Çocuklarda Akrep Zehirlenmeleri ve Yönetimi

Amaç: Akrep zehirlenmesi tanısı ile Çocuk Yoğun Bakım Ünitemize yatan hastaları geriye dönük olarak inceleyerek hastaların klinik ve laboratuvar bulgularını, tedavi yöntemlerini ve sonuçlarını değerlendirmek. Gereç ve yöntem: Ocak 2012-Ekim 2013 tarihleri arasında Çocuk Yoğun Bakım ve Yoğun Bakım Servislerinde akrep zehirlenmesi tanısı ile tedavi edilmiş olan 30 hasta çalışmaya dahil edildi. Bu hastaların klinik ve laboratuvar bulguları, tedavi yöntemleri incelendi. Bulgular: Hastaların yaşları ortalama 6,6±4 yıl olup, 12’ si %40 kız, 18’ i %60 erkek idi. Tüm hastalara antivenom tedavisi uygulandı. 9 hastaya prazosin, 8 hastaya dopamin, 3 hastaya dopamin ve dobutamin tedavisi uygulandı. Vakaların 5’ünde kalp yetmezliği ve 2’sinde akciğer ödemi gelişti. Laboratuvar sonuçları; hemoglobin 11,8±1 g/dl 9,6-13,1 , lökosit 10,5±3,1 bin/mm3 6,3-12,6 , trombosit 284±42 bin/mm3 , kan şekeri 135±50 mg/dL , kreatin kinaz miyokard izoenzimi CK-MB 40±22 U/

Evaluation of Patients Diagnosed with Brain Death in Pediatric Critical Care

Introduction: The incidence of brain death in pediatric intensive care units is not known precisely. Studies of brain death-organ donation in children are few and the etiology of brain death in pediatric patients is different than in adults. Our aim was to present cases of brain death occurred in our pediatric intensive care unit in a two-year period and discuss the causes of organ donation failure. Methods: Medical reports of patients diagnosed with brain death between January 1, 2015 and December 31, 2016 in our pediatric intensive care unit were retrospectively reviewed. Data were screened according one age, gender, reason of hospitalization and mean duration of brain death evaluation. Results: A total of 806 patients were followed up in our pediatric intensive care unit in the two-year period. Of these patients, 83 (10.2%) died and brain death was detected in 14 (17%) of this patients. The mean duration of brain death was 2.14±1.16 days. The reasons for hospital admission were infection in 3 patients, asphyxia in 4 patients, malignancy in 4 patients, drowning in 2, and trauma in 1 patient. The mean age of the patients diagnosed with brain death was 6.96±5.53 (minimum: 0.6, maximum: 16 year) years. 6 patients (42.8%) were female and 8 patients (57.2%) were male. Doppler ultrasonography was used as an additional test for the diagnosis of brain death in 11 patients (78.6%). None of the patients became organ donor because of medical unsuitability and family disagreement. Conclusion: Due to high occupancy, trauma patients may rarely be found in our pediatric intensive care unit. Most of the brain deaths are caused by asphyxia (mostly food aspiration), malignancy and drowning in water (freshwater). The rate of organ donation in pediatric patients is lower than in adults. For this reason, it is even more important to increase the number of patients diagnosed with brain death in pediatric intensive care units. We believe that the awareness of brain death may increase if it is known that also diseases other than traumatic brain injury may cause brain death. We also believe that increased awareness of brain death determination and communication with patient relatives are necessary to increase the number of organ donation

