Genel anestezinin işitsel beyinsapı cevap testine etkisi

Objective: The auditory brainstem response (ABR) test is usually applied during natural sleep, but it can also be conducted under anesthesia. This retrospective study aimed to compare the ABR findings of a general anesthesia group and a control group that underwent ABR test during natural sleep. Methods: The anesthesia group consisted of 42 (mean age 44.5±20.3 months) children, and the control group included 58 children (36.1±16.1 months). The results of the click ABR test of the two groups were compared in terms of amplitude, latency, interpeak latencies, and hearing thresholds. Results: The amplitudes of waves III and V were significantly decreased in the general anesthesia group compared with that in the control group. The ABR latencies of waves I and V and the interpeak latencies for I-V and III-V were prolonged in the anesthesia group compared with that in the control group. Moreover, the click threshold obtained in the anesthesia group was significantly higher than those of the control group. Conclusions: Clinicians and audiologists should advise families to know the effects of general anesthesia on ABR and be cautious in interpreting the results obtained in ABR test performed under anesthesia.Amaç: İşitsel beyinsapı cevap (ABR) testi genellikle doğal uyku sırasında uygulansa da anestezi altında da yapılabilir. Bu retrospektif çalışmanın amacı, genel anestezi grubu ile doğal uykuda ABR testi uygulanan kontrol grubunu ABR test bulguları açısından karşılaştırmaktır. Yöntemler: Anestezi grubu 42 (yaş ortalaması 44,5±20,3 ay) ve kontrol grubu 58 (yaş ortalaması 36,1±16,1 ay) çocuktan oluşmaktaydı. İki grubun klik ABR test sonuçları amplitüd, latans, dalgalar arası latans ve işitme eşikleri açısından karşılaştırıldı. Bulgular: Genel anestezi grubunda, III ve V. dalganın amplitüdü kontrol grubuna göre anlamlı olarak azaldı. Genel anestezi grubunda, I. ve V. dalgaların latansları, I-V ve III-V dalgalar arası latanslarında kontrol grubuna göre uzama gözlendi. Ayrıca genel anestezi grubunda elde edilen klik eşiği kontrol grubuna göre anlamlı olarak daha yüksek elde edildi. Sonuçlar: Klinisyenler ve odyologlar, ailelere genel anestezinin ABR üzerindeki etkilerini bilmesini tavsiye etmeli ve anestezi ABR ile elde edilen sonuçları yorumlarken dikkatli olmalıdır

Optimisation of phenolic compound biosynthesis in grape (Bogazkere Cv.) callus culture

The objective of this study was to improve metabolite accumulation of grape cells by manipulating culture and environmental conditions. Response surface methodology (RSM) was used to design and conduct the study with the independent variables being: percent depletion of KH2PO4 or NH4NO3 and light intensity. Wounded grape leaves (Bogazkere cv.) were used for the initiation of callus formation. Grape calli were placed on the modified Murashige and Skoog (MS) media (from 0 to 75% KH2PO4 or NH4NO3 depleted) under various light regimes (from 30 to 120 μmol m-2 s-1), and incubated in a controlled environment for three weeks to stimulate secondary metabolite biosynthesis. The anthocyanin - total phenolic (TP) contents of the calli were determined using chemical analyses and the antioxidant capacity of the cultures were determined by using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. Higher KH2PO4 depletion and 75 μmol m-2 s-1 light intensity favored the biosynthesis of anthocyanins and the other phenolic compounds and resulted in elevated antioxidant capacity in the cultures. However, an increase in KH2PO4 or NH4NO3 depletion resulted in a significant decrease in cell weight. Similar to that, increase of light intensity was correlated with decrease of cell weight. Further elevation of light intensity and KH2PO4 -NH4NO3 depletion was fatal to grape cells and resulted in formation of non-growing waterybrownish cultures. Individual phenolic compounds found in the grape cell cultures were identified using the gas chromatography-flame ionization detector (GC-FID) system. Catechin and epicatechin were identified as the most abundant simple phenolic compounds present in the cultures.Keywords: Antioxidant capacity, callus, grape, phenolic compounds, response surface methodology.African Journal of Biotechnology Vol. 12(25), pp. 3922-393

