The Effects of the Violence Tendency Levels of Nursing Students on Their Attitudes Towards Homosexual Individuals

BACKGROUND/AIMS: Nurses' attitudes towards homosexuality are an important factor affecting the quality of care given to homosexual individuals. Therefore, attitudes towards homosexual individuals and the variables affecting these attitudes should be investigated in the undergraduate period of nursing students. This study was conducted to determine the effects of the violence tendency levels of nursing students on their attitudes towards homosexual individuals.MATERIAL AND METHODS: This study used a cross-sectional and descriptive design. It was conducted with 502 nursing students at a state university. The data were collected using a student information form, the Hudson and Ricketts Homophobia Scale (HRHS) and the Violence Tendency Scale (VTS).RESULTS: The mean HRHS score of the students was 94.25 +/- 22.23, and their mean VTS score was 37.82 +/- 8.25. It was found that the students' attitudes towards homosexuals were related to their academic year, number of siblings, the region they lived in, and whether they live with their parents or not. Additionally, it was determined that the students' level of tendency towards violence was low, and low levels of violence tendency were related to higher levels of education of the mother ( p<0.05). There was no significant relationship between the students' violence tendency levels and their homophobia levels (R-2=0.001).CONCLUSION: It was determined that the nursing students' level of tendency towards violence was low, but their attitudes towards homosexuals were negative. Their level of tendency towards violence did not explain their attitude towards homosexuals significantly. These results showed that there are different factors affecting nursing students' homophobic attitudes

Time-Kill Kinetics and In Vitro Antifungal Susceptibility of Non-fumigatus Aspergillus Species Isolated from Patients with Ocular Mycoses

Aspergillus species can cause ocular morbidity and blindness, and thus, appropriate antifungal therapy is needed. We investigated the in vitro activity of itraconazole, voriconazole, posaconazole, caspofungin, anidulafungin, and amphotericin B against 14 Aspergillus isolates obtained from patients with ocular mycoses, using the CLSI reference broth microdilution methodology. In addition, time-kill assays were performed, exposing each isolate separately to 1-, 4-, and 16-fold concentrations above the minimum inhibitory concentration (MIC) of each antifungal agent. A sigmoid maximum-effect (Emax) model was used to fit the time-kill curve data. The drug effect was further evaluated by measuring an increase/decrease in the killing rate of the tested isolates. The MICs of amphotericin B, itraconazole, voriconazole, and posaconazole were 0.5–1.0, 1.0, 0.5–1.0, and 0.25 µg/ml for A. brasiliensis, A. niger, and A. tubingensis isolates, respectively, and 2.0–4.0, 0.5, 1.0 for A. flavus, and 0.12–0.25 µg/ml for A. nomius isolates, respectively. A. calidoustus had the highest MIC range for the azoles (4.0–16.0 µg/ml) among all isolates tested. The minimum effective concentrations of caspofungin and anidulafungin were ≤0.03–0.5 µg/ml and ≤0.03 µg/ml for all isolates, respectively. Posaconazole demonstrated maximal killing rates (Emax = 0.63 h−1, r2 = 0.71) against 14 ocular Aspergillus isolates, followed by amphotericin B (Emax = 0.39 h−1, r2 = 0.87), voriconazole (Emax = 0.35 h−1, r2 = 0.098), and itraconazole (Emax = 0.01 h−1, r2 = 0.98). Overall, the antifungal susceptibility of the non-fumigatusAspergillus isolates tested was species and antifungal agent dependent. Analysis of the kinetic growth assays, along with consideration of the killing rates, revealed that posaconazole was the most effective antifungal against all of the isolates

Identifying the care behavior perception of nursing students and the time they allocated to the direct care practices

