İleri Evre Gastrointestinal Kanserli Hastalarda Fibrin ile İlişkili Yeni Bir Biyobelirteç Olan Serum DR-70 Düzeyinin Prognostik ve Prediktif Değeri

Amaç: DR-70, kandaki fibrin yıkım ürünlerini tespit eden yeni geliştirilmiş bir testtir. Bu çalışmada ileri evre gastrointestinal (GI) kanserlerde DR- 70’in tedavi yanıtını izlemedeki etkinliğini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmaya farklı serilerdeki sistemik tedaviler ile tedavi edilen ileri evre GI kanserli hastalar dahil edildi. Görüntüleme çalışmaları, DR-70 ve geleneksel tümör belirteçleri [karsinoembriyonik antijen (CEA), karbonhidrat antijeni (CA) 19-9] başlangıçta ve tedavinin üçüncü ayında tekrarlandı. Bulgular: Çalışmaya kolorektal (%52,1), özofagogastrik (%32,4) ve pankreatikobiliyer kanser (%15,5) tanısı konan toplam 142 hasta alındı. Hastaların çoğu birinci basamak tedavi alıyordu (%56,3). Hastaların %57’sinde ikinci kan örneği alındı. Özofagogastrik kanseri olan hastalarda, DR-70 yanıtı tedavi yanıtı ile iyi korelasyon gösterdi (p=0,007) ve başlangıçta düşük serum DR-70 düzeyi, daha uzun genel sağkalım ile anlamlı şekilde ilişkiliydi (p=0,02). Kolorektal kanserli hastalarda tedavi öncesi DR-70 ile CEA düzeyleri arasında pozitif fakat zayıf bir korelasyon (p=0,03, r=0,244) varken, tedavi öncesi DR-70 ile CA 19-9 arasında özofagogastrik ve pankreatikobilier kanserlerde orta düzeyde pozitif bir korelasyon vardı (sırasıyla p=0,01, r=0,402 ve p=0,04, r=0,515). DR-70 konsantrasyonunda %25’ten fazla azalma, daha iyi genel ve progresyonsuz sağkalım ile ilişkiliydi. Sonuç: DR-70, özellikle özofagogastrik kanserde tedaviye yanıtı ve sağkalımı ön gören güçlü bir belirteçtir

Diagnostic utility of the neutrophil-lymphocyte ratio in patients with acute mesenteric ischemia: A retrospective cohort study [Akut mezenterik iskemili hastalarda nötrofil-lenfosit oranının tanısal yararı: Geriye dönük kohort çalışma]

BACKGROUND: Acute mesenteric ischemia (AMI) remains fatal in 50-70% of cases. AMI is recognized as a vascular emergency, requiring rapid and efficient clinical evaluation and treatment. In the present retrospective study, the possible utility of the neutrophillymphocyte ratio (NLR) in the early diagnosis of AMI was explored. The potential use of this ratio to distinguish AMI from non-vascular bowel necrosis (NVBN) was investigated. METHODS: A total of 58 AMI, 62 NVBN, and 62 control patients were enrolled between May 1, 2010 and April 30, 2015. Patients who underwent laparotomies and/or bowel resections to treat AMI were included, as were NVBN patients who underwent segmental bowel resection to treat incarcerated and strangulated hernias. Controls were patients who presented to the emergency room with non-specific abdominal pain. RESULTS: Mortality rate was 51.7% in the AMI and 4.8% in the NVBN groups. White blood cell (WBC) count, C-reactive protein (CRP) level, and red cell distribution width (RDW) were highest in the AMI group. NLR was higher in the AMI and NVBN groups than in the control group (p<0.001), though no difference in NLR was found between the AMI and NVBN groups. In addition, WBC count, CRP level, and NLR were higher in the NVBN group than in the controls (p<0.001). CONCLUSION: We suggest that preoperative NLR aids in the diagnosis of AMI, and can be used to distinguish this condition from NVBN. NLR should be calculated, in addition to clinical examination. © 2016 TJTES

A prospective clinical study of the effects of the physical features of the appendix on perforation [Apendiksin fiziksel özellklerinin perforasyon üzerine etkileri: İleriye yönelik klinik çalışma]

