Core professionalism education in surgery: A systematic review

Background: Professionalism education is one of the major elements of surgical residency education. Aims: To evaluate the studies on core professionalism education programs in surgical professionalism education. Study Design: Systematic review. Methods: This systematic literature review was performed to analyze core professionalism programs for surgical residency education published in English with at least three of the following features: program developmental model/instructional design method, aims and competencies, methods of teaching, methods of assessment, and program evaluation model or method. A total of 27083 articles were retrieved using EBSCOHOST, PubMed, Science Direct, Web of Science, and manual search. Results: Eight articles met the selection criteria. The instructional design method was presented in only one article, which described the Analysis, Design, Development, Implementation, and Evaluation model. Six articles were based on the Accreditation Council for Graduate Medical Education criterion, although there was significant variability in content. The most common teaching method was role modeling with scenario- and case-based learning. A wide range of assessment methods for evaluating professionalism education were reported. The Kirkpatrick model was reported in one article as a method for program evaluation. Conclusion: It is suggested that for a core surgical professionalism education program, developmental/instructional design model, aims and competencies, content, teaching methods, assessment methods, and program evaluation methods/models should be well defined, and the content should be comparable. © 2018 by Trakya University Faculty of Medicine / The Balkan Medical Journal published by Galenos Publishing House

Genetic diversity and population structure of Turkish native cattle breeds

Cattle are an important livestock species for human life, but certain breeds are at risk of extinction. Maintaining genetic diversity plays an important role in sustainable breeding and conservation programmes in farm animals. The aim of this study was to determine genetic diversity among five Turkish native cattle breeds. A total of 199 Turkish native cattle of the Native Southern Yellow (n = 40), South Anatolian Red (n = 40), Anatolian Grey Cattle (n = 40), Native Black Cattle (n = 39) and East Anatolian Red (n = 40) breeds were investigated using 22 autosomal microsatellite markers. The analysis revealed considerable genetic variation among these breeds. All loci were polymorphic, and a total of 545 alleles were found. Among these loci, only INRA032 was at Hardy-Weinberg equilibrium. Thirty-four private alleles with frequencies greater than 5% were found. Expected heterozygosity and polymorphic information content indexes were 0.87 and 0.88, respectively. Native Southern Yellow, South Anatolian Red and Native Black Cattle breeds were closely related.Keywords: animal genetic resources, microsatellite, genetic relationship, genetic conservatio

Constraints on North Anatolian Fault Zone Width in the Crust and Upper Mantle From S Wave Teleseismic Tomography

We present high-resolution S wave teleseismic tomography images of the western segment of the North Anatolian Fault Zone (NAFZ) in Turkey using teleseismic data recorded during the deployment period of the Dense Array for Northern Anatolia array. The array comprised 66 stations with a nominal station spacing of 7 km, thus permitting a horizontal and vertical resolution of approximately 15 km. We use the current S wave results with previously published P wave teleseismic tomography to produce maps of relative VP/VSanomalies, which we use to highlight the difference in overall composition of the three terranes separated by the northern (NNAF) and southern branches of the NAFZ. Our results show a narrow S wave low-velocity anomaly beneath the northern branch of the NAFZ extending from the upper crust, where it has a width of ∼10 km, to the lower crust, where it widens to ∼30 km. This low-velocity zone most likely extends into the upper mantle, where we constrain its width to be ≤ 50 km and interpret it as indicative of localized shear beneath the NNAF; this structure is similar to what has been observed for the NAFZ west of 32°, and therefore, we propose that the structure of the NNAF is similar to that of the NAFZ in the east. The southern branch of the NAFZ does not show a very strong signature in our images, and we conclude that it is most likely rooted in the crust, possibly accommodating deformation related to rotation of the Armutlu/Almacik Blocks situated between the two NAFZ branches

Cone beam computed tomography evaluation of ponticulus posticus in patients with cleft lip and palate: a retrospective radio-anatomic study

Background: Ponticulus posticus (PP) is an abnormal bony bridge on the atlas. It plays a significant role in patients undergoing C1 lateral mass screw procedure. Patients with cleft lip and palate (CLP) have higher risk than patients in general population for the appearance of cervical vertebral anomalies. The purpose of the this study was twofold: to determine the prevalence and characteristics of PP in patients with CLP, and to compare the findings with patients in general population using cone beam computed tomography. Materials and methods: Cone beam computed tomography images from 54 individuals who had undergone surgical repair of cleft lip and/or palate were analysed as the study group. For comparison purposes a control group was randomly selected from 108 patients and matched with the CLP subjects. Results: Although 12 of the 54 (22.3%) patients with surgically repaired cleft lip and/or palate in the study group were identified to have PP, only 10 of the 108 (9.2%) patients in the control group had PP. The distribution of the presence of PP between the groups was statistically significant. Conclusions: Ponticulus posticus is an important anomaly and the presence of PP is important for patients. PP can have clinical significance in cervical spine surgery as this study has indicated that the likelihood of encountering PP is higher in patients with CLP. We suggest that PP should be taken into account prior to cervical vertebral surgery in patients with CLP. (Folia Morphol 2018; 77, 1: 72–78)

Podwyższony poziom greliny w stanie przedrzucawkowym: czy grelina jest przyjacielem czy wrogiem?