Amaç: Araştırma, hemşirelik öğrencilerinin klinik uygulamalar sırasında doğrudan bakım uygulamalarına ayırdıkları zamanı ve öğrencilerin bakım davranışları algısını belirlemek amacıyla planlanmıştır. Yöntem: Araştırma tanımlayıcı tipte olup araştırmanın örneklemini bir vakıf üniversitesinin hemşirelik bölümünde öğrenim gören birinci sınıflar hariç toplam 80 öğrenci oluşturmuştur. Çalışmanın verileri “Klinik Uygulamada Hemşirelik Öğrencilerinin Aktivitelerini İzlem Formu” ve “Bakım Davranışları Ölçeği” ile toplanmıştır. Veriler gözlem yoluyla elde edilmiştir. Bulgular: Öğrencilerin klinikte bir uygulama gününde doğrudan bakım uygulamalarına harcadıkları süre; ikinci sınıflarda 138,8±57,0 dakika, üçüncü sınıflarda 105,6,7±40,3 dakika, dördüncü sınıflarda 99,8±60,1 dakika olarak belirlenmiştir, Bakım uygulamaları dışındaki faaliyetlere ikinci sınıfların 50,2±40,3, üçüncü sınıfların 6,1±15,6, dördüncü sınıfların 38,4±43,3 dakika harcadıkları belirlenmiştir. Sınıflara göre öğrencilerin doğrudan bakım ve diğer faaliyetlere harcadıkları süreler arasında istatistiksel olarak fark bulunmuştur (p<0,05). Öğrencilerinin Bakım Davranışları Ölçeği-24’ten aldıkları toplam puan ortalaması 5,14±0,59 puan olarak belirlenmiş, mesleği isteyerek seçen öğrencilerin puanları diğerlerine göre yüksek bulunmuştur. (p<0,05). Öğrencilerin bakım davranışları algıları olumlu olmasına rağmen, doğrudan bakım uygulamalarına ayırdıkları sürenin az olduğu belirlenmiştir. Sonuç: Öğrencilerin bakım kalitesi algılarının yüksek olmasına rağmen, doğrudan bakım uygulamalarına ayırdıkları sürenin az olduğu belirlenmiştir.Aim: The research was planned for the purpose of identifying the time allocated by nursing students to direct care practices during clinical practices and the students’ care behavior perceptions. Method: The research was conducted as a descriptive type and the sample of the research consisted of 80 students in total, excluding first-year students studying in the nursing department of a foundation university. The data of study were collected with “Inspection Form for Nursing Students’ Activities in Clinical Practices” and “Care Behaviors Scale”. Data were collected by observation. Results: The time allocated by the students to direct care practices during a practice day in clinic was identified as; 138,8±57,0 minutes on average in second graders, 105,6,7±40,3 minutes on average in third graders, and 99,8±60,1 minutes on average in fourth graders, It was identified that the second graders spend 50,2±40,3 minutes, the third graders spend 6,1±15,6 minutes, and the fourth graders spend 38,4±43,3 minutes for the practices other than care practices. It was statistically found a difference between the times allocated by the students to direct care and other practices with regard to grades (p<0,05). The total average score of the students in Care Behaviors Scale-24 was identified as 5,14±0,59, and the scores of the students who chose the profession voluntarily were found as higher than the other students. (p<0,05). Although the students' perceptions of care behaviors were positive, it was determined that the time they allocated to direct care practices was less. Conclusion: It was identified that although the care quality perception of the students are high, the time they allocated to direct care practices is low

Nesnelerin İnterneti Yaklaşımıyla Konvoy Araçların Yönetimi

Toplu taşıma sistemleri farklı üreticilerin sağladığı donanım ve yazılım birimleriyle etkileşim içerisinde çalışmaya başlamıştır. Sistemin çalışır hale gelmesiyle otomatik olarak ağ ayarlarının yapılması ve çalışan servislerin sistem içerisinde yayınlanması gereksinimi karmaşık cihaz yönetimi problemini ortaya çıkartır. Farklı tür donanım ve yazılım birimlerini bütünleşik yönetebilmek için toplu taşıma filoları için ITxPT birliği tarafından geliştirilen mimari standartlaşmaya başlamıştır. Mimari içerisinde yazılım servisleri ve bu servislerin birbirleriyle etkileşimi belirli protokoller altında tanımlanmıştır. Çalışma içerisinde değerlendirilen mimari genişletilerek konvoy araçların da nesnelerin interneti yaklaşımına uygun olarak yapılandırılıp yönetilmesi planlanmıştır

