Can Propranolol be used as the first line treatment in infantile hemangioma?

Hemangiomas are the most common tumors of infancy. Most of them require no treatment, but treatment is needed if dramatic aesthetic, and/or functional impairment as visual or airway obstruction or ulceration arises. We reported a 6-month-old infant presented with a 6-week history of a rapidly growing cutaneus hemangioma on the right eyelid and caused visual impairment. The patient was successfully treated with the use of oral propranolol therapy. We suggest that propranolol can be considered as a first line treatment in a patient with infantil hemangioma

Narrating Paradox Affects: Unaccompanied Minor Asylum-Seekers in Austria

Asylum-seeking unaccompanied children and youngsters are situated at the crossroads between exclusionary and repressive asylum policies, on the one hand, and relatively inclusive and caring child welfare policies, on the other. This is the ‘asylum-child welfare paradox’ (Dursun and Sauer 2021). In this article, we explore the role of affect, feelings, and emotions in how unaccompanied minors respond to and process but also co-construct and resist this structural paradox through their ‘affective narratives’ (Bargetz and Eggers 2022). Based on qualitative interviews conducted with (former) unaccompanied minors in Austria in 2015, we observe that minors mobilize a set of feelings of fear, disappointment, frustration, and uncertainty due to experiences of rejection or loss of control; but unaccompanied minors also express feelings of confidence, joy, hope, and solidarity vis-à-vis their new environment and their future. Furthermore, the highly affective issues of belonging and non-belonging to their host country, of proximity and distance to other human beings hold an important place in their narratives as well as the ordering of time. We conclude that, rather than merely reacting to paradoxes that structure their social positions, minors actively shape such paradoxes and render them tangible and workable by means of narrating contradictory feelings and emotions and by mobilizing affectivity

Evaluation of apoptosis along with bcl-2 and ki-67 expression in patients with intestinal metaplasia

The primary aim is to compare individuals with intestinal metaplasia (IM), chronic active gastritis (CAG), and normal gastric mucosa (NGM) in terms of apoptosis, proliferation, and Bcl-2 expression. The secondary aim is to determine whether these parameters are different between patients with and without gastric cancer in first-degree relatives. We enrolled 106 patients whose histopathological results were consistent with IM (n: 42), CAG (n: 51), or NGM (n: 13). Antral biopsies were immunohistochemically stained for Bcl-2 and Ki-67 expression. Apoptosis was detected using TUNEL assay. While no significant difference was determined between three groups with regard to apoptosis and Bcl-2 expression (p > 0.05), Ki-67 expression was significantly higher in the IM group when compared with the CAG and NGM groups (29.90 ± 22.87 vs. 18.18 ± 16.22 vs. 18.54 ± 20, respectively; p = 0.012). Helicobacter pylori was determined to increase apoptosis (49.3% vs. 25.7%, p < 0.05), nevertheless, it had no significant effect on proliferation and Bcl-2 expression. Bcl-2 and Ki-67 expression and apoptosis were not different among patients with and without a history of gastric cancer in first degree relatives. Although intestinal metaplasia cases demonstrate an increase in proliferation, no elevation is observed in apoptosis. This can be an important factor in the progression to gastric cancer

Investigation of the Frequency of Viral Agents in Children with Acute Gastroenteritis in the 0-5 Years Age Group

