Pain Management

Postoperative pain is caused by neuronal damage that occurs during the surgical procedure and the stimulation of the nociceptors. In postoperative period, total knee arthroplasty (TKA) is painful, and pain management is quite difficult. The main purpose of postoperative pain relief is to reduce the pain of the patient, to contribute to the healing process, to shorten the length of hospital stay, and to reduce hospital costs. Techniques such as intravenous analgesia, epidural analgesia, and peripheral nerve blocks are used to prevent postoperative pain. In addition, oral and parenteral analgesics, patient-controlled analgesia (PCA), nerve blocks, and periarticular injection methods are used as multimodal analgesia methods. Pain scales such as visual analogue scale (VAS), verbal descriptive scale (VDS), and numerical rating scale (NRS) are used as the standard methods in the evaluation of pain of patients. Systemic opioids, nonsteroidal anti-inflammatory drugs, and local anesthetics are used for postoperative analgesia. Preemptive analgesia, defined as analgesia initiated prior to surgical incision, and multimodal analgesia have been shown to reduce opioid consumption associated with high complication rates. Postoperative pain management should be planned considering the clinical characteristics of the patient, experience of the anesthetist, and clinical facilities. Early postoperative analgesia reduces systemic complication rates and improves early rehabilitation, patient satisfaction, and quality of life

Usage of Infrared-Based Technologies in Forensic Sciences

Infrared (IR) radiation comprises a beam located in the electromagnetic radiation family; it arises from the thermal vibrations of radiation that have longer wavelengths than visible light, but shorter wavelengths than microwave radiation. Its wavelength is between 750 nm and 1 mm. The amount of thermal IR radiation emitted by an object is associated with the temperature of the object, the surface area of the object and the spreading of light. IR-based technologies have been demonstrated as a method of evidence identification in forensic sciences in addition to many daily uses

UMREK KODUNA GÖRE ÇAYIRHAN B LİNYİT SAHASININ REZERV KESTİRİMİ

Maden yataklarının kaynak ve rezervleri ile kalitesinin belirlenmesi için, maden yatağı hakkında yeterli bilgilerin elde edilmesi gerekmektedir. Bundan dolayı, kaynak ve rezervler bu bilgilerin nitelik ve niceliklerinin yeterliliği ölçüsünde belirlenmekte ve sınıflandırılmaktadır. Bir maden sahasında yapılan arama ve ilgili değerlendirme çalışmaları sonucunda yatağın hacmi ve tonajının yanı sıra fiziksel, jeokimyasal, jeolojik, mineralojik ve yapısal özellikleri de belirlenmektedir. Bu çalışmalar yardımıyla yatakta gerçekleştirilen proje faaliyetinin teknolojik, ekonomik, hukuki, çevresel ve sosyal boyutlarını ortaya çıkarmak için yapılan tüm çalışmaların bileşimi, o yatağın kaynağının/rezervinin belirlenmesine esas teşkil etmektedir. Madencilik, doğası gereği büyük riskler taşıyan, yatırım maliyetlerinin yüksek olduğu ve yatırımın geri dönüşünün uzun zaman aldığı bir sektördür. Öte yandan madencilik sektöründe getiri oldukça yüksektir. Arama faaliyetleri sonucunda keşfedilen madenin miktar ve kalitesinin tahmin edilmesindeki zorluklar, risklerin ana nedenidir. Bu risklerin azaltılması için arama dönemi ve sonrasında bilimsel, teknolojik ve çok disiplinli çalışmalar büyük önem taşımakta olup, uluslararası standartlara uygun numune analizlerinin akredite laboratuvarlarda yapılması ve yetkin kişiler tarafından raporlanması gerekmektedir. Bu sayede çalışmalar açık, şeffaf ve güvenilir olacak, mühendisler, yatırımcılar, finans kuruluşları gibi konu ile ilgili kişilerin fikir birliğine varması sağlanacaktır. Bu çalışmada, Ankara ili Beypazarı ilçesi sınırları içerisinde yer alan Çayırhan B linyit sahasının UMREK (Ulusal Maden Kaynak Rezerv Raporlama Komisyonu) Kodu’na göre rezerv miktarının kestirimi amaçlanmıştır. Rezerv kestirim çalışması, sahada daha önce MTA ve Palaris firması tarafından yapılan kaynak kestirim raporu doğrultusundaki çalışmanın devamı niteliğindedir

