Severe iron overload and hyporegenerative anemia in a case with rhesus hemolytic disease: therapeutic approach to rare complications

A 33 weeks’ gestation, a baby with rhesus hemolytic disease (RHD), who had received intrauterine transfusions twice, developed cholestatic hepatic disease and late hyporegenerative anemia. Her serum ferritin and bilirubin levels increased to 8842 ng/ml and 17.9 mg/dl, respectively. Liver biopsy showed cholestasis and severe iron overload. Treatment with recombinant erythropoietin (rHuEPO) decreased the transfusion need, and intravenous deferoxamine resulted in a marked decreased in serum ferritin levels and normalization of liver function. In patients who have undergone intrauterine transfusions due to RHD, hyperferritinemia and late hyporegenerative anemia should be kept in mind. Chelation therapy in cases with symptomatic hyperferritinemia and rHuEPO treatment in cases with severe hyporegenerative anemia should be considered

KÖPRÜÖREN HAVZASI (KÜTAHYA) SU KAYNAKLARININ ÇEVRESEL İZOTOPLAR İLE İNCELEMESİ

Bu çalışmada Kütahya Köprüören Havzası’nda bulunan su kaynaklarının izotopik özellikleri ortaya konulmuştur. İncelenen örneklerin δ18O ve δD içerikleri sırasıyla kurak dönemde -10.84‰ ile -7.09‰ ve -73. 6‰ ile -53.3‰ arasında, yağışlı dönemde ise -10.81‰ ile -4.71‰ ve -73.3‰ ile -41.5‰ arasında değişmektedir. Örneklerin çoğu Küresel Meteorik Su Doğrusu üzerinde olduğu halde bazıları bu doğrudan sapma göstermektedir. Bu sapmanın nedeni söz konusu örneklerin δ18O ve δD imzalarının buharlaşma ile değişmiş olmasına bağlanmıştır. Termal su örnekleri için su-kayaç etkileşiminin örneklerin δ18O içeriğinde değişikliğe neden olmadığı belirlenmiştir. Bunun nedeni sıcak su örneklerinin kuyubaşı ve rezervuar sıcaklıklarının düşük olmasına bağlanmıştır. Örneklerde belirlenmiş trityum içerikleri yağışlı dönemde ~0 ile 6 TU, kurak dönemde ise ~0 ile 8 TU arasında değişmektedir. Buna göre, yeraltısuyu örneklerinin bazıları güncel yağışlar ile beslenmiş, akiferde uzun süre kalmamış, sığ dolaşımlı sulardır. Bunun yanı sıra, düşük trityum içeriğine sahip örnekler (sıcak sular ve iki adet yeraltısuyu örneği) akifere nükleer denemeler öncesinde girmiş, nispeten uzun dolaşımlı sulardır. Bu örneklerin yeraltında kalış süresi ile ilgili daha detaylı bilgiye sahip olunabilmesi için δ13C ve 14C’den yararlanılmıştır. 5 örnekte belirlenmiş δ13C ve modern karbon içerikleri sırasıyla -5‰ ile -14.6‰ ve 8.2 ile 78 pmc arasında değişmektedir. Bu örnekler için karbonat çözünmesine karşı düzeltilmiş 14C yaşlarına göre suların yeraltında kalış süreleri günümüzden 11500 yıl öncesine kadar uzanmaktadır. Dolayısıyla, havzada derin dolaşımlı ve yaşlı suların (paleo su) varlığından bahsedilebilir. δ13C verilerine göre sıcak suların 14C konsantrasyonları su-kayaç etkileşimi sonucunda seyrelmiştir

Kompleks akifer sistemlerinde beslenim ve boşalım mekanizmalarının çevresel izotoplar ve asal gazlar aracılığıyla belirlenmesi.