Amaç: Viral gastroenteritler, çocukluk çağında görülen gastroenteritlerin en sık nedenidir. Başlıca enterik virüsler; rotavirüsler, enterik adenovirüsler, astrovirüsler, nörovirüsler ve sapovirüsleri içeren kalisivirüslerdir. Çeşitli ülkelerde yapılan son çalışmalarda nörovirüsler, çocukluk çağı gastroenteritlerinde önemli bir enterik patojen olarak belirlendi. Ancak nörovirüs enfeksiyonlarının epidemiyolojik özellikleri ve hastalık yükü bilinmemektedir. Çalışmanın amacı viral gastroenteritlerde nörovirüs sıklığını belirlemektir. Gereç ve Yöntemler: Kasım 2011-Aralık 2012 tarihleri arasında ishal atağı ile pediatri polikliniğine ayaktan başvuran 96 hastanın gaita örnekleri analiz edildi. Gaita örneklerinde, rotavirüs, enterik adenovirüs ve nörovirüs immünokromatografik yöntemle araştırıldı. Akut gastroenteritli 1-60 ay arası çocuklar çalışmaya dahil edildi. İshal atağının şiddeti 'Vesikari' skoru kullanılarak belirlendi. Bulgular: Hastalardan alınan 96 gaita örneğinin 53'ünde viral antijen tespit edildi. Rotavirüs %39.6, adenovirüs %10,4, nörovirüs %5.2, oranında tespit edildi. Hastaların ortalama yaşı 20,414,5 aydı. Çalışmada, gastroenteritle ilişkili semptomlardan kusma %77.1, ateş %50, karın ağrısı %24, bulantı %18.8 oranında bulundu. Kusma, rotavirüs pozitif hastalarda %92.1 oranında tespit edildi, istatiksel olarak anlamlı bulundu (p0.005).Sonuç: 0-5 yaş arası akut gastroenteritli çocuklarda 6 ay süren çalışmada, nörovirüsler; rotavirüs ve enterik adenovirüslerden sonra üçüncü viral patojen olarak saptanmıştır.Objective: Viral gastroenteritis is the most frequent cause of gastroenteritis in childhood. The major enteric viruses are rotaviruses, enteric adenoviruses, astroviruses and human caliciviruses including noroviruses and sapoviruses. Recent surveys conducted in various countries have identified noroviruses as an important enteric pathogens in sporadic cases of gastroenteritis in childhood. However, the epidemiological features and disease load are unknown. The aim of this study was to determine the incidence of norovirus gastroenteritis among viral gastroenteritis cases. Material and Methods: Stool specimens of 96 cases who had presented to our pediatrics outpatient clinic between November 2011 and April 2012 due to diarrhea were analyzed. Rotavirus, enteric adenovirus and norovirus were searched for in stool specimens using the immunochromatographic method. Patients with acute gastroenteritis between the ages of 1-60 months were included in the study. The severity of gastroenteritis was assessed by using the Vesicari scale. Results: Viral antigens were determined in 53 of the 96 stool specimens. Rotaviruses were identified in 39.6%, adenoviruses in 10.4%, and noroviruses in 5.2%. The mean age on admission was 20.414.5 months. The clinical symptoms associated with viral gastroenteritis in this study were vomiting (77.1%), fever (50%), abdominal cramps (24%), and nausea (18.8%). Vomiting was identified in 92.1% of rotavirus positive patients and this was statistically significant (p0.005). Conclusion: During the study period of six months, norovirus has determined as third viral pathogen after rotavirus and adenovirus with gastroenteritis in children 0-5 age group

Clinical Significance Of DNA Repair Genes Expressions In Neurofibromatosis Type 1 Cases

