Treatment of persistent large cystic lesions of the humerus with vascularized fibular grafts

Objectives: In this study, we aimed to evaluate the short-to -mid-term results of the resection and reconstruction of large cystic lesions of the humerus. Patients and methods: Eight male patients (median age: 22.9 +/- 10.4 years; range, 12 to 42 years) with large cystic lesions of the humerus operated between January 2017 and December 2019 were retrospectively analyzed. The age of the patients, their previous treatments and follow-up periods, the size and location of the cysts, postoperative functional scores, presence of a union, recurrence of the cyst, and graft resorption were examined. Results: The mean follow-up was 42.8 +/- 7.5 (range, 34 to 54) months. Preoperatively, the mean length of the cystic lesions was 15.1 +/- 2.6 (range, 10 to 18) cm. At the final follow-up, the patients had a normal range of shoulder flexion-extension, internal rotation-external, abduction-adduction, and elbow flexion-extension, pronation-supination. The patients had a mean DASH score of 1.13 +/- 1.1 (range, 0 to 3.3) and MSTS score of 28.75 +/- 1.8 (range, 26 to 30) postoperatively. Complications such as pseudoarthrosis, graft resorption, or cyst recurrence were not observed in any of the patients. Conclusion: Although the risk of recurrence is low in small cystic lesions of the humerus, it increases as the size of the lesion increases. This reconstruction technique using vascularized fibular grafts, which we applied, seems to be extremely successful in ensuring biological healing and preventing recurrence and complications in patients with large cystic lesions of the humerus

A rarely seen breast tumor: looking over the literature related to intracystic papillary carcinoma

Intracystic papillary carcinoma of the breast is a rarely seen tumor. It is often classified as a variant of in situ ductal carcinoma. Intracystic papillary carcinoma is slow growing and usually surrounded and limited by fibrosis capsule. Presently described is case of a 51-year-old postmenopausal patient. She felt a tumor in her left breast, and after examination, it was diagnosed as intracystic papillary carcinoma. Following adjuvant chemotherapy breast excision, and axillar dissection, patient was given curative external radiotherapy and hormonal treatment. As result of 40-month follow-up, the patient was evaluated as having local recurrence and no distant metastases. Follow-up and treatment protocols should be observed on case-by-case basi

Safra kesesinin intravasküler diffüz büyük hücreli lenfoması

Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal B-cell lymphoma characterized by the growth of lymphoma cells within the lumina of small vessels. Two major patterns of clinical presentation have been recognized: the first is in European countries, with brain and skin involvement, and the second in Asian countries, where patients typically present with multiorgan failure, hepatosplenomegaly, pancytopenia, and hemophagocytic syndrome [1,2,3,4,5]. Primary IVLBCL of the gallbladder is exceedingly rare

Assessment of cardiac ultrasonography in predicting outcome in adult cardiac arrest

Objective: A prospective follow-up study to evaluate the ability of cardiac ultrasonography performed by emergency physicians to predict resuscitation outcome in adult cardiac arrest patients. METHODS: Ultrasonographic examination of the subxiphoid cardiac area was made immediately on presentation to the emergency department with pulseless cardiac arrest. Sonographic cardiac activity was defined as any detected motion within the heart including the atria, ventricles or valves. Successful resuscitation was defined as any of: return of spontaneous circulation for ≥ 20 min; return of breathing; palpable pulse; measurable blood pressure. RESULTS: The study enrolled 149 patients over an 18-month period. The presence of sonographic cardiac activity at the beginning of resuscitation was significantly associated with a successful outcome (19/27 [70.4%] versus 55/122 [45.1%] patients without cardiac activity at the beginning of resuscitation). CONCLUSIONS: Ultrasono -graphic detection of cardiac activity may be useful in determining prognosis during cardiac arrest. Further studies are needed to elucidate the predictive value of ultrasonography in cardiac arrest patients. © 2012 Field House Publishing LLP

Internal organ pathologies in synthetic cannabinoid-related deaths: A single-centered sectional autopsy study

