Does applied ultrasound prior to laparoscopy predict the existence of intra-abdominal adhesions?

diagnostic tool, in predicting the presence of intraabdominal adhesions, especially near the trocar entry area, to provide safe surgical access to the abdomen. Materials and methods: Fifty-nine women with a previous history of open abdominal surgery (group A) and a group of 91 women with no previous history of surgery (group B) underwent dynamic ultrasound evaluation of the abdominal fields before laparoscopic operations. The anterior abdominal wall was divided into six quadrants: right upper, right lower, left upper, left lower, suprapubic, and umbilical. Adhesions were evaluated by surgeons during the operation and by radiologists using USG prior to the operation. Visceral organ movements greater than 1 cm was defined as normal visceral slide (positive test), with less than 1 cm of movement defined as abnormal visceral slide (negative test). Sliding test measures movements of omental echogenicity or a stable echogenic focus that corresponds to intestine peritoneal echogenicity that underlies abdominal wall during exaggerated inspiration and expiration. Adhesions observed during surgery were evaluated on a four-point scale, with 0 indicating no adhesions present, 1 indicating the presence of a thin, filmy avascular adhesion, 2 indicating the presence of a dense and vascular adhesion, and 3 indicating adhesions that connect surrounding organs with the overlying peritoneal surfaces. The McNemar test was used to compare the results of USG and laparoscopy for each measure. Results: We found that preoperative USG was successful in identifying adhesions [sensitivity, 96.39% (95% CI 89.8–99.2); specificity, 97.43%] Conclusion: Preoperative ultrasound examination of the abdominal wall may enhance the safety of abdominal entry during laparoscopic operations

An immunohistochemical analysis of the neuroprotective effects of memantine, hyperbaric oxygen therapy, and brimonidine after acute ischemia reperfusion injury

Purpose: This study applies treatment methods to rat retinas subjected to acute ischemia reperfusion injury and compares the efficacy of memantine, hyperbaric oxygen (HBO) therapy, and brimonidine by histopathological examination

Hizmet Kalitesinin Ekoserv Yöntemi İle Ölçülmesi: Fethiye Kelebekler Vadisinde Bir Araştırma

Kelebekler Vadisi, Ölüdeniz (Lagün), Babadağ, Kayaköy, Telmessos, Saklıkent, Çalış plajı gibi birçok doğal, tarihi ve kültürel çekiciliğe sahip Fethiye ilçesi önemli bir turizm merkezidir. Deniz turizminde önemli bir destinasyon olan bölge, aynı zamanda alternatif turizm türlerinden özellikle ekoturizm açısından önemli bir potansiyele sahiptir. Bu çalışmanın amacı ekoturizm potansiyeline sahip Kelebekler Vadisi’ni ziyaret eden turistlerin hizmet kalitesi beklenti ve algılarını EKOSERV ölçeği ile tespit ederek hizmet kalitesini ölçmektir. Araştırmada yerli ve yabancı 151 turiste anket uygulanmıştır. Araştırma EKOSERV hizmet kalitesi ölçüm modelindeki somut/fiziki özellikler, güvenilirlik, heveslilik, güven, empati ve ekolojik çevre olmak üzere altı boyutta ele alınmıştır.Fethiye District is an important tourism center that possesses a lot of natural, historical and cultural appealing such as The Butterfly Valley, Dead Sea, Babadağ, Kayaköy, Telmessos, Hidden City and Caliş Beach. This district which is an important destination for sea tourism has a great potential in terms of ecotourism. This study aims to measure the perceptions and expectations of the service quality of the tourists that visit The Butterfly Valley, where possesses an ecotourism potential, via ECOSERV method and find out service quality. A survey has been applied to 151 foreign and local tourists in this study. The study has been evaluated under six dimensions in EKOSERV service quality measuring model in terms of tangibles, assurance, reliability, responsiveness, eco-tangibles and empathy

Koroner Arter Baypas Grefti İçin Farklı Yöntemler Kullanılarak Alınan Safen Veninin Apopitotik İndekslerinin Karşılaştırılması

Amaç: Koroner arter grefti olarak kullanılan safen venin hazırlanmasında farklı cerrahi toplama tekniklerikullanılmaktadır. Bu çalışmanın amacı koroner arter baypas greftlemesi (KABG) için kullanılan safen ven hazırlamaişlemlerinden geleneksel yöntem ile “no-touch” tekniği arasında apoptotik indeks açısından farklılığı araştırmaktır.Gereç ve Yöntemler: KABG uygulanan 40 hastada geleneksel ve “no-touch” cerrahi yöntemleri kullanılarak toplanansafen venlerde apopitoz bakılarak prospektif, randomize bir klinik çalışma yapıldı. Toplanan safen ven parçalarıparaformaldehitte bekletilerek tespit edildi. Kriyo cihazı ile 5 mikrometre kalınlığında kesitler alındı. Örnekler modifiyeTUNEL yöntemi ile işaretlenerek apopitotik hücre ölümleri gösterildi. Doku kesitlerindeki TUNEL (+) ve (-) hücrelerStereo Investigator version 7.5 görüntü işleme yazılımı kullanılarak tarafsız ve eşit 100 çerçeveye optik olarakbölünmüş alanlarda sayıldı. Apoptotik indeks; Hücre / Toplam Hücre oranı kullanılarak hesaplandı. Sonuçlar bağımsızgruplarda t testi ile istatistiksel olarak değerlendirildi.Bulgular: Geleneksel yöntem ile “no-touch” tekniği apoptotik indeksleri karşılaştırıldı. Geleneksel tekniğinuygulandığı grubunun apoptotik indeksi “no-touch” tekniği uygulanan diğer gruba göre anlamlı oranda yüksekbulundu. Mekanik ve yapısal koruma venin etrafını kuşatan yastıkçıklar tarafından sağlanmaktadır. Bu yastıkçıklardaapoptotik hücre ölümünün daha az görülmesi safen vendeki doku hasarının daha az olduğunu gösterir.Sonuç: Safen ven grefti hazırlamasında geleneksel yöntem yerine ‘no-touch’ cerrahi tekniğinin tercih edilmesi ile dokuhasarı ve vazospazm oluşumunun azalabileceği ve baypas sonrası greftin açık kalma olasılığının artabileceği sonucunaulaşıldı

