STATE-TRAIT ANXIETY CONDITION AND ITS AFFECTING FACTORS IN PREGNANT WOMEN LINKED TO THE COVID-19 PANDEMIC

Background: This study intends to address the COVID-19 pandemic process with specific regard to pregnant women, aiming to determine their state-trait anxiety levels. Subjects and methods: The study has a quantitative design. Ethical permissions were obtained, data were collected digitally, and power analysis was performed for sample size. The sample size was calculated as 656 pregnant women. In the collection of the data, the Personal Information Form, and the State-Trait Anxiety Inventory (STAI) were used. Results: In our study, the majority of pregnant women (86.3%) were concerned about the pandemic process, with more than half thinking that their pregnancy (62.9%) and delivery processes would be affected (66.2%). In the meantime, 60.2% of the pregnant women postponed their health checks and they indicated being most concerned about their babies (57.1%). In 51.2% of the pregnant women, the state anxiety levels were low, and 89.8% of the trait anxiety levels were moderate. Conclusions: In crisis periods like the pandemic, pregnant women are among the priority groups. Screening, prevention, early diagnosis, and treatment of affective disorders in the prenatal period are important for maternal and fetal health

Evaluation of tissue oxygenation in cesarean cases under spinal anesthesia: A prospective observational study

Objective: Hypotension is common in cesarean section due to the sympathetic blockage induced by spinal anesthesia. We aimed to investigate the effect of vasoactive drugs and fluids, and uterotonic drugs on tissue oxygenation. Methodology: Patients scheduled for elective cesarean section were included in this study. Routine monitoring values, thenar oxygen saturation and hemoglobin (Hb) indices were recorded preoperatively at the operating table (T1), at 3rd minute after spinal block (T2) and after the administration of uterotonic drugs (T3). Results: Data of 61 patients were analyzed. In 24 cases (39%), Hb values were < 11 g/dl. The incidence of hypotension following spinal anesthesia was 34.4%. The mean amount of ephedrine administered before the baby removal was similar in all patients (214 mg). Baseline StO2 values of anemic patients were similar to that of non-anemic patients; tissue hemoglobin index values of the former were significantly lower (p = 0.017). T3 systolic arterial blood pressures of patients with intraoperative hypotension were significantly lower (p = 0.001); tissue oxygen saturation and Hb indices were similar (p = 0.301). Conclusion: Tissue oxygenation may be influenced by the presence of anemia, hypovolemia, and hypotension. Its measurement may be influenced by pregnancy-dependent factors like edema and adipose tissue thickness in the monitoring site. We found that maintaining systolic blood pressure above 100 mmHg in this patient cohort was sufficient to preserve tissue oxygenation despite presence of anemia; and tissue oxygen saturation and hemoglobin indices were reliable

Drugs with a negative impact on cognitive function (Part 1): chronic kidney disease as a risk factor

People living with chronic kidney disease (CKD) frequently suffer from mild cognitive impairment and/or other neurocognitive disorders. This review in two parts will focus on adverse drug reactions resulting in cognitive impairment as a potentially modifiable risk factor in CKD patients. Many patients with CKD have a substantial burden of comorbidities leading to polypharmacy. A recent study found that patients seen by nephrologists were the most complex to treat because of their high number of comorbidities and medications. Due to polypharmacy, these patients may experience a wide range of adverse drug reactions. Along with CKD progression, the accumulation of uremic toxins may lead to blood–brain barrier (BBB) disruption and pharmacokinetic alterations, increasing the risk of adverse reactions affecting the central nervous system (CNS). In patients on dialysis, the excretion of drugs that depend on kidney function is severely reduced such that adverse and toxic levels of a drug or its metabolites may be reached at relatively low doses, unless dosing is adjusted. This first review will discuss how CKD represents a risk factor for adverse drug reactions affecting the CNS via (i) BBB disruption associated with CKD and (ii) the impact of reduced kidney function and dialysis itself on drug pharmacokinetics

