The effect of folate on ischemia/reperfusion injury in a rat adnexal torsion model

Purpose The ischemia/reperfusion (I/R) injury of ovaries in adnexal torsion may have inadvertent consequences. Many agents have been studied in terms of their ability to prevent reperfusion damage to ovaries in suspected cases. In this study, folic acid, known to have antioxidative properties, was investigated to determine whether it played a role in the prevention of I/R damage in a rat ovarian torsion model.Methods In this experimental study, 40 female adult Wistar-Albino rats were randomly divided into fve groups as control, ischemia, I/R, Fol2 (2 mg/kg folic acid), and Fol4 (4 mg/kg folic acid). In the Fol2 and Fol4 groups, folic acid was intra peritonelly administered 30 min before reperfusion. Blood samples were obtained from the tails of each rat at the second hour of reperfusion.Results The total oxidant status (TOS), total antioxidant status, cystatin C and folic acid levels of the fve groups were investigated. Folic acid in 2 mg/kg dose could moderately increase the serum folic acid concentration (15.75–19.95 ng/ml, p0.05), although there was no statistical diference in TOS levels (p=0.07). Folic acid in 4 mg/kg dose, could signifcantly increase the serum folic acid concentration (15.75–37.65 ng/ml). However, it did not signifcantly reduce the level of cystatin C (0.18–0.19 µg/L, p>0.05), and did not improve oxidative stress injury (76.05–130.58, p>0.05).Conclusion Folic acid in 2 mg/kg dose might improve the ovarian I/R injury though this was not statistically signifcant. Further studies are required to reach a defnitive conclusion about the protective efect of folic acid in I/R injury

Effects of transformational leadership behaviours on organizational health in hotels: A study in Afyonkarahisar

Turizm sektöründe özellikle 1950’li yıllardan sonra rekabetin artması ve küresel boyuta ulaşması ile bu sektör içerisinde yer alan konaklama işletmeleri varlıklarını sürdürebilmek için birçok yeni yönetim tekniğini bünyesinde uygulayarak başarı sağlama gayreti içerisine girmiştir. Bu süreçte işletmelerin başarı sağlamasında temel unsurlardan birisi işletme örgütünün sağlığı olmuştur. Temel olarak bir örgütün çevresine adapte olabilme, çalışanları arasında uyum yaratma ve hedeflerine ulaşma kabiliyeti şeklinde ifade edilen örgüt sağlığı kavramı, dinamik rekabet koşulları sonucunda, son dönemde yoğun olarak incelenmeye başlamıştır. Diğer yandan bir işletme örgütünün sağlıklı olabilmesi için bu örgütlerde etkin dönüşümcü liderlerin bulunması gerekir. Dolayısıyla işletmelerde örgütün sağlıklı kılınması için dönüşümcü liderlik davranışlarının örgüt sağlığı üzerine olan etkilerinin kapsamlı olarak araştırılması gerekmektedir. Bu kapsamda araştırmada Afyonkarahisar ilinde faaliyet gösteren termal konaklama işletmelerinde dönüşümcü liderlik davranışları ile örgüt sağlığı arasındaki ilişkiler incelenmiştir. Araştırma evrenini; Afyonkarahisar’da faaliyet gösteren Bakanlık belgeli termal turizm işletmelerinden ankete katılmayı kabul eden işletme çalışanları oluşturmaktadır. Çalışmada örnekleme yöntemi olarak “Kolayda Örnekleme Yöntemi” uygulanmıştır. Toplamda ulaşılması gereken minimum sayı 303 olarak hesaplanmış olup, hata payı, yanlış ya da eksik kodlama nedeniyle değerlendirmeye alınmayacak anketlerin olabileceği düşüncesiyle 500 adet anket formu dağıtılmış bunlardan ancak 400 adet anket elde edilebilmiştir. Elde edilen anketlerin incelenmesi sonucunda 36 anket değerlendirmeye uygun bulunmamış ve toplamda 364 anket değerlendirmeye alınmıştır. Araştırma kapsamında anketi yanıtlayan katılımcılara ait demografik değişkenlerin analiz edilmesinden sonra, söz konusu katılımcıların ankette yer alan örgüt sağlığı ölçeği ve dönüşümcü liderlik davranışları ölçeğine vermiş olduğu yanıtlar yüzde analizi, aritmetik ortalama ve standart sapma yöntemi ile analiz edilmiştir. Örgüt sağlığı ve dönüşümcü liderlik davranışları arasındaki ilişkinin ölçümüne yönelik korelasyon analizi gerçekleştirilmiştir. Yapılan araştırmanın sonucunda genel olarak dönüşümcü liderlik davranışları ile örgüt sağlığı arasında ve iki değişkene ait tüm alt boyutlarda istatistikî olarak anlamlı bir ilişkinin olduğu saptanmıştır.In the tourism sector, competition has increased rapidly after the 1950s. The growth of the tourism industry worldwide, is located within the accommodation sector enterprises, which ensure the success of applying the many new management techniques in order to survive. In this process, the most basic element to success; the health of the organization. Basically an organization’s ability to adapt to its environment, creating harmony between employees and the ability to achieve their goals as stated in the organization’s health, as a result of competitive conditions in recent years have been investigated extensively. The other hand, the organization must have effective transformational leaders to be healthy. Therefore, it is necessary to investigate their effects on the health of a comprehensive organization of transformational leadership behaviors of the organization to be healthy. In this research, the relationship between thermal hotel business in transformational leadership behaviors and organizational health in Afyonkarahisar were examined. Study population who agreed to participate in the survey of the Ministry certified businesses operating in Afyonkarahisar thermal hotel consists of those employees. In the study as a sampling method “Sampling Method” is used. For the total sample is calculated as the required number of 303. However, the margin of error, with the idea of the survey may not be considered due to incorrect or incomplete coding 500 questionnaires were distributed. However, 400 questionnaires were obtained. Examination of the resulting questionnaire was not appropriate to evaluate the results of 36 surveys. For this reason, it is only 364 questionnaires were evaluated. After analyzing demographic variables of participants who responded to the survey This survey is located organizational health survey participants scale and transformational responses given by the leadership behavior scales percentage analysis, we have calculated the mean and standard deviation values. Organizational health and transformational correlation analysis for the measurement of the relationship between leadership behavior were mad

