Is general anesthesia a risk for myocardium? Effect of anesthesia on myocardial function as assessed by cardiac troponin-i in two different groups (isofluran+N2O inhalation and propofol+fentanyl iv anesthesia)

Demet Dogan Erol1, Ibrahim Ozen21Department of Anaesthesiology and Reanimation, School of Medicine, Kocatepe University, Afyonkarahisar, Turkey; 2Department of Anaesthesiology and Reanimation, Karadeniz Technical University Faculty of Medicine, Trabzon, TurkeyBackground and objectives: Peroperative myocardial infarction (MI) is the most common cause of morbidity and mortality. What is the role of general anesthesia in this process? Is general anesthesia a risk for myocardial infarction? The present study was designed to determine whether the measurement of serum levels of cardiac troponin I (cTnI), a highly sensitive and specific marker for cardiac injury, would help establish the diagnosis of myocardial infarction in two different types of anesthesia.Method: Elective abdominal hysterectomy was planned with the permission of the ethic committee in 40 patients who were 20–45 years range, in ASA-I group, and have a Goldman Cardiac Risk Index-0. The patients were divided into two groups. Isoflurane + N2O was administrated to first group, and Propofol + Fentanyl to second group. cTnI levels were determined before anesthesia, after induction before surgery and 9 hours after the second period respectively.Results: There was no significant difference between the groups by the means of demographic properties, hemodynamic parameters and cTnI levels, and the cTnI levels were determined under the basal levels in all samples.Conclusion: General anesthesia is not a risk for myocardial infarction to state eliminating risk factors and protection hemodynamia cardiac.Keywords: cardiac troponin-I, myocardial infarction, isofluran + N2O inhalation anesthesia, propofol + fentanyl intravenous anesthesia

Singapore Logistics Cluster and Ankara Logistics Base As the Examples of Logistics Clusters in the Framework of Competition and Value Chain

DergiPark: 326015trakyasobedWith th globalization, increasing number of industry clusters was followed byt he emergence of logistics clusters which was an outcome of the increase in the volumes of production and Foreign trade as well as the demand for the logistic sservices. The countries, intending to increase their competitive strength, utilize the establishment and encouraging of logistics clusters as a statepolicy. In our country, the Ankara Logistics Base is the first established logistics cluster; it wa sfounded in 2004 by only the private sector, as there is not a legal regulation, supportor an incentive System for logistics clusters in the country. In this study, by conducting the respective Literature survey, the cases of Singapore logistics cluster and the Ankara Logistics Base are compared and an interview was made with the Administrative Unit of the Ankara Logistics Base to assess the position of the Base within the value chain and a survey was made with a total of 16 transportation, storageanddistributioncompanies, 15 of whichwerelocated inside the Base and 1 outside. Furthermore, the cluster schema of the Base is created by making a research to answer the questions whether the Base is a logistics cluster, whether it has been established in a plan in the process, whether it is a sub-cluster of a larger one in terms of the value chain or a logistics cluster on its own, what the service leve land scale of the Base is in terms of spatial distribution as well as who there late dactors are. As the result, the Ankara Logistics Base is expected to be a model for the logistics clusters, to be established in our countryKüreselleşme ile birlikte sayıları artan sanayi kümelenmelerini, artan üretim ve dış ticaret hacmi ile lojistik hizmetlere olan ihtiyacın artması sonucu lojistik kümelenmelerin oluşması takip etmiştir. Rekabet gücünü arttırmak isteyen ülkeler, lojistik kümelenmelerin kurulmasını ve teşvik edilmesini bir devlet politikası olarak uygulamaktadırlar. Ülkemizde ise; ilk kurulan lojistik kümelenmesi Ankara Lojistik Üssü olup; 2004 yılında Ülkemizde lojistik kümelenmelere yönelik herhangi bir yasal mevzuat, destek veya teşvik sisteminin bulunmaması sebebiyle sadece özel sektör tarafından kurulmuştur. Bu çalışmada, ilgili literatür taraması yapılarak; Singapur’da yer alan lojistik kümelenmesi ile Ankara Lojistik Üssü örnekleri karşılaştırılmış ve Ankara Lojistik Üssü’nün değer zinciri içerisindeki yerinin değerlendirilmesi için Ankara Lojistik Üssü Yönetim Birimi ile mülakat ve Üs içindeki 15 ile Üs dışında 1 taşımacılık, depolama ve dağıtım firması olmak üzere toplam 16 firma ile anket yapılmıştır. Ayrıca, yapılan çalışmalar ile Üssü’n kümelenme modeli bağlamında bir lojistik kümelenme olup olmadığı, süreç bağlamında planlı bir şekilde oluşup oluşmadığı, değer zinciri bağlamında herhangi büyük bir kümelenmenin alt kümelenmesi mi yoksa başlı başına bir lojistik kümelenme mi olduğu, mekansal yayılım bağlamında Üssü’n hizmet düzeyi ve ölçeğinin yanı sıra ilişkili aktörlerin kimler olduğu araştırılarak; Üssü’nün kümelenme şeması ortaya konmuştur. Sonuç olarak, Ankara Lojistik Üssü’nün Ülkemizde kurulacak lojistik kümelenmelere bir model teşkil etmesi beklenmektedi

