COMPARING INTERVENTIONS AND BELIEFS ABOUT AUTISM AND LINKS TO INTERPERSONAL RELATEDNESS IN TWO CITIES, IN TURKEY AND ENGLAND

This thesis explores similarities and differences between interventions and beliefs about autism in Turkey and England. It is known that Turkish culture is interdependent and English culture is independent. It is also known that differences in interpersonal relatedness affect views about social behaviour, life goals and social priorities. This thesis, therefore, also explores whether interpersonal relatedness influences interventions and belief about autism in both countries. This research is based on case studies of special and mainstream schools in two cities, one in Turkey and one in England. The study used mixed research methods including questionnaires, interviews and observations. Participants included teachers, parents, children and clinicians. The quantitative data from questionnaires showed similarities between parents in both contexts regarding beliefs and priorities, but also important differences in interpersonal relatedness, sense of support and goals for their children. There were also differences within the two countries in the degree to which parents had an interdependent or independent orientation. Interdependent orientation across both contexts was associated with lower self-esteem, higher sense of helplessness and beliefs about the need for socio-communicative interventions. The qualitative data from interviews and observations showed similarities in the desire to improve outcomes for children with autism with many similarly held priorities and commitment to a range of interventions and approaches. Nevertheless there were substantial differences in resources and approach to teaching and involvement of family and community in the education of the children. Both the qualitative and quantitative data indicated that cultural orientations linked to interpersonal relatedness, societal priorities and resources influenced the care and education that children received and the relationships between families, schools and other professionals.Turkish Ministry of National Educatio

Near-field radiation from nano-particles and nano-antennas illuminated with a focused beam of light

The interaction of photons with metallic nanoparticles and nanoantennas yields large enhancement and tight localization of electromagnetic fields in the vicinity of nanoparticles. In the first part of this study, the interaction of a spherical nanoparticle with focused beams of various angular spectra is investigated. This study demonstrates that the focused light can be utilized to manipulate the near-field radiation around nanoparticles. In the second part of this study, the interaction between linearly and radially polarized focused light with prolate spheroidal nanoparticles and nano-antennas is investigated. Strong and tightly localized longitudinal components of a radially polarized focused beam can excite strong plasmon modes on elongated nanoparticles such as prolate spheroids. The effect of a focused beam on parameters such as the numerical aperture of a beam and the wavelength of incident light, as well as particle geometry and composition are also studied

Arduous Journey to Hedjaz: Turkestani Pilgrims, The Caliph and Istanbul (16th -20th Centuries)

This article aims to analyse how the unique religious ritual such as the Muslim pilgrimage the hajj can draw together, politically and culturally, two civilizations with historical ties and commonalities as well as create a mutual interaction between them. In the 16th century, the Ottoman conquest of the Islamic Holy Lands was the beginning of a new era for the Islamic world. This new situation brought about a novel dimension for the Ottomans and all the Muslim states. The paths of all Muslims who wished to fulfil the sacred duty, the hajj pilgrimage, intersected within the Ottoman domains. Central Asian pilgrims who could not undertake the pilgrimage via Iran due to political problems had to cover almost all of the Ottoman domains from north to south to undertake this ritual. As a result, they became the carriers of culture from Central Asia to Anatolia and from Anatolia to Central Asia

Psoriasis and 5HT-R2C Gene Polymorphism: Association between Clinical, Demographic and Therapeutic Parameters in the Turkish Population

We aimed to investigate the relationship between single nucleotide polymorphism (SNP) in the promoter region of the 5-HT-R2C gene and stress-related disease psoriasis in the Turkish population. The putative association between the 5-HTR2C variant (rs6318 Cys23Ser allele) and patients with psoriasis was investigated. 100 patients with psoriasis and 100 age-sex matched, unrelated healthy subjects representing the control group were included in the study. The PCR-RFLP method was used for genotyping the 5-HTR2C variation. There was no statistically difference in terms of genotype distributions and allele frequencies between the control subjects and patients with psoriasis (P=0.360 and P=0.439, respectively). The comparison between the presence and absence of the 5-HTR2C gene rs6318 G allele within the determined clinical subsets resulted in a significant difference with regard to treatment methodology only when conventional therapy and one or more medical therapy was compared (P=0.021). This study is the first clinical study to investigate the association between 5-HTR2C polymorphism and psoriasis. The role of the 5-HTR2C gene should be examined with more parameters in a larger case series

Evaluation of left ventricular systolic asynchrony in patients with subclinical hypothyroidism

