Being A Child Born After Loss: A Qualitative Research

The loss of a child is one of the most traumatic experiences a person can go through. Parents who have suffered the loss of a child may bring another child into the world after or before completing the grieving process. Children born after the loss are referred to as subsequent children. The reality of loss and the attitudes of the bereaved parent affect the identity and mental state of the child born after loss. This study used the qualitative research method to understand the life experiences of children born after loss in depth. In line with the determined research method, semi-structured individual interviews were conducted with ten participants born after loss. The data obtained in the study were analyzed by thematic analysis. As a result of the thematic analysis, the main themes of "about the lost child", "the effect of being born after loss on life", "being a child born after loss", and "grief" were determined. The main theme "about the lost child" included information about the deceased sibling, objects and photographs, the cause and manner of death, images and fantasies about the sibling, emotions, and contact needs. Under the main theme of "the impact of being born after the loss of life", both the identity and psychological development of individuals, the impact on their career choices and their parents' attitudes were found. Under the main theme, "being a child born after loss", participants talked about being a scapegoat, a comforting child, or a gifted child. In the last main theme, "grief", participants gave information about their parents' grief, their grief, and their experiences of coping with this grief. It has been shown that coming into the world after loss affects individuals' identity, mental state, and choice of profession, and they may face negative parental attitudes. It may be recommended to monitor the grief processes of parents with child loss and to guide the planning of new children

Cooperative virulence can emerge via horizontal gene transfer but is stabilized by transmission

Intestinal inflammation fuels Salmonella Typhimurium ( S .Tm) transmission despite a fitness cost associated with the expression of virulence. Cheater mutants can emerge that profit from inflammation without enduring this cost. Intestinal virulence in S .Tm is therefore a cooperative trait, and its evolution a conundrum. Horizontal gene transfer (HGT) of cooperative alleles may facilitate the emergence of cooperative virulence, despite its instability. To test this hypothesis, we cloned hilD , coding for a master regulator of virulence, into a conjugative plasmid that is highly transferrable during intestinal colonization. We demonstrate that virulence can emerge by hilD transfer between avirulent strains in vivo . However, this was indeed unstable and hilD mutant cheaters arose within a few days. The timing of cheater emergence depended on the cost. We further show that stabilization of cooperative virulence in S .Tm is dependent on transmission dynamics, strengthened by population bottlenecks, leading cheaters to extinction and allowing cooperators to thrive

Short and long term outcomes of primary angioplasty in patients aged 75 years and over

The treatment of elderly patients with ST segment elevated myocardial infarction (STEMI) remains controversial. This study aimed to investigate the effects of primary angioplasty in elderly patients on in-hospital and long term major adverse cardiac events (MACE).Materials and methods: From October 2003 to March 2008, we retrospectively enrolled 220 patients aged 75 years and over with STEMI who underwent primary angioplasty. Patients’ characteristics, in-hospital and long term events were recorded.Results: Male/Female ratio of patients was 129/91 and mean age was 78.7 ± 3.6 (range, 75-97) years, and 58.6% of male). Of these patients 29.2% were diabetics, 69.8% were hypertensive, 34.4% were smoker and 43.5% were anemic at admission. Anterior myocardial infarction was diagnosed in 52.3% of patients. Mean pain-balloon time was 222 ± 116 minutes. Eighty two (38.2%) of these 220 patients had three-vessel disease and 12 (5.7%) were diagnosed as cardiogenic shock. Procedural success was observed in 79.6% of patients. Heart failure was observed 27.7% in hospital and intra aortic pump was used in 14.5% of patients. There was no significant difference between age groups in long term major cardiac events and in hospital mortality. Diabetes, leukocyte count at admission and in hospital heart failure were independent predictors of short term MACE and low hemoglobin level at admission and peak CKMB levels were independent predictors of long term MACE.Conclusions: Primary angioplasty in patients aged 75 years and over seems to be associated with low procedural complication, high procedural success, improved short and long term survival

Uterin Serviksin Minimal Deviasyon Adenokarsinomu MDA

Minimal deviasyon adenokarsinom MDA servikal adenokarsinomların %1-3 oranında görülen bir varyantıdır.Nadir görülmesi nedeniyle standart tanısal metot ve tedavi protokolü yoktur. Uterin servikste 10-12 cm boyutunda kitlesi olan vakamızda tanı servikal biyopsi ile konamadı.Manyetik rezonans görüntülemede MRI MDA tanısı düşünüldü ve operasyon sonrası tanı kondu. Postoperatif olarak adjuvant kemoradyoterapi KRT uygulandı ve hasta 16 aylık bir süre rekürrens olmadan izlend

4+4+4 Eğitim Sisteminin Beşinci Sınıf Öğrencilerine Yansıması: Öğretmen Görüşleri

ÖZ: Bu çalışmanın amacı 4+4+4 eğitim sistemiyle birlikte ortaokul olan 5. Sınıf öğrencilerinin yaşadığı problemlerin öğretmen görüşleri açısından ele alınmasıdır. Araştırmanın örneklemini 2013-2014 eğitim ve öğretim yılı, Niğde ili 147 beşinci sınıf branş öğretmenleri oluşturmaktadır. Araştırmada nitel ve nicel araştırma yöntemleri bir arada kullanılmıştır. Elde edilen açık uçlu anket sorularından en temel görüşler; öğrenci kaynaklı olduğu düşünülen sorunların kısaca, öğrencilerin yaşlarının küçük olduğu, kendilerini ilkokul gibi hissettikleri, ergenlik çağındaki çocuklarla bir arada olmalarının sakıncalı olabileceği, derslere ilgisiz oldukları yönündedir. öğretmen kaynaklı olduğu düşünülen sorunların öğrencilerin davranışlarını yönetememe (sınıf ve davranış yönetimi), ders anlatım yöntem ve tekniklerinde hissedilen eksiklikler, haftalık ve günlük ders saatlerinin fazlalığı ile derslere giriş-çıkış saatleri şeklinde yoğunlaşmıştır; diğer etmenler olarak kısaca ders saatlerinin fazlalığı, giriş çıkış saatlerinin uygun olmayışı, ders kitapları ve müfredat programının uygun olmadığı ve son olarak açlıkla başedememe olarak dile getirilmiştir. Bunlara ek olarak nicel bulgular da bu sonuçları destekler niteliktedir.Anahtar kelimeler: 4+4+4 eğitim sistemi, 5. Sınıf öğrencileri, öğretmen görüşleri

