Genç daimi dişlerde kök ucu oluşumunun devamını sağlayan tedavi yöntemi: apeksifikasyon

The process of root development in children is a very critical period that is susceptible to trauma for anterior teeth and to caries for posterior teeth. Apexification should be done for providing continuing root development if the pulp of young permanent teeth became non-vital because of trauma or caries. The purpose of treatment is the completion of root development. The materials used in apexification, their efficiency and administration protocols have been developing with the help of researches in this field. In the light of developing technology, the dentists should pursuit improvements and decide the best treatment plan for their patients. This review focuses on apexification procedure in young permanent teeth, materials and their efficiency. ÖZET Çocuklarn dişlerinde kök gelişimlerinin devam ettiği dönem, ön dişlerinin travmalara ve arka grup dişlerinin de çürüğe karşı hassas olduğu dönemdir. Enfeksiyon veya travma nedeniyle hasara uğramış genç daimi dişte pulpa canlılığını kaybederse, kök gelişiminin devamını sağlamak için “Apeksifikasyon” tedavisi yapılmalıdır. Tedavinin amacı, dişin kök gelişiminin devamını sağlamaktır. Yapılan birçok araştırma ile apeksifikasyon tedavisinde önerilen materyaller, etki mekanizmaları ve uygulama protokolü ile ilgili bilgiler artmaktadır. Diş hekimleri, gelişen teknolojiyle birlikte bu yenilikleri takip etmeli ve bu bilgilerin ışığı altında hastalarına uygun tedavi yöntemini uygulamalıdırlar. Bu derlemede, genç daimi dişlerde apeksifikasyon işlemi, kullanılan materyaller ve etki mekanizmaları sunulacaktır. Anahtar Kelimeler: Apeksifikasyon, MTA, kalsiyum hidroksit, kök hücr

Epidemiology of pemphigus in Turkey: One-year prospective study of 220 cases

Pemphigus is a group of rare and life-threatening autoimmune blistering diseases of the skin and mucous membranes. Although they occur worldwide, their incidence shows wide geographical variation, and prospective data on the epidemiology of pemphigus are very limited. Objective of this work is to evaluate the incidence and epidemiological and clinical features of patients with pemphigus in Turkey. All patients newly diagnosed with pemphigus between June 2013 and June 2014 were prospectively enrolled in 33 dermatology departments in 20 different provinces from all seven regions of Turkey. Disease parameters including demography and clinical findings were recorded. A total of 220 patients were diagnosed with pemphigus during the 1-year period, with an annual incidence of 4.7 per million people in Turkey. Patients were predominantly women, with a male to female ratio of 1:1.41. The mean age at onset was 48.9 years. Pemphigus vulgaris (PV) was the commonest clinical subtype (n=192; 87.3%), followed by pemphigus foliaceus (n=21; 9.6%). The most common clinical subtype of PV was the mucocutaneous type (n=83; 43.2%). The mean Pemphigus Disease Area Index was 28.14±22.21 (mean ± Standard Deviation).  The incidence rate of pemphigus in Turkey is similar to the countries of South-East Europe, higher than those reported for the Central and Northern European countries and lower than the countries around the Mediterranean Sea and Iran. Pemphigus is more frequent in middle-aged people and is more common in women. The most frequent subtype was PV, with a 9-fold higher incidence than pemphigus foliaceus.   </p

Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol for a randomized controlled trial

Background: Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. Methods/design The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multicenter, two-arm, international randomized controlled trial. In total, 2013 obese patients with body mass index ≥35 kg/m2 scheduled for at least 2 h of surgery under general anesthesia and at intermediate to high risk for PPCs will be included. Patients are ventilated intraoperatively with a low tidal volume of 7 ml/kg (predicted body weight) and randomly assigned to PEEP of 12 cmH2O with lung recruitment maneuvers (high PEEP) or PEEP of 4 cmH2O without recruitment maneuvers (low PEEP). The occurrence of PPCs will be recorded as collapsed composite of single adverse pulmonary events and represents the primary endpoint. Discussion To our knowledge, the PROBESE trial is the first multicenter, international randomized controlled trial to compare the effects of two different levels of intraoperative PEEP during protective low tidal volume ventilation on PPCs in obese patients. The results of the PROBESE trial will support anesthesiologists in their decision to choose a certain PEEP level during general anesthesia for surgery in obese patients in an attempt to prevent PPCs. Trial registration ClinicalTrials.gov identifier: NCT02148692. Registered on 23 May 2014; last updated 7 June 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1929-0) contains supplementary material, which is available to authorized users

