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Objective:This study aimed to determine the sleep habits and sleep problems of patients with conduct disorder (CD) and to compare them with healthy controls.Materials and Methods:This cross-sectional study included 45 children diagnosed with CD and 50 healthy controls. Sleep was evaluated by children’s sleep habits questionnaire (CSHQ). Qualitative variables between groups were compared using chi-square test, whereas quantitative variables were compared using t-test. Correlation analyses were conducted to evaluate relationships between the quantitative variables. Linear regression analysis was conducted to evaluate the predictors of severity of CD symptoms. P was set at 0.05.Results:The average ages of children in CD and control groups were 11.04±1.20 and 10.00±1.55 years, respectively. Moreover, 71.1% in the CD group were boys (vs. 78.0% in the control group). The groups were comparable in terms of socio-demographic features (all p>0.05). Scores of all CSHQ subscales were significantly elevated in the CD group compared with the control group (p

Background: Orofacial clefts are the most common congenital craniofacial anomalies, globally. However, few reports describe cleft demographic, clinical, and surgical information in a Turkish population. Aims and Objectives: The aim of this study is to investigate the demographic, clinical, surgical information and outcomes of cleft lip and/or palate (CL/P) patients in Northwestern Turkey. Materials and Methods: We assessed demographic, clinical, operative characteristics, and postoperative complications data in this retrospective review of electronic medical records at a tertiary referral center from 2005 to 2015. Results: Our study included 150 CL/P patients (88 men, 62 women). Cleft lip and palate (CLP) was the most prevalent type of cleft (60%), followed by isolated cleft palate (31.3%) and isolated cleft lip (8.7%). The rates of maternal folic acid use, smoking, alcohol intake, and consanguinity were 83.3%, 5.3%, 1.3%, and 3.3%, respectively. Nasoalveolar molding was applied mostly in bilateral—not unilateral—CLP patients. The modified, extended Mohler technique was common for cleft lip repairs. Most cleft palate repairs used Bardach's two-flap palatoplasty combined with radical intravelar veloplasty. Most cases required grommet insertion. For cleft palate patients, myringotomy or paracentesis was performed in 12.8% of repairs, and acellular dermal matrix was used in 28.5% of repairs. Conclusion: Knowledge of CL/P characteristics is crucial for treatment planning and satisfactory health care. To our knowledge, this is the first study to assess CLP data in a Turkish population.

Objective: The epigastric artery perforator flap is commonly used in the breast reconstruction. Ischemia during surgery results in the necrosis of the flap. We aimed to study the effect of fondaparinux in reperfusion injury in perforator flap model and determined its effects on the flap viability. Materials and Methods: Twenty-eight female Wistar Albino rats were included in this study. Rats were separated into three groups: A control (n = 9), B ischemia (n = 9), and C ischemia + drug (n = 10). Superior epigastric artery perforator flap on the single perforator was elevated in all groups. In Group A, flap was sutured back. In Group B, ischemia was applied for 4 h to the pedicle. In Group C, fondaparinux was administered 30 min before the reperfusion of the flap. Serum malondialdehyde (MDA), myeloperoxidase (MPO) levels, and histopathological examination of the flaps were studied. Results: The mean survival areas of flaps were 92.5%, 50.1%, and 91.1% in Group A, Group B, and Group C, respectively. Statistical differences were observed between these values (P < 0.05). The means of MPO and MDA were 22.3 ng/ml and 4.5 nmol/ml; 31.1 ng/ml and 4.7 nmol/ml; 27.1 ng/ml and 4.5 nmol/ml, respectively, for Group A, Group B, and Group C, and no statistically significant difference was found between groups (P > 0.05). Histopathologically, statistically significant difference was found between Group A, Group B, and Group C in terms of the infiltration of the leukocytes with polymorph nuclei (PMNL) for 24 h (P < 0.05). In the histopathological examinations done at the 7th day, statistically significant difference was found between groups in terms of edema, necrosis, increase in connective tissue, and leukocytes with polymorph nuclei (PMNL) (P < 0.05). Conclusion: Administration of fondaparinux after ischemia increased the flap viability in the epigastric artery perforator flap model.

