High Flow Nasal Oxygen Therapy in Pediatric Intensive Care Unit

Objective:Acute respiratory failure is the most common reason for hospitalization to pediatric intensive care units. Invasive and non-invasive respiratory support methods are used for the treatment of patients with acute respiratory failure findings. The aim of this study is to evaluate the effectiveness of high flow nasal cannula (HFNC) oxygen therapy in pediatric intensive care.Method:This retrospective observational study was conducted between February 2017 and January 2018 in pediatric intensive care unit of Bahçeşehir Liv Hospital, İstinye University Faculty of Medicine. Patients aged between 1 month and 18 years, who received HFNC oxygen therapy for respiratory support in the pediatric intensive care unit, were included in the study.Results:HFNC therapy was received by 67 patients during one year of the study. 58.2% of the patients were male. The mean age of the patients was 37.2 months (R, 1-192), and their average body weight was 11.8 kg (R, 2.8-50). 65.7% of patients had an underlying disease. The most underlying disease was neurological disease with the rate of 35.8%. 94% of our patients received HFNC therapy due to acute respiratory failure, 3% due to acute heart failure and 3% due to shock. 40.3% of our patients received HFNC therapy due to pneumonia, 16.4% due to bronchopneumonia, 14.9% due to bronchiolitis, and 11.9% due to postextubation. 71.6% of patients receiving HFNC therapy improved their clinical findings without intubation. After HFNC therapy, there was a statistically considerable decrease in the respiratory rate, heart rate and retraction of the patients. HFNC therapy failure rates were statistically significantly higher in patients with underlying disease and especially in those with cardiac disease.Conclusion:As a result, it is known that HFNC therapy has been used effectively in children in recent years, and it provides improvement in vital findings and blood gas parameters. In our study, 71.6% of our patients benefited from HFNC therapy

Kıvırcık, Sakız ve Gökçeada Yerli Irk Dişi Kuzuların İlk Yaş Üreme ve Büyüme Özellikleri

Bu çalışma, Bandırma Koyunculuk Araştırma İstasyonunda yetiştirilen Kıvırcık, Sakız ve Gökçeada yerli koyun ırklarımızın ilk yaş üreme özellikleri ve büyüme performansını belirlemek amacıyla yapılmıştır. Araştırmada ilk yaş üreme özellikleri için 15 baş Kıvırcık, 8 baş Sakız ve 10 baş Gökçeada dişi kuzu, büyüme özellikleri için ise 16 baş Kıvırcık, 12 baş Sakız ve 11 baş Gökçeada dişi kuzunun verileri kullanılmıştır. Kızgınlık tespitleri kuzuların beşinci ayını doldurması ile beraber arama koçları ile on iki saat arayla günde iki kez yapılmıştır. Kıvırcık, Sakız ve Gökçeada kuzularında ilk kızgınlık canlı ağırlığı sırasıyla; 37,93; 33,35 ve 29,75 kg, ilk kızgınlık yaşı; 315, 320 ve 337 gün, kızgınlık süresi; 30,99; 25,85 ve 20,28 saat, kızgınlık siklusu; 16,59; 17,91 ve 17,76 gün bulunmuştur. Kıvırcık, Sakız ve Gökçeada dişi kuzuların doğum ağırlığı sırasıyla; 3,64; 3,90; 3,28 kg, sütten kesim ağırlığı; 31,01; 25,44 ve 23,67 kg, altıncı ay canlı ağırlığı; 32,87; 26,95 ve 24,15 kg, bir yaş canlı ağırlığı; 39,01; 30,95 ve 30,27 kg ve günlük canlı ağırlık artışı; 0,271; 0,257 ve 0,202 kg bulunmuştur.This study was conducted to determine first age reproduction characteristics of indigenous Kıvırcık, Sakız and Gökçeada sheep breeds and growth performances of ewe lambs which have been kept in Bandırma Sheep Research Station (BSRS). The data of reproduction characteristics of ewes and growth characteristics of lambs were collected on 15 Kıvırcık, 8 Sakız and 10 Gökçeada ewes, and on 16 Kıvırcık, 12 Sakız and 11 Gökçeada lambs, respectively. After the lambs completed their fifth month ages, estrus detection was carried out with a teaser ram twice a day with 12 hour intervals. For the Kıvırcık, Sakız and Gökçeada lambs, the first oestrus weights were 37.93, 33.35 and 29.75 kg; first oestrus ages were 315, 320 and 337 days; oestrus durations were 30.99, 25.85 and 20.28 hours and the duration of the oestrus cycles were 16.59, 19.91 and 17.76 days, respectively. The birth weights of Kıvırcık, Sakız and Gökçeada lambs were found to be 3.64, 3.91, 3.28 kg; the weaning weight (WW), 31.01, 25.44 and 23.67 kg, the six month live weight (SMLW), 32.87, 26.95 and 24.15 kg, the yearling live weight (YLW), 39.01, 30.95 and 30.27 kg and the average daily weight gain (ADWG), 0.271 0.257 and 0.202 kg, respectivel

