NUTRITION TYPES IN HEALTHY INFANTS AND INFANT FEEDING PRACTICES OF MOTHERS: QUESTIONNAIRE STUDY

Amaç: Çalışma, ailelerin anne sütü verilmesi ve bebek beslenmesi konusundaki uygulamalarını belirlemek ve bu uygulamalar üzerine etkili olabilecek çocuk ve aile ile ilgili faktörleri araştırmak amacıyla yapıldı. Gereç ve yöntem: Çalışmaya yaşları 10-18 ay arası (ortalama:14,4 ± 0,2 ay) olan 111 bebek alındı. Çalışma, Sağlam Çocuk Polikliniği'ne aşı uygulaması veya rutin kontrol için getirilen bebeklerin annelerine anket soruları sorulması ile gerçekleştirildi. Bulgular: 52 bebeğe (%46,8) doğumdan sonra ilk yarım saatte anne sütü başlanmıştı. Ankete katılan tüm aileler ilk 24 saatte anne sütü vermeye başlamışlardı. Bebeklerin ek gıdaya başlama zamanları ortalama 5,5 ± 0,1 ay idi. İlk 4 ayda ek gıdalara başlama oranı % 19,8 bulundu. Bunların %14'üne ek gıda başlanmasını bir hekim önermişti. Ailenin ekonomik geliri ile ve annenin eğitim durumu ile anne sütüne ilk başlama zamanı, sadece anne sütü verme zamanı, ek gıdalara başlama zamanı ve inek sütüne başlama zamanı açısından anlamlı farklılık saptanmadı (p>0,05). Annelerin %80,0'i (89 anne) profesyonel destek almanın bebeklerinin beslenmesine pozitif yönde katkı sağladığını belirtti. Sonuç: Çalışmamızda anne sütü verilme oranlarının ülkemiz genel verilerinden daha iyi olması annelere bebek beslenmesi konusunda düzenli eğitim verilmesinden kaynaklanıyor olabilir. Bebek beslenme pratikleri konusunda düzenli olarak ailelere eğitim verilmesi, bebeklerin doğru beslenmesi konusunda en önemli uygulamalardan biridir. Objective: To study attidutes of the families and practices on breastfeeding and to delineate the factors affecting these attidutes and practices of parents or children. Material and method: 111 infants with a mean age of 14.4 ± 0.2 months (range 10-18 months) was studied. A questionnaire was filled by mothers of children presenting for immunization or routine health control. Results: Of the infants, 52 (%46.8) had received breastmilk within the first ½ hour after delivery. All infants had received brastmilk within the first 24 hours after delivery. Average time for initiation of supplemental feeding was 5.5 ± 0.1 months. The 19.8 % of infants had received supplemental feeding within the first 4 months. Fourteen per cent of these were adviced to do so by a physician. Monthly family income and mothers' educational status was not related to time of first breastfeeding, time of starting supplemental feeds, and time of starting cow's milk (p>0.05). Of all mothers %80 indicated that professional councelling had a positive effect on their infants nutrition Conclusion: Breastfeeding ratios in our study were higher than the national average. This may have resulted from professional councelling provided to mothers in our institution. Providing professional education on infant feeding is one of the most important factors to correct infant nutrition

Endobronchial Watanabe Spigot in the treatment of bronchobiliary fistula

Bronchobiliary fistula (BBF) is a rare condition in which an abnormal communication exists between the bile ducts and the bronchial tree. Malignancy is the most common etiology of BBF, although many others are possible. A 74-year-old male patient with an inoperable Klatskin tumor presented with a complaint of yellow-green sputum and cough; the patient underwent fiber-optic bronchoscopy based on a preliminary diagnosis of bronchobiliary fistula. Using fiber-optic rigid bronchoscopy, the laterobasal segment of the lower right lung lobe was occluded using three pieces of 5-mm Endobronchial Watanabe Spigot. Bile drainage subsequently ceased. A bronchoscopic approach provides an alternative option for BBF treatment, particularly in patients who choose not to undergo surgery, or for whom surgery is not an option due to their underlying general condition