Objectives: To investigate maternal serum ghrelin levels in pregnancies complicated by preeclampsia and to explore the relationship between ghrelin level and disease severity. Materials and methods: This case-control study included 40 healthy pregnant women, 42 women with mild preeclampsia, and 40 women with severe preeclampsia. The groups were matched in terms of maternal and gestational age and body mass index. Serum ghrelin levels were measured via enzyme immunoassay. Results: Serum ghrelin levels were significantly higher in women with mild and severe preeclampsia than in healthy controls (p < 0.001). Although serum ghrelin levels were somewhat higher in the severe compared to the mild preeclampsia group, the difference was not statistically significant (p > 0.05). In the control group, no significant correlation was observed between ghrelin level and any other parameter, but in the preeclampsia group, serum ghrelin levels were negatively correlated with uterine artery Doppler index values and both systolic and diastolic blood pressure (all p-values < 0.05). Multivariate stepwise linear regression analysis revealed that systolic blood pressure (β = 0.493, p = 0.023) was independently associated with serum ghrelin level. Conclusion: Elevated blood ghrelin levels were correlated with disease severity in pregnancies complicated by preeclampsia.Cel pracy: Ocena poziomu greliny w surowicy kobiet w ciąży powikłanej stanem przedrzucawkowym i określenie związku między poziomem greliny a ciężkością choroby. Materiał i metoda: Do badania włączono 40 zdrowych kobiet w ciąży, 42 z łagodnym stanem przedrzucawkowym i 40 z ciężkim stanem przedrzucawkowym. Grupy były dobrane pod względem wieku ciążowego, wieku matek i wskaźnika masy ciała. Poziom greliny w surowicy był mierzony metodą immunoenzymatyczną. Wyniki: Poziom greliny w surowicy był istotnie wyższy u kobiet z łagodnym i ciężkim stanem przedrzucawkowym niż w grupie kontrolnej (p < 0,001). Chociaż poziom greliny w surowicy był wyższy w grupie z ciężkim stanem przedrzucawkowym niż w grupie z łagodnym stanem przedrzucawkowym, to ta różnica nie była istotna statystycznie (p > 0,05). W grupie kontrolnej nie obserwowano żadnych istotnych związków pomiędzy poziomem greliny a jakimkolwiek innym parametrem, ale w grupie ze stanem przedrzucawkowym poziom greliny w surowicy był ujemnie skorelowany z indeksami przepływów Dopplera w tętnicy macicznej oraz ciśnieniem krwi skurczowym i rozkurczowym (all p-values < 0,05). Wieloczynnikowa analiza regresji liniowej wykazała, że skurczowe ciśnienie krwi było niezależnym czynnikiem związanym z poziomem greliny w surowicy (β = 0,493, p = 0,023). Wnioski: Podwyższony poziom greliny we krwi był związany z ciężkością choroby w ciążach powikłanych stanem przedrzucawkowym

Clear otorrhea: a case of Munchausen syndrome in a pediatric patient

This paper reports a case of Munchausen syndrome in a pediatric patient. An 11-year-old girl presented with the complaint of clear fluid otorrhea. She underwent numerous investigations with deception of the physicians. The literature with respect to Munchausen syndrome in the pediatric patient is reviewed. Diagnosis of Munchausen syndrome is difficult especially during the initial assessment, although suspicion might be aroused by inconsistencies in the patient’s history and discrepancies between signs and symptoms

Defect-induced room temperature ferromagnetism in B-doped ZnO

ZnO microrods were grown on glass substrates by the spray pyrolysis method and boron was doped into the ZnO microrods by diffusion. X-ray diffraction results confirmed that the incorporation of B leads to a slight reduction in the deposit texture. Scanning electron microscopy measurements showed that the morphology of the ZnO samples changed from a microrod to nanocrystalline structure with B-doping. Photoluminescence data indicate that B-doping leads to a relative increase of the unstructured green band intensity. Magnetic measurements revealed that B-doped ZnO samples exhibited room temperature ferromagnetism related to defects, in agreement with first principles theoretical calculations

Isolated interrupted inferior vena cava with azygos continuation mimicking paraesophageal lymph node enlargement

We report a case of interrupted inferior vena cava with azygos continuation diagnosed as a isolated finding in a patient with lung carcinoma. Findings of the unopacified CT scan initially simulated a paraesophageal lymphadenopathy. The contrast - enhanced spiral CT scan showed a dilated azygos vein in the absence of definable inferior vena cava

Heterotopic Ossification in the Paraplegic Patients

Heterotopic ossification is a process characterized by the formation of genuine new bone in soft tissues especially between muscle and joint capsule and frequently encountered after spinal cord and traumatic brain injury. A 35-year-old woman who had developed severe pain and decrease in range of motion in her bilateral hip after 11 months following a spinal cord injury referred to our department for bone scintigraphy is presented