AMAÇ: Nörofibromatozis Tip 1 (NF1), çeşitli fenotiplere sahip, sık görülen otozomal dominant genetik bir hastalıktır. NF1 hastalarının klinik çeşitliliğinin genetik nedeni sorgulanmaktadır. DNA onarım genleri DNA' daki hataların onarımından sorumludur. Bu çalışmada DNA onarım genlerinin ekspresyonunu ve onların NF1 hastalarındaki klinik önemini nörofibrom, hamartomatöz lezyon, diğer tümörler ya da ailesel NF1 varlığı ile karşılaştırarak analiz etmek ve gen ekspresyonları ile klinik bulgular arasında ilişki olup olmadığını belirlemek amaçlandı. YÖNTEMLER: NF1' li hastalar ve NF1 ile birlikte malignitesi olan hastalar çalışmaya alındı. Kontrol grubu olarak da benzer yaş grubundaki her hangi bir hastalığı olmayan çocuklar ve NF1 ile ilgisi olmayan maligniteli olgular oluşturdu. Çalışma toplam 46 olgu içermekteydi: 36 NF1 hastası (30 çocuk; 6 ebeveyn), hiç bir hastalığı olmayan 8 kontrol olgusu, rabdomiyosarkomlu NF1 olmayan 2 kontrol olgusu çalışmaya alındı. Her bir hasta ve kontrol grubundan periferik kandan mononükleer hücre izolasyonu yapıldı. RNA izolasyonu ve cDNA dönüşümünden sonra, her bir olguda Real-Time PCR ile DNA onarımı ile ilişkili 84 genin ekspresyonu (standart array, SABiosciences) belirlendi. Ekspresyonların kontrol grubuna göre kat değişiklikleri ve T test ile p değeri karşılaştırmalı gruplarda değerlendirildi. BULGULAR: Araştırma grubunu 36 NF1 hastası, kontrol grubunu ise 8 sağlam çocuk ve 2 adet de NF1 ile ilişkisi olmayan maligniteli olgu (rabdomiyosarkom) oluşturmaktadır. 8 kontrol olgusunun yaş ortalaması 17±7,03 (10-30 yaş) (ortanca 13 yaş) idi. NF1 olgularının 17' si kadın 19' u erkekti. NF1' li olgularımız için tanı anındaki yaş ortalaması 10,08±8,86 (9 ay- 38 yaş) (ortanca 8 yaş) iken hastalarımızın çalışmaya alınan ebeveynlerinin yaş ortalaması 40,50±1,22 (39-42 yaş) (ortanca40 yaş) idi. 36 hastanın, 17' si nörofibromlu, 17' si hamartomatöz lezyonluydu. 1 hastada rabdomiyosarkom (RMS) gözlenmiş, 1 hasta meme kanseri ve 4 hasta da optik gliomluydu. NF1 olgularında, PNKP, RAD18, XAB2, XRCC3, XRCC4 ve XRCC5 genlerinin ekspresyonu kontrol grup ile karşılaştırıldığında azaldı (p&lt;0.05, T test). Nörofibromlu NF 1 olgularında, nörofibromsuz NF 1 olgularıyla karşılaştırıldığında POLB ekspresyonu artarken; ERCC3,LIG1,MGMT, MRE11A, MPG, MSH6, PARP2, PRKDC, RAD51B, RAD52, RPA3, SMUG1, TREX1, UNG ekspresyonu azaldı. RAD18 ailesel NF 1 varlığında ekspresyonu azalmış ve istatistiksel olarak önemli olduğu saptandı. Malign tümör olgularında NF 1' li ya da NF 1' siz gruplar karşılaştırıldığında gen ekspresyonunda kat değişiklikleri vardı. Maligniteli olgularda DDB2, MGMT, MLH1, POLB UNG, XPA ekspresyonları arttı. NF 1'li RMS olgusu ile NF 1' siz RMS olguları karşılaştırıldığında DDB2, MGMT, MLH1, POLB, UNG, XPA olmak üzere 6 genin ekspresyonu 10 kattan fazla artmış saptandı. SONUÇ: Bulgularımız NF 1 olgularındaki klinik bulgulardan tümör gelişimini öngörmek için DNA onarım sistemi ilişkili gen ekspresyon değişikliklerinin rolü olabileceğini göstermiştir. POLB nörofibrom varlığı belirteci, DDB2, MGMT, MLH1, POLB UNG, XPA malign tümör gözlenme belirteci olmaya aday genler olarak saptandı. Bu genlerin ekspresyonlarının daha geniş seri NF1li ve maligniteli olgularda çalışılması uygundur. OBJECTIVE: Neurofibromatosis Type 1 (NF1) is a a common autosomal dominant genetic disorder that has a variable phenotype. The genetical causes of clinical variability of NF1 patients is questioned. DNA repair genes are responsible for proofreading the missing in the DNA. We aimed to analyze expression of DNA repair genes and their clinical significance in NF1 patients; comparing exsistance of neurofibroma or hamartomatous lesions or other tumours or existance of NF1 in the family. The other aim of this study was to determine whether any relationship between gene expressions and clinical findings. METHODS: NF1 patients and malignancy with NF1 pateints were included and in this study. In the control gruop children that they are in the similar age group and they have no disease and no malignacy group were included. This study included total 46 cases. 36 NF1 patients (30 children; 6 parents), 8 control cases without any disease, two control cases with rhabdomyosarcoma without NF1 were included in this study. The mean age of control group was 17±7,03 (10-30 age) (median 13 age). In the NF1 pateints gruop 17 of them are female, and 19 are male. The mean age at diagnosis is 10,08±8,86 (9 months- 38 age)(median age 8) for children and 40,50±1,22 (39-42 age) (median age 40) for parents. Among 36 patients, 17 had neurofibromas, 17 had hamartomatous lesions. Rhabdomyosarcoma (RMS) was observed in one patient, breast cancer in one patient and four patients suffered optic glioma. Peripheral blood was obtained from each cases and mononuclear cells were separated. After RNA isolation and cDNA converting, expressions of 84 genes related with DNA Repair in standard array (SABiosciences) were determined by Real-Time PCR for each case. Fold changes and p values compared with control groups and fold changes evaluated with T test and p value in the comperative groups. RESULTS: 36 NF1 patients, 8 healthy children as a control and 2 cases no NF1 relationship with malignancy (rhabdomyosarcoma) were included in the study group. In NF1 cases PNKP, RAD18, XAB2, XRCC3, XRCC4 and XRCC5 genes were downregulated compared with control group. In NF1 cases having neurofibromas, POLB was over expressed; while ERCC3, LIG1, MGMT, MRE11A, MPG, MSH6, PARP2, PRKDC, RAD51B, RAD52, RPA3, SMUG1, TREX1, UNG were downregulated compared with the NF1 cases without neurofibromas (p&lt;0.05, T test). RAD18 is the downregulated and statistical significant gene for existence of NF1 in the family. There are gene expression fold change differences determined when malign tumor cases with/without NF1 were compared. DDB2, MGMT, MLH1, POLB UNG, XPA are increased. &nbsp; CONCLUSION: Our results may point toward a role of gene expression changes of DNA repair system to be predictive for clinical manifestations in NF1 cases

