3M Syndrome: A Report of Four Cases in Two Families

3M syndrome is a rare entity characterized by severe growth retardation, dysmorphic features and skeletal changes as its major components. It is differentiated from other types of dwarfism by its clinical features and by the typical slender long bones an

Delirium in Diabetic Ketoacidosis: A Case Report

A 15-year-old female patient with known type 1 diabetes mellitus was referred because of abdominal pain. On admission, she was alert but dehydrated with marked Kussmaul breathing. Blood glucose was 414 mg/dL (23 mmol/L). Blood gas analysis revealed severe metabolic acidosis (pH: 6.99) with an elevated anion gap (29.8 mmol/L) and an increased base excess (-25.2 mmol/L). At the sixth hour of treatment with intravenous fluids and insulin, the patient became delirious. The delirium persisted despite the normalization of the acidosis and became difficult to manage. Brain imaging studies revealed neither brain edema nor other intracranial pathology. No evidence of intoxication could be found. The patient gradually regained consciousness and was diagnosed as a case of severe diabetic ketoacidosis (DKA) associated with infection. We were unable to find a similar case in the pediatric literature and thought that reporting this unusual case would be a contribution to the literature on DKA in children

Hormonal control during infancy and testicular adrenal rest tumor development in males with congenital adrenal hyperplasia: a retrospective multicenter cohort study

IMPORTANCE Testicular adrenal rest tumors (TARTs), often found in male patients with congenital adrenal hyperplasia (CAH), are benign lesions causing testicular damage and infertility. We hypothesize that chronically elevated adrenocorticotropic hormone exposure during early life may promote TART development. OBJECTIVE This study aimed to examine the association between commencing adequate glucocorticoid treatment early after birth and TART development. DESIGN AND PARTICIPANTS This retrospective multicenter (n = 22) open cohort study collected longitudinal clinical and biochemical data of the first 4 years of life using the I-CAH registry and included 188 male patients (median age 13 years; interquartile range: 10-17) with 21-hydroxylase deficiency (n = 181) or 11-hydroxylase deficiency (n = 7). All patients underwent at least 1 testicular ultrasound. RESULTS TART was detected in 72 (38%) of the patients. Prevalence varied between centers. When adjusted for CAH phenotype, a delayed CAH diagnosis of >1 year, compared with a diagnosis within 1 month of life, was associated with a 2.6 times higher risk of TART diagnosis. TART onset was not predicted by biochemical disease control or bone age advancement in the first 4 years of life, but increased height standard deviation scores at the end of the 4-year study period were associated with a 27% higher risk of TART diagnosis. CONCLUSIONS AND RELEVANCE A delayed CAH diagnosis of >1 year vs CAH diagnosis within 1 month after birth was associated with a higher risk of TART development, which may be attributed to poor disease control in early life

Comparative analysis of science and technology lessons in Turkey and Canada

Bu araştırmada Türkiye’de fen ve teknoloji derslerinin işlenişini fen başarısında dünya çapında oldukça iyi bir yere sahip olan Kanada ile karşılaştırmanın faydalı olacağı düşünülmüştür. Örnek olay yaklaşımı kullanılarak iki ülkenin fen eğitim sistemleri içinde işlenen örnek bir fen dersi hakkında detaylı bilgi sahibi olmak amacıyla “gözlem yöntemi” kullanılarak, Kanada ve Türkiye’de seçilen okullardan toplam beş farklı sınıfta işlenen “Madde ve Isı” ve “Işık” ünitelerinin işlenişi gözlenmiştir. Türkiye ve Kanada’da gözlemlenen okullarda derslerin yapıldığı sınıfların fiziksel özellikleri arasında çoğunlukla farklılıkların olduğu görülmüştür. Fen Teknoloji Dersi Öğretim Programı (FTDÖP) 7.sınıf “Işık” ve Ontario Fen ve Teknoloji Müfredatı (OFTM) 8. sınıf “Optik” ünitesi; ve FTDÖP 6. sınıf “Madde ve Isı” ve OFTM 7. sınıf “Madde ve Isı” üniteleri için yapılan gözlemler genel olarak değerlendirildiğinde kullanılan öğretim yöntem ve teknikleri açısından benzerliklerin ve farklılıkların olduğu ve Kanada örneğinde gözlenen sınıflarda öğrencilerin bireysel çalışmasına daha çok yer verildiği görülmüştür. İki ülkede gözlenen örnek sınıflarda ölçme ve değerlendirme teknikleri ve proje çalışmalarının yürütülmesi bakımından farklılıkların benzerliklerden daha çok olduğu dikkati çekmiştir

