Search

Objective: The aim was to evaluate the effect of activated bleaching agents on the nanoceramic composite resins based on microhardness and surface roughness measurements. Methods: Opalescence Boost (Ultradent Products, USA) and Whiteness HP Blue Calcium (FGM Dental Products, Brazil) bleaching agents and a nanoceramic composite resin Ceram.X® SphereTEC™ One (DENTSPLY, Germany) were used in the study. Fifty composite samples in disc form (8x2mm) were prepared. The samples were polished with discs (Sof-Lex, 3M Dental Products, St.Paul, USA) and incubated in the dark in distilled water. Samples were divided into 5 main groups (n=10). Control group (C), Opalescence Boost/ without light (OB), Opalescence Boost/ with light (OBL), Whiteness HP Blue/ without light (WB), and Whiteness HP Blue/ with light (WBL). Surface roughness (Ra) and Vickers microhardness (VHN) measurements were conducted after the bleaching process. Statistical analyses were performed using the Kruskal Wallis – H test and the Mann Whitney – U test; a p value of < 0.05 was considered statistically significant. Result: The VHN was significantly different among groups in terms of the application of bleaching agents and light (p = 0.008). The Ra was not significantly different among groups with respect to the application of bleaching agents or lighting conditions (p = 0.144). Conclusion: Within the conditions of this study, after bleaching procedure the microhardness values of the nanoceramic composite increased, however bleaching did not show any effect on surface roughness.

BACKGROUND/AIMS: There is a pressing need for new therapies for the most aggressive subtype of breast cancer, triple-negative breast cancer (TNBC). Tenascin-C (TN-C) codes for a tumor microenvironment-specific protein, which promotes apoptosis evasion and cell proliferation. The aim of this study was to knock down TN-C by using the clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 system to induce cancer cell apoptosis and stunt cell proliferation, laying the grounds for a new gene therapy approach in TNBC.MATERIALS and METHODS: The human TNBC cell line, MDA-MB-231 cells were transfected by TN-C-specific CRISPR/Cas9 plasmids. TN-C messenger RNA levels were assessed by real-time polymerase chain reaction to determine the knock-down efficiency. Two days after the transfection, the percentage of apoptotic cells and the proportion of cells in cell cycle phases were compared between the treatment and the control groups using flow cytometry. The resultant change in cell proliferation due to the knock-down was determined by MTT assay. RESULTS: Transfection with the TN-C CRISPR/Cas9 plasmid reduced TN-C levels in the cells by approximately 49% relative to the scrambled -control CRISPR/Cas9 transfected cells. This TN-C downregulation increased the percentage of cells in apoptosis and induced G1-phase arrest. The combined effect of apoptosis and cell cycle arrest led to a significant decrease in the number of cancer cells in the treatment group.CONCLUSION: Our successful preliminary study of a potential TNBC gene therapy based on TN-C genome editing by the CRISPR/Cas9 system led to significant decrease in TNBC cell numbers and it justifies the testing of this system in more advanced preclinical studies.

The vascular endothelium is one of the main targets of oxidative stress which plays an important role in the pathophysiology of vascular damage. Recent studies show that vitamin D can positively regulate endothelial functions in various chronic diseases and in cases of increased oxidative stress. In our study, we investigated the restorative and protective potentials of paricalcitol which is frequently used in patients with chronic renal failure, a vitamin D analogue, in human umbilical vein endothelial cells (HUVEC) before and after H2O2-induced oxidative stress. Paricalcitol treatment after the oxidative stress induced by H2O2 increased cell viability in endothelial cells depending on the dose that was used. While paricalcitol (500 nM) decreased caspase-3 activity and mitochondrial membrane potential loss, it increased nitric oxide (NO) production and reduced glutathione (GSH) levels. Paricalcitol treatment before oxidative stress increased cell viability. It increased NO production and mitochondrial membrane potential while significantly reducing caspase-3 activity. While paricalcitol caused a significant inhibition of protein disulfide isomerase (PDI) reductase activity in healthy endothelial cells, it did not cause a significant change on the PDI reductase activity under oxidative stress conditions. Present study showed that paricalcitol has restorative and protective effects on endothelial cells against oxidative injury, but these effects occur at high concentrations of paricalcitol.