Health-counselling and lifestyle changes - from a patient perspective

Introduktion. En människas levnadsvanor påverkar den egna hälsan. Idag är de största folksjukdomarna kopplade till osunda levnadsvanor. Hälsosamtal syftar till att motivera personer till att förändra osunda levnadsvanor och är en viktig uppgift i distriktssköterskans sjukdomsförebyggande arbete. Syfte. Syftet med pilotstudien är att belysa personers uppfattningar om hälsosamtalets betydelse vid förändring av levnadsvanor. Metod. Metoden bygger på induktiv kvalitativ ansats där resultatet grundas på intervjuer med fyra personer som deltagit i hälsosamtal på en vårdcentral. Intervjuerna tolkades och analyserades enligt kvalitativ innehållsanalys. Resultat. Ur analysen framkom tre kategorier. Att få stöd till förändring av levnadsvanor, Ökat välbefinnande och Att bli stärkt till att förändra levnadsvanor. Kategorin Att få stöd till förändring av levnadsvanor har fyra underkategorier: Att medvetandegöra, Kunskap, Verktyg och Betydelsen av en bra vårdrelation. Resultatet visar att hälsosamtalen utgjort ett stöd för intervjupersonerna och att de blev motiverade och stärkta till att förändra sina levnadsvanor. Diskussion. En god vårdrelation och kontinuerliga hälsosamtal ger stöd och trygghet. Att bli sedd och lyssnad på skapar en delaktighet som främjar personens självtillit vilket ger ökad kontroll över de faktorer som påverkar hälsan. Hälsosamtalet lyfter fram personens inneboende kraft, stärker och motiverar personen till förändring av levnadsvana. Hade denna pilotstudie gjorts som fullskalig studie tror vi eventuellt att en mer nyanserad bild av hälsosamtalet framkommit. Författarna är medvetna om pilotstudiens få deltagare och att det är omöjligt att dra valida slutsatser från pilotstudiens data

När skolmedicinen inte räcker till En litteraturöversikt av Komplementär och Alternativ Medicin i vården (KAM)

Inom dagens hälso- och sjukvård finns det metoder som kompletterar den västerländska skolmedicinen. Metoder som kan komma att användas när skolmedicinen inte räcker till. Genomgående för vården med Komplementär och alternativ medicin, KAM metoder är en prägling av helhetstänkande ibland även kallat holistiskt synsätt.Syftet med denna uppsats är att beskriva den befintliga forskningslitteraturen med avseende på sjuksköterskans och övriga vårdpersonalens uppfattningar om KAM samt hur KAM används inom vården.Åtta studier sammanställdes och analyserades i en litteraturöversikt för att få en överblick över kunskapsläget. Resultatet presenteras med två huvudkategorier. Kategorierna är Uppfattning om KAM och Hur KAM används i vården. Uppfattning om KAM påverkas av önskan om mer kunskap om KAM, oklar definition av KAM, varierande personligt förhållningssätt till KAM och bristande evidens hos KAM. Hur KAM används i vården påverkas av hur sjuksköterskorna och övrig vårdpersonal uppfattar det att tala med patienter om KAM samt att makt- och organisationsstrukturer är ett hinder på arbetsplatsen. I diskussionen behandlas underkategorierna att tala med patient om KAM, där det diskuteras om hur sjuksköterskorna och övrig vårdpersonal talade om KAM med patienter trots att de kände sig obekväma, sjuksköterskor och övriga vårdpersonals önskan om ökad kunskap samt makt- och organisationsstrukturer som hinder för KAM inom hälso- och sjukvården.Program: Sjuksköterskeutbildnin

Genç daimi dişlerde kök ucu oluşumunun devamını sağlayan tedavi yöntemi: apeksifikasyon

&lt;p&gt;The process of root development in children is a very critical period that is susceptible to trauma for anterior teeth and to caries for posterior teeth. Apexification should be done for providing continuing root development if the pulp of young permanent teeth became non-vital because of trauma or caries. The purpose of treatment is the completion of root development. The materials used in apexification, their efficiency and administration protocols have been developing with the help of researches in this field. In the light of developing technology, the dentists should pursuit improvements and decide the best treatment plan for their patients. This review focuses on apexification procedure in young permanent teeth, materials and their efficiency.&lt;/p&gt; &lt;p&gt;&lt;strong&gt; &lt;/strong&gt;&lt;/p&gt; &lt;p&gt;&lt;strong&gt;ÖZET&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;Çocuklarn dişlerinde kök gelişimlerinin devam ettiği dönem, ön dişlerinin travmalara ve arka grup dişlerinin de çürüğe karşı hassas olduğu dönemdir. Enfeksiyon veya travma nedeniyle hasara uğramış genç daimi dişte pulpa canlılığını kaybederse, kök gelişiminin devamını sağlamak için “Apeksifikasyon” tedavisi yapılmalıdır. Tedavinin amacı, dişin kök gelişiminin devamını sağlamaktır. Yapılan birçok araştırma ile apeksifikasyon tedavisinde önerilen materyaller, etki mekanizmaları ve uygulama protokolü ile ilgili bilgiler artmaktadır. Diş hekimleri, gelişen teknolojiyle birlikte bu yenilikleri takip etmeli ve bu bilgilerin ışığı altında hastalarına uygun tedavi yöntemini uygulamalıdırlar. Bu derlemede, genç daimi dişlerde apeksifikasyon işlemi, kullanılan materyaller ve etki mekanizmaları sunulacaktır.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Anahtar Kelimeler: &lt;/strong&gt;Apeksifikasyon, MTA, kalsiyum hidroksit, kök hücre&lt;/p&gt

