Search

Resumo Fundamento: A hipertensão pulmonar é uma condição que envolve a remodelação do ventrículo direito. A remodelação contínua também está associada ao prognóstico da doença. Durante o processo de reestruturação, alterações complexas como hipertrofia e dilatação também podem se refletir nos parâmetros eletrocardiográficos. Objetivos: Nosso estudo teve como objetivo investigar a relação entre prognóstico e parâmetros eletrocardiográficos em pacientes com hipertensão arterial pulmonar. Métodos: O estudo foi desenhado retrospectivamente e incluiu pacientes com diagnóstico de hipertensão arterial pulmonar entre 2010 e 2022. Os pacientes foram divididos em dois grupos com base no resultado de sobrevida. Vários parâmetros, incluindo parâmetros eletrocardiográficos, demográficos, ecocardiográficos, de cateter e sanguíneos, foram comparados entre os dois grupos. Um valor de p

Cystic echinococcus (CE) is a parasitic disease in humans and animals. Our study was performed with the aim of identifying the serology of hydatic cyst disease caused by the Echinococcus granulosus vector, causing a significant health problem in Eastern Anatolia and specifically in our province, among people living in rural areas and involved in animal husbandry. The population for this study comprised 75 volunteers living in rural regions of Erzurum practicing animal husbandry. Blood samples were stored at -40 °C until the time of the study. A survey form was completed to be able to identify the demographic data of participants and to reveal risk factors in terms of infectious vectors. After thawing blood samples at the time of the study, the immunochromatographic test procedure was implemented. The age distribution in the study group was 18 to 70 years, with a mean age of 46.8±15.97 years. The group comprised a total of 75 people, including 29 women (38.7%) and 46 men (61.3%). Of these 75 people with immunochromatographic screening performed, 72 were negative (96%) and 3 were weakly positive (0.5) (4%). It is notable that 4% CE seropositivity was found among individuals with no complaints. Linked to this seropositivity result, it is considered that creating a comprehensive CE screening program will be beneficial for individuals involved in animal husbandry. [Med-Science 2023; 12(3.000): 818-22]

Abstract The aim of this study, research the potential use of probiotics in reducing the toxic effect of Aflatoxin M1 in cow milk, goat milk, sheep milk, and Phosphate-buffered saline (PBS). Milk and Phosphate-buffered saline were contaminated with Aflatoxin M1 at a concentration of 100 ppt. Then, various study groups were formed by adding Lactobacillus acidophilus DSMZ 20079, Lactobacillus rhamnosus GG, and Bifidobacterium bifidum DSMZ 20456 probiotic bacteria at a density of 108 CFU/ml. Then, working groups were stored for 1 day and Aflatoxin M1 levels were analyzed by an Enzyme-Linked Immunosorbent Assay kit. The binding level of Aflatoxin M1 by probiotic bacteria varies between 2.32-12.52% in Phosphate-buffered saline, 9.08-40.14% in cow milk, 15.01-38.01% in goat milk, and 32.49-42.90% in sheep milk. The highest binding level of Aflatoxin M1 was detected in sheep milk and the lowest in Phosphate-buffered saline. The binding ability of Aflatoxin M1 is ranked from highest to lowest in sheep milk, cow milk, and goat milk. The data obtained from this study is important because it is the first study to show that if sheep and goat milk is enriched with probiotics, it can reduce AFM1 exposure.

ABSTRACT Phenotypic drug susceptibility testing (DST) requires a standardized amount of inoculum to produce reproducible susceptibility results. The most critical step in the application of DST in Mycobacterium tuberculosis isolates is the preparation of the bacterial inoculum. In this study, the effect of bacterial inoculum prepared in various McFarland turbidities on primary antituberculosis drug susceptibility of M. tuberculosis strains was investigated. Five standard ATCC strains (ATCC 27294 [H37Rv], ATCC 35822 [izoniazid-resistant], ATCC 35838 [rifampicin-resistant], ATCC 35820 [streptomycin-resistant], ATCC 35837 [ethambutol-resistant]) were tested. Inoculums of McFarland standard of 0.5, 1, 2, 3, and 1:100 dilutions of 1 McFarland standard of each strain were used. The effect of inoculum size on DST results was determined by the proportion method in Lowenstein-Jensen (LJ) medium and nitrate reductase assay (NRA) in the LJ medium. In both test methods, the increase in inoculum size did not affect the DST results of the strains. On the contrary, DST results were obtained more rapidly as a result of the use of dense inoculum. DST results obtained in all McFarland turbidities were found to be 100% compatible with the recommended amount of inoculum, 1:100 dilution of 1 McFarland standard (inoculum size of gold standard method). In conclusion, the use of a high amount of inoculum did not change the drug susceptibility profile of tuberculosis bacilli. Minimizing manipulations during the inoculum preparation phase of susceptibility testing, this outcome will decrease the need for equipment and make the test application easier, particularly in developing countries. IMPORTANCE During DST application, it can be challenging to evenly homogenize TB cell clumps with lipid-rich cell walls. These experiments must be carried out under Biosafety Level-3 (BSL-3) laboratory conditions with personal protective equipment and taking safety precautions because the procedures applied at this stage cause the formation of bacillus-laden aerosols and carry a serious risk of transmission. Considering this situation, this stage is important given that it is not possible to establish a BSL-3 laboratory in poor and developing countries. Reducing the manipulations to be applied during the preparation of bacterial turbidity will minimize the risk of aerosol formation. Perhaps there will be no need to do these steps for susceptibility tests in these countries or even in developed countries.