Objective: In-stent restenosis (ISR) is the narrowing of a stented coronary artery lesion. A considerable number of patients undergoing percutaneous coronary intervention (PCI) are affected by ISR. The predominant mechanism in the development of ISR is an inflammatory response to vessel wall injury during PCI. Vitamin D is reported to have anti-inflammatory properties, so it may also be related with ISR. Therefore, in this study the relationship between vitamin D receptor (VDR), vitamin D binding protein (VDBP) gene variations and ISR were investigated.Methods: Fifty-eight ISR patients who have chest pain, underwent angiography and were found to have restenosis in the previously inserted stent were included in the patient group and thirty-five patients who have chest pain and were not found to have restenosis in their previous stent in coronary angiography were included in the control group. rs7041 and rs4588 variations in VDBP; rs1544410 and rs2228570 variations in VDR were investigated by real-time polymerase chain reaction (RT-PCR).Results were evaluated statistically. Results: The CC genotype of rs2228570 variation of VDR and the CA genotype of rs4588 variation of VDBP were found statistically high in patient group. rs7041 variation was found statistically high in patients who had myocardial infarction history before stent implantation. Additionally, it was demonstrated that vitamin D deficiency (vitamin D level

Obesity is considered an important global public health challenge, and its prevalence is rapidly increasing in children. We investigated in this study if the upper-normal TSH level may be associated with metabolic syndrome parameters, including obesity, high blood pressure, and dyslipidemia and changes in insulin sensitivity in overweight and obese children. We also investigated whether there is a relationship between BMI and these parameters. This prospective case-control study comprised 145 participants (74 females, 71 males) aged 5–18 years. Participants were divided into three groups according to their BMI z-score, as overweight, obese and control. The control group included 35 age and sex-matched healthy subjects. Thyroid stimulating hormone levels of control, overweight and obese groups were 2.14 ± 1.27, 2.97 ± 1.26 and 3.13 ± 1.11, respectively (p

Background. Doctors have higher rates of mental illness and suicide than the general population worldwide. Suicides of doctors are known to be underreported in developing countries. To the best of our knowledge, there are no studies investigating suicides among medical students and doctors in Turkey.Objectives. To investigate the characteristics of suicides in medical school students and doctors in Turkey.Materials and methods. In this retrospective study, newspaper websites and Google search engine were searched for information on medical school student and doctor suicides in Turkey between 2011 and 2021. Cases of suicide attempt, parasuicide or deliberate self-harm were not included in the study.Results. Sixty-one suicides were reported between 2011-2021. There was a male predominance (45 (73.8%)), and more than half of the suicides (32 (52.5%)) occurred among specialist doctors. Self poisoning, jumping from heights and firearms were the most common methods of suicide (18 (29.5%), 17 (27.9%) and 15 (24.6%), respectively). Cardiovascular surgery, family medicine, gynecology, and obstetrics specialties had the highest numbers of suicide deaths. Depression/mental illness was the most common speculated etiology. These results show that suicides among medical students and doctors in Turkey have characteristics that differ from both suicided among the general population in Turkey and doctor suicides in other countries.Conclusions. In this study, we identified the suicidal characteristics of medical students and doctors in Turkey for the first time. The results help us to better understand this understudied topic and provide an avenue for future studies. The data also indicate that it is important to monitor the individual and systemic difficulties experienced by doctors, starting from the medical education stage, and to provide individual and environmental support to help decrease the risk of suicide.

Objective: This study was carried out to evaluate the relationship between the nutritional status, anthropometric measurements and dietary inflammatory index (DII) of professional football players exposed to long-term intense exercise. Method: Twenty-one professional male football players with a mean age of 26.00±5.69 years playing in the same club participated in the study. The nutritional status of the football players was evaluated with 3-day food consumption record (2 days of training and 1 match day). DII scores were calculated using data on 34 nutrient/nutritional ingredients obtained from the food consumption records. Body fat percentage in the anthropometric evaluations were determined by caliper and skinfold thicknesses. Results: The median DII scores of the football players were found as – 3.42 (-9.95 – 0.95), and their nutritional intake were found to be antiinflammatory. When the relationship between the DII scores of the football players and their anthropometric measurements was examined, a positive and significant correlation (R: .476; p: .029) was found between their DII score and their abdominal adiposity. However, there was no significant correlation (p> .05) between the DII scores and the other anthropometric measurements. In addition, there was a significant negative correlation (R: – .468; p: .032) between fiber consumption and abdominal adiposity, and a significant positive correlation between carbohydrate and fat consumption and body weight (respectively R= .730 p= .000; R= .526 p= .014). Conclusion: It has been revealed that the football players participating in our study generally have an anti-inflammatory diet. It was also found that abdominal adiposity was higher in the football players with high DII scores.

Objective: School nursing education has not been standardized in Turkey so that it was decided the Delphi technique would be used to develop a curriculum for a program of education in school nursing. Methods: The data were collected from the expert panel via the Delphi technique by means of e-mail. Data were collected in three consecutive Delphi rounds. The population of the study comprised academic nurses and school nurses working in the area of school nursing in Turkey. A total of 83 experts were invited to participate in the study. The data were evaluated in terms of Quartile 1, Quartile 3, medians, interquartile ranges. Interquartile range refers to the difference between Quartile 3 and 1. Consensus was considered as less than the interquartile range of 1.2. Results: At the end of Round-1, 177 learning outcomes, nine main topics, 262 sub-topics were obtained. At the end of Round-2, 167 learning outcomes, nine main and 255 sub-topics were gathered, while at the end of Round-3, agreement was reached regarding nine main topics, 255 sub-topics, 167 learning outcomes, thus ending the Delphi rounds. Conclusions: The curriculum on which agreement was reached will be treated as a guide to school nursing education and contribute to the standardization of this instruction.