Serum Ischaemia-modified albumin concentration in hyperemesis gravidarum

Introduction: The role of oxidative stress in the pathogenesis of hyperemesis gravidarum (HEG) has been demonstrated in a lot of studies. The present study aimed to compare the ischaemia-modified albumin (IMA) serum levels of patients diagnosed with HEG with healthy pregnant women, and to investigate whether oxidative stress caused increased serum IMA in HEG. Methods: Pregnant women were classified into a group diagnosed with HEG (n=45) and an age- and body mass index-matched control group without HEG (n=45). Serum IMA levels were assessed by the enzyme-linked immunosorbent assay (ELISA) method. Results: Serum IMA levels were higher in the HEG group than the control group (HEG: 8.2 +/- 0.2 ng/mL, control: 6.9 +/- 03 ng/mL, p<0.001). Conclusion: We found that HEG was related to increased maternal serum IMA levels. The high levels of IMA in HEG can he considered as a reflection of increased oxidative stress

Jeden z gigantów neurochirurgii odszedł od nas ponad dekadę temu, a w literaturze neurochirurgicznej nie poświęcono mu większej uwagi

One of the giants of neurological surgery left us over a decade ago. Charles George Drake died September 15, 1998 in London, Ontario after an extended bout with lung cancer. Although he will always be identified with taking posterior fossa aneurysm surgery from the realm of the daring to the domain of the routine, his contributions were much broader. Clinical neurosciences have been blessed in the past century by the life and works of Drake. In the neurosurgical world, the achievements of Drake are very well known and have been well recorded. Unfortunately, in the past decade since his passing, only one paper has been published about him and his contributions to neurosurgery. This is a historical paper regarding Charles George Drake that attempts to (1) remember Drake as a pioneer; (2) to evaluate lessons that we have learned from him; and (3) to address the question ‘What made him great?’. As per Drake's teachings, this paper is meant to articulate the unique perspectives Charlie provided with respect to how we learn our craft, maintain the integrity of reporting, and implement suggestions as to how we may progress into the future. In conclusion, it is our hope that this paper will bring to life the unique character of Drake and his unprecedented blend of genius, creativity, technical skill, introspection, and ever-present humility for all international neurosurgeons to appreciate.Charles George Drake, jeden z gigantów neurochirurgii, zmarł przed ponad 10 laty. Chociaż jego nazwisko będzie zawsze kojarzone z wprowadzeniem do praktyki chirurgicznego leczenia tętniaków tylnego dołu czaszki, wkład Drake'a w neurochirurgię jest znacznie szerszy. Niestety, w ciągu dekady od jego odejścia opublikowano tylko jeden artykuł poświęcony jego życiu i wkładowi w neurochirurgię. Niniejszy historyczny artykuł dotyczący Charlesa George'a Drake'a podejmuje próbę upamiętnienia go jako pioniera, poddania ocenie pozostawionej przez niego spuścizny i odpowiedzi na pytanie, co uczyniło go wielkim. Mamy nadzieję, że artykuł ten przybliży środowisku neurochirurgów wyjątkowy charakter Drake'a i cechujące go bezprzykładne połączenie geniuszu, kreatywności, sprawności technicznej, wglądu i nieodłącznej skromności

Reproductıve and Growth Chacterıstıcs First Age of Bandırma-I and BandırmaII Crossbred Ewe Lambs