Abstract Background: Migraines are headaches caused by changes in the trigeminovascular metabolic pathway. Migraine headache attacks are associated with neurovascular inflammation, but their pathophysiological mechanisms have not been fully explained. Objective: To investigate the relationship between serum vaspin, visfatin, chemerin and interleukin-18 (IL-18) levels and the frequency of attacks in migraine headache. Methods: Three groups were established: migraine with aura (n = 50), migraine without aura (n = 50) and control group (n = 50). The migraine diagnosis was made in accordance with the International Classification of Headache Disorders-III beta diagnostic criteria. The analyses on serum vaspin, visfatin, chemerin and IL-18 levels were performed using the enzyme-linked immunosorbent assay method. Results: The serum vaspin, visfatin, chemerin and IL-18 levels were found to be significantly higher in the migraine patients than in the control group (p < 0.01). No statistically significant differences in serum vaspin, visfatin, chemerin and IL-18 levels were found among the migraine patients during attacks or in the interictal period (p>0.05). The serum visfatin and chemerin levels of the migraine patients were positively correlated with their serum IL-18 levels (p < 0.01), while their serum chemerin and visfatin levels were positively correlated with their serum vaspin levels (p < 0.05). Conclusions: This study showed that these biomarkers may be related to migraine pathogenesis. Nonetheless, we believe that more comprehensive studies are needed in order to further understand the role of vaspin, visfatin, chemerin and IL-18 levels in the pathophysiology of migraine headaches.

Background: The aim of this study was the validation of AYC.2.2 agar and AYC.2.1 broth for the breakpoint values of first- and second-line drugs for Mycobacterium tuberculosis. Method: A total of 12 isolates including 5 reference strains and 7 well-defined clinical isolates were tested for their antituberculosis susceptibilities. Inhibitory effects of first- and second-line antituberculous drugs including isoniazid, rifampicin, streptomycin, ethambutol, amikacin, capreomycin, kanamycin, para-aminosalicylic acid, ethionamide, rifabutin, ofloxacin, levofloxacin, and moxifloxacin were tested. Results: According to the minimal inhibitory concentration values obtained in 7H10 agar, 7H9-S broth, AYC.2.2 agar, and AYC.2.1 broth, category agreement is 100%, and very major discrepancy (MAD), MAD, and minor discrepancy ratios were determined as 0 for all drugs. Conclusion: It was concluded that breakpoint values by CLSI recommendation for 7H10 agar can be also used for AYC.2.2 agar and AYC.2.1 broth. In addition, further multicenter studies are needed to use the new medium in routine mycobacteriology laboratories.

Introduction: This study aimed to define the role of chlorhexidine gluconate (CG) in preoperatively skin cleansing and surgical site infection (SSI) and bacterial colonization reduction. Materials and Methods: This study was conducted in a public hospital on 120 patients, of whom 61 consisted the intervention group and 59 in the control group. The intervention group used bath gel that contains CG and the control group used bath gels/soap without any antiseptics. Using a swab, samples from the surgical site were taken from all patients before and after bath. Surgical sites were inspected in terms of redness, edema, or fluid drainage daily during their hospital stay, as well as at the 10th and 30th days after discharge. Fever, heart rate, and blood pressure were also followed closely. This data was recorded and statistically analyzed. Results: Infection was detected in 3.3% (n=120) of participants. In the control group, 6.8% were infected. Infection was not observed in the intervention group. Five bacteria were analyzed in terms of the effect of CG use on bacterial colonization and it was found that only Coagulase-Negative Staphylococci (CNS) growth was decreased with the use of CG. This decrease was found to be statistically significant. Conclusion: Our results suggest that cleansing the skin with CG before thoracic surgery may be beneficial in preventing SSI and reducing CNS colonization.

Abstract Natural killer (NK) cells are a critical component of the innate immune system. Chimeric antigen receptors (CARs) re-direct NK cells toward tumor cells carrying corresponding antigens, creating major opportunities in the fight against cancer. CAR NK cells have the potential for use as universal CAR cells without the need for human leukocyte antigen matching or prior exposure to tumor-associated antigens. Exciting data from recent clinical trials have renewed interest in the field of cancer immunotherapy due to the potential of CAR NK cells in the production of “off-the-shelf” anti-cancer immunotherapeutic products. Here, we provide an up-to-date comprehensive overview of the recent advancements in key areas of CAR NK cell research and identify under-investigated research areas. We summarize improvements in CAR design and structure, advantages and disadvantages of using CAR NK cells as an alternative to CAR T cell therapy, and list sources to obtain NK cells. In addition, we provide a list of tumor-associated antigens targeted by CAR NK cells and detail challenges in expanding and transducing NK cells for CAR production. We additionally discuss barriers to effective treatment and suggest solutions to improve CAR NK cell function, proliferation, persistence, therapeutic effectiveness, and safety in solid and liquid tumors.

This study focused on the prevalence of Demodex spp. in the students at Igdir University Vocational School of Health Services (VSHS) and on possible factors for this occurrence.The study was conducted with a total of 171 students (in the 1852 age group, mean age: 21.33±3.14, of whom 73 were male and 98 were female) between January 2018 and May 2018. Samples were taken from the students faces - especially the nasal root, forehead, and cheeks - using the cellophane tape method. The samples were analyzed under a microscope, without dyeing,at 10X and 40X magnifications. To discover possible causes for the Demodex spp. prevalence, a survey was given to the same students.In this investigation, 59 out of 171 students were found to have Demodex spp. There was no immediate relationship between the prevalence of Demodex spp. and variables such as gender, age, family type, the presence of chronic disease, or facial hygiene. However, the ratio of Demodex spp. prevalence reached 19% in students who habitually ate dried nuts and fruits compared to those who did not.We concluded that the Demodex spp.the infestation was very high in students at VSHS. We also detected a negative correlation between the prevalence of Demodex spp. and the habit of eating dried nuts and fruits. [Med-Science 2020; 9(4.000): 844-7]

The aim of this study is to investigate the effect of goal orientation and motivation of female footballers in sports on resilience power. In the study, there 183 female footballers based upon the leagues Süper Lig (Super League), PTT 1st League, 3rd League and Amateur League. As data collection tools, Resilience Scale, Task and Ego Orientation in Sport Questionnaire and Sport Motivation Scale were used. The results were obtained through One-way ANOVA and Regression analyses. As a result of the analyses, the female footballers have significant, positive and low level correlation between goal orientation and resilience; on the other hand, there is a significant, positive and very low level correlation between goal orientation and sport motivation (p lt;0,05). A significant, positive and low level correlation among the mean scores of resilience, goal orientation and sport motivation (p lt;0,05). There is a significant, positive and low level correlation between sport motivation and goal orientation (p lt;0,05). As a consequence of the results obtained, various suggestions are made in order to shed a light on the possible future studies.

