Conducta Anestésica en Niño con Osteogénesis Imperfecta y Hemorragia Epidural

ResumenLa osteogénesis imperfecta (OI) es el resultado de una mutación genética que causa la formación defectuosa o insuficiente de colágeno. La OI puede causar varias complicaciones anestésicas a causa del manejo difícil de las vías aéreas, de la presencia de deformidad de la columna vertebral, de enfermedades respiratorias, anomalías cardíacas, trastorno de la función plaquetaria, riesgo de hipertermia, invaginación bacilar, deformidades óseas y trastornos metabólicos. El abordaje anestésico de pacientes con OI debe ser hecho con cautela, ya que existe un riesgo de ciertas complicaciones respiratorias. Esos riesgos son causados por deformidad del tórax, fracturas óseas durante el movimiento o el cambio de posición, fracturas mandibulares y cervicales relacionadas con la intubación, intubación difícil e hipertermia maligna. Las técnicas anestésicas con el uso de anestesia venosa total (AVT) y mascarilla laríngea, son adecuadas para el manejo de paciente pediátrico con OI. Sin embargo, esas técnicas todavía no han sido mencionadas como útiles en relatos de casos neuroquirúrgicos. En este estudio, presentamos el uso de AVT y mascarilla laríngea ProSeal (MLP) en un niño con OI y hemorragia epidural. Concluimos que la MLP y la AVT pueden ser usadas con seguridad en el manejo anestésico de pacientes con OI y problemas anestésicos graves

Effects of Long Term Volleyball Training on Mineral Metabolism and Hematological Parameters

Objective: Following acute exercises, changes in mineral and hematological concentrations are observed in the organism depending on the exercise, but regular and submaximal exercises do not fully reveal the mineral and hematological effects. This study was conducted to determine the effects of volleyball training on mineral metabolism and hematological parameters over a period of three months. Method:The research group included 20 healthy male volunteers in the 13-16 age group. A training program of 80 minutes per day, 4 days per week, for three months was applied to the athletes who participated in the study. Blood samples were taken twice before and at the end of the training sessions from the resting athletes. Sodium, potassium, chlorine, calcium, magnesium, WBC, RBC, HGB, HCT, MCV, MCH, MCHC, PLT, MPV and PDW levels were determined in the blood samples collected. The data were analyzed using the SPSS 22 package program. The Paired Samples t-test was used to compare the research group's pre-final test data. Significance was considered to be p>0.05. Finding: The analysis showed that the research group had statistically significant differences in sodium, chlorine, phosphorus, magnesium, RBC, HCT, MCV, MCH, MCHC, MPV and PCT levels (p<0.05) and no statistically significant differences in potassium, calcium, WBC, HGB, PLT, RDW-CV and PDW levels (p>0.05). Conclusion: As a result, volleyball training over a long period of time has been observed to cause changes in mineral metabolism and some hematological parameters. It was found that the regular training schedule caused differences in some mineral and whole blood values. In the light of this information, we believe that long-term adolescent training will have a positive impact on the health of athletes

Experience with oral tofacitinib in severe alopecia areata with different clinical responses

Background: Alopecia areata (AA) and generalized form, universalis (AU) are common causes of noncicatricial alopecia, targeting anagen hair follicles. A dominant interferon-gamma transcriptional signaling and cytotoxic T lymphocytes were accused as the main drivers of disease pathogenesis. Tofacitinib is a Janus kinase inhibitor that has been proven to interfere with the positive feedback loop between the follicular cell and the cytotoxic T lymphocytes in AA. There is an increasing number of studies reporting success with tofacitinib in AA. Aims: We aimed to assess oral tofacitinib's safety and efficacy in 13 recalcitrant AA and AU patients. Methods: This is a retrospective pilot study performed between 2017 and 2020. The demographic features and the treatment responses were evaluated with Severity of Alopecia Tool score changes. Results: Thirteen recalcitrant alopecia areata patients (3 AA, 10 AU), aged between 17 and 49, were included in the study. The treatment duration was 3-15 months. All three AA patients responded well; however, the therapy was unsuccessful in five of ten AU patients. Relapse was observed in one of the AA and three of the AU responders. Acneiform lesions and elevation of transaminases were the major side effects. Conclusion: Tofacitinib seems to be more promising and thriving in the treatment of AA than AU. Starting the therapy earlier can bring more successful results. Unfortunately, even in the cases that fully respond to treatment, relapse can be observed after discontinuation of the treatment. It is essential to inform patients about this situation in reducing the frustrations that may occur later

Perspectives of dermatology specialists and residents on COVID-19 vaccines: a questionnaire-based survey

AbstractBackground: To evaluate the perspectives of dermatology specialists and residents on coronavirus disease 2019 (COVID-19) vaccines.Methods: Present questionnaire-based study was conducted on dermatology resi dents and specialists between January 5 and 20. A non-validated online questionaryevaluating the attitude of the participants about the COVID-19 vaccine was per formed. In the first step of the study, data related to the demographic features, all par ticipants' clinical characteristics, and working conditions were recorded. Thereafter answers given to 12 specific questions were recorded. The study population was divided into two groups: dermatology residents (n = 138) and specialists (n = 159). Mentioned variables were compared between the two defined groups. Furthermore, a correlation analysis was performed to assess the relationship between vaccination acceptance and various study parameters.Results: Majority of the cases had positive attitudes against COVID-19 vaccines. However, there were significant differences between the resident and specialist groups related to the source of information, working conditions, degree of concern, and type of vaccines. Statistically significant negative, weak correlations were observed for age and duration of medical practice (r = -.128, P = .028; r = -.132, P = .041 respectively). Statistically significant positive weak correlations were observed for chronic diseases, level of knowledge about COVID-19 vaccines, number of information sources about COVİD-19, and previous COVİD-19 infection (r = .133, P = .021; r = .207, P < .001; r= .335, P < .001; r = .176, P = .002 respectively).Conclusion: The acceptance of COVID-19 vaccination may be affected by working conditions, medical experience, level of knowledge and the presence of risk factors for severe disease among dermatology residents and specialists