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

MRI in CLN2 disease patients: Subtle features that support an early diagnosis

Neuronal ceroid lipofuscinosis type 2 (CLN2) disease is a rare, paediatric-onset, neurodegenerative disorder characterised in its early stages by language delay, seizures and loss of motor function. It is rapidly progressive and ultimately results in the premature death of patients. We aim to highlight common magnetic resonance imaging (MRI) features seen in early CLN2 disease and increase disease awareness among clinicians in order to facilitate early diagnosis and treatment of patients with disease-modifying enzyme replacement therapy.We obtained MRI scans from 12 Turkish children with CLN2 disease, at symptom onset or time of diagnosis, and at various times during disease progression. Patient details including age at onset of symptoms, age at diagnosis and clinical presentation were collected. MRIs were analysed to identify common features present in patients with CLN2 disease.The median diagnostic delay in this cohort was 2 years, highlighting the need for increased disease awareness among clinicians. Key MRI features suggestive of CLN2 disease that were identified included cerebellar atrophy in 11 patients, linear hyperintensity of central white matter in 10 patients, cerebral atrophy in 8 patients and thinning of the corpus callosum in 6 patients. Thalamic hypointensity was seen in 1 patient and may also indicate CLN2 disease.It is important to consider the presenting symptoms alongside clinical test results in order to support early diagnosis of CLN2 disease. Clinical suspicion of CLN2 disease accompanied by the detection of any of the above-mentioned features on MRI should encourage healthcare professionals to test for CLN2 disease.BioMarin Pharmaceutical Inc

High rates of malnutrition and epilepsy: Two common comorbidities in children with cerebral palsy

WOS: 000458367000005PubMed ID: 30761843Background/aim: The aim of this study was to evaluate the nutritional status of children with cerebral palsy and determine the particular characteristics of the disorder. Materials and methods: The nutritional status of the children was assessed by the Gomez classification using weight-for-age. The Gross Motor Function Classification System was used to determine the gross and fine motor functions. Results: The study was conducted with 197 children (58.4% males) between the ages of 1 and 18 years old. Asphyxia (44.1%) was the primary etiological factor, and spastic quadriplegia (41.6%) was the most common type of cerebral palsy. Malnutrition was the most frequent comorbidity and the overall malnutrition rate was 76.6%. The most common type of malnutrition was severe malnutrition, which was seen in 70 patients (35.5%). Epilepsy was the second most common comorbidity, seen in 51.7% of the cases. Conclusion: Our results revealed a high rate of malnutrition and epilepsy in children with cerebral palsy. These two more common significant comorbidities that influence the outcomes of children with cerebral palsy should be carefully evaluated and successfully managed. Families of children with cerebral palsy and their physicians should be educated about the nutritional status in these children

CİTİZENSHİP PERCEPTİONS İN SECONDARY SCHOOL TURKİSH REPUBLİC REVOLUTİON HİSTORY AND KEMALISM

Bu araştırmada T.C. İnkılap Tarihi ve Atatürkçülük ders kitabına yansıyan devletin vatandaşlık algısını ortaya çıkarmak amaçlanmıştır. Nitel araştırma yöntemine dayalı yapılan çalışmada doküman incelemesi yapılarak toplanan veriler içerik analizi tekniği kullanılarak analiz edilmiştir. Analiz sonucunda tespit edilen beş temel tema etrafında vatandaşlık algısının oluşturulduğu anlaşılmıştır. Ele alınan ders kitabına yansıyan vatandaşlık algısının demokrasi (milli egemenlik, seçme ve seçilme, katılım, özgürlük, eşitlik, çoğulculuk, çoğunluk, hoşgörü, hukuk devleti, kuvvetler ayrılığı), temel haklar ve ödevler (kanun ve kurallara uymak, kişinin sosyal, ekonomik, siyasal hakları ve ödevleri), vatanseverlik (milli gurur, milli kimlik, vatan sevgisi, din ve millet sevgisi, öteki devlet ve milletler), milli birlik ve beraberlik (milli kültür, dil birliği, tarih birliği, kültür birliği, ülkü birliği, Türklük bilinci) ve Atatürk, ilke ve İnkılapları (Atatürk, Atatürk ilkeleri, Atatürk inkılapları) başlıkları altında ele alındığı görülmüştür. Ders kitabından elde edilen sonuçlar incelendiğinde devletin vatandaş algısının genel olarak; Mustafa Kemal Atatürk’ün görüşleri doğrultusunda Cumhuriyetin temel ilke, kural ve prensiplerine bağlı, hak ve ödevlerinin farkında olan; vatan ve millet sevgisini yürekten hisseden; birlik ve beraberliğin gücüne inanan ve milli değerler doğrultusunda hareket eden bireyler yetiştirilmesinin hedeflendiği anlaşılmıştır

Brain MRI findings in two Turkish pediatric patients with aspartylglucosaminuria.

