How does disease location affect acute phase reactants in ulcerative colitis?

Background: We aimed to evaluate erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell (WBC), platelet (PLT) counts and albumin levels according to disease location in ulcerative colitis.Methods: The ESR, CRP, WBC, PLT counts and albumin levels of 206 ulcerative colitis patients with endoscopic activity were retrospectively evaluated. Endoscopic activity had been assessed using Rachmilewitz endoscopic activity index. Patients were grouped according to the extent of disease by Montreal classification, and they were evaluated regarding the location and severity of disease according to the laboratory test results.Results: Among 206 patients, 88 (42.7%) had extensive colitis, 89 (43.2%) of them had left sided colitis and 29 (14%) patients had proctitis. According to the endoscopic activity index, 32.04% of the patients had mild activity, 39.32% moderate activity and 28.64% had severe activity. As the disease extent progressed from the distal to the proximal intestine, CRP, ESR, WBC and PLT counts showed a significant increase while albumin levels showed a significant decrease. In our study, the test that yielded the best results in the assessment of disease activity was CRP, which was found to be high in 80% of patients with extensive colitis, followed by ESR, PLT and WBC counts. As the involved intestine shortened, the rate of patients with abnormal laboratory tests significantly decreasedConclusion: CRP, ESR, WBC, PLT counts and albumin levels are of limited value in determining disease activity in ulcerative colitis patients, especially in those with proctiti

Recurrent Intestinal Intussuseption in Adult: A Case Report

Intussusseption is an usually incident that may present in pediatric patients but we encounter rarely in adults. It leads to obstruction of the gastrointestinal tract. In pediatric patients, etiological factors are due to benign incidents usually, but in adults, often depends on tumors. Etiological factors should be investigated after obtaining the reduction of intussusception and intraluminal pathologies should be excluded. It will cause to intussusseption recurrence after years if reduction perform without treating etiological factors

Migrating from SAP ECC to SAP S/4 HANA : A multidimensional multiple case study analyses to identify critical success and risk factors at early adopters : A qualitative research for SAP S/4 HANA migration projects

SAP decided that it will stop supporting SAP ECC by 2025 and therefore it is for organizations and especially early adopters of utmost importance to know which factors are relevant for a successful migration from SAP ECC to SAP S/4 HANA. SAP S/4 HANA is the next generation ERP system and promises to deliver great benefits, however it seems that early adopters have many difficulties on many aspects. This thesis therefore provides a multidimensional view on such projects from the following four perspectives: (1) top-management perspective; (2) project management perspective; (3) technical perspective; and (4) end-user perspective. A multiple case study with semi-structured open-ended interviews were conducted among three organizations, from which two are situated in The Netherlands and one in Switzerland. Based on the analysis of the interviews and internal doc-umentations it enabled the researcher to validate and identify the critical success factors, critical risk factors and the risk mitigation strategies per perspective and per organization. Finally, an aggregated amount of 54 critical success factors and 24 critical risk factors were considered as of great im-portance when implementing and migrating from an on-premise SAP ECC environment to an on-premise SAP S/4 HANA environment

On convergence culture and transmedia storytelling

Gelişen teknoloji ile beraber hem yeni medyada hem geleneksel medyada çeşitlilik de artış göstermektedir. Günlük hayatın içinde kitle iletişim araçlarından gelen birçok veriye maruz kalan bireyler, seçimleri ile sürece dâhil olmuşlardır. Yeni medyanın önemli getirilerinden biri olan yakınsama, oluşturulan içeriklerin ve yer aldıkları mecraların birbiri ile yakınlaşması olarak ele alınmaktadır. Yakınsama kültürü ile katılımcı rolleri artan bireyler, içerik üreticilerini ve/veya yapımcıları yeni yöntem arayışlarına yöneltmiştir. Bu yöntemlerin en önemlilerinden biri olan transmedya hikâye anlatımı ile oluşturulan içerik medya araçları arasında uyumlu hale getirilerek hikâye anlatısının güçlenmesi sağlanmaktadır. Bu çalışmada “Eltilerin Savaşı” filmi transmedya hikâye anlatıcılığı açısından incelenmiş ve kullanıcıların / takipçilerin filmin resmi Instagram hesabına yaptıkları yorumlar, oluşturdukları içerikler betimsel analiz tekniği ile çözümlenmiştir.With the developing technology, the diversity in both new media and traditional media is increasing. Individuals who are exposed to many data from mass media in daily life have been involved in the process with their choices. With the convergence culture, which is one of the important benefits of new media, individuals whose participant roles have increased, have led content producers and / or producers to seek new methods. The content created with transmedia storytelling, one of the most important of these methods, is harmonized between media tools to strengthen storytelling. In this study, the movie “Eltilerin Savaşı” was examined in terms of transmedia storytelling and the comments made by the users / followers on the official Instagram account of the film and the content they created were analyzed with the descriptive analysis technique