Changing trends in dermatology practice during COVID-19 pandemic: A single tertiary center experience

The aim of this study was to evaluate the changing trends in dermatology clinical practice at a tertiary center during the coronavirus disease 2019 (COVID-19) pandemic. This retrospective cohort study was conducted on patients who were admitted to Ufuk University Hospital with dermatologic complaints/diseases before and during the pandemic. The patients were divided into two groups: (a) the pre-pandemic period (March-May 2019) and (b) the Pandemic period (March-May 2020). Demographic features, clinical characteristics, dermatologic diseases/complaints, dermatologic procedures/interventions, hospitalization rate, and use of biologic agents were compared between the two groups. Total number of hospital admissions have decreased from 1165 to 717. Admission rates for acne, dermatophytosis, and benign neoplasm of the skin significantly lower during the pandemic period (Pvalues were .02, .04, and .006, respectively). Contact dermatitis, acne accompanying dermatitis, cicatricial hair loss, lichen planus, and zona zoster infection rates were significantly higher (Pvalues were .007, <.001, .009, .04, and .03, respectively). Rates of biopsy and electrocautery procedures were decreased significantly (Pvalues were <.001 and .002, respectively). The hospitalization rate was similar between the groups (P= .51). However, the use of biologic agents significantly decreased during the pandemic period (P= .01). Updated clinical protocols should be established for the new normal period in accordance with these findings

Güney Marmara Şartlarında Organik Koyun Yetiştiriciliği ve Kuzu Besisi Üzerine Bir Araştırma

Bu araştırma, Marmara Hayvancılık Araştırma Enstitüsü’nde organik ve konvansiyonel sistemlerde yetiştirilen Kıvırcık koyunların döl verimi; kuzuların büyüme özellikleri ve besi performansları ile bazı kesim, karkas ve et özelliklerini karşılaştırmak amacıyla düzenlenmiştir. Organik yetiştiricilik Kıvırcık koyunların döl verimini ve kuzuların büyüme özelliklerini olumlu yönde etkilemiş; organik koyunlar konvansiyonellere göre daha yüksek doğum oranına sahip olmuşlardır. Konvansiyonel beside kuzular, konvansiyonel arpaya dayalı karma yemle ad-libitum düzeyde beslenmiş, ayrıca kuzu başına günde 100 g yonca kuru otu verilmiştir. Organik besi grupları merada otlatılmış, barınak içerisinde organik arpaya dayalı karma yemle beslenmişlerdir. Meranın yetersiz olduğu dönemde ise organik arpa hasılı verilmiştir. Denemede ortalama canlı ağırlığı 35 kg’a ulaşan gruplardaki tüm kuzular kesime gönderilmiştir. Organik kuzular, konvansiyonellere göre hedeflenen besi sonu canlı ağırlığa daha kısa sürede ulaşmışlardır. Organik kuzularda besi süresince günlük ortalama canlı ağırlık artışı konvansiyonellere göre daha yüksek olmuştur (P<0.05). Besleme sistemi sırt yağı kalınlığı üzerine etkili olmuş; organik kuzularda sırt yağı kalınlığı konvansiyonelden daha düşük bulunmuştur (P<0.05). Öte yandan, organik üretim özellikle erkek hayvan etlerindeki kolesterol düzeyini düşürmüştür

Effectiveness of percutaneous vertebroplasty in patients with multiple myeloma having vertebral pain

AMAÇ Multipl miyelomun vertebral tutulumu olan hastalarda perkütan vertebroplastinin (PV) etkinliğini, faydalarını ve güvenilirliğini değerlendirmeyi amaçladık. YÖNTEMLER Multipl miyelomlu 41 hastanın 166 omurunda uygulanan PV prosedürleri geriye dönük olarak değerlendirildi. Hastalarımızın çoğu seviye 3 (orta ila şiddetli ağrı) analjezik kullanıyordu. İşlemden önce multipl miyelomun vertebral tutulumunu değerlendirmek için manyetik rezonans görüntüleme yapıldı. Aşağıdaki değişkenler değerlendirildi: etkilenen vertebral seviyeler, vertebral vücut yüksekliği kaybı, PV sırasında vertebral gövdeye uygulanan polimetilmetakrilat (PMMA) çimento miktarı, PMMA çimento sızıntıları ve PV öncesi ve sonrası ağrı, görsel analog skala (VAS) ile değerlendirildi. . SONUÇLAR Hastaların medyan VAS skorları PV'den bir gün önce 9'dan işlemden bir gün sonra 6'ya, işlemden bir hafta sonra 3'e ve sonunda işlemden üç ay sonra 1'e düştü (P <0.001). PV işlemi sırasında 68 vertebral seviyede (% 41) çimento sızıntısı gözlendi. Omurga gövdesine uygulanan ortanca PMMA değeri 6 mL idi. SONUÇ Minimal invaziv ve düşük komplikasyon oranları ile kolay uygulanabilen bir işlem olan PV, multipl miyelom hastalarının ciddi sırt ağrılarında tercih edilmelidir