Relationship Between Acute Appendicitis and Platelet Indices in Childhood

Introduction: Appendicitis is the inflammation of the appendix vermiformis. Clinical diagnosis of acute appendicitis in children is still a problem. Platelet indices, platelet distribution width and mean platelet volume have been evaluated for some infectious and inflammatory diseases. In this study, we aimed to investigate whether platelet distribution width values and mean platelet volume were decisive for the diagnosis of appendicitis in children. Methods: In our hospital, 504 pediatric patients who presented with acute abdomen and received the diagnosis of acute appendicitis between 2011 and 2016, and 106 children living in the same region, who attended the pediatric outpatient clinics for general follow-up, were included in the study. The patient and control groups were analyzed for gender, age, platelet count, platelet distribution width and mean platelet volume. A receiver operating characteristic (ROC) curve was drawn to describe the parameters that may be statistically significant. Results: There was a significant difference in platelet distribution width and mean platelet volume values between the two groups (p14.3 fL for platelet distribution width for the diagnosis of appendicitis with a sensitivity, specificity, positive predictive value, and negative predictive value of 77.6%, 85.8%, 96.3%, and 44.6%, respectively. A cut-off value of <9.35 fL for mean platelet volume was used for the diagnosis of appendicitis with a sensitivity, specificity, positive predictive value, and negative predictive value of 78.1%, 81.1%, 95.2%, and 43.9%, respectively. Conclusion: Our results suggest that platelet distribution width and mean platelet volume may be used for the diagnosis of appendicitis in children with the sensitivity of at least 77.6% and 78.1%, respectively. Mean platelet volume and platelet distribution width, which can easily be investigated in complete blood count, may serve as markers for the diagnosis of appendicitis in children, however, further large-scale studies are needed

A novel study on bean common mosaic virus accumulation shows disease resistance at the initial stage of infection in Phaseolus vulgaris

Accurate and early diagnosis of bean common mosaic virus (BCMV) in Phaseolus vulgaris tissues is critical since the pathogen can spread easily and have long-term detrimental effects on bean production. The use of resistant varieties is a key factor in the management activities of BCMV. The study reported here describes the development and application of a novel SYBR Green-based quantitative real-time PCR (qRT-PCR) assay targeting the coat protein gene to determine the host sensitivity to the specific NL-4 strain of BCMV. The technique showed high specificity, validated by melting curve analysis, without cross-reaction. Further, the symptoms development of twenty advanced common bean genotypes after mechanical BCMV-NL-4 infection was evaluated and compared. The results showed that common bean genotypes exhibit varying levels of host susceptibility to this BCMV strain. The YLV-14 and BRS-22 genotypes were determined as the most resistant and susceptible genotypes, respectively, in terms of aggressiveness of symptoms. The accumulation of BCMV was analyzed in the resistant and susceptible genotypes 3, 6, and 9 days following the inoculation by the newly developed qRT-PCR. The mean cycle threshold (Ct) values showed that the viral titer was significantly lower in YLV-14, which was evident in both root and leaf 3 days after the inoculation. The qRT-PCR thus facilitated an accurate, specific, and feasible assessment of BCMV accumulation in bean tissues even in low virus titers, allowing novel clues in selecting resistant genotypes in the early stages of infection, which is critical for disease management. To the best of our knowledge, this is the first study of a successfully performed qRT-PCR to estimate BCMV quantification

Ekonomik krizlerin sigorta şirketlerinin mali yapılarına etkileri

ÖZETEkonominin içinde yer alan her işletme ekonomide meydana gelebilecek aksaklıklardan hangi alanda faaliyet gösteriyorsa göstersin az ya da çok ekonomik aksaklıklardan etkilenecektir. Ekonomide meydana gelen aksamalarda, olağan üstü durumlarda her işletme faaliyetlerinde oluşabilecek sorunları en aza indirmeye çalışır. Finansal sektörde meydana gelen önceden bilinmeyen ya da öngörülemeyen bazı gelişmeler makro düzeyde devlet mikro düzeyde ise firmaları ciddi olarak etkileyecek sonuçlar çıkarması anlamına gelir. İşte bu sonuçlarla baş edebilen sonuçları iyi yönetebilen işletmeler krizlerden yara almadan hatta daha da güçlenerek çıkmaktadırlar.Her işletme krizleri öngörmek krizleri yönetmek adına risk yönetimi departmanları oluşturmalı oluşabilecek riskleri bertaraf edebilmek için olasılıkları iyi hesaplamalıdır. Günümüzde bunu en iyi yapan işletmeler ise faaliyet gösterdikleri sektörün yapısında ve faaliyetlerinin tanımında yer alan ve temel faaliyetlerini oluşturan riskleri üzerlerine alan sigorta şirketleridir.Anahtar Kelimeler; Kriz, işletme, sigorta ve risk yönetimi.SUMMARYThe economy is contained in each business activity to interruptions that may ocur in the economy indicates which area will be affected by the economic problems may show more or less.Occurring in the economy every business activities that may occur in cases of extraordinary disruption to minimize the problems.The financial sector was previously unkown or unpredictable developments that occurred in the macro level will affect the state as the micro level means the results reveal serıous companies.That’s good results that can manage businesses cope with crisis unscathed an deven competitive markets grow out.Every business must manage crises on behalf of foresee the depertmants of risk management risks to suchs the possibilities well disposed.Today’s it is the best in the industry in which they operate and the activities of enterprises engaged in the definiition of the insurance companies that make up the basic avtivity and risks on them.Keywords;Crisis,business,insurance and risk management