The relatioship beetwen levels of altruism, empathy and assertiveness in nursing students

Intoduction. It is obvious that altruism, empathy and assertiveness have a direct relationship with the nursing profession. Moreover, altruism, empathy and assertiveness are the values that have to be fostered in nurses in their development of a professional identity during their education. Professional values and attitudes also promote development of professional characteristics including the definition of humanistic care and professional identity. The purpose of this study is to determine the relationship of altruism with empathy and assertiveness in nursing students. Aim. The purpose of thisstudy is todetermine the relationship of altruism with empathy and assertiveness in nursing students. Material and Methods: This is a descriptivestudy.This study was conducted with 659 nursing students in the Nursing Departments of the Health Colleges of two universities in the Central Anatolia Region of Turkey. The data were collected using a Personal Information Questionnaire, the Altruism Scale, Empathic Tendency Scale and Ruthus Assertiveness Inventory. In analyzing the data, percentage distribution, mean standard deviation, correlation analysis, and confidence analysis were used. Results: The students’ mean altruism score was found to be 62.69±11.35, their mean empathic tendency score 66.25±11.05 and their mean Ruthus Assertiveness Inventory score 7.36±15.52. A positive linear and statistically significant correlation was found between the altruism and empathic tendencies of the students who took part in the study (r=0.181, p=0.000) and between their altruism and Ruthus Assertiveness Inventory levels (r=0.186, p=0.000). Conclusion. As the students’ empathic tendencies and assertiveness increase, the level of their altruism also increases

Twin Reversed Arterial Perfusion (TRAP) Sequence; Characteristic Gray-Scale and Doppler Ultrasonography Findings

WOS: 000360808600013PubMed: 26557268Twin reversed arterial perfusion (TRAP) sequence is a syndrome with poor prognosis, seen only in monochorionic monozygotic twin pregnancies. The incidence is one in 35.000 births and one in 100 monozygotic twin pregnancies. It is characterized with a recipient fetus exhibiting lethal anomalies including acardia and a pump fetus. Mortality is usually due to heart failure or premature labor caused by polyhydramnios of pump fetus. Herein, we report a case of TRAP sequence that emphasizes the importance of gray-scale and color Doppler imaging in the diagnosis and management of TRAP sequence

Hemşirelerin tıbbi hata tutumları

Bu araştırmanın amacı, hemşirelerin tıbbi hata tutumlarının belirlenmesidir. Tanımlayıcı olan bu araştırmanın örneklemi bir devlet hastanesinde çalışan ve araştırmaya gönüllü olarak katılmayı kabul eden 173 hemşireden oluşmuştur. Araştırmanın verileri, “Hemşire Tanıtım Formu” ve “Tıbbi Hatalarda Turum Ölçeği (THTÖ)” kullanılarak toplanılmıştır. Verilerin değerlendirilmesinde sayı, yüzde, ortalama, standart sapma, Mann-Whitney U, Kruskal Wallis ve Cronbach alpha analizleri yapılmıştır. Araştırmaya katılan hemşirelerin %22’si 41-45 yaş aralığında ve yaş ortalaması 36.05±8.16’dır. Hemşirelerin %76.9’u kadın, %39.3’ü ön lisans mezunu, %42.2’sinin yatan hasta kliniklerinde, %54.9’unun nöbetli, % 64.7’sinin haftada 40 ve üzeri saat çalışmakta olduğu belirlenmiştir. Hemşirelerin THTÖ toplam puan ortalaması 3.36±0.36 olarak belirlenmiştir. THTÖ alt boyutları puan ortalaması sırasıyla; “tıbbi hata algısı” 2.65±0.85, “tıbbi hataya yaklaşım” 3.64±0.51, “tıbbi hata nedenleri” 3.84±0.55’dir. THTÖ toplam puan ortalaması ile yaş, cinsiyet, eğitim durumu, çalıştığı birim, çalışma şekli ve haftalık çalışma saati arasında istatistiksel olarak anlamlı bir farklılık bulunmadığı saptanmıştır (p>0.05). Bu araştırma sonucunda; hemşirelerin tıbbi hatalarla ilgili tutumlarının olumlu olduğu bulunmuştur