Syndromic and non-syndomic cleft lip-palate: Differential features

Amaç: Dudak-damak yarığı (DDY) olan bireyler, doğumdan erişkinliğe kadar ki süreçte multidisipliner bir ekip tarafından uzun süreli takip ve tedaviye ihtiyaç duymaktadırlar. Kimi zaman DDY’li bireyler çeşitli sendromlarla ilişkilendirilmektedirler. Sendromik olan ve olmayan DDY’li olguların birbirlerinden ayırt edici özelliklerinin belirlenmesi, multidisipliner ekip elemanlarının bu olgular için doğru yönlendirme yapmalarına ve hem cerrahi hem de terapötik olarak doğru müdahalede bulunmalarına olanak sağlamaktadır. Bu çalışmanın amacı, DDY’li bireylerde sendromlarla ilişkilendirilen sağlık sorunları, periferal bulgular, genel gelişim ve dil sorunları açısından sendromu olan ve olmayan DDY’li 2 grubu karşılaştırmaktır. Gereç ve Yöntemler: Çalışmanın katılımcıları dudak-damak yarığı, submuköz damak yarığı ve velofaringeal yetmezlik sorunlarından en az birini yaşayan 0-12 yaş arasındaki bireylerden oluşmaktadır. Katılımcılar, kraniyofasiyal sendromu olan (n=19) ve herhangi bir kraniyofasiyal sendromu olmayan (n=48) olgular olarak 2 gruba ayrılmıştır. Değerlendirmeler için DudakDamak Yarığı Değerlendirme Formu, Ankara Gelişim Tarama Envanteri (AGTE) ve Türkçe Erken Dil Gelişimi Testi kullanılmıştır. Toplanan veriler IBM SPSS 25.0 yazılımı kullanılarak analiz edilmiştir. Bulgular: Her 2 grup arasında oral-periferal özellikler, sistemik tıbbi sorunlar, dil gelişimi ve genel gelişim açısından istatistiksel farklılıklar bulunmuştur. AGTE sonuçları, özellikle motor gelişim alanlarında, tavan etkisi nedeniyle klinik gözlemlerle örtüşmeyen sonuçlar vermiştir. Sonuç: Sendromik olgularda sendromik olmayanlara göre; gelişim gerilikleri, dil bozuklukları, sistemik sağlık sorunları ve periferal malformasyonlar çok daha fazla gözlenmektedir. Bu sonuçlara göre DDY ile birlikte gözlenen sistemik ve periferik sorunların varlığında dil ve konuşma terapistlerinin sendrom şüphesi ile genetik yönlendirme yapmaları önerilmektedir.Objective: Management of cleft lip and palate, especially when it is associated with craniofacial syndromes, requires long term treatments, several follow ups and multidisciplinary approach. It is necessary to differentiate between syndromic and non-syndromic cleft palate for accurate referrals, realistic goals and right surgical or educational treatments. The aim of this study is to compare individuals with syndromic and non-syndromic cleft palate in terms of systemic health problems, peripheral malformations, developmental disorders and language disorders. The purpose is to draw attention of the speech and language pathologists to the symptoms may differentiate syndromic individuals with cleft lip and palate from non-syndromic ones. Material and Methods: The participants of the study consisted of individuals aged 0-12 years who experienced at least one of the problems of cleft palate, submucous cleft and velopharyngeal insufficiency. Participants divided into two groups; with syndrome (n=19) and without syndrome (n=48). Cleft Lip and Palate Assessment Form, Ankara Development Screening Inventory, Test of Early Language Development were used for the assessments. Statistical analysis was done by SPSS and Chi Square Test was used to compare the groups. Results: We found statistical differences between two groups in terms of systemic health problems, peripheral malformations, developmental disorders and language disorders. Conclusion: The health problems which are not related with cleft lip and palate directly but accompanying it must be assessed in details and these individuals must be referral to the genetic department

Effects of vapocoolant spray prior to SC LMWH injection: an experimental study

The aim of this study was to evaluate the effects of vapocoolant spray administration prior to subcutaneous (SC) low molecular weight heparin injection on local ecchymosis, hematoma, and pain. This randomized controlled study was carried out on 64 patients (n = 128 injections) in an orthopedics and traumatology clinic. After randomization, vapocoolant spray and then heparin injection was applied on one arm. The second necessary dose of heparin was applied to his or her other arm as a placebo by a water spray. Then, the pain of the patients was assessed. After 2 days, ecchymosis and hematoma were evaluated. Significant lower pain scores were determined in applications in which the vapocoolant spray was used. There was no statically significant difference between the mean diameter values of ecchymosis in both arm groups. There was no hematoma on the injection site after injections. However, this method did not create any significant reductive effect on ecchymosis. Nurses are advised to take advantage of vapocoolant spray effects prior to SC heparin injection

