A New Approach to Surgical Gowns

Emerging diseases such as Ebola hemorrhagic fever, hepatitis B, hepatitis C, SARS, and most recently the Covid 19 epidemic have increased the importance of hygiene in the world, bringing the need for personal protective equipment (PPE) to the forefront. An important part of PPE in healthcare is surgical gowns, which are worn by doctors and nurses in the operating room to serve a dual function of preventing the transmission of microorganisms and body fluids from surgical staff to patients and from patients to staff. This chapter presents the history and importance of surgical gowns. The factors to be considered in the selection of surgical gowns are discussed. The model characteristics and fabric properties of surgical gowns currently on the market and the environmental impact of reusable and disposable gowns are outlined. Finally, shortcomings in available gowns are discussed, a new knitted surgical gown design is introduced, and recommendations are given in the final section. The chapter provides broad coverage of surgical gowns for both experienced readers and those new to the field

Validity and reliability of the assessment tool for Asthma (ATA) questionnaire: the ATA study

OBJECTIVES: A multicenter trial was designed to validate the “Assessment Tools for Asthma (ATA)” questionnaire, a newly developed questionnaire, which evaluates both asthma control and risk factors associated with asthma control with a single instrument. MATERIALS AND METHODS: This cross-sectional study involved 810 cases from 14 clinics in 9 Turkish cities. The ATA questionnaire and Asthma Control Test (ACT) were administered. The Visual Analog Scale (VAS) was used to evaluate the control status of 100 randomized cases. ATA is an eight-item physician-administered questionnaire. It comprises the following two sections-ATA1, assesses symptomatic control criteria, and the remaining section, queries the flre-up of asthma, control of comorbidities, treatment adherence, and inhaler technique. RESULTS: The mean scores for ATA1, ATA total, VAS, and ACT were 24.7±14.8, 53.8±19, 7.1±3, and 18.8±5.5, respectively. According to the ATA questionnaire, among all patients, 34.3% had controlled, 18.8% had partly controlled, and 46.9% had uncontrolled asthma. Furthermore, 16.6% patients had flre-ups between visits, 96.4% patients had uncontrolled comorbidity, 17% patients had irregular asthma treatment, and only 8.4% patients used the incorrect inhaler technique. The ATA questionnaire showed internal consistency (Cronbach’s alpha coeffiient=0.683). ACT, ATA1, and two specialists’ evaluations using VAS correlated strongly with the ATA total scores (Spearman correlation coeffiient (r) values: 0.776, 0.783, and 0.909, respectively; p-values: p<0.001, p<0.001, and p<0.001, respectively). According to Receiver Operating Characteristic analysis, the cut-off value of ATA was 50 (sensitivity=84.4%, specifiity=82.40%). CONCLUSION: The validated ATA questionnaire may be a practical tool for physicians in asthma management

Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF

The progress of configuration postmodern marketing process

Zaman ve toplumdaki değişimler, tüketicilerin de algılamalarını etkilemekte ve beklentilerini farklılaştırmaktadır. Çok hızlı ve sürekli bir değişimin her alanda kendini gösterdiği günümüzde bu değişime ve gelişime ayak uyduramayan işletmelerin rekabetçi ortamda tutunmasının zor olduğu bir gerçektir. Başarılı olmanın en önemli yolu, içinde bulunulan süreci doğru çözümlemek ve buna uygun stratejiler geliştirmektir. Değişen tüketiciye ve tüketim alışkanlıklarına, doğru stratejilere yanıt verebilmek için ortaya çıkan postmodern pazarlamada en önemli faktör marka-tüketici ilişkisini, etkili iletişim araçları ile sağlayabilmektir. Bu tez çalışmasında modernizm ve postmodernizm kavramları çerçevesinde 21. yüzyılın tüketicisinin özellikleri dikkate alınarak postmodern pazarlama kapsamında kitlesel bireyselleştirilme fikrinden yola çıkılarak postmodern pazarlama, marka yönetimi ve postmodern iletişim süreci sorgulanmıştır. Buradan çıkan sonuç şudur ki; postmodern pazarlama özgürleştirilmiş birey kavramını ortaya çıkarmaktadır. Postmodern birey; mekana bağlı olmadan hareket edebilmekte, sürekli değişebilmekte, ürün, marka ve mağaza değiştirebilmekte ve düşüncelerini özgürce ifade edebilme olanağı bulmaktadır. Gelecek döneme ?sadık müşteri? yi korumak açısından bakıldığında, markaların tüketici toplumundaki yerinin daha da önem kazanacağı düşünülmektedir. Marka-müşteri ilişkisinin temellerinin mantıksal boyuttan duygusal boyuta geçtiği açıkça görülmekte, postmodern pazarlama da tüketici olarak imaj tüketmektedir. Marka-müşteri ilişkisinin duygusal boyutlara taşınması nedeniyle postmodern pazarlamanın başarısı tüketicilerin iletişim filtrelerinin açılması ve daha çok nörolojik tabanlı iletişim yöntemlerinin ve araçlarının kullanılmasına bağlı olarak gelişeceği düşünülmektedir.Continuous changes and evolutions in daily life and societies affect the perceptions of consumers and as a result modify their expectations. The signs and effects of very fast and continuous changes are noticeable in almost every area. It is an obvious fact that no company can survive this fierce competition in case of discounting these changes. The most efficient way of succeeding is to be aware of the present circumstance and accordingly develop suitable strategies. Postmodern marketing appears to an appropriate strategy in response to changes in consumer market and consumer behaviour. Maintaining an insistent consumer - brand relationship by means of efficient communication means is an important instrument of postmodern marketing. In this study, the consumer profile in the twentyfirst century is analyzed on the bases of modernism and postmodernism concepts. By means of mass individualism, postmodern marketing, brand management and postmodern communication process are examined. The result is that; postmodern marketing is introducing the term of “ liberalized postmodern individual.” “The postmodern individual” is able to act without sticking to space, alter constantly himself, change the product, trade mark and the store and is able to use the opportunity to tell his ideas freely. Taking into consideration the conserving “loyal customer” for the next term, it is anticipated that trade marks are going to be more important in the consumer society. It is clearly seen that the basics of trade mark-consumer relationship have moved from logical dimension to the emotıonal one. ln postmodern marketing the consumer is now consuming the “ image.” In consequence of emotional dimension of trade mark-consumer relationship, the success of postmodern marketing is thought to develop depending upon consumer?s communicatıon filters being opened and using the communicatıon techniques and means mostly based on neurology

Meme Kanseri Radyoterapisinde IMRT ve Konformal Radyoterapi Uygulamaları için Tedavi Planlama Sisteminde Planlanan Doz Dağılımının Rando Fantomda Ölçülen Doz Dağılımıyla Uyumunun Araştırılması

Amaç: Bu çalışmada, meme kanseri radyoterapisinde kullanılan 3B konformal radyoterapi (3BKRT), Alan içinde alan (Field in Field, FinF) ve yoğunluk ayarlı radyoterapi (IMRT) tekniklerinin planlanan-ölçülen doz farklarının araştırılması amaçlanmıştır. Gereç ve Yöntem: Bu çalışma için su eşdeğeri bolus materyalinden meme şeklinde fantomlar (MŞF) oluşturularak, Alderson rando fantom üzerine yerleştirilmiş ve planlama amaçlı bilgisayarlı tomografisi çekilmiştir. Hedef yapı ve kritik organlar konturlandıktan sonra 3BKRT, FinF ve IMRT teknikleri için planlama (Varian Eclipse 8,6, PencilBeam) yapılmıştır. MŞF‘nın izomerkezden geçen sagital ve transvers düzlemlerine ayrı ayrı Gafchromic EBT2 filmler yerleştirilmiş ve her bir teknik için fantom ikişer kez ışınlanmıştır. İzomerkezden ve izomerkezin 1’er cm anterior-posterir, superior – inferior ve sağ-solundan geçen eksenlerden film üzerinden ölçülen dozlar aynı eksenlerde tedavi planlama sisteminden (TPS) okunan dozlarla kaşrılaştırılmıştır. Bulgular: Uygulanan tekniklerde planlanan-ölçülen doz farkı en yüksek %4.5 ile FinF tekniğinde, en az %0.05 ile IMRT tekniğinde bulunmuştur. Farkların %66.6‘sında ölçülen doz planlanandan daha yüksek bulunurken, bütün farkların %93‘ünde fark %3‘ün altında bulunmuştur. En az fark izomerkezden geçen eksenler boyunca görülürken, izomerkezden uzaklaştıkça farkın artığı bulunmuştur. Eksenlerle farklar arasında anlamlı bir ilişki bulunamamıştır. Sonuç: TPS’te hesaplanan doz dağılımları rando fantom üzerinde film ile ölçülen doz dağılımlarıyla karşılaştırıldığında, en iyi IMRT için olmak üzere her üç teknik için de uyumlu bulunmuştur

