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Contribution to the 2011 LESLLA Symposium.

This research aims at finding out the teachers’ effort in developing the students’ ability in reading Al-Yaqūt Al-Nafīs at class two senior high school. This research employed the Descriptive Qualitative method. Its findings indicate an increase in the teachers’ effort in developing students’ ability in reading and translating Al-Yaqūt Al-Nafīs. The teachers applied sorogan method in the teaching and learning process and applied repetition and practice techniques in learning Al-Yaqūt Al-Nafīs.

Background. Endoscopic submucosal dissections (ESDs) allow removal of large gastrointestinal tumors and help patients avoid major oncologic surgery. In this study, the challenges and development of approaches toward successfully handling ESDs were analyzed in 279 colorectal specimens (114 rectal, 47 left, 118 right colonic; 90% adenoma with/without carcinoma). Methods. Each specimen was processed according to an established protocol including gross photography, mapping, and total submission for histopathologic examination. Results. Mean lesion size was 4.2 cm (range: 0.5-22 cm; 28% ≥5 cm; 6% ≥10 cm). Invasive carcinoma was present in 38 cases (14%), which had a mean overall tumor size of 3.8 cm (range: 1.1-17.5 cm), and mean largest size of the invasive component was 0.93 cm (range: 0.04-3 cm). Fifteen cases were staged as pT1a (submucosal invasion of

This work deals with the application of new approaches to welding production of modern light, strong, and heat-resistant metal composite materials in aeronautical and space technology. The objective of this article is to substantiate introduction of modern technology for welding composites in production, namely the development of argon-arc welding technology and the choice of equipment when using composites of the Al-B system for manufacturing the flame tube of the combustion chamber of an aircraft engine. Based on the study of technical literature and scientific publications, a short analysis of the existing technological processes for welding heat-resistant glass-ceramic composites was carried out. The problems arising in the process of welding aluminum composites reinforced with boron and steel fibers are considered. A modern gas tungsten arc welding based on new technological processes is offered with an example of welding in manufacturing a combustion chamber of a modern gas turbine modified engine.

Background Peroral endoscopic myotomy (POEM) is used to treat achalasia with efficacy and reliability. However, during the procedure potential complications require attention in terms of anesthesia. This study aimed to investigate complications of the POEM procedure and its effects on arterial blood gas (ABG) parameters, peak airway pressures (PIP), hemodynamics, and postoperative analgesia requirements. Methods Data from 220 patients who underwent POEM between 2014 and 2017 were retrospectively assessed. During the procedure, ABG samples, PIP, mean arterial pressure, and heart rate were recorded. The effects of the procedure and paracentesis on ABG, PIP, mean arterial pressure, heart rate, perioperative complications, and postoperative analgesia requirements were assessed. Results Data from 220 POEM patients were analyzed. During the procedure, the mean PaCO2 was 48.27±6.34 mm Hg, which was significantly higher than the PaCO2 values before and after the procedure. The mean increase in maximum PIP was 5.90±3.49 cmH2O during the procedure. However, there was a significant decrease in PaCO2 and PIP values in cases with paracentesis compared with those without paracentesis. With regards to complications, subcutaneous emphysema (48, 21.8%), pneumoperitoneum requiring decompression (66, 30%), pneumothorax (1, 0.5%), aspiration pneumonia (1, 0.5%), and bronchospasm (5, 2.2%) were observed during the procedure. In the postoperative period, 58 patients (26%) had additional analgesia requirements because of visual analog scale values >3. Conclusion Periprocedural abdominal decompression with veress needle led to a reduction in arterial PaCO2 and PIP, and improved postoperative analgesia. Serious complications because of perioperative aspiration and CO2 insufflation were observed during the POEM procedure.