Amaç: Sentetik kannabinoidler, CB1 ve CB2 reseptörleri aracılığıyla vücutta tetrahidrokannabinolün etkisini taklit eden psikoaktif maddelerdir. Sentetik kannabinoidlerin bu ölümcül yan etkileri ile ilgili bilgiler, olgu sunumları ve geniş olgu serileri ile sınırlıdır. Çalışmamızın amacı, sentetik kannabinoid ilişkili ölümlerde kardiyovasküler ve solunum sistemi organlarının patolojileri üzerinden ölüm mekanizmasının anlaşılmasına ve madde kullanımı/bağımlılığını önleme çalışmalarına katkı sunmaktır. Gereç ve Yöntemler: “Adli Tıp Kurumu Trabzon Adli Tıp Grup Başkanlığı” 2010-2019 yılları arasındaki 10 yıllık dönemde, ölümü sentetik kannabinoid kullanımına bağlanan olgulara ait otopsi raporları incelendi. Kan ve idrar örnekleri, AB-SCIEX 5500 QTRAP model sıvı kromatografi-kütle spektrometresi/kütle spektrometresi cihazı ile analiz edildi. Bulgular: Bu çalışmaya 22 olgu dâhil edildi. Olguların yaşları 18-50 arasında değişmekteydi. Medyan yaş 31, ortalama yaş ise 31,59±9,58 idi. Adli otopsileri yapılan olguların hiçbirinde travma bulgusu tespit edilmedi. Organların ağırlıkları -özellikle akciğer- artmış olarak bulundu. Organların makroskobik ve mikroskobik incelemesinde; 20 (%90,9) olguda akciğerde yaygın ödem tespit edildi. Akciğerlerin mikroskobik incelemesinde; 8 (%36,4) olguda intraalveoler kanama, 6 (%27,3) olguda atelektazi, 3 (%13,6) olguda pnömoni bulguları ve 2 (%9,1) olguda kalp hatası hücreleri olduğu görüldü. Sonuç: Uyutucu-uyuşturucu madde kullanımı dünya genelinde ciddi bir halk sağlığı sorunudur. Hem bu çalışmadaki hem literatürde diğer çalışmalardaki veriler ışığında, akciğer ağırlıklarında artış tespit edilmesi spesifik bir bulgu olmasa da sentetik kannabinoid ilişkili ölümlerde ciddi bir bulgu olarak tanımlanabilir.Objective: Synthetic cannabinoids are psychoactive substances that mimic the effect of tetrahydrocannabinol in the body via CB1 and CB2 receptors. Information on these fatal adverse effects of synthetic cannabinoids is limited to case reports and large case series. The aim of our study is to contribute to the elucidation of the death mechanism in synthetic cannabinoid-related deaths through the organ pathologies of the cardiovascular and respiratory system organs and to the studies on the prevention of substance use/addiction. Material and Methods: Autopsy reports of cases whose death was attributed to the use of synthetic cannabinoid in the 10-year period between 2010-2019 at the “Council of Forensic Medicine of Trabzon Forensic Medicine Group Department” were analyzed. Blood and urine samples were analyzed via AB-SCIEX 5500 QTRAP model liquid chromatography-mass spectrometry/mass spectrometry device. Results: Twenty-two cases were included in the study. The ages of the cases ranged between 18 and 50 years. The median age was 31, and the mean age was 31.59±9.58. Trauma findings were not found in any of the cases whose forensic autopsies were conducted. The weights of the organs, in particular the lung weights, were found to be increased. In the macroscopic and microscopic examination of the organs, diffuse edema in the lungs was detected in 20 (90.9%) cases. In the microscopic examination of the lungs; Intraalveolar hemorrhage in 8 (36.4%) cases, atelectasis in 6 (27.3%) cases, pneumonia in 3 (13.6%) cases, and siderophages in 2 (9.1%) cases were observed. Conclusion: Narcotic drug use is a serious public health concern across the world. Considering the data in both this study and other studies in the literature, an increase in lung weights can be defined as a serious finding in synthetic cannabinoid-related deaths, albeit it is not a specific finding

Are the Complication Rates for the Open Approach in the Surgical Treatment of Bladder Stones Higher Than Rates for Endoscopic Approaches? A Comparative Multivariate Analysis Study

Objective:To compare the effectiveness, safety and complication rates of open vs endoscopic approach for bladder stone surgery and investigate the predictive factor for success and complication rate in patients with bladder stone.Materials and Methods:The records of 128 patients, who underwent stone surgery between November 2010 and June 2017, were analyzed. The patients were divided into two groups according to surgical approach as endoscopic or open group. Duration of surgery and catheterization and length of hospital stay were recorded. Multivariate analyses were done using logistic regression test to determine the risk factors for complications.Results:A total of 130 procedures were performed in 128 patients included in the study. Of them, 93 were treated via endoscopic approach and 37 via open approach. The overall success rate in endoscopic and open groups was 92.5% and 100%, respectively (p=0.44). Increased age, type of surgical approach and using lithotripsy were found to be risk factors for complications in univariate analysis. Only the type of surgery was found to be an independent risk factor for complications in multivariate analysis (p=0.006).Conclusion:Open and endoscopic approaches showed similar effectiveness in patients with bladder stone. The only significant risk factor for complications was the type of surgical approach

Türkiye’de Halk Kütüphanelerinin Yerel Yönetimlere Devredilme Süreci Üzerine Ankara Özel İdare Yöneticilerinin Düşünceleri

