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Yanık, günümüzde en yaygın görülen fiziksel travmaların başında gelmektedir. Yanık ilk bakışta deride oluşan bir hasar olarak görülse de aslında vücudun genelinden oluşturmuş olduğu sistemik yangısal reaksiyonlar sonucunda birçok doku ve organı etkileyebilmektedir. Bunların başında ise kan dolaşımı yönünden zengin olan akciğer dokusu yer almaktadır. Yanık yarası tedavisinde birçok doğal bileşen çalışmalarda kullanılmıştır. Antiinflamatuvar, antioksidan ve antiapoptotik etkinlikleri bilinen Seryum Nitrat (SN) ve Plateletten Zengin Plazma (PZP) bu doğal maddeler arasında yer almaktadır. Bu doğal maddeler her ne kadar yanık tedavisinde kullanılsa da yanık sonrası akciğer dokularında nasıl bir etki ettiği net bir şekilde bilinmemektedir. Bu sebeple, deride oluşturulan termal yanık sonrasında akciğer dokusunda meydana gelen hasara karşı SN ve PZP’ nin koruyucu etkinlikleri bu çalışmada araştırıldı. Ratlarda deride çalışmanın ilk gününde termal yanık hasarı oluşturuldu. SN grubunda yanık sonrası 0.04 molar Seryum Nitrat banyo solüsyonunda ratlar 30 dakika boyunca bekletildi. PZP grubunda ise ratların yara bölgelerine 0.1 ml’lik PZP deri altı enjekte edildi. Çalışmanın 21. gününün sonunda ratlar genel anestezi altında sakrifiye edildi ve akciğer dokuları alındı. Akciğer dokularında yanık sonrasında histopatolojik olarak; interalveoler bölgelerde kanama ile mononükleer hücre infiltrasyonları ve buna bağlı olarak kalınlaşma gözlendi. Bronşiollerin etrafında mononükleer hücre infiltrasyonları görüldü. İmmünohistokimyasal incelemelerde; yanık sonrası akciğer dokularında şiddetli Tnf-α ve 8-OHdG ekspresyonları gözlendi. SN ve PZP uygulanan gruplarda ise yanık sonrası oluşan histopatolojik ve immünohistokimyasal bulguların normal değerlere yaklaştığı tespit edildi. Sonuç olarak; yanık sonrası akciğer dokusunda oluşan hasarlara karşı SN ve PZP’ nin koruyucu etkinliği olduğu ortaya konuldu.

Abstract Multiple sclerosis (MS) is a neurological disease of the central nervous system that is the leading cause of non-traumatic disability in young adults. Clinical laboratory tests and neuroimaging studies are the standard methods to diagnose and monitor MS. However, due to infrequent clinic visits, it is fundamental to identify remote and frequent approaches for monitoring MS, which enable timely diagnosis, early access to treatment, and slowing down disease progression. In this work, we investigate the most reliable, clinically useful, and available features derived from mobile and wearable devices as well as their ability to distinguish people with MS (PwMS) from healthy controls, recognize MS disability and fatigue levels. To this end, we formalize clinical knowledge and derive behavioral markers to characterize MS. We evaluate our approach on a dataset we collected from 55 PwMS and 24 healthy controls for a total of 489 days conducted in free-living conditions. The dataset contains wearable sensor data – e.g., heart rate – collected using an arm-worn device, smartphone data – e.g., phone locks – collected through a mobile application, patient health records – e.g., MS type – obtained from the hospital, and self-reports – e.g., fatigue level – collected using validated questionnaires administered via the mobile application. Our results demonstrate the feasibility of using features derived from mobile and wearable sensors to monitor MS. Our findings open up opportunities for continuous monitoring of MS in free-living conditions and can be used to evaluate and guide the effectiveness of treatments, manage the disease, and identify participants for clinical trials.

Amaç: C-reaktif protein/albümin oranı (CAO) yakın zamanda yeni bir inflamatuar biyobelirteç olarak tanımlanmış ve inflamasyonun belirlenmesinde birçok hastalıkta potansiyel rolü ortaya konulmuştur. Bu çalışma, aksiyel spondiloartritte (axSpA) hastalık aktivitesinin belirlenmesinde CAO’nun rolünü araştırmayı amaçlamaktadır. Gereç ve Yöntem: Bu çalışma retrospektif vaka-kontrol çalışmasıdır. Toplam 128 hasta ve 111 yaş-cinsiyet uyumlu sağlıklı kontrol çalışmaya dahil edilmiştir. Serum albumin, C-reaktif protein (CRP), eritrosit sedimantasyon hızı (ESH) kaydedildi. CAO, serum CRP/Albumin şeklinde hesaplanmıştır. Hastalık aktivitesini belirlemek için Bath Ankilozan Spondilit Hastalık Aktivite İndeksi (BASDAI) ve Ankilozan Spondilit Hastalık Aktivite Skoru-CRP (ASDAS-CRP) skorları kullanıldı. Hastalar ASDAS-CRP skoruna göre iki alt gruba ayrıldı: ≥1,3 aktif hastalık,