Effects of interval sprint trainings on lactate level and heart rate

The aim of this study is to investigate the effects of interval sprint trainings on lactate level and heart rate in elite swimmers. 10 licenced swimmers (5 male-5 female) participated in the study voluntarily who train regularly at the Akdeniz University Swimming Team and as individual whose mean age was 20,20±1,54 years, the mean sport age was 9,10±1,59 years,  the mean height was 175,00±8,39 cm and the mean of weight was in pre-test 67,07±10,74 kg; in post-test 67,18±10,37 kg. Lactate and heart rate tests were applied to the swimmers at the beginning and end of training program that was 8 weeks, 4 days a week, at least 120 minutes a day and including interval sprints in its content. Handled datas were compared by using “Paired t Test” by SPSS 22.0 statistic programme. As a result of lactate and heart rate pre and post-test values, the differences were found to be statistically significant (p<0,05). According to the data obtained, positive improvements were observed in the swimming performances. In addition, it has been concluded that interval sprint trainings have also positive impacts on lactate levels and heart rates. We believe that our study will make positive contribution to sportive performance of swimmers as well as providing reference values for swimming coaches applying interval trainings in swimming

Underground mining method assessment using decision-making techniques in a fuzzy environment: case study, Trepça mine, Kosovo

Purpose. The purpose of this paper is to reevaluate the currently used underground mining method with the intention to verify if cut-and-fill stoping method is appropriate for deep future excavation mining levels > 800 m below the ground surface. Methods. Decision-making methods i.e., Analytical Hierarch Process (AHP) and Fuzzy Multi-Attribute Decision-making Methods (FMADM), and UBC selection tool are implemented. Findings. According to UBC approach six alternatives – Block Caving, Cut-and-Fill Stoping, Sub-level Caving, Sub-level Stoping, Square Set Stoping, and Top Slicing have been considered as technically feasible alternatives. Results shows that cut-and-fill stoping method is the optimal mining method for deep excavation mining levels. Optimal underground mining method for Trepça mine due to the priority of this alternative (0.443) is the highest value compared with the other alternatives. Originality. This study attempts to find most suitable underground mining method among the possible alternatives based on AHP and FMADM techniques. Practical implications. In mine planning and design stage, mining method selection (MMS) for a mineral deposit is one of the most critical and challenging decision that experts have to make mainly based on geological, economical and geotechnical properties of the ore deposit.Мета. Оцінка ефективності сучасних способів підземної розробки та шарова виїмка із закладкою є адекватним способом для глибокої виїмки на глибинах 800 м і більше на основі теорії прийняття рішень. Методика. Були використані наступні способи прийняття рішень: аналітичний ієрархічний процес (АІП), нечіткі багатокритеріальні методи прийняття рішень (НБМПР) і вибір способу розробки методом Університету Британської Колумбії (УБК). При виборі способу розробки методом Університету Британської Колумбії в якості технічно доцільних було виділено 6 можливих варіантів розробки: поверхове обвалення, шарова виїмка із закладкою, підповерхове обвалення, підповерхо-камерна, виїмка із станковим кріпленням і шарове обвалення. Результати. Розроблено моделі прийняття багатокритеріальних рішень, що містять 4 основні критерії та 11 підкритеріїв для 4 альтернатив, що дозволило в порівнянні зі старими методологіями вибору методів видобутку обрати оптимальний метод підземних гірничих робіт науковим чином, зберігши при цьому лояльність і об’єктивність. Виявлено, що шарова виїмка із закладкою є оптимальним способом розробки на глибоких горизонтах. Так, для шахти “Трепча” даний спосіб підземної розробки є оптимальним, оскільки його ефективність за загальною оцінкою альтернативи (0.443) значно вище, ніж при інших способах розробки. Наукова новизна. Для умов шахти “Трепча” виявлено найбільш ефективний спосіб підземної розробки на основі методів прийняття рішень АІП і НБМПР. Практична значимість. При плануванні та проектуванні розробки вибір способу видобутку є найважливішим і часто ризикованим рішенням, яке фахівці повинні прийняти на основі аналізу геологічних, економічних і геотехнічних характеристик рудника.Цель. Оценка эффективности современных способов подземной разработки на глубинах 800 м и более на основе теории принятия решений. Методика. Были использованы следующие способы принятия решений: аналитический иерархический процесс (АИП), нечеткие многокритериальные методы принятия решений (НММПР) и выбор способа разработки методом Университета Британской Колумбии (УБК). При выборе способа разработки методом Университета Британской Колумбии в качестве технически целесообразных было выделено 6 возможных вариантов разработки: этажное обрушение, слоевая выемка с закладкой, подэтажное обрушение, подэтажно-камерная, выемка с креплением станковой крепью и слоевое обрушение. Результаты. Разработаны модели принятия многокритериальных решений, содержащие 4 основных критерия и 11 подкритериев для 4 альтернатив, что позволило по сравнению со старыми методологиями выбора методов добычи выбрать оптимальный метод подземных горных работ научным образом, сохранив при этом лояльность и объективность. Выявлено, что слоевая выемка с закладкой является оптимальным способом разработки на глубоких горизонтах. Так, для шахты “Трепча” данный способ подземной разработки является оптимальным, так как его эффективность по общей оценки альтернативы (0.443) значительно выше, чем при других способах разработки. Научная новизна. Для условий шахты “Трепча” выявлен наиболее эффективный способ подземной разработки на основе методов принятия решений АИП и НММПР. Практическая значимость. При планировании и проектировании разработки, выбор способа добычи является важнейшим и зачастую рискованным решением, которое специалисты должны принять на основе анализа геологических, экономических и геотехнических характеристик рудника.This study was financially supported by the Scientific Research Project Supporting Commission of Eskişehir Osmangazi University (grant number 201715A238)

