Moyamoya disease associated with antiphospholipid syndrome

Moyamoya (MMD) is a disease that often involves the vascular structures of anterior cerebral circulation, particularly the proximal segments of anterior and middle cerebral arteries. The etiology of the disease is unknown. MMD often presents with cerebral ischemia and rarely with cerebral hemorrhage. The pathology is termed Moyamoya syndrome (MMS) when the pathological cerebral angiography findings are accompanied by meningitis, neurofibromatosis, neoplasm, Down syndrome or polycystic kidney disease. Autoimmune diseases including Graves’ disease, Behcet’s disease and antiphospholipid syndrome might also lead to the development of MMS. In this manuscript, we presented an interesting case of MMD associated with antiphospholipid syndrome, which is quite a rare cause of acute cerebral infarction in childhoo

QUALITY OF LIFE AND THE FACTORS AFFECTING IT AMONG PEOPLE AGED 75 YEARS AND OVER LIVING IN A HEALTH CENTER REGION IN IZMIR

Esentepe Sağlık Ocağı Bölgesi\'nde yaşayan 75 yaş ve üzerindeki yaşlıların yaşamkalitesini ve etkileyen etmenleri belirlemektir.Gereç ve yöntem: Kesitsel tipteki çalışma Ekim 2006-Mayıs 2007 tarihleri arasındaİzmir Esentepe Sağlık Ocağı Bölgesi\'nde gerçekleştirildi. Araştırma evreni bu bölgedeyaşayan 75 yaş ve üzeri 851 kişiydi. Standart sapma 46, ± 5 hata, %95 güvendüzeyinde 235 kişi, sistematik örneklemeyle belirlendi. Araştırmanın bağımlı değişkeniyaşam kalitesi, bağımsız değişkenleri sosyo-demografik özellikler, sosyal destek, depresyon,günlük yaşam etkinlikleri bağımlılık durumuydu. Yaşam kalitesi için SF 12,günlük yaşam etkinlikleri için Barthel İndeksi, depresyon için Geriatrik DepresyonÖlçeğinin kısa formu kullanıldı. Veri yüz-yüze görüşme tekniğiyle toplandı, bağımsızgruplarda t testi, Mann-Whitney U Testi ve çoklu regresyon ile çözümlendi.Bulgular: Araştırma grubunun yaş ortalaması 79,1 ± 4,3 (75-98), %58,9\'u kadın, %51,4\'ü evli, %45,9\'u ilkokul mezunuydu. %92,5\'inin sağlık güvencesi vardı. Yaşlıların %24,7\'sinin GYE\'de bağımlı olduğu ve %24,0\'ında depresyon varlığı saptandı.İki değişkenli analizlerde Fiziksel Bileşen Özet Skor (FBÖS) ve Ussal Bileşen ÖzetSkor (UBÖS) kadınlarda anlamlı olarak daha düşükken ortaokul veya üstü eğitimlilerde,geliri giderine eşit veya fazla olanlarda anlamlı olarak daha yüksekti. Bastonkullananlarda hem FBÖS hem de UBÖS daha düşüktü (p<0,05). FBÖS evlilerde vesağlık güvencesi olanlarda daha yüksekken kronik hastalığı olanlarda daha düşüktü(p<0,05). FBÖS ve UBÖS, depresyon ve GYE\'de bağımlılık saptananlarda anlamlıolarak daha düşüktü. Çoklu regresyon analizi sonucunda cinsiyet, baston kullanımı,bağımlılık puanı ve kronik hastalık sayısı ile FBÖS, bağımlılık ve depresyon puanı ileUBÖS arasında anlamlı ilişki olduğu saptandı.Sonuç: Yaşlılarda bağımlılık, kronik hastalık, depresyon varlığı, baston kullanımı vecinsiyet yaşam kalitesi için önemli risk etmenleri olarak bulunmuştur. Risk grupları gözönünde bulundurularak yaşlı nüfusun YK\'lerini arttırmak önemli sağlık hedeflerindenolmalıdır.Objective: The aim of the study is to define the quality of life (QoL) and the factorsaffecting it in elderly people over 75 years living in Izmir Esentepe Health CenterRegion.Material and method: The cross-sectional study was conducted during October2006 and May 2007 in Izmir Esentepe Health Center Region. The study population ofthe research consisted of 851 elderly people of 75 years of age or over living in thisregion. Twohundredthirtyfive people were determined by systematic sampling, with astandard deviation of 46, ±5 error, and 95% confidence level. The dependent variableof the study was QoL, the independent variables were socio-demographic characteristics,social support, depression, and dependency on activity of daily living (ADL). TheSF-12 was used for QoL assessment, Barthel Index for ADL, and the short form ofGeriatric Depression Scale for depression assessment. The data were collected byface to face interviews and analyzed by t test, Mann-Whitney U test and multipleregression analysis.Results: The average age was 79.1 ± 4.3 (75-98), with a female proportion of 58.9%,51.4% of the study population were married, 45.9% of them primary school graduates,and 92.5% had health insurance. It was determined that 24.7% of the elderly peoplewere dependent on GYE and 24.0% of them had depression.In univariate analyses, Mental Component Summary Score (MCSS) and PhysicalComponent Summary Score (PCSS) were significantly lower in women, althoughMCSS and PCSS were significantly higher in elderly people with middle school orhigher education, in those with spending equal to income or more income thanspending. In the elderly people using the stick, both MCSS and PCSS were lower(p<0.05). MCSS were higher in married people and in the ones with health insurancealthough in the ones with a chronic disease were lower (p<0.05). MCSS and PCSSwere significantly lower in those with depression or dependency to ADL. At the end ofmultiple regression analysis, significant relations were found between sex, dependencyscore, number of chronic diseases and using stick and MCSS and betweendependency, depression score and PCSS.Conclusion: The presence of dependency, chronic disease, and depression, usingstick and gender were found as significant risk factors for QoL. Taking risk groups intoconsideration, improving the QoL\'s of the elderly population should be one of theimportant health goals