Aspartylglucosaminuria is a rare lysosomal storage disorder that occurs as a result of a deficiency of the aspartylglucosaminidase enzyme. Because the disease is commonly referred to as the Finnish disease heritage, it is underdiagnosed outside of Finland. To date, only three Turkish patients are described in the literature. Here we describe the clinical and brain magnetic resonance imaging findings in two Turkish cousins with aspartylglucosaminuria, which can raise the suspicion of this rare disease in clinical practice

Research about drying time efficency of microwave and cabinet dryer on dried fruit pulp

Sağlıklı beslenme, günümüz dünyasında önemini giderek arttıran yaşam kalitemizi yükselten önemli bir ihtiyaçtır. Bu ihtiyaca cevap vermek dengeli beslenmeyi sağlamakla mümkündür. İşlenmiş ürünlerden uzak durmanın yanı sıra meyve tüketimini arttırmak da dengeli beslenmenin bir parçasıdır.Günümüz şartlarında ihtiyaçların yanı sıra küresel gereklilikleri ve ekonomik nedenlerle maliyetleri de göz ardı etmeden proses koşulları oluşturulmalıdır. Bu çalışmada da sayılan her iki yöndeki ihtiyaçlara cevap vermek amacıyla tasarlanan; yüksek meyve içerikli, şekerli ürünlere ikame olarak tüketilebilecek pestilin işlem sürecinde mikrodalganın kabin tipi kurutucunun ve her iki kurutma cihazının etkinlikleri ve verimlilikleri deneylenmiştir. Deney için çilek, şeftali, kayısı ve elma meyvelerine ait püreler, elma ve üzüm suyu konsantreleriyle tatlandırılmış, nişasta, pektin, keçiboynuzu zamkı gibi ajanlarla kıvamı arttırılmıştır. Ön işlemle suyu %60 civarına getirilen kurutulmamış pestil hammaddesinin (herle) 10 g'ı için 90-180-360 ve 600 W enerji sarfiyatıyla mikrodalga fırında, %30 bağıl nemde çalışmaya ayarlanmış 2.6 m3'lük, ortamı RNK 100 ile kurutulan kabin tipi kurutucularda ve etkin kurutma sağlanırken son ürünün istenen tekstürde olmasını sağlamak için iki prosesin ortak kullanımıyla kurutulması deneylenmiştir. Mikrodalga fırın çalışmalarında 90 W' lık enerji sarfiyatı etkinliğin gözlenmesi için olumlu veriler sağlamamıştır. 180 ve 360 W' lık çalışmalar kurutma zamanını % 90 oranında azaltırken 600 W' lık çalışmada etki süresi ne kadar kısaltılırsa kısaltılsın yanma gözlemlendiğinden uygun değildir.Mikrodalga kurutma sistemi enerji verimliliği ve işlem süresi açısından daha etkin gözükse de tek başına kullanımı son üründe beklenen tekstür ve duyusal değerleri karşılamak için yeterli değildir. Ayrıca mikrodalgayla kurutulan ürünlerde son üründeki denge nem değeri istenen değerlerin altındadır. Daha düşük nem değerlerine ulaşılabiliyor olması kurutma etkinliği açısında olumlu gözükse de son üründeki denge nem değerinin daha düşük olması ürün maliyetlerini yükseltme açısından istenen bir durum değildir. Çalışma sonucunda özel olarak formülize edilmiş meyveli ürünlerin kurutulması için mikrodalga ve kabin tipi kurutucu sistemlerinin bir arada kullanılmasının işletme maliyetleri açısından daha verimli olduğu sonucuna varılmıştır.Healthy diet, gradually increasing importance in today's world is a need to enhance our quality of life. To answer this need, it is possible to provide a balanced diet. Increase the consumption of fruit as well as decrease the consumption of processed meals, makes a balanced diet.Global requirements of today's specialties, processing conditions should be established without ignoring the costs, economic reasons as well as consumer?s requirements. Considered in this study is designed to respond to needs in both these two requirements, high fruit content, fruit pulp processing products instead of candy consumed in the process as a cabinet-type dryer and microwave drying device effectiveness and efficiency. Strawberry, peach, apricot and apple purees, sweetened with apple and grape juice concentrate, starch, pectin, locust bean gum, such as thickened agents are formulated to test. 10 gram dried fruit pulp raw material which is brought to around 60% of moisture is processed with 90-180-360 ve 600 W microwave, cabinet type dryers which is set to work to 30% relative humidity with RNK 100 for 2,6 m3. When to ensure an effective drying process it is tested to reach the desired texture of the final product. 90 W microwave oven works' for health monitoring of energy consumption efficiency has made no positive data. Studies at 180 and 360 W reduce drying time by 90%. Study at 600 W while how much is shortened duration of action (impression time) is not appropriate, as important role of combustion.Microwave drying system in terms of energy efficiency and processing time may seem more efficient but use alone is not sufficient to meet the expected texture and sensory values of the final product. In addition, the final microwave dried products? equilibrium moisture value is under the desired values. Lower humidity levels to be accessible is a good result in terms of the effectiveness of drying, but the final product may seem a positive moisture balance to be lower than the value of product costs in terms of the upgrade is not a desirable situation. As a result, for drying the fruit products, which are specially formulated for this study, using a combination of microwave and cabinet type dryer was found more efficient about operation cost.Yüksek LisansM.Sc