Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

Agenesis of the isthmus of the thyroid gland

WOS: 000440304200016PubMed: 29756110The thyroid is an endocrine gland composed of two lobes connected by the isthmus tissue. Thyroid isthmus agenesis is a rare condition, and only a few cases have been reported in the literature. Here, we discuss the case of a 56-year-old female patient in whom agenesis of the thyroid isthmus was discovered incidentally during surgery for a multinodular goitre. When agenesis of the isthmus is found, associated thyroid lobe agenesis and the presence of ectopic thyroid tissue must be considered. In addition, associated autoimmune thyroid nodule, thyroiditis, primary thyroid carcinoma, metastasis, and amyloidosis must be considered in the differential diagnosis. Preoperative awareness of potential agenesis of the isthmus and its associated thyroid anomalies in patients with planned thyroid surgery will significantly contribute to safety during surgical procedures and result in fewer surgery-related complications

Esophageal squamous papilloma

[Cukurova Med J 2016; 41(0.100): 118-119

Evaluation of agricultural management costs pre-and postland consolidation projects

Bu çalışmada arazi toplulaştırması öncesi ve sonrası tarımsal işletmecilik maliyetlerinin değerlendirilmesi amacıyla Kayseri İli Yeşilhisar İlçesi Kesik Mahallesi tarım arazilerinde gerçekleştirilen arazi toplulaştırma uygulamaları dikkate alınmıştır. Çalışma, arazi toplulaştırma çalışmalarının işletme ekonomisine katkısını belirlemek amacı ile yapılmıştır. Arazi toplulaştırma projelerinde parsellere ulaşım sağlanması, parsellerin şekilleri düzenlenip parsellerin birleştirilmesi, su kaynaklarının etkin kullanılması buna bağlı olarak maliyetlerin azaltılması başta olmak üzere birçok yararı bulunmaktadır. Araştırmada toplulaştırma öncesi ve sonrası şartlarda tarımda girdi kullanımı, projelerin toplulaştırma oranı, toplulaştırmanın parsel şekil büyüklük ve sayısına etkisi, toplulaştırma öncesi ve sonrası zaman farkı ve yakıt tüketimindeki değişim performansları belirlenmiş ve karşılaştırılmıştır. Çalışma alanından 5 adet örnek işletme seçilmiştir. Yol uzunlukları ve güzergahlardaki değişimler belirlenmiştir. Yollardaki toplam azalma miktarını belirlemek için, köy merkezinden tüm parsellere ulaşım için kat edilen yol uzunluğu, NETCADGIS 7.0 bilgisayar ortamında hesaplanmıştır. Toplulaştırma sonrasında yola cephesiz parsel sayısı azalmış, tarımsal mekanizasyon kolaylığı açısından dikdörtgen şeklindeki parsel sayısı ve oranında artış sağlanmıştır. Toplulaştırma öncesi parsel sayısı 2136 iken toplulaştırma sonrası 1562 ye düşmüştür. Ayrıca toplulaştırma öncesi dikdörtgen şekilli parsel oranı %38.25 iken toplulaştırma sonrası %48.05 olmuştur. Toplulaştırma oranı %26.87 olarak gerçekleşmiştir. Çalışmada Haziran 2019 yılı için yakıt tüketimi ve kullanılacak olan alet ekipmanlar belirlenmiştir. Motorin fiyatı Kayseri İli Yeşilhisar İlçesi için 6.35TL/lt olarak alınmıştır. Çalışmada toplulaştırma sonrası işletme merkezi ile parseller arası yol uzunluklarında ki değişimler ile tarla başına kadar traktör hız faktörleri hesaba katılarak toplam çalışma süreleri hesaplanmış ve zamandan tasarruf sağlanmıştır. Bu şekilde doğru ve verimli mekanizasyon kullanımı tarımda kaliteyi ve büyümeyi arttırmıştır. Arazi toplulaştırması ile sürüm giderlerinde değişen oranlarda maliyet azalmakta ve tasarruf sağlamaktadır.In this study, land consolidation practices carried out in the agricultural land of Kesik Quarter of Yeşilhisar District of Kayseri Province were taken into consideration in order to evaluate the agricultural management costs before and after land consolidation. The aim of this study is to determine the contribution of land consolidation activities to enterprise economy. Land consolidation projects provide access to parcels, the parcels are arranged and merged parcels, the effective use of water resources associated with the reduction of costs has many benefits. In this research, the use of inputs in agriculture in non-aggregated and aggregated conditions, the aggregation rate of the projects, the effect of aggregation on the size and number of parcel shape, the time difference before and after aggregation and the change performances in fuel consumption were determined and compared. 5 sample enterprises were selected from the study area. Changes in path lengths and routes were determined. In order to determine the total amount of reduction in the roads, the length of the road traveled to reach all parcels from the village center was measured in Netcad CIS 7.0 computer environment. After the consolidation, the number of parcels without facade has decreased and the number and proportion of rectangular parcels, which are parcel shape, have been increased in terms of ease of agricultural mechanization. The number of parcels before consolidation decreased from 2136 to 1562 after consolidation. In addition, the ratio of rectangular parcels before consolidation was 38.25% and 48.05% after consolidation. The aggregation rate was 26.87%. In this study, fuel consumption of June 2019 and instrument equipments to be used were determined. Diesel price was taken as 6.35TL / lt for the Yeşilhisar District of Kayseri. In the study, after the consolidation, the changes in the road lengths between the operation center and the parcels were taken into account and the total working time was determined by taking into account the tractor speed factors per field and within the field and saving time. In this way, the use of correct and efficient mechanization has increased the quality and growth in agriculture. With land consolidation, the cost of version decreases and costs are reduced at varying rates