Determination Of Physicochemical Properties Of Walnut Oil Obtaining with the Cold Press Technology

Ceviz (Juglans regia L.), Juglandaceae familyasında yer alan, anavatanı Türkiye olan önemli bir meyvedir. 2015 yılı TUİK verilerine göre Türkiye'de yıllık 190.000 ton ceviz üretimi yapılmıştır. Ceviz yaklaşık %52-70 değerleri arasında yağ içermektedirler. Türkiye'deki cevizlerin bileşimi üzerine yapılan çalışmalarda; cevizin yaklaşık olarak %3.2-4.4 su, %12.0-19.6 protein, %61.3-73.8 yağ, %1.8-2.3 kül ve %2.2-4.5 şeker ihtiva ettikleri görülmektedir. Ayrıca ceviz, Ca, P, Mg, Fe, Na, K gibi mineral maddeler bakımından zengin olduğu gibi A, B?, B?, B?, C vitaminlerini de içermektedir. Soğuk pres yağ teknolojisi ile üretilen yağlar son yıllarda tüketiciler tarafından gittikçe rağbet görmektedir. Bu teknoloji ile elde edilen yağlar oldukça düşük sıcaklık derecelerine maruz kalmakta (40-50?) ve yağ elde edilmesi esnasında hiçbir şekilde solvent (çözücü) uygulaması söz konusu olmamaktadır. Bu çalışmada, ceviz yağı soğuk pres yöntemiyle elde edilerek ceviz yağının bazı fizikokimyasal özellikleri belirlenmiştir. Ceviz yağının iyot sayısı, sabunlaşma sayısı, serbest asitlik, peroksit sayısı değerleri sırasıyla 139.57, 191.039, %0.38 (oleik asit cinsinden), 5.24 meqO?/kg olarak tespit edilmiştir. Ceviz yağının yağ asitleri bileşimi değerlendirildiğinde; palmitik asit %7.10, stearik asit %4.58, oleik asit %26.50, linoleik asit %50.77, linolenik asit %11.05 olarak tespit edilmiştirDETERMINATION OF PHYSICOCHEMICAL PROPERTIES OF WALNUT OIL OBTAINING WITH THE COLD PRESS TECHNOLOGY Walnut (Juglans regia L.) which is native to Turkey, is an important fruit in the family of Juglandaceae. According to the TUIK data of 2015, 190 thousand tons of walnut were produced annually in Turkey. Walnuts contain about 52–70% fat. Walnut was found to consist approximately 3.2–4.4% water, 12.0–19.6% protein, 61.3–73.8% fat, 1.8–2.3% ash and 2.2–4.5% sugars in studies about the composition of walnuts in Turkey. Walnut is also rich in minerals such as Ca, P, Mg, Fe, Na, K as well as A, B?, B?, B?, C vitamins. The oils produced with cold press oil technology are increasingly popular by consumers in recent years. The oils obtained with this technology are exposed to very low temperature (40–50?) and there is no solvent application during the oil production. In this study, walnut oil was obtained by cold pressing method and some physicochemical properties of walnut oil were determined. The iodine number, saponification number, free acidity and peroxide number values of walnut oil were determined as 139.57, 191.039, 0.38% (as oleic acid) and 5.24 meqO?/kg, respectively. When fatty acid composition of walnut oil is evaluated; Palmitic acid, stearic acid, oleic acid, linoleic acid, linolenic acid were determined as 7.10%, 4.58%, 26.50%, 50.77%, 11.05%, respectivel

