Comparıson Of Fever Measurement Technıques

Yeni geliştirilen termometreler son yıllarda cıvalı termometrenin yerini almaktadır. Ancak her yöntemin avantaj ve dezavantajları olmakla birlikte vücut sıcaklığının ölçümünde hangi yöntemin en doğru olduğu ve nereden ölçüm yapılacağı hala tartışılmaktadır. Bu çalışma cıvalı termometre yerine kullanılan termometrelerin performansının değerlendirilmesi, doğruluk, özgüllük ve duyarlılığının karşılaştırılması amacıyla yapıldı. Gazi Üniversitesi Hastanesi Çocuk Sağlığı ve Hastalıkları Bölümü servislerinde 01 Kasım 2014 ile 28 Şubat 2015 tarihleri arasında yatarak izlenen ve acil servise ayaktan başvuran 151 hasta çalışmaya alındı. Hastalarda koltuk altı cıvalı termometre, koltuk altı dijital termometre, alından temassız termometre, timpanik termometre ve alından temporal arter termometre ile 3. , 5. ve 8. dakikalarda vücut sıcaklığı ölçümü yapıldı. Her hasta için 15 ölçüm olmak üzere toplamda 2265 ölçüm yapıldı. 151 hastanın 81 i (% 54) erkek, 70 i (% 46) kız olup; erkek/kız oranı 1.15 şeklindeydi. Çalışmaya dâhil edilen hastaların yaşları 2 ile 18 arasında değişmekteydi. Ortalama yaş 7.95 ± 4.48 yıl; ortanca yaş 7 olarak bulundu. Hastaların 83 ü serviste yatan hastalar iken, 68 i acil servise başvuran hastalar idi. Tanılarına göre gruplandırıldığında 83 (% 55) hastada üst solunum yolu enfeksiyonu, 18 (% 11,9) hastada alt solunum yolu enfeksiyonu (pnömonibronşiolit), 12 (% 7,9) hastada gastrointestinal sistem hastalıkları, 9 (% 6) hastada hematolojik hastalıklar, 7 hastada (% 4,6) idrar yolu enfeksiyonu, 6 hastada (% 4) onkolojik hastalıklar, 6 hastada (% 4) selülit, 5 hastada (% 3,3) lenfadenit ve 5 hastada (% 3,3) nefrolojik-romatolojik hastalıklar vardı. Termometrelerin ortalama, ortanca, standart sapma, en düşük, en yüksek ölçüm değerleri hesaplandı. Ortalama değerleri karşılaştırıldığında temporal arter termometre 38.20C, cıvalı aksiller termometre 37.80C, timpanik termometre 37.50C, temassız alın termometre 37.50C dijital aksiller termometre 37.60C olduğu görüldü. Cıvalı 72 ve dijital aksiller termometrenin 8. dakikaya kadar yükselmeye devam ettiği görüldü. Temporal arter termometresi ve temassız alın termometresi ile yapılan tekrarlayan ölçümlerde fark görülmedi. 12 yaş altında timpanik termometre ile yapılan tekrarlayan ölçümlerde fark olduğu görüldü. Spearman korelasyon testi ile karşılaştırıldığında cıvalı termometre ile diğer termometrelerin pozitif yönde çok güçlü ve anlamlı korelasyonu olduğu görüldü. Cıvalı termometre ile 380C ateş kabul edildiğinde aksiller dijital termometrenin duyarlılığı % 98 özgüllüğü % 85 pozitif prediktivitesi % 98 negatif prediktivitesi %92, temporal arter termometresinin duyarlılığı % 94 özgüllüğü %93 pozitif prediktivitesi % 94 negatif prediktivitesi %88, temassız termometrenin özgüllüğü % 100 duyarlılığı % 69 pozitif prediktivitesi % 100 negatif prediktivitesi % 93, timpanik termometrenin özgüllüğü % 98, duyarlılığı % 87, pozitif prediktivitesi % 98, negatif prediktivitesi % 92 olarak hesaplanmıştır. Sonuç olarak dijital termometre cıvalı termometrenin yerine kullanılabilir. Fakat bekleme süresi üretici firmanın belirttiğinden daha fazla olmalıdır. (En az 3 dakika) Temporal arter termometresi cıvalı termometre kadar iyi ölçüm yapabilmektedir. Temassız alın termometresi cıvalı termometreye göre daha düşük duyarlılığa sahiptir. Ateş takibi için uygundur. Timpanik termometre de cıvalı termometre kadar iyi ölçüm yapabilmektedir. 