Gestasyon haftasına göre küçük olmak prematüre bebeklerde nörogelişimsel sonuçları olumsuz etkiler

Introduction: There is insufficient data on neurodevelopmental outcomes of infants small for gestational age (SGA) with ≤30 weeks of gestation. The aim of our study was to compare the neurodevelopmental outcomes of preterm infants who are ≤30 weeks, in terms of being SGA or appropriate for gestational age (AGA). Materials and Methods: The data of infants who were born at ≤30 GW, were evaluated retrospectively. Neurological examinations and developmental assessment using Bayley Scales of Infant Development 2nd edition was performed at the corrected age of 18-24 months. Results: The data of 228 infants of whom 65 were SGA and 163 were AGA was evaluated in terms of neurodevelopment at the corrected age of 18-24 months. The mean gestational age (GA) was 28.4±1.1 in both groups (p=0.82) and the mean BW was 810±135 g in the SGA group and 1175±183 g in the AGA group (p<0.001). The SGA group had significantly lower Mental Development Index (p=0.01) and Psychomotor Development Index (p<0.001). In multivariate regression analysis, SGA was identified as an independent risk factor for neurodevelopmental delay (RR: 2.27; p=0.02). Conclusion: Being SGA is a risk factor for neurodevelopmental impairment of preterm infants (≤30 GW).Giriş: Gestasyon haftasına göre küçük (SGA) olan ≤30 hafta bebeklerin nörogelişimsel sonuçları hakkında yeterli veri bulunmamaktadır. Çalışmadaki amacımız SGA ve gestasyon haftasına göre normal (AGA) doğum ağırlığına sahip ≤30 hafta prematüre bebeklerde nörogelişimsel sonuçları karşılaştırmaktır. Gereç ve Yöntem: Düzeltilmiş 18-24. aylarda nörolojik muayeneleri ve “Bayley Bebekler için Gelişimsel Değerlendirme Ölçeği II” ile gelişimsel değerlendirmeleri yapılan ≤30 hafta prematüre bebeklerin verileri retrospektif olarak değerlendirildi. Bulgular: Düzeltilmiş 18-24. ayda SGA (n=65) ve AGA (n=163) gruplarında toplam 228 bebek nörogelişimsel açıdan değerlendirildi. SGA ve AGA grubunda ortalama gestasyon yaşı (sırasıyla 28,4±1,1 ve 28,4±1,1, p=0,82) ve doğum ağırlığı (sırasıyla 810±135 ve 1175±183 g, p<0,001) olarak tespit edildi. Nörogelişimsel değerlendirmede, SGA grubunda bilişsel ölçek puanı (p<0,01) ve hareket ölçek puanı (p<0,001) anlamlı olarak daha düşük bulundu. Çok değişkenli lojistik regresyon analizinde SGA’nın nörogelişimsel gerilik için bağımsız risk faktörü olduğu saptandı (RR: 2,27, p=0,02). Sonuç: Prematüre bebeklerin (≤30 hafta) gestasyon haftasına göre düşük doğum ağırlığı ile doğmaları, nörogelişimsel gerilik açısından risk faktörüdür

