Tracheobronchopathia osteochondroplastica and cervical spine involvement in rheumatoid arthritis

A 62-year-old man presented to our outpatient clinic with a neck pain that began 4-month ago. The pain was increasing in severity without any neurological symptom or radiating to arms. The patient had a history of cerebrovascular accident without sequelae (1 year ago), 40 pack-year smoking, and diagnosis of rheumatoid arthritis (RA) 10 years ago. He had received an irregular treatment with prednisolone, methotrexate, and rituximab (discontinued 2 years ago)

Deterministic Approximation Algorithms for Volumes of Spectrahedra

We give a method for computing asymptotic formulas and approximations for the volumes of spectrahedra, based on the maximum-entropy principle from statistical physics. The method gives an approximate volume formula based on a single convex optimization problem of minimizing $-\log \det P$ over the spectrahedron. Spectrahedra can be described as affine slices of the convex cone of positive semi-definite (PSD) matrices, and the method yields efficient deterministic approximation algorithms and asymptotic formulas whenever the number of affine constraints is sufficiently dominated by the dimension of the PSD cone. Our approach is inspired by the work of Barvinok and Hartigan who used an analogous framework for approximately computing volumes of polytopes. Spectrahedra, however, possess a remarkable feature not shared by polytopes, a new fact that we also prove: central sections of the set of density matrices (the quantum version of the simplex) all have asymptotically the same volume. This allows for very general approximation algorithms, which apply to large classes of naturally occurring spectrahedra. We give two main applications of this method. First, we apply this method to what we call the "multi-way Birkhoff spectrahedron" and obtain an explicit asymptotic formula for its volume. This spectrahedron is the set of quantum states with maximal entanglement (i.e., the quantum states having univariant quantum marginals equal to the identity matrix) and is the quantum analog of the multi-way Birkhoff polytope. Second, we apply this method to explicitly compute the asymptotic volume of central sections of the set of density matrices