Restless legs syndrome and depression-anxiety disorder association in iron deficiency anemia patients

Restless Legs Syndrome (RLS) is a disorder in which the person experiences a strong urge to move their legs or other extremities during rest. This urge to move is associated with tingling, pulling or other unpleasant and uncomfortable feelings; it usually slowly increases in the affected limb and often affects sleep. The incidence in general population is 5-15%. Although the pathophysiology is not fully understood, it was thought to result from the iron and dopamine metabolism irregularities and also has a genetic component. There are publications that show the frequency of disease in patients with iron deficiency or renal failure reaches up to 80%. In this study, we investigated the incidence of restless leg syndrome in anemic patients without any other organic disease or drug use, which can cause restless legs syndrome. We also tried to find out if there is a relation between restless legs syndrome, ferritin levels, anxiety and depression. Our retrospective, cross sectional study was made in The Ministry of Health and family medicine, neurology and psychiatry outpatient clinics of Ordu University Education and Research Hospital. 47 patients who were admitted to above mentioned clinics whose ferritin levels were under 50 ng/ml without any other disease and were not on medication (including those indicated for iron deficiency anemia) was included in to the study. All patients were given the Beck depression inventory and Beck anxiety inventory. The patients were questioned in terms of the basic diagnostic criteria established by International Restless Legs Syndrome Study Group. Definitive diagnosis could be established by the patients that meet the four criterias for the diagnosis. International Restless Legs Scale applied to patients diagnosed with RLS. Of 47 patients, 39 were female and 8 were male. 28 (%59.6) of the patients met the criteria of RLS. 28 patients with a diagnosis of RLS; 4 of them mild, 11 of them moderate, 8 of them severe and 5 of them experienced very severe symptoms of RLS. The relationship between the RLS and ferritin levels were checked and there was no statistically significant difference between them. A significant difference was not found in Beck depression scores between patients with and without RLS, but when the groups were compared in terms of Beck anxiety score, there were a significant difference. There was no significant relationship between RLS severity and Beck depression or Beck anxiety scores. RLS can be seen in %5-15 of general population and it is much more likely to emerge in the presence of an organic problem such as iron deficiency anemia. The diagnosis of the disorder is set clinically and RLS had a different significance because it may cause sleep disturbances and psychiatric disorders. If not questioned, this problem, which is not easily noticeable, can lead to misdiagnosis and misinterpreted as an anxiety disorder or a primary sleep disorder. Therefore the symptoms that could be corrected only by iron deficiency treatment, could be inşamed further by giving antidepressants and hypnotics

A prognostic marker in idiopathic sudden sensorineural hearing loss serum calprotectin