Background: Since the third molar teeth are the last to erupt in the oral cavity, they can become more impacted than other teeth. Insufficient retromolar space and the eruption direction of the third molars can affect this situation. The condition, distribution, and prevalence of impacted third molars in skeletal Class I, II, and III anomalies are important in treatment predictability. Purpose: The aim of this study is to classify impacted lower third molars in patients with different skeletal malocclusions. Methods: This retrospective study examined panoramic X-ray records of patients treated at Inonu University Faculty of Dentistry, Department of Orthodontics, between 2014 and 2021. In total, 1219 mandibular third molar teeth were considered. Impacted mandibular third molar teeth of individuals with different skeletal structures were grouped according to the Pell and Gregory, Winter, and Archer classifications. Results: In this study, 37.74% of the participants were male, and 62.26% were female; 40.94% of examined teeth were skeletal Class I, 41.84% were Class II, and 17.23% were Class III. It was determined that 91.63% of all examined teeth were impacted, and 8.37% had erupted. According to the Pell and Gregory classification, 21.41% of teeth were Grade (I), 38.06% were Grade (II), and 40.53% were Grade (III). According to the Winter classification, 3.12% of examined teeth were buccal, 6.89% were horizontal, 23.71% were mesioangular, and 66.28% were vertical. According to the Archer classification, 14.44% of examined teeth were in position A, 30.02% were in position B, and 55.54% were in position C. No statistically significant relationship was established between grades and gender (p>0.05). Conclusion: A relationship was ascertained between the impacted positions of mandibular third molars in different skeletal structures.

The aim of this study was to evaluate the prognostic factors for and determine the effect of neoadjuvant chemotherapy (NACT) on oncologic outcome in stage IVB pure serous endometrial carcinoma patients who received taxane and platinum. Forty-two patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IVB uterine serous carcinoma were enrolled from six gynecologic oncology centers and a study group was created. The study group had a 2-year disease-free survival (DFS) of 32% and 2-year disease-specific survival (DSS) of 73%. On univariate analysis; lymphadenectomy (not performed vs. performed), paraaortic lymph node metastasis (positive vs. negative) and number of metastatic lymph node count (≤5 vs. >5) were found to have statistical significance for DFS (p

