Can the delta neutrophil ındex be used as a preliminary biomarker ın the evaluation of periodontal disease: a pilot study

Objective: Tissue destruction in periodontal diseases is related to inflammatory mediators in the host. However, it is unknown whether a relationship between delta neutrophil index (DNI) and neutrophil-lymphocyte ratio (NLR) in Stage 3 Grade A patients occurs. This cross-sectional study aimed to investigate the relationship between periodontal disease and DNI and NLR. Methodology: The study included 74 systemically healthy, non-smoking adults separated into 3 groups. Group 1: 26 subjects with good periodontal health, Group 2: 26 subjects with gingivitis, and Group 3: 22 subjects with Stage 3 Grade A periodontitis. After determining which group the patient will be included in, a clinical periodontal examination was made of each patient and pocket depth (PD), clinical attachment level (CAL), gingival index (GI), bleeding on probing (BOP) and plaque index (PI) parameters were measured. Venous blood samples were taken and examined with an automatic hematology analyzer for DNI, immature granulocytes (IG), NLR, C-reactive protein (CRP), procalcitonin, neutrophil count and lymphocyte count. Results: DNI, IG, CRP, and neutrophil count were observed to be highest in Group 3, followed by Group 2, and the difference between the groups in these parameters was determined to be statistically significant (p<0.001, p<0.001, p=0.046, p=0.016). DNI, IG, CRP and neutrophil count were observed to be positively correlated with periodontal parameters. Conclusion: The findings of this study support the role of DNI as a new biomarker for periodontal diseases. DNI may better reflect the systemic level of stage 3 grade A periodontitis than traditional inflammatory markers

Evaluation of the Awareness of Physicians and Dentists for the Relationship Between Periodontal Status and Systemic Diseases

Aim: It is important that physicians and dentists have knowledge about the relationship between systemic and periodontal diseases and work collaboratively when necessary. The aim of this study was to evaluate the awareness of physicians and dentists of the relationship between periodontal status and systemic diseases. Materials and Methods: A 14-item questionnaire was sent to 6974 participants via social media and e-mail. The questionnaire items were related to periodontal disease and information about diabetes, cardiovascular disease, pregnancy and medication. Responses were obtained from 167 physicians and 228 dentists, and these were compared between the groups. Results: The vast majority of participants (97%) agreed that periodontal disease is a complication of diabetes mellitus. More than half of the physicians (69%) thought periodontitis was a risk factor for cardiovascular disease. Physicians had significantly less awareness than other groups about drugs that can cause gingival growth. The awareness of physicians about possible complications of pregnancy related to periodontal disease was significantly low. Almost all of the dentists thought that the second trimester of pregnancy was the best time for dental treatments, while this rate was 40% for specialist physicians and 30% for general practitioners. Conclusion: Physicians should consider that there may be a bidirectional relationship between periodontal status and systemic diseases. For physicians and dentists to to be able to increase their awareness and update their knowledge it would be beneficial to have regular training programs and courses organize

Mikofenolat mofetil ile remisyon sağlanan steroide dirençli otoimmün hemolitik anemi

Autoimmune hemolytic anemia (AIHA) is a disease that is seen in 1/10.000 people and characterized by forming antibodies against red blood cells and degradation of these red blood cells in reticuloendothelial system. Even autoimmune diseases can accompany, it is seen usually idiopathic. Paleness due to anemia, jaundice, tachycardia, darkening in urine color, hepatosplenomegaly are frequently seen clinical findings. Clinically normochrome and normocytic anemia, reticulocytosis, polychromasia in peripheral smear, spherocytes, indirect hyperbilirubinemia and increased lactate dehydrogenase are seen. Direct coombs test is the diagnostic test. Steroids are the first line drugs in treatment. The dosage and the treatment duration is formed according to patient's clinical situation. The treatment is checked by complete blood count, reticulocyte and Coombs test. Immunosuppressor treatments are given to patients that don't respond to treatment in 4-6 weeks or less patients who has recurrence at the time of decreasing the treatment dosage of corticosteroids. In few patient, that did not respond steroids, immunosuppressive treatments are used. Here, we present a patient, who is diagnosed with AIHA that we couldn't manage remission by steroid treatment, and no response to rituxumab as an immunosuppressor, but treated successfully with microphenolat mofetil

Investigation of the Relationship between Empathy and Burnout Levels of Nursing Students

