Nontraumatic Massive Spontaneous Hemothorax with Concomitant Warfarin Use

Hemorrhagic complications due to warfarin use are frequently seen in emergency departments. However, nontraumatic massive hemothorax is an unexpected complication. We report a 59-year-old woman with warfarin overdose, who had massive hemothorax in right lung without any history of trauma. Her main complaint was significant dyspnea, which has gradually increased in three days. On her physical examination, she was tachypneic and had decreased lung sounds on her right hemithorax. She took warfarin regularly for aortic and mitral valve replacement for 18 years. Her INR level was 12.9 (0.8–1.2). Computed tomography of thorax revealed massive hemothorax with mediastinal shift. Fresh frozen plasma infusion was started immediately. Tube thoracostomy was performed for reexpansion of right lung and 2000 cc blood was drained in 5 minutes. Although hemorrhagic complications can be expected in warfarin therapy, thoracic hemorrhage related to warfarin therapy is relatively rare (3% of all hemorrhagic complications due to warfarin therapy). To our knowledge, massive hemothorax due to warfarin use is an extremely rare condition

The influence of alcohol related accidents on health care cost

Introduction: Road traffic accidents are globally leading causes of mortality and morbidity. Alcohol is among the most frequently used pleasure-inducing substances in the world. Use of motor vehicle under the influence of alcohol is completely illegal in some countries. However, it is allowed up to a certain level of eth- anol in blood in other countries. Traffic accidents caused by alcohol consumption are known to cause more harmonhealthofindividuals.Thealcoholaffectsnervoussystem. Alcoholslowsreflexesandimpairsbalance. In other words, alcohol intake reduces capability of individuals while using any motor vehicle. This study aims to search the health care cost of individuals who had traffic accidents under the influence of alcohol.  Methods: This present study included 657 patients who were admitted to the E.R. resulting from traffic accidents between the dates 01.01.2017–01.06.2017. Demographic information of the patients, their time of hospital admission, medical analyses and examinations, the cost of those analyses and examinations, and their ethanol levels were recorded.  Results: 657 patients were included in the study. 460 (68.1) of those patients were males. Their age average was 35.57 ± 15.18. 61 (9.0%) of the patients were seen to have ethanol positive blood. The health care expenditures of ethanol positive patients were found to be 374,75 ± 251,3 TL whereas the expenditures of ethanol free patients were identified to be 283,17 ± 222,72 TL. The health care expenditures of ethanol positive patients were seen to have substantially increased. (p = 0,003).  Conclusions: Alcohol intake is known to be a leading cause of traffic accidents that generally results in deaths and heavy injuries. This present study displays that traffic accidents caused by alcohol consumption increases the cost of health care as well.

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TÜBİTAK SBB01.02.200

Responsiveness in cultural-ecological context

Theoretical and empirical research on responsiveness focused mostly on cultural ecologies of independence. Emerging studies suggest that the responsiveness process may unfold differently in cultural ecologies of interdependence. We organize these studies into a working conceptual model. The model argues that two mechanisms—expectations of culturally normative relationship behaviors and relative centrality of relationships—carry the influence of cultural ecology on responsiveness. Together, these mechanisms explain variation in (a) self-expressive behaviors thought to elicit responsiveness, (b) associations between partner behaviors and perceived responsiveness, and (c) associations between perceived responsiveness and well-being

Today you care, tomorrow you don't: differential roles of responsiveness variability and average responsiveness in romantic attachment

Past work has shown that perceived responsiveness is a key predictor of relational outcomes. However, this work has focused solely on average levels of responsiveness and never studied the role of responsiveness variability (consistency of responsiveness) in intimate relationships. The present study addressed this gap by investigating the long-held but scarcely tested tenet that responsiveness variability and average responsiveness play differential roles in romantic attachment. New romantic couples (N = 151) reported partner-specific attachment anxiety and avoidance in six sessions. Every evening during the three-week period in between the first two sessions, participants reported perceived partner responsiveness, allowing us to assess both average responsiveness and responsiveness variability. Our findings provided the first empirical evidence that responsiveness variability uniquely predicted increases in partner-specific attachment anxiety, whereas average responsiveness uniquely predicted decreases in partner-specific attachment avoidance. Average responsiveness and responsiveness variability continued to predict attachment orientations assessed about half a year later

A Comparison Of Pre And Post-Season Proprioception, Functional Endurance, And Coordination Changes Of Professional Soccer Players

Objectives: Soccer is amongst the most popular sports in the world, and also it is one of the sports in which physical injury occurs most. The aim of the present study was to investigate soccer players’ pre- and post-season physical injury-related parameters, to analyze the effectiveness of the training program, and to evaluate changes in their physical performance throughout the season. Methods: In the present study, 16 soccer players (mean age: 18.87±0.61 years) and 16 sedentary individuals (mean age: 20.93±4.48 years) were recruited. In both groups, proprioception, functional endurance, and coordination were assessed. Soccer players were assessed twice: pre- and post-season, while the sedentary group was assessed only once. Results: Pre-season concentric and eccentric coordination levels of the soccer players were found to be higher than those of the sedentary group (p0.05). When the pre-season values were compared with the post-season values in the soccer group, while there was a significant decrease in concentric coordination values (p<0.05). There was a significant increase in concentric endurance values (p<0.05). Conclusion: Pre- and post-season detailed evaluations of the soccer players would be beneficial in terms of not only identifying their physical needs and the shortcomings in their physical fitness but also they would be beneficial in designing the training programs.PubMe

A new measure for adult attachment styles: The psychometric evaluation of Experiences in Close Relationships - Revised (ECR-R) on a Turkish sample

In this study, the reliability and validity of Experiences in Close Relationships-Revised (ECR-R), a scale developed to measure adult attachment dimensions, were examined in a Turkish student sample. Exploratory and confirmatory factor analyses revealed that ECR-R has a two-factor solution representing attachment-related avoidance and attachment-related anxiety. The relationships of avoidance and anxiety dimensions with the related variables support the validity of ECR-R. Moreover, it is found that the dimensions measured by ECR-R have high internal consistency and test-retest reliability. In light of these findings, it is suggested that researchers use ECR-R, which has higher measurement precision as compared to other scales, in the assessment of adult attachment