Introduction and objective Hepatitis A Virus (HAV), reportedly the most common cause of acute viral hepatitis in developing countries, infects millions of people worldwide each year. The aim of the study is to investigate the seropositivity of anti-hepatitis A virus (HAV) IgG and IgM in all age groups in Erzurum, and to determine the effect of various factors such as age, gender, climatic conditions and HAV vaccination (included in 2012 in the National Immunization Schedule on seroprevalence) on the seropositivity. Material and methods The serological results of 25,007 individuals referred to Erzurum Public Health Microbiology Laboratory between January 2015 – December 2018 were retrospectively reviewed to test for the presence of anti-HAV IgG and IgM. The patient ages were 0–93 years. Serum samples were analyzed by ELISA. S/CO values of ≥1.00 and >1.21 were considered positive for anti-HAV IgG and IgM, respectively; results below this value were considered negative. Results Anti-HAV IgG and IgM seropositivities were 87.3% and 0.2%, respectively. Anti-HAV IgG prevalence – 88.5% and 86.4%, anti-HAV IgM positivity – 0.1% and 0.3% in men and women. Anti-HAV IgG seroprevalence – 87%, 73.2%, 58.7%, 75.2%, 86.1%, 89.8%, 96.1%, 99.1%, 99.1% and 99.3%, respectively, at 0–4, 5–9 10–14, 15–19, 20–24, 25–29, 30–39, 40–49, 50–59 and >60 age groups. Anti-HAV IgM seropositivity – 0, 0.1%, 0.7%, 0.7%, 0.3%, 0, 0.1%, 0.2%, 0.1%, and 0.2%, respectively, in the same age groups. Anti-HAV IgM positivity was the highest in November – 36(0.97%. Conclusions In Erzurum, anti-HAV IgG prevalence is tremendously high, whereas prevalence of anti-HAV IgM is exceptionally low, especially in the paediatric age group. Therefore, HAV vaccine is provided free of charge in Turkey, including Erzurum, since 2012.

Background: Because pyrazinamide (PZA) is only effective for Mycobacterium tuberculosis at an acidic pH, susceptibility tests are more difficult to perform than those for other anti-tuberculosis (TB) drugs. The purpose of our work was to investigate the effectiveness of colorimetric methods to detect PZA susceptibility and to detect pncA gene mutations in resistant isolates by sequence analysis. Methods: In this study, 30 clinical isolates and 2 reference isolates were used, 15 of which were resistant to PZA. The PZA susceptibility of all the isolates was determined by the BACTEC MGIT 960 reference method. As colorimetric methods, Resazurin Microtiter Assay (REMA), Nitrate Reductase Assay (NRA), Malachite Green Decolorization Assay (MGDA), and Crystal Violet Decolorization Assay (CVDA) methods were included in the study. In addition, mutations in the pncA gene were investigated using sequence analysis in PZA-resistant isolates. Results: As a result of the comparison of the colorimetric methods with the reference method, agreement was determined as 93.3% in REMA and NRA, 90% in MGDA, and 93.3% in CVDA. In 13 of 15 resistant isolates, the pncA gene mutation was detected by sequence analysis. Conclusions: As a result of the work, the results from the colorimetric methods were found to be at a high level of concordance with the reference method. They are also inexpensive and easily applicable methods.

Tongue squamous cell carcinoma (TSCC) is known to be the most malignant cancer type amongst other oral cancers with increasing incidence and mortality rates in the past five years. Since the life expectancy for TSCC patients is limited and the current chemo-radiotherapy treatments are not curative, novel biomarkers are urgently needed. As many other solid tumors, TSCC has a heterogeneous cancer cell population, which includes a small subpopulation identified as cancer stem cells (CSCs) that are considered as the driving force for tumor initiation, development, spread, recurrence, and resistance to chemo-radiotherapy. Although the underlying molecular mechanisms of how CSCs are involved in the carcinogenesis are not completely understood, scientists and clinicians aim to utilize those cells as therapeutic tools in fight against different cancer types including TSCC. Here, we reviewed and summarized important findings and the most current literature to shed light on the potential of cancer stem cells markers in TSCC. Possible functions of CSCs biomarkers in TSCC pathogenesis during cancer initiation, progression, invasion or metastasis are also summarized.

Introduction: Physicians are the most burn-outed group among the occupations. Among the physicians, family physicians have the highest burnout rates. Our objective in this study is to determine factors that are effective on work satisfaction of family physicians and their correlations with their burnout, anxiety-depression levels. Subjects and Methods: This cross-sectional descriptive study was carried out in primary health care professionals in region of Southeastern Anatolia from Diyarbakır Turkey. A survey form consists of 74 questions, and which questions burnout, job satisfaction, and anxiety-depression level has been applied on family medicine doctors, supplementary items in a questionnaire. Total of 343 family medicine doctors were reached, and the questionnaires were administered by face-to-face interview. Statistical Package for Social Sciences for Windows 18.0 software was used for statistical analysis. Results: Work satisfaction of family physicians who are on call lower compared to doctors who are not on call among family physicians who have joined to study (P < 0.005). It is determined that there is negative correlation between work satisfaction level of family physicians and emotional burnout, desensitisation, anxiety and depression point (P = 0.001 r = -0.23, P = 0.015, r = -0.16, P = 0.06, r = -0.124, P = 0.0001, r = -0.23), there is positive correlation between emotional burnout levels and anxiety, depression average points (P = 0.001, r = 0.34, P = 0.0001, r = 0.41), there is positive correlation between anxiety and depression points (P = 0.0001, r = 0.57). Conclusion: The work satisfaction level of family physicians, who are on call and whose financial income expectation is not satisfied, was found low. It is seen that there is strong correlation between inadequacy of work satisfaction with burnout and anxiety, depression. As this can have negative effects on work performance, there is a need to look for solutions to increase work performance of family physicians.