Growth, Blood Parameters, Immune Response and Antioxidant Enzyme Activities in Rainbow Trout (Oncorhynchus mykiss Walbaum, 1792) Fed Diets Supplemented with Fumitory (Fumaria officinalis)

In a feeding experiment for 75 days, the effects of fumitory (Fumaria officinalis) extract on growth, haematology, immune response and antioxidant enzyme activities in rainbow trout (Oncorhynchus mykiss) were evaluated. The aqueous methanolic extract of the plant was mixed with feeds at three different levels, 0.1% (FO1), 0.2% (FO2) and 0.3% (FO3), and feed with no plant extract donated as the control. All four groups (mean initial weight: 13.02 ± 0.02 g) were fed with the prepared diets twice daily ad libitum in a triplicate experiment. Blood and liver samples were taken from the fish on 15, 30, 45, 60 and 75 days. Also, overall growth parameters were determined based on body weight data recorded from all fish before and at the end of feeding trial. Results indicated that there were variations in nonspecific immune parameters (lysozyme, myeloperoxidase and oxidative radical production), but supplementation of the plant extract did not affect the immune response of the fish significantly. On the other hand, there was a general increase in the antioxidant enzyme activities (superoxide dismutase, catalase, glutathione peroxidase, and glucose-6-phosphate dehydrogenase) evaluated in this study. Furthermore, possibly the most remarkable finding of the study is that the growth performance in the FO3 group was roughly 30% higher than that of the control group. Considering all findings in the present study, we conclude that 0.3% supplementation of fumitory extract would be beneficial for rainbow trout farming with respect to elevated growth and antioxidant status