Background: The heart was very sensitive to fluctuating thyroid hormone levels. To assess intra-left ventricular (LV) systolic asynchrony in patients with subclinical thyroid dysfunction. Methods: Fifty patients with subclinical hypothyroidism and 40 controls were included. A diagnosis of subclinical hypothyroidism was reached with increased TSH and normal free T4. All subjects were evaluated by echocardiography. Evaluation of intra-LV systolic asynchrony was performed by tissue synchronization imaging (TSI), and four TSI parameters of systolic asynchrony were calculated. LV asynchrony was defined by these parameters. Results: All of the groups were similar in terms of demographic findings and conventional and Doppler echocardiograpic parameters except peak systolic velocity and early diastolic velocity. LV systolic asynchrony parameters of TSI including; standard deviation of Ts of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any 2 of the 12 LV segments (Ts-12), standard deviation of TS of the 6 basal LV segments (Ts-SD-6), maximal difference in Ts between any of the 6 basal LV segments (Ts-6) were significantly lengthened in patients with subclinical hypothyroidism than controls (p < 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). The prevalence of LV asynchrony was significantly higher in patients with subclinical hypothyroidism than control. Conclusions: Patients with subclinical hypothyroidism present evidence of LV asynchrony by TSI. LV systolic asynchrony could be a warning sign of the early stage in cardiac systolic dysfunction in subclinical hypothyroid patients

Evaluation of left atrial mechanical functions and atrial conduction abnormalities in patients with clinical hypothyroid

Background: The aim of this study was to investigate left atrial (LA) mechanical functions, atrial electromechanical delay and P wave dispersion in hypothyroid patients. Methods: Thirty-four patients with overt hypothyroid and thirty controls were included. A diagnosis of overt hypothyroid was reached with increased serum TSH and decreased free T4 (fT4) levels. LA volumes were measured using the biplane area length method and LA active and passive emptying volumes and fraction were calculated. Intra- and interatrial electromechanical delay (EMD) were measured by tissue Doppler imaging (TDI). P wave dispersion was calculated by 12 lead electrocardiograms. Results: LA diameter were significantly higher in patients with overt hypothyroid (p = 0.021). LA passive emptying volume and LA passive emptying fraction were significantly decreased with hypothyroid patients (p = 0.002 and p < 0.001). LA active emptying volume and LA active emptying fraction were significantly increased with hypothyroid patients (p < 0.001 and p < 0.001). Intra- and interatrial EMD, were measured significantly higher in hypothyroid patients (30.6 &#177; 6.1 vs 18.0 &#177; 2.7, p < 0.001; and 10.6 &#177; 3.4 vs 6.9 &#177; 1.4, p < 0.001, respectively). P wave dispersion were significantly higher in hypothyroid patients (48.8 &#177; 6.2 vs 44.3 &#177; 7.2, p = 0.022). In stepwise regression analysis demonstrated that, interatrial EMD and LA active emptying fraction related with TSH and fT4. Conclusions: This study showed that impaired LA mechanical and electromechanical function in hypothyroid patients. TSH and T4 were independent determinant of interatrial EMD and LA active emptying fraction

Korelacja odsetka hemoglobiny glikowanej z ciężkością choroby wieńcowej występująca u młodych osób niezależnie od tradycyjnych czynników ryzyka

Introduction: In this study, we aimed to investigate the relationship between glycated haemoglobin (HbA1c) levels and the severity of coronary artery disease (CAD) in < 40 years old patients. Material and methods: The study population consisted of 211 premature coronary atherosclerotic patients (pCAP) (aged 36.4 &#177; 2.5 years) and 160 control subjects (36.4 &#177; 2.4 years). The severity of CAD was evaluated by the Gensini scoring system. HbA1c levels and the other basic biochemical parameters were analysed, and relations with severity of CAD were evaluated. Results: There were statistically significant differences in serum HbA1c levels between the two groups (pCAP = 6.1 &#177; 1.8%, control = 4.7 &#177; 1.2%, p < 0.001). HbA1c levels significantly positively correlated with the Gensini score in pCAP (r = 0.662, p < 0.001). In linear multivariate regression analysis (including age, sex, HbA1c, smoking, diabetes mellitus and hypertension as dependent parameters), only HbA1c was found to be an independent risk factor for the presence of severe CAD (Beta = 0.374, p < 0.001). In ROC curve analysis, the optimal cut-off value of HbA1c to predict severe CAD was 6.52%, with 74.4% sensitivity and 75.1% specificity (area under the curve 0.781, 95% confidence interval 0.661 to 0.901, p < 0.001). Conclusions: HbA1c levels were found to be correlated with the Gensini score in pCAP with and without diabetes. In this respect, glucose metabolism abnormalities, indicated by HbA1c, may play an important role in premature CAD. (Endokrynol Pol 2012; 63 (5): 367-371)Wstęp: Niniejsze badanie przeprowadzono w celu oceny zależności między odsetkiem hemoglobiny glikowanej (HbA1c) a ciężkością choroby wieńcowej (CAD) u chorych w wieku < 40 lat. Materiał i metody: Badana populacja składała się z 211 chorych z przedwczesną miażdżycą tętnic wieńcowych (pCAP) (w wieku 36,4 &#177; 2,5 roku) i 160 osób stanowiących grupę kontrolną (36,4 &#177; 2,4 roku). Ciężkość CAD określano na podstawie wartości wskaźnika Gensiniego. Przeanalizowano odsetek HbA1c oraz inne wyjściowe parametry biochemiczne i oceniono ich zależności z ciężkością CAD. Wyniki: Stwierdzono statystycznie istotne różnice między grupami w zakresie stężeń HbA1c w surowicy (pCAP = 6,1 &#177; 1,8%, grupa kontrolna = 4,7 &#177; 1,2%; p < 0,001). Wartości HbA1c były istotnie skorelowane z wartościami wskaźnika Gensiniego u chorych z pCAP (r = 0,662; p < 0,001). W wieloczynnikowej analizie regresji liniowej (w której uwzględniono wiek, płeć, stężenie HbA1c, palenie tytoniu, cukrzycę i nadciśnienie tętnicze jako zmienne zależne) jedynie stężenie HbA1c okazało się niezależnym czynnikiem ryzyka wskazującym na występowanie ciężkiej CAD (Beta = 0,374; p < 0,001). Jak wykazano w analizie krzywych ROC, optymalny punkt odcięcia wartości HbA1c pozwalający prognozować ciężką CAD wynosi 6,52%, przy czułości metody 74,4% i swoistości 75,1% (pole pod krzywą 0,781, 95-proc. przedział ufności 0,661&#8211;0,901; p < 0,001). Wnioski: U osób z pCAP, zarówno chorych na cukrzycę, jak i bez tej choroby, stwierdzono korelacje między wartościami HbA1c i wskaźnikiem Gensiniego. Jak wynika z powyższych obserwacji, zaburzenia metabolizmu glukozy, których wyznacznikiem jest odsetek HbA1c, mogą odgrywać ważną rolę w rozwoju przedwczesnej CAD. (Endokrynol Pol 2012; 63 (5): 367-371

