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Sepsis is the leading cause for death in critically ill patients. While the exact mechanisms are not clear, multiple organ dysfunction syndrome induced by sepsis might cause mitochondrial dysfunction. Spesific nutrients may help regulating immunological and inflammatory responses. Glutamine and arginine amino acids have both important roles in growth, tissue repair, cell renewal and collagen synthesis. There are different results of studies with immunmodulatory nutrients in critically ill patients such, they have no effect on mortality or decrease sepsis incidance. The aim of this study is to evaluate the effects of enteral supplementation of glutamine, arginine and glutamine and arginine combination in lipopolysaccharide (LPS) induced sepsis. Twenty eight male Sprague Dawley rats were randomly divided into four groups: Glutamine, Arginine, Glutamine + Arginine and Control. Glutamine group received 500 mg/kg/day glutamine, Arginine group recieved 500 mg/kg/day arginine, Glutamine + Arginine group received 250 mg/kg/day glutamine and 250 mg/kg/day arginine containing suspension. Rats were fed for 10 days and 3 mg/kg LPS was implemented. 24 hours later, all rats were sacrified. C-Reactive Protein (CRP), Interleukin (IL)-1ß, IL-6, Tumor Necrosis Factor-?(TNF-?), Aspartat aminotransferase (AST) and Alanine aminotransferase(ALT) levels were studied, livers were examined histopathologically. Serum TNF-? levels were significantly lower in Glutamine + Arginine group in comparison with Control group. Liver histopathology analysis showed that apsis, hepatocyte damage, kupffer cell proliferation and portal inflammation were more frequent and severe in control group than all groups. These results revealed that enteral supply of glutamine, arginine and their combination have positive effects on liver damage and inflammation. © Mattioli 1885.

[No abstract available] 2-s2.0-85091713858

Galenos Yayincilik, Introduction: In this study, we aimed to determine the incidence of anemia in children between the ages of 1-15. Materials and Methods: A total of 14449 patients admitted to pediatric outpatient clinic between 01.01.2012 and 31.12.2012 were retrospectively reviewed from hospital records. Patients between the ages of 1-15 without chronic disease were included into the study in order to evaluate the prevalence of anemia. Results: Of patients admitted to hospital, 8747 were male (60.5%) and 5707 were female (39.5%). Patients were divided into five groups according to age groups including, 2531 patients in 1-3 age group (17.5%), 2872 patients in 4-6 age group (19.9%), 2735 patients in 7-9 age group (18.9%), 2637 patiens in 10-12 age group (18.3%) and 3674 patients in 13-15 age group (25.4%). Anemia was detected in 853 (5.9%) patients, and 465 of them were male (54.5%) and 388 of them were female (45.5%). The distrubition of anemia according to age group was as follows: 205 patients in 1-3 age group (8.1%), 97 in 4-6 age group (3.4%), 98 in 7-9 age group (3.6%), 128 in 10-12 age group (4.9%) and 325 in 13-15 age group (8.9%). The distribution of low MCV values according to age groups was as follows: 1-3 age group; 9.4% (237), 4-6 age group; 5.3% (151), 7-9 age group; 3.8% (104), 10-12 age group; 4.5% (119), 13-15 age group; 8.0% (294). Conclusions: Anemia is one of the most common diseases in the pediatric age group. Anemia continues to be a major health problem in childhood in spite of the policies of the health in our country. Diagnosis and treatment is easy. Physicians should be alert to anemia in childhood and families should be informed about this topic. Also all society must work to improve this situation which affects the health and mental development. © The Journal of Current Pediatrics, published by Galenos Publishing., Karagün, B.Ş.; Çukurova Üniversitesi Tıp Fakültesi, Balcalı Hastanesi, Çocuk Hematoloji Bilim DalıTurkey

OBJECTIVE: This study was performed to determine the tick species infested to the cattle and small ruminants in Kütahya Province and their seasonal activity and prevalence.METHODS: Examination was performed in terms of infestation in 2402 farm animals and their shelters in 10 villages between October 2010 and October 2011.RESULTS: The infestation rate of animals was detected as 9.55%. A total of 657 adult ticks were collected. A total of 11 tick species consisting of Ixodes ricinus, Ixodes hexagonus, Rhipicephalus (Boophilus) annulatus, Dermacentor marginatus, Hyalomma marginatum, Haemaphysalis parva, Haemaphysalis sulcata, Haemaphysalis punctata, Rhipicephalus bursa, Rhipicephalus sanguineus and Rhipicephalus turanicus were determined. Seasonal fluctuations of tick species were also determined. Ixodes ricinus and R. (Boophilus) annulatus species were encountered mostly during fall and winter months. Dermacentor marginatus was usually found in winter time. Hyalomma marginatum, was found between April and July. Haemaphysalis parva was found in October, November and March. Haemaphysalis sulcata was found in November and March. Haemaphysalis punctata was found only in March and November. Rhipicephalus species were generally found in late spring and summer.CONCLUSION: Finally, these results will be helpful for the determination of control methods of tick infestations and tick-borne diseases in the region.

