Osteomalazili hastalarda vitamin D tedavisine verilen cevabın değerlendirilmesi

Introduction: The current study aimed to examine the relationship between 25 hydroxyvitamin D [25(OH)D] levels and demographic, clinical and laboratory parameters and response to treatment in patients living in a Central Anatolian city of Turkey and diagnosed with osteomalacia.Methods: A total of 533 patients who live in the continental climate, older than 18 years old, and have 25(OH)D levels lower than 30 ng/ml were enrolled prospectively. Patients' age, body mass index (BMI), type of clothing, season in which they were diagnosed, type of treatment and duration were recorded. At the time of diagnosis, the patients were evaluated with clinical and laboratory parameters at 1st, 2nd, and 4th months.Results: Mean serum 25(OH)D level was 7.59±4.41 ng/mL at the time of diagnosis. 25(OH)D level was 24.42±14.77 ng/ml after treatment, with severe deficiency ( 0.05). However, as BMI increased, the response given to the treatment decreased.Conclusions: The current study showed that vitamin D deficiency is common in study population. The current findings demonstrate that treatment and follow-up should be continued until achieving normal serum 25(OH)D levels, taking into account geographic and ethnical structures to bring vitamin D levels to adequate levels.Giriş: Bu çalışmada Türkiye’nin bir Orta Anadolu kentinde yaşayan, osteomalazi tanısı alan hastalarda 25 hidroksivitamin D [25(OH)D] düzeylerinin demografik, klinik ve laboratuvar parametreleriyle olan ilişkisi ve tedaviye yanıtının incelenmesi amaçlandı.Yöntem: Karasal iklimdeki şehirde, 25(OH)D 18 yaşından büyük olan 533 hasta prospektif olarak dahil edildi. Hastaların yaşı, vücut kitle indeksi (VKİ), giyim şekli, tanı aldığı mevsim, tedavi şekli ve süresi kaydedildi. Hastalar tanı anında, 1., 2. ve 4. aylarda klinik ve laboratuvar parametreleri ile değerlendirildi.Bulgular: Tanı anında ortalama serum 25(OH)D 7,59±4,41 ng/mL idi. Hastaların %74’ünde ciddi eksiklik (0,05). Ancak VKİ arttıkça tedaviye verilen cevabın azaldığı bulundu.Sonuç: Bu çalışma, bölgemizde vitamin D eksikliğinin yaygın olarak görüldüğünü ortaya koymuştur. Bulgularımız D vitamini düzeyini yeterli seviyeye çıkarmak için coğrafik ve etnik yapıların da göz önünde bulundurularak, normal serum 25(OH)D düzeyine ulaşıncaya kadar tedavi ve takibe devam edilmesi gerektiğini göstermektedir

Prevalence and etiologies of pulmonary hypertension at Somalia-Turkey Training and Research Hospital in Mogadishu

Introduction: pulmonary hypertension (PH) is one of the leading causes of mortality in the world. This study aimed to determine the ratio distribution and etiological characteristics of PH in Somalia-Turkey Training and Research Hospital. Methods: the study was designed as a hospital-based retrospective observational study and included 260 patients who were diagnosed with PH by transthoracic echocardiography (TTE) in the cardiology outpatient clinic in Somalia-Turkey Training and Research Hospital in Mogadishu. Sociodemographic and clinical characteristics and data on morbidity were retrieved from clinical records. Results: the echocardiographic prevalence of PH was found to be 18% (n=260). PH due to left heart disease was the most common form of PH (n=151, 58%), followed by PH due to lung disease (n=61, 23%), group 1 PH (n=38, 16%), group 5 PH (n=7, 2%), and chronic thromboembolic PH (CTEPH) (n=3, 1%). Conclusion: the present study showed that the prevalence of PH in Somalia is relatively higher than the rest of the world's average. The distribution characteristics of the disease could be related to the region-specific differences of the causative diseases. Further studies are needed to better capture the epidemiology of PH in Somalia

Metode savladavanja dormantnosti i značajke klijavosti sjemena vrste Acer trautvetteri Medvedev