Ekonomik krizlerin sigorta şirketlerinin mali yapılarına etkileri

Ekonominin içinde yer alan her işletme ekonomide meydana gelebilecek aksaklıklardan hangi alanda faaliyet gösteriyorsa göstersin az ya da çok ekonomik aksaklıklardan etkilenecektir. Ekonomide meydana gelen aksamalarda, olağan üstü durumlarda her işletme faaliyetlerinde oluşabilecek sorunları en aza indirmeye çalışır. Finansal sektörde meydana gelen önceden bilinmeyen ya da öngörülemeyen bazı gelişmeler makro düzeyde devlet mikro düzeyde ise firmaları ciddi olarak etkileyecek sonuçlar çıkarması anlamına gelir. İşte bu sonuçlarla baş edebilen sonuçları iyi yönetebilen işletmeler krizlerden yara almadan hatta daha da güçlenerek çıkmaktadırlar. Her işletme krizleri öngörmek krizleri yönetmek adına risk yönetimi departmanları oluşturmalı oluşabilecek riskleri bertaraf edebilmek için olasılıkları iyi hesaplamalıdır. Günümüzde bunu en iyi yapan işletmeler ise faaliyet gösterdikleri sektörün yapısında ve faaliyetlerinin tanımında yer alan ve temel faaliyetlerini oluşturan riskleri üzerlerine alan sigorta şirketleridir. Anahtar Kelimeler; Kriz, işletme, sigorta ve risk yönetimi. SUMMARY The economy is contained in each business activity to interruptions that may ocur in the economy indicates which area will be affected by the economic problems may show more or less.Occurring in the economy every business activities that may occur in cases of extraordinary disruption to minimize the problems.The financial sector was previously unkown or unpredictable developments that occurred in the macro level will affect the state as the micro level means the results reveal serıous companies.That’s good results that can manage businesses cope with crisis unscathed an deven competitive markets grow out. Every business must manage crises on behalf of foresee the depertmants of risk management risks to suchs the possibilities well disposed.Today’s it is the best in the industry in which they operate and the activities of enterprises engaged in the definiition of the insurance companies that make up the basic avtivity and risks on them. Keywords;Crisis,business,insurance and risk management

A research on the development of consumer loyalty programs: An example of a hotel business