Enerji tüketiminin azaltılması ülkelerin gelişimi için çok önemlidir. Yapılarda enerji tüketimi bu nedenle büyük önem arz etmektedir. Binalarda ısı kaybını azaltmak için ısı köprülerini, ısı köprülerini oluşturan yalıtım sisteminin etkilerini ve kullanılan malzemenin davranışlarını çok iyi bilmek gerekmektedir. Bu çalışma, teras katlarda beton, duvar ve yalıtım malzemelerinin ısıl iletkenlik katsayılarının değişiminin ısı köprüsüne etkilerini incelenmektedir. Bunun için literatürden farklı olarak Türkiye'de betonarme binaların teras katları için en sık kullanılan 9 kesit üzerinde inceleme gerçekleştirilmiştir. "Yalıtım sistemi, beton ve/veya duvar malzemesinin değişiminin ısı köprüsüne etkisi ne olmaktadır?" sorusuna yanıt aranmıştır. Hesaplamalar TS 825’te belirtilen birinci derece gün bölgesi için sıvalı durum göz önünde bulundurularak yapılmış olup farklı yalıtım çeşitlerinde duvar-döşeme-kiriş birleşimlerinin ısı akıları ve sıcaklıkları hesaplanmıştır. Hesaplamalarda gerçeğe yakın değerler veren ve sonlu elemanlar metodunu kullanan, QuickField 5.6 programından yararlanılmıştır. Bu çalışmanın sonuçları ile ısı köprülerinde beton, duvar ve yalıtım malzemelerinin ısıl iletkenlik değerlerinin değişiminin iki boyutlu olarak nasıl değiştiği görülmektedir. En büyük ısı kaybı, betonun ısıl iletkenlik katsayısının artması sonucunda elde edilmektedir. Ayrıca elde edilen sonuçlarla teras katlarda kullanılan yalıtım çeşitlerinin hangisinin daha verimli olduğu sorularına da yanıt verilmektedir.

İnceleme alanında Paleozoyik ve Tersiyer yaşlı oluşuklar, yüzeylenmektedir. Pelitikşist, serizitşist, kloritşist, kuvarsşist, kalkşist, kuvarsit ve mermerlerden ibaret Paleozoyik yaşlı birimler temeli oluştururlar. Bu temel üzerine açılı uyumsuzlukla gelen Pliyosen yaşlı gölsel çökeller, çakıltaşı, kumtaşı, silttaşı, kiltaşı ve kumlu kireçtaşlarından ibarettir. Jeotermik gradyanla ısınan su, kırık ve fay hatları boyunca yükselerek yeryüzüne ulaşmış ve Köşk kaplıca kaynağını oluşturmuştur. Termal suyun debisi 20.08.1997'de bilinen hacim yöntemi ile 3,66 l/s (320 m3/gün), 21.09.1997'de ise 3,46 l/s (300 m3/gün) ölçülmüştür. Kaynak ağzında suyun sıcaklığı maksimumlu termometre ile 35 oC ölçülmüştür. Sıcaklık ölçümlerine ve kimyasal analiz sonuçlarına göre kaynağın suyu, Uluslararası Hidrojeologlar Birliği'nin tanımına göre "Ca, Mg, SO4'lı sıcak ve mineralli su" dur. Köşk kaplıcasının mevcut suyunun debisini ve sıcaklığını artırmak amacıyla 7-8 Eylül 1997 tarihlerinde 7 noktada AB/2 = 700 m açılımlı Rezistivite Düşey Elektrik Sondaj (D.E.S.) ölçümü yapılmıştır. Yapılan jeofizik incelemeler ile jeolojik ve hidrojeolojik gözlemlerin ışığında termal suyun sıcaklığının ve debisinin artmasıbeklenmektedir. Jeofizik-rezistivite D.E.S. verilerine göre suyun debisini ve sıcaklığını artırmak için en uygun sondaj yerinin, 2 ve 3 nolu D.E.S. noktaları arasında hem fayı hem de şistler arasındaki yüksek rezistiviteli kalkşist-kuvarsitleri hedefleyecek şekilde seçilmesi gerekmektedir.