In this study, seed dormancy removal and germination characteristics of Acer trautvetteri Medvedev, is one of the major maple species of the eastern Black Sea region, were studied. To do that, the seeds were collected in 2008 three times with aproximately 15-days intervals. In order to remove dormancy, several germination treatments were applied. The treatments were (1) different seed collection time, (2) soaking in water, (3) cold-moist stratification and (4) GA3 (gibberellic acid) application. The treated seeds were germinated in growing chamber at 5 0C and in greenhouse conditions. This research indicated that seeds of Acer trautvetteri exhibit physiological dormancy and require stratification period to remove seed dormancy. The highest germination percentage in the growing chamber subjected to GA3 application after eight weeks of stratification treatment was 66 % for Acer trautvetteri seeds. The highest germination percentage in greenhouse was obtained with cold stratification after eight weeks (81 %). Although GA3 treatment had a positive effect on germination in growth chamber + 5 0C, GA3 treatment had a negative effect on germination in greenhouse conditions. Soaking in water of nonstratified seeds wasn’t any significant difference on seed germination. There was a positive correlation between seed collection time and germination (r=0.59). As a result, the third collection time (in october) should be preferred as seed collection time in Acer trautvetteri seeds, considering that it may vary according to the climatic conditions of the year.Vrsta Acer trautvetteri Medvedev geografski je rasprostranjen na Kavkazu i u Turskoj. Pridolazi na visinama od 400 do 2100 m. U ovom radu raspravljamo o savladavanju dormantnosti i značajkama klijanja sjemena vrste Acer trautvetteri Medvedev, jedne od glavnih vrsta javora u istočnom crnomorskom području. U tu je svrhu godine 2008. prikupljano sjeme u tri navrata s razmakom od 15 dana. Kako bismo savladali dormantnost, primijenili smo nekoliko tretmana klijanja. Tretmani su uključivali (1) različito vrijeme sakupljanja sjemena, (2) namakanje u vodi, (3) hladno-vlažnu stratifikaciju i (4), primjenu GA3 (giberelinske kiseline). Tretirano sjeme klijalo je u komori rasta pri 5 0C i u stakleničkim uvjetima. Ovom studijom utvrđeno je da sjeme vrste Acer trautvetteri pokazuje fiziološku dormantnost i da je za savladavanje dormantnosti potreban period stratifikacije. Najviši postotak klijavosti sjemena vrste Acer trautvetteri u komori rasta uz primjenu GA3 nakon osam tjedana stratifikacije iznosio je 66 % . Najviši postotak klijanja u stakleniku postignut je hladnom stratifikacijom nakon osam tjedana (81 %). Postotak klijanja sjemena vrste Acer trautvetteri stratificiranog tijekom osam tjedana bio je viši od postotka klijanja nestratificiranog sjemena i u komori rasta i u stakleničkim uvjetima. Ova činjenica potvrđuje da sjeme vrste Acer trautvetteri pokazuje fiziološku dormantnost i da je za savladavanje dormantnosti sjemena potreban period stratifikacije. Iako je tretman s GA3 imao pozitivan utjecaj na klijavost u komori rasta pri +5 0C, tretman s GA3 negativno je utjecao na klijanje u stakleničkim uvjetima. Namakanje nestratificiranog sjemena u vodi nije pokazalo neku značajniju razliku na klijavost sjemena. Postoji pozitivna korelacija između vremena prikupljanja sjemena i klijanja (r=0.59). Shodno tome, preporučuje se treće vrijeme prikupljanja (u listopadu) sjemena vrste Acer trautvetteri. Točno vrijeme sakupljanja sjemena može varirati ovisno o klimatskim godišnjim uvjetima

Utjecaj različitih tretmana na prekid dormantnosti i klijavost sjemena Acer cappadocicum Gleditsch var. cappadocicum

