Contribution of city councils to the local democracy: a research on city councils

Kent konseyleri, yerelde demokratik katılımın sağlanması, kentsel bilincin geliştirilmesi, kentin temel sorunların çözülmesinde ortak aklın oluşturulması, hemşeri ve kentli haklarının geliştirilmesi, kent kaynaklarının etkili ve verimli kullanılmasına katkı sağlaması, kentin hem sorunlarını çözmede hem de gelecek ile ilgili stratejik planların yapılmasında kentte ortak aklın oluşmasına yardımcı olmak amacıyla kurulmuş gönüllülük esasına dayanan yerel meclislerdir. Yerelde Belediye yönetimine hemşerilerin katılımına imkân veren kent konseyleri, bu temel hedeflerin hangi düzeyde gerçekleştirildiğinin ve demokrasiye olan katkısının ortaya çıkartılıp araştırılması, çalışmanın temel hedefini oluşturmaktadır. Araştırmanın amacına uygun olarak, kent konseylerinin yerel demokrasi üzerindeki etkisini ölçmek için örneklemdeki kent konseyleri ile anket çalışması yapılmıştır. Çalışma örneklemini, Türkiye’deki kent konseylerini kapsamaktadır. Çalışma sonucunda kent konseylerinin yerel demokrasiyi güçlendirdiğine, ancak kent konseylerinin kent ile ilgili almış olduğu kararların belediyelerce dikkate alınmadığı görülmüştür.City councils are local parliaments based on volunteer work and are constituted in order to support participation to local democracy, develop a civic consciousness, generate a common sense while solving basic problems of the city, develop the right of town-dwellers and townsman, to contribute to the usage of city sources effectively and productively and help to form a common sense while both solving the city problems and making strategical plans related to the future. City councils, which enable the townsmen to participate in the local municipality administration is the main purpose of this study by searching of the realization degrees and its contribution to the democracy. According to the aim of the study, a survey has been performed with exemplary councils in order to me a sure the effect of city councils on local democracies. The sample of research includes the metropolitan city councils in Turkey. As a result of the study, it was seen that city councils strengthened local democracy, but the decisions of city councils regarding the city were not taken into consideration by the municipalities

Bronşektazide Cerrahi Öncesi ve Sonrasında Uygulanan Pulmoner Rehabilitasyon Yöntemleri

Bronşektazi balgam üretimi ve tekrarlayan enfeksiyonla birlikte havayolunun kalıcı genişlemesi durumudur. Bronşektazide cerrahi artık çok sık uygulanmamaktadır. Fakat maksimal ilaç tedavisiyle kontrol altına alınamayan lokalize bronşektazide cerrahi düşünülmektedir. Cerrahi öncesi aktif ve akut enfeksiyon antibiyotiklerle ciddi şekilde tedavi edilmelidir. Komple bakterial eradikasyon imkansız olmasına rağmen, antibiyotik tedavinin amaçları balgamın volümünü ve rengini azaltmaktır. Bu yüzden pürülan ve bol balgamlı hastalarda göğüs fizyoterapisi ve antibiyotikler balgam volümü minimum olana kadar ve rengi mukoid olana kadar devam edilmelidir. Bu minimum 2 haftayı almaktadır. Daha sonra bu hastalar cerrahi öncesi 2 gün yoğun göğüs fizyoterapisi ve vibratör masajlı postüral drenaj programına alınmalıdırlar. Buna postoperatif dönemde de devam edilmelidir. Proflaktik antibiyotiklere de başlanmalı ve postoperatif 48 saate kadar verilmelidir. Bronşektazi cerrahisi sonrası tedavi akciğer rezeksiyonu geçiren hastalarla aynıdır. Erken mobilizasyon, agresif pulmoner temizlik, göğüs fizyoterapisi ve beslenme önemlidir. Bronşektazili hastaların egzersiz kapasitesi ve yaşam kalitesi azalmaktadır.  Pulmoner rehabilitasyon bu sorunları azaltabilmektedir.  Bronşektazi cerrahisi sonrası hastalara, standart akciğer rezeksiyonundan sonra uygulanan tedavi yöntemleri uygulanmaktadır. Erken mobilizasyon, agresif pulmoner temizlik, göğüs fizyoterapisi ve beslenme desteği önemli konulardandır. Operasyon öncesi ve sonrası uygulanan pulmoner rehabilitasyon programı; egzersiz ve inspiratuar kas eğitimini, ventilasyonu arttıran teknikleri, hava yolu temizleme tekniklerini ve hasta eğitimini içermektedir

