A Case Of Pulmonary Tuberculosis Detected While Being Investigated With A Preliminary Diagnosis Of Covid-19 Infection

A 15-year-old female patient, who had no previous history of illness, had the complaint of intermittent cough and chest pain for 2 months. Two days ago, she applied to the hospital with difficulty in breathing added to her complaints. Tomography (CT) was planned due to the presence of pneumonic infiltration in the left lung (Figure 1) in the chest radiography of the patient who was hospitalized in the intensive care unit due to respiratory distress. The patient was referred to us after Covid-19 was considered. On physical examination, there was bilateral diffuse ral in the lung with auscultation and respiratory sounds were decreased in the left lung. Its oksigen saturation was determined as 89% on room air, RR:28/min. Pathologically in laboratory evaluation; Erythrocyte Sedimentation Rate:56 mm/hour, C-reactive protein:8 mg/dl. The patient was admitted to the pandemic service with the pre-diagnosis of Covid-19 infection and Pneumonia. There was a history of smoking 1 pack per day for 2-3 years. The pneumonia treatment of the patient was arranged as Ceftriaxone and Azithromycin. Covid-19 PCR Tests taken resulted as Negative. In thoracic CT imaging, it was evaluated as significant by the radiology in terms of tuberculosis (TB)(Figure 2). The PPD of the patient was evaluated as negative with 3 mm (BCG single scar). There was no known history of tuberculosis contact in the family history. With the diagnosis of "Pulmonary Tuberculosis" with the diagnosis of sputum ARB (++), antituberculosis treatment consisting of Isoniazid, Rifampicin, Pyrazinamide and Ethambutol was initiated due to cavity-widespread pulmonary TB. The patient, whose need for oxygen decreased during follow-up, was discharged on the 10th day of his treatment, with outpatient follow-up planned. In some individuals, tuberculosis bacillus reacts and multiplies, causing the development of post-primary TB. Although the post-primary TB radiological findings may overlap with the findings of primary TB, it has some distinctive findings such as preferring the upper lobes, not following lymphadenopathy, and a tendency to create cavitation (1). Tomography provides important contributions in the detection of parenchymal pathology and lymphadenopathies in patients who are evaluated with the pre-diagnosis of tuberculosis, or in patients with suspected tuberculosis clinically but without radiographic findings (2). In this period when Covid-19 infection is common, tuberculosis should be kept in mind in patients with long-term cough

Increase in Odontogenic Cervicofacial Infection Requiring Hospitalization in Children During COVID-19 Quarantine

The aim of this study was to evaluate the effect of Coronavirus disease-2019 (COVID-19) quarantines on children hospitalized for odontogenic cervicofacial infection. The data of patients aged 1 month-18 years, who were followed up with the diagnosis of odontogenic cervicofacial infection in Çanakkale Onsekiz Mart University Hospital between January 2019 and June 2021 was examined, retrospectively. Thirteen patients with a mean age of 8.5±3.8, 7 of whom were male were included in the study. Three of the patients were diagnosed in the pre-COVID-19 period and 10 of them were diagnosed in the second year of COVID-19. Five patients had a known history of dental caries. On physical examination, it was determined that all patients had dental caries in the area corresponding to the infection site. Four patients required abscess drainage, all of whom were presenting in the second year of COVID-19, we isolated Eikenella corrodens, Streptococcus anginosus and Streptococcus intermedius microorganisms in 3 patients. The mean duration of hospitalization was 5.3±3 days. In conclusion, COVID-19 quarantine causes an increase in odontogenic cervicofacial infection requiring intravenous antibiotics and abscess drainage

Brucellosis in childhood: retrospective evaluation of 37 cases and review of the literature