Utilization of electrostatic precipitators for healthy indoor environments

A healthy and comfortable indoor environment is the most basic requirement of human beings. The importance of indoor air quality has been increasing day to day. Although ventilation systems have an essential role in improving indoor air quality, it is inevitable to clean the particulates, microorganisms and pollutant gases in the outside fresh air before being transferred to the indoor environment. Electrostatic precipitators are commonly used for collecting particles mostly in industrial plants. This paper presents a review of electrostatic filtration technology. In this study, theoretical and technical developments of electrostatic precipitators, design parameters that effect filtering performance, advantages, challenges, and limitations are discussed

Urban Resilience and Ecosystem Services: How Can Be Integrated in the Case of Istanbul - Sultanbeyli District?

As estimated by UN, in 2030, 95 % of population growth will result from urban areas while a few metropolitan areas of rapidly growing developing countries will absorb much of this growth. Due to the accelerated urban growth and uncontrolled urban dispersion through naturally significant areas, sustainable urban growth management becomes a critical urban development policy for the global agenda. Istanbul has been attracting much of the internal migration with a dramatic urban growth process since 1950s and Istanbul Province, with over 12 million people, in 2010 is the most populated city of Turkey. Sultanbeyli, as a unique case for informal housing development in Istanbul, expanded like mushrooming after 1980’s and located itself on the largest drinking water source of Istanbul: the Omerli Watershed. The population of Sultanbeyli District grew from 82,298 (1990 census) to 272,758 people (2007 census) (TUIK, 1990;2007): more than threefold increase in less than two decades with consequent environmental degradation, uncontrolled ground water pumping, lack of drinking and waste water infrastructures. These endanger the well-being of the environment and of the society. On the other hand, the serious poverty problem is the main concern in Sultanbeyli for urban resilience (UR) which can be defined as the degree to which cities are able to tolerate alteration before reorganizing around a new set of structures and processes and which can be measured by how well a city can simultaneously balance ecosystem services (ES) and human functions (Resilience alliance, 2007). This paper aims to discuss how to integrate ecosystem services and resilience theory which will be essential to resolve the problems reflected by social, economic and administrative characteristics of Sultanbeyli District to enhance its urban resilience capacity in Istanbul

Learning Probabilistic Discriminative Models of Grasp Affordances under Limited Supervision

peer reviewe

Apelin: A new biomarker in fatty liver disease

Apelin is a peptide known for its insulin-sensitizing effect. This study aimed to examine the relationship between apelin and fatty liver disease. Non-diabetic patients were evaluated by ultrasound in this prospective, single-center, case-control study between 1 April 2020 and 1 April 2021. Serum apelin levels were measured, and the relationship with ultrasonography results and degree of hepatosteatosis was examined. Statistical analysis was carried out using NCSS 2007. This study was conducted with 80 non-diabetic participants, 53 females and 27 males. The mean age of the cases was 40.55 +/- 13.82 (interquartile range = 27-51) years, and their mean body mass index (BMI) was 29.34 +/- 7.44 (interquartile range = 23.4-35.2) kg/m(2). There was no hepatosteatosis according to ultrasound in 42% (n = 34) of the cases. When patients with or without hepatosteatosis were compared, there was no difference in terms of gender, alanine aminotransferase (ALT), and hemoglobin levels, whereas fasting blood glucose (FBG), HOMA-IR, triglycerides, LDL-cholesterol, BMI, creatinine, and age were higher in the group with hepatosteatosis. Apelin was found to be lower in patients with non-diabetic hepatosteatosis than in those without hepatosteatosis (p = .001). As the degree of fatty liver increased, the apelin level decreased further. There was also a negative correlation between apelin and age. However, the relationship between apelin and hepatosteatosis was independent of age. In non-diabetic patients with fatty liver disease, compared to those without fatty liver disease, serum apelin level was lower and was negatively correlated with the degree of steatosis, independent of age