Comparing the efficiency of tramadol and lornoxicam in patient control analgesia at postoperative pain in patients undergoing lumbar disc surgery Lomber disk cerrahisi yapilan hastalarda postoperatif analjezide lornoksikam ve tramadolün hasta kontrollü analjezi yöntemi ile etkinliklerinin karşilaştirilmasi

Aim: In this study we aimed to compare the efficiency of tramadol, which is used widely in controlling postoperative pain, and lornoxicam, which enters usage newly, by using intravenous patient control anaesthesia method one by one and together. Materials and Methods: Under general anaesthesia, patient in status. ASA I-II, a total of 81 patients (21-60 years old), who planned to be performed lumbar disc surgery surgery were included the study. These patients in recovery unit are divided into four equal groups when they said pain complaint as group 1 (tramadol 10 mg/hour-1), group 2 (lornoxicam 1 mg/hour-1), group 3 (lornoxicam 1.5 mg/hour-1) and group 4 (lornoxicam 1 mg/hour-1 and 20 mg bolus tramadol). Visual analog scale (VAS), 10 cm., was used for efficiency of analgesia and Observer's Assessment of Alertness/Sedation scale (OAA/S) to evaluate the sedation. Measurements were obtained at the beginning of the treatment, at 30 minutes, first, second, third, fourth, eight, 12th, 16th and 24th hour. Result: When group 1 and 4 compared the VAS values were obtained more lower at group 4 like at first 30 minutes 1.90±0.40;1. 60±0.30, at first hour 1.40±0.40; 1.20±0.50, at second hour 1.30±0.40;1.00±0.30 and at third hour 1.30±0.40;1. 00±0.30 (p0.05). The VAS values of group 1 and 4 were obtained lower then group 2 and 3 (p0.05). Conclusion: As a result, we concluded that, in postoperative analgesia, when we consider the efficiency and side effects, combination of tramadol and lornoxicam can provide maximum quality and patients pleasure

The effects of propofol-ketamine combination on QTc interval in patients with coronary artery disease

The purpose of this study was to evaluate the effects of propofol-ketamine combination on QTc, T wave (Tp-e) interval, hemodynamics during the induction of anesthesia in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting (CABG). Patients were prospectively randomized, in a double blinded manner, to either the propofol group (Group P, n=41) or the propofol-ketamine combination group (Group PK, n=45). In both groups the drugs were infused at an IV dose of 2 mg/kg administered over 30 seconds. After that, 5µg/kg fentanyl and 0.1mg/kg vecuronium were administered and tracheal intubation was performed. ECG recordings were performed prior to induction of anesthesia (baseline, T1), 2 min after the beginning of study drugs (T2), 3 min after vecuronium (immediately before intubation, T3), and 30 s (T4), 1 min (T5) and 5 min (T6) after intubation. Eighty-six patients were evaluated in the study. The baseline QTc interval values were similar between the groups, In Group P, QTc interval increased significantly for T3-T6 in all periods according to baseline value. Also in Group P, QTc interval increased significantly in T4, T5, T6 according to T3. In group PK, QTc interval increased significantly in T3-T6 according to baseline value. Group PK increased significantly in T5 and T6 compared to T3. In both groups a statistically significant change was not found in Tp-e intervals of all periods. Following induction with propofol-ketamine combination, QTc interval did not increase, but it prolonged postintubation QTc interval just like propofol. Assuming that increased repolarization transmural dispersion (TDR) is a reliable indicator of risk of torsade de pointes (TdP), and lack of any change in Tp-e interval, in the presence of depressed hemodynamic response to intubation, we think that this combination can be safely used for the induction of anesthesia in patients with CAD undergoing CABG. [Med-Science 2021; 10(2.000): 278-82

Recurrent Intestinal Intussuseption in Adult: A Case Report

İnvajinasyon genellikle pediatrik hastalarda karşımıza çıkabilen, erişkinde nadir rastladığımız bir hadisedir. Gastrointestinal sistem obstrüksiyonuna yol açar. Pediatrik hastalarda etiyoloji genellikle benign hadiseler iken, erişkinlerde sıklıkla bir tümöre bağlıdır. İnvajinasyon redüksiyonu sağlandıktan sonra etiyolojik faktör mutlaka aranmalı ve intraluminal patolojiler ekarte edilmelidir. Etiyolojik faktör tedavi edilmeden yapılan redüksiyon, yıllar sonra bile invajinasyonun tekrarlamasına neden olacaktır.Intussusseption is an usually incident that may present in pediatric patients but we encounter rarely in adults. It leads to obstruction of the gastrointestinal tract. In pediatric patients, etiological factors are due to benign incidents usually, but in adults, often depends on tumors. Etiological factors should be investigated after obtaining the reduction of intussusception and intraluminal pathologies should be excluded. It will cause to intussusseption recurrence after years if reduction perform without treating etiological factors