The importance of gastronomy routes in the sustainability of gastronomy tourism

Gastronomi, toplumların yiyecek-içecek kültürlerini yansıttığı gibi, yerli ve yabancı turistlerin ihtiyaç ve taleplerine de cevap vermektedir. Gastronomi turizmi; destinasyonlara gerçekleştirilen, eğlenme amaçlı yiyecek-içecekle ilgili rekreasyonel deneyimsel etkinliklerin bütünüdür. Gastronomi turizminin temel motivasyonu, özel bir yemeği tatmak, bir yemeğin üretim aşamalarını görmek için yiyecek-içecek üreticilerini, festivalleri, restoranları ve özel alanları ziyaret etmektir. Gastronomi rotaları ise belli bir güzergâhın belirleyici unsurlarıyla, yerinde yeni ürünler deneme, geleneksel pazarları ziyaret etme ve yerel dükkânlardan alışveriş yapma vb. etkinliklerin sunulmasıdır. Gastronomi rotalarının temel motivasyonu; turistik bir destinasyona ziyarette bulunacak turistlerin, bölgede karşılaşabilecekleri yiyecek-içecekler, gastronomik etkinlikler ve gastronomik ürünler hakkındaki bilgileri toplu olarak bir arada bulabilmelerini sağlamaktır. Türkiye’de gastronomi bakımından zengin birçok il bulunmaktadır. Gastronomi rotalarının belirlenmesiyle ve turistlere duyurulmasıyla, meşhur yemeklerin, restoranların, yemek festivallerinin vb. turistik olanakların, turistler tarafından kolayca öğrenilmesi ve daha tatmin edici seyahat deneyimlerinin yaşanması sağlanabilecektir. Ayrıca rotaları belirlenen şehirlerin tanınırlığının ve tercih edilirliğinin artmasına da katkıda bulunulacaktır. Bu bağlamda söz konusu çalışmanın amacı; gastronomi turizminin sürdürülebilirliğinde, gastronomi rotalarının önemini ortaya koymaktır. Bu çalışmada literatür taraması yapılmış, gastronomi rotalarının belirlenmesi ve gastronom turizminin sürdürülebilirliği için öneriler geliştiren çalışmalar incelenmiş, söz konusu çalışmalardan yola çıkılarak, gastronomi turizminin sürdürülebilirliğinin sağlanmasında, gastronomi rotalarının belirlenmesinin önemi ortaya koyulmaya çalışılmıştır. Literatür taramasından elde edilen bulgulara göre; CBS vb. sayısal veri sistemlerinin turizm sektöründe kullanılmasıyla, doğal/kültürel mekânların korunmasının, kayıt altına alınmasının, sürdürülebilir bir anlayışla gelecek nesillere aktarılmasının sağlanabileceği, turizm değerlerinin modern olarak pazarlanmasına katkıda bulunulabileceği, destinasyonların rekabet gücünün arttırılabileceği, zeytin vb. ürünlerle ilgili gastronomi rotalarının çıkartılmasıyla, turistik ürün olarak kullanılabilecek ürünlerin yetiştirildiği tarlaların kapasitesinin verimli kullanılabileceği, turistik destinasyonlara ait kültürel özelliklerin ve yöresel gıda ürünlerinin daha iyi tanınmasının sağlanabileceği gibi konuların incelendiği tespit edilmiştir. Söz konusu bu literatür taramasıyla elde edilen bulgulardan yola çıkılarak Türkiye’deki gastronomik zenginliğe sahip olan destinasyonların, akademik çalışma ve projelerle teker teker incelenmesinin ve bu destinasyonlara yönelik rotaların çeşitli sayısal sistemler kullanılarak tespit edilmesinin, gastronomi turizminin sürdürülebilirliği bakımından önemli faydalar sağlayabileceği düşünülmektedir.Gastronomy not only reflects the food and beverage cultures of societies, but also responds to the needs and demands of domestic and foreign tourists. Gastronomic tourism; It is the whole of recreational experiential activities related to food and beverage for entertainment purposes carried out in destinations. The main motivation of gastronomic tourism is to visit food and beverage producers, festivals, restaurants and special areas to taste a special dish and see the production stages of a dish. Gastronomy routes are defined as that is consist of trying new products on the spot, visiting traditional markets and shopping at local shops, etc., with the defining elements of a particular route. presenting activities. The main motivation of the gastronomic routes; It is to ensure that the tourists who will visit a touristic destination can find together information about the food and beverages, gastronomic events and gastronomic products that they may encounter in the region. There are many provinces in Turkey that are rich in gastronomy. With the determination of gastronomic routes and announcing them to tourists, famous dishes, restaurants, food festivals, etc. touristic opportunities will be easily learned by tourists and more satisfying travel experiences will be experienced. It will also contribute to increasing the recognition and preferability of the cities whose routes are determined. In this context, the aim of this study is; to reveal the importance of gastronomy routes in the sustainability of gastronomic tourism. In this study, literature review was made, studies that developed suggestions for the determination of gastronomy routes and the sustainability of gastronomy tourism were examined, and the importance of determining gastronomy routes in ensuring the sustainability of gastronomy tourism was tried to be revealed based on these studies. According to the findings obtained from the literature review; GIS etc. with the use of digital data systems in the tourism sector, it is possible to protect natural / cultural places, to record them, to transfer them to future generations with a sustainable understanding, to contribute to the modern marketing of tourism values, to increase the competitiveness of destinations, olive etc. it has been determined that by removing the gastronomic routes related to the products, the capacity of the fields where the products that can be used as touristic products can be used efficiently, the cultural characteristics of the touristic destinations and the local food products can be better recognized. Based on the findings obtained from this literature review, it is thought that examining the gastronomic rich destinations in Turkey one by one with academic studies and projects and determining the routes to these destinations using various numerical systems can provide important benefits in terms of the sustainability of gastronomic tourism

Comparison of controlled-intermittent anal dilatation and lateral internal sphincterotomy in the treatment of chronic anal fissures: A prospective, randomized study