Objectives. Calprotectin, a protein released by neutrophils, has been used in many studies as a biomarker showing the presence of inflammation. In this study, it was aimed to investigate the relationship between serum calprotectin level and response to the treatment of idiopathic sudden sensorineural hearing loss (ISSHL). Methods. The present study is a prospective, cross-sectional historical cohort study.The study group consisted of 44 patients with ISSHL, and the control group consisted of 41 healthy volunteers without ear pathology. At the same time, patients in the study group were divided into three groups according to the response to ISSHL treatment (recovered, partially recovered, unrecovered). The relationship between the groups was statistically evaluated in terms of serum calprotectin levels. Results. The mean serum calprotectin value was 75.67 +/- 19.48 ng/mL in the study group and 50.24 +/- 29.14 ng/mL in the control group (P=0.001). Serum calprotectin value according to the severity of hearing loss in the mild, moderate and severe was 66.20 +/- 8.82, 70.35 +/- 16.77, and 91.23 +/- 1.9.73 ng/mL, respectively. Serum calprotectin value in the severe group was significantly higher compared to the moderate and mild groups (P=0.004, P=0.001, respectively). Serum calprotectin value according to the treatment response in the recovered, partially recovered and unrecovered groups was 63.36 +/- 11.54, 80.17 +/- 12.06, and 85.33 +/- 22.33 ng/mL, respectively. Serum calprotectin value in the recovered group was significantly lower compared to the partially recovered and unrecovered groups (P=0.002, P= 0.001, respectively). Conclusion. Serum calprotectin value informs the clinician about both the severity of hearing loss and the response to treatment. Hence, serum calprotectin can be used as an important biomarker in ISSHL patients for the determination of the prognosis of disease

Elevated serum calprotectin as an inflammatory marker in obstructive sleep apnea

OBJECTIVE To investigate the serum calprotectin (SCal) levels and neutrophil/lymphocyte ratio (NLR) values in patients with obstructive sleep apnea (OSA). METHODS Sixty-seven OSA patients and 46 healthy volunteers without any sleep disorders were included in the study. The patient group was divided into three subgroups according to the severity of OSA. The SCal levels and NLR values were compared among subgroups and between the experimental and control groups. RESULTS The mean SCal level and NLR value were higher in the study group than in the control group (p = 0.002 and p = 0.001, respectively). The SCal levels were significantly higher in patients with severe OSA than in those with moderate and mild OSA (p = 0.004 and p = 0.001, respectively). DISCUSSION Unlike NLR, the SCal level may inform the severity of OSA and could be used as an indicator for OSA

Predicting mechanical ventilation, intensive care unit admission, and mortality in COVID-19 patients: Comparison of seven different scoring systems

Objective: In this study, we investigated whether scoring systems determine coronavirus disease-2019 (COVID-19) severity. Materials and Methods: COVID-19 patients hospitalized between 01.09.2020 and 31.04.2021 were retrospectively assessed. The national early warning score (NEWS), modified early warning score, rapid emergency medicine score, quick sequential organ failure assessment score (q-SOFA), CURB65, MuLBSTA, and ISARIC-4C scores on admission day were calculated. Scoring systems' ability to predict mechanical ventilation (MV) need, intensive care unit (ICU) admission, and 30-day mortality were assessed. Results: A total of 292 patients were included; 137 (46.9%) were female, and the mean age was 62.5 +/- 15.4 years. 69 (23.6%) patients required ICU admission, 45 (15.4%) needed MV, and 49 (16.8%) died within 30 days. No relationship was found between q-SOFA and MV need (p=0.167), but a statistically significant relationship was found between other scoring systems and MV need, ICU admission, and 30-day mortality (p5.5) and NEWS (optimal cut-off >3.5) had the highest area under the curve in receiver operating characteristic curve analyses, whereas q-SOFA had the lowest. Conclusion: The severity of COVID-19 could be estimated by using these scoring systems, especially ISARIC-4C and NEWS, at the first admission. Thus, mortality and morbidity would be reduced by making the necessary interventions earlier. Keywords: COVID-19, ISARIC-4C, mortality, NEWS, scoring system

Remission of a Pregnant Woman with Persistent Hyperemesis Gravidarum with Corticosteroid Treatment