Assessment of the dissimilarities of totally 186 countries and regions according to COVID-19 indicators at the end of March 2020

Background This study is aimed at evaluating the relationship between the number of days elapsed since a country's first case(s) of coronavirus disease 2019 (COVID-19), the total number of tests conducted, and outbreak indicators such as the total numbers of cases, deaths, and patients who recovered. The study compares COVID-19 indicators among countries and clusters them according to similarities in the indicators. Methods Descriptive statistics of the indicators were computed and the results were presented in figures and tables. A fuzzy c-means clustering algorithm was used to cluster/group the countries according to the similarities in the total numbers of patients who recovered, deaths, and active cases. Results The highest numbers of COVID-19 cases were found in Gibraltar, Spain, Switzerland, Liechtenstein and Italy were also of that order with about 1500 cases per million population. Spain and Italy had the highest total number of deaths, which were about 140 and 165 per million population, respectively. In Japan, where exposure to the causative virus was longer than in most other countries, the total number of deaths per million population was less than 0.5. According to cluster analysis, the total numbers of deaths, patients who recovered, and active cases were higher in Western countries, especially in central and southern European countries, which had the highest numbers when compared with other countries. Conclusion There may be various reasons for the differences between the clusters obtained by fuzzy c-means clustering. These include quarantine measures, climatic conditions, economic levels, health policies, and the duration of the fight against the outbreak

Multiple immunoassay interference in a patient with falsely elevated calcitonin

Calcitonin (CT) is a diagnostic and follow-up marker of medullary thyroid carcinoma. Heterophile antibodies (HAbs) may interfere during immunometric assay measurements and result in falsely high CT levels and different markers. A 50-year-old female patient was referred to our institution for elevated CT levels (3,199 pg/mL [0-11,5]). Physical examination and thyroid ultrasonography show no thyroid nodules. Because of the discrepancy between the clinical picture and the laboratory results, various markers and hormones were examined to determine whether there was any interference in the immunometric assay. Thyroglobulin (Tg) and Adrenocorticotropic hormone (ACTH) levels were also found inaccurately elevated. After precipitation with polyethylene glycol, CT, Tg, and ACTH levels markedly decreased, showing macro-aggregates. Also, serial dilutions showed non-linearity in plasma concentrations. Additionally, CT samples were pretreated with a heterophilic blocking tube before measuring, and the CT level decreased to < 0.1 pg/mL, suggesting a HAb presence. Immunoassay interference should be considered when conflicting laboratory data are observed. This may help reduce the amount of unnecessary laboratory and imaging studies and prevent patients from complex diagnostic procedures

Sodium pentaborate pentahydrate and pluronic containing hydrogel increases cutaneous wound healing in vitro and in vivo

After a disruption of skin integrity, the body produces an immediate response followed by a functional and comparable regeneration period, referred to as wound healing. Although normal wounds do not need much attention during the healing period, chronic (non-healing) wounds are the major challenge of current dermatological applications. Therefore, developing new, safe, and effective wound healing drugs has always been an attractive area of international research. In the current study, sodium pentaborate pentahydrate (NaB), pluronics (Plu; F68 and F127), and their combinations were investigated for their wound healing activities, using in vitro and in vivo approaches. The results revealed that NaB significantly increased migration capacity and superoxide dismutase activity in primary human fibroblasts. Combinations of optimized concentrations for pluronic block co-polymers further increased cell migration, and the messenger RNA (mRNA) expression levels of important growth factor and cytokines (vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-ß), and tumor necrosis factor alpha (TNF-?)). NaB containing hydrogel co-formulated with pluronics was also investigated for their wound healing activities using a full thickness wound model in rats. Macroscopic and histopathological analysis confirmed that wounds in combination gel-treated groups healed faster than those of control groups. NaB/Plu gel application was found to increase wound contraction and collagen deposition in the wound area. Therefore, our results suggest that NaB, and its pluronics combination, could be used in dermatological clinics and be a future solution for chronic wounds. However, further studies should be conducted to explore its exact action of mechanism and effects of this formulation on chronic wounds