Altı asrı aşan uzun ömrüyle Osmanlı Devleti 20. yüzyıl öncesi İslam tarihinin ikinci yarısı (hicri sekizinci asır ve sonrası) boyunca varlığını sürdürdü. Bu geniş zaman aralığında Ortadoğu ve Kuzey Afrika’daki kadim Müslüman coğrafya ile Avrupa’nın doğu ve güney topraklarının önemli bölümünü bir bütün halinde yönetti. Doğal olarak İslami düşünce ve uygulamaların -bu kapsamda İslam hukukunun- tarih boyunca geçirdiği değişim ve dönüşüm safhalarının günümüze bakan kısmına tanıklık etti. Yalnız tanık olmakla kalmayıp anılan sürecin başlıca aktörü ve sürükleyici gücü haline gelerek öncülüğünü de üstlendi. Osmanlılar Müslüman bir devlet ve toplum olarak orta çağın geç devirlerinde, Moğol istilasının az sonrasından devraldıkları İslam hukuku birikimini -özelde Hanefi fıkhını- modern zamanların başlarına taşımayı başardılar. Tevarüs ettikleri birikimin özüne ve temel ilkelerine sonuna dek sadık kaldılar. Fakat aynı zamanda yeni teoriler, kurum ve kalıplar, gelenek ve teamüller ortaya koymak suretiyle fıkhın işleyen, sorunlara çözüm üreten ve böylelikle güncelliğini muhafaza eden modern bir hukuk sistemine evrilmesine de zemin hazırladılar. Dolayısıyla İslam hukuk düşüncesini, işleyişini ve uygulama yöntemlerini kavrayabilmek, bir bakıma Osmanlı tecrübesini doğru anlamakla eşdeğerdir. Osmanlı hukukunun klasik yapısı büyük ölçüde 16. yüzyılın ilk yarısında şekillendi. Bu yapının temel bileşenlerinden biri olan fetva kurumu, İstanbul’un fethi sonrasında yeniden teşkilatlandırılan devlet sistemi içinde giderek daha önemli ve görünür hâle geldi. Şeyhülislamlık, bir terim ve kurum olarak henüz mevcut değilse de başkent müftüsünün etkisi ve konumu dönem içinde güçlendi. Onların fetvaları, ülkede geçerli olan hukuk normlarının tespitinde ve hukuk birliğini sağlama yolunda belirleyici etkiye sahip bir argüman olarak öne çıktı. Anılan gelişmenin bir yansıması olarak kadı sicillerinde davanın tarafı olan kişilerin müftülerden alınmış fetvaları mahkemeye sunduğu ve bu yolla yargılamayı kendileri lehine sonuçlandırmaya çabaladığı görülmektedir. Bu makale kapsamında, 16. yüzyılın ilk yarısında İstanbul (Üsküdar) mahkemesinde gerçekleşen yargılamaların kayıtlarını içeren kadı sicilleri taranarak yargı sürecine fetvanın dâhil olduğu davalar (makalede “fetvalı dava” olarak anılacak) tespit edildi. Bu yolla oluşturulan veri havuzundan yola çıkılarak, Osmanlı Devleti’nde fetvanın yargılama aşamalarına ve sicil kayıtlarına dâhil oluş yöntemleri ile dava sonuçlarındaki etkisinin boyutları belirlenmeye çalışıldı. Ayrıca mahkemeye intikal eden fetva miktarında zaman ve müftüye bağlı olarak adet ve oran bakımından yaşanan farklılaşma ortaya konuldu. Fetvalı davaların miktarına ilişkin sayısal veriler temel bir gösterge kabul edilerek dönemin hukuk anlayışında yaşandığı varsayılan değişimin izi sürüldü. İstanbul müftüsünün özelde dönemin yargısı üzerinde genelde ise Osmanlı hukuk sistemi içindeki etkinliğinin ölçülmesi amaçlandı. Çalışmada elde edilen sonuçlar ortaya koymaktadır ki, on bir bin civarında kayıt barındıran 15 defterdeki fetvalı dava miktarı (31 adet) ve bunların genele oranı (‰2,83) son derece düşüktür. Bununla birlikte 1515-1549 arasına yayılan bu davaların tamamında yargılamanın fetvaya mutabık sonuçlanmış olması müftü fetvalarının dönemin Üsküdar mahkemesinde görev yapan hâkimler nezdinde hukuki bir karşılığı olduğuna işaret etmektedir. Diğer yandan fetvalı dava sayılarına dair istatistikler yüzyılın başından ortalarına doğru İstanbul müftülüğünün Osmanlı hukuk sistemi içindeki etkinliğinde düzenli bir artıştan söz edilemeyeceğini de göstermektedir. Aksine 1530’lu yıllarda zirveye ulaşan söz konusu etkinlik sonraki yıllarda bariz bir gerilemeye sahne olmuştur. Müftülük görevini deruhte etmekte olan âlimin karizmasının ve sahip olduğu bireysel niteliklerin bu konuda belirleyici bir unsur olduğu değerlendirilmektedir. Doğrudan dönemin ilmiyesinin geride bıraktığı arşiv malzemesinden üretilen sayısal verilerin yorumlanmasına dayalı bu çalışma İslam-Osmanlı hukukunun kritik dönemlerinden birine, bugüne dek bakılmamış bir pencereden ışık tutmaktadır.

Objective: Tetrasomy 9p is a rare fetal condition. Cases are usually mosaic. Here, we present a non-mosaic tetrasomy 9p case with cytogenetic analysis, fluorescence in situ hybridization, microarray data, ultrasound findings, and phenotypic presentation. Case report: A pregnancy was referred to cytogenetic analysis because of increased nuchal translucency in prenatal ultrasound at 13 weeks of gestation. Prenatal laboratory analysis revealed an extra marker chromosome with a non-mosaic pattern. Ultrasonographic findings were unilateral cleft lip and palate, micrognathia, and atrioventricular septal defect at the 17th week; additionally, ventriculomegaly, left axis deviation of the fetal heart, and a single umbilical artery were determined at the 23rd week. Conclusion: Phenotypic severity in non-mosaic tetrasomy 9p widely differs depending on the chromosomal content. We recommend performing appropriate genetic tests in those pregnancies with the suspicion of tetrasomy 9p, evaluating the mosaic state, and following those cases with detailed ultrasonographic examinations.

Drug-induced neuropsychiatric effects are important for disease management. We aim to evaluate the neuropsychiatric effects of montelukast–levocetirizine combination therapy in children. This descriptive study was conducted with children aged 2–5 years, diagnosed with asthma and allergic rhinitis, who began to receive montelukast and levocetirizine combination therapy. The respiratory and asthma control test for children (TRACK), Rhino Conjunctivitis Scoring System (RCSS), and common neuropsychiatric effects (irritable behavior, hallucinations, headaches, nightmares, sleep disorders, behavioral and mood disorder, restlessness, depression) were ascertained by the questionnaire applied before and 4 weeks after the treatment. Parents answered on behalf of their children. The most common finding before and after treatment was irritable behavior. While irritable behavior was observed in 82.4% (n = 56) of children before the treatment, this percentage was 63.2% (n = 43) after the treatment (p = 0.004). The percentage of children who developed at least one neuropsychiatric symptom after treatment was 22.1% (n = 15). There was no significant effect of age, gender, RCSS, TRACK, or allergy test positivity on the development of neuropsychiatric symptoms (p > 0.05). According to the results, at least one neuropsychiatric finding developed in approximately one in five children. Identifying risk factors will enable more careful treatment or consideration of alternative treatments for children at higher risk in the clinical follow-up period.

