Search

Purpose: The aim of this study was to investigate the effects of a chemotherapeutic agent Cytosine Arabinoside (Ara-C) and a natural anticancer agent of Thymoquinone (TQ) on apoptosis and cell proliferation of AML cell lines (Kasumi-6) both alone and in combined form. Material and method: Kasumi-6 AML cells were treated with three different doses of Ara-C (0.1, 0.5 and 1 µmol) and TQ (25, 50 and 100 µM) for 48 and 72 hours incubations. After Annexin V and Propidium Iodide (PI) staining, apoptosis, viability, and cell proliferation were evaluated for each group in flow cytometry. Results: As a result, AML cell lines showed a statistically significant difference in a single treatment of the active substances. Their combined treatment showed an increase in apoptosis and a decrease in viability in both groups at 48 and 72 hours incubation times (p < 0.001). In each group, it was observed that apoptosis was increased and viability was decreased and consequently cell proliferation was suppressed. Conclusion: Ara-C was used for the first time in this study with TQ in AML. It was determined that the combined use of TQ and Ara-C did not have a synergistic effect on apoptosis.

Aim: Confirmatory factor analysis (CFA) and Rasch Analysis are commonly used methods to examine the structure of the psychological scales. In this study, it is aimed to evaluate the factor structure Turkish version of the State-Trait Anxiety Inventory by using statistics based on the Rasch model and CFA.Methods: The State-Trait Anxiety Inventory (STAI) was used for the analysis. Of the study group, 186 (46.5%) were male and 214 (53.5%) were female. Unidimensionality was investigated using a Rasch-based principal component analysis (PCA) of the residuals, chi-square tests, item fit statistics, and other statistics. CFA has also been applied to test the hypothesis of a one-factor solution.Results: The item-trait interaction chi-square statistic was 342.344 for the state scale (p, Amaç: Doğrulayıcı faktör analizi (DFA) ve Rasch Analizi, psikolojik ölçeklerin yapısını incelemek için yaygın olarak kullanılan yöntemlerdir. Bu çalışmada, Durumluk-Sürekli Kaygı Envanteri’nin Türkçe versiyonunun faktör yapısının Rasch modeli ve DFA temelli istatistikler kullanılarak değerlendirilmesi amaçlanmıştır.Yöntem: Analiz için Durumluk-Sürekli Kaygı Envanteri’nin kullanıldığı çalışmada, grubunun 186’sı (% 46,5) erkek, 214’ü (% 53,5) kadındı. Tek boyutluluk, rezidüellerin Rasch tabanlı temel bileşen analizi (TBA), ki-kare testleri, madde uyumu istatistikleri ve diğer istatistikler kullanılarak araştırılmıştır. Aynı zamanda ölçeğin tek faktörlü yapısına ait hipotezi test etmek için DFA uygulanmıştır. Bulgular: Madde-özellik interaksiyon ki-kare istatistiği, durumluk kaygı ölçeği için 342.344 (p

WOS: 000399676500009 PubMed: 28442957 Introduction: Although the administration of rectal thiopental for sedation during magnetic resonance imaging (MRI) has been well described, there are limited data regarding its intravenous (IV) use in this clinical scenario. The aim of this study was to investigate the efficiency of IV thiopental for sedation during MRI in the pediatric population. Methods: A retrospective review was conducted over a 12-month period of pediatric patients who received IV thiopental for sedation during MRI. Data collected included the procedure length, the induction dose, the time to sedation, recovery time, total sedation time, and adverse events. The parents were telephoned and questioned regarding any adverse effect after discharge and their satisfaction (yes = satisfied; no = not satisfied) regarding the sedation process. Results: A total of 300 (American Society of Anesthesiology I-II status) pediatric patients received IV thiopental for sedation during MRI. The average age of the patients was 4.7 +/- 3 years. Thiopental was administered as an initial IV bolus dose of 3 mg/kg, followed by additional bolus doses of thiopental (1 mg/kg) as needed to achieve a Ramsay sedation score of 4. The average procedure length was 20.7 +/- 11.9 min. The average total dose of thiopental during the procedure was 5.6 +/- 0.9 mg/ kg. Patients recovered in an average time of 11 +/- 5.6 min after a total sedation time of 31.7 +/- 14.2min. None of the patients had oxygen desaturation, adverse effects before or after discharge, and no patient required unplanned hospital admission. All parents were satisfied with the sedation process. Conclusion: IV thiopental is an effective, safe, and inexpensive medication for the sedation of children undergoing MRI.

