Transforaminal lumbar interbody fusion as revision surgery for patients previously treated by discectomy or instrumentation of the lumbar spine

Purpose:Transforaminal lumbar interbody fusion (TLIF) is a surgical method that allows stable fusion of the anterior spinal column and restoration of disc height and lumbar lordosis. The aim of this study was to evaluate the clinical and radiological data of the patients who underwent lumbar discectomy, posterior instrumentation and laminectomy or TLIF surgery and who applied to our clinic with the complaint of discogenic back or leg pain and investigate the effectiveness of procedure.Material and Methods:Between the years 2012-2016, patients who underwent TLIF procedure were analyzed retrospectively. Inclusion criteria; patients undergone surgery due to any disc pathology from the lumbar region, complaints that did not respond to a minimum of 6 weeks of conservative treatment, patients undergoing revision surgery with two levels or more TLIF procedure with posterior instrumentation and a follow-up period longer than 2 years. Radiological and clinical data of 13 patients who met these criteria were examined for the study.Results:The study group consisted of 11 women and 2 men. The mean follow-up period was 39.3 months (range 26-58). The mean age was 62.2 (range 56-71). 7 patients had previously undergone lumbar discectomy, 4 patients had posterior instrumentation and laminectomy, 2 patients had posterior instrumentation and TLIF procedure. The dominant complaint was back pain in all patients. There were also complaints of varying rates of radicular pain and combinations of neurological deficit. Indications for revision surgery; lumbar degenerative disc disease, recurrent lumbar disc herniation, lumbar spinal canal stenosis, segmental instability and spondylolisthesis with two levels and higher. A total of 77, mean 5.9 (±1.4) pedicle screws were placed. A total of 32, average 2.4 (±0.5) levels of TLIF were applied. In 8 (61.5%) patients, pedicle screws was augmented with cement. The mean operative time was 378.8 min, and the mean amount of blood loss was 684.6 ml. The mean amount of autotransfusion and allogeneic blood transfusion was 569.2 ml. Mean duration of hospital stay was 4.6 days. One patient had dural tear during the operation. In one patient, the wound drainage that started in the postoperative 10. day was healed with wound debridement and antibiotic treatment. None of the patients had proximal or distal adjacent segment fracture, implant failure, nonunion or loss of correction during the follow-up. Complete neurological recovery was observed in all patients except the patient who was admitted with a 6-month history of foot drop.Conclusions:TLIF is a safe and effective procedure for the treatment of spinal pathologies in revision surgery. Elimination of spinal stenosis and instability, decompression of nerve roots, restoration of intervertebral disc heights, restoring lumbar lordosis, neutralization of global spinal balance and pain relief are possible.Publisher's Versio

Examining the effect of teaching method and learning style on student course achievement for hospitality students

This study attempts to bridge the gap between effective teaching and empirical research on hospitality education by bringing a learning-based theoretical framework and a validated assessment tool together within a research setting. A specific objective of the study was to determine the effect of students\u27 learning styles on student course achievement. The author examined the effect of learning styles and instructional strategies on student course achievement in consideration with students\u27 GPA, and the influence of demographic variables including gender, age, class standing, student classification as being either international or domestic, and students\u27 industry experience. Additionally, the relationship between students\u27 overall satisfaction with instructional methods utilized in the classroom and students\u27 course achievement was explored. The study also offers a unique comprehensive approach where the above-mentioned variables and concepts are included together within the same research study; The results of the analysis indicated that there was no significant relationship between students\u27 dominant learning style and student course achievement. An interesting finding of this study was that when students perceived the classroom instruction provided to match their preferred learning styles, they demonstrated higher overall satisfaction with instructional methods utilized in the classroom. In accordance, it was determined that higher overall satisfaction with instructional methods utilized in the classroom led to higher student course achievement. It is suggested that future research must repeat similar studies across a variety of hospitality courses to establish patterns of learners\u27 preferred learning styles and learners\u27 reaction to instructional methods. Such efforts could potentially help hospitality educators revise and modify lesson plans to accommodate all learning styles in the classroom. Further, evidence of patterns obtained from such types of research could help establish a guide for addressing the needs of particular learners, grouped by their dominant learning styles, and customize instructional content accordingly