Nausea and vomiting affect more than 50% of pregnancies. It presents a broad spectrum of symptoms ranging from mild symptoms to severe weight loss and that may affect daily activities. Hyperemesis gravidarum is a severe pathologic form of nausea and vomiting of pregnancy characterized by a greater than 5% loss of weight and unexplained ketonuria. Hyperemesis gravidarum affects approximately 0.5% of pregnancies. The pathogenesis of hyperemesis gravidarum is not exactly known but multifactorial. Previous pregnancy history, low body mass index, maternal inheritance, maternal mood disorders are thought to be associated with. Other causes of nausea and vomiting, such as gastrointestinal tract, genitourinary system, central nervous system, toxic metabolism, must be ruled out. The risk factors include family history, obstetric history, molar pregnancy, multiple pregnancy, nulliparity, female fetus, hyperthyroidism, diabetes, asthma, depression, peptic ulcer or other gastrointestinal disorders. Severe symptoms affect daily activities, cause anxiety, and sometimes may even lead to the termination of pregnancy and cancellation of future pregnancy plans. The symptoms that started in the first trimester of pregnancy decrease and recover to starting of the second trimester. In our case, we will discuss the successful treatment of severe form of hyperemesis gravidarum with parenteral and oral corticosteroids atypically in the second trimester

SINGLE CENTER EXPERIENCE: IDA-FLAG TREATMENT IN PATIENTS WITH RELAPS / REFRACTORY ACUTE LEUKEMIA AND LYMPHOBLASTIC LYMPHOMA

Amaç: Primer refrakter ve/veya relaps akut lösemi olgularının yönetimi son derece zorolup sınırlı sayıda tedavi seçenekleri vardır ve bu hastalarda tam remisyon oranı düşükve remisyon süreleri çok kısadır. İda-FLAG rejimi erişkin relaps, refrakter vesekonder Akut Myeloblastik Lösemi, yüksek riskli Myelodisplastik Sendrom verelaps/refrakter Akut Lenfoblastik Lösemi olgularında yaygın olarak kullanılmakta vebu hastalarda ikincil remisyon için iyi bir seçenek olarak kabul edilmektedir.Gereç ve yöntem: Bu yazıda, merkezimizde İda-FLAG kemoterapisi uygulanan, yaşortalaması 43,5 (21-61) olan 13 relaps ve/veya refrakter akut lösemi ve 1 B hücrelilenfoblastik lenfomalı 14 hastanın sonuçları retrospektif olarak değerlendirilmiştir.Bulgular: Hastalardan 11'i ex olmuş (%78,6) 3 hastada (%21,4) ise komplet remisyonsağlanmıştır. Hastaların mortalite nedenleri incelendiğinde; 7 hasta sepsis, 2 hastahastalık progresyonu, 1 hasta kanama ve 1 hastada Tip I solunum yetmezliği nedeni ileex olmuştur. Bizim çalışmamızda en sık yan etki enfeksiyon olup, 10 hastada (%71)Grade III-IV olmak üzere hastaların tümünde enfeksiyon gelişmiştir.Sonuç: Bizim sonuçlarımız literatür verileri ile karşılaştırıldığında hastalarımızdakomplet remisyon oranı düşük, toksisite profili ise daha yüksek olarak bulunmuştur.Bu sonuçlarla Relaps/Refrakter Akut Lösemi olgularında ikincil remisyon indüksiyonuamacı ile kullanılan İda-FLAG rejiminin iyi bir seçenek olmadığıdüşünülmüştür.Objective: Management of primary refractory and/or relapsed patients with acutelymphoid and myeloid leukemias is difficult. Treatment options are limited andresponse rates and duration are not satisfactory. Ida-FLAG regimen is generallyaccepted as a good therapeutic option in adult patients with relapsed and/or refractoryleukemias in order to obtain remission.Material and method: In this paper, we have analyzed 13 patients with relapsedand/or refractory acute leukemia and one patient with B-cell lymphoblastic lymphoma who were treated with Ida-FLAG regimen retrospectively. Median age of the patientswas 43.5 year (min. 21 and max. 61).Results: Three patients had complete hematological remission (21.4%). Eleven of thepatients died (78.6%). Mortality reasons were sepsis in 7, disease progression in 2,severe disseminated bleeding in 1 and type one respiratory insufficiency in 1. The mostfrequent side effect of the regimen was grade lll-lV infections in 10 (71%) patients.Conclusion: Regarding both our results and data complete remission rate was verylow and toxicity was very high with Ida-FLAG regimen. These results indicate that Ida-FLAG is not a favorable regimen in this group of patients and there is a great need forimproving new treatment options

Discovery of a small molecule that selectively destabilizes Cryptochrome 1 and enhances life span in p53 knockout mice