WOS: 000440322900024 PubMed: 29770735 Objective: The purpose of this study was to examine whether the combined use of MR diffusion tensor imaging (DTI) parameters [DTI-apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD)] could provide a more accurate diagnosis in differentiating between low-grade and atypical/anaplastic (high-grade) meningioma. Methods: Pathologically proven 45 meningioma patients [32 low-grade, 13 high-grade (11 atypical and 2 anaplastic)] who had received DTI before surgery were assessed retrospectively by 2 independent observers. For each lesion, MR DTI parameters (ADCmin, ADCmax, ADCmean, FA, AD, and RD) and ratios (rADCmin, rADCmax, rADCmean, rFA, rAD, and rRD) were calculated. When differentiating between low- and high-grade meningioma, the optimum cutoff values of all MR DTI parameters were determined by using receiver operating characteristic (ROC) analysis. Area under the curve (AUC) was measured with combined ROC analysis for different combinations of MR DTI parameters in order to identify the model combination with the best diagnostic accuracy in differentiation between low and high-grade meningioma. Results: Although the ADCmin, ADCmax, ADCmean, AD, RD, rADCmin, rADCmax, rADCmean, rAD, and rRD values of high-grade meningioma were significantly low (p = 0.007, p = 0.045, p = 0.035, p = 0.045, p = 0.003, p = 0.02, p = 0.03, p = 0.03, p = 0.045, and p = 0.01, respectively), when compared with low-grade meningioma, their FA and rFA values were significantly high (p = 0.007 and p = 0.01, respectively). For all MR DTI parameters, the highest individual distinctive power was RD with AUC of 0.778. The best diagnostic accuracy in differentiating between low- and high-grade meningioma was obtained by combining the ADCmin, RD, and FA parameters with 0.962 AUC. Conclusion: This study shows that combined MR DTI parameters consisting of ADCmin, RD, and FA can differentiate high-grade from low-grade meningioma with a diagnostic accuracy of 96.2%. Advances in knowledge: To the best of our knowledge, this is the first study reporting that a combined use of all MR DTI parameters provides higher diagnostic accuracy for the differentiation of low- from high-grade meningioma. Our study shows that any of the model combinations was superior to use of any individual MR DTI parameters for differentiation between low and high-grade meningioma. A combination of ADCmin, RD, and FA was found to be the best model for differentiating low-grade from high-grade meningioma and sensitivity, specificity, and AUC values were found to be 92.3%, 100%, and 0.96, respectively. Thus, a combination of MR DTI parameters can provide more accurate diagnostic information when differentiation between low and highgrade meningioma.

Statistical Process Control (SPC) is a technique that enables the quality controllerto monitor, analyze, predict, control, and improve a production processthrough control charts. So to use of SPC in medical field is very important.The cases were obtained at the Ondokuz Mayis University Faculty of medicinedepartments of surgical sciences within two year were evaluated. The outcomesof the operations in these departments were followed throughout twenty-fourmonths. For a surgical procedure has two possible outcomes; a nonconformingproduct (the patient dies) or a conforming one (the patient survives), theboth the death and the alive were accepted as attribute data. The four type ofattribute charts were applied to this data. These were p-chart, np-chart, c-chartand u-chart. If the statistical process was an “in-control” or not was tried todetermine by the attribute charts. As a result of the statistical processes of thesedepartments were evaluated, this provided easily be viewed the pattern of process.The aim of this research is to use the attribute control charts in medicalfield (especially hospital performance evaluation) and to show availability ofthe attribute control charts in medical field.

The most important goal ofa test is having reliable and valid measurement tools. The purpose of thisstudy is to conduct item analysis to questions for an exam which measures thebiostatistics knowledge of students and to assess the Biostatistics Program. The study group consists ofa total of 261 students in their second year of Ondokuz Mayıs UniversityFaculty of Medicine. 132 (50.6%) of the students are female, while 129 (49.4%)are male. Item analysis was assessed by using classical method and Raschanalysis. The average value of the test which consisted of a total of 60multiple choice questions was 47.47± 6.99; thelowest score was 15, while the highest score was 57. KR 20 value was found as0.86. When all the questions were analyzed with Rasch analysis, item difficultyof 75% of the items was between -1.60 and 1.60. As a conclusion, the exam was found to bereliable and it was shown to be a moderately difficult exam which assessed theknowledge of the students. Future studies are planned to assess Biostatisticsteaching in different levels of class.