Introduction: The aim of this study is to evaluate the demographic, clinical and laboratory characteristics and treatment results of pediatric patients followed up with the diagnosis of brucellosis in our clinic.Methods: Patients who were followed up with the diagnosis of brucellosis in Kayseri Training and Research Hospital, Pediatric Infectious Diseases Clinic between October 2016 and December 2018 were retrospectively analyzed.Results: A total of 37 patients, 26 (70.3%) male, were included in the study. The mean age of the patients whose ages ranged from 1 to 17 years was 9.3±4.3 years. Unpasteurized milk and/or dairy products were consumed in 86.5% of the patients and 48.6% had a family history of brucellosis. Joint pain (75.7%) was the most common presenting complaint. In the laboratory evaluation, 8.1% of the patients had leukopenia, 2.7% had thrombocytopenia and 21.4% had ALT elevation. Doxycycline plus rifampicin (43.2%) was the most commonly preferred treatment regimen. Addition of aminoglycoside to initial therapy in hospitalized patients was statistically higher than in outpatients (81.2% vs. 23.8%) (p=0.001). During the follow-up, relapse developed in a total of 4 (10.8%) patients, 3 of whom were outpatients. There was no statistical relationship between the initial treatment regimen and relapse (p=0.418).Conclusion: In conclusion, brucellosis should be kept in mind in terms of differential diagnosis in patients who present with joint pain in our country and who have cytopenia and/or isolated aminotransferase elevation in their investigations.Keywords: Child, Brucellosis, Relaps

Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic

Introduction:Inter-hospital transport is an important process of pediatric emergency and pediatric intensive care; the patient is transferred to another center with the emergency medical services. Inter-hospital transport can be life-saving for pediatric patients, but the process can logistically be difficult and risky. The actions required to prevent unwanted events during transport depend mostly on the accurate and reliable data obtained. We think that research on the transport of pediatric patients is limited in our country. Our study investigated the characteristics of pediatric patients transferred to our unit by ambulance and the problems during transport.Methods:One hundred and eighty-three patients under the age of 18 who were referred to the pediatric emergency service between June 2017 and June 2019, whose data were regularly recorded, were included in our study. Data of patients who were sent to the external center for consultation via 112 were excluded. The list of the transferred patients was obtained from 112 command centers in our city and the patient records were analyzed retrospectively with the hospital information management system.Results:Fifty-nine percent of the 183 patients included in our study were male. The mean age of the patients was 62.2±39.1 months. Fourty-two percent of the patients were between 1 month and 3 years old. We found that the most frequent transports are in the spring with 42.6% and 50.9% of the transports took place between 16.00-00.00 hours. We found that the most common transported patients were pneumonia with 28.4% and respiratory distress was the most common adverse event during transport with 7.1%.Conclusion:In the transfer of pediatric patients between hospitals, every step, from the training of staff to the equipment in the ambulance, should be planned in detail. We believe that more studies are needed to examine transport protocols for children’s emergency medical services, the level of education required by the transport team, the state of the medical device used in the transport process, the patient’s pre and posttransport stability, and the safety of the patient during the transport period

The Value of Cervical Length Measurement at 10-15 and 20-25 Weeks to Predict Preterm Birth