This study was carried out to determine effects of different pretreatment on seed germination and to overcome dormancy in Acer cappadocicum seeds. The seeds were collected in 2008 three times with aproximately 15-days intervals. In order to overcome dormancy, several germination treatments were applied. The treatments were (1) different seed collection time, (2)soaking in water, (3) cold-moist stratification and (4) GA3 (gibberellic acid) application. The treated seeds were germinated in growing chamber at 5 0C and in greenhouse conditions. This research showed that seeds of Acer cappadocicum exhibit physiological dormancy and require stratification period to overcome seed dormancy. The highest germination percentage in the growing chamber subjected to GA3 process after eight weeks of stratification treatment was 62 % for Acer cappadocicum seeds. The highest germination percentage in greenhouse was obtained with cold stratification after eight weeks (95 %). It was found out that GA3 treatment had a significant effect on germination in growth chamber + 5 0C but GA3 treatment didn’t have a significant effect on germination in greenhouse conditions. GA3 treatment and soaking of unstratified seeds in water for 48 hr didn’t have any positive effect on germination value in greenhouse conditions. Although growth chamber and green house results both indicated that seed collection time did not seem to play a role as statistically on seed germination, Duncan’s test showed that the third seed collection time was in a different group.Acer cappadocicum var. cappadocicum široko je rasprostranjen na Kavkazu, u Zapadnoj Aziji i na Himalaji. Javlja se u sjeveroistočnoj Anatoliji u Turskoj na visinama od 400 m do 1600 m, a uobičajen je i u regijama Ordu, Giresun, Trabzon, Rize i Artvin u Turskoj. Iako se Acer cappadocicum prirodno širi u šumama istočnog Crnog mora, on se ne može proizvesti u dovoljnim količinama u privatnim i šumskim rasadnicima. U istraživanju pošumljavanja jedno od glavnih načela odnosi se na korištenje prirodno rastućih vrsta. U ovom radu istraženo je otklanjanje dormantnosti sjemena Acer cappadocicum, jedne od važnih vrsta Acer u području istočnog Crnog mora. Ovaj rad bavi se istraživanjem ­utjecaja U ovom radu istražen je utjecaj predtretmana na klijavost sjemena i otklanjanja dormantnosti sjemena Acer cappadocicum. Sjeme je prikupljeno 2008. godine u tri navrata u intervalima od približno 15 dana. Kako bi se otklonila dormantnost, primijenjeno je nekoliko tretmana klijanja. Tretmani su uključivali (1) različito vrijeme prikupljanja sjemena, (2) potapanje u vodi, (3) hladno-vlažnu stratifikaciju i (4) primjenu GA3 (giberelinska kiselina). Tretirano sjeme podvrgnuto je klijanju u komori rasta na temperaturi od 5 0C i u stakleničkim uvjetima. Ovim istraživanjem je utvrđeno da sjeme Acer cappadocicum pokazuje fiziološku dormantnost i da je za otklanjanje dormantnosti sjemena potrebno razdoblje stratifikacije. U preliminarnim pokusima sjeme Acer cappadocicum podvrgnuto je hladno-vlažnoj stratifikaciji tijekom osam tjedana. Kad je period stratifikacije produžen, većina sjemena proklijala je tijekom perioda stratifikacije. Najviši postotak klijavosti u komori rasta izloženom postupku s GA3 nakon osam tjedana stratifikacije iznosio je 62. Najviši procenat klijavosti u stakleniku postignut je postupkom hladne stratifikacije nakon osam tjedana (95 %). Utvrđeno je da tretman s GA3 nije imao značajniji utjecaj na klijavost u stakleničkim uvjetima. Prema tomu, za sijanje sjemena Acer cappadocicum u stakleničkim uvjetima ne preporučuje se primjena GA3. Tretman s GA3 i potapanje nestratificiranog sjemena u vodi 48 sati nije imao pozitivne učinke na vrijednosti klijavosti u stakleničkim uvjetima. Iako rezultati dobiveni u komori rasta i stakleniku pokazuju da vrijeme prikupljanja sjemena nije statistički utjecalo na klijavost sjemena, Dunkanov test ukazuje na to da se kllijavost sjemena sakupljenog u trećem navratu signifikantno razlikuje u odnosu na klijavost sjemena sakupljenog u prva dva navrata. Rezultati pokazuju da je najbolje vrijeme za prikupljanje sjemena Acer cappadicucum ono iz trećeg navrata (u listopadu), ali ono može i varirati ovisno o klimatskim uvjetima tijekom godine

Evaluation of hearing and cochlear function by audiometric testing in patients with hyperemesis gravidarum

INTRODUCTION: The aim of this study was to investigate cochlear functions in patients with hyperemesis gravidarum (HG).METHODS: Twenty-nine HG patients (58 ears) and 31 healthy control subjects (62 ears) were included. Audiometry testings at 250 and 500 Hz and 1, 2, 4, 8, 10, 12, 14, 16 kHz were performed to the patients and controls.RESULTS: Mean age of patients with HG was 26,5 ± 4,4 years and the mean age of control group was 28,0 ± 4,2 years. At the time of the tests mean gestational age of the HG group and controls were 9 and 11 weeks respectively. No differences were observed between the groups in tympanic membrane status, or other otolaringological evaluations. No significant differences were observed in audiometric tests at any frequencies between the groups (p values for all > 0.05).CONCLUSION: There was not a difference between pregnant cases with HG and cases with normal pregnancy in terms of audimetric tests. Cochlear functions are not affected remarkably in women with HG

An investigation of export–import ratios in Turkey using spline regression models

This paper examines the use of spline functions in linear, squared, and cubic spline regression models and exhibits the estimation of spline parameters from data by ordinary least squares. Determination of the number and the location of knots is central to spline regression. In this paper, we initially propose a method based on the coefficient of determination R2 related to the estimation of knots in spline regression. This proposed method as applied to export–import ratio distributions in Turkey for the years 1923–2010 determines the knots, and linear, quadratic, and cubic spline regression models are established accordingly. Results reveal that spline regression models offer better results than polynomial regression models, and that the quadratic spline regression model is the best explanatory model for export–import ratio distributions in the smoothest spline regression models

Evaluation of hearing and cochlear function by audiometric testing in patients with hyperemesis gravidarum

