An Inlet Patch Case with Difficulty Swallowing

Heterotopic Gastric Mucosa (inlet patch) is a clinical entity, described firstly by Schmit as a congenital anomaly, char-acterized by settling of gastric mucosa in any part of the gastrointestinal mucosa. It causes various clinical symp-toms due to acid secretion. Our case is oberved rarelly in case of inlet patch

TEACHER'S VIEW ABOUT PRACTISING NEW TEACHING CURRICULUM OF SCIENCE AND TECHNOLOGY LESSON OF 4th, 5th AND 6th GRADES IN ELEMENTARY SCHOOL

Bu arastırma, T.C. MEB, Talim ve Terbiye Kurulu Baskanlığı 2004 yılı öğretim programı reformu çerçevesinde \"Fen Bilgisi Dersi Özel İhtisas Komisyonu\" tarafından hazırlanan ve 2005-2006 öğretimin yılında 4. ve 5. sınıflarda, 2006-2007 öğretim yılında 6. sınıflarda uygulamaya konulan İlköğretim 4., 5. ve 6. sınıf Fen ve Teknoloji Dersi Öğretim Programı'nın amaçları, içeriği ve öğrenme-öğretme süreci ile ilgili öğretmen görüslerini belirlemek üzere yapılmıstır. Arastırmanının evrenini, Ankara ili Çankaya ilçesinde bulunan ilköğretim okullarında görevli 4., 5. sınıf öğretmenleri ve 6. sınıf fen ve teknoloji dersi öğretmenleri olusturmustur. Örneklem, Çankaya ilçesinde bulunan ilköğretim okullarından gelisigüzel seçilen 20 ilköğretim okulunda görevli 100 öğretmenden olusmustur. Veriler, arastırmacı tarafından hazırlanan 40 soruluk Anket Formu'nun örnekleme uygulanması yoluyla elde edilmistir. Verilerin analizinde; frekans ve yüzde değerleri veri toplama aracında yer alan her bir maddenin incelenmesiyle elde edilmis,aritmetik ortalamalar ise yapılan istatistiksel hesaplamalar sonucu bulunmustur.Yapılan bu arastırmada asağıdaki sonuçlara ulasılmıstır: İlköğretim 4., 5., 6. Sınıflar Yeni Fen ve Teknoloji Dersi Öğretim Programı'nın; i) amaçları ile ilgili öğretmen görüslerinde genel kanı; iyi (X =3.67) seklinde olmustur. ii) içeriği ile ilgili öğretmen görüslerinde genel kanı; iyi (X =3.58) seklinde olmustur. iii) öğrenme-öğretme süreci ile ilgili öğretmen görüslerinde genel kanı; iyi (X =3.63) seklinde olmustur.Science Education Curriculum Development Commission put the elementary science and technology education programme of 4th, 5th and 6th grades into practice in 2005-2006 education in grades 4 and 5 and in 2006-2007 in grade 6 with in the frame of 2004 curriculum imitiated by the Board of Education reform. This research was done order to determine teacher's views about the new curriculum's relevance in the dimensions of goals, context and teaching learning processes in achieving the goals of primary science education. The population of this study is the science teachers and classroom teachers who worked in elementary schools in Çankaya - Ankara. The sample is consisted of 100 teachers who work in 20 primary schools which were selected randomly in Ankara province Çankaya administrative district. The data were collected by means of administering a 40 item questionaire that was prepared by the researcher. In the analysis of data, frequency and percentages were obtained by analyzing each item and the arithmetical averages were calculated. In this research the following results were obtained: The teacher's view about the New Science and Technology Curriculum in 4th, 5th and 6th grades; i) as good (X =3,67) according to its goals; ii) as good(X =3,58) according to its extend and coverage; iii) as good(X =3,58) according to its proposed processes of teaching and learning