Amaç: Düşük riskli gebelerde, 10-15. haftalar ve 20-25. haftalar arasında ölçülen serviks uzunluğu ile preterm doğum ilişkisini belirlemek amaçlanmıştır. Yöntemler: İstanbul Eğitim ve Araştırma Hastanesi Gebe Polikliniğine Nisan 2008- Ocak 2009 tarihleri arasında rutin antenatal takip amacıyla başvuran, çalışma kriterlerine uyan 118 gebe ile çalışma grubumuz oluşturuldu. Çoğul gebelikler, daha önce preterm doğum yapanlar, kronik hastalığı olanlar, bilinen uterin anomalisi olanlar ve fetal anomalili gebelikler çalışma dışı tutuldu. 37. gebelik haftasından önceki doğumlar preterm doğum grubunu, 37. gebelik haftasından sonraki doğumlar term doğum grubunu oluşturdu. Bulgular: Çalışma kapsamındaki gebelerin %88,99'u 37. gebelik haftasının üzerinde, %11,01'i 37. gebelik haftasının altında doğum yaptı. Term grupta 10-15. ve 20-25. haftalardaki servikal uzunluk değerleri, preterm gruba göre anlamlı derecede fazla bulunmuştur (p<0,01, p<0,001). Preterm doğum için eşik değer 10-15 hafta servikal uzunluk ölçümleri için 41,4 bulunurken, 20-25 hafta için 33,7 bulundu. Sonuç: Asemptomatik gebelerin taranmasında ve riskli olguların belirlenmesinde 20-25. haftada yapılan transvaginal ulatrasonografi etkili görülmektedir. Erken doğum açısından kötü obstetrik öyküye sahip olan ve risk altında olan gebelerin taranmasına daha erken başlanıp başlanmayacağı konusunda daha ileri çalışmalara ihtiyaç vardır.Objective: We aimed to predict the risks of preterm labor by measuring the cervical length between 10 and 15 weeks gestation and between 20 and 25 weeks gestation, in low risk pregnants. Methods: Our study group was formed in the outpatient clinic of the Ministry of Health Istanbul Education and Research Hospital with 118 pregnants who fulfilled the inclusion criteria and wished to attend our study during routine antenatal screening. Delivery before 37 weeks gestation constituted the preterm labor group, delivery after 37 weeks gestation constituted the term group. Multiple pregnancies, previous preterm delivery, chronic diseases, history of preterm labor, previously diagnosed uterine abnormalities and fetal anomalies were stated as exclusion criteria. Results: In our study pregnant patients who delivered after 37 weeks gestation constituted 88.99% (n: 105) of the study group, whereas 11.01% (n: 13) pregnant patients delivered before 37 weeks gestation. Cervical length measurements in both 10-15 weeks and 20-25 weeks were significantly higher in the term group (p&lt;0.01, p&lt;0.001). Cut off value of cervical length for preterm labor was found as 41.4 among 10 to 15 gestation weeks and 33.7 among 20 to 25 gestation weeks. Conclusion: Transvaginal sonography performed at 20 to 25 gestational weeks has an impressive role when screening asymptomatic pregnants and defining the risks. We need more studies to decide whether to begin earlier screening or not for preterm labor when an individual has a poor obstetric history and is under such risks

Supporting novice mathematics teachers: The impact of an e- mentoring and video-based professional development program on teachers? noticing skills

Karadeniz Technical University Scientific Research Foundation [7178]The study was supported by Karadeniz Technical University Scientific Research Foundation with the project number 7178.This paper focuses on e-mentoring of novice mathematics teachers as professional development, and reports findings of the e-mentoring practices enriched with videos to improve noticing skills of novice teachers. A single group pre- and post-test study was conducted with the participation of 17 mentees, novice middle school mathematics teachers. Participants' noticing skills were assessed through a whole-class teaching video shown to them before and after the intervention. The responses of the teachers to the video assessment were analyzed considering attending, interpreting and decision-making dimensions of noticing. The results revealed that the ementoring program improved the novice mathematics teachers' noticing skills significantly in all dimensions.WOS:000978797700007Emerging Sources Citation IndexarticleUluslararası işbirliği ile yapılmayan - HAYIRMayıs2023YÖK - 2022-2

Evaluation of cases with acute lymphoblastic leukemia treated with TR ALL-2000 protocol