Granular Cell Tumor on Perianal Region: A Case Report

Granular cell tumor (GCT) was first described by Abrikossoff in 1926. GCT is a rarely seen soft tissue tumor and is generally benign. While the tumor can be seen in all parts of the body it is generally located on the head and neck region, and especially on the tongue. GCT is rarely seen in the anal-perianal region. In accordance with literature this case was reported because it was thought to be the 27th anal-perianal located GCT case. In this case report, approximately 0,5-1 cm pedunculated polypoid lesion was determined in the perianal region during the physical examination of a 23 year old female patient who applied with palpable mass complaint in the perianal region. Lesion in the patient was totally excited with healthy skin-subcutaneous tissue under local anesthesia. A benign granular cell tumor was detected in the histopathological examination. Positive staining was monitored immunohistochemically with S-100 and neuron specific enolase (NSE). GCT is a rarely seen tumor in the anal-perianal region and its malign transformation rate is very low. Even lesions seen in the perianal region have clinically a benign appearance, a histopathological examination should be conducted and also GCT should be kept in mind during diagnosis. Malign-benign separation of these lesions is difficult so histopathological examination should be conducted with great care. Large local excision in the treatment provides curative treatment. But for those presenting malign transformation further examination must be performed for metastasis. After the treatment local recurrence and metastasis should be considered carefully. Prognosis of metastatic disease is very bad

Agenesis of isthmus of thyroid gland in the presence of ectopic thyroid tissue associated with papillary carcinoma

WOS: 000455434800020PubMed: 30630576The thyroid is an endocrine gland composed of two lateral lobes connected by a strip of thyroid tissue called an isthmus. The thyroid gland is usually associated with extensive morphological variations and developmental anomalies. During the 4th intrauterine week, the thyroid gland begins to develop mainly from the invagination of the endodermal cells of the ventral floor of the primitive pharynx. One of the anomalies of the thyroid gland is the agenesis of the isthmus of the thyroid. It is a rare condition and very few cases have been reported in the literature. Another rare developmental abnormality is the presence of ectopic thyroid tissues, which are characterised by the presence of thyroid tissue in locations other than the anterolateral region of the second and fourth tracheal cartilages. Ectopic thyroid tissues are most commonly found in the lingual region but are also found in the other head/neck localisations as well. In this present case report, a 54-year-old female patient with the agenesis of the isthmus of the thyroid gland with accompanying tissues of multifocal and multicentric papillary thyroid carcinoma will be discussed. When an agenesis of the isthmus of the thyroid is detected, the agenesis of the thyroid lobes or the presence of an ectopic thyroid tissue must be considered. Especially in the patients who will undergo a thyroid surgery, it should not be forgotten that the identification of an agenesis of the isthmus as well as the other thyroid anomalies during the preoperative examination, will make a remarkable contribution in deciding the strategy of the surgery and will help in preventing the development of surgical complications. However, it is not always possible to detect the presence of these anomalies, during the preoperative examinations of the patients who will undergo thyroid surgeries; therefore, one must be careful with regard to these type of anomalies in the perioperative examinations. To the best of authors' information, the present case is considered to be the first in the literature in English, presenting with an agenesis of the isthmus of the thyroid gland in the presence of ectopic thyroid tissues associated with papillary carcinoma

A Case of Traumatic Asphyxia due to Motorcycle Accident

Background. Perthe's syndrome (traumatic asphyxia) is rare, which is caused by sudden compressive chest trauma and characterized by subconjunctival hemorrhage, facial edema, craniocervical cyanosis, and petechiae on the upper chest and face and should always be kept in mind as a possible complication of injuries of the chest and abdomen. Case Report. In this case report a 36-years-old male patient brought to the emergency room due to thorax trauma related to motorcycle accident was discussed. Distinct cyanotic, edematous, and multiple petechiae were present on the face, neck, and upper thorax regions of the patient. Bilateral subconjunctival hemorrhage was determined. Conclusion. Treatment for traumatic asphyxia is supportive and patient recovery is related to the generally associated injuries. Prognosis of the patients is quite good with effective and timely treatment

Heterotropic Gastric Mucosa in Sigmoid Colon: Report of One Case

In this case presentation we aimed to discuss, with literature, a female patient with rarely seen sigmoid localized heterotopic gastric mucosa. An approximate 0.5 and ndash; 1 cm polyp was determined in the rectosigmoidoscopy of the 37-year-old female patient who had applied to the general surgery department with a constipation complaint. Heterotopic gastric mucosa was detected as a result of histopathological examination. Heterotopic gastric mucosa is frequently determined in the upper gastrointestinal tract. The number of cases of heterotopic gastric mucosa localized on the lower gastrointestinal tract is considerably low in literature. [Arch Clin Exp Surg 2013; 2(1.000): 63-65