Bringing Packed Red Blood Cells to the Point of Combat Injury: Are We There Yet?

INTRODUCTION: Hemorrhage is the leading cause of injury related pre-hospital mortality. We investigated worst case scenarios and possible requirements of Turkish Military. As we plan to use blood resources during casualty transport, the impact of transport related mechanical stress on PRBC (packed red blood cell) were analyzed. MATERIAL AND METHODS: The in vitro experiment was performed in the environmental test laboratories of ASELSAN(R). Operational vibrations of potential casualty transport mediums such as Sikorsky Helicopters, Kirpi(R) Armoured Vehicle and NATO vibration standardsoftware MIL-STD-810G were recorded. The most powerful mechanical stress, which was created by the NATO standard, was applied to 15 units of fresh (7 day) PRBC in a blood cooler box. The vibrations were simulated by TDS v895 Medium-Force Shaker Device. On site blood samples were analyzed at 0, 6th and 24th hours for biochemical and biomechanical analyses. RESULTS: The mean age of fresh and old PRBCs was 4.9 (SD +/- 2.2) and 32.8 (SD +/- 11.8) days, respectively. Six-hour mechanical damage of fresh PRBC was demonstrated by increased erythrocyte fragmentation rates (p=0.015), hemolysis rates (p=0.003), supernatant potassium levels (p=0.003) and decreased hematocrit levels (p=0.015). Old PRBC hemolysis rates (p=0.015), supernatant potassium levels (p=0.015), supernatant Hb (p=0.015) were increased and Htc levels were decreased (p=0.015) within 6 hours. Two (%13) units of fresh and none of the old PRBC were eligible for transfusion after 6 hours of mechanical stress. CONCLUSION: When the austere combat environment was simulated for 24 hours, fresh and old PRBC hemolysis rates were above the quality criteria. Currently, a technology to overcome this mechanical damage does not seem to exist. In the light of the above data, a new national project is being performed

The Use of Social Media in SMEs: A Case Study for Burdur, Turkey

In today’s business world, social media tools (i.e. facebook, twitter, Linkedin, etc.) begin to play an important role in reaching and communicating with customers for businesses. However, the importance of using social media can’t be still understood by SMEs so far.  Businesses use different social media tools in various purposes in their life. In this research we aim to investigate the ideas of SMEs about social media and their aims of using social media tools. Data were collected from SMEs operating in Burdur by simple random sampling. The data obtained from the 84 questionnaires was entered to computer and statistical analysis was carried out by using SPSS 20 statistical program. In this study, reliability analysis was used firstly. Then, some descriptive analyses were carried out about using social media for SMEs. Finally, a frequency table regarding the social media usage in SMEs was given. As a result, it was seen that 82.1% of SMEs participating in this study have a social network page. Secondly, SMEs are using facebook social media network mostly. In addition, SMEs have expressed that they attend all statements involved in the use of social media scale

AN EVALUATION OF PATIENTS WITH TULAREMIA IN DUZCE PROVINCE IN THE WESTERN BLACK SEA REGION OF TURKEY

Tularemia is a zoonotic infectious disease caused by Francisella tularensis. The aim of our study was to examine the epidemiological and demographical characteristics, laboratory findings, treatment methods, and treatment results of 68 tularaemia cases reported from Duzce, Western Black Sea region of Turkey, between 2016-2019. Clinical diagnosis was confirmed by micro-agglutination test (>= 1/160 titres). A total of 68 patients (35 females, 33 males) were diagnosed with tularemia. The most common symptoms among the patients in the study were swelling in the neck in 88.2% patients, sore throat in 73.5% patients and tonsillopharyngitis in 72.8% of the patients. Lymph node surgery was performed on 29.4% of patients despite receipt of antibiotherapy. The rate of ciprofloxacin use among patients not requiring lymph node surgery(46%) was significantly higher than that in patients requiring such surgery (20%) (p=0.046). No difference in lymph node surgery was observed among patients receiving combination antibiotherapy (p>0.05).WOS:00059603870005

Clinical Study Assessment of Technetium-99m Labeled Macroaggregated Albumin Rhinoscintigraphy for the Measurement of Nasal Mucociliary Transport Rate: Intratest, Interobserver, and Intraobserver Reproducibility

Objectives. The measurement of mucociliary transport velocity by rhinoscintigraphy with Tc-99m-macroaggregated albumin ( 99m Tc-MAA) is reliable measure of mucociliary clearance. The aim of this study is to assess the intratest, interobserver, and intraobserver reproducibility of nasal mucociliary transport rate (NMTR) measurement. Materials and Methods. Twenty-two subjects were evaluated to determine intratest reproducibility and a group of 35 subjects was examined to determine interand intraobserver reproducibility. Rhinoscintigraphy with 99m Tc-MAA was used to measure NMTR in all study subjects. Paired NMTR measurements were compared using a range of statistical methodologies. Intraclass correlation coefficients (ICC) and repeatability coefficients and Bland-Altman plots were applied to assess the degree of intratest, interobserver, and intraobserver variation. Results. Statistical analysis of test and retest experiments demonstrated the statistical equivalence of intratest NMTR measurements, interobserver NMTR measurements, and intraobserver NMTR measurements. The intratest ICC, interobserver ICC, and intraobserver ICC were 0.96, 0.83, and 0.91, respectively, indicating that intratest and intraobserver reproducibility are excellent and interobserver reproducibility is good. Conclusions. Rhinoscintigraphy using 99m Tc-MAA results in highly reproducible measurement of NMTR. The use of radionuclide imaging in measuring NMTR results in excellent intratest and intraobserver reproducibility and good interobserver reliability