Hipokalemik periyodik paralizi ile başlangıç gösteren primer Sjögren sendromu

Primer Sjögren sendromu (PSjS) heterojen klinik bulgularla seyreden kronik sistemik otoimmün bir hastalıktır. PSjS’de renal tutulum sıklığı %4.9 ve renal tutulum öncesi ortalama hastalık süresi iki yıl olarak bildirilmiştir. En sık renal tutulum tübülointerstisyel nefrit (TIN) olup daha az sıklıkla glomerülonefrit de görülebilmektedir. TIN bazı hastalarda izole elektrolit bozukluğu, distal renal tübüler asidoz (dRTA) yaparken bazı hastalarda ise son dönem böbrek yetmezliğine yol açabilmektedir (6). dRTA'un ise en sık klinik bulgusu hipokalemik paralizidir, bunun yanında nefrokalsinozis ve metabolik kemik hastalığına da yol açabilir. Bu yazıda PSjS’nin nadir bir başlangıç şekli olan renal tübüler asidoz ve hipokalemik periyodik paralizi olgusunu sunmaktayız.Primary Sjögren’s syndrome (PSjS) is a chronic systemic autoimmune disease with heterogeneous clinical findings. The incidence of renal involvement in PSjS was reported as 4.9% and the mean duration of disease before renal involvement was two years. The most common renal involvement is tubulointerstitial nephritis (TIN) and less frequent glomerulonephritis. TIN may lead to isolated electrolyte disorder and distal renal tubular acidosis (dRTA), while in some patients it may lead to end-stage renal failure (6). The most common clinical manifestation of DRTA is hypokalemic paralysis, which may lead to nephrocalcinosis and metabolic bone disease. We report a rare initial form of PSjS presenting with renal tubular acidosis and hypokalemic periodic paralysis

Lomber mikrodiskektomi operasyonundan sonra epidural tramadol infi ltrasyonu postoperative analjezik gereksinimini azaltır

Amaç: Çalışmanın amacı epidural tramadol infi ltrasyonunun postoperatif analjezik etkilerini araştırmak. Tramadol lokal anestezik ve antienfl amatuvar özellikleri de bilinen zayıf opioiddir. Yöntem ve gereç: Genel anestezi altında lomber mikrodiskektomi operasyonu geçiren ASA I veya II sınıfı 60 hasta çalışmaya alındı. Anestezi indüksiyonu 2-2.5 mg kg–1 propofol, 0.5 mg kg–1 roküronyum bromid, ve 1 ?g kg–1fentanil ile sağlandı. Anestezi idamesinde % 2-2,5 sevofl uran ve N2O/O2 (FiO2 = % 35) karışımı kullanıldı. Hastalar rastgele iki gruba ayrıldı. Çalışma grubunda operasyonun sonunda cerrahi saha kapanmadan önce epidural bölgeye 5 mL salin içinde 1 mg kg–1 tramadol verilirken, kontrol grubunda hastalara eşit volümde salin uygulandı. Ağrı vizüel analog skala (VAS) ile (0 ila 10 cm) her 4 saatte bir postoperatif ilk 24 saat boyunca değerlendirildi. Hasta kontrollü analjezi (HKA) cihazı 15 ?g fentanil bolus istek 10 dakika kilitli kalacak şekilde ayarlandı. Bulgular: Her iki grup arasında VAS değerleri açısından fark yoktu. Postoperatif ilk 24 saat fentanil tüketimi kontrol grubunda 328,5 ± 221,8 ?g ve tramadol grubunda 194,5 ± 147,4 ?g bulundu (P = 0,030). HKA bolus istek gereksinimi ise kontrol grubunda 51,2 ± 77,9 ve tramadol grubunda 20,1 ± 23,7 tespit edildi (P = 0,02). Yan etki profilleri arasında fark bulunmadı. Sonuç: Mikrodiskektomi operasyonu geçiren hastalarda epidural bölgeye uygulanan tramadol infi ltrasyonu analjezik gereksinimi belirgin ölçüde azaltmaktadır.Aim: To investigate the postoperative analgesic effects of epidural tramadol infi ltration. Tramadol is a weak opioid that has local anesthetic and antiinflammatory properties. Materials and methods: Sixty patients of American Society of Anesthesiologists class I or II undergoing lumbar microdiscectomy with general anesthesia were included in the study. The induction of anesthesia was performed with propofol (2-2.5 mg kg–1), rocuronium bromide (0.5 mg kg–1), and fentanyl (1 &amp;#956;g kg–1). A sevofl urane and N2O/O2 (FiO2 = 35%) mixture was used for maintenance. Patients were randomly divided into 2 groups. Tramadol (1 mg kg–1) in a 5-mL saline epidural infiltration was given in the study group at the end of the operation, before surgical closure, and saline in the same volume was given to the control group. Pain was assessed by a visual analog scale (0 to 10 cm) at 4-h intervals during the first postoperative 24 h. A patient-controlled analgesia (PCA) device was adjusted to deliver fentanyl (15 &amp;#956;g bolus) on demand, with a 10-min lockout interval. Results: No significant difference was found in the visual analog scales between the groups. Tramadol infiltration significantly decreased fentanyl consumption in the first 24 h (fentanyl dose in the control group: 328.5 &plusmn; 221.8 &amp;#956;g, tramadol group: 194.5 &plusmn; 147.4 &amp;#956;g, P = 0.030). The number of demands for PCA were 51.2 &plusmn; 77.9 and 20.1 &plusmn; 23.7 in the control and the tramadol groups, respectively (P = 0.02). No difference was found in side-effect profiles between the groups. Conclusion: Tramadol administration to the epidural space significantly decreased analgesic consumption in patients undergoing microdiscectomy

