Examination of the Views of High School Teachers and Students with Regard to Discipline Perception and Discipline Problems

This research is a qualitative study comparatively examining the views of high school teachers and students related to discipline perception and discipline problems. The study has been realized at a vocational school during the 2014/2015 school term. Maximum diversity and criterion sampling methods have been followed for the formation of the study groups with 18 teachers and 16 students. The data collected through semi-structured interview forms has been evaluated by content analysis. As a result of the study, it has been observed that the teachers define discipline as a wholistic system, self-control and providing the necessary learning environment, while the students define it as self-control, obeying the rules and respect. The participating teachers, who agreed on the idea that discipline does not mean bullying or passivizing the individuals, described rudeness, lack of interest in the lesson and misbehavior as disciplinary problems. According to the teachers, not fulfilling the responsibilities and rudeness; according to the students, preventing the course from running and not being interested in the course are the most experienced discipline problems at their respective schools. Pursuant to the acquired results, the students differ from the teachers by thinkink that behavior such as not obeying the directives, using hazardous items and harming the environment/objects are the most common problems

Comparison of inhaled nitric oxide and aerosolized iloprost in pulmonary hypertension in children with congenital heart surgery

Background: Pulmonary arterial hypertension is of importance in congenital cardiac surgery as being a significant cause of morbidity and mortality. Although therapy options are limited, inhaled nitric oxide (NO) is used as a standard therapy. The present study aimed to compare inhaled NO and aerosolized iloprost in children with secondary pulmonary hypertension who underwent congenital cardiac surgery. Methods: Sixteen children included in the study were randomized into either inhaled NO or aerosolized iloprost group. For both groups, the observation period terminated at 72 h after cardiopulmonary bypass. Results: There was no significant difference between the groups in terms of mean age, weight, cross clamp time, pump time, and extubation time. No significant change was observed in the arterial tension and central venous pressure of both groups before the operation, 30 min after the pump, 45 min after the pump, and after extubation, whereas an increase was observed in the heart rate and cardiac output, and a decrease was observed in the pulmonary artery pressure. The mean values at the above-mentioned time points showed no difference between the groups. No serious adverse event and mortality was detected. Conclusions: Both inhaled NO and aerosolized iloprost were found to be effective and comparable in the management of pulmonary hypertension

Učinak resveratrola na razinu ekspresije SIRT2, SIRT3 i oksidacijsko oštećenje DNK kod hepatotoksičnosti izazvane fumonizinom u BALB/c miševa