Factors Predicting Microinvasion in Ductal Carcinoma in situ

Background: Whether sentinel lymph node biopsy (SLNB) should be performed in patients with pure ductal carcinoma in situ (DCIS) of the breast has been a question of debate over the last decade. The aim of this study was to identify factors associated with microinvasive disease and determine the criteria for performing SLNB in patients with DCIS. Materials and Methods: 125 patients with DCIS who underwent surgery between January 2000 and December 2008 were reviewed to identify factors associated with DCIS and DCIS with microinvasion (DCISM). Results: 88 patients (70.4%) had pure DCIS and 37 (29.6%) had DCISM. Among 33 DCIS patients who underwent SLNB, one patient (3.3%) was found to have isolated tumor cells in her biopsy, whereas 1 of 14 (37.8%) patients with DCISM had micrometastasis (7.1%). Similarly, of 16 patients (18.2%) with pure DCIS and axillary lymph node dissection (ALND) without SLNB, none had lymph node metastasis. Furthermore, of 20 patients with DCISM and ALND, only one (5%) had metastasis. In multivariate analysis, the presence of comedo necrosis [relative risk (RR)=4.1, 95% confidence interval (CI)=1.6-10.6, P=0.004], and hormone receptor (ER or PR) negativity (RR=4.0, 95% CI=1.5-11, P=0.007), were found to be significantly associated with microinvasion. Conclusions: Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with comedo necrosis or hormone receptor negativity are more likely to have a microinvasive component in definitive pathology following surgery, and should be considered for SLNB procedure along with patients who will undergo mastectomy due to DCIS

The evaluation of relationship between disability rates and age and gender

INTRODUCTION: In this study, medico-legal reports about 548 cases admitted for disability assessment in Van were retrospectively evaluated. It was aimed that the determination of profiles of disabilty cases in Van, and the investigation of statistical correlation between disability rates and age/sex as had not taken part in the studies in the Turkish literature. METHODS: In this study, medico-legal reports about 548 cases who admitted to two years period between 01.01.2014 and 31.12.2015 were retrospectively reviewed. These cases were evaluated according to event type, age, sex, injury date, distincs, injured body regions causes to disabilty or not disabilty, distrubution of disability rates for every body regions and general disability rates. RESULTS: 69.9% of cases were males and 30.1% were females. The injuries occured due to traffic accidents in 91.6% of cases. In 19.5% of cases, special expertise board came to a decision that there were not disability because their injuries healed whitout cause to any sequel. DISCUSSION AND CONCLUSION: In this study, there was not statistically meaningful difference in mean disability rates of both genders. However, it was determinet that mean disability rates above 40 years old were statistically meaningful higher. This finding was evaluated that there was relation between mean disability rates and aging. Together with aging, some illness such as osteoporosis, development of arthrosis, cardiac and lung diseases cause to exacerbation of damage due to trauma and inhibition of healing process

Renal replacement therapies in the aftermath of the catastrophic Marmara earthquake

Renal replacement therapies in the aftermath of the catastrophic Marmara earthquake.BackgroundRenal replacement therapy is of vital importance in the treatment of crush syndrome victims, who are frequently encountered after catastrophic earthquakes. The Marmara earthquake, which struck Northwestern Turkey in August 1999, was characterized by 477 victims who needed dialysis.MethodWithin the first week of the disaster, questionnaires containing 63 clinical and laboratory variables were sent to 35 reference hospitals that treated the victims. Information considering the features of dialyses obtained through these questionnaires was submitted to analysis.ResultsOverall, 639 casualties with renal complications were registered, 477 of whom (mean age 32.3 ± 13.7 years, 269 male) needed dialysis. Among these, 452 were treated by a single dialysis modality (437 intermittent hemodialysis, 11 continuous renal replacement therapy and 4 peritoneal dialysis), while 25 victims needed more than one type of dialysis. In total, 5137 hemodialysis sessions were performed (mean 11.1 ± 8.0 sessions per patient) and mean duration of hemodialysis support was 13.4 ± 9.0 days; this duration was shorter in the non-survivors (7.0 ± 8.7 vs. 10.0 ± 9.8 days, P = 0.005). Thirty-four victims who underwent continuous renal replacement therapy had higher mortality rates (41.2 vs. 13.7%, P < 0.0001). Only eight victims were treated by peritoneal dialysis, four of whom also required hemodialysis or continuous renal replacement therapy. The mortality rate in the dialyzed victims was 17.2%, a significantly higher figure compared to the mortality rate of the non-dialyzed patients with renal problems (9.3%; P = 0.015).ConclusionSubstantial amounts of dialysis support may be necessary for treating the victims of mass disasters complicated with crush syndrome. Dialyzed patients are characterized by higher rates of morbidity and mortality