Antalya

No sponso

H-Ras Oncogene Expression and Angiogenesis in Experimental Liver Cirrhosis

Background. Proto-oncogenes, particularly ras, may not only affect cell proliferation but also contribute to angiogenesis by influencing both proangiogenic and antiangiogenic mediators. The aim of this study was to investigate whether any relationship exists between ras expression and angiogenesis during diethylnitrosamine- (DEN-) induced experimental liver fibrosis. Materials and Methods. Liver cirrhosis was induced in rats by intraperitoneal injections of DEN. The animals were sacrificed 2 weeks after the last administrations and a hepatectomy was performed. Masson’s trichrome staining was used in the evaluation of the extent of liver fibrosis. The vascular density in portal and periportal areas was assessed by determining the count of CD34 labeled vessel sections. For quantitative evaluation of H-ras expression, in each section positive and negative cells were counted. Results. In fibrotic group H-ras expression was higher than that in nonfibrotic group and was more widespread in cirrhotic livers. Friedman’s test showed that there was a significant correlation between H-ras expression and VD (P<0.01). Conclusion. The results of this descriptive study reveal that H-ras expression gradually increases according to the severity of fibrosis and strongly correlates with angiogenesis

The paradox of students’ acceptance from different programs for tourism guidance postgraduate education

The Article 23 which takes place in Tourist Guide Profession Regulation states; “undergraduate, bachelor and master degree graduates of the department of Tourist Guide program and who is acquired with sufficient foreign language” opens a way to be approved for the profession. On the basis of Article 23, the aim of this study is to present a critical point of view concerning with the approvement of non-field students in Tourist Guide master degree program. A qualitative approach was preferred to evaluate the perspective of the chosen sample in accordance with the rights provided by respective regulation. Snowball sampling technique which one of the purposive sampling methods has been adopted. The data obtained by applying a semi-structured interview form upon tourism guide undergraduate and postgraduate students, academicians, and tourist guides, were subjected to descriptive analysis. The themes emerging within the scope of the opinions regarding Article 23 are: lack of education; inadequacy of education program; degeneration of profession; psychological effect on tourist guides; psychological effect on students of tourist guide department; deficiency of professional belongingness; professional insufficiency; effect on professional employment; criticism of postgraduate program; teaching academics; curriculum of education program; planning of curriculum content; postgraduate recruitment requirements; program improvement, and integration for students. While these themes present a macro perspective regarding the article in question, the themes also portray the opinions and recommendations related to postgraduate tourism guide education.Turist Rehberliği Mesleği Yönetmeliği’nde yer alan Madde 23 “üniversitelerin turist/turizm rehberliği bölümlerinin ön lisans, lisans veya yüksek lisans programlarından mezun olan ve yabancı dil yeterliliğine sahip bulunanlara” mesleğe kabul edilmenin yolunu açmaktadır. Bu maddeden yola çıkarak bu çalışmanın amacı yüksek lisans programlarına alan dışı öğrencilerin kabulüne ilişkin eleştirel bir bakış açısı sergilemektir. Söz konusu yönetmeliğin sunduğu haklar gereği seçilen örneklemin duruma ilişkin bakış açısını değerlendirmek üzere nitel araştırma yöntemi tercih edilmiştir. Amaçlı örnekleme yöntemlerinden kartopu örnekleme tekniği benimsenerek ve yarı yapılandırılmış görüşme formu kullanılarak turizm rehberliği lisans ve lisansüstü öğrencileri, turist/turizm rehberliği akademisyenleri ve turist rehberlerinden elde edilen veriler, betimsel analize tabi tutulmuştur. Madde 23’e yönelik görüşler kapsamında ortaya çıkan temalar şunlardır: eğitim eksikliği; eğitim programının yetersizliği; mesleki dejenerasyon; rehberlere yönelik psikolojik etki; rehberlik bölümü öğrencilerine yönelik psikolojik etkisi; mesleki aidiyet eksikliği; mesleki yetersizlik; meslek istihdamına etkisi; lisansüstü programına yönelik eleştiriler; eğitim veren akademisyenler; eğitim programı müfredatı; müfredat içerik planlama; lisansüstü alım koşulları; program iyileştirme ve öğrencilere yönelik entegrasyondur. Bu temalar, söz konusu maddeye ilişkin makro bakış açısı sunarken, lisansüstü rehberlik eğitimine ilişkin görüşler ve önerilerde tanımlanmıştır.No sponso

Obstrüktif uyku apnesi tan›s›nda periferik arteriyel tonometrinin de¤erlendirilmesi