12 yaşından küçük hastalarda ölçüm zorluğu mevcuttur. Maliyeti göreceli olarak daha fazladır.In recent years newly developed thermometers replacing mercury thermometers. Although every measurement technique has its advantages or disadvantages, which technique and body region is right for measurement of body temperature is controversial. This study s aim is evaluate performance of thermometers used instead of mercury thermometers and compare their accuracy, specificity and sensitivity. A total of 151 outpatients and inpatients applied to Gazi University Hospital Pediatrics Department clinic or emergency service between 01/11/2014 and 28/02/2015 are included in this study. Each patient s body temperature were measured by axillary mercury thermometer, axillary digital thermometer, forehead thermometer, tympanic thermometer and temporal artery thermometer from forehead in 3, 5, 8 minutes. In a total of 2265 measurement, 15 measurements were performed for each patient. 81 patients (%54) were male, 70 patients (%46) were female and male/female ratio was 1.15. Ages of patients included in study were between 2 and 18 years. The mean age was 7.95 ± 4.48 years and median age was 7 years. 83 of patients were treated as inpatients in pediatrics clinic and 68 of them were applied to emergency service. Classified as diagnosis, 83(%55) patients have upper respiratory tract infection, 18(%11.9) patients have lower respiratory tract infection(pneumonia, bronchiolitis), 12(%7.9) patients have gastrointestinal system diseases, 9(%6) patients have hematological diseases, 7(%4.6) patients have urinary tract infection, 6(%4) patient have oncologic diseases, 6(%4) patient have cellulite, 5(%3.3) patients have lymphadenitis and 5(%3.3) patients have nephrologic -rheumatologic diseases. Each thermometer s mean, median, standard deviation, lowest and highest measurement values were calculated. Compared averages of temperature measurement values, temporal artery thermometer s mean was 38.2 C, axillary mercury thermometer s mean was 74 37.8 C, tympanic thermometer s was 37.5 C, forehead thermometer s mean was 37.5 C, axillary digital thermometer s mean was 37.6 C. Mercury thermometer and digital axillary thermometer continued to rise up to 8 minute. There isn t any difference in repeating measurements performed by temporal artery thermometer and forehead thermometer. Under age 12, there is difference in repeating measurements performed by tympanic thermometer. Compared using Spearman correlation test, it was seen there is a very strong significant positive correlation between mercury thermometer and others. When the temperature measured by mercury thermometer was accepted 38 C, axillary digital thermometers sensitivity was % 98 specificity was %85 positive predictivity was % 98 negative predictivity %92, temporal artery thermometers sensitivity % 94 specificity %93 positive predictivity % 94 negative predictivity %88, forehead thermometers specificity % 100 sensitivity % 69 positive predictivity % 100 negative predictivity % 93, tympanic thermometers specificity % 98, sensitivity % 87 positive predictivity % 98 negative predictivity % was 92. In conclusion, digital thermometers can be used instead of mercury thermometers. But waiting time must be longer than manufacturer s proposed. (At least 3 minutes) Temporal artery thermometers can perform measurements as good as mercury thermometers. Forehead thermometers have less sensitivity than mercury thermometers. They are suitable for temperature monitoring. Tympanic thermometers also can perform measurements as good as mercury ones. There is measurement difficulties in patients under age 12 and it s cost is relatively higher