Objective: Insomnia is an important health problem affecting physical, spiritual and social well-being of individuals negatively and it should be early diagnosed as well. The purpose is to appraise the psychometric features of the Turkish version of the Bergen Insomnia Scale (BIS) for adults. Methods: A total of 495 adults were included in the methodological study in Turkey. Turkish form of BIS was designed within the scope of study conducted in adolescent sample. Construct validity was appraised with exploratory, confirmatory factor analysis, convergent and discriminant validity. Internal-consistency and test-retest analysis were used for reliability. Results: According to results of explanatory, confirmatory factor analysis; it was identified that BIS showed a two-factor structure as daytime symptoms (α=.85) and nocturnal symptoms (α=.80). Item-total correlations were found as ≥.59 and test-retest correlation as .83. Conclusions: The Turkish version of the Bergen Insomnia Scale for adults was assessed as valid and reliable.

Objective: This phenomenologic study aims to investigate the difficulties experienced by a group of nursing students during the pandemia process thoroughly and to explain coping strategies. Methods: This research was carried out using the phenomenological method, which is one of the qualitative research methods, to examine the views of nursing students on their pandemic experiences and their coping strategies “Information Form” and “Questionnaire Form” were sent to the students online, and forms that were filled out completely and sent back were included in the content analysis. Results: Participants mean age was 21.19±1.06. Of the participants, 77.00% were female, 34.4% stated that they live in a metropolis during the pandemia process, while 83.6% mentioned that they were with their family, 31.1% did not leave their homes unless it is necessary. As a result of data analysis, the main themes of difficulties/stressors, stress/anxiety increasing factors, and coping strategies were reached. Conclusion: Student nurses experience more than one difficulty regarding the pandemia process; some students state that the pandemia process has changed their perception of their profession, and they mostly use positive methods to cope with these difficulties.

Objective: To investigate the effect of a novel mineral containing toothpaste in comparison to a fluoride toothpaste in children with white spot lesions. Method: The clinical study was conducted from 2016 to 2018 at Marmara University Department of Pediatric Dentistry Clinic after approval from the ethics review committee of Yeditepe University, Istanbul, Turkey, and comprised children of either gender aged 4-5 years having white spot lesions. They were randomly allocated into two groups. The FT ( Fluoridated Toothpaste ) group was given a 500ppm fluoridated toothpaste, while the Mineral Containing Toothpaste (MCT) group was given toothpaste containing calcium glycerophosphate, magnesium chloride, and 12% xylitol. The white spot lesions were examined using Laser Fluorescence (LF) at baseline and after a month of usage. The two readings were compared. Stimulated saliva was collected for measuring the salivary potential of hydrogen, buffering capacity, and streptococcus mutans. Data was analysed using SPSS 19. Results: Of the 26 children, 10(38%) were girls and 16(62%) were boys. The overall mean age was 4.77+/-0.54 years. There were 13(50%) subjects in each of the two groups. Of the 381 measurements done, 198(52%) were in the MCT group and 183(48%) in the FT group. LF scores decreased in both the groups (p=0.001). The remineralising potential was not significantly different (p=0.866), while salivary buffering capacity and potential of hydrogen increased in both the groups but the change was not significant (p>0.05). The number of children positive for streptococcus mutans decreased in both the groups (p>0.05). ---Continue

Objective: The aim of the study was to evaluate the possible protective effects of alpha-lipoic acid (α-LA), donepezil and memantine combined therapy in the scopolamine-induced amnesia rat model. Objective: The aim of the study was to evaluate the possible protective effect of donepezil, memantine and alpha-lipoic acid (α-LA) combined therapy in the scopolamine-induced amnesia rat model. Methods: In this study, the effect of combined therapy used in the treatment of scopolamine-induced amnesia on behavioural parameters was evaluated using Y-maze and new object recognition (NOR) test. In addition, muscarinic acetylcholine receptor subtype M1, N-methyl-D-aspartate receptor NR2B subunit, brain-derived neurotrophic factor (BDNF) and mitochondrial apoptosis-related proteins [B-cell lymphoma-2 (Bcl-2) / Bcl-2 associated X (Bax) ratio, caspase (casp) -3, and -9] expression levels were evaluated using the western blot method in the frontal cortex and hippocampus regions. Results: The main findings of this study demonstrated that in scopolamine-induced amnesia rats, cognitive dysfunction determined by both the Y-maze and the NOR test were reversed with the combined treatment of memantine, donepezil and α-LA. According to immunoblotting results in both brain regions, scopolamine-induced decreased M1, BDNF, Bcl-2 / Bax ratio and increased NR2B, casp-3 and -9 expression levels were found to be reversed to almost control values with combined treatment. Conclusion: Consistent with the literature, our study results suggest that the positive contribution of α-LA to the combined treatment of donepezil and memantine, which is used in the routine treatment of neurodegenerative diseases, may be a treatment option in the future. Results: The main findings of this study demonstrated that in scopolamine-induced amnesia rats, cognitive dysfunction determined by both the Y-maze and the NORT test were reversed with the combined treatment of memantine, donepezil and α-LA. In addition, decreased BDNF, M1, bcl-2/bax ratio and increased NR2B, caspase-3 and caspase-9 expression levels due to scopolamine in both regions were improved with α-LA, donepezil and memantine combined therapy. Conclusion: The results of our study and other study results in the literature suggest that α-LA may be a future treatment option due to its positive contribution to the effects of other drugs used in the routine treatment of neurodegenerative diseases.