Tıpta Uzmanlık TeziBu çalışmanın amacı, TR ALL-2000 kemoterapi protokolü alan hastalarda klinik ve laboratuvar bulguları, kemik iliğinin morfolojik, sitogenetik, immünfenotipik özelliklerinin, kemoterapiye yanıtın incelenmesi, yaşam süreleri, prognoza etki eden faktörlerin saptanması ve ölüm nedenleri, nüksler ve ikincil malignitelerin değerlendirilmesiydi. Aralık 2000 - Haziran 2011 tarihleri arasında Trakya Üniversitesi Tıp Fakültesi Çocuk Hematoloji ve Onkoloji Kliniği'nde yeni tanılı akut lenfoblastik lösemi tanısı ile izlenen ve TR ALL-2000 protokolü uygulanan 18 yaşından küçük toplam 54 hastanın dosyaları geriye dönük incelendi. Tüm hastalardan alınan kemik iliği örnekleri sitokimyasal boyalarla değerlendirilip, flow sitometri ile immünfenotipleme yapılmıştır. Sitogenetik inceleme yapılmış t(9;22) ve t(4;11) çalışılmıştır. Tedavinin 8. gününde steroide yanıt periferde blast sayımı ile değerlendirilmiş, 15. ve 33. günlerde kemik iliği tekrarlanmıştır. Hastalarımızın yaşları 16 ay ile 16 yıl arasında, ortalama 6,4±4 yıldı. Hastaların %50'si erkek, %50'si ise kız hastalardı (erkek/kız oranı 1). En sık başvuru şikayetleri halsizlik, solukluk, ateş, kilo kaybı, iştahsızlık ve iskelet sistemi ağrılarıydı. Başvuruda lökosit sayıları için ortalama değer 42,879/mm³ (1,000-401,000/mm³) bulundu. En sık ekstramedüller tutulum mediasten %9,3, santral sinir sistemi %5,6, testis %3,7, böbrek %3,7 olarak bulundu. hepatosplenomegali hastaların yaklaşık 1/3'ünde, lenfadenomegali 2/3'ünde, kanama bulgusu ise 1/4'ünde saptandı. Morfolojik sınıflamaya göre L1 ve L2'deki dağılımları sırasıyla %48,1 ve %51,9 idi, L3 morfolojisinde ise hastamız yoktu. İmmünfenotipleri incelendiğinde prekürsör B- Akut lenfoblastik lösemi %77,8 ve T-Akut lenfoblastik lösemi ise %22,2 oranında görülmüŞtür. Sitogenetik incelemede t(9;22) translokasyonu 52 hastanın hiçbirinde saptanmazken, t(4;11) ise beş hastada (%9,6) saptanmıştır. Hastalarımızın 11(%20,4)'inde relaps gelişmişti. İkincil maligniteler 54 olgunun birinde (%1,9) görüldü, bu da akut miyeloblastik lösemi-M4 idi. Toplam 18 hastamız kaybedildi, 5 yıllık olaysız sağkalım %65±%1 olarak hesaplandı. Çalışmanın sonuçları değerlendirildiğinde, erkek cinsiyet, tanı sırasındaki lökosit sayısının >20.000/mm³ olması, mediastinal tutulum varlığı, santral sinir sistemi tutulumu, orta veya yüksek risk grubunda olma, 15.gün kemik iliği yanıtının M2 veya M3 olması, relaps varlığı sağkalım oranlarını olumsuz etkilemektedir. Bu bulgulara göre, tedavi sonuçlarımız TR ALL-2000 protokolü uygulanan diğer merkezlerle benzerdir.Anahtar Kelimeler; Akut lenfoblastik lösemi,Tedavi, TR ALL-2000, Olaysız sağkalımAbstractIn this study we aimed to evaluate acute lymphoblastic leukemia patients who were treated with TR ALL-2000 protocol. Clinical and laboratory findings at admission, cytochemical, morphologic and immunologic features of bone marrow, response to chemotherapy, survival rates, causes of death, relapses and prognostic factors have been evaluated. Chart review of from, 54 newly diagnosed acute lymphoblastic leukemia patients who had been admitted to Trakya University Pediatric Hematology Department December 2000 to June 2011 were evaluated retrospectively. All bone marrow samples from patients were evaluated by cytochemical dyes, and by flow cytometry immunophenotyping. Moleculer genetic investigation was performed for t (9; 22) and t (4;11). Response to steroid therapy on the eighth day of treatment was evaluated, by peripheral blast count and bone marrow aspiration was repeated at 15th and 33th days. Patients? ages were between 16 months to 16 years, with a mean of 6.4± 4 years and male/female ratio of 1. The most frequent complaints were fatigue, pallor, fever, weight loss, anorexia and skeletal system pain. The average number of leukocytes was 42.879/mm³ (1.000-401.000/mm³). The most frequent extramedullary involvement site was mediastinum (9.3%) followed by central nervous system (5.6%), testis (3.7%) and 71kidney (3.7%). Hepatosplenomegaly was present in 1/3, lymphadenomegaly in 2/3 and bleeding symptoms in 1/4 of cases. According to the morphological classification, L1 and L2 were found in 48,1% and 51,9% of cases respectively, no patient had L3 morphology. Immunophenotype analysis revealed that the rate of precursor B- acute lymphoblastic leukemia was 77,8% and T- acute lymphoblastic leukemia was 22,2%. Moleculer genetic examination, t(4; 11) resulted with a positivity in 5 of 52 patients (9.6%) while t(9; 22) was not found. Eleven patients (20.4%) relapsed, secondary malignancies were observed in 1 out of 54 cases (1.9%), it was acute myeloblastic leukemia-M4. Eighteen of our patients died, 5-year event free survival was 65%±1%. The results of this study demostrate that male gender, leukocyte count >20.000/mm³ at diagnosis, mediastinal involvement, central nervous system involvement, being in medium or high risk group, bone marrow response at 15th day showing M2 or M3 and presence of relapse have negative effect on survival of these patients. According to these findings, our results with TR ALL-2000 protocol are similar to other centers which follow the same protocol.Key Words;Acute lymphoblastic leukemia,Treatment,TR ALL-2000, Event free surviva

