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Purpose: Inappropriate dosing of direct oral anticoagulants is associated with an increased risk of stroke, systemic embolism, major bleeding, cardiovascular hospitalization, and death in patients with atrial fibrillation. The main goal of the study was to determine the prevalence and associated factors of inappropriate dosing of direct oral anticoagulants in real-life settings. Methods: This study was a multicenter, cross-sectional, observational study that included 2004 patients with atrial fibrillation. The study population was recruited from 41 cardiology outpatient clinics between January and May 2021. The main criteria for inappropriate direct oral anticoagulant dosing were defined according to the recommendations of the European Heart Rhythm Association. Results: The median age of the study population was 72 years and 58% were women. Nine-hundred and eighty-seven patients were prescribed rivaroxaban, 658 apixaban, 239 edoxaban, and 120 dabigatran. A total of 498 patients (24.9%) did not receive the appropriate dose of direct oral anticoagulants. In a logistic regression model, advanced age, presence of chronic kidney disease and permanent atrial fibrillation, prescription of reduced doses of direct oral anticoagulants or edoxaban treatment, concomitant use of amiodarone treatment, and non-use of statin treatment were significantly associated with potentially inappropriate dosing of direct oral anticoagulants. Conclusion: The study demonstrated that the prevalence of inappropriate direct oral anticoagulant dosing according to the European Heart Rhythm Association recommendations was 24.9% in patients with atrial fibrillation. Several demographic and clinical factors were associated with the inappropriate prescription of direct oral anticoagulants. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Background: Clear cell hidradenoma (acrospiroma) is adnexal tumors that arise from the distal excretory duct of eccrine sweat glands. It is generally defined in humanbeings. It presents solitary structure in firmness nodule. Most frequently are encountered in head, face, and upper extremities in humans. Hidradenomas are called generally by definition benign. Their malignant transformations and metastasis are seen very rarely. In veterinary literature database, the malignant form of tumor has been defined as an unique report in four dogs. They are extremely rare tumors in dogs. It is not documented within multiple tumor complex up to now. Case: In the case, three tumors were detected in a 9-year-old neutered female German shepherd dog. After clinical examination, a complete surgical resection of all masses was performed and masses were sent to Pathology for diagnosis. A mass on the right last rib was a 8x6 cm in diameters with severe ulceration. The mass had a hard texture, immobility and irregular borders. Other masses were localized on the back and left caudo-abdominal mammary lobe. Tumors on the back and the mammary lobe did not invade muscle layer, but the tumor on the last rib aggressively invaded surrounding tissue and were very difficult to remove surgically After macroscopy, all the masses were stained with hematoxylin-eosin (H&E), Mayer's mucicarmine and Periodic Acid Shiff (PAS) stainings. In the first mass, there were multilobular epithelial islands between prominent fibrous septa from the upper to deep of dermis. The neoplastic cells were generally round or polyhedral in shape. Some of cytoplasms were eosinophilic at different degree. But cytoplasms were generally finely granular and vesicular or clear in appearance. Some cells had possible glycogen deposits. Nucleus was oval to round and had fine reticular chromatin and a distinct nucleolus. The tumor was diagnosed as clear cell hidradenoma. Others were was belonged to hemangioma on the back and malignant mixed tumor in the mammary gland. Discussion: In our case, two cell types having benign characteristics were also noted. Some clear cells contained PAS (+) material showing glycogen deposits. Additionally, there were some fibrous septa separating those cell islands. Thus, it is thought that the histopathology shows parallelism to many reports described in human beigns. Clear cell hidradenoma described in this case is first documentation as benign counterpart on the basis of veterinary literatures even though a previous report including clear cell hidradenocarcinoma in four dogs. And also, it has been reported to be very rarely seen tumor in human beings. However, any hormonies in terms of its predilection site can not be found among the cases with clear cell hidradenoma in human counterparts, because the tumor is encountered at skin of last right rib. This situation has shown us the tumor does not select any predilection site as described in this case. It has been understood on the basis of literatures that this is the first case report of describing benign tumor of ecrine sweat duct in dogs. Also, there has been no any documentation regarding in this multiple tumor complex. © 2018 Universidade Federal do Rio Grande do Sul. All rights reserved. The case report were presented as poster presentation in European Veterinary Conference Voorjaarsdagen 2017 in Netherland.