Sultan Murad IV 's Baghdad campaign and Kasr-i Shirin

Osmanlı Devleti, kuruluşundan XVI. Yüzyıla kadar, birçok devletle ilişki içinde olmuştur. Ancak XVI. Yüzyılın başından XVII. Yüzyılın ortalarına kadar, Devletin doğudaki en büyük meselesi Safeviler oldu. IV. Murat’ın başa geçişinin hemen ardından yaşanan Bekir Subaşı isyanıyla, Osmanlının en önemli eyaletlerinden biri olan Bağdad Safevilerin eline geçti. Doğudan gelen ticaret yolları üzerinde olmasının yanı sıra, içinde Sünniler için manevi bir değeri olan İmam-ı Azam Ebu Hanefi türbesinin bulunması, buna karşın Şiilerin kutsal saydıkları Kerbela ve Necef’in de Bağdad eyaleti sınırları içinde yer alması, bölgenin hassasiyetini gözler önüne seriyor. İki devlet de Bağdad’a sahip olmak için hiçbir fedakarlıktan kaçınmamıştır. IV. Murat’ın ilk saltanat döneminde, Bağdad üzerine üç sefer düzenlendi. Sultanın henüz çocuk yaşta olması nedeniyle, Veziriazamların önderliğinde yapılan bu seferler hiçbir sonuca ulaşılamadığı gibi, Bağdad ele geçirilemedi. Büyük askeri ve mali kayıplar verildi. 1632 yılında Sultan Murad, idareye tam anlamıyla hakim olduktan sonra, ilk hedefi Safeviler oldu. 1635’de Revan’a yürüdü ve 10 gün süren kuşatmanın ardından Revan Kalesi ele geçirildi. Ardından Bağdad’a yürüme düşüncesinde olan Sultan, hastalığı sebebiyle geri dönmek zorunda kaldı. Revan ise, bastıran kış mevsimini fırsat bilen Şah Safi tarafından, 6 ay sonra tekrar Safevi topraklarına katıldı. Bu kayıp, Sultan Murad’ın bizzat başında olacağı ikinci büyük Doğu seferini zorunlu hale getirdi. Nitekim Sultanın Safevilere duyduğu kin iyice artmıştı. 1636’dan itibaren, Doğu seferi hazırlıkları başlamıştı. 1638’de Sultan Murad, ordusunun başında Bağdad üzerine yürüdü. Musul’dayken, ordunun bir kısmını Revan üzerine yolladı ve ardından Bağdad kuşatıldı. 40 gün süren kuşatmadan sonra kale ele geçirildi. Sultan iyice şiddetlenen hastalığı yüzünden İstanbul’a dönmeye karar verdi ve Veziriazam Kara Mustafa Paşayı Bağdad’ta bırakarak, Safevilerle yapılacak barış görüşmelerine tayin etti. Veziriazam İran içlerine yürüyüşe geçtiği sırada, Safevi Şahı Safi barışa razı oldu. 1639’da Zehab Ovası yakınındaki Kasr-ı Şirin’de Safevilerle barış antlaşması imzalandı. Antlaşma metni, tasdiklenmek üzere İstanbul’a yollandı ve Sultanın onayından geçti. Böylece İran ve Osmanlı arasında uzun yıllar sürecek bir barış dönemi başladı. Kasr-ı Şirin’de çizilen sınır ise günümüze kadar geçerliliğini korudu. Bu bakımdan, yapılan antlaşmanın ne denli gerçekçi olduğu şüphe götürmez bir gerçektir.The Ottoman Porte was in good company with many goverments beginning from its establishment to the 16th century. The greatest problem for the government from the beginning to the midst of the 17th century were the Safavis. With the Bekir Subasi insurgence, immediately after Murad IV succeeded to the throne, Baghdad, one of the most important states of the of the Ottoman Empire, was captured by the Safavis. Besides being situated on the trade roads running from the east, the existence of both, Imam-ı Azam Ebu Hanefi’s tomb, which is holy for the Suni, and the holy Shi’a shrines of Najaf and Karbala in the region of Baghdad state make the importance of the place clear to the eye. The Ottoman and the Safavis made every sacrifice to conquer and own Baghdad. During the first period of Murad IV reign, three attempts of conquest of Baghdad were made. As the Sultan was at the age of a child, none of these attempts, made with the leadership of the Veziriazams, were successful and Baghdad couldn’t be seized. There were a great amount of military and financial losses. After 1632, Sultan Murad having gained control of all governing, he attacked on the Safavis in the first place. He then moved on Revan in 1635 and after the 10 days’ siege, the Revan Castle was captured. The Sultan, who intended to move on Baghdad, had togo back due to his illness. Six months later, Revan was recaptured by Shah Safi and was added to the Safavian land. This loss forced the second biggest movement to the east led by Sultan Murad himself. Thus, the hatred in him to the Safavis had fully increased. The eastern movement was started in 1636. Sultan Murad, leading his armies, moved on Baghdad. While in Mosul, he sent some of his troops on Revan and then Baghdad was besieged. After the forty days’ siege, the castle was seized. Owing to his worsened illness, Sultan Murad decided to go back to İstanbul, appointing Veziriazam Kara Mustafa Pasa to the negotiations of peace with the Safavis in Baghdad. When the Veziriazam moved on interior Iran, the Safavian Shah Safi agreed to make peace. The peace treaty with the Safavis was signed in Kasr-ı Sirin near Zehab plain in 1639. The text of the agreement was sent to İstanbul to be signed by the Sultan. Thus, the period of peace between Iran and the Ottomans, that would last for years, was started. The territories designed with the Kasr-ı Sirin treaty has been valid so far. For this reason, how practical the treaty mentioned above is, beyond doubt, is a solid fact

Primary squamous cell carcinoma of the breast: A case report in a review of current literature

Primary squamous cell carcinoma of the breast is a rare malignancy considered a subtype of metaplastic breast carcinomas. Here we presented a case of 56-year-old female patient with a history of modified radical mastectomy, chemotherapy and radiotherapy for invasive ductal carcinoma of the right breast in 2005. After eleven years primary squamous cell carcinoma of the breast has been detected in the left breast. Any other localization were screened for squamous cell carcinoma but there was no localization beyond the breast. The case was discussed and complied in a review of current literature