An Inlet Patch Case with Difficulty Swallowing

Heterotopik gastrik mukoza (inlet patch), ilk kez Schmidt tarafından tanımlanmış, gastrik mukozanın gastro intestinal sistemin herhangi bir yerine yerleşmesi ile karakterize, salgılanan asit nedeniyle çok değişik klinik bulgulara yol açan bir klinik antidedir. Olgumuz, nadir görülen bir semptom olan yutma güçlüğü ile başvurması nedeniyle sunulmuştur.Heterotopic Gastric Mucosa (inlet patch) is a clinical entity, described firstly by Schmit as a congenital anomaly, characterized by settling of gastric mucosa in any part of the gastrointestinal mucosa. It causes various clinical symptoms due to acid secretion. Our case is oberved rarelly in case of inlet patch

Acute Stroke Management in Türkiye: Intravenous Tissue Plasminogen Activator and Thrombectomy NöroTek: Türkiye Neurology Single Day Study

Objective: To reveal the profile and practice in patients with acute stroke who received intravenous tissue plasminogen activator (IV tPA) and/or neuro-interventional therapy in Türkiye. Materials and Methods: On World Stroke Awareness Day, May 10, 2018, 1,790 patients hospitalized in 87 neurology units spread over 30 health regions were evaluated retrospectively and prospectively. Results: Intravenous tPA was administered to 12% of 859 cases of acute ischemic stroke in 45 units participating in the study. In the same period, 8.3% of the cases received neurointerventional treatment. The rate of good prognosis [modified Rankin score (mRS) 0–2] at discharge was 46% in 83 patients who received only IV tPA [age: 67 ± 12 years; National Institutes of Health Stroke Scale (NIHSS): 12 ± 6; hospital stay, 24 ± 29 days]; 35% in 51 patients who underwent thrombectomy (MT) alone (age: 64 ± 13 years; NIHSS: 14.1 ± 6.5; length of hospital stay, 33 ± 31 days), 19% in those who received combined treatment (age: 66 ± 14 years; NIHSS: 15.6 ± 5.4; length of hospital stay, 26 ± 35 days), and 56% of 695 patients who did not receive treatment for revascularization (age: 70 ± 13 years; NIHSS: 7.6 ± 7.2; length of hospital stay, 21 ± 28 days). The symptom-to-door time was 87 ± 53 minutes in the IV treatment group and 200 ± 26 minutes in the neurointerventional group. The average door-to-needle time was 66 ± 49 minutes in the IV tPA group. In the neurothrombectomy group, the door-to-groin time was 103 ± 90 minutes, and the TICI 2b-3 rate was 70.3%. In 103 patients who received IV tPA, the discharge mRS 0–2 was 41%, while the rate of mRS 0–1 was 28%. In 71 patients who underwent neurothrombectomy, the mRS 0–2 was 31% and mRS 0–1 was 18%. The door-to-groin time was approximately 30 minutes longer if IV tPA was received (125 ± 107 and 95 ± 83 minutes, respectively). Symptomatic bleeding rates were 4.8% in IV recipients, 17.6% among those who received only MT, and 15% in combined therapy. Globally, the hemorrhage rate was 6.8% in patients receiving IV tPA and 16.9% in MT. Conclusion: IV thrombolytic and neurointerventional treatment applications in acute ischemic stroke in Türkiye can provide the anticipated results. Heterogeneity has begun to be reduced in our country with the dissemination of the system indicated by the “Directive on Health Services to be Provided to Patients with Acute Stroke.”. © Copyright 2023 by the Turkish Neurological Society / Turkish Journal of Neurology published by Galenos Publishing House

Gastrostomy in hospitalized patients with acute stroke: "NoroTek" Turkey point prevalence study subgroup analysis