The Results of Urodynamics and Pressure Flow Study of Patients with Neurological Disease in a Single Center for 12 Years: Neurogenic Bladder Etiology

Aim:Generally, urodynamic-pressure flow study (U-PFS) is performed on patients with lower urinary tract symptoms (LUTS) for verifying the diagnosis and evaluating the rate of response for treatment. The aim of the study was to assess the results of the U-PFS of patients according to the etiology of neurological disorders.Materials and Methods:The data of 2,489 patients who underwent U-PFS in our clinic between 2010-2022 were analyzed retrospectively. A total of 535 patients with LUTS and neurogenic disorder were included in the study. Patients were divided into subgroups according to their diagnosis. The patient’s age, gender, and U-PFS data (sensation of first urine, maximum cystometric capacity (MSC), maximum detrusor pressures in the filling phase, presence of urgency, and bladder compliance status) were evaluated and compared according to neurological disorders.Results:Cervical and lumbar disc disorder was found in 204 (38.1%) patients, multiple sclerosis (MS) in 103 (19.2%), and cerebrovascular incidents in 74 (13.8%) patients (SVI), spinal cord injury in 48 (8.9%), polyneuropathy in 43 (8.0%), Parkinson’s disease (PD) in 30 (5.6%), diabetic neuropathy in 18 (3.4%), and operated spine bifida (oSB) in 15 (2.8%) was detected. Detrusor pressures in the filling phase were compared according to neurological disorders, and detrusor pressures were statistically significantly higher in patients with oSB and PD (52.66±40.78 mmHg; 45.30±34.43 mmHg, respectively; p<0.001). When the MSCs were compared, it was observed that the bladder capacity was significantly lower in PD and ASD patients, whereas bladder capacity was relatively increased in lomber and servical disc disorder, spinal cord injury and polyneuropathy patients (respectively 308.71±190.25 mL, 264.81±140.25 mL, 491.90±167.49, 474.52±182.92, 447.67±168.03, p<0.001).Conclusion:These specific patient groups (oSB and spinal cord injury) are hazardous groups for the development of end-stage kidney failure. Clinicians should take into consideration that patients and their relatives have to be informed about possible long-term complications

The Ki-67 proliferation index predicts recurrence-free survival in patients with dermatofibrosarcoma protuberans

Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue sarcoma that originates from the dermis or subcutaneous tissue in the skin. While its prognosis is generally favorable, disease recurrence is relatively frequent. Because morbidity after repeated surgery may be significant, an optimized prediction of recurrence-free survival (RFS) has the potential to improve current management strategies. The purpose of this study was to investigate the prognostic value of the Ki-67 proliferation index with respect to RFS in patients with DFSP. We retrospectively analyzed data from 45 patients with DFSP. We calculated the Ki-67 proliferation index as the percentage of immunostained nuclei among the total number of tumor cell nuclei regardless of the intensity of immunostaining. We constructed univariate and multivariate Cox proportional hazards regression models to identify predictors of RFS. Among the 45 patients included in the study, 8 developed local recurrences and 2 had lung metastases (median follow-up: 95.0 months; range: 5.2−412.4 months). The RFS rates at 60, 120, and 240 months of follow-up were 83.8%, 76.2%, and 65.3%, respectively. The median Ki-67 proliferation index was 14%. Notably, we identified the Ki-67 proliferation index as the only independent predictor for RFS in multivariate Cox proportional hazards regression analysis (hazard ratio = 1.106, 95% confidence interval = 1.019−1.200, p = 0.016). In summary, our results highlight the potential usefulness of the Ki-67 proliferation index for facilitating the identification of patients with DFSP at higher risk of developing disease recurrences