Objective: To assess the changes in children’s oral health-related quality of life following the treatment of severely affected molar-incisor hypomineralisation with Glass Hybrid Restorative System (GH) after selective caries removal. Method: The observational cross-sectional study was conducted at the Marmara University, School of Dentistry, Department of Pediatric Dentistry. Children aged 11–14 years (n = 55) who were diagnosed with MIH and had finished their dental treatment from November 2018 to December 2019, were included. The children’s MIH-affected teeth were treated with GH after SCR. Participants answered the Child Perceptions Questionnaire (CPQ) prior to their dental treatment and 6 months after the treatment. Results: Of the fifty-five patients, 40 patients (24 girls-16 boys) completed baseline and follow-up data. The mean age of the children was 11.85 (±1.02) years. The overall CPQ score ranged from 3–83 (average 33.27 ± 16.46) at baseline and 0–61 (average 11.67 ± 11.21) at follow up. The emotional well-being among children was the highest score at baseline. A significant decrease (p < 0.001) in the mean values was observed for both the overall CPQ scores and for the scores of the oral symptoms, functional limitations, and social-emotional well-being limitation. All subdomains showed large effect sizes and oral symptom limitation domain presented the greatest effect. Wilcoxon Rank test was used to determine the statistical significance of the changes and the magnitude of change was determined by calculating and classifying the effect size. Conclusion: Restorative treatment with GH following selective caries removal positively influenced the oral health-related quality of life of children with severe molar-incisor hypomineralisation. Key Words: Health-related quality of life, Dental enamel hypoplasia, Questionnaires, Child, Oral health.

Objective: The study aims to investigate the standardized, traceable dose amounts that will create the desired therapeutic physiological change in the tissue and prevent the risk of tissue damage in the light of metrology principles Methods: In the study carried out in TÜBİTAK National Metrology Institute Medical Metrology Laboratory, a muscle phantom simulating the acoustic properties of muscle tissue was created and thermocouples were placed in it. Ultrasound at different intensities and durations at 1 MHz frequency was applied to the phantom. The temperature changes measured by the thermocouples were recorded. Each measurement was repeated three times and averaged Results: 14 minutes application at 1 W/cm2 density, 10 minutes application at 1.5 W/cm2 density, ~7 minutes application at 2 W/cm2 density, and ~4 minutes application at 2.5 W/cm2 density have been achieved for the temperature range needed to produce therapeutic effect. Conclusions: In order to achieve the therapeutic effect, the ultrasound doses used in the procedure should be checked. Measurements in multi-layer phantoms would be useful in future research.

Objective: The study aimed to evaluate medication review in older adults (≥65 years) at a community pharmacy by identifying the prevalence of potentiality inappropriate medication and calculating medication appropriateness index. Methods: This descriptive study was carried out in a community pharmacy for six months. The older adults (≥65 years) using one or more medications were included. During clinical pharmacist-led medication review; the medication appropriateness index was calculated for each medication of older adults. Potentially inappropriate medications were evaluated according to the 2019 American Geriatrics Society Beers Criteria®. Result: Among a hundred older adults, 46.0% were female. The median age of the patients was 75.5 (IQR, 68.0-78.8). The median number of medications was 9.0 (7.0-10.0). Polypharmacy has been detected in 97.0% of the patients. At least one potentially inappropriate medication was detected in 63.0% of them. The median score of medication appropriateness index score was 53.0 (IQR: 38.6-67.9). Conclusion: To best our knowledge, this is the first study of clinical pharmacist-led medication review by calculating the medication appropriateness index carried out at a community pharmacy in Turkey. There was a high rate of potentially inappropriate medication with a higher score of medication appropriateness in older adults. This study highlights the importance of medication review led by the clinical pharmacist at community pharmacy to optimize medication usage in older adults. Keywords: Older adults, clinical pharmacist, medication appropriateness index, potentially inappropriate medication

Axillary artery branching pattern variations are commonly observed during routine dissections. These variations have great importance due to the wide range of therapeutic and diagnostic procedures carried out in the axillary region. Therefore, neurovascular abnormalities should be well-known before surgeries involving the axillary region in order to prevent complications. This case report presents a common trunk at the third part of the axillary artery which gives rise to the deep brachial artery.