BACKGROUND: Acute appendicitis (AA) is one of the most common surgical emergencies, whosepostoperative morbidity and mortality increase significantly when the appendix perforates. The identification of factors that lead to perforation in these patients might effectively reduce morbidity. In this study, factors associated with perforation in AA were examined. METHODS: The study included sixty patients divided into equal non-perforated and perforated groups. Preoperative body mass index (BMI) and prehospital delay of the patients, the appendix location, presence of fluid or abscesses during surgery, and the appendix wall thickness, root and end diameters, and length in the surgery specimen were compared. RESULTS: The patients were comprised of forty males and 20 females, with a median age of 27 (range 16–84) years. BMI was significantly higher in the perforated group than the non-perforated group (p=0.039). There was no difference between the groups in terms of the presence of fluid (p=0.792); the presence of abscess was higher in the perforated group (p=0.017). The most common location of the appendix was retrocecal in the perforated group (p=0.007). While there was no difference in the appendix end diameter, root diameter was significantly higher in the perforated group (p=0.041), as were wall thickness (p<0.001) and appendix length (p=0.037). CONCLUSION: BMI, prehospital delay, a retrocecally positioned appendix, presence of an abscess, and appendix wall thickness, root diameter, and length are risk factors for perforation in AA. © 2015 TJTES

Beneficial effects of garlic (Allium sativum) oil in experimental corrosive esophageal burns effects of garlic oil in esophageal burns [Deneysel korozif özefagus yanıklarında sarımsak yağının (Allium Sativum) yararlı etkileri]

BACKGROUND: Corrosive esophageal burns, particularly common in developing countries, lead to different problems in different age groups. The ingestion of corrosive substances can cause such problems as stricture of the esophagus, to acute perforation, and even death. Because stricture formation is related to the severity of the initial injury, the prevention of stricture constitutes a main goal of treatment. The aim of this study was to investigate the protective and anti-inflammatory effects of garlic (Allium sativum) oil in corrosive esophageal burn. METHODS: Twenty-eight rats were randomly divided into 4 equal groups: group 1 (sham), group 2 (control), group 3 (topical treatment), and group 4 (topical and systemic treatment). In groups 2, 3, and 4, corrosive esophageal burns were generated by applying sodium hydroxide to a 1.5-cm segment of the abdominal esophagus. Normal saline was applied to group 2, topical garlic oil to group 3, and topical and systemic garlic oil were used in group 4. RESULTS: The level of hydroxyproline was lower in the topical treatment groups than in the control group (p=0.023). There was difference in tumor necrosis factor alpha level between the systemic treatment groups and the control group (p=0.044). Treatment with garlic oil decreased stenosis index (SI) and histopathological damage score (HDS) in corrosive esophageal burn rats. The SI in the topical treatment group was significantly lower than that of the control group (p=0.016). The HDS was significantly lower in group 4 when compared with the control group (p=0.019). CONCLUSION: Garlic oil is an effective agent in promoting the regression of esophageal stenosis and tissue damage caused by corrosive burns. While the protective effect of garlic oil on tissue damage is more significant when applied topically, the anti-inflammatory effect is more pronounced when applied systemically. Therefore, we believe that the application of garlic oil in patients with corrosive esophageal burns can reduce complication rates. © 2017 TJTES

Cultural Viewpoints of Nursing Students on Patient Privacy: A Qualitative Study

PMID = 3264808

Nonlinear Structural Coupling: Experimental Application

In this work, the nonlinear structural modification/coupling technique proposed recently by the authors is applied to a test system in order to study the applicability of the method to real structures. The technique is based on calculating the frequency response functions of a modified system from those of the original system and the dynamic stiffness matrix of the nonlinear modifying part. The modification can also be in the form of coupling a nonlinear system to the original system. The test system used in this study is composed of two cantilever beams with their free ends held between two thin identical beams which yield cubic stiffness. Thus two linear structures are coupled with a nonlinear connecting element. The frequency response functions of the coupled nonlinear system are measured at several different harmonic forcing levels, and the experimental values are compared with the theoretical values calculated using the nonlinear structural coupling method