Oxidative stress, which is characterized by disruption of the oxidant/antioxidant balance, causes pathological processes, including toxicities induced by certain mycotoxins. The present study was designed to investigate the effects of resveratrol on sirtuin deacetylases (SIRT2 and SIRT3), nitric oxide (NO), reduced glutathione (GSH) and malondialdehyde (MDA) in fumonisin B1-induced hepatotoxicity. Regarding the experimental design, forty BALB/c mice were divided into four groups corresponding to the control, resveratrol (10 mg/kg, i.p), fumonisin B1 (2.25 mg/ kg, i.p) and resveratrol + fumonisin B1 (10 mg/kg + 2.25 mg/kg) groups. At the end of the 14 day-treatment, expression levels of SIRT2 and SIRT3 protein in the serum and liver were revealed by western blotting and antioxidant/oxidant activity analysis. SIRT2 and SIRT3 expression levels in the liver were significantly decreased by fumonisin B1 in comparison to the control. However, resveratrol supplementation coupled with fumonisin B1 increased the expression levels of SIRT2 and SIRT3, in relation to the fumonisin B1 treatments alone, but did not exhibit significant differences from those of the control group. As substantial indicators of stress and damage, the 8-OH-2-deoxyguanosine, NO and MDA levels of the liver tissue were assayed, and were higher in the fumonisin B1-treated groups, in relation to the control. As expected, resveratrol treatment significantly reduced the levels of NO and MDA in comparison to the fumonisin B1 treatments alone. Also, resveratrol attenuated the liver 8-OH-2- deoxyguanosine levels in the resveratrol + fumonisin B1 group. In conclusion, the findings revealed that resveratrol might possess protective effects against fumonisin-induced hepatotoxicity through modulation of the expression of sirtuin proteins, and by protecting the cell from oxidative/nitrosative stress.Oksidacijski stres, koji obilježava poremećaj ravnoteže oksidansa i antiksidansa, uzrokuje patološke procese, uključujući toksičnost potaknutu određenim mikotoksinima. U ovom je radu istražen učinak resveratrola na sirtuin-deacetilazu (SIRT2 i SIRT3), dušikov oksid (NO), sniženi glutation (GSH) i malondialdehid (MDA) kod hepatotoksičnosti izazvane fumonizinom B1. Istraživanje je postavljeno tako da je 40 BALB/c miševa podijeljeno u četiri skupine: kontrolnu, skupinu koja je dobivala resveratrol (10 mg/kg, ip.), skupinu koja je dobivala fumonizin B1 (2,25 mg/kg, ip) i skupinu koja je dobivala resveratrol i fumonizin B1 (10 mg/kg+2,25 mg/kg). Nakon 14 dana određena je razina ekspresije proteina SIRT2 i SIRT3 metodom western blotting te analiza aktivnosti antioksidansa i oksidansa u serumu i jetri. Razina ekspresije SIRT2 i SIRT3 u jetri bila znakovito smanjena u skupini s fumonizinom B1 u usporedbi s kontrolnom skupinom. U skupini s dodatkom resveratrola i fumonizina B1, međutim, povećana je razina ekspresije SIRT2 i SIRT3 u usporedbi sa skupinom koja je dobivala fumonizin B1, no bez znakovite razlike između tih skupina i kontrolne skupine. Analizirani su ključni pokazatelji stresa i oštećenja, razine OH-2-deoksigvanozin, NO i MDA u tkivu jetre, koje su bile veće u skupini s fumonizinom B1, u usporedbi s kontrolnom skupinom. Kao što se očekivalo, primjena resveratrola znakovito je smanjila razine NO i MDA u usporedbi sa skupinom kojoj je primijenjen samo fumonizin B1. Također, resveratrol je smanjio razinu 8-OH-2- deoksigvanozina u jetri u skupini kojoj su dani i resveratrol i fumonizin. Rezultati pokazuju da bi resveratrol mogao imati zaštitni učinak u slučaju hepatotoksičnosti uzrokovane fumonizinom putem modulacije ekspresije sirtuin proteina i zaštite stanice od oksidacijskog/nitrosativnog stresa

Echocardiographic evaluation of diastolic functions in patients with polycystic ovary syndrome: A comperative study of diastolic functions in sub-phenotypes of polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder among reproductive-aged women. It is known to be associated with cardiovascular diseases. The aim of this study was to determine and compare the echocardiographic data of patients according to the phenotypes of PCOS. Methods: This study included 113 patients with PCOS and 52 controls. Patients were classified into four potential PCOS phenotypes. Laboratory analyses and echocardiographic measurements were performed. Left ventricular mass was calculated by using Devereux formula and was indexed to body surface area. Results: Phenotype-1 PCOS patients had significantly higher homeostasis model assessment — insu­lin resistance (HOMA-IR) (p = 0.023), free testosterone (p < 0.001), LDL cholesterol levels (p < 0.001) and free androgen index (p < 0.001) compared with the control group. There were significant differences between groups regarding the septal thickness, posterior wall thickness, Left ventricular ejection frac­tion, E/A ratio and left ventricular mass index (for all, p < 0.05). PCOS patients with phenotype 1 and 2 had significantly higher left ventricular mass index than the control group (p < 0.001). In univariate and multivariate analyses, PCOS phenotype, modified Ferriman-Gallwey Score and estradiol were found as variables, which independently could affect the left ventricular mass index. Conclusions: This study showed that women in their twenties who specifically fulfilled criteria for PCOS phenotype-1 according to the Rotterdam criteria, had higher left ventricular mass index and decreased E/A ratio, which might be suggestive of early stage diastolic dysfunction. (Cariol J 2017; 24, 4: 364–373

Ocjena apsorpcije, djelotvornosti protiv bakterije Escherichia coli i citotoksičnosti krutih lipidnih nanočestica s moksifloksacinom