In the study area, Paleozoic and Tertiary aged rock units outcrop. Paleozoic aged rock units which form the basement, are peliticschists, sericitschists, chloriteschists, quartzschists, quartzites and marbles. Pliocene aged rock units, which are lacustrine sediments, conglomerates, sandstones, siltstones, claystones and sandy limestones overlie this basement with angle disconformity. The meteoric water, circulated in the region is heated by the effect of geothermic gradient and emerges near the small town of Köşk, forms the Köşk thermal. Recharge of the thermal water is 3,66 l/s in 20.08.1997 and 3,46 l/s in 21.09.1997. Temperature of the water is 35 oC which measured by using max-thermometer in the emerging point of (well) the water. According to do thermal measurements and the results of chemical analyses the water can be defined as "Ca, Mg, SO4 thermal and mineralized water" by the IUGS standarts. AB/2 = 700 m Rezistivite Deep Electric Drilling has been done to increase the recharge and temperature of the Köşk thermal water at seven points in 7-8 Septemper, 1997. In the light of this geophysical investigations and with the support of geological and hydrogeological conditions, it can be expected that the temperature and recharge of the thermal water would be increased. On the basis of geophysic resiztivite data, to increase of water recharge and its temperature it is suggested that the best drilling sites are between 2 and 3 well-points which are located between fault and high-resiztivite chalkschists-quartzite within schists.

İnceleme alanında Paleozoyik ve Tersiyer yaşlı oluşuklar, yüzeylenmektedir. Pelitikşist, serizitşist, kloritşist, kuvarsşist, kalkşist, kuvarsit ve mermerlerden ibaret Paleozoyik yaşlı birimler temeli oluştururlar. Bu temel üzerine açılı uyumsuzlukla gelen Pliyosen yaşlı gölsel çökeller, çakıltaşı, kumtaşı, silttaşı, kiltaşı ve kumlu kireçtaşlarından ibarettir. Jeotermik gradyanla ısınan su, kırık ve fay hatları boyunca yükselerek yeryüzüne ulaşmış ve Köşk kaplıca kaynağını oluşturmuştur. Termal suyun debisi 20.08.1997'de bilinen hacim yöntemi ile 3,66 l/s (320 m3/gün), 21.09.1997'de ise 3,46 l/s (300 m3/gün) ölçülmüştür. Kaynak ağzında suyun sıcaklığı maksimumlu termometre ile 35 oC ölçülmüştür. Sıcaklık ölçümlerine ve kimyasal analiz sonuçlarına göre kaynağın suyu, Uluslararası Hidrojeologlar Birliği'nin tanımına göre "Ca, Mg, SO4'lı sıcak ve mineralli su" dur. Köşk kaplıcasının mevcut suyunun debisini ve sıcaklığını artırmak amacıyla 7-8 Eylül 1997 tarihlerinde 7 noktada AB/2 = 700 m açılımlı Rezistivite Düşey Elektrik Sondaj (D.E.S.) ölçümü yapılmıştır. Yapılan jeofizik incelemeler ile jeolojik ve hidrojeolojik gözlemlerin ışığında termal suyun sıcaklığının ve debisinin artmasıbeklenmektedir. Jeofizik-rezistivite D.E.S. verilerine göre suyun debisini ve sıcaklığını artırmak için en uygun sondaj yerinin, 2 ve 3 nolu D.E.S. noktaları arasında hem fayı hem de şistler arasındaki yüksek rezistiviteli kalkşist-kuvarsitleri hedefleyecek şekilde seçilmesi gerekmektedir.

Ilıcapınar (Polatlı)'ın BGB'sında yer alan sıcak ve mineralli su kaynağının hidrojeoloji incelemesini amaçlayan bu araştırmada yaklaşık 50 km 2 'lik bir alanın 1/25000 ölçekli jeoloji haritası yapılmıştır. Çatlak ve kırıklar boyunca yerin derinlikerine doğru yer çekim etkisiyle süzülen meteorik sular jeotermik gradyanla ısınmışlardır. Hidrostatik basınç ve sudaki gazların genleşmesi vb. nedenlerle faylar boyunca yükselerek yeryüzüne çıkmışlardır. Sıcak ve mineralli su kaynakları K-G doğrultusunda uzanan fay boyunca çıkmışlardır. Kaynak sıcaklığı 28.5 °C olup debisi 8.4 l/s'dir. Sıcak ve mineralli suların geldiği derinlik 700 m'dir. AIH'a göre Ilıcapınar sıcak ve mineralli su kaynağı Na'lu, HCO3'lu, Cl'lu S'lü, sıcak ve mineralli sudur.