Providing continuity and homogeneity in quality of traditional and local products enables producers to increase their income and consumers to protect themselves besides protection of these products as a cultural heritage. The procedure which is called “geographic indication” during registration of local products differentiates a product from the others through a reference to a given geographical area and proving its originality. Supplying a product to consumers with a registration, indicating that the product belongs to a certain region, is important in terms of, i) making the product different in quality and price, ii) assuring committed features of the product, iii) contributing to its producers and production area through increasing the added value, iv) protecting their producers against fraud. The numbers of geographic indications (GIs), of which efficiency has improved in the protection of small producers and products from small scale, are getting increased day by day thanks to its being a common brand. Turkish legislation regarding the issue has been improved following the EU legislation. Recently, there are some challenges in practice although there are nearly 150 GIs in Turkey. EU registration has been open to applications of the third countries by the amendment of Council Regulation (EC) No 510/2006 since the year 2006. The first product with geographic indication from non-EU countries is had been the Colombian Coffee. It was followed by China with 4 products and India, Thailand Vietnam, each with 1 product. The other products in the evaluation process are originated from China, India, Morocco, Andorra and Turkey. In this context, “Antep Baklavası” and “Aydın İnciri” from Turkey have applied to be registered with GIs in the EU Food Quality Scheme. This study discusses the potential importance of GIs through investigating current status, related terminology, application and control mechanisms based on related legislation and database in both Turkey and EU., Geleneksel ve yerel ürünlerin kalitelerinde bir örnekliğin ve sürekliliğin sağlanması bu ürünlerin kültürel miras olarak korunmalarının yanı sıra üreticilerinin gelirlerinin yükselmesini ve tüketicilerinin korunmasını mümkün kılmaktadır. Yerel ürünlerin tescili uygulamalarında “coğrafi işaret” olarak adlandırılan bu işlem, bir ürünün belirli bir yöreye aitliğini gösterir ve özgünlüğünü onaylayarak diğer ürünlerden farkını ortaya koyar. Ürünün bir bölgeye ait olduğunun tescili ile tüketiciye sunulması i) ürünü kalite ve fiyat açısından farklı kılmakta; ii) taahhüt ettiği özelliklerini garantilemekte; iii) katma değer artışıyla üreticisine ve üretildiği bölgeye katkı sağlamakta; iv) taklitleri karşısında üreticilerini korumaktadır. Ortak bir marka olması itibariyle, özellikle küçük üreticilerin ve az miktarlarda üretilen ürünlerin korunmasında etkinliği artan coğrafi işaretlerin sayısı da gün geçtikçe artmaktadır. Türkiye'nin konuyla ilgili mevzuatı AB'nin ilgili mevzuatına benzer olarak geliştirilmiştir. Bugün Türkiye'de sayıları 150 civarında olan coğrafi işarete rağmen uygulamada eksiklikler söz konusudur. 2006 yılında 510/2006 sayılı Konsey Tüzüğü ile yapılan değişiklik ile AB ilgili mevzuatı üçüncü ülkelerden başvuruları da kabul edecek şekilde yenilemiştir. AB coğrafi işaretli Birlik dışı ilk ürün Kolombiya kahvesidir. Bunu, dört ürünle Çin, birer ürün ile Hindistan, Tayland ve Vietnam izlemektedir. Başvuruları değerlendirme aşamasında olan diğer ürünler ise Çin, Hindistan, Fas, Andora ve Türkiye orijinlidir. Bu kapsamda Türkiye'den “Antep Baklavası” ve “Aydın İnciri”, AB Gıda Kalite Sistemi'nden coğrafi işaret tescili almak için başvurusunu yapmıştır. Bu çalışmada AB ve Türkiye ile ilgili mevzuat ve veri tabanlarına dayalı olarak mevcut durum, konuyla ilgili terminoloji, başvuru ve kontrol mekanizmaları incelenerek, coğrafi işaretlerin kalkınmadaki potansiyel yeri tartışılmaktadır.