Background: Effective control of tuberculosis is achieved by early diagnosis and drug susceptibility testing for initiation of appropriate treatment. The performance of crystal violet decolorization assay (CVDA) for susceptibility testing of Mycobacterium tuberculosis to isoniazid (INH) and rifampicin (RIF) was compared in a multicenter study. Methods: Seventy-two M. tuberculosis isolates were tested in two phases by CVDA. Results: In Phase I, the specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and agreement for INH were 100%, respectively. Specificity, sensitivity, PPV, NPV, and agreement for RIF were 98.2%, 100%, 94.1%, 100%, and 98.6%, respectively. In Phase II, specificity, sensitivity, PPV, NPV, and agreement were 98%, 100%, 95.4%, 100%, and 98.6% for INH, respectively. Specificity, sensitivity, PPV, NPV, and agreement for RIF were 96.3%, 88.2%, 88.2%, 96.3%, and 94.4%, respectively. Results in the study were obtained on average 10.9 ± 3.1 days in Phase I and 9.8 ± 2.2 days in Phase II. Conclusion: CVDA can be performed for drug susceptibility testing in developed and developing countries. In addition, further studies with larger sample size are needed for evaluation of this method.

This research was conducted in order to determine the effects of different sowing times and plant densities on yield and some yield components of second crop sesame under semi-arid climate conditions at the GAP Agricultural Research Institute, Talat Demirören Research Station in 2015 and 2016 growing seasons in Şanlıurfa. Arslanbey sesame cv. seeds were used as material and the trial was carried out according to randomized blocks split plots experimental design with 3 replications. The main parcels were consisted of planting times (01 June, 15 June and 01 July), sub-parcels were divided into 2 different inter-row spaces (35 and 70 cm), and sub-sub plots were divided into 4 different intra-row spaces (5, 10, 15 and 20 cm). According to the findings in the study; the number of capsules per plant, number of seeds per capsule, oil ratio and seed yield were found statistically significant in terms of planting time in two years. Although the number of capsules per plant, oil ratio and seed yield were found significant in terms of inter-row distances, the number of seeds per capsule were found insignificant. The number of capsules per plant, number of seeds per capsule (except 2016), oil rate and seed yield were found statistically significant in terms of intra-row distances. As a result, it has been determined that the highest seed yields and oil ratio in second crop sesame cultivation obtained from the sowing densities of 35x5 and 35x10 cm in sowing dates of 1 and 15 of June under semi-arid climatic conditions.

Amaç: Bu çalışmanın amacı distal tibia kırığı nedeniyle minimal invaziv yöntem ve biyolojik fiksasyon prensipleri ile plak kullanarak osteosentez uyguladığımız olgularda klinik, radyolojik sonuç ve komplikasyonların değerlendirilmesidir.Gereç ve Yöntem: Bu çalışmada distal tibia kırığı nedeniyle minimal invaziv yöntem ve biyolojik fiksasyon prensipleri ile ameliyat olan 58 hasta (35 erkek, 23 bayan, ortalama yaş 32) ortalama 28 aylık takibleri sonucunda değerlendirildi. Hastaların kırıkları AO/OTA sınıflamasına göre değerlendirildi. Buna göre 16 hastada A1 (%27.6), 13 hastada A2 (%22.4), 14 hastada B1 (%24.1), 11 hastada B2 (%19), 4 hastada ise C1 (%6.9) tipi kırık mevcuttu. Tüm hastalarda kırıkların kaynama sonuçları, aktiviteye dönüşleri, ayak bileği hareket açıklıkları, enfeksiyon ve komplikasyonlar Johner ve Wruhs kriterlerine göre değerlendirildi.Bulgular: Hastalarda kırıkların ortalama kaynama süresi 13 hafta (11-24 arası) idi. Tüm olgularımızda kaynama elde edilirken bir hastada gecikmiş kaynama görüldü. Hiçbir olgumuzda enfeksiyon ve yara yeri problemi görülmedi. İki olguda kaynama sonrasında 5 derece varus deformitesi tespit edildi. Dört olgumuzda diğer ayağa kıyasla 5 derece, 4 olguda ise 10 derece dorsifleksiyon kaybı görüldü. Sonuç olarak Johner ve Wruhs değerlendirme kriterlerine göre 48 hasta mükemmel (%82.75), 10 hasta (%17.25) iyi olarak değerlendirildi.Sonuç: Yumuşak doku azlığı, zayıf vaskülarizasyon gibi nedenlerden dolayı komplikasyonla karşılaşma oranının yüksek olduğu distal tibia kırıklarında, minimal invaziv yöntem ve biyolojik plaklama prensipleri ile başarılı sonuçlar alınabilmektedir.r.

ABSTRACT Objective: Our study analyzed the incidence of posterior pelvic injury patterns and their influence on the surgical treatment of transverse-oriented acetabular fractures . Methods: Fifty-one transverse-oriented acetabular fracture cases admitted between 1999 and 2013 were evaluated retrospectively. Comparative studies were performed for groups organized by acetabular fracture type, degree of sacroiliac separation, and postoperative reduction quality . Results: Associated posterior pelvic injuries were found in 34 (66.7%) of the 51 patients. There were 32 sacroiliac separations in the 34 patients with associated posterior pelvic injury, and ipsilateral sacroiliac separations were more frequent in this subgroup. Measurements guided by computerized tomography showed that 16 sacroiliac separations were ≤0.5 cm (mean=0.43±0.14 cm), 10 were 0.5-1 cm (mean=0.73±0.17 cm), and the remaining 6 were >1 cm (mean=1.55±0.15 cm). In the group of 34 patients with associated posterior pelvic injury, acetabular reduction was anatomic in 19 (55.9%) patients, imperfect in 10 (29.4%) patients, and poor in 5 (14.7%) patients. For isolated acetabular fractures, reduction rates were as follows: 12 (70.6%) anatomic, 3 (17.6%) imperfect, and 2 (11.8%) poor. The rate of anatomic reduction was significantly higher when sacroiliac separation was ≤0.5 cm (p=0.027) . Conclusion: Associated posterior pelvic injuries, especially ipsilateral sacroiliac joint separation, accompany most transverse-oriented acetabular fractures and may influence the quality of acetabular reduction. Level of Evidence III, Therapeutic Studies Investigating the Results of Treatment.