Mühendislik Eğitiminde Disiplinlerarası Yaklaşımlar

In order to prepare graduates for work in cross-disciplinary and multicultural enviroments, it has become almost essential for engineering education to be founded on the base of multiple disciplines. When an engineering program is supported by a number of disciplines, academic resources are much better integrated, and a general improvement in both the quality and efficiency of engineering education can be achieved. In this study, various new methods and solutions for developing engineering education in academic institutions have been examined and various properties of the related training structures have been compared. This paper shows that such approaches for developing engineering education can respond and adapt more quickly to the needs and expectations of the societ

Evaluation of anterior segment parameters using pentacam in silicone oil-injected patients after pars plana vitrectomy

Background: The aim of this study is to evaluate anterior segment changes with Pentacam Scheimpflug camera after pars plana vitrectomy (PPV) and silicone oil injection. Materials and Methods: In all, 44 eyes of 44 patients who underwent PPV by one surgeon were evaluated with Pentacam preoperatively, first week, and first month after surgery. The patients were divided into two groups, eyes with silicone injection after PPV and eyes with PPV and no endotamponade. Main outcome measures were preoperative and postoperative anterior chamber volume (ACV), anterior chamber depth (ACD), anterior chamber angle (ACA), and central corneal thickness (CCT) obtained with pentacam. Results: Each group consisted of 22 patients. In both groups no significant difference was detected among preop and postop changes in ACV and ACA values ( p > 0.05). The increase in ACD in silicone oil-injected group and the decrease in ACD in PPV group at postop 1 week were statistically significant ( p < 0.05). The increase in CCT in silicone oil-injected group at postop 1 week and then decrease in postop 1 month were also significant ( p < 0.05). Surgically induced astigmatism (SIA) was 3.7 Dioptry (D) in silicone oil-injected group and 2.4 D in PPV group at postop 1 week. SIA decreased to 1.7 D and 1.5 D, respectively, at postop 1 month. Changes in SIA were significant ( p < 0.05). Conclusion: PPV effects cornea and anterior segment. Changes in cornea and anterior segment after PPV seem to return to preoperative values among 1 month after surgery

The Cause of Decortication Material, 1.5 kg in Weight, In a Child Patient: Tuberculous Pleurisy

Tuberculosis still remains an important cause of morbidity and mortality in the world. Tuberculous pleurisy develops due to delayedtype hypersensitivity caused by tuberculosis bacteria and antigen-stimulated CD4+ T lymphocytes in patients with open and bacilli disseminating sub-pleural tuberculosis lesion. The increase in capillary permeability is the most important reason for effusion development after pleurisy. Effusions can be detected on plain chest X-ray or computed tomography. When pleural thickening reaches serious dimensions, lung expansion is prevented. In this case, the removal of thickened pleura by decortication is a necessity. Total decortication was performed on a 15-year-old male patient who applied to our clinic due to shortness of breath, chest pain, cough and fever upon detecting massive pleural effusion on the right and serious pleural thickening. In this study, the patient’s clinical presentation, diagnosis and treatment steps were presented in company with a review of the literature

Assessment of Cost-Effectiveness of Computerized Cranial Tomography in Children with Mild Head Trauma

