Kalıcı yapıtlar bırakan bir müzik adamıydı

Taha Toros Arşivi, Dosya No: 259-Melih Kiba

Recent scoring systems predicting stone-free status after retrograde intrarenal surgery; a systematic review and meta-analysis

Introduction Several scoring systems and nomograms have been developed to predict the success of retrograde intrarenal surgery. But no meta-analysis for the performance of scoring systems has yet been performed. The aim of this study was to compare predictive ability of recent scoring systems for stone-free rate of retrograde intrarenal surgery. Materials and methods PubMed and Web of Science databases were searched systematically between April and May 2021. The scoring systems which were validated externally or studied at least by two different researcher groups were selected for further analysis. Of 59 records, 14 studies met the inclusion criteria (n = 4137). Area under curve (AUC) values of selected scoring systems were pooled in random or fixed effects. Thertest was used to quantify heterogeneity. Results Eight, 5, 8, 4 and 3 studies included in meta-analyses for the modified Seoul National University Renal Stone Complexity Score (S-ReSC), R.I.R.S., Resorlu-Unsal Score (RUS), S.T.O.N.E., and Ito's Nomogram, respectively. We found pooled AUC values 0.709 (95% CI 0.670-0.748), 0.704 (95% CI 0.668-0.739), 0.669 (95% CI 0.646 to 0.692), and 0.771 (95% CI 0.724 to 0.818), for first four of them, respectively. Heterogeneity was very high to pool AUC values for Ito's nomogram. Conclusions Although S.T.O.N.E. score showed higer pooled AUC value, this systematic review and meta-analysis has not revealed superiority of any scoring system. High heterogeneity between studies and dependencies between scoring systems make it difficult to design a comparative statistical model to generalize the findings. Also, limitations aside, neither scoring system has demonstrated good predictive/discriminative performance

Evoluation of childhood poisoning at our hospital

Amaç: Acil servislere başvurular içerisinde sayıları giderek artan zehirlenmelere dikkat çekmek ve hastanemize zehirlenme ile başvuran olguları değerlendirmek için bu çalışma planlanmıştır. Gereç ve Yöntem: Dr Behçet Uz Çocuk Hastanesine 1994 yılı Ocak-Mayıs ayları arasında zehirlenme nedeni ile başvuran 123 olgu geriye dönük olarak yaş, cins, alınan toksik maddenin türü, başvuru süreleri, başvuru şikayetleri, tedavi yöntemleri hastanede kalış süreleri açısından değerlendirilmişlerdir. Bulgular: Olguların %80'inin 5 yaşından küçük, erkek/kız oranının 1.2 olduğu saptanmıştır. Zehirlenmelerin sırasıyla ilaçlarla (%61), petrol türevi hidrokarbonlu bileşiklerle(%17), besinlerle (%7.2), organik fosforla (%6.5), fare zehiriyle (%4), CO gazıyla (2.4) ve kimyasal ajanlarla (1.7) olduğu tespit edilmiştir. Zehirlenme olgularının %95.2'si kaza sonucunda meydana gelmiş, %4.8'i istemli ilaç alımı şeklinde olmuştur. Sonuç: Zehirlenmeler daha çok 5 yaş altındaki çocuklarda görülmektedir. ılaçlar ve hidrokarbonlu bileşikler en sık çocukluk çağı zehirlenmelerine yol açan ajanlardır. Çocukların bu ajanlardan uzak tutulması bu tip zehirlenmeleri önleyecektir.Objective: The aim of this study is to evaluate childhood poisoning at our hospital and to draw the attention to the increasing incidence of childhood poisoning. Material and Method: In this retrospective study, the records of 123 cases who were hospitalized due to poisoning between January 1standMay 1stin 1994 were evaluated. Their age, sex, the type of material ingested, initial complaints, hospitalization time, the duration of hospitalization, treatment protocols were investigated. Results: Eighty percent of cases studied were younger than five years old with a male/female ratio of 1.2. The toxic agents ingested orexposedwere as follows: Drugs 61%, hydrocarbon compound 17%, food7.2%, organic phosphorus 6.5%, ratpoison4%, CO 2.4% and other chemicals 1.7%. Ninety five percent of cases wereexposed to the toxic agents accidentally whereas 4.8 % had ingested onpurpose. Conclusion: Poisoning is observed more commonly in children younger than five years old. Drugs and hydrocarbon compounds are the most common agents causing childhood poisoning. Keeping children away from these agents canprevent these types of poisoning