Aim: The results of controlled-intermittent anal dilatation (CIAD) or lateral internal sphincterotomy ( LIS) in the treatment of chronic anal fissures are presented. Material and methods: Forty patients who were randomized to two groups underwent CIAD or a LIS. The pre- and post-operative mean anal canal resting pressures (MACRPs) and symptoms were recorded and the results were compared. Results: Two months post-operatively, 18 patients in the CIAD group and 17 patients in the LIS group had healed completely, and had no anal incontinence or other complications. The post-operative improvement in pain, bleeding, and constipation did not differ significantly between the two groups. In the CIAD and LIS groups, the pre-operative MACRPs were 89.7 +/- 16.5 and 87.6 +/- 12.3 mmHg, respectively; 2 months post-operatively, the MACRPs had significantly decreased to 76.9 +/- 13.7 and 78.1 +/- 11.3 mmHg in the CIAD and LIS groups, respectively. No statistical difference existed in the pre- or post-treatment MACRPs between the groups. Conclusion: CIAD applied with a standardized technique reduced anal canal resting pressure and provided symptomatic healing that was equivalent to a LIS. Since there were no findings of incontinence, or situations which resulted in sphincter damage, we conclude that CIAD is suitable for patients with chronic anal fissures because it is less invasive than LIS, with equivalent efficacy and safety. In addition, the CIAD method may be an alternative procedure in older and multiparous women who has a higher risk of incontinence. (c) 2009 Published by Elsevier Ltd on behalf of Surgical Associates Ltd

Elastic Stable Intramedullary Nailing for Pediatric Forearm Fractures: A Retrospective Analysis of Thirty Four Cases

Aim: The purpose of this investigation was to present our institutional experience of 34 pediatric both bone forearm fractures treated with titanium elastic intramedullary nails. Methods: Thirty-four patients, who were treated with titanium elastic nail for both bone forearm fractures diagnosis between 2011 and 2016, were included in the study. Clinical and radiological evaluation of the patients was retrospectively analyzed. Results: Bone healing process was completed for all patients at a mean of 6.6 weeks. The implants were removed at a mean time of 9.7 months from the index operation. Complications, including skin infections at the entry side of the nail, were recorded in three (8.82%) patients. These three patients had type 1 open fracture according to the Gustilo-Anderson classification and were treated with first generation cephalosporins. In a subjective measure of outcome during follow-up, it was observed that 33 patients (97.06%) were very satisfied and one (2.94%) was satisfied; no patient reported being not satisfied. Conclusion: Since titanium elastic nailing is a safe and effective method of treatment with advantages of easy implantation and removal as well as excellent cosmetic and functional results, elastic stable intramedullary nailing is the first treatment option that should be considered in pediatric both bone forearm fractures

Nevşehir ilinde yaşatılan geleneksel alevi-bektaşi mutfağına yönelik sözlü kültür araştırması

Türkiye’de yaşayan her etnik grubun kendine özgü yeme-içme kültürü, mutfak ve sofra gelenekleri vardır. Bu araştırma kapsamında, Nevşehir ili sınırları içerisinde oldukça yüksek bir popülasyona sahip ve özellikle mutfak kültürü açısından zengin bir içeriği bünyesinde barındıran Alevi-Bektaşi topluluğu incelenmiştir. Gerçekleştirilen yapılandırılmış mülakatlar neticesinde, Kavimler Göçü’nden bu yana Anadolu’da varlığını devam ettiren ve Türkiye’de kısıtlı düzeyde bilgi sahibi olunan Alevi-Bektaşi topluluğunun mutfak kültürüne yönelik birtakım çıkarımlar elde edilmiştir. Bu bağlamda, Nevşehir İli Hacıbektaş ilçesinde yaşayan, farklı demografik ve kişisel özelliklere sahip 15 katılımcı ile birebir görüşmeler gerçekleştirilmiştir. Görüşmeler sonucunda Alevi-Bektaşilerin Cem İbadetlerinde, Muharrem Orucu günlerinde, Toplu tören ve bayramlarda ne tür yiyecek-içecekler tükettikleri, hangi yiyecek ve içeceklere özel anlam yükledikleri, hangi hayvanların etini neden yemedikleri, sofra adabı ile ilgili tespitlerde bulunulmuştur

Sol diafram yaralanması tespiti nasıl yapılmalıdır?