Starting basketball/sports at young ages, participating in practices and games for years improves children in various subjects. Chronic exercise provides a physical and physiological improvement, while also supporting cognitive development significantly. The aim of this study is to apply cognitive tests that we think reflects some cognitive skills to both athlete and sedentary adolescents compare and evaluate these test results. Twenty-two licensed male adolescent basketball players (x̄:15.59 ±.66 age) and 13 sedentary adolescents (x̄: 15.08 ±.76 age, 5 female) who did not exercise in their daily routine participated in the study. All participants were aged between 12 and 18. Three different cognitive skill tests (Mackworth Clock Test, Timewall Test, and Change Detection Test) were applied among the participants via the “Psychology Experiment Building Language Test Battery” on a laptop computer, and the results were recorded. When the findings were analyzed, the results of the Change Detection Test comparisons showed that the athletes’ times of completing the whole test and their times of response to each question were shorter than those of the sedentary adolescents (both p lt;0.01). When the timing scores were analyzed according to the comparisons of the Time-Wall Test, it was seen that the athletes were significantly more successful (p lt;0.01). According to the results of the Mackworth Clock Test comparisons, the athletes’ correct reaction rates and reaction times were significantly better (both p lt;0.001). In this study, some cognitive performances of the basketball player and sedentary adolescents were tested and compared to each other. Athletes are continuously exposed to a cognitive process during a practice or a game, and furthermore, they need to make a decision quickly under stress and pressure. As a result of this situation. it might be thought that adolescent athletes may have better cognitive performance than their sedentary peers since they always use these cognitive skills during practices and games for years.

Recent advances in hematology analyzers have enabled to improve the reliability in the results and also provided additional hematological parameters. In the present study, we aimed to determine the reference ranges for automated erythrocyte and reticulocyte parameters in healthy individuals on Sysmex XN 1000 hematology analyzer.

This study was conducted to compare the long-term oncological outcomes of laparotomy and laparoscopic surgeries in endometrial cancer under the light of the 2016 ESMO-ESGO-ESTRO risk classification system, with particular focus on the high–intermediate- and high-risk categories. Using multicentric databases between January 2005 and January 2016, disease-free and overall survivals of 2745 endometrial cancer cases were compared according to the surgery route (laparotomy vs. laparoscopy). The high–intermediate- and high-risk patients were defined with respect to the 2016 ESMO-ESGO-ESTRO risk classification system, and they were analyzed with respect to differences in survival rates. Of the 2745 patients, 1743 (63.5%) were operated by laparotomy, and the remaining were operated with laparoscopy. The total numbers of high–intermediate- and high-risk endometrial cancer cases were 734 (45%) patients in the laparotomy group and 307 (30.7%) patients in the laparoscopy group. Disease-free and overall survivals were not statistically different when compared between laparoscopy and laparotomy groups in terms of low-, intermediate-, high–intermediate- and high-risk endometrial cancer. In conclusion, regardless of the endometrial cancer risk category, long-term oncological outcomes of the laparoscopic approach were found to be comparable to those treated with laparotomy. Our results are encouraging to consider laparoscopic surgery for high–intermediate- and high-risk endometrial cancer cases.

Success in fencing is gained by making quick decisions and acting quickly during the bout. This study aimed to determine the body composition of fencers competing in the U 10-12 age categories and to examine the relationship between the 30-m speed test (30-m ST) and the 7-m repeat lunge ability test (7-m RLAT). Thirty-eight sabre fencers (female: 25 and male: 13) participated in the study. The anthropometric properties of the participants were determined, then the 30-m ST and the 7-m RLAT, a specific test for fencing, were performed. The differences between sexes were evaluated using the Mann-Whitney U test because the data were not distributed normally, and Spearman correlation analysis was performed to determine the relationship between performance tests. When the results of the study were examined, there was no significant difference between the sexes in the physical characteristics and performance tests of the athletes (p gt;0.05). Also, when all fencers were evaluated together, a significant relationship was found between the 30-m ST and the 7-m RLAT (rs(36)=0.526, p=0.001). When the sexes were examined separately, a significant relationship was found between the 30-m ST and the 7-m RLAT only in the male group (rs(23)=0.659, p lt;0.001). The 7-m RLAT can be used instead of or in addition to anaerobic power and speed tests for performance measurement in fencers.