This study is carried out in order to reveal the local managers’ approaches about “transferring public libraries to local authorities” which has been intensely argued for  the last three-four years in Turkey. Within this frame, a poll was conducted on countyspecial provincial administration directors working in the counties of Ankara. According to the results of the poll dated June, 2010 which was conducted on totally 15 county directors, they state that they do not find themselves sufficient about shaping the public library services and do not want any change about connecting the public libraries to themselves and they think that an alteration regarding the transferring of the public libraries would not create a significant difference on the existing situation.Bu çalışma, Türkiye’de son üç-dört yıldır yoğun olarak tartışılan “halk kütüphanelerinin yerel yönetimlere devri” konusunda yerel yöneticilerin yaklaşımlarını ortaya çıkarmak amacıyla yapılmıştır. Bu çerçevede, Ankara ilçelerinde görev yapan ilçe özel idare müdürlerine anket uygulanmıştır. Toplam 15 ilçe müdürüne Haziran 2010 tarihinde uygulanan bu anket ile elde edilen sonuçlara göre, halk kütüphanesi hizmetlerini yönlendirme konusunda kendilerini yeterli görmediklerini, halk kütüphanelerinin kendilerine bağlanması yönündeki bir değişikliği istemediklerini belirtmekte ve halk kütüphanelerinin devrine ilişkin bir değişikliğin var olan durumda önemli bir farklılık yaratmayacağını düşünmektedirler

Parental modelling in child’s nutrition behaviours and attitudes

While there are many factors influencing obesity, it can be said that the risk of obesity in children is increased by the nutrition behaviours and attitudes of parents as well as negative relationships within the family. In this regard, the aim of this study is to identify obesity and eating habits of children, parents’ attitudes for such behaviours, and factors influencing nutrition. A questionnaire with 4 parts was administrated to the parents of 650 children. Non-parametric and parametric statistical tests were applied on the collected data. At the end of the study, it was found that child nutrition is influenced by psychological and environmental factors, and that the child’s attitudes for healthy nutrition are influenced by the age and gender in children as well as the age, gender, the number of children, and education in parents. Furthermore, it was found that the behaviours of parents that influence the child’s nutrition include especially following the nutrition habits of the child, preventing the child to consume hazardous foods and guiding the child in nutrition

Sınıf Öğretmenlerinin Nomofobi Durumları

Öğretmenlerin nomofobi düzeylerinin araştırıldığı bu çalışma, 2022-2023 eğitim yılında Denizli ili metropol ilçelerinde resmi ilkokullarda çalışan sınıf öğretmenlerinin katılımıyla yapılmıştır. Araştırma, nicel ve tarama modelindedir. Basit eleman örnekleme ile 260 öğretmene ulaşılarak veri toplanmıştır. Öğretmenlerin nomofobi düzeylerinin en yüksek düzeyde iletişim kuramama boyutunda olduğu görülürken bunu bilgiye erişememe ve rahatlıktan feragat etme boyutları orta düzeyde izlemiştir. En düşük nomofobi düzeyi ise hafif düzeyde ve çevrimiçi bağlantıyı kaybetme boyutundadır. Öğretmenlerin genel olarak nomofobi düzeyi orta düzeyde ölçülmüştür. Sınıf öğretmenlerinin nomofobi düzeylerinin demografik özelliklerine göre bağımlılık öz değerlendirmesi ve hanede yaşayan insan sayısına göre farklılık göstermemiştir. Ancak cinsiyet, yaş, okulun sosyo ekonomik çevresi, kullanılan sosyal ağ sayısı ve günlük telefon kullanım süresine göre anlamlı farklılık göstermiştir. Sınıf öğretmenlerinin cinsiyete göre rahatlıktan feragat etme, iletişim kuramama ve genel nomofobi düzeylerinin kadınlarda erkeklere göre anlamlı düzeyde yüksek olduğu sonucuna ulaşılmıştır. Öğretmenlerin nomofobi düzeylerinin yaşa göre bilgiye erişememe, rahatlıktan feragat etme, iletişim kuramama ve genel nomofobi düzeylerinin yaşı küçük olanlar lehine anlamlı düzeyde yüksek olup öğretmenlerin yaşları küçüldükçe nomofobi seviyelerinin arttığı sonucuna ulaşılmıştır. Sınıf öğretmenlerinin nomofobi düzeylerinin okulun bulunduğu çevrenin sosyo ekonomik düzeyine göre bilgiye erişememe, rahatlıktan feragat etme, iletişim kuramama, çevrimiçi bağlantıyı kaybetme boyutlarıyla genel nomofobi düzeyinin okulun sosyo ekoomik düzeyi yüksek olan yerde çalışan öğretmenler lehine yüksek olduğu tespit edilmiştir. Öğretmenlerinin nomofobi düzeylerinin kullandıkları sosyal ağ sayısına göre bilgiye erişememe, rahatlıktan feragat etme, iletişim kuramama ve genel nomofobi düzeyinde kullandığı sosyal ağ sayısı düşük olanlara göre yüksek olanlar lehine yüksektir. Sınıf öğretmenlerinin nomofobi düzeylerinin öğretmenlerin günlük telefon kullanım süresine göre bütün boyutlarda ve genel olarak saat süresi fazla olanlar lehine anlamlı farklılık gösterdiği tespit edilmiştir