Evaluation of the efficacy of heat shock protein inhibitors and antifungal drug combinations against Candida spp.

Candida species are one of the predominant causes of fungal infections and show drug-resistant infections in immune-compromised individuals. Simultaneous targeting of existing antifungal drugs with heat shock protein 90 (Hsp90) inhibitors may be an approach that increases the efficacy of antifungal drugs. Also, since most of the patients at risk for invasive fungal infections use these anticancer or immunosuppressive drugs, synergistic interaction in combination treatment can reduce the dose of antifungal drugs and create an alternative for the toxicity problem. In this study, in vitro efficacy of commonly used antifungals (amphotericin B, caspofungin, itraconazole, voriconazole, and fluconazole) in combination with four heat shock protein inhibitors geldanamycin, 17-allylamino-17-demethoxygeldanamycin, radicicol, and novobiocin against 30 clinical Candida isolates (C. albicansn = 13, C. krusein = 7, and C. glabratan = 10) were evaluated by time kill and checkerboard methods. The significant synergistic interaction determined especially in the combinations of geldanamycin with antifungal drugs suggests that substances with inhibitory effects on Hsp90 increase the effectiveness of antifungals or reduce the antifungal resistance. Although Hsp90 inhibitors alone did not have any significant antifungal activity, they did not show adverse interactions in combination with antifungals, and at some concentrations, they increased the effectiveness of the antifungals. These in vitro results have been found promising for the development of new therapeutic approaches in the treatment of invasive fungal infections. However, detailed studies are needed.TUBITAK [112S503]This work was supported by a grant from TUBITAK (Project No. 112S503)

Evaluation of Febrile Neutropenia in Hematologic Malignancy Patients

Introduction: Febrile neutropenia, developing in hematological cancer patients, is a common complication requiring hospitalization and resulting in death. It is assumed that it is caused by infection until its reason is clarified. Hence, it requires a multidisciplinary approach and treatment as a medical emergency. For these patient groups, most of whom are at high risk, death caused by infection is attempted to be minimized by continuously updating treatment approaches. This study aimed to determine clinical characteristics, risk factors, distribution and frequency variance of isolated pathogens and impact in mortality of hematological cancer patients with febrile neutropenia prospectively. Materials and Methods: In this study, 161 febrile neutropenia episodes of 99 patients with hematological cancer monitored between January 2012 and January 2013 in the Department of Hematology in the Hospital of our Medical Faculty were evaluated. Age, gender, underlying disease, chemotherapy regimens, hematologic and radiologic findings, antibacterial and fungal therapeutic regimens were recorded. Routine microbiological blood and urine cultures were performed. When necessitated, cultures from other sterile body sites were taken. Results: Mean age of the patients in the study group was 50.7 ± 15.9. Mean duration of hospitalization was 29.7 ± 14.9 days. Meanduration of neutropenia was 14.6 ± 5.7 days. In 21% of the evaluated episodes, microbiologically defined infection was found, where clinically defined infection was determined in 40% and fever of unknown origin was determined in 39%. A total of 47 isolates were isolated in total. When distribution of all isolated microorganisms, in all cultures was evaluated, 40% were grampositives, 47% were gram-negatives and 13% were fungi. The most frequently observed microorganisms were coagulase negative staphylococci with 31% and Escherichia coli with 22%. In blood cultures, 58% were gram-positives, 32% were gramnegatives and 10% were fungi. The most frequent febrile neutropenia treatment used in our center was carbapenem monotherapy. Mortality rate was 25.4%. Neutropenia duration and stage were the most important factors increasing mortality risk. Conclusion: Febrile neutropenia is a complication which may result in mortality in patients with hematological cancer. In order to define treatment models, each center is supposed to determine its center’s microorganism spectrum and antibiotic resistance profiles periodically