Risk of burns in pressure cooker usage: a comprehensive analysis of explosive injuries

BACKGROUND

Despite the widespread use of pressure cookers for quick and efficient cooking, literature has insufficiently highlighted the potential dangers resulting from inappropriate handling. This study aims to provide a comprehensive overview of 32 patients who presented with pressure cooker burns, emphasizing the serious risks associated with their misuse.

METHODS

Retrospective data were collected from patients admitted to Bağcılar Training and Research Hospital Burn Center between 2017 and 2020 with pressure cooker burns in Türkiye. Data encompassed patient characteristics, burn causes, locations, severities, treatments, and clinical outcomes.

RESULTS

The study included 32 patients (29 female/3 male) with a mean age of 42.3 (8-83). Patients were categorized based on burn areas, revealing associated injuries such as ocular (34.3%) and ear injuries (6.25%). The average hospital stay was 10.5 days [2-37]. While five pressure cookers exploded due to product-related issues, 26 explosions resulted from user errors (15.6%/81.2%). Importantly, no mortality was observed among the patients.

CONCLUSION

While pressure cookers facilitate rapid food preparation, this study underscores the severe risks arising from product or usage errors. This study emphasizes the need for more effective usage instructions and increased awareness about pressure cookers to prevent burn risks. We anticipate that educational programs focused on safe pressure cooker use could significantly reduce the incidence of serious injuries.

Investigation of the potential of miRNA candidates as non-invasive biomarkers for the diagnosis and follow-up of colorectal cancer

BACKGROUND

Colorectal cancer (CRC) is the third most common cancer worldwide, and despite advances in treatment, molecular biomarkers are needed for both early diagnosis and prognosis monitoring. It is known that microRNAs (miRNA), one of the epigenetic mechanisms, are effective in the initiation and development of cancer by regulating the activity of tumor suppressors and/or oncogenes. In this study, the potential of the molecules let-7, miRNA125b, and miRNA30a, which are known to play a role in cellular processes, as biomarkers for colorectal cancer and their molecular mechanisms were investigated in this model. The aim was to evaluate the diagnostic, prognostic, and predictive utility of the target miRNAs in colorectal cancer patients.

MATERIAL AND METHODS

The expression changes of miRNAs let-7, miRNA125b, and miRNA30a were investigated by miRNAs isolation and cDNA synthesis from the serum samples of 60 patients diagnosed with CRC or from the serum samples of 20 healthy individuals. The calculation was performed using the quantitative real-time polymerase chain reaction method to determine the expression level. The results were compared with clinical parameters.

RESULT

An 8-fold decrease in the expression of let-7 and miRNA125b and a 60-fold decrease in the expression of miRNA30a were found in the serum samples of patients diagnosed with colorectal cancer (CRC) compared to the healthy group. A decrease in let-7 was observed in 53.3%, miRNA125b in 58.3%, and miRNA30a in 55% of patients. A significant correlation was found between the reduced expression status and the stage, lymph nodes, local recurrence, and metastasis (p < 0.05). The ROC analysis showed that the miRNA30a level could be a diagnostic biomarker for CRC (p < 0.001). No significant impact of target miRNA expression changes on overall disease survival was observed.

CONCLUSION

It is thought that the target miRNA30a can be used for early diagnosis and screening and that the target miRNA let-7, miRNA125b, and miRNA30a can be used as non-invasive biomarkers for disease follow-up, with larger patient studies being conducted on CRC patients.

Rider sitting position widens lumbar intervertebral distance: a prospective observational study

BACKGROUND

Reduced lumbar lordosis may make the process of identifying the intervertebral distance easier. The primary aim of this study was to measure the L3...L4 intervertebral space in the same patients undergoing spinal anesthesia in three different sitting positions, including the classic sitting position (CSP), hamstring stretch position (HSP) and rider sitting position (RSP). The secondary aim was to compare ultrasonographic measurements of the depth of the ligamentum flavum and intrathecal space in these three defined positions.

METHODS

This study is a single-blinded, prospective, randomized study. Ninety patients were included in final analysis. the patients were positioned on the operating table in three different positions to perform ultrasonographic measurements of the spinal canal. The intervertebral distance (IVD), the distance between the skin and the ligamentum flavum (DBSLF) and the intrathecal space (IS) were measured in the L3...L4 intervertebral space in three different positions.

