Erişkin akciğer nakli alıcılarında hava yolu komplikasyonlarının ameliyat öncesi risk faktörleri: Sistematik derleme ve meta-analiz

Background: In this systematic review and meta-analysis, we aimed to identify recipient-related preoperative risk factors for airway complications following lung transplantation in adults. Methods: Articles published between November 1995 and February 2023 were searched by a thorough exploration of databases. Studies that addressed recipient-related risk factors for airway complications following adult lung transplantation, such as cohorts, case-control, or cross-sectional studies, were included. Fixed-effects or random-effects models were used to calculate the odds ratios (ORs) or mean differences (MDs) with 95% confidence interval (CI). Results: Twenty-one studies including a total of 38,321 recipients fulfilled the inclusion criteria. Based on the pooled analyses, taller height (MD=5.98, 95% CI: 5.69-6.27, I2 = 57.32%), intraoperative mechanical ventilation (OR=1.83, 95% CI: 1.41-2.38, I2=0%), male sex (OR=1.52, 95% CI: 1.33-1.74, I2=15.91%), preoperative extracorporeal membrane oxygenation (OR=1.58, 95% CI: 1.1-2.26, I2 =41.47 %), and preoperative steroid use (OR=1.21, 95% CI: 1.04-1.41, I2 = 0%) elevated the risk of airway complications following lung transplantation. Conclusion: Taller height, intraoperative mechanical ventilation, male sex, preoperative extracorporeal membrane oxygenation, and preoperative steroid use can increase the risk of airway complications after lung transplantation. Identifying high-risk recipients or riskless situations can support the advancement of selective treatments or prevent the unnecessary avoidance of certain interventions.Amaç: Bu sistematik derleme ve meta-analizde, erişkinlerde akciğer nakli sonrasında hava yolu komplikasyonlarının alıcı ile ilişkili ameliyat öncesi risk faktörleri belirlendi. Ça­lış­ma pla­nı: Kasım 1995 - Şubat 2023 tarihleri arasında yayımlanan makaleler kapsamlı bir veri tabanı araştırması ile tarandı. Kohortlar, vaka kontrol veya kesitsel çalışmalar gibi erişkin akciğer naklini takiben hava yolu komplikasyonları için alıcı ile ilişkili risk faktörlerini değerlendiren çalışmalar dahil edildi. %95 güven aralığı (CI) ile birlikte olasılık oranlarını (OR) veya ortalama farklarını (MD) hesaplamak için sabit etki veya rastgele etki modelleri kullanıldı. Bulgular: Toplam 38.321 alıcının yer aldığı 21 çalışma dahil edilme kriterlerini karşıladı. Birleştirilmiş analizlere göre uzun boy (MD=5.98, %95 CI: 5.69-6.27, I2=%57.32), ameliyat sırası mekanik ventilasyon (OR=1.83, %95 CI: 1.41-2.38, I2 =%0), erkek cinsiyeti (OR=1.52, %95 CI: 1.33-1.74, I2 =%15.91), ameliyat öncesi ekstrakorporal membran oksijenizasyonu (OR=1.58, %95 CI: 1.1-2.26, I2=%41.47) ve ameliyat öncesi steroid kullanımı (OR=1.21, %95 CI: 1.04-1.41, I2=%0) akciğer nakli sonrası hava yolu komplikasyon riskini artırdı. So­nuç: Uzun boy, ameliyat sırası mekanik ventilasyon, erkek cinsiyeti, ameliyat öncesi ekstrakorporal membran oksijenizasyonu ve ameliyat öncesi steroid kullanımı akciğer nakli sonrası hava yolu komplikasyon riskini artırabilir. Yüksek riskli alıcıları veya hava yolu komplikasyon riskini artırmayan durumları belirlemek, selektif tedavilerin seçimini destekleyebilir veya belirli girişimlerden gereksiz yere kaçınmayı önleyebilir

Breast Cancer and Exercise

Breast cancer is the most common type of cancer and the leading cause of death in women. Chemotherapy drugs, which are used to suppress growth and proliferation of cancer cells, prevent or minimize treatment-related symptoms, and improve the quality of life, lead to the destruction of normal cells with therapeutic effects as well as toxic effects. In response, symptoms such as pain, nausea, vomiting, fatigue, anorexia, anxiety, and depression occur in patients. Chemotherapy and its side effects adversely affect the physical and functional capacity of patients with cancer. In particular, the decrease in aerobic capacity affects muscle strength, endurance body awareness, and the quality of life. The practice of aerobic exercise programs during the treatment of breast cancer is important for reducing the side effects, improving physiological health, improving physical functions, preventing weight gain, and maintaining muscle strength. When the rehabilitation programs for breast cancer are individualized, become specific, and realistic goals are set, the positive effects of exercise can be seen