WOS: 000406344700003, PubMed: 28390141, Objectives-To evaluate renal parenchymal elasticity with acoustic radiation force impulse imaging in pediatric patients with chronic kidney disease (CKD) and compare with healthy volunteers. Methods-Thirty-eight healthy volunteers and 30 pediatric CKD patients were enrolled in this prospective study. The shear wave velocity (SW) values of both kidneys in CKD patients and healthy volunteers were evaluated. Results-The mean SW in healthy volunteers was 2.2160.34 m/s, whereas the same value was 1.81 +/- 0.49, 1.72 +/- 0.63, 1.66 +/- 0.29, 1.48 +/- 0.37, and 1.23 +/- 0.27 for stages 1, 2, 3, 4, and 5 in CKD patients, respectively. The SW was significantly lower for each stage in the CKD patients compared with healthy volunteers. Acoustic radiation force impulse could not predict the different stages of CKD, with the exception of stage 5. The cut-off value for predicting CKD was 1.81 m/s; at this threshold, sensitivity was 76.5% and specificity was 92.1% (area under the curve = 0.870 [95% confidence interval: 0.750-0.990]; P < .001). Interobserver agreement expressed as intraclass coefficient correlation was 0.65 (95% confidence interval: 0.34 to 0.83; P < .001). Conclusions-Acoustic radiation force impulse may be a potentially useful tool in detecting CKD in pediatric patients.

Amaç: Bu çalışmada sentetik bir kannabinoid olan Bonzai’nin hastaların solunum parametreleri üzerine etkisini değerlendirdik. Gereç ve Yöntem: Aralık 2013 ile Aralık 2014 arasında Samsun Eğitim ve Araştırma Hastanesi Acil Servisi’nde takip edilen ve Bonzai kullanım öyküsü olan 52 hastanın tıbbi kayıtları retrospektif olarak incelendi. Hastalar ilaç alımından hastaneye başvuru arası geçen süre, semptomlar, vital bulgular, fizik muayene bulguları, arteriyel kan gazı analizi ve diğer laboratuvar testleri ile değerlendirildi. Bulgular: Ortalama hastaneye başvuru süresi 89.7±57.8 (Min. : 30; Max.:250) dakikaydı. En sık görülen semptomlar 23 hastada (44.2%) bozulmuş mental durum, 13 hastada (25.0%) ajitasyon, 12 hastada (23.0%) halüsinasyonlar, 8 hastada (15.4%) ataksi, 2 hastada (3.8%) bulantı ve kusmaydı. Bradipne tüm hastalarda mevcuttu. Bununla uyumlu olarak tüm hastaların kan gazı analizlerinde hiperkapni ve hipoksi saptandı. Ortalama parsiyel oksijen basıncı (PaO2), parsiyel karbondioksit basıncı (PaCO2) ve alveolar-arteriyel oksijen gradient (A-a O2) değerleri sırasıyla 67.6±29.8 mmHg, 50.4±8.6 mmHg ve 19.4±26.6 mmHg olarak bulundu. Hastaneye başvuru süresi ile kan gazı değerleri arasında istatiksel olarak ters bir ilişki saptandı (p=0,001). Sonuç: Sentetik bir kannabinoid Bonzai kullanım öyküsü ile acil servise başvuran hastalarda solunum depresyonu çok sıktır. Hastaların erken oksijenizasyon ve repiratuvar destek açısından değerlendirilmesi önemlidir Purpose: We aimed to evaluate the effects of Bonsai, a synthetic cannabinoid, on patients’ respiratory parameters. Materials and Methods: We retrospectively reviewed the medical records of 52 patients who admitted emergency department (ED) of Samsun Training and Research Hospital between December 2013 and December 2014 after self-reported Bonsai use. We assessed the time from intake to admission, symptoms, physical examination findings, vital signs, arterial blood gas analysis and other laboratory tests at presentation. Results: The mean time to admission was 89.7±57.8 (Min.:30; Max.:250) minutes. The most common symptom was an altered mental state in 23 patients (44.2%), followed by agitation in 13 patients (25.0%), ataxia in 12 patients (23.0%), hallucinations in 8 patients (15.4%) and nausea and vomiting in 2 patients (3.8%). Bradipne was the common finding in all patients. Also, hypoxia and hypercapnia were detected in arterial blood gas analysis of all patients. In addition the alveolar-arterial oxygen gradient levels (A-a O2) were also elavated. The mean partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2) and A-a O2 gradient values were 67.6±29.8 mmHg, 50.4±8.6 mmHg and 19.4±26.6 mmHg, respectively. There was an inverse relationship between the time from intake to admission and parameters of blood gas analysis. (p=0,001) Conclusion: Clinicians should be aware of the importance of early blood gas analysis and respiratory depression in order to provide early oxygenation and respiratory support in patients admitted to the ED as a result of synthetic Cannabinoid/Bonsai use.