Twenty-four years old male patient complained of severe headache for 2 months without any prominent physical finding or neurological deficits. A well circumscribed mass measuring 1 cm in diameter of the third ventricle and dilatation in the ventricular system was seen on cranial computerized tomography. On histological examination, the cystic lesion was composed of pseudostratified columnar ciliated epithelial lining. This epithelium was positive for cytokeratin and epithelial membrane antigen and negative for glial fibrillary acidic protein immunohistochemically. Under this epithelial lining a cyst wall with a thin fibrous capsule was detected. Homogenous, amorphous, eosinophilic material was found within this cyst. Colloid cysts are one of the infrequent benign primary intracranial tumours. Although they are histologically benign, they may lead acute hydrocephalus and sudden death by obstructing foramen Monro. Even though it was supposed to originate from paraphysis or from olfactory nerve because of the cilia that were detected on the cyst epithelium, today the epithelium is supposed to originate from endoderm/respiratory epithelium. Colloid cysts are surgically challenging because of their deep midline location. Early detection and entire excision of the colloid cyst carries an excellent prognosis as presented case. Copyright © 2007 by Türkiye Klinikleri.

We examined the expression pattern of cyclooxygenase-2 (COX-2) and c-kit in uterine smooth muscle neoplasms and tried to determine the role of these markers in differential diagnosis. Archival tissue from 64 patients with uterine smooth muscle neoplasms (20 leiomyomas (LMs), 22 atypical leiomyomas (ALMs), and 22 leiomyosarcomas (LMSs)) was immunostained with antibodies against estrogen (ER) and progesterone receptors (PR), COX-2 and c-kit. 7 of 20 LM cases and 5 of 22 ALM cases were immunopositive for COX-2, whereas none of the LMS cases stained immunopositive (p?0.05). 4 of 20 LM cases and 5 of 22 ALM cases were immunopositive for c-kit, whereas 15 of 22 LMS cases showed c-kit immunopositivity (p?0.05). In conclusion, very few LMs and ALMs show COX-2 immunopositivity. LMSs usually do not express COX-2. COX-2 expression in smooth muscle tumors is not a prominent feature. Therefore, COX-2 inhibitors may not be useful in LMS therapy. C-kit was significantly expressed in uterine LMSs. © 2007 The Authors.

Objective: To analyse fetal autopsies in a period of 13 years in our institution. Material and Method: In our pathology department 362 fetal autopsies performed in 13 years were anaysed and documented according to sex distribution, fetal autopsy diagnosis and congenital anomalies. Results: In our institution our autopsy median is 25 and autopsy/death rate is 7.1%. The distribution of fetal autopsy diagnosis is 45% congenital anomalies, 27% anoxia, 10% infection; while in 19% of the cases no spesific diagnosis could be made due to autolysis. The most common congenital anomaly was neural tube defects as 19.3% and this is followed by skeletal anomalies (dysplasia or limb reduction) in 11.8% of the cases and renal anomalies as 10.2% of the cases. Conclusions: Perinatal autopsy is an important procedure for assessing the cause of fetal and neonatal deaths or complications which would help us to regard the risk rate in the consequent pregnancies and lead us in the management of the following pregnancies.

Objective: The objective of this study is to analyse the patients with eye mass who were admitted to our clinic in a period of 20 years to classify both benign and malignant orbital or ocular tumors and to inform the pediatricians about the outcome of our analysis. Material and Method: The records of 315 patients applied or referred to our pediatric hematology-oncology department with eye mass between January1985 and December 2004 were reviewed. The sex distribution, the involvement site and the age at dignosis were analysed. Results: 156 (49.5%) patients were males while 159 (50.5%) were females. 151 of the masses involved the left eye (47.9%) while 147 of them (46.7%) were at the right side and 17 (5.4%) involved both eyes. The age at diagnosis range ed between 1 and 192 months. The median age at diagnosis was 25 months. 282 (89.6%) of the cases had orbital tumors, 22 (6.9%) cases had ocular surface tumors and 11 (3.5%) had intraocular tumors. Conclusions: Pediatricians should notice the signs and symptoms of pediatric ocular and orbital tumors while examining their patients. We would like to emphasize the importance of noticing the signs and symptoms of pediatric ocular and orbital tumors and vitality of referring patients to ophtalmologist in time.

We observed toxicity in a patient who had taken high doses of slow-release verapamil. A 49 year-old female patient had ingested 25 tablets of verapamil (240 mg) with suicidal intentions. She presented with nausea and vomiting, hypotension, bradycardia. A reduced consciousness level was noted after 6 hours. She was admitted to our hospital 14 hours after presentation. We administered-gastric lavage and active charcoal treatment before taking her to the intensive care unit. Due to an atrio-ventricular nodal block, a temporary pacemaker was inserted. She was treated for hypotension, bradycardia, hypocalcemia, pulmonary oedema, pleural effusion and hyperglycemia. She was discharged on day 14 when clinical and laboratory findings became normal. In order to prevent long-term complications of slow-release verapamil intoxication, patients must be observed in the intensive care unit for a sufficiently long time. Copyright © 2005 by Türkiye Klinikleri.