Determination of the mycotoxin activity of filamentous fungi isolated from the intestinal region of adult honey bees by the pcr and uhplcorbitrap- hrms methods

Honey bees are threatened by many fungal, parasitic and bacterial diseases. This study was aimed at identifying filamentous fungi colonizing the intestinal region of dead adult honey bees and determining resultant mycotoxin activity and its potential adverse implications for bee and human health by the PCR and UHPLC-Orbitrap- HRMS methods. For this purpose, dead bees were collected from the ground in front of 95 hives displaying mass mortality in the Hatay, Iğdır and Bingöl provinces, and 22 filamentous and 6 yeast-like fungi were isolated and identified from the intestinal region of these bees. Of the filamentous fungal isolates, 8 were identified as Aspergillus spp., 3 as Fusarium spp., 2 as Alternaria spp. 5 as Penicillium spp., 4 as Mucor spp., and 2 as Rhizopus spp.. The PCR analysis of the filamentous fungi using primers targeting the aflatoxin and ochratoxin A genes revealed the presence of aflatoxin in only 1 out of the 22 samples. Aflatoxin and ochratoxin were not detected in any of the other samples. The UHPLC-Orbitrap-HRMS method revealed the presence of aflatoxin B1 in 17, both B1 and B2 in 6, B1, B2 and G1 in 5, and aflatoxin G2 in 1 of the filamentous fungal samples. The results obtained in the present study suggest that filamentous fungi may produce mycotoxins in the intestinal region of honey bees, and thereby, honey bees may distribute mycotoxins into the environment and cause indirect adverse effects on human and animal health

Elderly and aged asthma have different characteristics: results of a multicenter study

Background/aim: Characteristics of asthma in the elderly population is not well-known. The aim of the present study was to evaluate asthma in the elderly population, to compare disease characteristics between patients diagnosed <60 (aged asthma) and ≥60 (elderly asthma) years of age. Materials and methods: The study was a prospective, multicenter, cross-sectional type. A questionnaire was filled out to patients 60 years of age and over, that have been followed for asthma for at least 3 months. Asthma Control Test (ACT), eight-item Morisky Medication Adherence Scale (MMAS-8) was filled out, inhaler device technique was assessed. Results: A total of 399 patients were included from 17 tertiary care centers across the country. Mean age was 67.11 years and 331 (83%) were female. The age at asthma diagnosis was ≥60 in 146 (36.6%) patients. Patients diagnosed ≥60 years were older (p < 0.001), had higher education level (p < 0.001), more commonly had first-degree relative with asthma (p = 0.038), asthma related comorbidities (p = 0.009) and accompanying rhinitis/rhinosinusitis (p = 0.005), had better asthma control (p = 0.001), were using less controller medications (p = 0.014). Inhaler technique was correct in 37% of the patients with no difference in between the groups. Treatment compliance was better in elderly asthma patients (p < 0.001). In the multivariate logistic regression analysis, having well-controlled asthma (odds ratio = 1.61, CI = 1.04-2.51), and high medication adherence rate (odds ratio = 2.43, CI = 1.48-4.0) were associated with being in the elderly asthma group. Conclusion: The characteristics of asthma are different among patients aged 60 years and over which seems to be related to onset age of asthma. In our cohort, the elderly asthma patients had higher education level, and treatment adherence and asthma control was better. Patients diagnosed ≥60 years of age did not have more severe disease

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

2018 sosyal bilgiler öğretim programı'na ilişkin öğretmen ve akademisyenlerin görüş ve değerlendirmeleri

