Bağlama Operasyonları Esnasında Kopan Halat Yaralanmalarının Bulanık Hata Ağacı Yöntemi ile Analizi

Pek çok sektörde olduğu gibi denizcilik sektöründe de ölümlere, yaralanmalara, çevre kirliliklerine veya maddi hasarlara sebep olan kazalar yaşanmaktadır. Denizcilik sektörünün omurgasını oluşturan gemi taşımacılığı operasyonları, yapılan işin doğası gereği ciddi riskler barındırmaktadır. Bu riskleri yok etmek ya da kabul edilebilir risk seviyelerine indirgeyebilmek için pek çok emniyet tedbiri uygulanıyor olmasına rağmen gemi operasyonlarında yaşanan kazaların sayısı oldukça fazladır. Gemi operasyonları ile ilgili yaşanmış kazalar ve kaza istatistik raporları incelendiğinde gemi bağlama operasyonlarında yaşanmış olan kaza oranının oldukça yüksek olduğu görülmektedir. Çalışma kapsamında, Hata Ağacı Analizi yöntemi ile tanker terminal operasyonları için kopan halat yaralanması riski ve buna sebep olan kök sebepler tespit edilmiş olup Bulanık Mantık yöntemi ile de sayısal analizi gerçekleştirilmiştir. Tanker terminal bağlama operasyonlarında görevli gemi ve sahil çalışanlarından oluşan uzman grubu görüşlerine dayandırılarak oluşturulan model ile kopan halat yaralanma kazası risk değerinin hesaplanması ve alınabilecek önlemlerle bu risk değerinin azaltılabileceğinin bilimsel bir yaklaşımla ortaya konması hedeflenmiştir

Servikal Ranula: Bir Olgu Sunumu

Plunging veya servikal ranula sublingual bezden kaynaklanan ve mylohyoid kası içinden uzanım gösteren nadir görülen bir mukus ekstravazasyon kistidir. Mukus doku planlarını ayırarak aşağı doğru iner ve sıklıkla submental veya submandibular alanda şişlik olarak kendini gösterir. Tedavide ile seçenek plunging ranulanın cerrahi eksizyonudur. Basit eksizyon, marsüpiyalizasyon ve intraoral veya servikal yaklaşımla ranula ve sublingual gland eksizyonu gibi çeşitli cerrahi varyasyonlar bulunmaktadır. Bu tedavi seçeneklerine rağmen hastaların bir kısmında rekürrens görülmekte ve daha büyük lezyonlar ortaya çıkabilmektedir. Skleroterapi cerrahi önerilmeden önce primer tedavide kullanılabilecek potansiyel küratif bir tedavi prosedürüdür. Tedavisinde servikal yaklaşım ile sublingual gland ve plunging ranulanın total eksizyonu uygulanan bir olgu sunuldu

The Efficacy of Continuous Renal Replacement Therapy and Hemoabsorption Treatments in COVID- 19 Patients in the Intensive Care Unit: A Retrospective Evaluation

Objective:The World Health Organization has emphasized that as there is no specific anti-coronavirus disease-2019 (COVID-19) treatment, supportive care according to disease severity is important. Previous studies have shown that acute kidney injury (AKI) develops in 30% of severe COVID-19 patients followed up in intensive care units and most these require renal replacement therapy. This study aimed to evaluate the COVID-19 prognosis, renal function, and organ systems of adult, severe COVID-19 patients treated with continuous renal replacement therapy (CRRT) and the effects on secondary hemophagocytic lymphohistiocytosis with the additional application of absorption filters.Materials and Methods:A retrospective examination was made of the data of COVID-19 patients who applied for CRRT between 11.03.2020 and 15.06.2021. The demographic data of the patients were recorded together with the renal function test results before and after CRRT, and the biochemical parameters were included in the COVID-19 prognosis.Results:Positive changes were determined in the kidney functions with CRRT applied to patients who developed AKI. No statistically significant difference was observed in the biochemical parameters included in the COVID-19 prognosis. In the 14 patients who applied with hemoabsorption, the need for short-term inotropic support was reduced. In our study, the mortality of the patients who were treated with CRRT was 95% (2 patients transferred to the ward), while the average intensive care unit stay was 18.2±11 days. While improvement was detected in renal function tests with CRRT applied to patients with AKI, no statistically significant difference was found in biochemical parameters in the prognosis of COVID-19. While mortality was 92.8% in 14 patients who underwent hemoabsorption, a short-term improvement was observed in the need for inotropes in these patients.Conclusion:Although vaccinations are expected to definitively eliminate COVID-19, for critical COVID-19 patients for whom the treatment options are limited, it would seem rational to adopt immunomodulator strategies including extracorporeal blood purification and supportive treatment such as CRRT. The results of this study have shown that CRRT applied to severe COVID-19 patients who develop AKI is an effective treatment for kidney failure. However, the effect on the progression of COVID-19 could not be clearly shown

Determination of the Optimal Polypropylene Fiber Addition to the Dense Bituminous Mixtures by the Aid of Mechanical and Optical Means

Polypropylene fibers are completely native modifiers and they do not have any dependence on abroad in case of technology. When viewed from this point, the modification of bituminous binders with polypropylene fibers is a very important step for our country’s “economical” concerns. In this study, first of all, the physical and chemical effects of polypropylene fibers on bitumen were investigated. Next, the amount of “optimum” polypropylene fibers that has to be added into the mixture was determined. In order to determine it, first, static creep tests and Marshall tests were carried out and then, images of the polypropylene fiber added bituminous binders under fluorescence microscopy were researched. With the application of physical and mechanical tests to the Marshall specimens prepared with the optimum polypropylene amount that was obtained, optimum bitumen content was determined and finally economical analyses were carried out. By carrying out extensive analyses it was seen that the utilisation of polypropylene fibers improves the physical and mechanical properties of the resultant asphalt mixture mainly by enhancing the permanent deformation resistance. On the other hand, polypropylene modification results in 30% economy from bitumen which is a clear indication of the benefit in the mass production of asphalt concrete

Pediatric surgeons and whatsapp: First impressions of daily use of instantaneous messaging software in pediatric surgery Çocuk cerrahlari ve whatsapp: Anlik mesajlasma yaziliminin çocuk cerrahisinde günlük kullanimi ile ilgili ilk izlenimler

2017 © Logos Medical Publishing. All Rights Reserved.Aim: WhatsApp, a instantaneous communication software program has been instrumental in medical professionals' daily routines. Apart from WhatsApp's many advantages, some potential risks in its use for medical purposes exist. Here, we investigated WhatsApp use among pediatric surgeons in terms of daily social and medical life routines and opinions about its risks. Material and Methods: Using a questionnaire comprising 10 main queries, we questioned the participants' attitudes about WhatsApp use. Age; sex; professional status; type of working hospital; social media and method of WhatsApp use, opinions, and future expectations regarding the advantages and disadvantages of using this program were inquired. SPSS 22.0 was used for statistical data analysis. Results: Fifty-two pediatric surgeons responded the questions (29 M, 23 F). The main advantages noted by the parti-cipants were easy communication, and facilitated consultation among colleagues (n:42), group messaging and short briefing about the patients (n:34), and instant sharing of medical images (n:28). The main disadvantages were time loss (n:14); medical, ethical, and legal risks (n:13), and potential privacy act infringement (n:12). Conclusion: WhatsApp use has established an important place in pediatric surgeons' daily routines. However, many pediatric surgeons disregard some of the potential risks