BAYDIN, AHMET/0000-0003-4987-0878 WOS: 000376693400024 Introduction: An index for Pulmonaty Artery Computed Tomography Index Ratio (PACTOIR) may have important prognostic and therapeutic implications and as well as providing a standard to evaluate thrombolytic therapy response. The aim of this study was to determine whether PACTOIR predict the thrombolytic therapy in the treatment of pulmonary embolism (PE). Materials and methods: This retrospective study was conducted by reviewing charts of 52 patients (aged >= 18 years) who were admitted to our emergency department (ED) with initial diagnosis of pulmonary embolism and confirmed diagnosis of PE by Computed Tomography Pulmonary Angiography (CPTA). The patients were divided into two groups as follows: Group 1 (n=14) consisted of the patients who received thrombolytic therapy and Group 2 (n=38) consisted of the patients who did not receive thrombolytic therapy. PACTOIR was calculated in both groups to estimate thrombus load. We evaluated the effectiveness of thrombolytic therapy by comparing the levels of D-dieter and Troponin I. Results: Mean value for PACTOIR, D-dimer and Troponin I levels were 56.4 (%), 6.21 (mg/L) and 0.35 (mu g-IL) in Group 1 whereas they were 20.46 (%), 220 (mg/L) and 0.11 (mu g/L) in Group 2, respectively. Significant difference was detected between Group 1 and Group 2 (p

Sağlık alanında bireylerin sağlam olup olmadıklarını belirlemek amacı ile kullanılan laboratuartekniklerine, klinik gözlemlere veya çeşitli ölçümlere bağlı olarak karara erişilen değerlendirme kurgularına tanı testleri denir. Olgulardan elde edilen ölçümlerin, eşik değerininaltında veya üstünde yer alması ile pozitif veya negatif tanı konur. İşlem Karakteristik (Receiver Operating Characteristic) Eğrisi, farklı eşik değerleri için hesaplanan, dikey eksen üzerinde doğru pozitiflik (duyarlılık) ve yatay eksen üzerinde yanlış pozitiflik (1- özgüllük) oranlarının yer aldığı bir grafiktir. ROC eğrisinin altında kalan alan (Area Under Curve), tanı testlerinin üstünlüğü için bir karşılaştırma ölçeği olarak kullanılır. AUC ne kadar büyük ise, hastalık durumunun tahmin edilmesinde söz konusu test, o kadar iyi bir tanı testidir. AUC tahmininde genellikle iki yöntem kullanılır. Bunlar binormal ve nonparametrik yöntemlerdir. Bu derlemenin amacı, ROC eğrileri, AUC ve tahmin yöntemleri hakkında bilgi vermek ve bir hipotez testinde kullanılan iki tanı testine ait AUC’lerin karşılaştırmalarını irdelemektir.The evaluative operations used to make a decision depending on laboratory techniques, clinical observations or various measurements to determine if individuals are healthy or not are called diagnostic tests. A positive or negative diagnosis is made by comparing the measurement with a cutoff value. A receiver operating characteristic (ROC) curve shows the characteristics of a diagnostic test by graphing the false-positive rate (1-specificity) on the horizontal axis and the true-positive rate (sensitivity) on the vertical axis for various cutoff values. The area under of a ROC curve (AUC) is a popular measure for the accuracy of a diagnostic test. A diagnostic test which has a larger AUC makes a better predict for the existence of a disease. Two methods are used to widely estimate the AUC. These include the binormal and the empirical (nonparametric) methods. The purpose of this paper is to give a reviewed information about the research of ROC curves, AUC, estimation methods and to compare AUC of two diagnostic tests using a hypothesis test.