RESULTS

The RSP produced the largest mean distance between the spinous processes. The RSP yielded a significantly larger IVD than did the CSP (p < 0.001) and HSP (p < 0.001). The DBSP was larger in the CSP than in the HSP (p = 0.001). The DBSLF was significantly larger in the RSP than in the HSP (p = 0.009).

CONCLUSIONS

Positioning the patient in the RSP significantly increased the intervertebral distance between L3...L4 vertebrae compared to the CSP and HSP, suggesting easier performance of lumbar neuraxial block.

Push and Pull Factors of Why Medical Students Want to Leave Türkiye: A Countrywide Multicenter Study

Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians' migration decisions are still unclear. Despite its wide coverage in the media and among physicians in Türkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in Türkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in Türkiye in 2022. Besides participants' migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in Türkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research & Development were 1.37 (95% CI: 1.22-1.54) times more likely to emigrate. The push factor that was related to emigration intention was the "working conditions in the country" (OR: 1.89, 95% CI: 1.56-2.28) whereas the "social environment/lifestyle abroad" was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45-2.06). In addition, the quality problem in medical schools also had a significant impact on students' decisions (OR: 2.20, 95% CI: 1.83-2.65). Insights: Although the percentage of those who want to emigrate "definitely" was at the same level as in the other developing countries, the tendency to migrate "permanently" was higher in Türkiye. Improving working conditions in the country and increasing the quality of medical faculties seem vital in preventing the migration of physicians.

Anticancer Effects of Urtica Dioica in Breast Cancer

Objective:

The goal of this study is to look into the antiproliferative capabilities of Urtica Dioica (UD) on breast cancer.

Methods:

The cytotoxicity of UD extracts against breast cancer cell lines was investigated. Flow cytometry analyses were used to investigate in vitro apoptosis of breast cancer cells using Annexin V labeling. In vivo tests also performed.

Results:

UD showed cytotoxicity to three cancer cell lines. The number of Annexin-positive cells was higher in UD-treated cell lines than in untreated control cells. When compared to the untreated control group, the rats treated with UD had greater expressions of caspase 3, p53 protein, and TUNEL positive cells. When compared to the control group, Ki-67 expression was reduced in the treatment groups. In vivo tests revealed that, when compared to untreated rats, the mean tumor volume inhibition ratio in the UD group was 38 percent.

Conclusion:

These findings suggest that Urtica Dioica may have antitumoral properties in the treatment of breast cancer.

The importance of body core temperature evaluation in balneotherapy

It is not wrong to say that there are no application standards or best practices in balneotherapy considering traditional applications. There is not enough information about how changes in body temperature, duration, and frequency of exposure to heat affect therapeutic outcomes of balneotherapeutic applications. Body core temperature (BCT) is probably the best parameter for expressing the heat load of the body and can be used to describe the causal relationship between heat exposure and its effects. There are several reasons to take BCT changes into account; for example, it can be used for individualized treatment planning, defining the consequences of thermal effects, developing disease-specific approaches, avoiding adverse effects, and designing clinical trials. The reasons why BCT changes should be considered instead of conventional measures will be discussed while explaining the effects of balneotherapy in this article, along with a discussion of BCT measurement in balneotherapy practice.

A review on the application of nanoporous zeolite for sanitary landfill leachate treatment

This review deals with low-cost nanoporous zeolites for the treatment of sanitary landfill leachate. Organic contaminants and ammoniacal nitrogen are significant parameters in landfill leachate treatment. Adsorption processes are regarded as promising alternative treatment options in this respect. Zeolites are aluminosilicate materials that are widely used in separation, filtration, adsorption and catalysis. Natural zeolite is a low-cost and readily available form of zeolite and is a promising candidate to be used as an ion-exchange material for ammonia and other inorganic pollutant removal from landfill leachate. In this review, adsorption isotherms and kinetic models in batch systems are evaluated and adsorption design parameters of the fixed-bed system are presented. Studies on ammonia removal from landfill leachate via zeolites have been thoroughly investigated. Leachate treatment systems combined with zeolites are presented. Cost of zeolites are also reported in comparison with other adsorbents. The investigated studies demonstrate that activated zeolite can improve the removal of chemical oxygen demand, NH₃-N and colour significantly compared to the case where raw zeolite is used. Moreover, the composite of activated carbon and zeolite is also favorable for ammonia removal according to reported findings, where best adsorptive removal is attained on the composite media (24.39 mg/g).