Pathogen invasion-dependent tissue reservoirs and plasmid-encoded antibiotic degradation boost plasmid spread in the gut

Many plasmids encode antibiotic resistance genes. Through conjugation, plasmids can be rapidly disseminated. Previous work identified gut luminal donor/recipient blooms and tissue-lodged plasmid-bearing persister cells of the enteric pathogen; Salmonella enterica; serovar Typhimurium (; S; .Tm) that survive antibiotic therapy in host tissues, as factors promoting plasmid dissemination among Enterobacteriaceae. However, the buildup of tissue reservoirs and their contribution to plasmid spread await experimental demonstration. Here, we asked if re-seeding-plasmid acquisition-invasion cycles by; S; .Tm could serve to diversify tissue-lodged plasmid reservoirs, and thereby promote plasmid spread. Starting with intraperitoneal mouse infections, we demonstrate that; S; .Tm cells re-seeding the gut lumen initiate clonal expansion. Extended spectrum beta-lactamase (ESBL) plasmid-encoded gut luminal antibiotic degradation by donors can foster recipient survival under beta-lactam antibiotic treatment, enhancing transconjugant formation upon re-seeding.; S; .Tm transconjugants can subsequently re-enter host tissues introducing the new plasmid into the tissue-lodged reservoir. Population dynamics analyses pinpoint recipient migration into the gut lumen as rate-limiting for plasmid transfer dynamics in our model. Priority effects may be a limiting factor for reservoir formation in host tissues. Overall, our proof-of-principle data indicates that luminal antibiotic degradation and shuttling between the gut lumen and tissue-resident reservoirs can promote the accumulation and spread of plasmids within a host over time

Tip-I interferon ilişkili hastalıklarda immün yanıtların karakterizasyonu.

Type-I interferonopathies are a heterogeneous group of diseases arising from deregulation in nucleic acid sensing pathways, leading to constitutive type-I interferon release and pathology. DNA damage, if not repaired can also potentially activate such pathways. To test the hypothesis that 2 different DNA damage repair and immune deficiencies, Ataxia telangiectasia (AT) and Artemis deficiency could suffer from clinical manifestations associated with elevated type I IFN response, we compared the immune status of AT and Artemis deficient patients to healthy controls and to two patients with confirmed type I interferonopathies (one SAVI (STING-associated vasculopathy with onset in infancy) and one TREX-1 deficient patient diagnosed with Aicardi-Goutières Syndrome (AGS)). Our results demonstrated that type-I and III interferon signatures were elevated in plasma and peripheral blood cells of AT and Artemis deficient patients. Specifically, compared to healthy controls, circulating IP-10 (9- and 14-fold), IFN (5- and 7-fold) and IFN1 (4- and 5-fold) concentrations were significantly higher in AT and Artemis deficient patients, respectively. Moreover, AT and Artemis deficient peripheral blood mononuclear cells (PBMC) secreted ~4- and ~5 fold more IFN-α than healthy controls in the absence of any stimulation. This exaggerated response was still maintained when cells were stimulated with the STING ligand 2’3’-cGAMP (6- and 31-fold more IFN secretion from AT and Artemis deficient cells). Measurement of phosphorylated STAT1 concentrations within PBMCs revealed elevated levels in AT and Artemis deficient patients with respect to healthy controls. These results suggest that AT and Artemis deficient patients have immune features consistent with elevated type I IFN signature. Next, we hypothesized that aberrant IFN production could activate neutrophils and contribute to tissue damage. Herein, we show for the first time that neutrophils of AT, Artemis deficient and SAVI patients spontaneously produced neutrophil extracellular traps (NETs). Consistent with neutrophil activation, plasma elastase was significantly higher in all tested patient groups suggesting that neutrophils might be contributing to tissue damage in classical and proposed type-I interferonopathies.M.S. - Master of Scienc

FEN BİLİMLERİ ENSTİTÜSÜ/LİSANSÜSTÜ TEZ PROJESİ

İMMÜN BASKILAYICI TERAPÖTİK OLİGODEOKSİNÜKLEOTİDLERİN THP-1 MONOSİT/MAKROFAJ HÜCRE HATTINDA İNFLAMAZOM OLUŞUMU ÜZERİNE ETKİLER

TİP-I İNTERFERON İLİŞKİLİ HASTALIKLARDA İMMÜN PATOLOJİYE NEDEN OLAN YOLAKLARIN KARAKTERİZASYONU

TİP-I İNTERFERON İLİŞKİLİ HASTALIKLARDA İMMÜN PATOLOJİYE NEDEN OLAN YOLAKLARIN KARAKTERİZASYON

FEN BİLİMLERİ ENSTİTÜSÜ/LİSANSÜSTÜ TEZ PROJESİ

İMMÜN BASKILAYICI TERAPÖTİK OLİGODEOKSİNÜKLEOTİDLERİN THP-1 MONOSİT/MAKROFAJ HÜCRE HATTINDA İNFLAMAZOM OLUŞUMU ÜZERİNE ETKİLER