Geçmişten günümüze farklı şekillerde sürekli karşımıza çıkan sadakat kavramı büyük örgütlerin yaşamsal döngülerinde rol oynayan önemli bir olgudur. Günümüzde bu olgunun öneminin bir hayli farkında olan büyük şirketler, sadakat programlarının gelişmesinde en kritik rolleri üstlenmekten hiç kaçınmamış, kendi çıkarları doğrultusunda bu programların kullanım alanlarını, içeriklerini ve faydalarını değiştirerek müşterilerin sadakatlerini kazanmayı başarmışlardır. Çalışmanın konusunu oluşturan sadakat programları, konaklama endüstrisinde yer edinmeyi başarmış, sektörde birbirinden farklı isimler fakat benzer içeriklerle karşımıza çıkmaktadır. Sektör içerisindeki önemli bir yere sahip olan Hilton markasını ele alan bu çalışmada markanın sadakat programı olan Hilton Honors incelenmiş, programa üye olan kullanıcılar ile kullandıkları programlarlar hakkında görüşmeler gerçekleşmiştir. Gerçekleşen bu görüşmelerde programın nihai amaçlarına ulaştığı ve geliştirilebilir olduğu gözlemlenmiştir. Hilton markasının oldukça büyük ve global bir yapıya sahip olması kullandığı sadakat programının birçok kişi tarafından kullanıldığı anlamı taşımaktadır. Bu durum beraberinde bazı sorunları meydana getirmektedir. Çalışma içerisinde programın olumlu yönlerine rastlandığı gibi olumsuz yönleri ile de karşılaşılmıştır.The concept of loyalty, which is constantly encountered in different ways from the past to the present, is an important phenomenon that plays a role in the life cycles of large organizations. Today, large companies, which are highly aware of the importance of this phenomenon, have never avoided taking the most critical roles in the development of loyalty programs, and have succeeded in gaining the loyalty of their customers by changing the usage areas, contents and benefits of these programs in line with their own interests. Loyalty programs, which are the subject of the study, have succeeded in gaining a place in the accommodation industry, and we encounter different names in the sector but with similar contents. In this study, which deals with the Hilton brand, which has an important place in the sector, the brand's loyalty program, Hilton Honors, was examined, and interviews were held with the users who are members of the program about the programs they use. In these interviews, it was observed that the program reached its final goals and could be improved. The fact that the Hilton brand has a large and global structure means that the loyalty program it uses is used by many people. This situation brings with it some problems. In the study, positive aspects of the program were encountered as well as negative aspects

Investıgatıon Of Workıng Equıpment Used In Rubber Productıon In Terms Of Occupatıonal Health And Safety

Gelişen teknoloji ile birlikte üretim süreçleri, daha karmaşık hale gelmiştir. Bu durum, üretimin vazgeçilmez unsuru olan insan için anlık ve uzun vadede, tehlike ve risklerin oluşmasına zemin hazırlamıştır. Polimer türü malzemeler, günümüz dünyasında sürekli kullanılan ve her alanda yer alan işlevsel mühendislik malzemeleridir. Bir polimer türü olan kauçuk malzemeler ile imalatta kullanılan iş ekipmanları, çalışanlar için birçok tehlike ve risk oluşturmaktadır. Sosyal Güvenlik Kurumu istatistiklerine göre; 2016 yılında gerçekleşen 286 068 iş kazasının kimya sektörü ile ilgili kısmı incelendiğinde, en çok iş kazasının 9258 iş kazası ile kauçuk ve plastik ürünler imalatı iş kolunda meydana geldiği görülmüştür. Bu nedenle kauçuk imalat sektöründe var olan tehlike ve riskleri ortadan kaldırmak veya en aza indirmek, meydana gelecek iş kazası ve meslek hastalıklarının sayısını azaltacaktır. Bu çalışmada, kauçuk imalat sektöründe en çok kullanılan iş ekipmanları, iş sağlığı ve güvenliği açısından incelenmiş, tehlike ve riskler analiz edilerek ortadan kaldırılması ve en aza indirilmesi için önerilerde bulunulmuştur. Tanımlanan tehlikeler ve riskler, sektörde sık kullanılan L MATRİS risk analiz yöntemi ile değerlendirilmiştir. Böylece yapılan çalışma ile işletmelerde uygulanan risk değerlendirmesi çalışmalarına katkı sağlanması hedeflenmiştir.With the developing technology, the production processes have become more complicated. This situation can cause danger and higher risk for people who are indispensable element of production at the present time and long-term polymer-type materials are functional engineering elements which are consistantly used and essential part of the production in today's world. A polymer type of rubber materials which are used in the manufacturing cause many hazards and risks for employees. According to the Social Security Institution in Turkey, when the part of the 286 068 occupational accidents in 2016 related to the chemical sector was examined, it was seen that the most occupational accident occurred in the "rubber and plastic products manufacturing" business with 9258 occupational accidents. For this reason, minimizing the risks and elimination of hazards in the rubber manufacturing sector will reduce the number of occupational accidents and occupational diseases. In this study, most common work equipments which are used in rubber and manufacturing sector were examined in terms of occupational health and safety. Risk and hazards were analyzed and suggestions were given in order to remove or reduce them to minimum. The identified hazards and risks in the sector was assessed by the risk analysis method commonly used L MATRIX. Thus, it is aimed to contribute to the risk assessment studies applied in the enterprises