Moxifloxacin (MOX) is an important antibiotic commonly used in the treatment of recurrent Escherichia coli (E. coli) infections. The aim of this study was to investigate its antibacterial efficiency when used with solid lipid nanoparticles (SNLs) and nanostructured lipid carriers (NLCs) as delivery vehicles. For this purpose we designed two SLNs (SLN1 and SLN2) and two NLCs (NLC1 and NLC2) of different characteristics (particle size, size distribution, zeta potential, and encapsulation efficiency) and loaded them with MOX to determine its release, antibacterial activity against E. coli, and their cytotoxicity to the RAW 264.7 monocyte/macrophage-like cell line in vitro. With bacterial uptake of 57.29 %, SLN1 turned out to be significantly more effective than MOX given as standard solution, whereas SLN2, NLC1, and NLC2 formulations with respective bacterial uptakes of 50.74 %, 39.26 %, and 32.79 %, showed similar activity to standard MOX. Cytotoxicity testing did not reveal significant toxicity of nanoparticles, whether MOX-free or MOX-loaded, against RAW 264.7 cells. Our findings may show the way for a development of effective lipid carriers that reduce side effects and increase antibacterial treatment efficacy in view of the growing antibiotic resistance.Moksifloksacin je važan antibiotik koji se često rabi za liječenje rekurentne infekcije bakterijom Escherichia coli (E. coli). Cilj je ovog istraživanja bio ocijeniti njegovu djelotvornost u formulaciji s krutim lipidnim nanočesticama (engl. solid lipid nanoparticles, krat. SNL) i nanostrukturiranim lipidnim nosačima (engl. nanostructured lipid carriers, krat. NLC) kao njegovim vehikulima. U tu smo svrhu osmislili dva SLN-a (SLN1 I SLN2) te dva NLC-a (NLC1 i NLC2) različitih svojstava (veličine čestice, raspodjele veličina, zeta potencijala i sposobnosti enkapsulacije) te ih obogatili moksifloksacinom kako bismo utvrdili njegovo otpuštanje, djelovanje protiv E. coli i citotoksičnost za makrofagnu staničnu liniju RAW 264.7 in vitro. S bakterijskom apsorpcijom od 57,29 %, SLN1 se pokazao značajno djelotvornijim vehikulom moksifloksacina od njegove standardne formulacije (otopine), a formulacije s SLN2, NLC1 odnosno NLC2 s odgovarajućim apsorpcijama od 50,74 %, 39,26 % odnosno 32,79 % iskazale su djelotvornost sličnu onoj standardnog antibiotika. Test citotoksičnosti nije pokazao značajnu toksičnost nanočestica bez obzira na to jesu li sadržavale moksifloksacin ili nisu. Naši rezultati upućuju na mogući smjer razvoja djelotvornih lipidnih nosača kojima bi se mogle smanjiti nuspojave i povećati antibakterijska djelotvornost liječenja s obzirom na sve veću bakterijsku rezistentnost

The role of cardiac biomarkers as predictors of trastuzumab cardiotoxicity in patients with breast cancer

Aim: Identification of patient with increased risk of cardiotoxicity would allow not only prevention and early diagnosis of chemotherapy related cardiotoxicity but also administration of optimal dose and duration of chemotherapy. Materials and methods: Fifty-two women with HER2+ breast cancer treated with trastuzumab were included in this study. Patients were prospectively followed with routine cardiac evaluation. Before and after administration of trastuzumab blood samples for NT-proBNP were also taken. Results: The median age was 48.5 year (range: 26–74). Hypertension and obesity were two most common co-morbidities. The median duration application of trastuzumab was 52 weeks. During median 14.5 (3–33) months follow-up cardiac adverse events occurred in 5 (9.6%) patients and 2 out of 5 was grade III–IV heart failure. Both patients had preserved left ventricular ejection fraction and no symptom of heart failure before trastuzumab but older than 65 years old and had diabetes mellitus and obesity. High level of NT-proBNP (> 300 ng/ml) was observed in both patients and heart failure recovery was not observed. There was statistically significant difference regarding body mass index (p = 0.004) and diabetes mellitus (p = 0.002) between patients with and without cardiotoxicity. Conclusion: Although, cardiac biomarkers still cannot replace routine cardiac monitoring, natriuretic peptides may provide additional tool for detection of patients with high risk of cardiotoxicity and early detection of cardiotoxicity. Key Words: breast cancer, trastuzumab, heart failure, left ventricular dysfunction, natriuretic peptides