INTRODUCTION: The aim of this study was to investigate cochlear functions in patients with hyperemesis gravidarum (HG).METHODS: Twenty-nine HG patients (58 ears) and 31 healthy control subjects (62 ears) were included. Audiometry testings at 250 and 500 Hz and 1, 2, 4, 8, 10, 12, 14, 16 kHz were performed to the patients and controls.RESULTS: Mean age of patients with HG was 26,5 ± 4,4 years and the mean age of control group was 28,0 ± 4,2 years. At the time of the tests mean gestational age of the HG group and controls were 9 and 11 weeks respectively. No differences were observed between the groups in tympanic membrane status, or other otolaringological evaluations. No significant differences were observed in audiometric tests at any frequencies between the groups (p values for all > 0.05).CONCLUSION: There was not a difference between pregnant cases with HG and cases with normal pregnancy in terms of audimetric tests. Cochlear functions are not affected remarkably in women with HG

Diagnosis of comorbid migraine without aura in patients with idiopathic/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria

BackgroundMigraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.MethodsIn this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis.ResultsLonger headache duration (<4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea/vomiting, and photophobia and/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (n = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone.ConclusionLonger headache duration, throbbing pain, increase of pain by physical activity, photophobia and/or phonophobia, presence of vertigo/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I/GEs

Sınıf öğretmenlerinin yapılandırmacı öğretmen özelliklerini gösterme düzeylerine ilişkin algılarının bazı değişkenlere göre incelenmesi

Bu arastırmanın amacı, sınıf ögretmenlerinin yapılandırmacı ögretmen özelliklerini gösterme düzeylerine iliskin algılarının bazı degiskenlere göre degisip degismedigini belirlemektir. Arastırmanın evrenini stanbul li Avcılar lçesiʼnde bulunan 22 ilkögretim okullarında görevli toplam 545 sınıf ögretmeni, örneklemini seçkisiz örnekleme ile belirlenen 10 ilkögretim okulunda bulunan toplam 202 sınıf ögretmeni olusturmustur. Veriler, yapılandırmacı ögretmen özelliklerine göre hazırlanan öz degerlendirme ölçegi ile elde edilmistir. Verilerin analizinde, frekans, yüzde, ortalama, standart sapma ve tek yönlü varyans analizi (Anova) kullanılmıstır. Arastırma sonucunda, sınıf ögretmenlerinin yapılandırmacı ögretmen özelliklerini gösterme düzeylerine iliskin algıları çok yüksek çıkmıstır. Ayrıca sınıf ögretmenlerinin yapılandırmacı ögretmen özelliklerini gösterme düzeylerinin, mezun oldukları yüksek ögretim kurumu, hizmet yılı, cinsiyet, sınıflarındaki ögrenci sayısı gibi bazı degiskenlere göre anlamlı bir farklılık olusturmadıgı görülmüstür

Development of ejector for anode gas recovery in solid oxide fuel cells

Bu tez kapsamında 4 kW güç kapasiteli metan yakıtlı bir katı oksit yakıt pili sistemi için ejektör tasarımı yapılmıştır. Ejektör giriş basıncı, çıkış basıncı, egzoz hattı giriş basıncı, egzoz hattı çıkış basıncı ve metan giriş sıcaklığı ile ilgili olarak 1140 farklı dizayn noktası oluşturulmuştur. Daha sonra ejektör performansına etkisi yüksek olan geometrik parametrelerden; boğaz çapı, ıraksak nozul açısı, ıraksak nozul uzunluğu, karışım bölgesi giriş çapı, nozul konumu, ikincil akışkanın yönü ve açısı, karışım bölgesi uzunluğu, difüzör uzunluğu ve difüzör ıraksama açısı ile ilgili olarak toplam 6592 farklı durum için nümerik çözüm elde edilmiştir. Elde edilen nümerik çözümler neticesinde tasarlanan ejektör ile literatürle uyumlu olarak 3,043 buhar karbon oranı ve 8,712 sürüklenme oranına ulaşılmıştır.In this thesis, the design of the ejector for a 4 kW power capacity methane-fueled solid oxide fuel cell system is performed. 1140 different design points are created with respect to the ejector inlet pressure, outlet pressure, exhaust line inlet pressure, exhaust line outlet pressure and methane inlet temperature. However, numerical solutions are obtained for a total of 6592 different situations related to some important ejector geometric parameters including the throat diameter, divergent nozzle angle, divergent nozzle length, mixing zone inlet diameter, nozzle position, direction and angle of secondary fluid, mixing zone length, diffuser length and diffuser divergence angle. In accordance with the literature, the numerical results show that the steam to carbon ratio of 3.043 and the entrainment ratio of 8.712 are achieved for the ejector designed