Pulmonary hyalinizing granuloma

Pulmonary hyalinizing granuloma (PHG) first described by Engleman et al. in 1977, was generally reported as individual cases in the world literature.1 In most cases, PHG occurs as solitary or multiple pulmonary nodules with well defined boundaries.2 They usually grow slowly or may not grow at all; Although positron emission tomography CT is useful in ruling out metastatic lesions, increased metabolic activity may occur in PHG lesions.3 In histolog- ical analysis, homogeneous hyaline lamellae are usually detected in a perivascular distribution, surrounded by the collection of plasma cells, lymphocytes and histiocytes

Terrain visibility optimization problems

Ankara : The Department of Industrial Engineering and the Institute of Engineering and Sciences of Bilkent University, 2001.Thesis (Master's) -- Bilkent University, 2001.Includes bibliographical references leaves 92-96The Art Gallery Problem is the problem of determining the number of observers necessary to cover an art gallery such that every point is seen by at least one observer. This problem is well known and has a linear time solution for the 2 dimensional case, but little is known about 3-D case. In this thesis, the dominance relationship between vertex guards and point guards is searched and found that a convex polyhedron can be constructed such that it can be covered by some number of point guards which is one third of the number of the vertex guards needed. A new algorithm which tests the visibility of two vertices is constructed for the discrete case. How to compute the visible region of a vertex is shown for the continuous case. Finally, several potential applications of geometric terrain visibility in geographic information systems and coverage problems related with visibility are presented.Düger, İbrahimM.S

A New Parameter for Predicting Right Ventricular Dysfunction in Pulmonary Embolism: Immature Granulocytes

INTRODUCTION: Pulmonary embolism is an urgent health problem and causes high morbidity and mortality when diagnosis is delayed. In addition, detecting the severity of the disease early and starting appropriate treatment prevents complications and mortality due to pulmonary embolism. In recent years, efforts to determine the severity of pulmonary embolism with hemogram parameters that can be easily performed anywhere and anytime, instead of time-consuming and costly examinations, have increased. Right ventricular dysfunction, which indicates the severity of pulmonary embolism, is determined by echocardiography. In this study, we investigated the relationship between inflammatory parameters in the hemogram and immature granulocytes, a new parameter, with right ventricular dysfunction in order to screen for the necessity of echocardiography in pulmonary embolism. METHODS: 57 patients admitted to the university hospital between January 1, 2018 and July 1, 2023 and diagnosed with pulmonary embolism by computed tomography pulmonary angiography were included in the study. Demographic, echocardiographic, radiological and laboratory data of the cases were obtained from hospital records and the results were analyzed retrospectively RESULTS: Of the 57 patients included in the study, 36 (63.2%) were male and 21 (36.8%) were female. There were 18 (31.6%) patients with right ventricular dysfunction and 39 (68.4%) patients without. Mean age was 52.39+-15.56. A significant correlation was found between right ventricular dysfunction and immature granulocyte count (p<0.05). In multivariate logistic regression analysis, immature granulocyte value was found to be a significant and independent variable in predicting right ventricular dysfunction (p˂ 0.05). DISCUSSION AND CONCLUSION: As a result, the relationship between immature granulocytes measured in complete blood count and pulmonary embolism was examined. For the first time, the increase in immature granulocytes was found to be a significant and independent variable in predicting right ventricular dysfunction in pulmonary embolism. We believe that this result may have prognostic value for estimating the severity of pulmonary embolism and the need to screen for right ventricular dysfunction

Influenza and pneumonia vaccination rates and factors affecting vaccination among patients with chronic obstructive pulmonary disease

Background: Influenza and pneumococcal vaccinations are recommended in chronic obstructive pulmonary disease patients to decrease associated risks at all stages. Although the prevalence of chronic obstructive pulmonary disease is high in our country, as previously reported, vaccination rates are low. Aims: To assess the vaccination rates of chronic obstructive pulmonary disease patients and factors that may affect these. Study Design: Multi-centre cross-sectional study. Methods: Patients admitted to the chest diseases clinics of six different centres between 1 February 2013 and 1 January 2014 with a pre-diagnosis of Chronic obstructive pulmonary disease according to the Global initiative for chronic obstructive lung disease criteria, who were in a stable condition were included in the study. The survey, which included demographic characteristics, socioeconomic status, severity of disease and vaccination information, was first tested on a small patient population before the study. The survey was completed by the investigators after obtaining written informed consent. Results: The average age of the 296 included patients was 66.3 +/- 9.3 years and 91.9% were male. Of these, 36.5% had the influenza vaccination and 14.1% had the pneumococcal vaccination. The most common reason for not being vaccinated was 'no recommendation by doctors': 57.2% in the case of influenza vaccinations, and 46.8% in the case of pneumococcal vaccinations. Both vaccination rates were significantly higher in those patients with comorbidities (influenza vaccination p0.05). Vaccination rates were significantly higher in those with a white-collar occupation and higher education level, and who presented to a university hospital (p<0.001). Conclusion: Medical professionals do not request vaccinations as often as the International Guidelines suggest for chronic obstructive pulmonary disease patients. Awareness of the importance of these vaccinations among both doctors and patients needs to be addressed