Adult lumbar scoliosis

Scoliosis in the adult is a disorder that involves a convergence of deformity and degenerative disease in the spine. It can be defined as a coronal deformity with Cobb angle of more than 10 degrees in mature patients. The treatment of adult lumbar scoliosis deformity requires a multidisciplinary approach and preoperative planning, and to be extended to the development of new treatment methods in the future along with the expected life expectancy. It often manifests with low back pain. Etiology of the disease is related with primary degeneration or continuation of a deformity from adolescence. The main objective of surgical management is to decide which patient is to be treated with surgical treatment, to evaluate the general condition and to analyze the comorbidities of the patient and to draw a treatment scheme considering the patient’s expectations.Publisher's Versio

Ottoman and Old Anatolian Turkish Texts that as Influence Ranks from Dialects that are Source of These Texts Language

Bu makale iki bölümden oluşmaktadır. Birinci bölümde Eski Anadolu Türkçesi metinleri ağızlardan etkilenme derecelerine göre genel bir sınıflandırmaya tabi tutulmuştur. İkinci kısımda ise, bu metinlerde kullanılan yazı dilinin hangi yerel ağızlara dayandığı araştırılmıştır. Sonuçta Eski Anadolu ve Osmanlı Türkçesi yazı diline kaç ağzın kaynaklık ettiği ve bunların dil özellikleri karşılaştırmalı olarak ortaya konulmuştur. This article consists of two chapters. In the first chapter, Old Anatolian Turkish texts were classifıed in general according to the degrees they affected by different dialects. In the second chapter we examined from which local dialects these texts borrowed their textual language. To sum up, we pointed out how many dialects influenced Old Anatolian Turkish and Ottoman Turkish and compared the linguistic features of these dialects

Machining strategy development in 5-axis milling operations using process models

Increased productivity and part quality can be achieved by selecting machining strategies and conditions properly. At one extreme very high speed and feed rate with small depth of cut can be used for high productivity whereas deep cuts accompanied with slow speeds and feeds may also provide increased material removal rates in some cases. In this study, it is shown that process models are useful tools to simulate and compare alternative strategies for machining of a part. 5-axis milling of turbine engine compressors made out of titanium alloys is used as the case study where strategies such as flank milling (deep cuts), point milling (light cuts) and stripe milling (medium depths) are compared in terms of process time by considering chatter stability, surface finish and tool deflections

Korelacja odsetka hemoglobiny glikowanej z ciężkością choroby wieńcowej występująca u młodych osób niezależnie od tradycyjnych czynników ryzyka

Introduction: In this study, we aimed to investigate the relationship between glycated haemoglobin (HbA1c) levels and the severity of coronary artery disease (CAD) in < 40 years old patients. Material and methods: The study population consisted of 211 premature coronary atherosclerotic patients (pCAP) (aged 36.4 &#177; 2.5 years) and 160 control subjects (36.4 &#177; 2.4 years). The severity of CAD was evaluated by the Gensini scoring system. HbA1c levels and the other basic biochemical parameters were analysed, and relations with severity of CAD were evaluated. Results: There were statistically significant differences in serum HbA1c levels between the two groups (pCAP = 6.1 &#177; 1.8%, control = 4.7 &#177; 1.2%, p < 0.001). HbA1c levels significantly positively correlated with the Gensini score in pCAP (r = 0.662, p < 0.001). In linear multivariate regression analysis (including age, sex, HbA1c, smoking, diabetes mellitus and hypertension as dependent parameters), only HbA1c was found to be an independent risk factor for the presence of severe CAD (Beta = 0.374, p < 0.001). In ROC curve analysis, the optimal cut-off value of HbA1c to predict severe CAD was 6.52%, with 74.4% sensitivity and 75.1% specificity (area under the curve 0.781, 95% confidence interval 0.661 to 0.901, p < 0.001). Conclusions: HbA1c levels were found to be correlated with the Gensini score in pCAP with and without diabetes. In this respect, glucose metabolism abnormalities, indicated by HbA1c, may play an important role in premature CAD. (Endokrynol Pol 2012; 63 (5): 367-371)Wstęp: Niniejsze badanie przeprowadzono w celu oceny zależności między odsetkiem hemoglobiny glikowanej (HbA1c) a ciężkością choroby wieńcowej (CAD) u chorych w wieku < 40 lat. Materiał i metody: Badana populacja składała się z 211 chorych z przedwczesną miażdżycą tętnic wieńcowych (pCAP) (w wieku 36,4 &#177; 2,5 roku) i 160 osób stanowiących grupę kontrolną (36,4 &#177; 2,4 roku). Ciężkość CAD określano na podstawie wartości wskaźnika Gensiniego. Przeanalizowano odsetek HbA1c oraz inne wyjściowe parametry biochemiczne i oceniono ich zależności z ciężkością CAD. Wyniki: Stwierdzono statystycznie istotne różnice między grupami w zakresie stężeń HbA1c w surowicy (pCAP = 6,1 &#177; 1,8%, grupa kontrolna = 4,7 &#177; 1,2%; p < 0,001). Wartości HbA1c były istotnie skorelowane z wartościami wskaźnika Gensiniego u chorych z pCAP (r = 0,662; p < 0,001). W wieloczynnikowej analizie regresji liniowej (w której uwzględniono wiek, płeć, stężenie HbA1c, palenie tytoniu, cukrzycę i nadciśnienie tętnicze jako zmienne zależne) jedynie stężenie HbA1c okazało się niezależnym czynnikiem ryzyka wskazującym na występowanie ciężkiej CAD (Beta = 0,374; p < 0,001). Jak wykazano w analizie krzywych ROC, optymalny punkt odcięcia wartości HbA1c pozwalający prognozować ciężką CAD wynosi 6,52%, przy czułości metody 74,4% i swoistości 75,1% (pole pod krzywą 0,781, 95-proc. przedział ufności 0,661&#8211;0,901; p < 0,001). Wnioski: U osób z pCAP, zarówno chorych na cukrzycę, jak i bez tej choroby, stwierdzono korelacje między wartościami HbA1c i wskaźnikiem Gensiniego. Jak wynika z powyższych obserwacji, zaburzenia metabolizmu glukozy, których wyznacznikiem jest odsetek HbA1c, mogą odgrywać ważną rolę w rozwoju przedwczesnej CAD. (Endokrynol Pol 2012; 63 (5): 367-371