Objective: In our study we aimed to retrospectively analyze a total of 2.233 patients who underwent direct laryngoscopy (DL) between 2000 and 2010 at Ondokuz Mayis University, Department of Anesthesiology. Method: The data were obtained by analyzing preoperative-intraoperative anesthesia registration forms and hospital computerized-automation system. Results: According to the results, the number of patients underwent DL increased over the years, the indication in 57% of the patients was benign and malignant diseases of the larynx, 88% of the patients were male, 54% were aged between 45 and 65, 15% had an ASA score of 3-4, 98% were underwent elective surgery and 64,5% had one or more additional systemic disease. 6,3% of the patients (140 patients) were identified as having a difficult intubation. Mallampati score (MS) could be obtained for only 1542 patients (69,1). Accordingly, 1482 patients (%96) had a Mallampati score of 1-2 and 60 patients (%4) had a Mallampati score of 3-4. The most commonly used agents in anesthesia were propofol (93%) for induction, succinylcholine (48%) and mivacurium (39%) as muscle relaxants, sevoflurane (%56) and nitrous oxide (68%) in maintenance. In recent years, the use of propofol, rocuronium, and remifentanil was increased. Conclusion: We suggest that several studies can be done from anesthesia records maintained regularly and systematically, and doing these studies at certain intervals may contribute to continuous assessment of the clinical interventions and to the development of anesthesiology, enabling comparisons to be made between clinics.

The fiscal stimulus packages that were put in place in the wake of the recent global financial crisis consisted of massive public investment spending. Moreover, substantial increases in public debt levels in the aftermath of the crisis have highlighted the importance of fiscal discipline and thus the appropriate form of fiscal policy regimes. Motivated by these experiences, this paper provides a comparative assessment of two fiscal regimes: a balanced budget rule with tax finance and a golden rule with debt finance, with special reference to the level and the efficiency of public investment. We find that, although the golden rule is likely to be more public investment-friendly, adopting a golden rule rather than a balanced-budget rule does not guarantee that public investment will improve economic outcomes. Our results suggest that only when the rate of return on public capital is greater than the cost of public borrowing expansion of public investment beneficial. As such, we arguethat policymakers should prioritize the productivity of public investment, not just its level.

Objective: We aimed to compare the effect of bupivacaine and levobupivacaine which are intrathecally used during the elective cesarean section under spinal anesthesia. Material and Method: Eighty patients were included in the study groups who were managed with a cesarean section under spinal anesthesia. Randomly selected fourty pregnant were administered with 12.5 mg bupivacaine+20 ?g fentanyl and the other 40 pregnant were administered with 12.5 mg levobupivacaine+20 ?g fentanyl. The basal heart rate and arterial pressure values were preoperatively obtained. These values were recorded by one minute intenals till the baby came out and then measured by 3 minutes interval. After the 20 minutes, measurements were recorded by 5 minutes interval till the block level regressed to T10. Additionally, sensorial and motor block, satisfaction of patient and surgeon, and analgesia quality were evaluated. Results: The Bromage scores at first minute in the levobupivacaine group were significantly lower compared with the bupivacaine group's (p0.05). Conclusion: Levobupivacaine is a good alternative for bupivacaine in equal doses during the cesarean section under the spinal anesthesia.

In this study, we aimed to evaluate the effects of preemptive application of intravenous paracetamol in patients operated under general anesthesia on intraoperative anesthesic consumption, postopoperative recovery criterias and postoperative analgesic requirement. 60 patients between 18-70 years of ages were divided into two groups randomly planned histerectomy. In the preop period, groups were named as Group P were intravenous paracetamol 45 min before operation and intravenous saline applied control group as Group K. Depth of anesthesia was adjusted as to keep bispectral index (BIS) value between 45-55. In preoperative and intraoperative period, heart rate, blood pressure, oxygen saturation, ETCO2, BIS and minimum alveoler consantration (MAC) value, adverse reactions, postoperative aldrete score, amount of volatile agent consumption, extubation time and eye opening time were also recorded. Patient controlled analgesia (PCA) was prepared with meperidine for all of the patients. In postoperative period, PCA use by patients and amount of analgesic consumption, visual analog scale (VAS) values during rest and cough were recorded. Volatile agent consumption was lower in paracetamol group than control group but this was not statistically signifcant. In postoperative period, there was also no difference between analgesic requirement in recovery room, aldrete score and VAS values. PCA usage number and amount of used analgesic were found statistically signifcantly lower in Group P according to Group K (p< 0.05). It was thought that could be alternative in preemptive analgesia intravenous form of paracetamol with lower side effects, wide safety margine, easy usage. © 2011 OMÜ Tüm haklari saklidir.