Today, being healthy is strongly associated with quality of life, and the air quality and climate comfort become more important. With the Major Health Reform that was put into effect in 2000 in Germany, the illness-oriented perspective was replaced with a health-based approach. Although the use of thermal water therapies has increased in recent years, the climate (air)-based therapies have not yet been used in Turkey. These therapies that are performed by using the climate, which is of vital importance, contribute to increased quality of life, and they also protect and enhance the public health. From this viewpoint, it is aimed to review and analyze the climate therapy practices that are common in Germany and Austria, to discuss current status of climate therapy, to form a general framework through the findings, and to call the attention of practitioners and academics to the importance of this subject in Turkey. It is also aimed to encourage sustainable initiatives for economic development in rural areas and for prevention of immigration by preserving-using the natural resources that are already in hand for rapidly-growing health tourism in Turkey. In the study, descriptive research method was used. The data were retrieved from secondary sources about climate therapy studies and applications, and relevant websites. As a result of this study, it was observed that climate therapy has not yet been used in Turkey, and it was suggested that the climate therapy centers in Germany and Austria may be taken as examples, and these models may be implemented in cities with critical air pollution levels. It is predicted that Medical Ecology and Hydroclimatology Departments in Medical Schools and the tourism industry may collaborate on this matter.

Objectives: We evaluated the antibody response, natural killer cell response and B cell phenotypes in healthcare workers (HCW) who are vaccinated with two doses of CoronaVac with or without documented SARS-CoV-2 infection and unvaccinated HCWs with SARS-CoV-2 infection. Methods: HCWs were divided into four groups: vaccine only (VO), vaccine after SARS-CoV-2 infection (VAI), SARS-CoV-2 infection only (IO), and SARS-CoV-2 infection after vaccine (IAV). Anti-SARS-CoV-2 spike protein (Anti-S) antibodies were measured by Elecsys Anti–SARS–CoV–2 S ELISA kit. Memory B cells (CD19+ CD27+ ), plasmablast B cells (CD19+ CD138+ ) and long-lived plasma cells (LLPC; CD138+ CD19- ) were measured by flow cytometry in 74 patients. Interferon gamma (IFN-c) release by natural killer (NK) cells were measured by NKVue Test (NKMAX, Republic of Korea) in 76 patients. RT-PCR was performed with Bio-speedy COVID-19 qPCR detection kit, Version 2 (Bioexen LTD, Istanbul, Turkey). Results: The Anti-S antibodies were detectable in all HCWs (n: 224). The median Anti-S titers (BAU/mL) was significantly higher in VAI (620 25–75% 373–1341) compared to VO (136, 25–75% 85–283) and IO (111, 25–75% 54–413, p < 0.01). VAI group had significantly lower percentage of plasmablasts (2.9; 0– 8.7) compared to VO (6.8; 3.5–12.0) and IO (9.9; 4.7–47.5, p < 0.01) (n:74). Percentage of LLPCs in groups VO, VAI and IO was similar. There was no difference of IFN-c levels between the study groups (n: 76). Conclusion: The antibody response was similar between uninfected vaccinated HCWs and unvaccinated HCWs who had natural infection. HCWs who had two doses of CoronaVac either before or after the natural SARS-CoV-2 infection elicited significantly higher antibody responses compared to uninfected vaccinated HCWs. The lower percentages of plasmablasts in the VAI group may indicate their migration to lymph nodes and initiation of the germinal center reaction phase. IFN-c response did not differ among the groups.

Objective: Alcea genus belongs to Malvaceae family and this genus is represented by 85 taxa in the world and 21 taxa in the Flora of Turkey.The flowers of Alcea genus contain plenty of mucilage and are used for the treatment of respiratory diseases such as asthma and cough.Alcea dissecta is known as ‘Govik, Hiro, Hero’ in Turkey, and the flowers and leaves of this species have been used in the treatment of asthma,injury, colds, and gastrointestinal diseases in Turkey. To the best of our knowledge, there is no report on the effect of extraction methods onthe biological activity of this plant. In addition, although this species is being used as a medical plant, there is no study of the antioxidant, antiurease,esterase, and anticholinesterase activity of the plant. Therefore, the aim of this study was to evaluate in vitro antioxidant, anti-urease,esterase, anticholinesterase activities of Alcea dissecta using a variety of extracts.Methods: The antioxidant activities of different extracts were examined by DPPH, ABTS, FRAP, and CUPRAC methods. The total phenoliccompounds contained in the extracts were determined using the Folin-Ciocalteu reagent (FCR) method. Anti-urease and anticholinesteraseactivities of different extracts were evaluated by indophenol and Ellman methods respectively. In addition, esterase activities of plant extractswere determined.Results: In the present study, ethanol:water (1:1, v/v) and chloroform extracts obtained maceration method showed stronger DPPH and ABTSradical scavenging activity than other extracts. The chloroform extract obtained Soxhlet method was found to have higher FRAP and CUPRACvalues than other extracts. It was also found that the ethanol extract obtained maceration method showed the most potent anti-urease andanticholinesterase activity. According to the results, the strongest inhibitory effect on both hCA I and II isoenzymes was shown by the petroleumether extract obtained Soxhlet method.Conclusion: As a result, it was determined that different plant extracts have antioxidant, anti-urease, esterase, anticholinesterase activities. Inaddition, the data obtained from this study will shed light on future research on the biological activities of this species.

