Relationship Between Xanthine Oxidoreductase Activity and BRCA1 Levels in Patients with Stage IIIA and IIIB Non-Small Cell Lung Cancer Being Treated with Neoadjuvant Chemotherapy

Objective: Lung cancer is the leading cause of cancer-related death worldwide. Treatment in locally advanced non-small cell lung cancer (NSCLC) is heterogeneous. The cure rates after complete surgical resections are not as good as expected. A better understanding of the biology of NSCLC might allow the selection of appropriate treatment. Only a few studies have been carried out on the prognostic value of xanthine oxidoreductase (XOR) and BRCA1 in lung cancer. Material and Methods: In this study, 35 patients with stage IIIA and stage IIIB of NSCLC were included. They were operated in Baskent Ankara and Adana hospitals and received neoadjuvant chemotherapy. The regular follow-up of all the patients was done in Baskent University Medical Oncology, Thoracic Surgery Department. The clinical and histopathological parameters (age, gender, stage, smoking history, performance status, and neoadjuvant chemotherapy), along with the immunohistochemical study of BRCA1 and XOR staining, were examined, and correlated with survival outcomes. Results: Median overall survival time was reported as 38.5 months, and 5-year survival rate was 33%. The presence of BRCA1 was positively associated with shorter overall survival in stage III lung cancer patients, who were followed up with the neoadjuvant platinum-based chemotherapy regime (p<0.05). There was no relation between XOR activity and overall survival outcomes. Conclusion: BRCA1-positive status might be prognostic in patients with Stage IIIA and IIIB of NSCLC

Evaluation of nutritional status in pediatric intensive care unit patients: The results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

Pulmonary Toxicity Secondary to Amiodarone Use

Amiodarone is an antiarrhythmic medication used for the treatment of ventricular tachycardia. In addition to unwanted effects in many tissues, one of the most important side effects of the drug is pulmonary toxicity. Toxicity may develop at any time after administration to the drug, and the risk increases depending on the dose and duration of the treatment. Clinical and laboratory findings are non-specific. In treatment, amiodarone is discontinued. In severe cases, corticosteroid therapy can be started. Here, we present the case of a patient who was followed up for two years for hypertrophic cardiomyopathy and presented to the pediatric emergency department with hemoptysis, dizziness clouding of consciousness and numb tongue. Amiodarone was used for two years to treat ventricular arrhythmia. The findings of the patient at presentation were thought to be due to amiodarone pulmonary toxicity. Amiodarone was stopped and corticosteroid therapy was initiated. Non-invasive mechanical ventilation was applied for 3 days. On the 8th day of hospitalization, the patient was transferred to the ward. The aim of this case report was to draw attention to pulmonary toxicity due to amiodarone administration

Assessment of the Prevalence of Head Lice Infestation and Parents’ Attitudes Towards Its Management: A School-based Epidemiological Study in İstanbul, Türkiye

Objective:Head lice infestation (HLI), caused by Pediculus humanus capitis, is an important public health problem worldwide, especially in primary school children. The aim of this study is to investigate HLI level, related factors, and families’ knowledge levels and attitudes about HLI in two primary schools in a relatively low socio-economic region in İstanbul.Methods:A questionnaire on HLI was developed initially and delivered to all children and parents in the school. A total of 340 primary school students, aged between 6-12, were enrolled in the study after the consent of their parents. Their hair were examined for HLI with special combs at their schools, and free anti-lice shampoos were given to parents of positive children. A total of 951 completed questionnaires were received and evaluated with chi-square test using the SPSS® 17.0 program, and the differences of p0.05).Conclusion:HLI is still a common health problem, especially in girls in primary schools. Parents are aware of the relationship between the hygiene and prevention against HLI, but low socio-economic resources seem to be important determinants. Regular combing and training activities in primary schools, in coordination with the local authorities and parents are no doubt useful in reducing the incidence of HLI among the children

Fatal encephalitis associated with novel influenza A (H1N1) virus infection in a child

A 4-year-old girl presented with fever, coughing, and vomiting; followed by unconsciousness. Magnetic resonance imaging showed hyperintense changes in the thalami bilaterally, brain stem, cerebellum, and subcortical cortex. Novel influenza A (H1N1) virus was identified by polymerase chain reaction in patient’s nasopharyngeal swab specimen. We reported a rare case of clinically severe, novel influenza A-associated encephalitis. Novel influenza A should be considered in the differential diagnosis in patients with seizures and mental status changes, especially during an influenza outbreak

Tip 1 diyabetes mellituslu çocuk ve adolesanlarda ambulatuvar kan basıncı monitörizasyonu ve serum nitrit / nitrat düzeyleri

TEZ4702Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2004.Kaynakça (1 s.) var.ix, 77 s. ; 30 cm.