Objective We present a case of maternal death due to COVID-19 and aimed to review our COVID-19 management strategies during pregnancy and changing strategies at different times of the epidemic through the present case. Case(s) Our patient was 35 years old, gravida 2, parity 1, 28 weeks pregnant, who admitted to the emergency service of our hospital for the first time with the complaints of severe dry cough, respiratory distress, fever, abdominal pain and vomiting, with suspected COVID-19. She was admitted to the delivery room. As the oxygen need increased within hours and the oxygen saturation decreased to 60%, the patient was intubated 21 hours after hospitalization and was admitted to our second level adult intensive care unit. Due to the development of fetal distress 1 hour after intubation, the patient was taken to emergency cesarean section. Four days after the operation, the patient died due to cardiopulmonary arrest in the 3rd level intensive care unit of the hospital where she was transferred. Conclusion This report demonstrates that COVID-19 can be severe in a pregnant woman, that the importance of early diagnosis and treatment, the difficulties of clinical management in case of progression of the disease, and ultimately, the maternal and neonatal consequences can be devastating.

Migraine is a neurological disorder that is associated with severe headaches and seriously affects the lives of patients. Diagnosing Migraine Disease (MD) can be laborious and time-consuming for specialists. For this reason, systems that can assist specialists in the early diagnosis of MD are important. Although migraine is one of the most common neurological diseases, there are very few studies on the diagnosis of MD, especially electroencephalogram (EEG)-and deep learning (DL)-based studies. For this reason, in this study, a new system has been proposed for the early diagnosis of EEG- and DL-based MD. In the proposed study, EEG signals obtained from the resting state (R), visual stimulus (V), and auditory stimulus (A) from 18 migraine patients and 21 healthy control (HC) groups were used. By applying continuous wavelet transform (CWT) and short-time Fourier transform (STFT) methods to these EEG signals, scalogram-spectrogram images were obtained in the time-frequency (T-F) plane. Then, these images were applied as inputs in three different convolutional neural networks (CNN) architectures (AlexNet, ResNet50, SqueezeNet) that proposed deep convolutional neural network (DCNN) models and classification was performed. The results of the classification process were evaluated, taking into account accuracy (acc.), sensitivity (sens.), specificity (spec.), and performance criteria, and the performances of the preferred methods and models in this study were compared. In this way, the situation, method, and model that showed the most successful performance for the early diagnosis of MD were determined. Although the classification results are close to each other, the resting state, CWT method, and AlexNet classifier showed the most successful performance (Acc: 99.74%, Sens: 99.9%, Spec: 99.52%). We think that the results obtained in this study are promising for the early diagnosis of MD and can be of help to experts.

Abstract Background To evaluate the clinical features and results of the revision total hip arthroplasties (THA) in patients with catastrophic failures and metallosis. Methods Fifteen hips of 14 patients with catastrophic failure and metallosis in hip arthroplasties were evaluated. They were followed for at least 4.2 years after the revision THA. Clinical evaluation was performed using Harris hip score. Osteolysis, loosening or presence of metallosis was evaluated with standard radiographs. Metallosis was evaluated intraoperatively according to the metallosis severity classification. Results The mean time from failure until revision surgery was 9.4 years. It was observed that in the primary THA, metal-on-ceramic (MoC), ceramic-on-ceramic (CoC) and metal-on-conventional polyethylene (MoCPE) bearings were used in 1, 3 and 11 hips, respectively. Grade III metallosis was observed in all patients during revision surgeries. The mean Harris hip score increased from 55 points before revision THA to 75 points at the final follow-up. In revision arthroplasty, MoCPE and CoC bearings were used in 13 and 2 hips, respectively. The femoral stem was replaced in 5 hips. All acetabular cups, except that of one hip, were revised. Conclusions Revisions of THAs with catastrophic failures and metallosis are quite challenging. Routine follow-up of arthroplasty patients is beneficial to examine for osteolysis, loosening, and asymmetric wear.

Shot accuracy is very important for success in wheelchair basketball (WB) and basketball games. The kinematics of the ball affects the shot accuracy. The main purposes of this study are to compare the kinematics of the ball according to the outcomes of WB and basketball players’ shots and compare the shooting accuracy of WB and basketball players. Male senior athletes (17 basketball, 6 WB) voluntarily participated in the research. Participants made static shots from 6 spots (n=1515) and the analyses were made. The shots were separated into 4 groups. The first group contained the “Clean Shot”s (CS) which the ball goes into the hoop with no or 1 hit to the rim. The second contained all the “Success” shots (S) but CS. The third contained “Missed” shots, the ball hit to the rim. Fourth contained the rest of the missed shots (Air Ball). Reliable and valid 94fifty Smart Sensor Basketball was used in this research. For both WB and basketball players, CS angles were significantly higher than other shots and no significant difference was found between S angles and unsuccessful shots. CS angles of WB players were significantly higher than basketball players. This research showed that the entry angle affects CS for both sports. It is thought that it may raise CS and shooting percentage if coaches train their players by taking entry angles into consideration. Another finding of this study was CS angles of WB players are higher than basketball players. The reason for this may be the more active, hence more improved, upper extremity motor skills of the WB players.