ACTIVE LEARNING APPLICATIONS IN GEOGRAPHY TEACHING

Bu arastırmanın amacı, aktif ögrenme yaklasımının, egitim fakültelerinin son sınıflarında verilmekte olan Çevre Sorunları Cografyası dersi içerisindeki Çevre Kirliligi (hava, su, toprak ve radyoaktif kirlilikleri) ünitesinin ögretiminde, ögrencilerin akademik basarıları ile Çevre Sorunları Cografyası dersine ve çevre sorunlarına iliskin tutumları üzerindeki etkisini belirlemektir. Arastırma deneysel desen modelinde gerçeklestirilmistir. Arastırmada veri toplama aracı olarak basarı testi ile çevre sorunları cografyası dersi ve çevre sorunları tutum ölçekleri kullanılmıstır. Gelistirilen ölçme araçları 20062007 Egitim Ögretim Yılında, Balıkesir Üniversitesi, Necatibey Egitim Fakültesi, İlkögretim Bölümü Sosyal ilgiler Ögretmenligi Anabilim Dalı son sınıf ögrencilerinden olusan 88 kisiye uygulanmıstır. Çevre Kirliligi ünitesi, Aktif ögrenme yöntemlerine göre derslerin islendigi deney grubu ile es zamanlı olarak, kontrol grubuyla, düz anlatım ve soru cevap yöntemleri kullanılarak, dersin sorumlu ögretim elemanı tarafından, islenmistir. Arastırmanın alt problemlerinin çözümlenmesinde; yüzde, frekans, aritmetik ortalama ile tek yönlü varyans analizi (ANOVA) ve tek faktör üzerinde tekrarlı ölçümler için iki faktörlü ANOVA (repeated measures) testi kullanılmıstır. Arastırma sonucunda, Çevre Kirliligi konusunda, basarı testi ve tutum ölçeklerinden elde edilen sonuçlarda, deney grubu lehine anlamlı bir farklılık tespit edilmistir.The purpose of this study is to find the effect of active teaching approach on the attitudes of learners towards environment problems and the class of Geography of Environmental Problems, and their academic achievement in learning the unit titled environment pollution (air, water, soil and radioactive pollution) in the class of Geography of Environmental Problems taught at the fourth class of education faculties. The research was conducted in the model of experimental design. In order to collect data, achievement test and a scale of attitudes towards environmental problems and the class of Geography of Environmental Problems were used. The instruments were administered to 88 participants who study at fourth class of the division of Geography Teaching of Department of Secondary Social Fields Education at Necatibey Education Faculty of Balikesir University. The unit on the environment pollution was taught by the teaching staff simultaneously using active learning methods in experimental group and traditional expression and question answer methods in control group. In the analysis of sub-problems of the research, percentages, frequencies, mean scores, one-way variance analysis (ANOVA) and two-way variance analysis for repeated measures on single factor were used. Depending on the findings obtained from achievement test and attitude scale, the results of the research indicated that there is a significant difference in favor of experimental group when the Environment Pollution is considered

The contribution of cooperative learning approach to the awareness of environment in Geography

AbstractIn the 21st century, one of the most important environment problems caused by mankind is waste and storage of it. The waste directly exposed to the nature has adverse effects on both physical and human environment. People, considering themselves the most valuable of all creatures, leave the waste on behalf of controlling the nature not only destroy it but also the human health and economy. The single solution of this artificial deterioration is hidden in the intervention of human himself. Although there are some broadcasts by some press associations, humans’ being less consciousness on this issue prevents the complete success. The reasons why people cannot predictor even refuse to accept the negative effects of the waste they leave haphazardly to the environment is due to the lack of enough environmental conscious. We should certainly make everyone conscious of the environment to have a livable geographical milieu. Only the conscious people have the capacity to envisage a future dimension of a step. This research has aimed to make pre-service teachers conscious of the issues such as waste, recycling and recovery. Waste and recycling subject in Environment education course has been conducted in a cooperative approach to the students of social sciences teaching program of Necatibey Education Faculty of Balıkesir University and students have been asked to make some activities and finally they have been taken for an observation to rubbish dump parse institution in Balıkesir city. With the observation it has been aimed to give the pre service teachers the consciousness on the issues by the experts and laid the groundwork for their understanding of the different aspects of the problem. As a result it has been understood that there was a significant difference between pre and post attitudes of the students and also they have declared to have some positive behavior changes during and after their courses