Evaluation of Sleep Quality in Patients with Lung Resection

Objective: The purpose of this study was to evaluate the sleep quality of patients with lung resection by posterolateral thoracotomy and to determine the factors affecting sleep. Materials and Methods: This study was carried out between May 2017 and August 2017 in the chest surgeon clinic and 70 patients between the ages of 18-75 who were admitted to surgery with posterolateral thoracotomy were taken. Data were collected using the Personal Information Form, a Form of Factors Affecting Sleep Pattern (FFASP) and the Pittsburg Sleep Quality Index (PSQI). Data analysis was performed at 95% confidence interval using number, percent, mean, standard deviation, Student t-test, paired t-test, Mann-Whitney U, Kruskal-Wallis, One-Way ANOVA and p<0.05 was considered significant. Results: A total of 70 patients participated in the study. The mean age of the patients was 56±9.84. FFASP score average 82.84±4.61; The mean PSQI score was found to be 8.54±0.30. Differences in personal and surgery characteristics of the patients did not significantly affect the FFASP and PSQI score averages (p>0.05). The factors that most affect sleep quality were the excessively bright room, the pain, the heat of the room and the lack of air. Conclusion: Patients with lung resection with posterolateral thoracotomy are experiencing intensive sleep problems after surgery. Sleep quality of patients should be determined after surgery, sleep pattern changes should be identified, evaluations should be performed to evaluate the patient’s sleep adequacy

Acute respiratory distress syndrome and mechanical ventilation strategiesAkut solunum sıkıntısı sendromu ve mekanik ventilasyon stratejileri

Acute respiratory distress syndrome is the greatest cause of acute respiratory failure. Progression of the syndrome causes short and long term complications such as increase in mortality rate, physical and cognitive impairment. Therefore, It is very important to recognize this syndrome earlier and start therapeutic applications. Despite the fact that pathophysiology is largely known, a well-accepted and definitive method of treatment is still undefined. The positive results of low tidal volume ventilation have been proven. In this article; current concepts for Acute respiratory distress syndrome are defined. In particular, new definitions of Acute respiratory distress syndrome, risk factors and recent validated ventilation strategies have been discussed.Extended English summary is in the end of Full Text PDF (TURKISH) file. ÖzetAkut solunum sıkıntısı sendromu akut solunum bozukluğunun en büyük nedenidir. Sendromun ilerlemesi mortalite hızında artışa,  fiziksel ve kognitif bozukluk gibi kısa ve uzun dönem komplikasyonlara neden olmaktadır. Buyüzden bu sendromun erken tanınması ve tedavi edici uygulamalara başvurmak oldukça önemlidir. Patofizyoloji büyük oranda bilinmesine rağmen kabul görmüş kesin bir tedavi yöntemi hala tanımlanamamıştır. Düşük tidal volüm ventilasyon uygulamasının olumlu sonuçları kanıtlanmıştır. Bu derlemede; Akut solunum sıkıntısı sendromu için yapılan güncel kavramlar tanımlanmıştır. Özellikle Akut solunum sıkıntısı sendromunun yeni tanımları, risk faktörleri ve son geçerli kabul görmüş ventilasyon uygulamaları tartışılmıştır.