Lynch syndrome is characterized by predisposition to colorectal cancer and mutations in genes involved in mismatch repair. Here, the authors use whole genome sequencing and immunohistochemistry of mismatch repair proteins to show a high prevalence of Lynch syndrome in the Icelandic population.

Background: Recently, total laparoscopic pancreatectomy has been performed at many centres as an alternative to open surgery. In this study, we aimed to present the difficulties that we have encountered in converting from classic open pancreaticoduodenectomy to total laparoscopic pancreatectomy. Materials and Methods: Between December 2012 and January 2014, we had 100 open pancreaticoduodenectomies. Subsequently, we tried to perform total laparoscopic pancreaticoduodenectomy (TLPD) in 22 patients. In 17 of these 22 patients, we carried out the total laparoscopic procedure. We analysed the difficulties that we encountered converting to TLPD in three parts: Preoperative, operative and postoperative. Preoperative difficulties involved patient selection, preparation of operative instruments, and planning the operation. Operative difficulties involved the position of the trocars, dissection, and reconstruction problems. The postoperative difficulty involved follow-up of the patient. Results: According to our experiences, the most important problem is the proper selection of patients. Contrary to our previous thoughts, older patients who were in better condition were comparatively more appropriate candidates than younger patients. This is because the younger patients have generally soft pancreatic texture, which complicates the reconstruction. The main operative problems are trocar positions and maintaining the appropriate position of the camera, which requires continuous changes in its angles during the operation. However, postoperative follow-up is not very different from the classic procedure. Conclusion: TLPD is a suitable procedure under appropriate conditions.

Background and Objectives. Chronic venous insufficiency (CVI) is a common pathology of the circulatory system and is associated with a high morbidity for the patients and causes high costs for the healthcare systems. Arterial stiffness has been shown to be a predictor of cardiovascular events and mortality. The relationship between CVI and arterial stiffness using pulse wave velocity (PWV) and augmentation index (Aix) was evaluated in this study. Methods. Sixty-two patients with the stage of C3-C5 chronic venous disease (CVD) and 48 healthy subjects were enrolled in the study. To assess arterial stiffness, all cases were evaluated with I.E.M. Mobil-O-Graph brand ambulatory blood pressure monitor device. PWV and Aix were used to assess arterial stiffness in this study. Results. The mean age was 61.9±11.05 years and 54 % of the patient population was females. PWV and Aix were significantly higher in CVI patients than controls (8.92±1.65 vs. 8.03±1.43, p=0.001; 25.51±8.14 vs. 20.15±9.49, p=0.003, respectively) and also positive linear correlation was observed between CVI and all measured arterial stiffness parameters (r=0.675 for CVI and PWV, r=0.659 for CVI and Aix, respectively). A PWV value of > 9.2 has 88.9 % sensitivity and 71.4 % specificity to predict the presence of CVI. Conclusions. PWV and Aix are the most commonly used, easy, reproducible, reliable methods in the clinic to assess arterial stiffness. Logistic regression analysis showed that PWV and Aix were the independent predictors of CVI. PWV has the sensitivity of 88.9 % and specificity of 71.4 % to detect the presence of CVI.

The purpose of this study is to evaluate four rapid colourimetric methods, including the resazurin microtitre assay (REMA), malachite green decolourisation assay (MGDA), microplate nitrate reductase assay (MNRA) and crystal violet decolourisation assay (CVDA), for the rapid detection of multidrug-resistant (MDR) tuberculosis. Fifty Mycobacterium tuberculosisisolates were used in this study. Eighteen isolates were MDR, two isolates were only resistant to isoniazid (INH) and the remaining isolates were susceptible to both INH and rifampicin (RIF). INH and RIF were tested in 0.25 µg/mL and 0.5 µg/mL, respectively. The agar proportion method was used as a reference method. MNRA and REMA were performed with some modifications. MGDA and CVDA were performed as defined in the literature. The agreements of the MNRA for INH and RIF were 96% and 94%, respectively, while the agreement of the other assays for INH and RIF were 98%. In this study, while the specificities of the REMA, MGDA and CVDA were 100%, the specificity of the MNRA was lower than the others (93.3% for INH and 90.9% for RIF). In addition, while the sensitivity of the MNRA was 100%, the sensitivities of the others were lower than that of the MNRA (from 94.1-95%). The results were reported on the seventh-10th day of the incubation. All methods are reliable, easy to perform, inexpensive and easy to evaluate and do not require special equipment.

The aim of this study was to investigate the performance of a new and accurate method for the detection of isoniazid (INH) and rifampicin (RIF) resistance among Mycobacterium tuberculosis isolates using a crystal violet decolourisation assay (CVDA). Fifty-five M. tuberculosis isolates obtained from culture stocks stored at -80ºC were tested. After bacterial inoculation, the samples were incubated at 37ºC for seven days and 100 µL of CV (25 mg/L stock solution) was then added to the control and sample tubes. The tubes were incubated for an additional 24-48 h. CV (blue/purple) was decolourised in the presence of bacterial growth; thus, if CV lost its colour in a sample containing a drug, the tested isolate was reported as resistant. The sensitivity, specificity, positive predictive value, negative predictive value and agreement for INH were 92.5%, 96.4%, 96.1%, 93.1% and 94.5%, respectively, and 88.8%, 100%, 100%, 94.8% and 96.3%, respectively, for RIF. The results were obtained within eight-nine days. This study shows that CVDA is an effective method to detect M. tuberculosis resistance to INH and RIF in developing countries. This method is rapid, simple and inexpensive. Nonetheless, further studies are necessary before routine laboratory implementation.