NLO’nun beyin apselerinin tanı ve farmakolojik tedavi yönetimine etkileri

Aim: The present study aims to examine the effectiveness of the neutrophil-tolymphocyte ratio in the treatment and diagnosis of patients with brain abscesses. Methods: In this retrospective study, radiological, neurological, and surgical data obtained from the medical records of healthy volunteers (n = 10) who presented to the hospital for check-ups and patients with brain abscesses who were treated (n = 10) were evaluated statistically. Alpha significance value was accepted as 0.05). The preoperative neutrophil-to-lymphocyte ratio in cases diagnosed with brain abscesses showed statistical significance compared to that in the healthy volunteers (P 0,05). Sağlıklı bireylere oranla beyin apsesi tanısı alan olgulara ait preoperatif NLO değerlerinin istatistiksel olarak anlamlılık (P<0,05) gösterdiği ve NLO değerinin sağlıklı bireylere oranla yaklaşık 3,31 kat artış gösterdiği kaydedildi. Sonuç: NLO oranı ile abse boyutu arasında (r=0,662; P=0,037) pozitif yönde kuvvetli ilişki bulunmaktadır. Artış gösteren NLO, beyin apsesinin tanısında erken uyarı sinyali olarak hizmet edebilir

Bacteremia due to Acinetobacter ursingii in infants: Reports of two cases

Acinetobacter ursingii is an aerobic, gram-negative, opportunistic microorganism which is rarely isolated among Acinetobacter species. We present two immunocompetent infants who developed bacteremia due to A.ursingii. The first patient is a two -month- old boy who had been hospitalized in pediatric surgery unit for suspected tracheo-esophageal fistula because of recurrent aspiration pneumonia unresponsive to antibiotic therapy. The second patient is a fourteen -month- old boy with prolonged vomiting and diarrhea. A. ursingii was isolated from their blood cultures. They were successfully treated with ampicillin-sulbactam. Although A.ursingii has recently been isolated from a clinical specimen; reports of infection with A.ursingii in children are rare. A.ursingii should be kept in mind as an opportunistic microorganism in children.Pan African Medical Journal 2016; 2

The Effect of Donor Age on Recipient Kidney Graft Function

Purpose: End-stage renal disease (ESRD) is a highly morbid and mortal condition. Renal transplantation is the most favorable and preferred solution of this disease. Age is an important factor that can effects the success of transplantation. In this study, we investigated the effect of donor age on the outcomes of kidney transplantation. Materials and Methods: 101 ESRD patients who underwent live or cadaveric kidney transplantation were included and analyzed retrospectively in this study. We reviewed age, sex and body mass index (BMI) of the donors and age, sex, BMI, length of stay, estimated glomerular filtration rate (eGFR) and serum creatinine measurements of the recipients were recorded. Recipient serum creatinine levels were determined at intervals up to 18 months after transplantation. Results: Donors were divided into 3 groups according to age (50 years (n:34). There was no statistically significant difference between the groups in terms of donor's gender, BMI, living/cadaveric ratio, and recipient's gender, age, and BMI (p>0.05). Length of hospital stay of recipients whose donor <40 years old were statistically significantly lower compared to other age groups (p:0.001). From the 1st month to the 18th month, a statistically significant decrease in GFR and an increase in serum creatinine were observed as the donor age increased (p<0.05). Conclusion: Donor age is an important factor for the graft survival and for the allocation procedures it should be kept in mind

Investigation of the Prognostic Values of the Shock Index and Modified Shock Index in Predicting the Clinical Outcomes in Elderly Hospitalized Patients with Coronavirus Disease-2019