In this study aiming the hydrogeological investigation of thermal and mineralized waters of WSW Ilıcapınar (Polatlı) area. 1/25000 scaled geological maps of appoxiamely 50 km 2 area have been done. Meteoric waters infiltrating to ward to the deep level of the ground along fractures and fissures have been warmed up due to geotermic gradient. They have been up rose to the surface throught fault planes a result of leaving of gases in the water and hydrostatic pressure. Thermal and mineralized waters of ılıcapınar spring discharge along the N-Strending fault. The temperature of the spring is 28.5 °C and discharge is 8.4 l/s. It is determined that the hot and mineralized water are come from about 700 m. According to the IAH standarts hot and mineralized water of ılıcapınar spring can be classifid as Na, HCO3, Cl, S bearing hot and mineralized water.

Ilıcapınar (Polatlı)'ın BGB'sında yer alan sıcak ve mineralli su kaynağının hidrojeoloji incelemesini amaçlayan bu araştırmada yaklaşık 50 km 2 'lik bir alanın 1/25000 ölçekli jeoloji haritası yapılmıştır. Çatlak ve kırıklar boyunca yerin derinlikerine doğru yer çekim etkisiyle süzülen meteorik sular jeotermik gradyanla ısınmışlardır. Hidrostatik basınç ve sudaki gazların genleşmesi vb. nedenlerle faylar boyunca yükselerek yeryüzüne çıkmışlardır. Sıcak ve mineralli su kaynakları K-G doğrultusunda uzanan fay boyunca çıkmışlardır. Kaynak sıcaklığı 28.5 °C olup debisi 8.4 l/s'dir. Sıcak ve mineralli suların geldiği derinlik 700 m'dir. AIH'a göre Ilıcapınar sıcak ve mineralli su kaynağı Na'lu, HCO3'lu, Cl'lu S'lü, sıcak ve mineralli sudur.

Acinetobacter baumannii is an opportunistic pathogen which is one of the most important agents of nosocomial infections. Being resistant to many antibiotics, complicates the treatment of the infections caused. Fluoroquinolones are used in the treatment of nosocomial and community-acquired infections and it is important to determine the mechanisms of resistance to these antibiotics. The aims of this study were to investigate ciprofloxacin (CIP) and levofloxacin (LEV) minimum inhibitor concentrations (MIC), clonal relationships, mutations that occur in DNA gyrase and topoisomerase IV genes and overexpression of efflux pumps in nosocomial A.baumannii isolates. A total of 81 A.baumannii strains, 79 CIP-resistant and two CIP-susceptible, isolated from different clinical samples in Ege University Faculty of Medicine, Department of Medical Microbiology were included in the study. CIP and LEV MIC values were determined by broth microdilution method. Clonal relationship among the strains was investigated by ERIC-PCR (Enterobacterial repetitive intergenic consensus-polymerase chain reaction). Mutations that occur in gyrA and parC genes were detected by DNA sequence analysis in 16 strains representing each clone and subtype. Overexpression of the efflux pumps was evaluated by broth microdilution and fluorometric accumulation experiments were carried out in the presence of pump inhibitors, among the representative strains. MIC(50) and MIC(90) values for CIP were 256 µg/ml and ≥ 256 µg/ml, while the values were 32 µg/ml and 128 µg/ml for LEV, respectively. Overall, CIP MIC values were found to be higher than that of LEV among the A.baumannii strains studied. Isolates were grouped into six main groups and 10 different clusters (39 strains in cluster A, 20 in B, 13 in C, two of each in I and J, one of each in D-H clusters), but it was observed that the majority of them were clonally related. The most common and important mutations detected in the gyrA and parC genes of the representative isolates were, Ser83Leu, Asp87Glu and Ser80Leu, respectively. While the overexpression of efflux pumps was observed in seven of the representative strains by microdilution method, in 11 by fluorometric assay and the results were positive in five of the strains by both methods. CIP was found to be better than LEV for detecting the overexpression of pumps by the use of microdilution method. It was concluded that, the reason of high fluoroquinolone MIC values of the studied nosocomial and clonally related A.baumannii strains were related to target mutations and overexpression of efflux pumps besides the plasmid-mediated mechanisms, such as Qnr might also have played a role.