Protective effects of exercise on heart and aorta in high-fat diet-induced obese rats

We investigated the protective effects of swimming exercise on high-fat diet-induced heart and aorta damage by evaluating oxidative stress and the endothelial nitric oxide (NO) system. Sprague Dawley rats were fed either standard chow (STD, 6% fat) or high-fat diet (HFD; 45% fat) for 18 weeks, with half of the animals trained by daily swimming sessions (EXC; 1 h per day for 5 days/week) for the last 6 weeks of the experimental period and half kept sedentary (SED). Heart and aorta tissues were prepared for routine light and electron microscopy evaluation. Endothelial NOS (eNOS) and inducible NOS (iNOS) distribution in the tissue samples were examined by immunohistochemistry. Biochemical examinations, including blood serum lipid profiles, malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), and tissue NO levels were measured. Deteriorated heart and aorta morphology, increased MDA levels and iNOS-immunoreactivity (iNOS-ir), as well as decreased GSH, NO, SOD, and eNOS-ir parameters were observed in the HFD+ SED group. These morphological and biochemical parameters were ameliorated in the HFD+ EXC group. Our study revealed that obesity-induced iNOS activation and increased oxidative stress in cardiac and aorta tissues. Exercise protected the obesity-induced cardiac and aortic tissue damage by modulating oxidant/antioxidant balance via involvement of the NO system

General aspects of hypersensitivity pneumonitis in Turkey

Hypersensitivity pneumonitis prevalence rates are between 5 and 15% of the overall population exposed to known inciting antigens but a small number of cases have been reported from Turkey until now. We aimed to present a broad picture of hypersensitivity pneumonitis in Turkey, thus promoting interest in this relatively common disease in developing countries. Search engines were utilized to retrieve the cases reported from Turkey. Other published journals and meeting abstracts which have not been registered into electronic databases were manually reviewed. Twenty-two cases from 13 reports were characterized by demographics, clinical features, occupational and environmental exposures, diagnostic tools and prognostic data. The majority of the group consisted of women (68.2%) and had a positive history for contact with an avian (59%). Mean exposure period was 69 ± 77.6 months. The most common reported clinical form was chronic hypersensitivity pneumonitis (58.8%). Reticulonodular pattern was the basic pathological finding (45%). Restrictive impairments of the forced vital capacity (FVC) and carbon monoxide diffusing capacity (DLCO) of the lungs were the basic pathologies observed in pulmonary function tests. Interstitial fibrosis was the most common pathological finding (61.5%). Few cases reported with preponderance of chronic hypersensitivity pneumonitis with avian exposure from 70 million populations suggest that many hypersensitivity pneumonitis cases, especially acute forms, have been ignored. Also, hypersensitivity pneumonitis somehow appears to be a neglected occupational disease. The present situation should be considered as a common problem currently faced by developing countries and occupational groups under risk must be investigated promptly