Measurement of environment interaction forces during robotic minimally-invasive surgery would enable haptic feedback to the surgeon, thereby solving one long-standing limitation. Estimating this force from existing sensor data avoids the challenge of retrofitting systems with force sensors, but is difficult due to mechanical effects such as friction and compliance in the robot mechanism. We have previously shown that neural networks can be trained to estimate the internal robot joint torques, thereby enabling estimation of external forces on the da Vinci Research Kit (dVRK). In this work, we extend the method to estimate external Cartesian forces and torques, and also present a two-step approach to adapt to the specific surgical setup by compensating for forces due to the interactions between the instrument shaft and cannula seal and between the trocar and patient body. Experiments show that this approach provides estimates of external forces and torques within a mean root-mean-square error (RMSE) of 1.8 N and 0.1 Nm, respectively. Furthermore, the two-step approach can add as little as 5 minutes to the surgery setup time, with about 4 minutes to collect intraoperative training data and 1 minute to train the second-step network.

Objective: To determine the effect of freedom of movement implemented in the dilatation stage, which is the first stage of labor, on the labor process in pregnant women who will give their first birth.Methods: This study was designed as a randomized controlled trial. The study consisted of 70 primiparous women, including 35 in the study group (SG) and 35 in the control group (CG). Freedom of movement was provided to the study group in the first stage of labor. Data were collected using a Personal Information Questionnaire, a Labor Assessment Form, and the Visual Analog Scale (VAS) for perceived pain.Results: The SG was observed to be walking when dilatations were 4-7 cm and mostly squatting when 8-10 cm (94.2%). The level of effacement, frequency of contraction, and descent of the fetal head were faster (p

Objective: The aim of this study is to inform surgeons regarding benign paroxysmal positional vertigo (BPPV) after indirect sinus liftingprocedures and to assess its relationship with age, gender, residual alveolar bone height (RAB), and cortical thickness of the sinus floor.Methods: This study included 138 patients presenting for evaluation and management of BPPV after indirect sinus lifting. Patients withRAB lengths of 5–8 mm had been taken for indirect sinus lifting. Preoperative RAB length and cortical thickness of the sinus floor had beendetermined by cone beam computed tomography (CBCT) in each patient. The patients diagnosed with BPPV were promptly treated by anotolaryngologist. Data were assessed by descriptive statistical methods (mean ± standard deviation). Results were evaluated at the p5.9 mm. BPPV is 4.54 times more prevalent in patients witha criterion cortical thickness value >0.8 mm than in patients with a criterion value 0.8 mm should be informed before undergoing surgery,and patients exhibiting postoperative symptoms associated with vertigo should be treated promptly.

Objective: To determine the needs and underline the experiences of mothers by focusing on the experiences of mothers with multiple babiesduring their breastfeeding period.Methods: This is a phenomenological, qualitative study. A total of 13 mothers with three – to 13-month-old babies were interviewed in-depthand individually. The data were collected by a single observer with a personal information form containing individual characteristics of theparticipants and an interview form with semi-structured, open-ended questions.Results: The three main themes formed based on the interviews with mothers were the meaning of being a mother with multiple babies andbreastfeeding them, challenging life experiences during breastfeeding, and the factors that affect motivation. The majority of the mothersexpressed feelings including concern, fear, guilt, and frustration. All mothers stated that, after delivery, they needed a knowledgeable anddependable helper preferably not from the family and that they experienced conflicts in their relationships.Conclusion: It is important to maintain social, emotional, and physical support for mothers with multiple babies. Similarly, avoiding judgmental,questioning, and accusing expressions is essential to circumvent conflicts in relationships. It is recommended for mothers’ concerns to beaddressed according to the source of the concern and for breastfeeding education content to be prepared accordingly. Each mother should beevaluated individually, and care plans and consultations should be prepared accordingly.