Effect of angiotensin converting enzyme inhibitors on periprocedural myocardial infarction in patients with metabolic syndrome

Background: Metabolic syndrome (MetS) has been reported as a risk factor for cardiovascular events. The aim of the present study is to investigate the association between chronic angiotensin-converting enzyme inhibitors (ACE-I) therapy and the rate of periprocedural myocardial infarction (PMI) after elective coronary stenting among patients with MetS. Methods: The inclusion criteria were MetS and plan for elective percutaneous coronary intervention. To assess the effect of ACE-I treatment on the incidence of PMI, measurements of cardiac biomarkers (CK-MB mass and troponin I) were performed at baseline and 24 h after the procedure. Results: A total of 459 patients fulfilling the inclusion criteria were recruited to chronic ACE-I treatment and ACE-I naive groups in a 2/1 ratio. Baseline troponin I and CK-MB levels were similar in both treatment groups, whereas they were significantly lower in ACE-I group 24 h after the procedure. Univariate analysis identified body mass index (BMI), LDL cholesterol, nitrate and ACE-I use as significant factors for the development of PMI. Multivariate regression model revealed that body mass index increased and use of nitrate and ACE-I decreased the probability of PMI independent from confounding factors (OR 1.14, 95% CI 1.05–1.23, p = 0.002 for BMI; OR 0.26, 95% CI 0.14–0.48, p = 0.01 for nitrate use, OR 0.51, 95% CI 0.27–0.93, p = 0.03 for ACE-I use). Conclusions: This prospective observational cohort trial demonstrated that chronic ACE-I therapy was an independent predictor for reduced PMI among patients with MetS who underwent elective coronary intervention

Environment education: Preparing the computer assisted instructional material at elementary school

Bu çalışmanın amacı, ilköğretimde çevre eğitimi için yapılandırmacı öğrenme yaklaşımına dayalı bilgisayar destekli öğreti_x000B_m materyali hazırlamaktır. Her biri birden fazla etkinlik içeren 13 çalışma yaprağından oluşan öğretim materyallerinde deney, sunum, etkileşimli animasyon, video, tartışma gibi etkinlikler yer almıştır. Bunların tamamı (deney, video vb.) ilköğretim öğrencilerinin çevre ile ilgili kavramları kolay ve aktif bir şekilde öğrenmelerine ve yapılandırmalarına yardımcı olacak şekilde hazırlanmıştır. Hazırlanan materyallerin ilk halleri, iki araştırmacı tarafından değerlendirilmiş ve test edilmiştir. Materyaller bu uygulama sonuçlarına göre gözden geçilmiş ve düzenlemeler yapılmıştır._x000B_Daha sonra materyalleri değerlendirmek için 5 fen ve teknoloji öğretmeni ve 15 öğrenci ile bir pilot uygulama yapılmıştır. Uygulama öncesinde öğretmen ve öğrencilere materyallerle ilgili bilgi verilmiştir. Yazılım öğretmen ve öğrencilere tanıtılmış, çalışma mantığı ve özellikleri anlatılmıştır. Uygulama sonrasında yapılan anket ile öğretmen ve öğrencilerin materyalin öğrenci düzeyine uygunluk, uygulanabilirlik, anlaşılabilirlik, kullanım kolaylığı gibi özellikleri konusundaki düşünceleri alınarak, materyal değerlendirilmiş ve gerekli değişiklikler yapılarak eğitim öğretime uygun hale getirilmiştir. The purpose of this study was to prepare the computer-assisted instructional materials based on constructivist learning approach for environmental education in primary education. The computer-assisted instructional materials composed of 13 worksheets, each having more than one activity, had several activities such as experiments, presentation, interactive animations, videos, discussion, texts. All computer-assisted instructional materials are intended to help primary school students learn and construct concepts related to environment actively and easily._x000B_Draft version of the computer-assisted instructional materials were reviewed and tested by two researchers. The materials were revised and modified according to the results of these tests. And then a pilot study with 5 primary school science teachers and 15 primary school students was conducted to evaluate the materials. Before pilot study, the teachers and students were given some information about the computer-assisted instructional materials. In the end of this application, the views of the primary school science teachers and the primary school students in İzmir were taken about the materials in terms of practicality, readability, comprehensibility, pacing and ease of use etc. by using a questionnaire. The material was revised again according to the results of this questionnaire and was made ready to use in environment education in the future