Klonal anaç genotiplerinin in vitro koşullarda bazı prunus türleriyle aşı tutma oranlarının saptanması

TEZ6636Tez (Yüksek Lisans) -- Çukurova Üniversitesi, Adana, 2008.Kaynakça (s.32-35) var.vi, 36 s. : rnk.res. ; 29 cm.This study was carried out in Biotechnology Laboratory of C.U. Faculty of Agriculture, Department of Horticulture during 2004-2006. The shoot tips of AK-1 (Nonpareil x Peach), AK-2 (Nonpareil x Peach) and GF-677 almond x peach hybrid genotypes and Ferragnes, Francoise and Ninfa genotypes taken from the orchards of C.U. Faculty of Agriculture, Department of Horticulture were used. As the experimental material the viability, shoot elongation and micrografting of the shoot tips were investigated . In the experiment, MS macro and micro nutrients, vitamins and Fe-Na EDTA composition was used. During shoot elongation and multiplication stage 1 mg/l BAP and 0.1 mg/l GA3 plant growth regulator concentrations were used. In this work, viability rate was found to be 50 % in AK-1, 25 % in AK-2 and 37.5 % in GF- 677, 85 % Ferragnes, 1 % Ninfa, 1 % Francoise; multiplication rate was 3 shoot/explant in AK-1 genotype, 2 shoot/explant in GF-677 and 8 shoot/explant in AK-2 genotype, 3 shoot/explant in Ferragnes genotype; micrografting rate was 25.1 % in AK-1 genotype, 25 % in GF-677 and 34.4 % in AK-2 genotype.Bu çalışma, 2006-2007 yılları arasında Ç.Ü. Ziraat Fakültesi Bahçe Bitkileri Bölümü Biyoteknoloji Laboratuvarı'nda yürütülmüştür. Çalışmada Ç.Ü. Ziraat Fakültesi Bahçe Bitkileri Bölümü Araştırma ve Uygulama parselinde bulunan AK-1, AK-2 ve GF-677 badem x şeftali melez genotipleri ile Ferragnes badem, Francoise şeftali ve Ninfa kaysı çeşitlerine ait sürgün uçları kullanılmıştır. Alınan sürgün uçlarının canlılık, sürgün oluşturma ve aşı tutma oranları incelenmiştir. Araştırmada MS makro ve mikro besin elementleri, vitaminleri ve Fe-NaEDTA kompozisyonu kullanılmıştır. Sürgün geliştirme ve çoğaltma aşamasında 1.0 mg/l BAP ve 0.1 mg/l GA3 konsantrasyonları kullanılmıştır. Çalışmada, canlılık oranı AK-1 genotipinde % 50, AK-2 genotipinde % 25, GF-677 genotipinde % 37.5, Ferragnes % 85, Francoise %1, Ninfa % 1; kardeşlenme sayısı AK-1 genotipinde 3 sürgün/eksplant, GF-677 genotipinde 2 sürgün/eksplant, AK-2 genotipinde 8 sürgün/eksplant, Ferragnes de 3 sürgün/eksplant; aşı tutma oranları AK-1 genotipinde % 25.1, AK-2 genotipinde % 34.4 ve GF-677 genotipinde % 25.0 olarak bulunmuştur.Bu çalışma Ç.Ü. Bilimsel Araştırma Projeleri Birimi Tarafından Desteklenmiştir. Proje No

