THE EFFECT OF DYNAMIC AND STATIC CORE EXERCISES ON PHYSICAL PERFORMANCE IN CHILDREN

The study aims to investigate whether or not there is an acute effect of dynamic and static core exercises applied to footballer children with 12-14 years of age on their physical performances. The experimental method with pre-test and post-test pattern and control group has been used in the study. A sampling of the study has been created from the athletes between 12-14 years of age and playing in a football team in a private school. A total of 48 students have participated voluntarily as dynamic core group (DCG, n=15), static core group (SCG, n=15) and Control Group (CG, n=15). Static and dynamic core exercises with 30-35 minutes and 3 days have been applied during 10 weeks to the study groups. Pre-test measurements of height, weight, vertical jump, pull-up, standing long jump, flamingo balance, flexibility hand grip strength and plank have been taken from child athletes before exercises. After obtained data has been applied in a computer environment, arithmetic mean (x) and standard deviation (ss) of DCG, SCG and CG groups have been taken and Paired Samples t-test has been applied for the differences between pre-test and post-test. Significance level has been studied in p>0.05 level. According to the findings, static and dynamic core exercises of 10 weeks have exhibited significant differences according to the performances of control group athletes. (p<0.05). In addition to this, it is observed that physical performance values of dynamic core exercises are better when compared with the group performing static core exercises. As a result, a contribution can be provided to development periods of child athletes with core exercise to be applied. Also, the fact that there are dynamic core exercises of movements within exercise program will affect strength developments much more when compared with static movements. It is contemplated that applying dynamic and static exercises in combination will affect their developments much more efficiently.  Article visualizations

Kronik obstrüktif akciğer hastalığında nötrofil-lenfosit oranının öngörücü rolü]

Objective: Recently neutrophil-to-lymphocyte ratio (NLR) -the level of neutrophil reflecting the severity of inflammation and lymphocyte occurring after physiological stress has been gaining popularity, which was, along with other inflammatory markers, commonly accepted as an accurate marker of the inflammatory status. In this multi-centered study, an early, rapid, and low-cost diagnosis method was investigated. To this end, the correlation between chronic obstructive pulmonary disease and inflammation was planned to be utilized and whether neutrophil-to-lymphocyte ratio can be used as a valid tool in the diagnosis of acute exacerbations of chronic obstructive pulmonary disease was investigated. Method: We retrospectively enrolled the 467 patients. Control group included sex and age-matched healthy people. C-Reactive protein, forced expiratory volume-1, forced vital capacity, complete blood count and clinical data A receiver-operating characteristic curve analysis was performed to determine the best cut-off value of N/L ratio and C-Reaktif protein to predict the exacerbation. Two-sided p values <0.05 were considered statistically significant. Results: By spearman analysis, there was a strong correlation between. C-Reactive protein and N/L ratio in both stable group (r=0.436, p<0.001) and exacerbation group (r=0.534, p=0.001). Conclusion: Neutrophil/lymphocyte ratio may be a useful predictor of inflammation in chronic obstructive pulmonary disease and acute exacarbation of chronic obstructive pulmonary disease patients

Evaluation of occult uterine leiomyosarcomas

Objectives: To determine the frequency of occult uterine leiomyosarcomas following hysterectomies and myomectomies performed for benign reasons at our clinic and to draw comparisons with similar studies in the literature.  Material and methods: All hysterectomies and myomectomies that have been performed for benign reasons at our clinic between 2010 and 2017 were retrospectively examined via the hospital’s information system and the patients that were found to have leiomyosarcomas were analysed. The incidence of occult uterine leiomyosarcoma per 1000 surgeries at our clinic was calculated using the Wilson score interval.  Results: A total of 6,173 hysterectomies were performed, and occult uterine leiomyosarcoma was identified in 5 patients. The incidence of occult uterine leiomyosarcoma was calculated to be 0.08% (95% CI 0.03–0.018%). Only 1 of the 771 patients who underwent myomectomy was identified with occult uterine leiomyosarcoma, making its incidence in myomectomy 0.12% (95% CI 0.02–0.073%). When all the patients are considered, occult uterine leiomyosarcoma was identified in 6 of the 6,944 patients, and the general incidence of occult uterine leiomyosarcoma was calculated as 0.08% (95% CI 0.03–0.018%).  Conclusions: In our study, the incidence of occult uterine sarcoma following myomectomy and hysterectomy was found to be lower than that reported in the literature. The reason for this lower incidence includes not only genetic causes and racial differences but also preoperative imaging, endometrial and cervical sampling that is performed on every patient

Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels &gt;2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p &lt; 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

Bir Üniversite Hastanesinden Hizmet Alan Uluslararası Hastaların Hizmet Kalitesini Değerlendirmeleri

Today, the intense competition brought by globalization, the rapid progress in information and technology, and the ease of access to information in every field, the increasing expectations affect all areas of our lives. The health sector is also one of the sectors most affected by these changes. As a consumer, human beings are much more sensitive, concerned and conscious about health than past. Patients are now going to health care facilities with some additional expectations besides treatment, and according to these expectations, they are evaluating the quality of the health-care service they receive. Health enterprises that follow the developments in science and technology and try to increase the quality of the services they offer by changing the diagnosis, treatment methods and the applications that make customers feel special competes for other business operating in the health sector in response to the increasingly conscious customer profile and increasing public expectations. Healthcare enterprises are obliged to adapt to new developments. In this context, the latest development is the "Health Tourism" which is emerged on the basis of globalization principle in health. Health tourism has become an area of intense competition among countries that want to increase their share in the international health market. Parallel to the shortening of the distance in the transportation field, the number of masses who want to travel in order to get cheap and high-quality services without waiting in medical and alternative medicine field is getting increased. Countries are trying to attract these requests. In this thesis, service quality was measured by SERVQUAL method for international patients receiving service from Hacettepe University Adult Hospital by emphasizing the necessity of measuring the existing quality level to increase the service quality. In this study, 102 international patients were reached in the Adult Hospital of Hacettepe University between December 2016 and May 2017. According to the hypothesis of the study, it is examined that the quality of service expectations and perceptions of these patients whether vary according to gender, age, educational status, marital status, income status and nationality. According to the results of the research, gender and age were not statistically significant, but statistically significant differences were found according to educational status and marital status. According to income status and nationality, only a significant difference was found in perceptions in terms of statistics.Günümüzde küreselleşmenin getirdiği yoğun rekabet, bilgi ve teknolojideki hızlı ilerleme, her konuda bilgiye erişimin kolaylaşması ile birlikte artan beklentiler insan yaşamının tüm alanlarını etkilemektedir. Sağlık sektörü de, bu değişikliklerden en çok etkilenen sektörlerden birisidir. Tüketici olarak insan, sağlık konusunda eskiye göre çok daha hassas, ilgili ve bilinçli davranmaktadır. Artık hastalar, tedavi yanında bazı ek beklentilerle sağlık kurumlarına gitmekte ve bu beklentilere göre de aldıkları sağlık hizmetinin kalitesinin değerlendirilmesini yapmaktadırlar. Bilim ve teknolojideki gelişmeleri takip eden, değişen tanı ve tedavi yöntemleri ve müşterileri özel hissettirecek uygulamalar ile sundukları hizmetlerin kalitesini arttırmaya çalışan sağlık kurumları; bilinçlenen müşteriler ve artan toplumsal beklentiler karşısında, sağlık sektöründe faaliyet gösteren diğer işletmeler ile rekabet etmektedirler. Sağlık kurumları kendilerini yeni gelişmelere de uygun hale getirmek mecburiyetindedir. Bu kapsamda, küresel ölçekte son dönemde ilgi odağı olan konu sağlık turizmidir. Sağlık turizmi günümüzde uluslararası sağlık pazarında paylarını attırmak isteyen ülkelerin yoğun rekabet içerisinde oldukları bir alan olmuştur. Ulaşım alanında yaşanan gelişmelerle mesafelerin kısalmasına paralel olarak medikal ve alternatif tıp alanında beklemeksizin, ucuz ve kaliteli hizmet almak amacıyla seyahat etmek isteyen kitlelerin sayısı giderek artmakta, ülkeler ise bu mevcut talebi kendilerine çekmek için arz kaynaklarında cazibe yaratmaya çalışmaktadırlar. Bu tez çalışmasında, hizmet kalitesinin arttırılabilmesi için mevcut kalite seviyesinin ölçülmesi gerekliliğine vurgu yapılarak; Hacettepe Üniversitesi Erişkin Hastanesi’nden hizmet alan uluslararası hastalara yönelik SERVQUAL metodu ile hizmet kalitesi ölçümü yapılmıştır. Çalışmada, Aralık 2016-Mayıs 2017 tarihleri arasında, Hacettepe Üniversitesi Erişkin Hastanesi’nden hizmet alan 102 uluslararası hastaya ulaşılmıştır. Çalışmanın hipotezleri gereği, Hacettepe Üniversitesi Erişkin Hastanesi’nden hizmet alan bu hastaların, hizmet kalitesi beklentilerinin ve algılarının; cinsiyetleri, yaşları, eğitim durumları, medeni durumları, gelir durumları ve uyrukları açısından farklılık gösterip göstermediği incelenmiştir. Araştırmanın sonuçlarına göre; cinsiyet ve yaşa göre istatistiki açıdan anlamlı bir farklılık bulunmazken, eğitim durumu ve medeni duruma göre istatistiki açıdan anlamlı bir farklılık bulunmuştur. Gelir durumu ve uyruklara göre ise, sadece algılarda istatistiki açıdan anlamlı bir fark bulunmuştur