Assessing the Neurocognitive function effects of ketamine in Cardiac Surgical patients

Background: Despite remarkable progress in surgical, cardiopulmonary bypass (CPB) and anesthetic tecniques, neurocognitive damage still remains an important cause of postoperative morbidity in cardiac surgery. The aetiology of neurocognitive damage is likely to be multifocal; including macro and microemboli, cerebral hypoperfusion, inflammation and nonpulsatile flow. N-methyl-D-asparticAcid (NMDA) receptors play an important role during neurocognitive damage. Ketamine is a non-competitive antagonist to the phencyclidine site of NMDA receptor for glutamate and directly suppresses proinflammatory cytokine production. The aim of the present study was to evaluate whether ketamine has neuroprotective effects during open-heart surgery through the use of neurocognitive tests. Methods: We considered all patients aged between 58-76 years who were referred to a single cardiothoracic surgical team for elective, primary coronary revascularization. Patients were excluded from the study for the following reasons: a history of neurological, psychiatric, gastrointestinal, hepatic, renal, hematologic and clotting systems disorder and repeat procedures. Undergoing CPB were randomized 2 groups: Group1 (ketamine)(n=25) or Group2 (propofol)(n= Patients 25) In the propofol group, anesthesia was induced with 3mg/kg propofol, 1µg/kg remifentanyl, 0.1mg/kg vecuronium. Remifentanyl 0.5-1μg/kg/min was infused intravenously throughout the whole procedure. In the ketamine group, anesthesia was induced with 1-2mg/kg propofol, 1-2mg ketamin, 0.1mg/kg vecuronium. Ketamin 1mg/kg/hour was infused intravenously. Pressors, inotropic agents and antiarrhythmics were used as needed. The Mini-Mental State Examination(MMSE) was administered the day before surgery and three days later. The change in scores for MMSE was calculated for each patient and all the group. The results were compared statistically with paired simple t-test. Results: The mean age, CBP duration, lowest temperature was not statistically significant (Table1). Peroperative and postoperative blood pressures and pulse rates showed differences between groups. There were no preoperative differences between the groups on any of the mean MMSE score (Table2). The ECG monitoring revealed that most patients remained in sinus rhythm, with no difference between groups. Conclusions: We could not demonstrate that intraoperatively administered ketamine resulted in greater neuroprotective effects compared with propofol. Ketamine in combination with propofol during cardiac surgery is associated with a stable hemodynamic profile. Propofol may reduce the delivery of microemboli to the cerebral circulation by decreasing the cerebral blood flow. Propofol has a direct neuroprotective effect in vitro, although Roach et al. could not demonstrate a protective effect of propofol during open-heart surgery. Propofol enhances the antiinflammatory response to surgery by several mechanisms. This might have masked a neuroprotective effect of ketamine because propofol was administered in both groups in our study

The relationships between perfectionism and aggression among adolescents

AbstractThe purpose of this study was to investigate the relations between perfectionism and aggression in a sample of 445 high school students. The Almost Perfect Scale-Revised (APS-R; Slaney, Rice, Mobley, Trippi, & Ashby, 2001) and the Buss-Perry Aggression Questionnaire (BPAQ; Buss & Perry, 1992) were used for data collection. The sub dimensions of the APS-R were high standards, order (adaptive perfectionism), and discrepancy (maladaptive perfectionism). The sub dimensions of the BPAQ were anger, physical aggression, hostility and verbal aggression. As hypothesized, the regression analyses revealed that, discrepancy was the positive predictor of anger, physical aggression and hostility while order was the negative predictor of anger, physical and verbal aggression. As predicted, high standards were found to be the negative predictor of hostility. However, unexpectedly, high standards were found to be the positive predictor of verbal aggression