Objective: Nutritional status assessment, dysphagia evaluation and enteral feeding decision are important determinants of prognosis in acute neurovascular diseases. Materials and Methods: NöroTek is a point prevalence study conducted with the participation of 87 hospitals spread across all health sub regions of Turkey conducted on 10-May-2018 (World Stroke Awareness Day). A total of 972 hospitalized neurovascular patients [female: 53%, age: 69±14; acute ischemic stroke in 845; intracerebral hematoma (ICH) in 119 and post-resuscitation encephalopathy (PRE) in 8] with complete data were included in this sub-study. Results: Gastrostomy was inserted in 10.7% of the patients with ischemic stroke, 10.1% of the patients with ICH and in 50% of the patients with PRE. Independent predictors of percutaneous endoscopic gastrostomy (PEG) administration were The National Institutes of Health Stroke Scale score at admission [exp (β): 1.09 95% confidence interval (CI): 1.05-1.14, per point] in ischemic stroke; and mechanical ventilation in ischemic [exp (β): 6.18 (95% CI: 3.16-12.09)] and hemorrhagic strokes [exp (β): 26.48 (95% CI: 1.36-515.8)]. PEG was found to be a significant negative indicator of favorable (modified Rankin’s scale score 0-2) functional outcome [exp (β): 0.032 (95% CI: 0.004-0.251)] but not of in-hospital mortality [exp (β): 1.731 (95% CI: 0.785-3.829)]. Nutritional and swallowing assessments were performed in approximately two-thirds of patients. Of the nutritional assessments 69% and 76% of dysphagia assessments were completed within the first 2 days. Tube feeding was performed in 39% of the patients. In 83.5% of them, tube was inserted in the first 2 days; 28% of the patients with feeding tube had PEG later. Conclusion: The NöroTek study provided the first reliable and large-scale data on key quality metrics of nutrition practice in acute stroke in Turkey. In terms of being economical and accurate it makes sense to use the point prevalence method.Amaç: Akut nörovasküler hastalıklarda nütrisyonel durum ve disfaji değerlendirmesi ve enteral beslenme kararı önemli prognoz belirleyicilerindendir. Gereç ve Yöntem: NöroTek, 10 Mayıs 2018’de (Dünya İnme Farkındalık Günü) Türkiye’nin tüm sağlık alt bölgelerine yayılmış 87 hastanenin katılımıyla gerçekleştirilen bir nokta prevalans çalışmasıdır. Hastanede yatan ve bu alt çalışma için toplanan verisi tam olan toplam 972 nörovasküler hasta (kadın: %53, yaş: 69±14 yıl; 845’i akut iskemik inme; 119’u intraserebral hematom ve 8’i post-resüsitasyon ensefalopatisi) analiz edildi. Bulgular: Gastrostomi iskemik inmeli hastaların %10,7, intraserebral kanamalıların %10,1 ve post-resusitasyon ensefalopatisi olanların %50’sine uygulanmıştır. Perkütan endoskopik gastrostomi (PEG) gereksiniminin bağımsız belirleyicileri, iskemik inme grubunda kabul NIHSS [exp (β): 1,09, %95 güven aralığı (GA): 1,05-1,14, puan başına] ile hem iskemik hem de hemorajik inmelerde mekanik ventilasyon uygulanmış olmasıdır [iskemik için: exp (β): 6,18, %95 GA: 3,16- 12,09] ve hemorajik inme için: [exp (β): 26,48, 95% GA: 1,36-515,8]. İnme olgularında PEG uygulaması hastane içi mortalite için bağımsız belirleyici değildi [exp (β): 1,731, 95% GA: 0,785-3,829]. Ancak, PEG uygulanmış olması taburculuk esnasında iyi prognoza (modifiye Rankin skoru 0-2) sahip olabilme için anlamlı bir negatif etmen olarak bulundu [exp (β): 0,032, %95 GA: 0,004-0,251]. Hastanede yatan nörovasküler hastaların yaklaşık üçte ikisinde malnütrisyon ve yutma bozukluğu açısından değerlendirme yapılmıştı. Nutrisyonel status değerlendirmesinin %69’u ve disfaji değerlendirmesinin %76’sı ilk 48 saat içinde gerçekleştirilmişti. Tüple enteral nütrisyon uygulama oranı %39’du. Beslenme tüplerinin %83,5’i ilk 2 gün içinde yerleştirilirken beslenme tüpü olan hastaların %28’ine daha sonra PEG açılmıştı. Sonuç: NöroTek çalışması ile Türkiye’de hastanede yatan akut inme hastalarında nutrisyonel uygulamaların temel kalite ölçütlerine ilişkin ilk güvenilir ve büyük ölçekli veri sağlanmıştır. Ekonomik olması ve doğruluğu açısından nokta yaygınlık yönteminin bu tip verilerin temini için daha fazla kullanılması mantıklıdır