Aims: The present meta-analysis aims to assess the evidence regarding the diagnostic accuracy and performance characteristics of the colorimetric redox indicator (CRI) assay with a special emphasis on the use of the resazurin microtiter assay (REMA) for determination of primary anti-tuberculosis drug resistance. Subject and methods: By updating previous literature searches in Medline PubMed, ISI Web, Web of Science and Google academic databases of the REMA test for determination of primary anti-tuberculosis drug resistance, this meta-analysis includes 14 studies for isoniazid (INH); 15 studies for rifampicin (RIF); 6 studies for streptomycin (STR); and 5 studies for ethambutol (EMB). SROC curve analysis was performed for meta-analysis and diagnostic accuracy was summarized. Results: Pooled sensitivity was 96% (94–98%) for INH, 97% (95–98%) for RIF, 92% (87–96%) for EMB and 92% (88–95%) for STR. Pooled specificity for INH, RIF, EMB and STR was 96% (95–98%), 99% (98–99%), 86% (81–89%) and 90% (87–93%), respectively. Susceptibility testing results had been obtained in 8–9days. Conclusion: In conclusion, REMA seems to be a reliable test for the determination of multi-drug resistant (MDR) isolates in laboratories with limited resources. However, few studies for STR and EMB have been found, and cost-effectiveness studies need to be determined to recommend its widespread use.

INTRODUCTION AND AIM: Biopsychosocial approach suggests that the individual's health condition is partly influenced by the interactions of biological, psychological, and social processes. It also concludes that the clinical method should be patient-centered, which is based on the physician's involvement in the patient's world and the physician's ability to see the illness from the patient's view. In this study, we aimed to determine the extent to which medical faculty assistant doctors use the biopsychosocial approach in their clinical practice. MATERIALS AND METHODS: Our study is a cross-sectional type, descriptive, and analytical research. The sample size consisted of assistant doctors who met the inclusion criteria which were accepted to participate in the study between December 1, 2017, and March 1, 2018, at the medical faculty hospital of Dicle University. Two hundred and three physicians participated in our study. The Patient–Physician Orientation Scale (PPOS), The Jefferson Scale of Physician Empathy (JSPE), and a survey study including questions in relation with sociodemographic characteristics were conducted in our study. The reliability of the Patient–Physician Orientation Scale (PPOS) and JSPE used in our study was tested with Cronbach's alpha and found to be 0.878 and 0.931, respectively. Questionnaires were administered by a face-to-face interview method during interview. Information on the purpose and method of the study was given. RESULTS: A total of 203 physicians participated in our study. One hundred and forty-three (70%) participants were male and 60 (30%) were female. According to medical disciplines, eight physicians (3, 9%) from psychiatry, 21 (10, 3%) from family medicine, 104 (51, 2%) from other internal medical disciplines, and 70 (34, 5%) from surgical medical disciplines participated in the study. In the first subgroup of the PPOS, which is used in our study, the average score of psychiatry physicians was 3.67 ± 0.99, family medicine assistant doctors 3.92 ± 0.67, other internal medical disciplines 3.98 ± 0.65, and surgical medical discipline 3.83 ± 0.61. In the second subgroup, which is defined as the care in the same scale, the average score of psychiatry assistant doctors was found to be 3.20 ± 0.45, family medicine assistant doctors 3.68 ± 0.54, other internal medical disciplines 3.49 ± 0.60, and surgical medical discipline 3.68 ± 0.58. The results of the Jefferson Scale used to determine the level of empathy in our study are found as psychiatry 78.25 ± 14.78, family physician 67.71 ± 14.69, other internal medical disciplines 72.03 ± 13.46, and surgical medical discipline 70.87 ± 15.24. CONCLUSIONS: The biopsychosocial approach is primarily an elementary approach model in medical discipline such as family medicine and should be applied to other internal and surgical medical disciplines as well. With conducting this study, the awareness of this area will be increased and related issues in the literature will be enriched.

Along with many other factors, capital plays an important role in the gradual increase of the globalization. As the fixed and financial capital becomes more fluid day by day, many countries are forced to take novel decisions about taxes on capital and implement these decisions. The taxes which aim to hold the available capital within the borders of the country and to invite the circulating capital into the country resulted in a shift from the principal of fairness in taxation to goal of fostering economic activity in Turkey. Dual taxation system has a crucial role in this change. This study tries to examine and analyze this process of change.

In this study we evaluated the crystal violet decolorization assay (CVDA) for detection of minimum inhibitory concentration (MIC) of antituberculosis drugs. 53 isolates were tested in this study and 13 of them were multidrug resistant (MDR) isolates. The antibiotics concentrations were 2-0.06 mg/L for isoniazid (INH) and rifampicin (RIF) and were 16-0.25 mg/L for streptomycin (STM) and ethambutol (EMB). Crystal violet (CV-25 mg/L) was added into the microwells on the seventh day of incubation and incubation was continued until decolorization. Decolorization of CV was the predictor of bacterial growth. Overall agreements for four drugs were detected as 98.1%, and the average time was detected as 9.5 ± 0.89 day after inoculation. One isolate for INH and two isolates for STM were determined resistant in the reference method, but susceptible by the CVDA. One isolate was susceptible to EMB by the reference method, but resistant by the CVDA. All results were concordant for RIF. This study shows that CVDA is a rapid, reliable and suitable for determination of MIC values of Mycobacterium tuberculosis. And it can be used easily especially in countries with limited-sources.

The microplate nitrate reductase assay (MNRA) and the rezasurin microtitre assay (REMA) were used for the susceptibility testing of 73 clinical isolates and the results were compared with those that were obtained using the Bactec 460 TB and Bactec MGIT 960 systems. The REMA and the MNRA were performed in 96-well plates. For the REMA, the concentrations of isoniazid (INH) and rifampicin (RIF) ranged from 1.0-0.01 µg/mL and 2.0-0.03 µg/mL, respectively. For the MNRA, the INH concentration was between 1.0-0.03 µg/mL and the RIF concentration was between 2.0-0.06 µg/mL. For the MNRA, the sensitivity, specificity, positive predictive value, negative predictive value and INH/RIF agreement were 100/95.6, 97.6/100, 96.8/100, 100/98 and 98.6/98.6, respectively, and for the REMA, they were 100/91.3, 90.4/100, 88.5/100, 100/96.1 and 94.5/97.2, respectively. Our data suggest that these two rapid, low-cost methods may be inexpensive, alternative assays for the rapid detection of multidrug resistant tuberculosis in low-income countries.