Comparison of wheat yield in Turkey : Hatay and Şanlıurfa study case

Bu çalışmada Hatay ve Şanlıurfa illerinde buğday verimi üzerinde etkili olan değişkenler incelenmiştir. Her iki bölge için buğday veriminde etkili olabileceği düşünülen ekoloji dışı 14 açıklayıcı değişken modelde kullanılmıştır. Modelde birim alandaki buğday veriminin düşük veya yüksek olması bağımlı değişken olarak yer almıştır. Örneklemeyle belirlenen 159 üreticiye ait verilerin binary lojistik regresyon ile analiziyle verimde etkili olan değişkenler belirlenmiştir. Sonuçlar iki bölgede buğday veriminde ekolojik faktörlerle birlikte, girdi kullanım düzeyinin ve yetiştirme dönemi uygulamalarının etkili olduğunu göstermiştir. Hatay ilinde buğday verimi üzerinde sulama ve gübre miktarının etkisi önemli bulunurken, Şanlıurfa ilinde sulama yapılması, gübre miktarı ve üretici yaşının artması önemli değişkenler olarak belirlenmiştir. Buğday üretiminde birim alandaki verimi artırmak için, üreticilerin girdi kullanımı, uygulama zamanı ve yöntemleri konusunda eğitilmesi önemlidir. Ayrıca en uygun girdi miktarı ve uygulama yöntemlerinin bölgesel düzeyde belirlenerek, üretici düzeyinde yaygınlaştırılması yararlı olacaktırIn this study, the variables affecting wheat yield in Hatay and Şanlıurfa provinces were examined. For both regions, 14 non-ecological explanatory variables considered effective in wheat yield were used in the model. In the model, the wheat yield in the unit area was dependent variable as low or high level. The data of 159 producers determined by sampling were analyzed by binary logistic regression, and the variables that effective in efficiency were determined. The results show that wheat yield in the two regions with ecological factors, input use level and cultivation period practices were determined to be effective. While the effect of irrigation and fertilizer amount on wheat yield in Hatay province was significant, irrigation, amount of fertilizer and increase of producer age were determined as important variables in Şanlıurfa province. Wheat production in order to increase the yield per unit area, it is important that farmers be trained in the use of inputs, time and methods of implementation. Also determined at regional level most appropriate input amount and method of applications, dissemination will be useful at the producer leve