Background: People are divided into different chronotypes in relation to their circadian rhythm features. The Morningness–Eveningness Questionnaire (MEQ), developed by Horne and Östberg, was the first and is the most used questionnaire for determining the chronotype of people. The reliability and validity of MEQ were tested in this study due to some deficiencies and inconsistencies in previous reliability and validity studies for the Turkish versions of MEQ and deficiencies regarding the validity and reliability of other versions of MEQ. Subjects and Methods: MEQ was translated into Turkish based on the opinions of five academics who were experts in their respective fields and the suitability and content validity of the questionnaire were ensured. The Turkish MEQ was administered to 419 undergraduate students aged 18–34 years. Robust minimum rank factor analysis (MRFA) was used to reveal the construct validity of the questionnaire. Results: As a result of the analyses, the questionnaire was examined in three factors. None of the items were excluded from the study and all items were collected under three factors. The explained total variance value was 42.7%, and the factors explained 64% of common (shared) variance in MRFA. According to the reliability analysis, Cronbach's alpha value for the MEQ Turkish version was satisfactory for the overall questionnaire (0.765). Conclusions: The MEQ version developed in this study is more valid and reliable compared with other versions. However, these results support that a more detailed instrument for morningness and eveningness can be developed.

Abstract Introduction Developmental dysplasia of the hip (DDH) is a common disorder and associated with significant morbidity of the hip joint. Several risk factors have been identified for DDH. The aim of this study is to investigate whether vitamin D and vitamin D receptor (VDR) levels differ in children with DDH and whether they have an effect on DDH development. Materials and methods A total of 40 (17 males, 23 females; 9 right hips, 16 left hips, 15 bilateral hips) children who were treated for developmental dysplasia and 40 (23 males, 17 females) healthy children without any musculoskeletal system and metabolic disorders were included in this study between January and June 2019. Blood samples from the DDH and control groups of children were collected to measure the serum levels of vitamin D, VDR, calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP). The levels of Ca, P, and ALP were analyzed using the automated standard spectrophotometric laboratory method. The levels of vitamin D and VDR in the samples were analyzed using enzyme-linked immunoassay. Results There were no significant differences in the serum levels of Ca, P, ALP, and vitamin D between the DDH and healthy groups (Ca 9.96 ± 0.47 vs. 9.92 ± 0.48 mg/dL, respectively, p = 0.721; P 5.3 ± 0.94 vs. 4.82 ± 0.88 mg/dL, respectively, p = 0.23; ALP 252.22 ± 170.15 vs. 245.3 ± 130.93 U/L, respectively, p = 0.839). However, serum VDR levels were significantly lower in children in the DDH group (5.77 ± 3.51 ng/mL) than in the healthy control group (9.25 ± 6.43 ng/mL) (p = 0.004). Conclusions In conclusion, we believe that low VDR levels can affect DDH regardless of the serum levels of Ca, P, ALP, and vitamin D. More comprehensive studies involving parents are needed to understand whether VDR levels mediate genetic transmission in DDH or not.

The aim of this study was to assess the impact of low-volume metastasis (LVM) on disease-free survival (DFS) in women with apparent early-stage endometrial cancer (EC) who underwent sentinel lymph node (SLN) mapping. Patients with pre-operative early-stage EC were retrospectively collected from an international collaboration including 13 referring institutions. A total of 1428 patients were included in this analysis. One hundred and eighty-six patients (13%) had lymph node involvement. Fifty-nine percent of positive SLN exhibited micrometastases, 26.9% micrometastases, and 14% isolated tumor cells. Seventeen patients with positive lymph nodes did not receive any adjuvant therapy. At a median follow-up of 33.3 months, the disease had recurred in 114 women (8%). Patients with micrometastases in the lymph nodes had a worse prognosis of disease-free survival compared to patients with negative nodes or LVM. The rate of recurrence was significantly higher for women with micrometastases than those with low-volume metastases (HR = 2.61; p = 0.01). The administration of adjuvant treatment in patients with LVM, without uterine risk factors, remains a matter of debate and requires further evaluation.

The segmentation of the liver is a difficult process due to the changes in shape, border, and density that occur in each section in computed tomography (CT) images. In this study, the Adding Inception Module-Unet (AIM-Unet) model, which is a hybridization of convolutional neural networks-based Unet and Inception models, is proposed for computer-assisted automatic segmentation of the liver and liver tumors from CT scans of the abdomen. Experimental studies were carried out on four different liver CT image datasets, one of which was prepared for this study and three of which were open (CHAOS, LIST, and 3DIRCADb). The results obtained using the proposed method and the segmentation results marked by the specialist were compared with the Dice similarity coefficient (DSC), Jaccard similarity coefficient (JSC), and accuracy (ACC) measurement parameters. In this study, we obtained the best DSC, JSC, and ACC liver segmentation performance metrics on the CHAOS dataset as 97.86%, 96.10%, and 99.75%, respectively, of the AIM-Unet model we propose, which is trained separately on three datasets (LiST, CHAOS, and our dataset) containing liver images. Additionally, 75.6% and 65.5% of the DSC tumor segmentation metrics were calculated on the proposed model LiST and 3DIRCADb datasets, respectively. In addition, the segmentation success results on the datasets with the AIM-Unet model were compared with the previous studies. With these results, it has been seen that the method proposed in this study can be used as an auxiliary tool in the decision-making processes of physicians for liver segmentation and detection of liver tumors. This study is useful for medical images, and the developed model can be easily developed for applications in different organs and other medical fields.