Cryptochromes are negative transcriptional regulators of the circadian clock in mammals. It is not clear how reducing the level of endogenous CRY1 in mammals will affect circadian rhythm and the relation of such a decrease with apoptosis. Here, we discovered a molecule (M47) that destabilizes Cryptochrome 1 (CRY1) both in vitro and in vivo. The M47 selectively enhanced the degradation rate of CRY1 by increasing its ubiquitination and resulted in increasing the circadian period length of U2OS Bmal1-dLuc cells. In addition, subcellular fractionation studies from mice liver indicated that M47 increased degradation of the CRY1 in the nucleus. Furthermore, M47-mediated CRY1 reduction enhanced oxaliplatin-induced apoptosis in Ras-transformed p53 null fibroblast cells. Systemic repetitive administration of M47 increased the median lifespan of p53−/− mice by ~25%. Collectively our data suggest that M47 is a promising molecule to treat forms of cancer depending on the p53 mutation

The Evolution of David Hare's Political Drama as Observed in Fanshen, The Secret Rapture and The Absence of War

The aim of this dissertation is to expose how David Hare’s political drama evolves within the social and political context of three decades, the 1970s, the 1980s and the 1990s and to illustrate this evolution by examining one distinctive play by the playwright from each decade, respectively Fanshen (1975), The Secret Rapture (1988) and The Absence of War (1993). In accordance with this purpose, each play is analysed within its contemporary political context as well as in its theatrical context. Such a contextual study of the plays helps to expound the varying attitudes Hare adopts and the different roads he takes in order to deal with British contemporary politics of each decade. In addition to the contextual framework, the extensive analysis of these plays demonstrates the evolution in Hare’s political playwriting from an overt representation of a socialist revolution to discuss socialist politics as exemplified in Fanshen, through the depiction of the virtues of the Left only within the boundaries of the characters’ private lives as illustrated in The Secret Rapture to the assertion that the institutions are required though they are dominated by the principles of the Right as argued in The Absence of War. These three plays also help to instance the wide range of techniques and forms Hare employs in his political drama from epic theatre techniques to cinematographic devices, from classical dramatic forms to novel forms of his time. Besides, the scope of the plays provides the opportunity to observe Hare’s transference from fringe theatre companies to mainstream theatres. It is concluded in this dissertation that Hare’s political drama evolves, in terms of the themes and the issues he discusses, the techniques he utilises and the theatrical venues his plays are staged, throughout three decades and under the influence of contemporary politics.Bu tezin amacı David Hare’in politik tiyatrosunun 1970’ler, 1980’ler ve 1990’ların sosyal ve siyasal şartları çerçevesinde nasıl bir evrime uğradığını açığa çıkarmak ve bu evrimi yazarın söz konusu üç döneminin her birinden belirgin bir oyunu, sırasıyla Fanshen (Devrim) (1975), The Secret Rapture (Sessiz Ölüm) (1988) ve The Absence of War (Savaşın Yokluğunda) (1993)’u inceleyerek örneklemektir. Bu amaç doğrultusunda, her bir oyun kendi döneminin siyasî şartları çerçevesinde ve yine kendi dönemindeki tiyatronun içinde bulunduğu koşullar dâhilinde incelenir. Oyunların bu şekilde bağlamsal çerçevede ele alınması, Hare’in İngiltere’de her bir on yılın genel siyasî durumunu analiz etmek için benimsediği değişken tutumları ve izlediği farklı yolları göstermede fayda sağlar. Bağlamsal çerçevenin yanı sıra, oyunların kapsamlı bir biçimde analiz edilmesi Hare’in politik tiyatro yazımının Fanshen’de (Devrim) sosyalist siyaset bahsine ve sosyalist devrim betimlemesine odaklıyken, The Secret Rapture’da (Sessiz Ölüm) sol görüşe ait değerleri sadece karakterlerin özel hayatlarının sınırları içinde göstermeyi amaçladığını ve The Absence of War’da (Savaşın Yokluğunda) kurumların – sağcı muhafazakâr değerlerin etkisi altında olsalar dahi – gerekliliğinin savunucusu haline geldiğini kanıtlar. Bu üç oyun ayrıca, Hare’in politik tiyatrosunda kullandığı epik tiyatro tekniklerinden sinemacılık tekniklerine, klasik tiyatro formlarından çağdaş formlara kadar geniş bir yelpazede bulunan tekniklerin ve tiyatro formlarının örneklenmesine de yardımcı olur. Oyunların temsil ettiği zaman aralığı da Hare’in saçak tiyatro gruplarından ana akım tiyatrolarına geçişini gözlemleme olanağı sağlar. Bu tez, sonuç olarak Hare’in politik tiyatrosunun söz konusu üç dönem boyunca tartıştığı temalar ve konular, kullandığı teknikler ve oyunlarının sahnelendiği mekânlar bağlamında ve her bir dönemin politik gelişmeleri çerçevesinde evrildiği kanısına varmıştır