Introduction:Advanced age is an independent risk factor for increased mortality in coronavirus disease-2019 (COVID-19). However, the best method for estimating mortality in elderly patients with COVID-19 is still under debate. We performed this study to assess the shock index (SI) and the modified shock index (MSI) for the abovementioned problem.Methods:A retrospective study was conducted including elderly cases (≥65 years) confirmed with COVID-19 who admitted to a tertiary university hospital between March-December 2020. The SI and MSI at the time of the emergency department visits were used to evaluate the intensive care unit admission, ventilator support, septic shock, and 30-day mortality in all patients. The receiver operating characteristic and area under the curve (AUC) were used to measure the overall ability of SI and MSI to predict clinical outcomes.Results:We recruited 334 consecutive COVID-19 patients with a mean age of 75.2±7.3 and an almost equal gender distribution [170 males (50.9%)]. In deceased and surviving patients, the SI was 0.66±0.16 and 0.6±0.1 (p=0.014), while the MSI was 0.95±0.22 and 1.09±0.34 (p=0.003), respectively. In predicting mortality, the AUC of the SI and MSI were 0.590 [95% confidence interval (CI): 0.535 to 0.643] and 0.608 (95% CI: 0.553 to 0.660), respectively.Conclusion:Increased SIs and MSIs are associated with 30-day mortality. SI and MSI can benefit the triage of elderly patients hospitalized for COVID-19. However, it was found that there is no single cut-off value of SI or MSI with optimum accuracy for predicting COVID-19-related clinical outcomes

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic.