Credit process and credit risk management in commercial banks

Finansal sistem içerisinde bankalar; gerek ellerinde bulundurdukları pay, gerekse üstlendikleri fonksiyonlar açısından oldukça önemli bir yere sahiptirler. Özellikle gelişen ekonomik koşullar nedeniyle bankacılık sektöründe artan rekabet ve daralan kar marjları karşısında, toplanan kaynakların kredilendirme yoluyla isabetli plase edilebilmesi günümüz bankacılığının temel problemlerini oluşturmaktadır. Bankacılık, doğası gereği, geniş ölçüde risk alınmasını gerektiren bir faaliyettir. Günümüzde bir bankanın faaliyet gösterdiği sektördeki başarısının en önemli ölçütleri arasında; maruz kaldığı riskleri ne ölçüde yönetebildiği, çalkantılı dönemlerini zarara uğramadan ne derece atlatabildiği, değişen koşullara hangi hızda ayak uydurabildiği gibi doğrudan risk yönetimi ile bağlantılı konular ön plana çıkmaktadır. "Kredilendirme" nin klasik bankacılığın temel fonksiyonlarından birisi olması nedeniyle, bankaların maruz kaldıkları en önemli risklerden biri de kredi riskidir. Bu doğrultuda, bankaların üstlendikleri kredilerdeki risk düzeyi, sahip oldukları kredilerin kalitesiyle doğrudan ilişkili olduğundan, alınacak kredilendirme kararları bankalar için stratejik önem taşımaktadır. Hayatımızın her alanında olduğu gibi, günümüz ekonomilerinin temel taşlarından biri olan bankalarda da maruz kalınan risklerin yönetilmesi konusu hayati bir öneme sahiptir. Bankalarda kredilendirme kararları alınırken, ne ölçüde titizlik gösterilirse gösterilsin, kredi riskini tümüyle ortadan kaldırmak mümkün değildir. Kredilendirme sürecinde risk; bir kredinin banka için yarattığı tehlikeyi, diğer bir ifadeyle kredinin geri dönmemesi nedeniyle bankanın uğrayacağı muhtemel zararların toplamını ifade etmektedir.Nitekim günümüzde banka kredilerinin bir bölümünün donuk hale gelmesi, bir bölümünün de tahsilinde karşılaşılan güçlükler, bu çalışmanın temel konusunu oluşturan kredi riski yönetiminin bankacılık açısından önemini somut bir şekilde ortaya koyduğu gibi, konuya güncellik de kazandırmaktadır. Banks have an important place in terms of both their share holding in the financial system and functions undertaken. The fundamental problem of banking consists of felicitous placing of collected resources by means of credit facility toward incresaing competition and narrowing profit margins in the banking sector particularly due to evolving economic conditions. Banking, by its nature, is an activity required to take risk to a large extent. Today, the subjects directly related to risk management such as to which extent it manages exposed risks, in which degree they overcome their unsettled periods without suffering loss, and at which pace they can keep up with changing conditions come into prominence among most important criteria of success of any bank in the sector it operates. One of the most important risks exposed by banks is credit risk, since "Credit Facility" is one of the basic functions of classical banking. In this direction, as risk level in credits undertaken by banks is directly related to quality of their credits, credit decisions to be taken is of strategic importance for banks. As in every area of our lives, the subject of manage risks exposed at banks being one of the cornerstones of today's economy is of vital importance. It is unlikely to completely eliminate credit risk, no matter how much diligence is shown when decisions of credit facility are taken at banks. In the process of credit facility, risk means the danger of a credit for the bank, in other words the sum of possible losses incurred by bank because of failure to return credit. Indeed, inactivity of some part of bank credits and difficulties encountered in collection of some part today are somehow revealed the importance of credit risk management, being main subject of this study, in terms of banking in concrete manner and it also provides to gain currency to the subject