Identifying the Components of Job Satisfaction Attributes: A Focus on Private Club Managers

The objectives of this study were to determine job attribute factors affecting overall job satisfaction and satisfaction factors predicting intention to choose and stay within a current job among managers of private clubs in the U.S. The findings indicate that selfworth and salary and benefits are significantly related to the overall job satisfaction. In addition, overall job satisfaction was a strong predictor for private club managers’ intention to choose the current job held, if given a second chanc

Effect of the COVID-19 pandemic on barriers to middle-aged adults' participation in physical activity in Turkey: a cross-sectional study

Background: Physical inactivity is one of the greatest problems facing the world today. The purpose of this study was to examine the level of barriers to physical activity for middle-aged adults during the COVID-19. Methods: Using an online survey, a sample of the Turkish population (n = 432: 48.6% female, 51.4% male; mean age 57.3 years) answered questions about sociodemographic characteristics as well as barriers to participation in physical activity during COVID-19 process. A scale of barriers to physical activity was used to determine the barriers to physical activity faced by the participants COVID-19 process. Since the data were homogeneously distributed across binary groups, independent t-tests and ANOVAs were performed for groups of three or more. In addition, if there were significant differences in the results of the ANOVA, Tukey's post hoc test was also applied. The data were analyzed using SPSS Version 22.0. (IBM Corp., Armonk, NY, USA). Results: According to the findings of this study, barriers to physical activity increase significantly as perceived health status decreases, and women's barriers to physical activity, participation are greater than those of men, and increase with age. At the same time, the strongest relationship was found for environmental factors. In addition, important results were found for the personal and social environment dimensions, and we also found that barriers to physical activity increase significantly with age. Conclusions: Finally, we determined that the barriers to physical activity for individuals with COVID-19 were significantly greater at the personal level compared to those who did not have COVID-19. That is the COVID-19 process negatively affected participation in physical activity

INVESTIGATION OF HEALTHY EATING SELF-EFFICACY AND CONSCIOUS AWARENESS: A STUDY ON ADOLESCENT CHILDREN WHO DIFFER ACCORDING TO THEIR SPORTING STATUS

This study aims to determine the mindfulness and healthy eating self-efficacy levels of adolescents according to their sports status. For this reason, healthy eating self-efficacy scale for children and mindfulness scale for adolescents were used in our study. After the scale data were collected by convenience sampling method, homogeneity results and cronbach alpha values were calculated. Then, the results of the study were obtained by MANOVA analysis. According to the results of the analysis, it has been determined that the ones with the highest value are male adolescent students who do sports. In addition, it has been concluded that doing sports has a positive effect on female students both on conscious awareness and on healthy eating self-efficacy levels. These results show that doing sports can provide significant physical and psychological benefits for adolescents