Travel-associated Legionnaires’ Disease Affected Two Individuals from the Same Family

In this report the first two cases of travel-associated Legionnaires’ disease in Turkey were discussed. It is known that 24 and 30 years old, previously healthy sisters had stayed in a hotel in central Anatolia, just ten days before admission to the hospital with fever, cough and weakness symptoms. Their serum samples were examined by indirect fluorescent antibody assay for the presence of Legionella antibodies. In both cases Legionella pneumophila antibodies were found to be positive in high titers, as 1/256 and 1/1024 respectively

Distribution of Bacterial Enteric Pathogens Isolated from Diarrheic Children

In this study, we planned to investigate the distribution of Salmonella, Shigella, Campylobacter jejuni and the other pathogens like Vibrio cholerae O1 and O139, Aeromonas spp, enterohemorrhagic Escherichia coli (EHEC) O157:H7 and Yersinia enterocolitica in the stool samples of children in whom gastrointestinal infections are most commonly seen. For this purpose, 1200 stool samples from diarrheic and 100 stool samples from healthy children were investigated between June 1995 and October 1997. After microscopic examination, the samples were inoculated in the enrichment broths, then streaked onto selective media. The suspected colonies were then identified by the conventional biochemical methods and/or by API 20E (BioMerieux, France). Then the diagnosis of Salmonella, Shigella, V. cholerae O1 and O139, EHEC 0157:H7 were confirmed by slide agglutination tests with Difco antisera. Enteric pathogens were determined in 13.7% of the samples. The distribution of enteric pathogens were as follows: C. jejuni (72 isolates, 6%), Shigella (54 isolates, 4.5%), Salmonella (30 isolates, 2.5%), EHEC 0157:H7 (5 isolates) and Aeromonas caviae/hydrophila (4 isolates). There were no V. cholerae O1 and O139 and Y. enterocolitica isolates in our population. In one sample A. hydrophila and C. jejuni were isolated at the same time. No enteric pathogen was determined in the healthy control group. We conclude that like most laboratories in the world, Salmonella, Shigella and Campylobacter species should be investigated in routine stool cultures unless there is an additional order for the other enteric pathogens

Legionella spp. in Plumbing Systems of Hotels: A Study in Aegean and Mediterranean Coasts

In this study, the presence of Legionella spp. in hotels’ plumbing systems between July 1995 and February 1997 has been investigated in resort places of Turkey. 592 water samples from 21 hotels were analyzed all through the study. A total of 324 water specimens was collected for initial sampling. Legionella spp. strains were detected in 61% of hotels (13/21) and 17.5% of water samples (57/324). These hotels were reevaluated whether bacteria were eliminated by decontamination procedures or not. Legionella colonization was found to be still positive in five of the plumbing systems. During the study, a total of 95 isolates of Legionella spp. was isolated from 92 water samples. The most frequent isolated species was Legionella pneumophila. This is the earliest data for the prevalence of Legionnaires’ disease agent in environmental samples from the hotels in the Aegean and Mediterranean coasts of Turkey. The persistent colonization of bacterium indicates that the certain hotels might be endemic focuses for Legionnaires’ disease in our country too

Are soluble IL-2 receptor and IL-12p40 levels useful markers for diagnosis of tuberculous pleurisy?