HİDROMEK'in tarihi ve Türk sanayisindeki yeri

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2013.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by Melike Ünal.Ünal, Melike. HIST 200-4ÜNAL HIST 200-4/2 2012-1

Design and Synthesis of Pyrrolotriazepine Derivatives: An Experimental and Computational Study

WOS: 000320298700006PubMed ID: 23647431The pyrrole derivatives having carbonyl groups at the C-2 position were converted to N-propargyl pyrroles. The reaction of those compounds with hydrazine monohydrate resulted in the formation of 5H-pyrrolo[2,1-d][1,2,5]-triazepine derivatives. The synthesis of these compounds was accomplished in three steps starting from pyrrole. On the other hand, attempted cyclization of a pyrrole ester substituted with a propargyl group at the nitrogen atom gave, unexpectedly, the six-membered cyclization product, 2-amino-3-methylpyrrolo[1,2-a]pyrazin-1(2H)-one as the major product. The expected cyclization product with a seven-membered ring, 4-methyl-2,3-dihydro-1H-pyrrolo[2,1-d][1,2,5]-triazepin-1-one was formed as the minor product and was converted quantitatively to the major product. The formation mechanism of the products was investigated, and the results obtained were also supported by theoretical calculations.Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [TBAG-112 T36]; Middle East Technical UniversityMiddle East Technical University; Turkish Academy of Sciences (TUBA)Turkish Academy of Sciences; BIDEB-TUBITAKTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK)We are indebted to the Scientific and Technological Research Council of Turkey (TUBITAK, Grant No. TBAG-112 T36), the Middle East Technical University, and the Turkish Academy of Sciences (TUBA) for financial support of this work. Furthermore, N.M. and Y.A. are grateful for a scholarship provided by BIDEB-TUBITAK

Our Results of Condyle Resurfacing Prosthesis Treatment in Knee Medial Condyle Focal Cartilage Defects in Active Patients

INTRODUCTION: In this study, we aimed to present the clinical results of articular resurfacing prosthesis cases applied to cartilage problems of active patients who cannot be treated conservative and biological surgical methods. METHODS: From April 2007 to March 2014, 32 patients were treated with femoral resurfacing using the HemiCAP implant. Indication for treatment with HemiCAP implant was symptomatic cartilage lesion at the medial femoral condyle demonstrated by MRI or arthroscopy, which was ICRS grade 3–4 and size less than 4 cm2. Patients were evaluated according to VAS score, American Knee Society Score, clinical improvement. RESULTS: 32 patients ( 8 males, 24 females) evaluated in this study. Mean age was 53.1 ± 3.2 years. 18 ( %56.3 ) patients were operated from right knee while 14 ( %43.7) of patients from left. Follow-up time was between 24 and 30 months ( 26.6 ±1.9 ). The decrease in postoperative VAS compared to preoperative VAS was statistically significant ( p<0.01 ). A statistically significant increase was observed in postoperative American Knee Society Score compared to preoperative knee scores ( p<0.01 ). Preoperative function score was 46.5 ± 9.1, postoperative function score was 77.3 ± 7.7. A statistically significant increase was observed in postoperative knee function scores compared to preoperative knee function scores ( p<0.01 ). DISCUSSION AND CONCLUSION: The femoral resurfacing treatment in active patients with local cartilage damage clinically reduces symptoms and improves knee function in the early period.Öz:Amaç: Bu çalışmada konservatif tedavi veya biyolojik yöntemler ile tedavi edilemeyen, aktif yaşantısı olan hasta grubunun kıkırdak sorunlarında uyguladığımız sınırlı yüzey artroplasti olgularımızın klinik sonuçlarını sunmayı amaçladık. Yöntem: Nisan 2010-Mart 2014 tarihleri arasında diz medial kondil sınırlı kıkırdak defekti nedeni diz yüzey kaplama artroplastisi uygulanan hastalar retrospektif olarak değerlendirildi. Çalışmaya medial femur kıkırdak lezyonu olan, MR veya artroskopiyle doğrulanmış, ICRS 3-4 ve 4 cm2’den az olan, hastalar dahil edilmiştir. Hastalar VAS, Amerikan Diz Cemiyeti Kriterlerine ve fonksiyon skorlarına göre değerlendirildiler. Bulgular: Çalışmaya 8 erkek, 24 kadın toplam 32 olgu dahil edildi. Olguların yaş ortalaması 53.1±3.2 yıldır. Olguların 18’ü (%56.3) sağ tarafından, 14’u (%43.7) sol tarafından operasyon geçirmiştir. Olguların takip süreleri 24 ile 30 ay arasında değişmekte olup, ortalaması 26.6±1.9 aydır Olguların preoperatif VAS düzeylerine göre postoperatif VAS düzeylerinde görülen düşüş istatistiksel olarak anlamlı bulunmuştur (p<0.01). Olguların preoperatif Amerikan Diz Cemiyet Skorlarına göre postoperatif diz skorlarında istatistiksel olarak anlamlı artış gözlemlenmiştir (p<0.01). Preoperatif diz fonksiyon skorları 46.5±9.1, postoperatif diz skorları 77.3±7.7 olarak görüldü. Olguların preoperatif diz fonksiyon skorlarına göre postoperatif diz fonksiyon skorlarında istatistiksel olarak anlamlı artış gözlemlenmiştir (p<0.01). Sonuç: Lokal kıkırdak hasarı olan hastalarda yüzeyel artroplasti uygulaması, klinik olarak erken dönemde şikayetleri azaltma ve diz fonksiyonlarında iyileşme sağlamaktadır