OBJECTIVES: Data on the factors that contribute to the antibody response to hepatitis B virus vaccination in peritoneal dialysis patients are scarce. The current study was conducted on a group of peritoneal dialysis patients to learn how the response to hepatitis B virus vaccination varies according to the patient's clearance of urea normalized to total body water (Kt/V). METHODS: A convenience sample of 33 peritoneal dialysis patients (13 women and 20 men, with a mean age of 49¡12 years) was administered double doses (20 μg IM in each deltoid muscle) of recombinant hepatitis B vaccine at 0, 1, 2, and 6 months. Response to immunization was measured at one to three months after the final dose of vaccine. The subjects were divided into groups according to the level of antibodies to hepatitis B surface antigen (anti-HBs), including non-responders ( < 10 IU/L), weak responders (10-100 IU/L), and good responders ( > 100 IU/L). RESULTS: Among non-responders, weak responders, and good responders, significant differences were found in age (54 ± 12 vs. 56 ± 9 vs. 45¡12 years, respectively; p = 0.049) and recombinant human erythropoietin use (20 vs. 29 vs. 76%, respectively; p = 0.016). No significant differences in weekly total Kt/V (p = 0.704), weekly peritoneal Kt/V (p = 0.064) and residual glomerular filtration rate (p = 0.355) were found across the three groups. CONCLUSIONS: Delivered clearance measured by weekly peritoneal Kt/V and total clearance measured by weekly total Kt/V did not predict the response to hepatitis B virus vaccination in patients on peritoneal dialysis.

Early detection of drug resistance in Mycobacterium tuberculosis isolates allows for earlier and more effective treatment of patients. The aim of this study was to investigate the performance of the malachite green decolourisation assay (MGDA) in detecting isoniazid (INH) and rifampicin (RIF) resistance in M. tuberculosis clinical isolates. Fifty M. tuberculosis isolates, including 19 multidrug-resistant, eight INH-resistant and 23 INH and RIF-susceptible samples, were tested. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and agreement of the assay for INH were 92.5%, 91.3%, 92.5%, 91.3% and 92%, respectively. Similarly, the sensitivity, specificity, PPV, NPV and agreement of the assay for RIF were 94.7%, 100%, 100%, 96.8% and 98%, respectively. There was a major discrepancy in the tests of two isolates, as they were sensitive to INH by the MGDA test, but resistant by the reference method. There was a minor discrepancy in the tests of two additional isolates, as they were sensitive to INH by the reference method, but resistant by the MGDA test. The drug susceptibility test results were obtained within eight-nine days. In conclusion, the MGDA test is a reliable and accurate method for the rapid detection of INH and RIF resistance compared with the reference method and the MGDA test additionally requires less time to obtain results.

BACKGROUND: Markers of an acute phase reaction, such as C-reactive protein (CRP) or tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-6, are predictive for cardiovascular morbidity and mortality in normal subjects and in chronic renal failure patients. In this study, we aimed to investigate serum TNF-α, IL-6, IL-10 and CRP levels in continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) patients.

The susceptibility of 49 Mycobacterium tuberculosis clinical isolates to isoniazid (INH) and rifampisin (RIF) (28 multi-drug resistant-tuberculosis samples) was determined by a nitrate reductase assay (NRA) on blood agar. Agreement between the NRA and other testing methods was found to be 93.8% for both INH and RIF. The sensitivity, specificity, positive predictive value and negative predictive value for INH were 92.8%, 94.2%, 86.6% and 97%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value for RIF were 90.4%, 96.4%, 95% and 93.1%. In conclusion, we show here that blood agar can be used effectively for the NRA test.

Acquired stuttering is a disorder of the fluency of speech. The mechanism underlying stuttering is unknown. It may occur after bilateral and unilateral cortical or subcortical brain damage. We report two cases who had stuttering resulting from left parietal infarction.

In recent studies, it was shown that blood agar can be used at least as effectively as Löwenstein-Jensen medium for growing Mycobacterium tuberculosis. It was also shown that susceptibility testing can be performed on blood agar. Additional validation of blood agar was performed on regional M. tuberculosis isolates from Turkey to determine critical concentrations of isoniazid (INH), rifampicin (RIF), ethambutol (ETM), and streptomycin (STR). In the current study, 40 M. tuberculosis clinical isolates were tested. H37Rv, which is susceptible to all antituberculosis agents, ATCC 35822 (INH-resistant), ATCC 35838 (RIF-resistant), ATCC 35837 (ETM-resistant), and ATCC 35820 (STR-resistant) quality control strains were used as control strains. Proportion method on 7H11 agar was considered as gold standard in the study. MIC values of the control strains and clinical isolates were detected on blood and 7H11 agar. Categorical agreements were 100% for each antibiotic, and essential agreements were 100%, 97.5%, 82.5%, and 95% for INH, RIF, ETM, and STR, respectively. According to the data, 0.2 µg/mL for INH, 1 µg/mL for RIF, 4 µg/mL for ETM, and 2 µg/mL for STR were appropriate breakpoint values for susceptibility testing on blood agar. Blood agar may be recommended for use in both developed and developing countries for the susceptibility testing of M. tuberculosis isolates to primary antituberculosis drugs.