Background: Uterine carcinosarcoma is rare neoplasm that mostly presents as metastatic disease. Stage is one of the most important prognostic factor, however, the management of the early stage uterine carcinosarcoma is still controversial. Aims: To evaluate prognostic factors, treatment options, and survival outcomes in patients with surgically approved stage I uterine carcinosarcoma. Study Design: Cross-sectional study. Methods: Data of 278 patients with uterine carcinosarcoma obtained from four gynecologic oncology centers were reviewed, and 70 patients with approved stage I uterine carcinosarcoma after comprehensive staging surgery were studied. Results: The median age of the entire cohort was 65 years (range; 39-82). All patients underwent both pelvic and paraaortic lymphadenectomy. Forty-one patients received adjuvant therapy. The median follow-up time was 24 months (range; 1-129). Nineteen (27.1%) patients had disease failure. The 3-year disease-free survival and cancer-specific survival of the entire cohort was 67% and 86%, respectively. In the univariate analysis, only age was significantly associated with disease-free survival (p=0.022). There was no statistical significance for disease-free survival between observation and receiving any type of adjuvant therapy following staging surgery. Advanced age (

The evidence-based medicine is rooted in the scientific truth. Oxford Dictionaries has released its 2016 word of the year: “Post-truth,” which they define as “relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief”. In everything from climate change denial to the anti-vaccine movement, we’re seeing the consequences of a failure to engage with scientific evidence. Fake news and post-truth pronouncements are increasingly common in social media and political era and are unfortunately also progressively being applied to the medical science. We also see some evidence of post-truth signals in daily cardiology procedures and guidelines including both interventional cardiology and cardiac electrophysiology. Guideline recommendations made before the randomized-controlled trials (RCT) are published might result in a scenario that the interventions or procedures have been performed on millions of people, costing billions of dollars, leading to unnecessary use of health care resources and often, ending up being even accepted as routine procedures in certain clinical situations. “Justice delayed is justice denied” is a legal cliché meaning that if timely justice is not provided to the sufferer, it loses it importance and violates human rights. In medicine, “The RCT delayed is justice denied”, as highlighted by ORBITA (Objective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina) trial and as may happen with CABANA (Catheter Ablation versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial) in the post-truth era. Keywords: Evidence-based medicine, Post-truth era, Cardiology, ORBITA trial, CABANA trial

We report a case of 72-year-old woman who was hospitalized with vaginal bleeding and abdominal pain. Magnetic resonance imaging showed tumor both in endometrial cavity and ovaries with multiple distant metastasis. Her serum alpha-fetoprotein level was >54000 ng/mL. Total abdominal hysterectomy with bilateral salpingo-oophorectomy, total omentectomy, appendectomy, bilateral pelvic and paraaortic lymph node dissection, a 20 cm ileal resection with ileal anastomosis, metastasectomy were performed and peritoneal washing was obtained. The pathologic diagnosis was endometrial hepatoid adenocarcinoma. Because of her poor medical condition, she received only palliative chemotherapy. After two days of 5-fluorouracil she died within 2 months. Hepatoid adenocarcinomas are extrahepatic neoplasms that exhibit features of hepatocellular carcinoma. It was first reported as gastric neoplasm but is seen in many different organs and its frequency is increasing. To date only 11 cases of hepatoid adenocarcinoma of the endometrium were reported. It has a poor prognosis and there isn’t an effective treatment yet.

Abstract Entrainment is an important tool for the diagnosis and location of reentry. The usefulness of this maneuver requires that, prior to cessation of ventricular pacing, the atrial rate accelerates to the ventricular pacing rate. Moreover, it is important to verify the continuation of the tachycardia following cessation of entrainment. The recognizing the last entrained atrial beat is utmost important to avoid erroneous A–A–V labeling.

Aims: Pulmonary vein isolation is effective in reducing atrial fibrillation (AF) episodes. Previous studies suggest single-shot techniques are effective and safe for this purpose. Procedural and clinical outcomes were compared between multi-electrode and point-by-point radiofrequency ablations by performing a meta-analysis of all randomized and non-randomized studies. Methods and results: Systematic reviews of MEDLINE and Cochrane Library databases were performed. Studies comparing procedural (procedure and fluoroscopy times) and clinical (AF recurrence) outcomes were included in the meta-analysis. A total of 13 clinical studies (5 randomized and 8 non-randomized) including 2152 patients met the inclusion criteria. In patients underwent multi-electrode ablation, there were significant reductions in both total procedure and fluoroscopy times, compared with point-by-point ablation (mean difference = −34.3 min [95% CI (−50.1 to −18.5)], p