Relation of neutrophil lymphocyte ratio with tumor characteristics in localized kidney tumors

Amaç: Nötrofil/Lenfosit oranının birçok ürolojik tümörde prognostik faktör olduğu gösterilmesine karşın lokalize böbrek tümörlerinde tümörün özellikleri ile ilişkisini araştırmayı amaçladık. Gereç ve Yöntemler: Kliniğimizde renal kitle tanısı ile opere edilen 125 hastanın laboratuvar ve patoloji sonuçları geriye dönük olarak incelendi. Tüm hastaların operasyon öncesi yapılan tam kan sayımlarından nötrofil/lenfosit oranı(NLR) tespit edildi. NLR'nin tümörün boyutu, tarafı, lokalizasyonu, histolojik tipi ve Fuhrman derecesi arasındaki ilişki istatistiksel olarak değerlendirildi. Bulgular: Preoperatif hesaplanan NLR ile hastaların cinsiyet ve yaş faktörleri, tümörün tarafı, lokalizasyonu, boyutu ile istatistiksel olarak anlamlı bir ilişki saptanmadı (p>0,05). Ayrıca tümör histopatolojilerine göre benign ve malign olarak, malign tümörlerde ise berrak hücreli olan ve olmayan olarak ikili gruplandırıldıklarında da NLR ile gruplar arasında istatistiksel olarak anlamlı bir ilişki izlenmedi (p>0,05). Berrak hücreli tümör patoloji raporlarından elde edilen Fuhrman dereceleri ile NLR arasında da istatistiksel olarak anlamlı bir sonuç saptanmadı (p>0,05). Sonuç: NLR'nin böbrek tümörlerinde diğer prognostik faktörlerden bağımsız bir değişken olduğu düşünülmesine rağmen literatürdeki farklı sonuçlardan dolayı daha kapsamlı geniş çalışmalara ihtiyaç vardır.Aim: Considering that neutrophil/lymphocyte ratio is indicated as prognostic factor in many urologic neoplasms, the purpose of this paper is to examine the relation between this ratio and characteristics of tumors in localized kidney tumors. Material and Methods: Laboratory and pathology results of 125 patients operated in our clinic with the diagnosis of renal lump were examined retrospectively. Neutrophil/lymphocyte ratios (NLR) of all patients were detected by an examination of pre-operation complete blood cell counts. The relations between NLR and size, side, location, histological type and Fuhrman degree of tumor were assessed statistically. Findings: Statistically significant relations could not be detected among preoperative NLR and sex and age of patients and size, side and location of tumor (p<0.05). Also, when tumors were divided into two as benign and malign and malign ones were grouped into two as tumors with and without clear cells, statistically significant relations could not be reported between NLR and these groups (p>0.05). A statistically significant relation could not be found between NLR and Fuhrman degrees obtained from clear cell tumor pathology reports (p>0.05). Conclusion: Although it is thought that NLR is a variable independent from the other prognostic factors in the kidney tumors, more comprehensive studies are needed due to different results available in the literature

