA. None of the patients needed a biopsy. Conclusions: Based on the results of our study, renal outcomes are safe and the drugs could be changed safely. Whether AdoportⓇ or PrografⓇ, whichever is used, it is important to take the drug at the recommended dose and time. The physician should be careful in dose adjustment after conversion, especially for those who are in the first year of transplantation.

The effects of raw (GP) and fermented grape pomace (FGP) on the growth performance, some carcass parameters, antioxidant status, intestinal morphology, and selected bacterial species in broiler chicken were investigated in this study. Grape pomace was fermented with Aspergillus niger for 7 d. In total, 140 one-day-old male chicks (Ross 308) were randomly assigned to four treatment groups, with five replicates and seven birds each. Chickens were fed either a basal diet (CON) or the basal diet supplemented with 0.25 g/kg synthetic antioxidants (5% butylated hydroxytoluene, 1% butylated hydroxyanisole, and 11% ethoxyquin) (AO), or 15 g/kg GP (GP), or 15 g/kg FGP (FGP) for 42 d. Dietary GP raised serum glutathione peroxidase (p = 0.031) and superoxide dismutase (p = 0.021) levels, increased ileum lamina muscularis thickness (p = 0.016), and did not affect selected bacterial species in the cecum of broiler chickens. Dietary FGP improved body weight (p = 0.003), increased the serum catalase level (p = 0.032), and decreased the cecal Clostridium perfringens count (p = 0.033) but did not affect the ileal morphology of broiler chickens. The carcass parameters, malondialdehyde level, pH, and color of the breast meat of chickens were not changed by either GP or FGP supplementation. Chickens fed with the synthetic antioxidants had similar growth performance with the chickens fed with FGP but had better body weight (p = 0.003) and feed conversion ratio (p = 0.045) compared with the chickens fed with GP. The obtained results showed that FGP can be used as an alternative to synthetic antioxidants in broiler diets.

Ochratoxin A is a toxic substance coming up with growing up of some species of Aspergillus and Penicillium at feedstuffs. Diseases and deaths can occur if this toxic substance is consumed by animals. Ochratoxin A can contaminate easily feedstuffs of mixed feeds while producing, harvesting and storing period and pose a serious threat for world and Turkey considering existing rate in feed and feedstuffs. Moreover taking account of passing to animal tissues, ochratoxin A pose a serious risk for human health. Regarding this, ochratoxin A has negative effects on human such as disorders of kidney and reproductive organs. In addition there is various methods to eliminate this damages made by ochratoxin A. In this review, existing of ochratoxin A in poultry feeds, the negative effects on poultry, transition to tissues and practices that can ease the negative effects were summarized.

Vena kava superior sendromunun VKSS belirti ve bulgularını damar tıkanıklığının seviyesi, şiddeti, süresi ile kollateral gelişimi belirlemektedir. Ayrıca hastalığın altında yatan nedene göre de belirti ve bulgulara rastlanabilir. Behçet Hastalığı damar tutulumuna bağlı olarak VKSS’una neden olabilmektedir. Türkiye, Behçet Hastalığının görülme sıklığı yüksek olan ülkelerden biridir. Bu olguda boyunda şişlik, nefes darlığı ve baş dönmesi ile başvuran hastada, Behçet Hastalığının neden olduğu VKSS anlatılmıştır

Abstract: Broad and deep perianal wounds are challenging in both adult and pediatric ICUs. These wounds, if contaminated with gastrointestinal flora, can cause invasive sepsis and death, and recovery can be prolonged. Controlling the source of infection without diverting stool from the perianal region is complicated. The option of protective colostomy is not well-known among pediatric critical care specialists, but it can help patients survive extremely complicated critical care management. These authors present three critically ill children who required temporary protective colostomy for perianal wounds because of various clinical conditions. Two patients were treated for meningococcemia, and the other had a total artificial heart implantation for dilated cardiomyopathy. There was extensive and profound tissue loss in the perianal region in the patients with meningococcemia, and the patient with cardiomyopathy had a large pressure injury. Timely, transient, protective colostomy was beneficial in these cases and facilitated the recovery of the perianal wounds. Temporary diverting colostomy should be considered as early as possible to prevent fecal transmission and accelerate perianal wound healing in children unresponsive to local debridement and critical care., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)