Cardiac rhabdomyoma associated with tuberosclerosis complex in a newborn

Cardiac rhabdomyomas are the most comman cardiac tumors in children. They are hamartomatous benign tumors composed of myocytes. They often presents as multiple lesions involving the ventricular cavities. Rhabdomyomas are usually detected in utero by fetal echocardiography. Although patients with cardiac rhabdomyomas are generally asymptomatic these tumors may cause heart failure, severe arrhyhmias and sudden death. Cardiac rhabdomyomas are often associated with tuberosclerosis and they may be the earliest manifestation of tuberosclerosis. Here, we report a newborn infant with antenatally detected cardiac rhabdomyomas associated with tuberosclerosis and we want to emphasize that other diagnostic features of tuberosclerosis should be evaluated in patients with cardiac rhabdomyomas

A novel fluorescent nano-scale sensor for detection of trace amounts of Ca (II) ions

kacmaz, sibel/0000-0003-3642-4940; Ertekin, Kadriye/0000-0001-9819-3610WOS: 000331667900044A photo-induced electron transfer (PET) based sensing approach for the direct determination of trace amounts of calcium ions is presented. The Ca2+ selective fluoroionophore Bis, 2,2'-{1,2 phenylenebis [nitrilomethylylidene]} diphenol (DMK) was encapsulated in polymeric ethyl cellulose. The sensing membranes were fabricated in form of nanofibers, exploiting the. prepared polymer. When embedded in nanomaterials, the DMK dye yielded strong absorbance, large Stoke's shift, high fluorescence quantum yield, and excellent short and long-term photostability. The sensing ability of the nanofibers was tested by steady state and time resolved fluorescence spectroscopy. To our knowledge, this is the first attempt using the DMK-doped electrospun nanofibrous materials for calcium sensing. The offered nanosensor displays a sensitive response with a detection limit of 0.016 nM for Ca2+ ions over a wide concentration range, 1.0 x 10(-10)-1.0 x 10(-4) M, and exhibits high selectivity over Mg2+ and other cations. Accuracy of the sensing system was proven by recovery tests. (C) 2013 Elsevier B.V. All rights reserved.Scientific Research Funds of Dokuz Eylul UniversityDokuz Eylul University [2012.KB.FEN.049, 2012.KB.FEN.031]Funding this research was provided by the Scientific Research Funds of Dokuz Eylul University 2012.KB.FEN.049 and 2012.KB.FEN.031. We also thank to the Scientific and Technological Research Council of Turkey (TUBITAK)

Clinical Charactheristics of Late Onset Mania

Objective: Our aim is to compare demographic and clinical characteristics of patients with early and late-onset diagnosed as bipolar disorder type I (BPD-I) manic episode retrospectively

Uterine tumors resembling ovarian sex cord tumors: A case report and literature review

Uterine tumors with ovarian sex cord-like elements are a rarely observed type of uterine body tumor with unknown etiology, and are divided into two groups: Endometrial stromal tumors with sex cord-like elements (ESTSCLEs) and uterine tumors resembling ovarian sex cord tumors (UTROSCTs). While ESTSCLEs are commonly associated with metastasis and recurrence, there is limited data in the relevant literature concerning the behavior of UTROSCTs. However, UTROSCTs are typically benign in nature. Although case numbers are limited, extra-uterine or lymph node metastasis has been reported. Surgical approaches may be altered according to the patient's age and desire for future fertility. Hysterectomies with bilateral salpingo-oopherectomy or hysteroscopic tumor resection are reported to be safe surgical treatment options. However, in the current report, a case of UTROSCT initially misdiagnosed as adenosarcoma following hysteroscopic tumor resection is presented. Staging surgery revealed the precise diagnosis of the tumor using appropriate immunohistochemical evaluations, and led to the discovery of a secondary tumor focus in the myometrium, adjacent to the location of the previously excised tumor. Thus, hysteroscopic resection is questionable as a definitive surgical treatment in patients exhibiting UTROSCT. If hysteroscopic resection is the selected treatment, close follow-up with diagnostic imaging is recommended

Low T Cell Numbers Resembling T-B+ SCID in a Patient with Wiskott-Aldrich Syndrome and the Outcome of Two Hematopoietic Stem Cell Transplantations.

Wo