Background: Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine carcinoma of the skin. In this study, we aimed to evaluate the clinicopathologic characteristics, treatment outcomes, and survival of MCC cases in Turkey. Materials and Methods: The patients diagnosed with MCC between 1999 and 2018 at twenty different centers in Turkey were included in the study. Patient and tumor characteristics and adjuvant and metastatis treatment outcomes were analyzed retrospectively. Results: The median age of totally 89 patients was 70 (26-93). The most common primary location was lower limbs (n = 29, 32.5%). Immunohistochemically, CK20 positivity was present in 59 patients (66.3%). Only two patients had secondary malignancy. The majority of the patients (n = 76, 85.4%) were diagnosed at the localized stage. Surgery was performed for all patients in the early stage, and adjuvant radiotherapy or/and chemotherapy was applied to 52.6% (n = 40) of nonmetastatic patients. The median follow-up was 29 months. Recurrence developed in 21 (27.6%) of the 76 patients who presented with local or regional disease. Two-year disease-free survival (DFS) was 68.1% and 5-year DFS was 62.0% for localized stage. The 5-year DFS was similar for patients receiving adjuvant treatment (chemotherapy, radiotherapy, or sequential chemoradiotherapy) and without adjuvant therapy (P > 0.05). Two-year overall survival in patients who presented with localized disease was 71.3% and 18.5% in metastatic patients (P < 0.001). In the metastatic stage, platinum/etoposide combination was the most preferred combination regimen. Median progression-free survival (PFS) in first-line chemotherapy was 7 months (95% confidence interval: 3.5-10.5 months; standart error: 1.78). Conclusions: Although MCC is rare in Turkey, the incidence is increasing. Gender, CK20 status, tumor size, lymph node involvement, and adjuvant treatment were not associated with recurrence. © 2021 Wolters Kluwer Medknow Publications. All rights reserved.

Pyruvate carboxylase (PC) deficiency is a rare autosomal recessive disease and provides clinics in three essential phenotypes. Type B PC deficiency is characterized by lactic acidosis and hyperammonemia. We report a Turkish patient who was diagnosed with type B PC deficiency. Despite the application of anaplerotic treatment with biotin, citrate and arginine-aspartate, continuous veno-venous hemodialysis (CVVHD) treatments were applied due to the failure to keep hyperammonemia and lactic acidosis under control. Ammonia values increasing to 860 mu mol/L were observed. A homozygous novel variant was detected in PC gene analyses containing a 12-base pair deletion on exon 8. Although the mutation found was not reported previously, it was accepted as a pathogenic variant due to its presence in a functional region of the protein. In type B PC deficiency, although a high level of ammonia is expected, it rarely exceeds 200 mu mol/L. As far as we know, the present case has the highest ammonia values in the literature. This paper has been shared to highlight to keep PC deficiency in mind regarding the differential diagnosis of hyperammonemia, particularly in the presence of lactic acidosis, and to serve as a model for the use of different modalities in the management process of PC deficiency. C1 [Kose, Melis Demir] Izmir Katip Celebi Univ, Sch Med, Dept Pediat, Div Inborn Errors Metab, Ismet Kaptan St, TR-35100 Izmir, Turkey. [Colak, Ruya; Ergon, Ezgi Yangin; Kulali, Ferit; Yildiz, Meral; Alkan, Senem; Calkavur, Sebnem] Behcet Uz Children Training & Res Hosp, Dept Neonatol, Izmir, Turkey. [Atilgan, Taner] Pamukkale Univ, Fac Med, Dept Neonatol, Denizli, Turkey. [Aslan, Fatma; Serdaroglu, Erkin] Behcet Uz Children Training & Res Hosp, Dept Nephrol, Izmir, Turkey. [Brown, Ruth; Brown, Garry] Oxford Univ Hosp NHS Fdn Trust, Oxford Med Genet Labs, Oxford, England.

Background: This study aims to investigate the factors affecting food intake in perioperative period of patients who undergo open heart surgery and the effects of body weight, albumin and hemoglobin values, nausea, vomiting and constipation on food intake.Methods: This cross -sectional study was conducted between 4 February 2015 and 4 May 2015 in a cardiovascular surgery clinic. A questionnaire including 25 questions was applied to a total of 86 volunteer participants (62 males, 24 females; mean age 61.310.8 years; range 38 to 82 years).Results: Patients consumed 38% of the food one day before the surgery and 51% one day after, 47% three days after, and 52% five days after the surgery. Factors affecting food intake were the procedure of discontinuing food intake for pre-surgery anesthesia preparation (84.9%), nausea (31.4%) one day after surgery, and constipation three (26.5%) and five (33.7%) days after surgery. Albumin levels decreased significantly in days after surgery compared to the day before surgery (p0.05). There was a significant positive correlation between food intake rates and albumin levels on the first, third and fifth days after surgery (r0.354, r0.353, and r0.521, respectively; p0.05).Conclusion: Patients’ body weight and albumin levels decreased in accordance with their nourishment status after surgery. Food intake was insufficient in the perioperative period. Amaç: Bu çalışmada açık kalp cerrahisi uygulanan hastaların perioperatif dönemde besin alımını etkileyen faktörler ve vücut ağırlığı, albümin ve hemoglobin değerleri, mide bulantısı, kusma ve kabızlığın besin alımı üzerindeki etkileri araştırıldı.Çalışma planı: Bu kesitsel çalışma 4 Şubat 2015-4 Mayıs 2015 tarihleri arasında bir kalp damar cerrahisi kliniğinde gerçekleştirildi. Toplam 86 gönüllü katılımcıya (62 erkek, 24 kadın; ort. yaş 61.2510.77 yıl; dağılım 38-82 yıl) 25 sorudan oluşan bir anket formu uygulandı.Bulgular: Hastalar cerrahiden bir gün önce besinin %38’ini, cerrahiden bir gün sonra %51’ini, üç gün sonra %47’sini ve beş gün sonra %52’sini tüketti. Besin alımını kesintiye uğratan faktörler cerrahi öncesi anestezi hazırlığında besin alımını durdurma prosedürü (%84.9), cerrahiden bir gün sonra bulantı (%31.4) ve cerrahiden üç (%26.5) ve beş (%33.7) gün sonra kabızlık idi. Albümin düzeyleri cerrahiden sonraki günlerde cerrahiden önceki bir güne kıyasla anlamlı olarak azaldı (p0.05). Cerrahi sonrası birinci, üçüncü ve beşinci günlerde besin alımı oranları ile albümin düzeyleri arasında anlamlı bir pozitif ilişki vardı (sırasıyla r0.354, r0.353 ve r0.521; p0.05).Sonuç: Cerrahi sonrası hastaların beslenme durumlarına göre vücut ağırlıkları ve albümin düzeyleri azaldı. Perioperatif dönemde besin alımı yetersiz idi.