Bu çalışmanın amacı, Marmara Hayvancılık Araştırma Enstitüsü’nde yetiştirilen Bandırma-I ve Bandırma-II melez kuzuların ilk yaş üreme özelliklerini ve büyüme performansını araştırmaktır. Kuzular, 3 aylık yaştan sonra bir sürü olarak bakılmıştır. Kızgınlık tespiti arama koçları yardımı ile günde iki defa on iki saat arayla yapılmıştır. Araştırmada, ilk yaş üreme özellikleri için 20 baş dişi Bandırma-I, 21 baş dişi Bandırma-II genotipi kuzu, büyüme özellikleri içinde 99 baş Bandırma-I ve 89 baş Bandırma-II kuzu materyali kullanılmıştır. Bandırma-I ve Bandırma-II kuzularında sırasıyla; ilk kızgınlık canlı ağırlığı, 45.30 kg ve 47.30 kg, ilk kızgınlık yaşı 317.73 gün ve 321.330 gün, kızgınlık süresi 19.42 saat ve 21.23 saat, kızgınlık siklusu 16.12 gün ve 17.07 gün, gebelik süresi 145.74 gün ve 145.87 gün, doğum ağırlığı (DA), 4.23 kg ve 4.12 kg, sütten kesim ağırlığı (SKA), 35.45 kg ve 34.27 kg, altıncı ay canlı ağırlığı (AACA) 46.03 kg ve 44.17 kg, bir yaş ağırlığı (BYCA) 47.97 kg ve 46.64 kg ve günlük canlı ağırlık artışı (GCAA), 0.394 kg ve 0.381 kg bulunmuştur. Kızgınlık süresi, siklusu ve ilk kızgınlık canlı ağırlığı üzerine genotip, ana yaşı ve doğum tipinin etkisi önemsiz (P>0.05) bulunmuştur. Kuzuların DA, SKA, AACA, BYCA ve GCAA üzerine genotip etkisi önemsiz (P>0.05), ana yaşı, doğum tipi ve cinsiyetin etkisi önemli (P<0.01) bulunmuştur. Sonuç olarak, Bandırma-I ve Bandırma-II genotipileri, ilk yaş üreme özellikleri ve canlı ağırlıklar bakımından benzer bulunmuştur.The purpose of the study was to investigate first age reproduction and growth characteristics of Bandırma-I and Bandırma-II crossbred lambs which have been keeping on Marmara Livestock Research Institute. Bandırma-I and Bandırma-II females were kept to gather in a single flock after 3 month of age. The oestrus detection was performed twice a day (per twelve hours) by using teaser rams. The materials of the study were used 21 head female for first age reproductive traits and for growth characteristics 99 head and 89 head Bandırma-I and Bandırma-II lamb. The results of live weight first oestrus for Bandırma-I and Bandırma-II lambs were 45.30 kg and 47.30 kg, age of first oestrus 317.73 day and 321.330 day, the duration of oestrus 19.42 hour and 21.23 hour the duration of the cycle 16.12 day and 17.07 day, the duration of gestation length 145.74 day and 145.87 day, birth weight (BW) 4.23 kg and 4.12 kg, weaning weight (WWLW) 35.45 kg and 34.27 kg, six mount live weight (SMLW) 46.03 kg and 44.17 kg, yearling live weight (YLW) 47.97 kg and 46.634 kg and average daily live weight gain (ADLG), 0.394 kg and 0.381 kg respectively. The effects of genotype on BW, WW, SMLW, YLW and DLWG were not significant statistically whereas the effects of age of dam, birth type, and sex on growth characteristic were significant (P<0.001). In conclusion, Bandırma-I and Bandırma-II crossbred lambs were similar first age reproduction and growth characteristic of lambs

Bilateral Severe Sterile Inflammation with Hypopyon after Simultaneous Intravitreal Triamcinolone Acetonide and Aflibercept Injection in a Patient with Bilateral Marked Rubeosis Associated with Ocular Ischemic Syndrome

We report the clinical course of a diabetic patient with bilateral cataract and rubeosis in association with ocular ischemic syndrome and initially treated him with simultaneous intravitreal 2 mg aflibercept and 2 mg triamcinolone acetonide injection at the same setting prior to planned cataract surgery and further photocoagulation. However, sterile anterior segment inflammation characterized by hypopyon occurred four days apart in OU. Right eye developed the sterile inflammation at the third postinjection day and the left eye developed the sterile inflammation at the seventh postinjection day (two days after the uneventful cataract surgery with intraocular lens implantation) without any pain or significant redness. Vitreous biopsy taken during the right phacovitrectomy was negative for any microbial contamination. Both eyes were treated successfully with intensive topical prednisolone acetate with a relatively good visual outcome. It is likely that underlying ocular ischemic syndrome might have facilitated the formation of sterile inflammation as blood-aqueous barrier disruption and flare have already been present

Prolonged respiratory failure responds to conventional therapy in isolated homocysteine remethylation defects

Isolated remethylation defects are rare inherited diseases caused by a defective remethylation of homocysteine to methionine, preventing various essential methylation reactions to occur. Patients present with a systemic phenotype, which can especially affect the central and peripheral nervous systems leading to epileptic encephalopathy, developmental delay and peripheral neuropathy. Respiratory failure has been described in some cases, caused by both central and peripheral neurological involvement. In published cases, the genetic diagnosis and initiation of appropriate therapy were rapidly performed following respiratory failure and led to a rapid recovery of respiratory insufficiency within days. Here, we present two infantile-onset cases of isolated remethylation defects, cobalamine (Cbl)G and methylenetetrahydrofolate reductase (MTHFR) deficiencies, which were diagnosed after several months of respiratory failure. Disease modifying therapy based on hydroxocobalamin and betaine was initiated and shows a progressive improvement and enabled weaning off respiratory support after 21 and 17 months in CblG and MTHFR patients respectively. We show that prolonged respiratory failure responds to conventional therapy in isolated remethylation defects, but can require a sustained period of time before observing a full response to therapy

A 12-Year-Old Girl with Bilateral Coats Disease and ABCA4 Gene Mutation

A 12-year-old girl with bilateral stage 2B Coats disease was screened meticulously for a possible underlying systemic disease as she was female and the disease was bilateral. Full systemic workout turned out to be unremarkable. However, an ABCA4 gene mutation was found in the genetic analysis. NDP and TINF2 gene mutations were not present. She was successfully treated with a bilateral, single intravitreal injection of dexamethasone implant and a single session of indirect laser photocoagulation with a relatively good anatomic and functional result. To the best of our knowledge, the present case is the only reported case of Coats disease with an ABCA4 gene mutation