Ailesel meme kanseri öyküsü olan ve olmayan kadınlarda meme kanseri tanılama davranısları.

Amaç: Bu çalışmada ailesel meme kanseri öyküsü olan ve olmayan kadınlarda meme kanseri korkusu, risk algısı, meme kanseri bilgisi ve meme kanseri tanılama davranışları arasındaki ilişkinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Tanımlayıcı- kesitsel tipte yapılan araştırma, Aralık 2019 – Nisan 2020 tarihleri arasında bir şehir hastanesinin Onkoloji ve Kemoterapi ünitesinde meme kanseri tedavisi gören 308 aile öyküsü olan ve diğer servislerde tedavi gören aile öyküsü olmayan 523 hasta yakını kadın ile yüz yüze görüşme yöntemi ile yapılmıştır. Bulgular: Aile öyküsü olan kadınların olmayan kadınlara göre on yıl içindeki meme kanseri risk algısının 1,938 kat, meme kanseri korku puanının 1,073 kat ve Geniş Kapsamlı Meme Kanseri Bilgi Testi (GKMKBT) tedavi edilebilirlik puanının 3,269 kat arttığı belirlenmiştir. Sonuç: Çalışmada aile öyküsü olan kadınların meme kanseri tanılama davranışlarının (KKMM yapma, KMM yaptırma, 40 yaş üstü kadınlarda mamografi çektirme) aile öyküsü olmayanlara göre anlamlı şekilde arttığı ancak her iki grupta da hala istendik düzeyde olmadığı belirlendi.Purpose: The aim of this article was to investigate the relationship between the fear of breast cancer, perceived risk, knowledge of breast cancer, and breast cancer diagnosis behaviors in women with and without a family history of breast cancer. Materials and Methods: The study used a descriptive and cross-sectional design and was carried out through face-toface interviews between December 2019 and April 2020 with 308 women who had a family history of breast cancer and were receiving breast cancer treatment in the Oncology and Chemotherapy unit of a city hospital and 523 patient relatives who were receiving treatment in other services of the hospital and had no family history of breast cancer. Results: The perceived risk of breast cancer in ten years by women with a family history of breast cancer, compared to that of women with no family history, increased by 1,938 times, the fear of breast cancer score increased by 1,073 times and that the Comprehensive Breast Cancer Knowledge Test (CBCKT) score increased by 3,269 times. Conclusion: The breast cancer diagnosis behaviors of women with a family history (performing BSE, having a CBE, having a mammogram in women aged over 40) increased significantly compared to those who did not have a family history, but that it was still not at the desired level in both groups