Catheter-associated recurrent intracardiac thrombosis and facotr V Leiden mutation in a child with non-Hodgkin's lymphoma

Patients with cancer have an increased risk for thromboembolism, which might be related to several factors including central venous catheters and chemotherapeutics. Congenital prothrombotic risk factors might also contribute to thrombotic events. In this report, we present a catheter-related recurrent intracardiac thrombosis in a boy with non-Hodgkin's lymphoma and factor V Leiden mutation. Screening for factor V Leiden mutation in children with cancer and recurrent thrombotic events is recommended. Periodic echocardiography may be considered for a group of patients if the catheter tip is in the right atrium and therapy includes L-asparaginase and corticosteroids

Design and Synthesis of Pyrrolotriazepine Derivatives: An Experimental and Computational Study

The pyrrole derivatives having carbonyl groups at the C-2 position were converted to <i>N</i>-propargyl pyrroles. The reaction of those compounds with hydrazine monohydrate resulted in the formation of 5<i>H</i>-pyrrolo­[2,1-<i>d</i>]­[1,2,5]­triazepine derivatives. The synthesis of these compounds was accomplished in three steps starting from pyrrole. On the other hand, attempted cyclization of a pyrrole ester substituted with a propargyl group at the nitrogen atom gave, unexpectedly, the six-membered cyclization product, 2-amino-3-methyl­pyrrolo­[1,2-<i>a</i>]­pyrazin-1­(2<i>H</i>)-one as the major product. The expected cyclization product with a seven-membered ring, 4-methyl-2,3-dihydro-1<i>H</i>-pyrrolo­[2,1-<i>d</i>]­[1,2,5]­triazepin-1-one was formed as the minor product and was converted quantitatively to the major product. The formation mechanism of the products was investigated, and the results obtained were also supported by theoretical calculations

Risk factors for coronary arterial involvement in Turkish children with Kawasaki disease: a multicenter retrospective study

Background. Coronary arterial lesions (CALs) are the major component of Kawasaki disease (KD), associated with significant morbidity, which affect a substantial proportion of patients despite proper treatment. The aim of this study was to define the risk factors for CALs in Turkish children with KD. Methods. Medical records of 399 KD patients from five pediatric rheumatology centers in Turkey were reviewed retrospectively. Demographic, clinical (including duration of fever before intravenous immunoglobulin [IVIG] and resistance to IVIG), laboratory and echocardiographic data were noted. Results. The patients with CALs were younger, had a higher male ratio and a longer duration of fever before IVIG. They also had higher lymphocyte and lower hemoglobin values before the initial treatment. Multiple logistic regression analyses defined the following three criteria as independent risk factors for predicting CALs in Turkish children with KD: age ≤12 months, male gender and duration of fever before IVIG ≥9.5 days. High sensitivity rates of elevated risk of CALs up to 94.5% were calculated despite specificity values falling to 16.5%, depending on which of these three parameters are taken into account. Conclusions. Based on the demographic and clinical features, we established an easily applicable risk-scoring system for predicting CALs in Turkish children with KD. This may be useful for choosing appropriate treatment and follow-up for KD to prevent coronary artery involvement. Further studies will show whether these risk factors can be used in other Caucasian populations as well

Characteristics of Patients With Rheumatoid Arthritis in Turkey: Results From the Turkish League Against Rheumatism Rheumatoid Arthritis Registry

Conclusion: The majority of patients with RA in Turkey are middle-aged homemakers. Despite the high rates of disease-modifying anti-rheumatic drugs use, the majority of patients had moderate and high disease activity. These findings indicate that treatment needs of RA patients are not met sufficiently