Amaç: Bu araştırma, hemşirelik öğrencilerinin empati ve tükenmişlik düzeyleri arasındaki ilişkiyibelirlemek amacı ile planlandı.Yöntem: Tanımlayıcı ve kesitsel türde gerçekleştirilen araştırmanın evrenini bir Hemşirelik Fakültesi’nde2016-2017 eğitim-öğretim yılında öğrenim gören 1294 öğrenci; örneklemini ise; tabakalı rastgeleörnekleme yöntemi ile belirlenen 290 hemşirelik öğrencisi oluşturdu. Veriler, “Yapılandırılmış SoruFormu”, “Empatik Beceri Ölçeği B-Formu” ve “Maslach Tükenmişlik Envanteri-Öğrenci Formu” kullanılaraktoplandı. Araştırmanın yürütüleceği fakülteden yazılı izin ve Etik Kurul’dan etik onay sağlandı. Veri analizi,SPSS 21.00 programında, tanımlayıcı ve önemlilik analizi kullanılarak yapıldı.Bulgular: Öğrencilerin %84.1’i kız, yaş ortalaması 20.28±1.47 yıldır. Empatik Beceri Ölçeği B-Formu puanortalaması 143.86±23.93; Maslach Tükenmişlik Envanteri-Öğrenci Formu alt boyutları puan ortalamalarıise tükenmede 15.11±4,69, duyarsızlaşmada 9.34±3.62, yetkinlikte ise 12.78±2.67 olduğu saptandı.Öğrencilerin Empatik Beceri Ölçeği puanı ile Maslach Tükenmişlik Envanteri Duyarsızlaşma alt boyutupuanları arasında istatistiksel olarak anlamlı düzeyde negatif bir ilişki bulunmaktadır (p<0.05).Sonuç: Hemşirelik öğrencilerinin tükenmişlik ve empati becerilerinin orta düzeyde olduğu ve bazı sosyodemografiközelliklerin empati ve tükenmişlik düzeylerini etkilediği belirlendi.Aim: This research was designed to determine the relationship between empathy and burnout levels of nursing students. Method: The population of this descriptive and cross-sectional research consisted of 1294 students studying at a Nursing Faculty in the 2016-2017 academic year and the sampling consisted of 290 nursing students who were selected by the stratified random sampling method. Data were collected using the “Structured Question Form”, the “Empathic Skill Scale B-Form” and the “Maslach Burnout Inventory-Student Form”. Written permission and ethical approval were obtained from the faculty where the research would be conducted. Data analysis was performed using the descriptive and significance analysis in the SPSS 21.00 program. Results: 84.1% of the students were female, and the average age was 20.28±1.47. It was determined that the mean score of the Empathic Skill Scale B-Form was 143.86±23.93, and that the mean scores of the sub-dimensions of the Maslach Burnout Inventory-Student Form were 15.11±4,69 in burnout, 9.34±3.62 in depersonalization, and 12.78±2.67 in competency. There is a statistically significant relationship between the Empathic Skill Scale score of nursing students and the Depersonalization sub-dimension score of the Maslach Burnout Inventory (p<0.05). Conclusion: It was determined that the burnout and empathy skills of nursing students were at a moderate level and that some socio-demographic characteristics affected their empathy and burnout levels

Wood-Veneer-Reinforced Mycelium Composites for Sustainable Building Components

The demand for building materials has been constantly increasing, which leads to excessive energy consumption for their provision. The looming environmental consequences have triggered the search for sustainable alternatives. Mycelium, as a rapidly renewable, low-carbon natural material that can withstand compressive forces and has inherent acoustic and fire-resistance properties, could be a potential solution to this problem. However, due to its low tensile, flexural and shear strength, mycelium is not currently widely used commercially in the construction industry. Therefore, this research focuses on improving the structural performance of mycelium composites for interior use through custom robotic additive manufacturing processes that integrate continuous wood fibers into the mycelial matrix as reinforcement. This creates a novel, 100% bio-based, wood-veneer-reinforced mycelium composite. As base materials, Ganoderma lucidum and hemp hurds for mycelium growth and maple veneer for reinforcement were pre-selected for this study. Compression, pull-out, and three-point bending tests comparing the unreinforced samples to the veneer-reinforced samples were performed, revealing improvements on the bending resistance of the reinforced samples. Additionally, the tensile strength of the reinforcement joints was examined and proved to be stronger than the material itself. The paper presents preliminary experiment results showing the effect of veneer reinforcements on increasing bending resistance, discusses the potential benefits of combining wood veneer and mycelium’s distinct material properties, and highlights methods for the design and production of architectural components