Introduction: socioeconomic factors play an important role in the prevalence of Helicobacter pylori (HP) infection. The aim of this study is to investigate HP prevalence among symptomatic patients in the upper socioeconomic segment of the population undergoing gastroscopy in an endemic urban region. Methodology: over a 12-month period, data were collected from the first consecutive 1000 patients (500 from university hospital, 500 from community hospital) who had gastroscopy and HP evaluation. Results: overall, 211/1000 patients (21.1 %) were found to have HP in gastric biopsies. The specificity, sensitivity, positive predictive value, negative predictive value and diagnostic accuracy of rapid urease test were 87.5%, 99.7%, 99%, 96.5%, and 96.9% respectively. Atrophic gastritis, gastric and duodenal ulcers were significantly more common in HP positive patients. Age based distribution of HP prevalence: > 6 decades (15.5%), 3rd-5th decades (26.1%), < 3rd decades (10.4%). Conclusion: in an HP endemic country, the prevalence of HP infection among symptomatic patients belonging to the upper socioeconomic segment of the population appears to be markedly lower. The lowest prevalence in young patients is expected to result in future decrease in HP prevalence., NA

Objective: In this study, it was aimed to examine whether the Compassion Scale, which can measure the compassion for others with six dimensions, is a valid and reliable tool for the operating room nurses. Material and Method: This methodological study was carried out with 236 nurses working in public and private hospitals between April and May 2017 in the European Side of Istanbul. In collecting the data, “Introductory Information Form” and “Compassion Scale”, consisting of 6 dimensions of 24 items, were used to measure the compassion for others. For the scale, the validity of the subject was obtained by taking the opinions of the colleagues and by the expert evaluation. Item-total score correlation and Cronbach’s alpha values were calculated for internal consistency/reliability. Exploratory and confirmatory factor analysis was performed for construct validity. Results: The Cronbach Alpha value of the scale was found to be 0,821. Spearman-Brown coefficient was 0.813. As a result of the Basic Component Analysis, the factor loadings of all items were above the accepted value of 0,40. According to the Lawshe method, the scope validity values of all items were between 0.64–1.00 values above 0.59, which is the lower limit for 11 experts. According to confirmatory factor analysis, fit indexes of the scale (CFI =.97; NNFI =.96; SRMR =.05 and RMSEA =.06) were found. Conclusion: According to the results of the study, it was determined that the Compassion Scale could be used as a valid and reliable scale in measuring the level of compassion of the operating room nurses. © Peter Lang GmbH Internationaler Verlag der Wissenschaften Berlin 2019. All rights reserved.

Erdogan, Kivilcim Eren/0000-0002-4951-8703; kilic bagir, Emine/0000-0002-1447-1060; Celik, Betul/0000-0001-9731-9939; Tatli Dogan, Hayriye/0000-0003-4318-2775; Cakir, Asli/0000-0003-0128-6947 WOS: 000414649400006 PubMed: 28272675 Objective: There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories. Material and Method: In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire. Results: The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells/Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers. Conclusion: There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.

[No abstract available]

Objective: There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories. Material and Method: In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire. Results: The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells/Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers. Conclusion: There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.