This study aims to determine the recharge, discharge and the mixing mechanisms of a complex aquifer system located above the Kazan trona ore field using the environmental isotopes of deuterium, oxygen-18, carbon-13 and carbon-14, chlorofluorocarbons (CFC- 11, CFC-12 and CFC-113) and the noble gas isotopes (He, Ne, Ar, Kr and Xe). The groundwater system consists of three different aquifers: shallow, middle and deep. The Akpınar formation lying between deep and middle systems acts as an aquitard. Oxygen-18 and deuterium data showed an isotopic contrast between the shallow and deeper aquifer systems and even between the unconfined and confined parts of the middle and deep aquifers. The Noble gas temperatures indicated the average yearly air temperatures in shallow aquifer system whereas the recharge temperatures came out to be lower than todays in deep groundwater system. This finding is also supported by the dissolved inorganic carbon’s radiocarbon activities being close to the detection limits in the same system. These activities together with the stable isotope data revealed there might be evidence of recharge to the middle and deep aquifer systems under colder climate conditions during the late Pleistocene. CFC concentrations indicated modern recharge to the shallow aquifer system, whereas the concentrations were close to the detection limits therefore CFC’s were unable to date the middle and deep aquifer systems however proved the existence of modern recharge to this system. Mantle-He escape to shallow aquifer system is believed to be along a deep buried fault system located in downgradient areas.Ph.D. - Doctoral Progra

Evaluating the effects of functional orthodontic treatment on mandibular osseous structure using fractal dimension analysis of dental panoramic radiographs

Objective: To evaluate the effects of functional appliance treatment on mandibular trabecular structure using fractal dimension (FD) analysis of dental panoramic radiographs.Materials and Methods: This study was conducted using digital panoramic radiographs of 45 patients with Class II malocclusion treated with functional appliances (treatment group, mean age: 11.39 +/- 0.97 years; 23 girls, 22 boys) acquired before (T-0) and after (T-1) treatment and the panoramic radiographs of 45 control subjects who had undergone no orthodontic treatment (control group, mean age: 11.31 +/- 0.87 years; 23 girls, 22 boys). FD values in the condylar process, mandibular corpus, and mandibular angle were analyzed from the panoramic radiographs of both groups.Results: Analysis of changes in FD between T-0 and T-1 revealed significant increases in the FD values of the right and left condylar processes and right mandibular corpus in the treatment group (P<.001) and in the right condylar process in the control group (P<.05). Between-group comparisons demonstrated that the treatment group showed greater changes in the condylar process (right, P<.001; left, P<.05) and right mandibular corpus (P<.05) compared to controls. Correlation analysis between the cephalometric and FD changes in the treatment group showed the right condylar process changes were negatively correlated with GoGn/SN angle (P<.05) and positively correlated with Co-Go (P<.05), although these correlations were weak.Conclusions: FD analysis demonstrated significant changes in trabeculation of the condyle and mandibular corpus in the treatment group compared to the control group. Functional appliance treatment may lead to skeletal correction by altering skeletal form and trabeculation of the mandibular bone

Effects of hand massage and therapeutic touch on comfort and anxiety living in a nursing home in Turkey: a randomized controlled trial

WOS:000519150900024 PubMed ID: 30982141This study was carried out to investigate the effects of hand massage and therapeutic touch on comfort and anxiety in the elderly living in nursing homes. The study was designed as a randomized controlled, experimental study (with a pre- and posttest control group). The study population comprised 255 older people aged 65-89 living in a nursing home in Izmir, a province in Turkey. The study sample included 30 older patients, who were assigned to hand massage (HM) (n = 10), therapeutic touch (TT) (n = 10) and control (C) (n = 10) groups. Of the elderly who participated in the study, 50% were female and 80% were single. It was determined that TT and HM decreased the anxiety and increased the comfort levels of the elderly living in the nursing home (p < 0.05). It is thought that nurses can easily integrate HM and TT which are non-medical, non-pharmacologic interventions with no adverse effects into care activities

İŞTAHSIZ ÇOCUĞA YAKLAŞIMDA, GÜNLÜK KALORİ VE PROTEİN ALIMININ DEĞERLENDİRİLMESİ

Genel olarak antroponometrik verileri standartlara uygun çocuklar, malnutrisyonları olmayan sağlıklı çocuklar olarak değerlendirilir