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world

Investıgatıon of Mesenchymal Stem Cell Expansıon inPacked Bed Bıoreactor

In the thesis study, it was aimed to investigate mesenchymal stem cell production in packed bed bioreactor where non-woven polyester fiber matrices (NWPF) are used as carrier. In the preliminary studies, MC3T3-E1 mouse pre-osteoblastic cells were used. Surface modification was carried out with 3M sulfuric acid in order to allow the cells to adhere to non-woven polyester fabric discs. The hydrophilicity of the discs was determined by water contact angle analysis. For this purpose, a cell culture study was performed with NWPF discs in static conditions, and the cells were adhered to the discs and evaluated by Scanning Electron Microscope (SEM). In the next stage of the study, preliminary dynamic cell culture studies were performed in the packed bed bioreactor (PBB) with MC3T3-E1 cells with a working volume of 0.5L, using Fibra-Cel® discs. Cells removed from discs on Day 1, 3, 5, and 7 of the culture were counted, and at the end of the culture, it was observed that the number of cells increased approximately 5-fold in the bioreactor. After carrying out bioreactor optimization, studies were performed with rat adipose mesenchymal stem cell (rAdMSC). The effects of different operating parameters such as packed bed height, mixing speed and cell seeding density in the bioreactor on the production efficiency of the cells were investigated. In order to increase the cell production efficiency in the bioreactor and reduce the production of material and make the production more economical, the scale of the bioreactor was reduced and a PBB design with a volume of 100mL was designed. In the last part of the thesis study, the viability of rat adipose mesenchymal stem cells on NWPF discs were investigated by MTT 3- [4,5-dimethylthiazol-2-yl] - 2,5-diphenyltetrazolium bromide) analysis, and their morphologies were F-actin / DAPI and crystal violet staining. As a result of the dynamic culture, the number of cells increased 4 times. Cell removal was carried out to examine the morphology of cells after removal from NWPF discs. It has been observed that 85% of cells have been successfully removed from disks. For this purpose, the culture was successfully continued by adding the cells removed to 75 cm2 flask. Glucose, lactate and urea analysis were performed to examine the metabolic activities of the cells. Although 50% of the medium was changed on certain days during the culture period, the number of cells increased continuously and the glucose concentration decreased 2.5-fold compared to the beginning of the culture. Due to the decrease in glucose concentration, lactate and urea concentrations in the medium increased 2-fold and 5-fold, respectively. From the obtained results, it was determined that there was no inhibition due to the lactate and urea concentrations accumulated in the dynamic cell culture. As a result, the dynamic cell culture made in PBB within the scope of the presented thesis showed that rat AdMKHs are attached to the fibers of NWPF disks and spread to all regions and have the potential to reach the number of cells needed in clinical applications.Tez çalışmasında, dokunmamış poliester fiber matrislerin (NWPF) taşıyıcı olarak kullanıldığı dolgulu yatak biyoreaktörde mezenkimal kök hücre üretiminin araştırılması amaçlanmıştır. Ön çalışmalarda hücre olarak MC3T3-E1 fare kemik öncül hücreleri kullanılmıştır. Hücrelerin NWPF disklere yapışmasını sağlamak amacıyla 3M sülfürik asit ile yüzey modifikasyonu gerçekleştirilmiştir. Disklerin hidrofilisitesi su temas açısı analizi ile belirlenmiştir. Ardından NWPF disklerle durgun koşullarda hücre kültürü çalışması yapılmış, hücrelerin disklere yapışıp çoğaldığı Taramalı Elektron Mikroskobu (SEM) ile değerlendirilmiştir. Çalışmanın sonraki aşamasında MC3T3-E1 hücreleri ile 0.5L çalışma hacmine sahip dolgulu yatak biyoreaktörde (DYB), Fibra-Cel® diskler kullanılarak ön dinamik hücre kültürü çalışmaları gerçekleştirilmiştir. Kültürün 1., 3., 5., ve 7. günlerinde disklerden kaldırılan hücreler sayılmış ve kültür sonunda hücre sayısının biyoreaktörde yaklaşık 5 kat arttığı gözlemlenmiştir. Biyoreaktör için çalışma koşulları belirlendikten sonra, deneylere sıçan adipoz mezenkimal kök hücreler (AdMKH) ile devam edilmiştir. Biyoreaktörde dolgulu yatak yüksekliği, karıştırma hızı ve hücre ekim yoğunluğu gibi farklı işletim parametrelerinin hücrelerin üretim verimine olan etkileri incelenmiştir. Biyoreaktörde hücre üretim verimini artırmak ve malzeme sarfını azaltarak üretimi daha ekonomik hale getirmek amacıyla biyoreaktörün ölçeği küçültülmüş ve 100 mL hacminde bir DYB tasarımı gerçekleştirilmiştir. Tez çalışmasının son aşamasında AdMKH’ların NWPF diskler üzerindeki canlılığı MTT 3-[4,5-dimetiltiazol-2-il]- 2,5-difeniltetrazolyum bromür) analizi ile, morfolojileri F-aktin/DAPI ve kristal viyole boyamaları ile incelenmiştir. Yüz mL hacimli DYB’de yapılan dinamik kültür sonucunda hücre sayısının 4 kat artış gösterdiği bulunmuştur. Ayrıca, NWPF disklerden hücrelerin %85’inin başarılı bir şekilde kaldırıldığı gözlemlenmiştir. Yüzeyden kaldırılan hücreler tekrar başarılı bir biçimde çoğaltılmıştır. Hücrelerin metabolik aktivitelerinin incelenmesi amacıyla glukoz, laktat ve üre analizi gerçekleştirilmiştir. Kültür süresince belirli günlerde ortamın %50’si değiştirilmesine rağmen glukoz konsantrasyonu kültür başlangıcına göre 2.5 kat azalmıştır. Glukoz konsantrasyonunun düşmesine bağlı olarak ortamda laktat ve üre konsantrasyonları sırasıyla 2 kat ve 5 kat artış göstermiştir. Elde edilen sonuçlardan dinamik hücre kültüründe biriken laktat ve üre konsantrasyonlarına bağlı inhibisyon oluşmadığı belirlenmiştir. Sonuç olarak sunulan tez kapsamında sıçan AdMKH’lerin üretilmesi için üç boyutlu NWPF disklerin kullanıldığı dolgulu yatak biyoreaktörün yüksek yüzey alanı/hacim oranı sağlayarak klinik uygulamalarda ihtiyaç duyulan yüksek miktarda hücre sayısına ulaşma potansiyeline sahip olduğu değerlendirilmiştir

The principles of sterilisation and air flow of operating rooms

Ameliyat sonrası gelişen enfeksiyonlar, halen önemli bir mortalité ve morbidité nedenidir. Bu enfeksiyonlar dezenfeksiyon ve sterilizasyon ilkelerine uyulması ile önlenebilmektedir. Bu yazıda enfeksiyon kontrolünde uyulması gereken kurallar ve havalandırma sistemlerinin temel özellikleri özet halinde sunulmuştur.Postoperative infections are still important causes of morbidity and mortality. These infections can be prevented by consideration of desenfection and sterilisation principles. We rewieved the principles of infection control and airflow patterns in operating rooms