Background: Mooren's ulcer is a chronic and painful ulceration of the cornea. It begins progressively in the periphery and spread centrally in cornea. In human, it is seen uniaterally in most of cases. Mooren ulcer has not been reported in any kind of animals up to now. Although its aetiology is not completely enlighted, it has been suspected of the inflammatory reaction against injuries-microbiological and immun mediated effects. Immun response in presence of accumulation of immune complexes into the limbal vessels.As a result of the deficit in the regulatory mechanism because the number of suppressor cells control over B and T lymphocytes, These situations can result in a progressive tendancy to inflammation because the production of autoantibodies and/or lymphokine from cytotoxic T-lymhocytes creates an immune-mediated vasculitis. Numerous immigrant inflammatory cells and proteins are evaded from vessels. After triggering inflammatory cells and releasing of meditors, corneal vascularization, scar tissue and re-epithelization develop. This regenerative-reperative process plays an important role during post-inflammatory process. Case: In this case, it was aimed to detect pathomorphological structure and immunologic relations in progressive Mooren's ulcer (MU). A 1 year-old mix breed cat was submitted to clinic with complaints of progressive painful and eyesight loss in left eye. There were 1 cm-ulceration, opacification and old haemorrhagic areas at peripheral cornea. Histopathologically, there was wide ulceration including all layers of corneal epithelium and particularly vacuolar degeneration at suprabasal cells. In corneal stroma, numerous neutrophiles and mononuclear cells were infiltrated. Neovascularisation and fibrosis beginning from limbus were also present. This fibrotic progress was confirmed by Masson's trichrome staining method. Immunohistochemically, Cytokeratin 3 (CK3) and cytokeratin 12 (CK12) positivities showing regenerative activity of suprabasal and basal cells were not widespread. Epidermal Growth Factor (EGF) positivities were generally weak in epithelial cells. In stroma, moderate vimentin positivities were detected proliferated in fibrocytes originating from limbus. ?1-antichymotrypsin (A1AC) was mildly reacted in neutrophiles. CD3 and CD4 confirmed the presence of regulatory and helper T lymphocytes. CD3 and CD8 marked cytotoxic T lymphocytes and CD20 marked B lymphocytes in inflammatory areas. CD34 were also positive in peripheral corneal stem cells derived from limbal basal epitheliums in partly regenerated area. CD57 positivity in T lymphocytes and NK cells and CD68 positivity in macrophages were attended to the area. Discussion: CD1a positivity in T lymphocytes proved mediating lipid and microbial origin glycolipid antigens. TUNEL reactions showing DNA in situ fragmentation were present in the destructive and aging epithelial cells at periphery. In conclusion, the case has been found as unique in terms of its immunohistochemical characterization. The markers show that CD1a and CD68 expressions follow different progress in animals unlike in humanbeings even though the ulcer of pathogenetic mechanism is found identical to humanbeings.. The roles of CD20 and CD57 markers have potential roles in this ulcer. It is also concluded that insufficient epithelial regeneration, fibrosis, inflammation and apoptosis showed progressive Mooren's ulcers having possibly microbial origin. © 2018 Universidade Federal do Rio Grande do Sul. All rights reserved. The case was presented in 4th International Conference and Exhibition on Pathology, 13-15 July 2015, New Orleans, USA.

Chartered Inst. of Building Services Engineers, The aim of this study was to evaluate coxofemoral joint luxation in cats clinically and radiographically, to treat with double-sided modified toggle pin technique and to share the early-term outcomes. The study material consisted cases of 17 cats which were brought with complaints of hind limb lameness and diagnosed with coxofemoral luxation by radiography and orthopaedic examination. Radiograms revealed that the luxations of all cases either at right or left sides were formed craniodorsally. Fractures of femur (n=2), sacroiliac luxation (n=1), and os pubis and os ischii fractures (n=1) accompanied coxofemoral luxation in some cats. Toggle pins of different sizes were prepared using Kirschner wires and they were sterilized a day before surgery. Approaching the hip joint craniolaterally, luxated coxofemoral joint was allowed to set to its anatomic position, using an apparatus prepared with toggle pin and nylon sutures (USP: 0). Double-sided modified toggle pin technique was performed for the treatment. Cats, which only had luxations were able to use their legs without any problems one day after surgery; although, this time was prolonged in cases having additional orthopaedic problems. However, postoperative clinical and radiographical findings were satisfactory in all cases. As a result, double-sided modified toggle pin technique was concluded to be an appropriate method for surgical treatment of coxofemoral luxations in cats, with its satisfactory joint stabilization, quick gain of extremity functions and its compatibility with body tissues. © 2016, Chartered Inst. of Building Services Engineers. All rights reserved., Bilgili, H.; Ankara Üniversitesi, Cerrahi Anabilim DalıTurkey; email: hbilgilitr@yahoo.com