BCG (Bacillus Calmette-Guérin) vaccine is a widely used vaccine with the recommendation of World Health Organization to protect children against miliary tuberculosis (TB) and TB meningitis. Severe side effects related to this vaccine mostly manifest in the presence of underlying immunosuppressive disease. In this report, an infant case with unknown chronic granulomatous disease (CGD) who developed disseminated BCG infection after administration of BCG vaccine, was presented. High fever, left axillary lymphadenopathy and hepatosplenomegaly have developed in a 3-month 28-day female infant, without a known health problem, following BCG vaccination. The acid-fast bacilli (ARB) was isolated from the material of excised lymph node cultivated in Löwenstein-Jensen medium, and the isolate was identified as Mycobacterium bovis. Mycobacterium tuberculosis complex DNA was detected in the axillary lymph node sample by polymerase chain reaction. Anti-tuberculous treatment included 20 mg/kg of rifampicin+10 mg/kg of isoniazid+15 mg/kg of ethambutol+30 mg/kg of streptomycin was started. The patient was then further evaluated for immunodeficiency and on the basis of the results of dihydroamine and LAD (lymphocyte adhesion defect) tests, diagnosed as autosomal recessive CGD. Based on the anamnesis, there was no known immunodeficiency history both in the case during neonatal period and her family members. Interferon-gamma therapy, which is recommended for the patients with CGD living in endemic areas, was initiated. Our patient's fever dropped at the 15th day of anti-tuberculosis treatment, and she was discharged on the 35th day and continued to receive treatment at home. The patient was followed up at outpatient clinic and had no additional complaints; her hepatosplenomegaly was back to normal at the third month. As a result, since BCG vaccine is contraindicated in CGD carriers, newborns with a family history of CGD should be immunologically examined and BCG vaccine should be avoided until the results are obtained. In addition, newborns without a family history, diagnosed as disseminated mycobacterial infection following BCG vaccination, should be evaluated for an underlying immunodeficiency condition.

Brucellosis remains a world-wide public health problem especially in developing brucellosis remains a world-wide public health problem especially in developing countries. Although involvement of the respiratory system in brucellosis is an acknowledged but rare event, its clinical manifestations and focal complications are often troublesome in making a diagnosis. Herein, we report a pneumonia case which proved due to Brucella melitensis in a 57-year-old man who presented with chronic cough, sputum, hemoptysis and fever.

Chronic pain is well appreciated as a universal problem in the sense that it causes serious impairment in the individuals' physical and psychosocial status of functioning. Research, psychological assessment and psychotherapeutic process towards chronic pain is most frequently based on the principles of cognitive-behavioral approach (CBA). However, Sharp criticised CBA for its ongoing dependency on the operant premises of the pure behavioral approach and proposed a "reformulated CBA" where the emphasis is on specific cognitive factors, primarily the pain beliefs. According to current studies in chronic pain, it is becoming increasingly apparent that pain beliefs play an important role in the maintainance and management of chronic pain. In Turkey, there are no studies and tools on pain beliefs. In this specific review, the literature on pain beliefs is discussed in terms of necessity of research and material development on pain beliefs that tab factors specific to Turkish culture.

Benign airway obstruction is known as curable by therapeutic bronchoscopic methods. Compared by surgical therapies it is comfortable and has no risks for the patients. For five patients who applied our clinic after tracheostomy and endotracheal intubation stenosis we used therapeutic bronchoscopic methods; "laser-stenotic silicon stent". In two patients after vaporization of membranous stricture by Neodimum Yttrium Aliminum Pevroskite Laser (Nd-YAP laser) who were seen posttracheostomy and postentubation; stenotic stent was implanted mechanically and/or by means of baloon dilatation. Membranous stricture area was coagulated by Nd-YAP-laser in other three cases and anatomic airway diameter was achieved mechanically and by baloon dilatation. In the follow up period we applied stenotic silicon stent implantation after second laser resection in whom restenosis observed. In conclusion; patients who had stenotic silicon stent implantation and having no problems in the follow up this therapeutic method is found to be curative.

Objectives: We compared the findings of magnetic resonance imaging (MRI) with histopathologic results in laryngeal cancer., Patients and Methods: Twenty-five patients (24 males, 1 female; mean age 58 years; range 24 to 80 years) were evaluated preoperatively by MRI with regard to involvement of the thyroid cartilage, anterior commissure, vocal cords, sinus pyriformis, subglottic region, and prelaryngeal soft tissues. The findings were compared with those of histopathologic examination., Results: The highest accuracy was found in the detection of invasion to the prelaryngeal soft tissue (92%). The accuracy of MRI was 84% for the anterior commissure, 80% for vocal cords, 76% for the thyroid cartilage, and 72% for sinus pyriformis and the subglottic region., Conclusion: Magnetic resonance imaging proved to be useful in the preoperative evaluation of laryngeal cancers.