Relationship digit ratio with penil length and testis volume in children

Giriş: Androjenlerin uyarımı ile fonksiyonelreseptörlerin aktive olması erkek iç ve dışgenitallerin farklılaşmasında rol oynamaktadır.Homeobox (Hox) genleri embriyogenez sırasındael ve ayak parmakları gibi ekstremite gelişimi,genital tomurcuk farklılaşması, testis ve penisgelişimini düzenlemektedir. Bu gen mutasyonlarındahem parmakların hem de genital sisteminetkilendiği sendromlar bildirilmiştir. Yapılan çalışmalardaikinci ve dördüncü parmak uzunlukoranları ile prenatal testosteron seviyesinin ilişkili,yetişkin testosteron seviyeleri ile de ilişkisizolduğu gösterilmiştir.Bizim çalışmamızda amacımız 2 yaşınınüzerinde hastanemize sünnet için başvuran erkekçocuklarda 2-4 parmak oranı ile penil uzunlukve testiküler volüm arasında ilişkiyi değerlendirmektir.Materyal ve Metod: 2016-2017 yılları arasındasünnet için başvuran 125 erkek çocukçalışmaya alındı. Hipospadias, inmemiş testis,hidrosel, genital veya skrotal cerrahi öyküsü,endokrin hastalıkları bulunan çocuklar çalışmayadahil edilmedi. Tüm çocukların boy ve kilolarıölçülüp vücut kitle indeksleri, boy ve kilogelişim persentil yüzedeleri hesaplandı. Penisve parmak uzunlukları ile testiküler hacim değerlendirmeleriise preoperatif ameliyathanedegenel anestezi sonrası yapıldı. Penil ve parmakuzunluk ölçümleri sürmeli kumpas (verniercaliper)ile testis hacim değerlendirmesi ise praderorşidometrisi ile yapıldı.Bulgular: Çalışmaya alınan çocukların yaşortalaması 7,33±1,22 idi. Gevşek penil uzunlukile sağ 4. parmak uzunluğu, sağ 2/4 parmakoranı ve sol 2/4 parmak oranı ile anlamlı sonuçsaptandı (p=0,001). Gergin penil uzunluk ile sağ4. parmak uzunluğu, sağ 2/4 parmak oranı vesol 2/4 parmak oranı ile korele olduğu görüldü(p<0,05, p<0,05, p=0,001). Total testis hacmiile hem gevşek hem gergin penil uzunluk arasındada anlamlı bir korelasyon izlendi (p<0,05,p=0,001). Sonuç: Literatürde parmak uzunluğu ve oranları ile ilgili değişikhipotezlerle oluşturulmuş birçok çalışma mevcuttur. Ancak bizim çalışmamızdaliterature ile uyumlu sonuçların yanında kısmen de olsa farklısonuçlara ulaşılmıştır. 2/4 parmak oranının hem gevşek hem gergin peniluzunluk için bir gösterge olabilieceği düşünülmektedir.Objective: The activation of functional receptors via the stimulation of androgens has a role in the differentiation of male internal and external reproductive organs. Homeobox (Hox) genes regulate the development of limbs including fingers, genital bud differentiation and the development of testis and penis during embryogenesis. Syndromes in which both the fingers and the genital system are affected due to Hox gene smutations have been reported. Studies have shown that the second and fourth digit length ratios are related the level of prenatal testosterone but not adult testosterone levels. In the present study we eveluated the releation between the 2.-4. Digit length ratio and the penile length and the testicular volume among the patients over two years of age who visited our hospital for circumcision. Materials and Methods: 125 children who applied for circumcision between the years 2016 and 2017 was included in this study. Children with hypospadias, undescended testis, hydrocele, genital or scrotal surgery record and with endocrine disorders was excluded. Weights and lengths of all children were measured, body mass indexes and weight and length development percentiles were calculated. Penile and digit lengths were measured and testicular volumes were assessed preoperatively after general anesthesia in the operating room. Prader orchidometer was used for the assessment of testicular volumes whereas penile and digit lengths were measured by using vernier caliper. Results: The meanage of children included in this study is 7,33±1,22. Significant results were found between flask penile length and right 4th digit length, right 2/4 digit ratio and left 2/4 digit ratio (p=0,001). It was seen that the stretched penile length was correlated with right 4th digit length, right 2/4 digit ratio and left 2/4 digit ratio (p<0,05, p<0,05, p=0,001 respectively). There was also a significant correlation between total testicle volume and both flaccid and streched penile length (p<0,05, p=0,001 respectively). Conclusions: There are many studies in literature with various hypotheses about digit lengths and ratios. In our work, however, results that are in line with literature have been achieved, as well as partly different results. We believe that 2.-4. finger ratio can be an indicator for both flaccid and stretched penile length