Purpose: Pediatric head traumas constitute the majority of admissions to emergency departments (ED) due to trauma. This study aims to draw attention to the use of cranial computerized tomography (CT) scans in the evaluation of children with head trauma under the age of 18, and to determine CT scans&rsquo; usefulness in terms of cost-effectiveness. Materials and Methods: Age, gender, mechanism of trauma and Glasgow Coma Scale (GCS), diagnosis, time of admission to hospital, hospitalization and operation, cranial computerized tomography and hospitalization costs of all cases were retrospectively analyzed. Results: A total of 26,412 patients younger than 18 years old who were admitted to the emergency department due to head trauma and who had a cranial tomography were analyzed. They had a mean age of 7.74 &plusmn; 5.66 years. In total, 26,363 (99.8%) of these patients had a GCS greater than 14. Out of these patients, only 402 (1.5%) had brain injury revealed by cranial CT, 41 (0.2%) of these patients were operated and 3 of the patients lost their lives. The total cost of patients admitted to the emergency department with a head injury amounts to USD 583,317. Furthermore, 75.78% of this cost comes from negative cranial CTs. A cost analysis according to different age groups did not show a meaningful difference between 0&ndash;2 years and 3&ndash;5 years (p = 1.000), but there was a meaningful difference for all the other age groups. Conclusion: Our findings show that applying algorithms to predict traumatic brain injury in children with mild head injury rather than scanning all patients with cranial CT will enable more reliable and cost-effective patient care. Current practices should be reviewed to avoid unnecessary radiation exposure and expense in the ED. It is also necessary to inform and educate parents about the risk/benefit ratio of cranial CT scans

Ganoderma Lucıdum İle İlişkili Melena: Vaka Sunumu

Melena acil servis hastaları arasında görülen hayatı tehdit edebilecek bir bulgudur. Olgu Sunumu: Biz burada, önceden bilinen herhangi bir mide şikayeti olmayan genç bir erkek hastada Ganoderma Lucidum kullanımı ile indüklenen bir melena olgusu sunacağız. Sonuç: G. lucidum'un bazı toksik etkileri bildirilmiştir ancak bildiğimiz kadarıyla, bu vaka bildirilen G. lucidum ile ilişkili ilk üst gastrointestinal sistem kanamasıdırMelena is a life-threatening complaint of patients presenting to the emergency department.Case Report: Herein we present a case of Ganoderma luciduminduced melena in a young man who did not have any symptoms of gastrointestinal disease before. Conclusion: Some toxic effects of G. lucidum have been reported previously. However, to the best of our knowledge, this is the first case report of upper gastrointestinal bleeding associated with G. lucidu

Classification of commonly used feed ingredients based on flow properties

The objective of this report was to classify ingredients based on their flowability. Twenty-six different feed ingredients (52 samples) were used including cereal grains, cereal by-products, oilseeds, oilseed meals, and animal-origin products. As an indication of flowability, the angle of repose was determined using a funnel test. In general, high protein oilseed meals had the lowest angle of repose, and therefore they had the highest flow ability with the exception of cottonseed meal. Corn gluten feed and wheat middlings had the highest angle of repose values (39 and 34??, respectively), and therefore they had the lowest flowability. Ingredients with a range of angle of repose values between 22 and 25??, between 27 and 30??, and more than 30??, were categorized as having an easy flow, a moderate flow, and cohesive, respectively. The greater the protein content, the smaller the compressibility value (r = ???0.38) and the lower the angle of repose (r = ???0.42). An increase in the ether extract content of the ingredients resulted in a subsequent increase in angle of repose (r = 0.31) and therefore a decrease in flowability (p<0.05). The angle of repose was positively correlated with compressibility and the Hausner ratio. In conclusion, oilseed meals were classified as ???easy flow???, most by-products as ???moderate flow???, and cereal grains as ???cohesive???

Impact of chemical and physical properties on flowability characteristics of corn distillers dried grains with solubles

The influence of the physical and chemical composition of corn distillers dried grains with solubles on its flowability was evaluated in the current study. The samples were evaluated for angle of repose, compressibility, Hausner ratio, tapped density, bulk density, mean bulk density, colour and nutrient content. PROC CORR and REG procedures were used to determine correlations. The ether extract was negatively correlated with crude protein and redness (a*), while crude protein was negatively correlated with yellowness (b*). Acid detergent fibre and neutral detergent fibre were negatively correlated with a* and positively correlated with lightness (L*), respectively. Compressibility showed a negative correlation with bulk density. Bulk density, tapped density and mean bulk density did not impact the angle of repose. The angle of repose was positively correlated with the compressibility and Hausner ratio. Apart from the correlation between acid detergent fibre and tapped density, the angle of repose and other physical parameters were not affected by the nutrient composition of the distillers dried grains with solubles samples. In conclusion, the results of this study indicate that nutrient composition has little influence over the flowability of distillers dried grains with solubles but compressibility and the Hausner ratio can be used to predict the potential flow characteristics of corn distillers dried grains with solubles