Parçacık Sürü Optimizasyonu Kullanılarak Boyutu Azaltılmış Mikrodizi Verileri Üzerinde Makine Öğrenmesi Yöntemleri ile Prostat Kanseri Teşhisi

Mikrodizi verilerine dayanan veri madenciliği analizi, hastalık teşhisi ve farmakoloji alanlarında kullanılmaktadır. Analiz aşamasında yaşanan en önemli zorluk, mikrodizilerin yüksek boyutlu olması ve çok sayıda gereksiz öznitelik içermesidir. Bu nedenle çalışmada kullandığımız prostat kanseri mikrodizi veri kümesi üzerinde öznitelik boyut azaltılması amacıyla Temel bileşenler analizi (TBA) ve Parçacık sürü optimizasyonu (PSO) kullanılmıştır. Bu sayede hastalıkları etkileyen genler tespit edilmektedir. Boyutu azaltılmış veri kümeleri Destek Vektör Makinesi ve k-En Yakın Komşuluk sınıflayıcı yöntemlerine giriş olarak verilmiş ve sınıflandırma başarı sonuçları değerlendirilmiştir. Sonuç olarak PSO boyut azaltma yöntemi ile prostat kanserinde etkin genler belirlenmiş ve 50 öznitelik ile %95.77 başarı elde edilmiştir

Stent placement after flexible ureterorenoscopy for renal stones can improve stone-free rate on final follow-up: A retrospective single center study

Aim: Although the advantage of ureteral double j (D/J) stenting has been shown in reducing post- operative pain after ureteroscopic surgery, its contribution to stone clearance for additional treatment has not been fully assessed. In this study we aimed to evaluate the effect of stenting on stone free rates at the end of the additional treatment. Methods: We reviewed the medical records of all patients who underwent flexible ureterorenoscopy (FURS) for kidney stones between October 2009 and January 2015. Patients with malignant ureteral stricture, severe skeletal malformation, renal unit malformation, non-opaque renal stone or lost to follow-up were excluded. 47 of 289 patients (stenting 24 patients, non-stenting 23 patients) assessed. The perioperative and postoperative parameters and stone-free rates were compared in patients whether they had intraoperative D/J stent (group 1) or not (group 2). Results: No differences were found between groups according to age, gender, body mass index, operation history, preoperative stenting history, shockwave lithotripsy history, ureteral stricture, stone size, access sheath rate, retreatment, or additional treatment number and stone location. Operation time was significantly higher in group 1. Those who refused additional treatment were insignificantly lower in group 1. Although the stone-free rates were similar for the two groups at the end of the first month, the stone-free rates after the additional treatments were significantly higher in group 1. Conclusion: Stenting during FURS, improved the stone-free rate on final follow-up, if residual stones remain

Factors affecting extubating time of postoperative patients who underwent congenital cardiac surgery: a randomized prospective study

OBJECTIVE: Anesthesia management in pediatric cardiac surgery using health resources sparingly focuses on reducing morbidity and mortality and increasing patients’ quality of life. The duration of postoperative mechanical ventilation (MV) heavily influences pediatric cardiac surgery recovery. Thus, in this study we aimed to determine factors influencing extubation times after pediatric cardiac surgery. PATIENTS AND METHODS: A total of 72 pediatric patients with an ASA score of III or above undergoing cardiac surgery were included in the study. As a result of their extubation time, the patients were divided into three groups as follows: those who were extubated immediately after surgery or in the operating room (OR) were recorded as Immediate Extubators (IE); those who were extubated within 6 to 48 hours of entering the intensive care unit were recorded as Early Extubators (EE), and those who were extubated after 48 hours or not extubated were recorded as Delayed Extubators (DE). RESULTS: A logistic regression analysis showed that anomalies and need of MV before surgery, airway difficulty, and prolonged cross-clamp (CC) time were observed as factors affecting DE. The risk of DE was significantly correlated with the presence of abnormality [Odds ratio (OR): 20.3, 95% Confident interval (CI): 2.8-142.7], with the need of MV before surgery (OR: 1,844, 95% CI: 1.8-1,790,461.9), and with the presence of airway difficulty (OR: 44.7, 95% CI: 4.4-445.0). In addition, it was determined that CC time increased the probability of DE 1.038 times per minute (95% CI: 1.004-1.072). CONCLUSIONS: Early and immediate extubation in children who underwent congenital heart surgery was successfully performed in our clinic. Early and immediate extubation in pediatric cardiac surgery can be completed safely and successfully when suitable conditions are provided

Ultrasonographic Evaluation of Gastric Content and Volume in Pediatric Patients Undergoing Elective Surgery: A Prospective Observational Study

Anesthesia-related complications, such as pulmonary aspiration of gastric contents, occur in approximately 0.02–0.1% of elective pediatric surgeries. Aspiration risk can be reliably assessed by ultrasound examination of the gastric antrum, making it an essential non-invasive bedside tool. In this prospective observational study, since most of our patients are immigrants and have communication problems, we wanted to investigate gastric contents and the occurrence of “high risk stomach” in children undergoing elective surgery for the possibility of pulmonary aspiration, even if the children and/or parents reported their last oral intake time. This risk is defined by ultrasound findings of solid content in the antrum and/or a calculated gastric volume exceeding 1.25 mL/kg. Children aged 2–18 were included in the study. Both supine and right lateral decubitus (RLD) ultrasound examinations were performed on the antrum before surgery. Using a qualitative grading scale from 0 to 2, we evaluated the gastric fluid content. The cross-sectional area (CSA) of the antrum was measured in the RLD position, aiding the calculation of the gastric fluid volume according to an established formula by Perlas. Ultrasound measurements of 97 children were evaluated. The median fasting duration was 4 h for liquids and 9 h for thick liquids and solids. Solid content was absent in all the children. Five children (5.2%) exhibited a grade 2 antrum, implying that fluid content was visible in both the supine and RLD positions. The median antral CSA in the RLD was 2.36 cm2, with a median gastric volume of 0.46 mL/kg. For patients with a grade 0 antrum, a moderate and positive correlation was observed between the antral CSA and BMI, and a strong and positive correlation was evident between the antral CSA and age, similar to a grade 1 antrum. Only a single child (1%) had a potentially elevated risk of aspiration of gastric contents. Hence, the occurrence of a “high risk stomach” was 1% (95% confidence interval: 0.1–4.7%) and is consistent with the literature. As a necessary precaution, we propose the regular use of ultrasound evaluations of gastric contents, given their non-invasive, bedside-friendly, and straightforward implementation, for identifying risks when fasting times are uncertain and for ruling out unknown risk factors in each potential patient