An Eye Movement Desensitization and Reprocessing (EMDR) Group Intervention for Syrian Refugees With Post-traumatic Stress Symptoms: Results of a Randomized Controlled Trial

The number of refugees has increased significantly over the past few years. PTSD and depression are among the most common mental health problems among refugees. Eye Movement Desensitization and Reprocessing (EMDR), an effective treatment for PTSD, is usually administered individually. The availability of mental health resources would be greatly enhanced when EMDR can be delivered to groups. The EMDR G-TEP is a group protocol based on Early EMDR intervention protocols. There is clinical evidence and one field study published on the effect of EMDR G-TEP and there is only one RCT published on the treatment of PTSD and depression in a refugee camp. The aim of our study was to investigate the efficacy of EMDR G-TEP in treating post-trauma symptoms and depression and preventing the development of chronic PTSD among refugees living in a refugee camp. 47 adult participants with PTSD symptoms were randomly allocated to experimental (n = 18) and control (n = 29) groups. We measured Impact of Event Scale (IES-R), Beck Depression Inventory-II (BDI-II) and International Neuropsychiatric Interview (MINI) at pre-, post- and 4-week follow-up. Analysis of the results showed that the EMDR G-TEP group had significantly lower PTSD and depression symptoms after intervention. The percentage of PTSD diagnosis decreased from 100 to 38.9% in the EMDR G-TEP group and was unchanged in the control group. Following the EMDR G-TEP intervention 61.1% of the experimental group no longer had a PTSD diagnosis; this decrease was maintained at 4 weeks follow-up. In the control group the percentage of people who no longer met the diagnostic criteria for PTSD was 10.3% post-test and 6.9% at 4 weeks follow-up. A significant decrease in depression symptoms from pre-test levels was found in EMDR group but not in the control group follow up-test. This study indicated that EMDR G-TEP effectively reduced PTSD symptoms among refugees living in a camp, after two treatment sessions conducted over a period of 3 days. Further studies need to be performed using a larger number of participants, followed for a longer period of time and given more treatment sessions to strengthen our findings

An Eye Movement Desensitization and Reprocessing (EMDR) Group Intervention for Syrian Refugees With Post-traumatic Stress Symptoms: Results of a Randomized Controlled Trial

The number of refugees has increased significantly over the past few years. PTSD and depression are among the most common mental health problems among refugees. Eye Movement Desensitization and Reprocessing (EMDR), an effective treatment for PTSD, is usually administered individually. The availability of mental health resources would be greatly enhanced when EMDR can be delivered to groups. The EMDR G-TEP is a group protocol based on Early EMDR intervention protocols. There is clinical evidence and one field study published on the effect of EMDR G-TEP and there is only one RCT published on the treatment of PTSD and depression in a refugee camp. The aim of our study was to investigate the efficacy of EMDR G-TEP in treating post-trauma symptoms and depression and preventing the development of chronic PTSD among refugees living in a refugee camp. 47 adult participants with PTSD symptoms were randomly allocated to experimental (n = 18) and control (n = 29) groups. We measured Impact of Event Scale (IES-R), Beck Depression Inventory-II (BDI-II) and International Neuropsychiatric Interview (MINI) at pre-, post- and 4-week follow-up. Analysis of the results showed that the EMDR G-TEP group had significantly lower PTSD and depression symptoms after intervention. The percentage of PTSD diagnosis decreased from 100 to 38.9% in the EMDR G-TEP group and was unchanged in the control group. Following the EMDR G-TEP intervention 61.1% of the experimental group no longer had a PTSD diagnosis; this decrease was maintained at 4 weeks follow-up. In the control group the percentage of people who no longer met the diagnostic criteria for PTSD was 10.3% post-test and 6.9% at 4 weeks follow-up. A significant decrease in depression symptoms from pre-test levels was found in EMDR group but not in the control group follow up-test. This study indicated that EMDR G-TEP effectively reduced PTSD symptoms among refugees living in a camp, after two treatment sessions conducted over a period of 3 days. Further studies need to be performed using a larger number of participants, followed for a longer period of time and given more treatment sessions to strengthen our findings

Axillary staging after neoadjuvant chemotherapy: The comparison of surgeon performed axillary ultrasound and 18F-FDG PET/CT with pathologic status of sentinel lymph nodes in clinically node-negative breast cancer

San Antonio Breast Cancer Symposium -- DEC 05-09, 2017 -- San Antonio, TXWOS: 00042548940033