In this study, we have evaluated the broth microdilution method (BMM) for susceptibility testing of Mycobacterium tuberculosis. A total of 43 clinical isolates of M. tuberculosis and H37Rv as a control strain were studied. All isolates were tested by the proportion method and the BMM for isoniazid (INH), rifampicin (RIF), streptomycin (STR), and ethambutol (ETM). The proportion method was carried out according to the National Committee for Clinical Laboratory Standards (NCCLS) on Löwenstein-Jensen (LJ) medium. The BMM was carried out using 7H9 broth with 96 well-plates. All strains were tested at 3.2-0.05 µg/ml, 16-0.25 µg/ml, 32-0.5 µg/ml, and 32-0.5 µg/ml concentrations for INH, RIF, STR, and ETM, respectively. When the BMM was compared with the proportion method, sensitivity was 100, 100, 96.9, and 90.2%, while specificity was 100, 85.7, 90.9, and 100% for INH, RIF, STR, and ETM, respectively. The plates were examined 7, 10, 14, and 21 days after incubation. The majority of the result were obtained at 14th days after incubation, while the proportion method result were ended in 21-28 days. According to our results, it may be suggested that the BMM is suitable for early determining of multidrug-resistance-M. tuberculosis strains in developed or developing countries.

Calciphylaxis is an uncommon complication of end stage renal disease (ESRD) and secondary hyperparathyroidism. It characterized by cutaneous necrosis with mural calcifications and thrombosis in the small vessels of dermis. It is important to diagnose and treat, because of mortality rate from calciphylaxis is very high. We present the case of a patient with ESRD and type II diabetes mellitus developing calciphylaxis of the both upper and lower extremities had normal corrected calcium-phosphate product level. After amputation, necrosis was showed rapid progression resulting in death in one month.

The objective of this study was to investigate the frequency and type of chromosome segregation patterns in cleavage stage embryos obtained from male carriers of Robertsonian (ROB) and reciprocal (REC) translocations undergoing preimplantation genetic diagnosis (PGD) at our reproductive center. We used FISH to analyze chromosome segregation in 308 day 3 cleavage stage embryos obtained from 26 patients. The percentage of embryos consistent with normal or balanced segregation (55.1% vs. 27.1%) and clinical pregnancy (62.5% vs. 19.2%) rates were higher in ROB than the REC translocation carriers. Involvement of non-acrocentric chromosome(s) or terminal breakpoint(s) in reciprocal translocations was associated with an increase in the percent of embryos consistent with adjacent 1 but with a decrease in 3∶1 segregation. Similar results were obtained in the analysis of nontransferred embryos donated for research. 3∶1 segregation was the most frequent segregation type in both day 3 (31%) and spare (35%) embryos obtained from carriers of t(11;22)(q23;q11), the only non-random REC with the same breakpoint reported in a large number of unrelated families mainly identified by the birth of a child with derivative chromosome 22. These results suggest that chromosome segregation patterns in day 3 and nontransferred embryos obtained from male translocation carriers vary with the type of translocation and involvement of acrocentric chromosome(s) or terminal breakpoint(s). These results should be helpful in estimating reproductive success in translocation carriers undergoing PGD.

The Portevin–Le Chatelier (PLC) effect manifests itself as an unstable plastic flow during tensile tests of some dilute alloys under certain regimes of strain rate and temperature. The plastic strain becomes localized in the form of bands which move along a specimen gauge in various ways as the PLC effect occurs. Because the localization of strain causes degradation of the inherent structural properties and surface quality of materials, understanding the effect is crucial for the effective use of alloys. The characteristic behaviors of localized strain bands and techniques commonly used to study the PLC effect are summarized in this review. A brief overview of experimental findings, the effect of material properties and test parameters on the PLC effect, and some discussion on the mechanisms of the effect are included. Tests for predicting the early failure of structural materials due to embrittlement induced by the PLC effect are also discussed.

The purpose of this research is to assess the sports and socialization of the students studying in different sports branches in Gumushane University. "Socialization-Sports and Socialization Scale" developed by Sahan was used in this research. A total of 742 students composed of 316 females and 426 males studying in Gumushane University participated in this survey modelled research. Data obtained were evaluated in SPSS package program. Reliability coefficient of the scale was found to be 0.896. T-Test, Kruskall Wallis and ANOVA were used in statistical assessment of data. Pearson Product-Moment Correlation analysis was used to determine whether there was a significant relation between socialization and sports-socialization scores and the causal relations between two variables were tested with simple linear regression analysis. The study was analyzed in terms of certain variables and it was concluded that the variables of gender, age, place of residence and type of sports done by the participants did not make a difference on sports-socialization and socialization scores. It is also observed that there is a positive and significant relation between the variables of socialization and sports-socialization (r = 0.624, p<0.01). In other words, it can be stated that the higher the socialization scores of the participants are, the higher their sports-socialization scores become, accordingly.

BACKGROUND Mycobacterium tuberculosis (MTB) is one of the most significant causes of mortality and morbidity. Early diagnose is important especially in multiple drug resistant tuberculosis to avoid transmission. Traditional techniques requires at least one to three weeks for diagnosis of tuberculosis. Diagnostic delays with multiple drug resistant tuberculosis are associated with worse clinical outcomes and increased transmission The Xpert MTB/RIF assay is one of the new diagnostic device for the diagnosis of tuberculosis and rapid detection of rifampicin resistance. OBJECTIVE We assessed the performance of Xpert MTB/RIF assay for detecting rifampicin resistance using phenotypic drug susceptibility tests as automated BD MGIT 960. METHODS Total of 2136 specimens were included in the study. Xpert MTB/RIF testing was performed on samples, using version 4 cartridges, according to the manufacturer's recommendations. The MTBC culture and first-line phenotypic DST were performed in automated BD MGIT 960 (Becton & Dickinson, USA) according to the recommendations of the manufacturer. Agar proportion was used in the case of inconsistency for rifampicin resistance. FINDINGS Thirty-four samples (19 respiratory and 15 nonrespiratory samples) were determined as positive for M. tuberculosis complex by Xpert MTB/RIF (Cepheid GeneXpert® System, USA). Xpert MTB/RIF assay detected 4/34 (11.7%) specimens as rifampicin resistant. One of the rifampicin resistant isolates was determined susceptible in MGIT 960 automated system. This isolate was also tested with agar proportion method and found susceptible to rifampicin. MAIN CONCLUSION The Xpert MTB/RIF assay can be used as first-line assay for the detection of M. tuberculosis. However, microbiologists must be aware of the limitations of the assay.