Changes in Orbicularis Oris Superior and Masseter Muscle Activities After Upper Incisor Protrusion in Class II Division 2 Malocclusion: An Electromyographic Study

Objective:This prospective study aimed to evaluate the orbicularis oris superior and masseter muscle activity changes after upper incisor protrusion in CII/2 malocclusion.Methods:A total of 20 patients (mean age 10.29 ± 0.90 years) with CII/2 malocclusion were selected for the study group. A total of 15 patients (mean age 10.56 ± 1.06 years) with Angle Class I malocclusion were recruited as control. Upper incisors were protruded with utility arch in the study group. Muscle activities were evaluated with Biopac MP150 surface electromyography device before and after upper incisor proclination and at the 6-month retention. Orbicularis oris superior and left–right masseter muscles were recorded during rest electromyography and maximum contraction electromyography. Repeated measures and two-way repeated-measures analysis of variance with Bonferroni correction were used for statistical analysis.Results:A significant change occurred over time in orbicularis oris superior (P 0.05. In the CII/2 group, orbicularis oris superior maximum contraction electromyography value was increased after upper incisor protrusion and this increase remained stable. Left masseter and right masseter maximum contraction electromyography measurements were decreased after protrusion and then increased after retention significantly. Rest electromyography values for all muscles were not statistically significant. No significant differences with the control group were found.Conclusion:Upper incisor protrusion increased orbicularis oris superior activity and the increase remained stable after retention. Masseter activities decreased after protrusion and then increased to the initial values. These changes did not show significant differences with the control group

Leptospirosis: twelve Turkish patients with the Weil syndrome

Twelve cases of leptospirosis followed by the Infectious Diseases Clinic of the Cukurova University Medical School, Adana, Turkey, between January 1994 and November 1995 are reported. Included are their clinical manifestation, laboratory findings and serotype. Nine men and three women with an average age of 40.4 years were studied. Symptoms, clinical manifestations, laboratory findings and treatment of the disease are evaluated. All of the patients had fever and chills and the following symptoms: nausea and vomiting (91.6%), lower back pain and myalgia (58.3%), headache (50%), epistaxis (16.6%) and confusion (25%). The predominant clinical findings were jaundice (91.6%), hepatomegaly (41.6%), dyspnea (25%), conjunctival suffusion (33%), and nuchal rigidity (33%). Diagnosis was based on dark-field examination of the blood, cerebrospinal fluid and urine specimens. Also, microscopic agglutination tests (MAT) were carried out for serodiagnosis. MAT showed L. inter-rogans serovar icterohaemorrhagiae in 11 cases and L. interrogans serovar grippomosocova in one case. There was cross reaction with L. biflexa patoc in all cases. Agglutinations were tested in the same specimens twice and confirmed in the Microbiology Laboratory of the Etlik Veterinary Research Institute in Ankara. All cases were treated with penicillin and doxycycline. In the end; 83.3% of the patients were cured and 16.6% died due to hepatorenal failure.</p

Characterization of greater middle eastern genetic variation for enhanced disease gene discovery

The Greater Middle East (GME) has been a central hub of human migration and population admixture. The tradition of consanguinity, variably practiced in the Persian Gulf region, North Africa, and Central Asia1-3, has resulted in an elevated burden of recessive disease4. Here we generated a whole-exome GME variome from 1,111 unrelated subjects. We detected substantial diversity and admixture in continental and subregional populations, corresponding to several ancient founder populations with little evidence of bottlenecks. Measured consanguinity rates were an order of magnitude above those in other sampled populations, and the GME population exhibited an increased burden of runs of homozygosity (ROHs) but showed no evidence for reduced burden of deleterious variation due to classically theorized ‘genetic purging’. Applying this database to unsolved recessive conditions in the GME population reduced the number of potential disease-causing variants by four- to sevenfold. These results show variegated genetic architecture in GME populations and support future human genetic discoveries in Mendelian and population genetics

Sources of metal pollution in the urban atmosphere (A case study: Tuzla, Istabul)

In this study, Istanbul-Tuzla Region atmosphere was selected as the working area for atmospheric pollution. Although the study area seems too local, this region contains shipyards and shipyard-related side product industries. It is also surrounded by aluminum (ASSAN) and copper (SARKUYSAN) facilities and tannery organized industrial district. For determined the atmospheric inputs, the sample collection was carried out as monthly in 2010. Particulate matter was filtered from aerosols via a high volume air sampler. The collected 46 ambient air samples were analyzed for Cr, Fe, Cu, Zn, Cd, Pb and Al using Atomic Absorption Spectrometry (AAS), Flame unit. Additionally, the volume of the air was drawn and meteorological data recorded