Osteoid osteoma and osteoblastoma are uncommon benign bone tumors which originate from osteoblasts in animals. Both tumors have similar characteristics. Osteoid osteoma is well described in humans, but there known to be only two cases in domestic animal species. Differentiating the diagnosis of osteoid osteoma from osteoblastoma by using immunohistochemistry was aimed in this study. A 12-year-old mix breed female dog was brought to the clinic with complaints of swelling in proximal forelimb and progressive loss of motion. Animal was died during surgery. In necropsy, tissue samples were taken from the mass and fixed in %10 formalin. Samples were stained with hematoxylin and eosin, Masson’s trichrome and Alizarin Red S. For revealing of cell differentiation, ABC-P method was applicated to adhesive section by using BMP6, S100, vimentin ve p53 markers. Macroscopically, proximal humerus was swollen. Cut section was generally lytic within bone residues. Soft tissue was haemorrhagic and edematouse. Microscopically, osteoblasts and hypervascular nidus were surrounded by large sclerotic and mineralized bone tissue. Large lytic areas were also observed. Masson’s trichrome revealed sclerosis and Alizarin Red S revealed osteoid matrix. Immunohistochemically, BMP6 was moderately reacted in osteoid matrix and S100 was moderately reacted with nerve fibers in nidus. Vimentin had strictly positive reaction in fibrocytes. P53 was negative in osteoblasts. In conclusion, this case is the third reported in domestic animals and the second in dogs. Also osteoid osteoma is evaluated for the first time by immunohistochemistry in animals.

PubMed ID: 26419526, Background: In Turkey, large regional inequalities were found in maternal and child health. Yet, evidence on regional inequalities in adult health in Turkey remains fragmentary. This study aims to assess regional and rural/urban inequalities in the prevalence of poor self-rated health and in disability among adult populations in Turkey, and to measure the contribution of education and wealth of individual residents. The central hypothesis was that geographical inequalities in adult health exist even when the effect of education and wealth were taken into account. Methods: We analyzed data of the 2002 World Health Survey for Turkey on 10791 adults aged 20 years and over. We measured respondents' rating of their own general health and the prevalence of five types of physical disability. Logistic regression was used to estimate how much these two health outcomes varied according to urban/rural place of residence, region, education level and household wealth. We stratified the analyses by gender and age (50 and 50 years). Results: Both health outcomes were strongly associated with educational level (especially for older age group) and with household wealth (especially for younger age group). Both health outcomes also varied according to region and rural/urban place of residence. Higher prevalence rates were observed in the East region (compared to West) with odd ratios varying between 1.40-2.76. After controlling for education and wealth, urban/rural differences in health disappeared, while regional differences were observed only among older women. The prevalence of poor self-rated health was higher for older women in the Middle (OR?=?1.69), Black Sea (OR?=?1.53) and East (OR?=?2.06) regions. Conclusion: In Turkey, substantial geographical inequalities in self-reported adult health do exist, but can mostly be explained by differences in socioeconomic characteristics of residents. The regional disadvantage of older women in the East, Middle and Black Sea may have resulted from life-long exposure to gender discrimination under a patriarchal ideology. Yet, not geographic inequalities, but the more fundamental socioeconomic inequalities, are of key public health concern, also in Turkey. © 2015 Ergin and Kunst.

Pseudochylotorax is usually associated with chronic inflammatory disorders like tuberculosis or rheumatoid arthritis [RA]. Pseudochylotorax due to RA is much more rare and there were only 21 cases in the English literature until 2009. Long standing pleural effusion [over 5 years] could result empyema and pseudochylothorax but our patients had a history of 2 years and 3 years. At this paper we report two cases of RA with pseudochylotorax and empyema for the supplement of the literature and to emphasize time is not a criterion for the diagnosis of pseudochylotorax.

Aim The aim of this study was to investigate the medical and forensic importance of thorax computed tomography in stable patients with blunt chest trauma. Material and Methods Fifty patients with blunt chest injury were retrospectively evaluated with chest radiography and thorax computed tomography in the first 24 hours after trauma. Patient demographics, thoracic lesions, management options, and forensic assessment were rewieved. Results The most common lesion of the study was rib fracture. Thorax computed tomography was significantly superior to chest radiography in detecting thoracic lesions. Sixty eight (33%) occult lesions were detected. Forty six (18%) of these were life threatening that not detected with plain chest radiography. Associated injuries were present in 33 (66%) patients. Pelvic and extremity fractures were the most common injury. Thorax computed tomography was significantly superior to chest radiography in detecting pneumothorax, hemothorax and lung contusion. Eightyone life threatening lesions were detected and 50 (61%; pneumothorax 13, hemothorax 24, lung contusion 9, and pneumomediastinum 4) of these lesions could not be detected with plain chest radiography. The clinical management [in 15 patients (30%)], and the forensic assesment was changed [in 14 (28%)] patients were changed. Conclusion We concluded that using Computed Tomography of the thorax in thoracic travmas prive meticulous assesment in management of patients and forensic issues.