ÖZET 2018 SOSYAL BİLGİLER ÖĞRETİM PROGRAMI’NA İLİŞKİN ÖĞRETMEN VE AKADEMİSYENLERİN GÖRÜŞ VE DEĞERLENDİRMELERİ Bu araştırmada, 2017 yılında Taslak Program olarak 1. 5. ve 9. sınıflarda uygulamaya konulan ve 2018-2019 eğitim öğretim yılından itibaren tüm sınıf düzeylerinde uygulanmaya başlayan 2018 Sosyal Bilgiler Öğretim Programına ilişkin öğretmen ve akademisyenlerin görüş ve değerlendirmeleri incelenmiştir. Çalışmada nitel araştırma yöntemi kullanılmıştır. Verilerin toplanmasında yarı yapılandırılmış görüşme soruları kullanılmıştır. Araştırmanın çalışma grubunu 10 sosyal bilgiler öğretmeni ve 10 akademisyen oluşturmaktadır. Çalışma grubunun oluşturulmasında amaçlı örneklem yöntemi kullanılmıştır. Öğretmenlerin 2018-2019 eğitim öğretim yılında görev yapmış olmaları ve öğretim üyelerinin sosyal bilgiler eğitiminde doktorayı tamamlamış olmaları ayrıca katılımcıların 2018 Sosyal Bilgiler Öğretim Programını okuyarak incelemiş olmaları dikkate alınmıştır. Araştırmanın sonucunda; katılımcıların 2018 Sosyal Bilgiler Öğretim Programının 2005 Sosyal Bilgiler Öğretim Programının güncellenmiş ve sadeleştirilmiş şekli olduğunu düşündükleri tespit edilmiştir. Katılımcılar, öğretim programındaki yeniliklerin ve sadeleştirmelerin yapılması gerektiğini belirtmişlerdir. Katılımcılar, programın çok yeni olması sebebiyle oluşabilecek aksaklıklar ve eksikliklerin süreç içerisinde belirlenebileceğini ifade etmişlerdir. Katılımcılar, programın amaçlarında milli ve manevi değerlere, ülke ve millet sevgisine vurgu yapıldığını ve programın genel olarak yapılandırmacılığa uygun olduğunu belirtmişlerdir. Katılımcıların görüşlerine göre öğretim programda beceri sayısının arttığı, kazanım sayısının azaltıldığı ve değerlere yönelik olarak kök değer kavramının getirildiği sonucuna varılmıştır. Katılımcılar öğretim programında belirlenen beceri ve değerlerin hayata aktarılabilir hale getirmenin önemli olduğunu belirtmişlerdir. Katılımcılar, 2018 öğretim programında uygulama ağırlıklı öğrenci merkezli çalışmalara vurgu yapıldığını fakat süreç içerisinde bunun yeterince gerçekleştirilemediğini, bu duruma sebep olarak da ders sürelerinin yetersiz olduğunu düşündüklerini belirtmişlerdir. v Katılımcılar öğretim programında çeşitli ölçme araçlarının kullanımına vurgu yapıldığını fakat uygulamada bu yöntemlere yer verilmediğini vurgulamışlardır. -------------------- TEACHERS’ AND ACADEMICS’ OPINIONS AND EVALUATIONS REGARDING 2018 SOCIAL SCIENCES CURRICULUM The research investigated opinions and evaluations of teachers and academics regarding the 2018 Social Sciences Curriculum which was implemented for the 1st, 5th and 9th grades as a draft program in 2017 until it was fully employed in all grades starting from the 2018-2019 academic year. Quantitative research methods were used in the study. As for data collection, semi-structured interview questions were administered. The study group of the research included 10 social sciences teachers and 10 academics. Participants were chosen among teachers who actively worked during 2018-2019 academic year and among academics who completed their PhDs from the field of teaching social sciences. In addition, it was made sure that all participants read and examined the 2018 Social Sciences Curriculum. As the result of the study, it was found that participants thought that 2018 Social Sciences Curriculum was the updated and simplified version of 2005 Social Sciences Curriculum. Additionally, participants stated that these innovations and simplifications in the program were necessary. Moreover, they proposed that any setbacks or deficits concerning the new program can be identified within the time process due to the program being quite new. On another note, participants deducted that national and moral values, and the love for the country and people were highly emphasized in the objectives of the program. The program was deemed to be in accordance with the constructivism. Furthermore, according to participants, the number of skills in the program increased while the number of learning outcomes decreased. In addition, a new concept “core values” was introduced to address the issue of values. It was stated by participants that it was important to handle skills and values suggested by the program in a way that they would be transferable to real life situations. Participants pinpointed that even though 2018 curriculum highlighted student-centered and practice-oriented activities, it was not possible for teachers to fully implement such an approach to lessons due to the lack of time for each class period. vii Participants reported that the curriculum underlined the use of certain measurement tools, yet such methods and tools were not used in practice