A graphics processing unit (GPU) is utilized to apply the direct-forcing immersed boundary method. The code running on the GPU is generated with the help of the Compute Unified Device Architecture (CUDA). The first and second spatial derivatives of the incompressible Navier-Stokes equations are discretized by the sixth-order central compact finite-difference schemes. Two flow fields are simulated. The first test case is the simulated flow around a square cylinder, with the results providing good estimations of the wake region mechanics and vortex shedding. The second test case is the simulated flow around a circular cylinder. This case was selected to better understand the effects of sharp corners on the force coefficients. It was observed that the estimation of the force coefficients did not result in any troubles in the case of a circular cylinder. Additionally, the performance values obtained for the calculation time for the solution of the Poisson equation are compared with the values for other CPUs and GPUs from the literature. Consequently, approximately 3× and 20× speedups are achieved in comparison with GPU (using CUSP library) and CPU, respectively. CUSP is an open-source library for sparse linear algebra and graph computations on CUDA.

Abstract An important therapeutic modality for heart failure with left ventricular dyssynchrony, left ventricular lead placement, cannot be achieved due to anatomic challenges in some cases. In the current case, a novel implantation technique to overcome an anatomic difficulty, angled takeoff of the side branch of the coronary sinus, was presented.

ABSTRACT Objective Thyroid hormones have both direct and indirect effects on thermogenesis such as modulating vascular smooth muscle cell proliferation. However, the influence of more subtle changes in thyroid hormones on coronary atherosclerosis remains a matter of speculation. Smooth muscle cells play a crucial role in the pathogenesis of in-stent restenosis (ISR). However, the relationship between free thyroxine (fT4) and ISR has not been studied. In the present study, we aimed to assess the role of preprocedural serum fT4 level on the development of ISR in patients undergoing coronary bare metal stent (BMS) implantation. Materials and methods We enrolled and analyzed clinical, biochemical, and angiographic data from 705 consecutive patients without a history of primary thyroid disease [mean age 60.3 ± 9.3 years, 505 (72%) male]; all patients had undergone BMS implantation and further control coronary angiography owing to stable or unstable angina pectoris. Patients were divided into 3 tertiles based on preprocedural serum fT4 levels. Results ISR was observed in 53 (23%) patients in the lowest tertile, 82 (35%) patients in the second tertile, and 107 (46%) patients in the highest fT4 tertile (p < 0.001). Using multiple logistic regression analysis, five characteristics emerged as independent predictors of ISR: diabetes mellitus, smoking, HDL-cholesterol, stent length, and preprocedural serum fT4 level. In receiver operating characteristics curve analysis, fT4 level > 1.23 mg/dL had 70% sensitivity and 73% specificity (AUC: 0.75, p < 0.001) in predicting ISR. Conclusion Higher preprocedural serum fT4 is a powerful and independent predictor of BMS restenosis in patients with stable and unstable angina pectoris.

Objectives: Apical aneurysms in patients with hypertrophic cardiomyopathy (HCM) represent an underrecognized but clinically important subset of HCM patients. However it may be frequently missed by echocardiography because of poor image quality of left ventricular apex. We aimed to compare electrocardiographic STE in HCM patients with and without apical aneurysm. Methods: We developed this clinical review using an extensive MEDLINE review of the literature and data from our laboratories; and some electrocardiographic parameters including STE were analysed in HCM patients with and without apical aneurysm. Results: There were 29 HCM patients without apical aneurysm (Group 1; 52.6 ± 17.7years, 69% male) and 28 HCM patients with apical aneurysm (Group 2; 59.6 ± 13.2years, 57% male). The STE in V4-6 derivations were statistically more frequent in patients with apical aneurysm compared to those without aneurysm (93% vs 7%, p

Dudak damak yarıkları yüz yapılarında en sık görülen konjenital anomalidir. Ülkemizde 1/800 oranında görülmektedir. Bu anomaliye sahip bireylere ameliyat öncesi ortopedik uygulamalar yaygın biçimde yapılmaktadır. Bu olgu sunumunun amacı, 3 boyutlu görüntüleme tekniği kullanılarak ameliyat öncesi nazoalveolar şekillendirme ve ameliyat sonrasında elde edilen değişiklikler açısından bilateral dudak damak yarıklı bir bebeğin tedavi sonuçlarını değerlendirmektir.Dudak damak yarıkları yüz yapılarında en sık görülen konjenital anomalidir.1 Ülkemizde 1/800 oranında görülmektedir.2 Dudak damak yarıklı bebeklerde en önemli sorun beslenme zorluğudur. Bunun yanı sıra, bu bireylerde işitme kaybı ve ağız kokusu görülmekte; ayrıca dental arklarda eksik ve/veya malforme diş bulunabilmektedir.3,4 İleri dönemlerde kendine güvende yetersizlik, konuşma güçlüğü ve konuşma bozukluğu, bunlara bağlı olarak öğrenmede güçlük ve sosyal izolasyon karşılaşılan diğer problemlerdendir