This article reviews the surgical and other invasive procedures in the management of pleural effusions. Pleural effusion is frequent in clinical practice. Pleural procedures vary from aspiration to more challenging procedures such as thoracoscopy. However it is difficult to make diagnosis by thoracentesis or closed pleural biopsy. Thoracoscopy is gold standart in the investigation and management of pleural disease. Pleural biopsy by thoracoscopy should be actively carried out in patients with pleurisy, because the technique has a high diagnostic rate and can be easily and safely performed. Flexible or rigid thoracoscope, bronchoscope, endoscope and mediastinoscope can be used for operation.

WOS: 000293901801170

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I. Avrasya Nükleer Bilimler ve Uygulamaları Konferansı : 23-27 Ekim 2000. İzmir, Türkiye. A gamma spectrometric method is described for the direct “absolute” determination of uranium contents in solid samples. To obtain the exact information about the measurement of 238U in samples by gamma-ray spectroscopy, it is essential that any one of the daughters of 238U should exist in radioactive equilibrium with 238U. This condition is mainly fulfilled by one of the first two daughters, namely, 234Th (24.1 d) and 234mPa (1.17 min) because these daughters are very short-lived compared with 238U. Therefore, the present analytical method employs direct determination of U via the 63.3 keV gamma emission from Th and via the 1001 keV gamma emission from 234mPa. The absolute photopeak efficiency data in the range of 40 keV to 2000 keV for the reverseelectrode Germanium(REGe) detector used is measured using a powder radioactive standard source. The certified uranium samples were prepared in thin thicknesses to minimize the selfabsorption of gamma rays. They are counted for the the time predetermined between 75,000 s and 125,000 s. The measured activities of 238U of the samples via the 63.3 keV (234Th ) and via the 1001 keV (234mPa) are corrected for self-absorption effects due to changes in composition of standard reference materials in a given sample-detector geometry. The self-absorption factors applied to the 46.5 keV(210Pb) peak and the 63.3 keV(234Th) peak results ranged from 10.5% to 33.1% and from 4.9% to 18.4%, respectively. For the 1001 keV(234mPa) gamma emission, the necessary self-absorption factors varied between 0.1% and 3.9%. The results obtained from the 46.5 keV of Pb being far distant member of U and those of the 63.3 keV from 234Th are used to check whether the equilibrium exist in the uranium samples. The results of U via the 63.3 keV peak of Th for the uranium standards agreed to within 0.1 to 6.9% with the certified values of 238U in the samples with uranium concentration ranging from 0.022±001 to 1.02±0.01 wt%. The results of 238U via the 1001 keV peak of 234mPa agreed well to within 0.01 to 4.7% with the certified activity values of 238U of the same samples. When the measurements of the uranium are carried out in a REGe detector system, the results indicate that the uranium concentrations in the samples can be determined to the average 7% error by using the 63.3 keV(234Th) gamma emission with appropriate corrections for self-absorption effects. The 1001 keV peak of 234mPa gives also accurate results for the determination of 238U in the same samples and the need for self absorption correction for the 1001 keV emission seems to be negligible, except in case of thicker samples than that of 1.5 cm thick.

Ergin, Irem/0000-0003-2373-5133; YAZLIK, Murat Onur/0000-0002-0039-5597; Polat, Mert/0000-0003-4029-1247 WOS: 000360297400006 A 2-year-old non pregnant Anatolian shepherd (case 1) and 3-year-old, pregnant pit bull terrier (case 2) each presented with a history of dysuria and a mass prolapsed from the vulva. Vaginal prolapse and retroflexion of the urinary bladder were diagnosed in both cases according to clinical and diagnostic examinations. Foetal stress was detected on ultrasonography and caesarean section was performed in case 2. The urinary bladder was replaced in the normal anatomic position and cystopexy was performed via a midline laparotomy in each dog, and an ovariohysterectomy (OHE) was performed to prevent recurrence of vaginal prolapse. Surgical amputation of the prolapsed vagina was performed after the cystopexy and OHE. This case report demonstrates the possibility of severe vaginal prolapse concurrent with cystocele in bitches.