WOS: 000350052900006PubMed ID: 25549699Background: The differential diagnostic utilities of the levels of soluble interleukin (IL)-12p40 and the IL-2 receptor in sera and pleural effusions were evaluated in patients with exudative pleural effusions. Methods: We enrolled a total of 120 patients with exudative pleural effusions. The clinical, radiological, and histopathological diagnoses were tuberculous pleurisy in 52, malignant pleurisy in 39, and parapneumonic effusions in 29 patients. Results: We measured serum IL-12p40 and adenosine deaminase (ADA) levels in patients with tuberculous pleurisy and in a control group treated for pleural effusion to determine if such levels were useful in the diagnosis of pleural effusion (p < 0.005). Definite microbiological or histopathological diagnoses of tuberculous pleurisy or pleural effusion were recorded, and we found that ADA and serum soluble IL-2 receptor levels aided in diagnosis (p < 0.001). The levels of ADA and soluble IL-2 in pleural effusions afforded sensitivities and specificities of 84.62% and 82.69% and of 70.59% and 80.88%, respectively. The soluble IL-2 receptor level afforded a sensitivity and specificity of 82.69% and 52.9%. IL-12p40 levels in pleural effusions and sera afforded sensitivities and specifi cities of 80.77% and 80.77% and of 60.29% and 39.71%, respectively. Conclusion: Soluble IL-2 receptor levels in patients with tuberculous pleurisy serve as markers of disease in non-endemic countries, similarly to ADA levels

Multidisciplinary approach in “pat pat” injuries: the role of vascular surgeon

In Turkey, farm machinery accidents are important factors for morbidity and mortality. In Western Black sea region, a specific farming toolis used, called 'Pat Pat'. In our clinic, we operated two patients with multiple lower extremity injuries occurred due to Pat Pat machines.First case had a right Gustilo-Anderson type IIIC open tibial fracture, anterior tibial artery disruption, and a left massive soft tissue defectwith popliteal nerve and artery disruption as determined by digital subtraction angiography. The second case had a right Gustilo-Andersontype IV open proximal tibial fracture, distal femoral fracture, and popliteal artery disruption. All injuries of popliteal arteries and veinsrepaired with saphenous vein interposition. On follow up, we observed that the saphenous vein grafts were thrombosed. We suppose thatvascular injuries occurred in those cases due to both penetrating and blunt mechanisms. Repeated thrombectomy was performed, and thepatency of the grafts were achieved. Heparin infusion (1000U/hour) was administered in first postoperative 24 hours, and the patientwas followed up every hour to keep activated clotting time ?200 sec. Consequently, saphenous veins of both cases were protected fromthrombosis. In conclusion, combination of penetrating and blunt trauma causing fractures and vascular injury to lower extremities can bemanaged with coordination of orthopedic, vascular and plastic surgeons. Prompt diagnosis, early intervention, heparin infusion in first 24hours and continuing with low-molecular-weight heparin results in successful management with palpable distal pulses and limb salvage inthose challenging injurie

Hatay Arkeoloji Müzesi

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2014.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by Öztürk, İbrahim Mert

Diagnostic Approches in Legionnaires’ Disease: A Clinical, Microbiological and Epidemiological Review on Cases Between 1995-2002

In this report, results of 183 cases, dispatched to our laboratory by suspicion of Legionnaires’ disease between February 1995 and July 2002, were interpreted for matching to the standard case definitions and outcomes. As diagnostic techniques, culture, direct fluorescence antibody assay, urinary antigen test, and serology were used according to the samples. Demographical, clinical and epidemiological characteristics were analyzed from the records of “Laboratory Request Log”. It is observed that the most of the cases (60.4%) were classified as community-acquired pneumonia. The 80.3% of these individuals came from the populations by having medium- and low socio-economic standards, that are controversial for the epidemiology of Legionnaires’ disease, were comprehended. The most preferred samples were urine (145) and the less preferred samples were from lower respiratory tract (52) for sending to the laboratory. Totally 6 (3.3%) cases were confirmed as Legionnaires’ disease based on positive urinary antigen test results. Four of these cases were reported as travel-associated Legionnaires’ disease based on their travel histories. Additionally 9 (4.1%) cases were classified as probable Legionnaires’ disease by serological findings. Since the clinical and radiological presentations of Legionnaires’ disease are not discriminative, definitive diagnosis requires application of specialized microbiology techniques. However, it seems that as the samples are sending to the laboratory to take into account some of the clinical and epidemiological characteristics is essential for using the time and sources effectively