Objective: Hyper-IgE syndrome (HIES) is characterized by susceptibility to infection and low number of Th17 cells. Th17 is believed to be critical in the clearance of fungal and extracellular bacterial infections. Present study investigates the differentiation of Th17 cells by evaluation of interleukin 17 (IL-17) secretion and RAR-related orphan receptor gamma t (ROR gamma t) expression in HIES compared with healthy subjects. Objective: Hyper-IgE syndrome (HIES) is characterized by susceptibility to infection and low number of Th17 cells. Th17 is believed to be critical in the clearance of fungal and extracellular bacterial infections. Present study investigates the differentiation of Th17 cells by evaluation of interleukin 17 (IL-17) secretion and RAR-related orphan receptor gamma t (RORγt) expression in HIES compared with healthy subjects. Method: Three children diagnosed with HIES and 4 healthy subjects were enrolled in the study. HIES scores were evaluated and clinical data of patients were collected from their hospital records. At Th17 polarizing conditions, Th17 differentiation was assessed by the secretion of IL-17 with ELISA and the expression of ROR-γt with real time PCR. Results: HIES (n=3) patients showed significantly lower levels of IL-17 secretion compared to the healthy subjects (n=4) regarding the peripheral blood mononuclear cells (PBMCs) and CD45+RA naive T cells cultured in Th17 differentiating conditions. In addition, phorbol 12-myristate 13-acetate (PMA) and ionomycin stimulated IL-17 levels of healthy group were significantly higher than unstimulated conditions. Moreover, PMA and ionomycin stimulated IL-17 levels of PBMC cultures were significantly higher when compared to unstimulated conditions for both HIES patients and healthy subjects. ROR-γt expression level of stimulated PBMCs for HIES patient was detected nearly half of that of the healthy subject. Conclusion: Evaluation of IL-17 secretion and ROR-γt expression should be performed to determine the patients who are candidates for mutation analyses. Performing these steps and selection of HIES patients without known mutations in our country would provide an opportunity to discover new genetic defects and so new therapeutic approaches in HIES Amaç: Hiper-IgE sendromu (HIES), enfeksiyona duyarlılık ve düşük sayıdaki Th17 hücreleri ile karakterize edilir. Th17 hücreleri fungal ve hücre dışı bakteriyel enfeksiyonların eliminasyonunda önemli rol oynarlar. Bu çalışmada amacımız, HIES hastaları ve sağlıklı kontroller arasında interlökin 17 (IL-17) salgılanması ve RAR-bağımlı orphan reseptör gama t (RORγt) ekspresyonunun ölçülmesi ile Th17 hücrelerinin farklılaşmasını araştırmaktır. Yöntem: Çalışmaya 3 adet HIES tanısı almış çocuk ve 4 adet sağlıklı kontrol alındı. HIES skorları değerlendirildi ve hastaların klinik verileri hastane kayıtlarından toplandı. Th17 farklılaşması, ELİSA yöntemi ile IL-17 üretiminin ve gerçek zamanlı PZR yöntemi ile ROR-γt ekpresyonunun ölçülmesiyle değerlendirildi. Bulgular: HIES hastalarında, peripheral kan mononükleer hücreler (PKMH) ve CD45+RA naif T hücreler Th17 farklılaştırma koşullarında kültüre edildiğinde, IL-17 sitokin seviyesinde sağlıklı bireylere göre önemli derecede azalma gözlendi. Buna ek olarak, sağlıklı kontrollerin IL-17 seviyeleri forbol 12-miristat 13-asetat (FMA) ve iyonomisin uyarımlı durumda uyarımsız duruma göre daha yüksek bulundu. Ayrıca PKMH kültürlerinde IL-17 seviyesi FMA ve iyonomisin uyarımlı durumda, HIES hastaları ve sağlıklı kontroller için uyarımsız koşullarla karşılaştırıldığı zaman önemli derecede yüksek gözlendi. HIES hastasında uyarılmış PKMH’lerdeki RORγt ekspresyon seviyesi, sağlıklı kontrolün yarı düzeyinde olarak tespit edildi. Sonuç: IL-17 salgılanması ve ROR-γt ifadesinin değerlendirilmesi mutasyon analizleri için aday olan hastaları belirlemek için yapılmalıdır. Ülkemizde bu adımların uygulanması ve bilinen mutasyonları olmayan HIES hastalarının seçimi, yeni genetik bozuklukların keşfedilmesine ve böylece yeni tedavi yaklaşımlarına olanak sağlayacaktır

Odontogenic cysts are by far the most common cysts of the jaws. A radicular cyst is a cyst that most likely results when rests of Malassez epithelial cells in the periodontal ligament are stimulated to proliferate and undergo cystic degeneration by inflammatory products from a nonvital tooth. Radiographically, their periphery usually have a well-defined border and their internal structures are radiolucent. In order to make definite radiological diagnosis, more than one projection methods may be needed. The aim of this report is to present a case with an unusual location of radicular cyst caused by a molar root which was left after a tooth extraction procedure and accompanied by reactive bone development. Çene kemiklerinde en sık görülen kistler odontojenik kistlerdir. Radiküler kist periodontal aralıktaki Malassez epitel artıklarının devital bir dişe ait enflamasyon uyaranlarıyla kistik değişikliğe uğramasıyla oluşan bir kisttir. Radyolojik olarak çevresi belirgin sınırlı ve ortası radyolusenttir. Tanı konulması zor olmamakla birlikte bazen kesin radyolojik tanı için birden fazla görüntüleme yöntemi gerekebilir. Burada amaçlanan diş çekimi sonrası bırakılmış molar diş köküyle birlikte farklı bir lokasyonda görülen reaktif kemik gelişiminin eşlik ettiği radiküler kist vakasını sunmaktır.