Discharge and exclusion in joint stock companies

Anonim Şirketler Türkiye'de tüzel kişiliklerinin bulunması ve ortaklarının sınırlı sorumlu olmasından dolayı en çok tercih edilen ortaklık türlerinden biridir. Ortaklar sınırlı sorumlu olduğundan sadece katılma payı tehlikeye atılır ve böylece bu şirketlerin bünyesinde büyük miktarda paralar toplanabilir. Anonim şirketleri diğer şirket türlerinden ayıran en temel özellik, kişisel unsurlara bu şirketlerde asgari düzeyde yer verilmiş olmasıdır. Anonim şirketler ülkelerin ekonomik yaşantısı üzerinde önemli etkiye sahip olduğundan dolayı diğer şirket türlerinden farklı bazı düzenlemelere tabi tutulmuştur. Bu çalışmada Türk Ticaret Kanunundaki anonim şirketlerden çıkma ve çıkarılmaya sebep olan haller sonuçları ile birlikte incelenecektir.Joint stock companies is one of the most preferred partnerships because they have their legal entities and their partners are limited, only shares are at risk and a large amount of Money can be collected within companies. The main property which distinguishes joint stock companies from other companies is that the personal features are observed in these companies at the minimum level. As joint stock companies are important on the economic life of countries, they are subject to some regulations as to other company types. In this study, the issues which lead to the discharge and exclusion from joint stock companies in the Turkish Commercial Code will be examined together with its results

Gender-based human rights violations against women in the context of natural disasters

Doğal afetler ve insan hakları karşılıklı yakın ilişki içerisindedir. Doğal afetler yaşama hakkı, nitelikli sağlık hizmetlerin yararlanma hakkı, güvenlik ve barınma hakkı gibi, kişilerin temel insan haklarına yönelik ihlallere yol açmaktadır. Doğal afetler aynı zamanda bir toplumda zaten daha önceden mevcut olan insan haklarına yönelik aykırılıkları ve eşitsizlikleri gün yüzüne çıkaran olaylardır. Bazı toplumlarda özellikle kadınlara ve kız çocuklarına yönelik yaygınlık gösteren cinsiyete dayalı şiddet ve ayrımcılık doğal afetlerle birlikte daha fazla artış göstermektedir. Bu artışın temelinde yatan en önemli unsur, cinsiyet eşitsizliğini destekleyen ve cinsiyete dayalı şiddeti yapılandıran sosyal ve kültürel faktörlerdir. Bu çalışmada yerel kaynaklarda şimdiye kadar sınırlı ele alınan doğal afetler ile cinsiyet temelli kadınlara ve kız çocuklarına yönelik insan hakları ihlalleri arasındaki ilişki ele alınmıştır. Ağırlıklı olarak nitel araştırma yöntemlerine dayalı bir literatür taraması yapılmıştır. Diğer yandan doğal afetler ile cinsiyete dayalı şiddet ve ayrımcılık arasındaki ilişkiyi nicel yöntemlerle inceleyen yabancı literatüre bakılmış ve bu çalışmalarda afetlerin, kadınları ve kız çocukları erkeklere kıyasla orantısız bir şekilde etkilediğine yönelik çok sayıda kanıtlara rastlanmıştır. Ayrıca doğal afetler kapsamında kadınlara yönelik insan hakları ihlalleri ile ilgili alternatif öneriler getirilmeye çalışılmıştır.Natural disasters and human rights are closely related. Natural disasters lead to violations of basic human rights of individuals such as the right to experience the right to benefit from qualified health services, the right to security and shelter. Natural disasters are also events that bring to light the already existing violations of human rights and inequalities in a society. Gender- based violence and discrimination, which is prevalent in some societies, especially against women and girls, increases with natural disasters. The most important factor underlying this increase is the social and cultural factors that support gender inequality and structure gender-based violence. In this study, the relationship between natural disasters and gender-based human rights violations against women and girls, which has been limited so far in local sources, is discussed. A literature review was conducted, mainly based on qualitative Research methods. On the other hand, foreign literature examining the relationship between natural disasters and gender-based violence and discrimination with quantitative methods was examined, and in these studies, a large amount of evidence was found that disasters affect women and girls disproportionately compared to men. In addition, alternative suggestions have been tried to be made regarding human rights violations against women within the scope of natural disasters