İş hukukunda uzman arabuluculuk

Alternatif uyuşmazlık çözüm yollarından biri olan arabuluculuk, esasında öteden beri var olan, özünde uzlaşma kültürünü barındıran ve geçmişimizde de uygulanan bir sistemdir. Ahilik teşkilatı 800 yıl öncesinden başlamak üzere esnaflarımız arasında barışa katkı sağla-mıştır. Ülkemizde ise 2013 yılında ihtiyari olarak uygulanmaya başlanan ve uyuşmazlıkla-rın daha az masrafla ve daha hızlı sürede çözümlenmesini sağlayan bir alternatif uyuşmazlık yöntemi olan arabuluculuğun son yıllarda farkındalığı artmış ve kullanımı yaygınlaşmıştır. 2018 yılında öncelikle iş uyuşmazlıklarında, 2019 yılında ticari uyuşmazlıklarda ve son olarak 2020 yılında tüketici uyuşmazlıklarında dava şartı sisteminin getirilmesi ile birlikte, uyuşmazlıkların taraf iradelerine uygun olarak, kazan-kazan esasına dayalı bir biçimde çö-zülmesi ve mahkemelerdeki dosya yükünün azaltılmasının yanı sıra arabuluculuğun vatan-daşlarımız ve iş dünyası nezdinde benimsenmesi sağlanarak ülkemizde uzlaşı kültürünün oluşturulmasına da önemli ölçüde katkı sunulmuştur. Öte yandan; hukuk sistemimizde dava şartı arabuluculuk sisteminin yaygınlaştırılması, uyuşmazlıkların türüne göre ilgili alanlarda uzman arabulucular desteğiyle çözümlenmesini gerekli kılmıştır. Arabuluculuk uygulamasında bir karar mercii olmamakla birlikte arabulu-cunun görev aldığı uyuşmazlık alanında uzmanlığa sahip olması, taraflar bakımından olduğu kadar arabulucunun kendisi bakımından da faydalı olacak, özellikle tarafların tıkandığı nok-tada olumlu ve yapıcı bir çözüm önerisi geliştirmesine ve arabuluculuk sürecinin anlaşma ile sonuçlanmasına yardımcı olacaktır. Bu amaçla; öncelikle iş hukukunda uzman arabulucu uygulamasına geçilmiş, iş uyuşmaz-lıklarında görev alabilmek için söz konusu alanda gerekli eğitimleri almak arabulucular için ön şart haline getirilmiştir

LIMPRINT study - the Turkish experience

Background: Lymphedema and chronic oedema is a major healthcare problem in both developed and non-developed countries The LIMPRINT study is an international health service based study to determine the prevalence and functional impact in adult populations of member countries of the International Lymphoedema Framework (ILF). Methods: 1051 patients from 8 centers in Turkey were recruited using the LIMPRINT study protocol. Data were collected using the core and module tools which assess the demographic and clinical properties as well as disability and QoL. Results: Most of the Turkish patients were recruited from specialist lymphedema services and were found to be female, housewives and having secondary lymphedema due to cancer treatment. The duration of lymphedema was commonly less than 5 years and most of them had ISL Grade 2 lymphedema. Cellulitis, infection and wounds were uncommon. The majority of patients did not get any treatment or advice before. Most of the patients had impaired QoL and decreased functionality, but psychological support was neglected. Although most had social health security access to Lymphedema centres nevertheless access seemed difficult due to distance and cost. Conclusion: The study has shown the current status and characteristics of lymphedema patients, treatment conditions, the unmet need for the diagnosis and treatment as well as burden of the disease in both patients and families in Turkey. National health policies are needed for the prevention, diagnosis and treatment in Turkey that utilise this informative data

Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

Wood-Veneer-Reinforced Mycelium Composites for Sustainable Building Components

The demand for building materials has been constantly increasing, which leads to excessive energy consumption for their provision. The looming environmental consequences have triggered the search for sustainable alternatives. Mycelium, as a rapidly renewable, low-carbon natural material that can withstand compressive forces and has inherent acoustic and fire-resistance properties, could be a potential solution to this problem. However, due to its low tensile, flexural and shear strength, mycelium is not currently widely used commercially in the construction industry. Therefore, this research focuses on improving the structural performance of mycelium composites for interior use through custom robotic additive manufacturing processes that integrate continuous wood fibers into the mycelial matrix as reinforcement. This creates a novel, 100% bio-based, wood-veneer-reinforced mycelium composite. As base materials, Ganoderma lucidum and hemp hurds for mycelium growth and maple veneer for reinforcement were pre-selected for this study. Compression, pull-out, and three-point bending tests comparing the unreinforced samples to the veneer-reinforced samples were performed, revealing improvements on the bending resistance of the reinforced samples. Additionally, the tensile strength of the reinforcement joints was examined and proved to be stronger than the material itself. The paper presents preliminary experiment results showing the effect of veneer reinforcements on increasing bending resistance, discusses the potential benefits of combining wood veneer and mycelium&rsquo;s distinct material properties, and highlights methods for the design and production of architectural components

PFAM catalyzed enantioselective diethylzinc addition to imines

Chiral amines are important starting materials for the synthesis of biologically important compounds. Enantioselective addition of dialkylzinc reagents to imines is a reliable method for the synthesis of these compounds. Different chiral catalysts were developed and used for this method. Phosphorous based PFAM catalysts were tried for the first time in the enantioselective synthesis of amines by reacting diethylzinc with N-sulfonyl imines and N-diphenylphosphinoyl imines. Chiral amines were isolated with moderate to acceptable yields and enantioselectivities