Amaç: Çalışmada, bir serbest eczanede klinik eczacı tarafından yürütülen ‘nikotin replasman tedavisiyle (nikotin sakızı ve nikotin tabletini içeren) sigara bırakma programının bir yıllık sonuçlarının değerlendirilmesi amaçlanmıştır. Yöntem: Çalışma Haziran 2009 - Haziran 2010 tarihleri arasında gerçekleştirilmiştir. İlk görüşmede katılımcıların demografik ve klinik verileri toplanmış ve her bir katılımcıya ‘Fagerstrom Nikotin Bağımlılık Testi’ uygulanmıştır. Daha sonra klinik eczacı tarafından katılımcılar sigaranın zararları hakkında bilgilendirilmiş ve her bir katılımcının bağımlılık derecesine göre uygun OTC (tezgah üstü ilaç- reçetesiz ilaç) nikotin replasman ürünü tavsiye edilmiştir. Katılımcılar klinik eczacı tarafından on iki ay boyunca yüz yüze veya telefonla yapılan düzenli görüşmelerle takip edilmiştir. Bulgular: Çalışmaya katılan 33 katılımcının yaş ortalaması 41.57±11.90 (aralık: 24-66 yıl) olarak hesaplanmıştır. Fagerstrom Nikotin Bağımlılık Testi sonuçlarına göre katılımcıların onbeşinde düşük nikotin bağımlılığı, dokuzunda orta bağımlılık ve kalan dokuz katılımcıda ise yüksek nikotin bağımlılığı saptanmıştır. Hastaların ikisi bir yıllık takipte kaybedilmiş, çalışma 31 hasta ile tamamlanmıştır. Çalışma sonunda, klinik eczacı danışmanlığında serbest eczanede yürütülen sigara bırakma programıyla bir yıl boyunca takip edilen otuz bir katılımcının yirmisinin (%64.5) sigara kullanmayı bıraktığı görülmüştür. Sonuç: Bu bilgiler ışığında, eğitimli ve kolay ulaşılabilir sağlık mensupları olan eczacıların sigara bırakma programlarında aktif rol almaları gerekmekte olduğu sonucuna ulaşılmıştır. Anahtar sözcükler: Sigara bırakma, klinik eczacılık, nikotin replasman tedavisi Objective: It was aimed to retrospectively evaluate the effects of clinical pharmacist-led smoking cessation program directed with nicotine replacement therapy including nicotine gum and nicotine tablet by determining the quitting rate of participants. Method: This study was conducted between June 2009- June 2010. At the first meeting, the demographic and clinical data were collected and ‘the Fagerstrom Nicotine Addiction Test’ was applied to each participants. The clinical pharmacist informed the participants about the harms of smoking and also advised the appropriate over the counter nicotine replacement products according to each participant’s degree of dependence. Participants were monitored by the pharmacist at regular intervals, either face-to-face or by telephone throughout the 12-month study period. Results: The study was conducted on 33 subjects. The mean age of the participants were 41.57±11.90 (range: 24-66). According to the results of the Fagerstrom Nicotine Addiction Test, 15 of them were determined as low nicotine dependent, 9 of them were determined as medium dependent and 9 participants were determined as high dependent. Two patients were lost to follow-up and the study was completed with 31 patients. At the end of the study, it was determined that 64.5% of the 31 participants successfully quitted smoking by the pharmacist-led smoking cessation program at the community pharmacy. Conclusion: According to these data, it was seen that pharmacists who are the competent and easy to access health care provider should involve in smoking cessation programs. Key words: Smoking cessation, clinical Pharmacist, nicotine replacement therapy

Objective: Hyper IgE Syndrome (HIES) and Common Variably Immunodeficiency (CVID) are immuno-deficiency diseases. HIES is characterized by recurrent skin abscesses, pneumonia, mucocutaneous fungal infections, eczama, eosinophilia and high serum IgE levels. CVID is characterized by recurrent bacterial infections in airways and gastrointestinal tract. In this study, differentiation of Th17 cells were aimed to be investigated in CVID and HIES patients.

Amaç: Bu çalışmada, alendronat kullanan senil osteoporozlu kadınlarda alendronat tedavisinin idrar kalsiyum/kreatinin oranları üzerine etkisinin değerlendirilmesi amaçlanmıştır. Yöntem: Bu amaçla, tedavi öncesi ve 3 aylık tedavi sonrasında hastaların idrar kalsiyum/kreatinin oranları ölçülmüş ve ayrıca serum kalsiyum, fosfor, alkalen fosfataz (ALP), paratiroid hormon (PTH) değerlerinin sonuçları değerlendirilmiştir. Bulgular: 3 aylık tedaviden sonra idrar kalsiyum/kreatinin oranında ve serum ALP, kalsiyum ve fosfor düzeylerinde istatistiksel olarak anlamlı bir düşüş ve serum PTH düzeyinde de bu değişikliklere cevap olarak anlamlı yükselme görülmüştür (p