Rediscovery of penicillin of psychiatry: haloperidol decanoate

BACKGROUND: Haloperidol has been used as an effective antipsychotic for many years and continues to be one of the first options in difficult patients who require parenteral therapy in the acute phase. However, the depot form is less preferred in the treatment of patients with non-adherence among these patients whose clinical stabilization has been achieved by using parenteral haloperidol in the acute phase. Therefore, updating the information about the side effects of the depot form of haloperidol, which is still an effective treatment option, will be useful in reconsidering the position of this medicine among new and different options. METHODS: A total of 54 schizophrenic patients with severe symptoms and poor adherence to treatment who were hospitalized and treated with depot haloperidol following an acute stabilization period were included in this study. First, the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-CV) was used to confirm the diagnosis, the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) to assess the clinical severity and Global Assessment of Functioning (GAF) to assess the functionality. The Simpson-Angus Scale (SAS) was used to assess extrapyramidal side effects. With the exception of Visit 0, plasma haloperidol levels were measured at all visits. Also, measurements of waist circumference and weight, plasma fasting blood glucose, triglyceride, HDL, iron, haemoglobin (Hgb), prolactin (PRL) and HbA1c were also used for evaluation of the metabolic effects. RESULTS: Significant improvements were observed in the BPRS, SANS, SAPS scores in the long-term follow-up with the depot haloperidol treatment. While the dosage decreased over time, the plasma levels remained changed, and symptom improvement was maintained. No signs such as neuroleptic malignant syndrome or acute dystonia were observed and SAS scores were within acceptable limits during the treatment (mu = 1.40 +/- 2.55). There is no statistically significant difference between measurements of the weight even there was a significant difference between three of the waist circumference values (p = 0.987). The first measurement of the waist circumference is statistically significantly higher than both the mid-measurement and the final measurement, interestingly (p = 0.002). When fasting blood glucose, triglyceride, HDL, iron, Hgb, PRL and HbA1c were measured at different times throughout the study, only prolactin levels increased significantly over time with the use of haloperidol (p < 0.001). At the end of a year, 50% of the patients participating in the study still continued to use the haloperidol decanoate. This means also that half of the patients had stopped to use haloperidol decanoate. However, only 18.5% of them (n = 5) discontinued use of this drug because of extrapyramidal side effects. CONCLUSION: Depot haloperidol remains an effective treatment option that improves treatment compliance in challenging schizophrenia patients with severe symptoms. The long-term metabolic and extrapyramidal side effect profile of the patients were generally within the safe limits with the use of haloperidol depot. According to the obtained data, the depot haloperidol continues to be a reliable treatment option in terms of adverse effects in the maintenance treatment of schizophrenia patients with severe symptoms and poor adherence to treatment

Cisplatin plus oral etoposide (EoP) combination is more effective than paclitaxel in patients with advanced breast cancer pretreated with anthracyclines: a randomised phase III trial of Turkish Oncology Group

Our objective was to determine whether oral etoposide and cisplatin combination (EoP) is superior to paclitaxel in the treatment of advanced breast cancer (ABC) patients pretreated with anthracyclines. From December 1997 to August 2003, 201 patients were randomised, 100 to EoP and 101 to paclitaxel arms. Four patients in each arm were ineligible. The doses of etoposide and cisplatin were 50 mg p.o. twice a day for 7 days and 70 mg m−2 intravenously (i.v.) on day 1, respectively, and it was 175 mg m−2 on day 1 for paclitaxel. Both treatments were repeated every 3 weeks. A median of four cycles of study treatment was given in both arms. The response rate obtained in the EoP arm was significantly higher (36.3 vs 22.2%; P=0.038). Median response duration was longer for the EoP arm (7 vs 4 months) (P=0.132). Also, time to progression was significantly in favour of the EoP arm (5.5 vs 3.9 months; P=0.003). Median overall survival was again significantly longer in the EoP arm (14 vs 9.5 months; P=0.039). Toxicity profile of both groups was similar. Two patients in each arm were lost due to febrile neutropenia. The observed activity and acceptable toxicity of EoP endorses the employment of this combination in the treatment of ABC following anthracyclines