Giriş: Travmatik diafram yaralanmaları künt ve delici aletle yaralanmalar sonrasında ortaya çıkan ve sıklıkla gözden kaçan bir sorun- dur. Biz çalışmamızda; kliniğimize sol torakoabdominal bölgeden olan yaralanma ile başvuran hastalar için uygulanan tanı yöntem- lerini karşılaştırdık. Metod: Kliniğimize sol delici kesici alet yaralanması ile konsulte edilen ve tetkik ve tedavisi yapılan 62 hasta ça- lışmaya dahil edildi. Hastalar akciğer grafisi, USG, tomografi ve laparoskopi yapılarak sonuçları incelendi. Sonuçlar: Hastaların 11’i inceleme dışı bırakıldı. Kalan 51 hastanın 26 tanesinde %50.98 diafram yaralanması mevcuttu 25 tanesinde %49.02 ise herhangi bir patoloji rastlanmadı. Tartışma: Sol torakoabdominal bölgeden olan delici kesici alet lezyonları sol tarafta diafram yaralanmasına sebep olması ve sağdaki gibi diafram karaciğer tarafından kapatılmadığından acil tanı almalı ve tedavi edilmelidir. Tanı için hastalara diagnostik laparaskopi yapılmalıdı

Traditional and complementary medicine perspectives of family physicians in Istanbul

Introduction: The World Health Organization, within the scope of the Traditional Medicine Strategy for 2014-2023, recommends the development of integrated health policies, particularly in the area of primary healthcare. However, family physicians often report feeling insufficiently trained to effectively integrate these practices into patient care. This study aims to assess the views, understanding, and experiences of family physicians regarding the utilization of Traditional amp; Complementary Medicine (T amp;CM).Methods: The family physicians employed by the Istanbul Health Directorate Public Health Services were solicited to participate in an 18-question online survey to assess their level of education in T amp;CM methods, their views on integration of T amp;CM into family medicine, and the impact of these practices on patient care.Results: A total of 324 family physicians took part in the survey; 12.0% were specialists, 64.5% had worked in primary care for over 10 years, and 59.6% were in the age range of 31-50 years. Among the physicians, the majority (70.1%) reported a preference for integrating T amp;CM practices with conventional medicine (ConvM). The majority of the participants (71.6%) had no formal T amp;CM training, and 66.4% reported inquiring about T amp;CM in their patient consultations. Over half of the physicians (56.79%) believed that T amp;CM methods should be used in preventive medicine. The most widely recognized T amp;CM technique was cupping therapy (18.5%), which was also the most frequently recommended method by physicians.Conclusion: Most of the family physicians who participated in the study expressed a desire for integrative medicine, despite acknowledging limited formal education in this field. Offering physicians training in evidence-based complementary medicine therapies could provide them with additional non-invasive treatment options. However, patients' diffidence to inform their family physicians about T amp;CM practices they undergo may pose significant risks. As a result, incorporating education on integrative medicine into formal medical education and residency training may be necessary.Keywords: Family physician, complementary medicine, integrative medicine, traditional medicin

Investigation of the Protective Effect of Nigella Sativa Oil in Cisplatin Induced Oral Mucositis: An Experimental Study

Objective: The aim of this experimental study was to investigate the histopathologic effect of Nigella Sativa oil (NSO) on cisplatin (Cis) induced oral mucositis (OM) in rats.Methods: Twenty-four rats were divided into four equal groups. The animals in Group 1 and Group 2 were given 5 mg/kg intraperitoneal (ip) Cis systemically on the 1st, 3rd and 5th days of the study. Additionally, 15 mL NSO were given to the rats in Group 2, with gavage feeding on days 1, 3, 5, 7, and 9. The animals in Group 3 were given per oral 15 ml NSO on days 1, 3, 5, 7 and 9. As the control group, Group 4 received a total of 15 mL 0.9% saline solution divided into 5 doses on days 1, 3, 5, 7 and 9 by oral gavage. On the 14th day, animals were euthanized and buccal mucosa from both sides, including submucosal tissues, were excised and taken to histopathological examination.Results: The mean mucosal thicknesses of the groups were 224.58 μm, 276.1 μm, 323.33 μm, and 331.33 μm, respectively for Groups 1, 2, 3, and 4 (p0.05).Conclusion: According to the results of this study, NSO, for which anti-inflammatory and antioxidant properties have been shown in previous studies, may also be effective in preventing Cis-induced OM