Objective:Peripheral arterial tonometry (PAT) as a portable method of monitoring sleep quality is a relatively recent innovation. The aim was to compare the results of PAT and polysomnography (PSG) and to evaluate the role of PAT in diagnosing obstructive sleep apnea syndrome (OSAS). Methods: This study included adult patients who admitted to ENT clinic with OSAS complaints (excessive daytime sleepiness, snoring, and witnessed apnea), undergone sleep monitorization using PAT system (WatchPAT 200TM; Itamar Medical Ltd., Caesarea, Israel) and had single-blind, level 1 polysomnography at sleep laboratory of Chest Diseases Department. Results: For the two sleep monitoring sessions as conducted at different times: the apnea-hypopnea index (AHI) and respiratory disturbance index (RDI) values were strongly correlated between sessions (r=0.749, r=0.753; p<0.001). The oxygen desaturation index (ODI) values were very strongly correlated (r=0.861; p<0.001). When the AHI scores calculated using PAT for the patients enrolled in the trial were taken into consideration; 89.7% of the patients were correctly diagnosed with OSAS (AHI?5); for RDI calculated (RDI?5) using PAT, 100% of OSAS diagnoses were correct; for AHI values calculated with the PAT method, taking 15 as cut-off point, the sensitivity was found to be at an extremely high level of 96.1%. Conclusion: PAT and PSG values were highly correlated. This finding demonstrated that the reproducibility of the results obtained with PAT was also high. This study shows that PAT can be used as a screening test for OSAS and in a group of patients who are highly suspected for OSAS.Amaç: Periferik arteriyel tonometrinin (PAT), uyku monitörizasyonunda ta?›nabilir bir yöntem olarak kullan›m› k›smen yeni bir yöntemdir. Bu çal›?mada, PAT sonuçlar› ile polisomnografi (PSG) sonuçlar›n›n kar?›la?t›r›lmas› ve obstrüktif uyku apnesi sendromu tan›s›nda PAT’›n rolününün de¤erlendirilmesi amaçland›. Yöntem: Bu çal›?maya KBB klini¤ine OSAS ?ikayetleri (gündüz uykululuk hali, horlama ve tan›kl› apne) ile ba?vurmu? ve uyku monitörizasyonu PAT sistemi (WatchPAT 200TM; Itamar Medical Ltd., Caesarea, ‹srail) ile yap›lm›?, daha sonra Gö¤üs Hastal›klar› Uyku Laboratuvar›nda kör olarak level 1 polisomnografi uygulanm›? eri?kin hastalar dahil edildi. Bulgular: ‹ki farkl› zamanda yap›lm›? uyku monitörizasyonunda apne hipopne indeksi (AHI) ve solunum bozuklu¤u indeksi (RDI) de¤erleri yüksek oranda korele idi (r=0.749, r=0.753; p<0.001). Oksijen desatürasyon indeksi (ODI) de¤eri ise çok yüksek oranda korele saptand› (r=0.861; p<0.001). Çal›?maya dahil edilen hastalar›n AHI skorlar› PAT yöntemiyle ölçüldü¤ünde; hastalar›n %89.7’si OSAS için (AHI?5) do¤ru tan› ald›; PAT testinde, RDI’ye göre yap›lan de¤erlendirmede (RDI?5) OSAS tan›lar›n›n %100’ü do¤ru idi; PAT yöntemiyle yap›lan ölçümde AHI de¤eri için e?ik de¤eri 15 olarak kabul edildi¤inde, duyarl›l›k %96.1 olarak oldukça yüksek bulundu. Sonuç: PAT ve PSG de¤erleri yüksek oranda korele idi. Bu durum PAT ile elde edilen sonuçlar›n tekrarlanabilirli¤inin de yüksek oldu¤unu göstermi?tir. Çal›?mam›z PAT’›n OSAS’da tarama testi olarak ve yüksek oranda OSAS ?üphesi olan hasta grubunda kullan›labilece¤ini göstermektedir

S100A8 and S100A9 Positive Cells in Colorectal Carcinoma: Clinicopathological Analysis

Introduction. In colorectal carcinoma, tumoral tissues infiltrate with various immune/inflammatory cells along their invasive margins and the increased S100A8/A9 expression in these immune cells infiltrating the tumor has recently been demonstrated. We examined S100A8/A9 as a potential therapeutic target in the treatment of colorectal carcinoma. Materials and Methods. The current study included a sample of 80 patients diagnosed with CRC (30 cases with distant metastasis, 30 cases with lymph node metastasis, and 20 cases with no metastasis). Peritumoral and intratumoral S100A8 and S100A9 expressing inflammatory cells were counted in primary tumors and their metastasis and correlated with clinicopathological parameters. Results. The peritumoral and intratumoral S100A8/A9 positive cells showed no correlation with age, gender, or depth of tumor invasion. However higher counts of peritumoral and intratumoral S100A8/A9 positive cells were associated with larger tumor size, higher grade, and the presence of metastasis (P<0.05). Conclusion. Our study also found significantly higher number of S100A8/A9 positive cells in the tumor microenvironment among patients with large tumor size, high grade, and metastatic disease. Moreover, in our study, we observed that the expression in the tumor metastasis appeared similar to that of primary tumor