Spinal anesthesia and infraclavicular brachial plexus block for upper extremity reconstruction requiring grafting

Combined use of upper limb blocks in the same surgery with lower limb central blocks is rarely performed due to the risk of systemic toxicity of local anesthetics. Therefore, general anesthesia is generally preferred in such surgeries. However, the use of ultrasound provides reliable anesthetic accumulation around the nerves, thereby reducing the need for local anesthetics, furthermore local anesthetic is used in spinal anesthesia compared to epidural anesthesia is much less.

The effect of parental age on NF1 patients in Turkey

Neurofibromatosis type 1 (NF1) is the most common neurogenetic disorder worldwide, and its clinical presentations are highly variable. NF1 is caused by mutations in the NF1 gene, and 50% of NF1 cases are sporadic, which occur in the absence of a family history of the disease and usually result from a new mutation in the germline of a parent. Advanced paternal age may increase the risk for germinal NF1 mutations; however, some dominant conditions, including neurofibromatosis, have shown a lesser association with paternal age, although there are conflicting reports in the literature. We investigated the effects of paternal and maternal age in 241 NF1 patients (121 sporadic and 120 familial cases) who were seen in Hacettepe hospital, a reference center for genetic diseases in Turkey. For statistical analysis, Spearman's and Chi-square tests were used. In this study, we evaluated paternal and maternal age at birth in sporadic and familial cases of NF1. We also compared the effect of parental age on the appearance and coexistence of various NF1 symptoms. There were no significant statistical differences between paternal age and coexistence of the NF1 symptoms. However, a slightly negative correlation was observed between paternal age and the coexistence of NF1 symptoms in familial cases (p < 0.05). We did not find strong evidence for the effect of parental age on the clinical severity of NF1.

Could edaravone prevent gentamicin ototoxicity? An experimental study

OBJECTIVES

Clinical application of gentamicin may cause nephrotoxicity and ototoxicity. Our study is the first study to investigate the protective effects of edaravone against the gentamicin-induced ototoxicity. We investigated the protective effect of intraperitoneal (i.p.) edaravone application against gentamicin-induced ototoxicity in guinea pigs.

METHODS

Fourteen guinea pigs were divided into two equal groups consisting of a control group and a study group. One-hundred sixty milligrams per kilogram subcutaneous gentamicin and 0.3 mL i.p. saline were applied simultaneously once daily to seven guinea pigs in the control group (group 1). One-hundred sixty milligrams per kilogram gentamicin was applied subcutaneously and 3 mg/kg edaravone was applied intraperitoneally once daily for 7 days simultaneously to seven guinea pigs in the study group (group 2). Following the drug application, auditory brainstem response measurements were performed for the left ear on the 3rd and 7th days.

RESULTS

Hearing threshold values of the group 1 and group 2 measured in the 3rd day of the study were detected as 57.14 ± 4.88 and 82.86 ± 7.56, respectively. This difference was statistically significant ( p < 0.05). Hearing threshold values of the group 1 and group 2 measured in the 7th day of the study were detected as 87.14 ± 4.88 and 62.86 ± 4.88, respectively. This difference was statistically significant ( p < 0.05).

CONCLUSION

A statistically significant difference between the average threshold values of edaravone-administered group 2 and that of group 1 without edaravone was found. These differences show that systemic edaravone administration could diminish ototoxic effects of gentamicin and the severity of the hearing loss.

Chemopreventive effects of hydatid disease on experimental breast cancer

Breast cancer is one of the most common and letal cancers in all over the world. Since there have been significant improvements in treatment of breast cancer, there is still a big need for alternative approaches. In this study, we aimed to investigate protective role of hydatid disease against breast cancer. Twenty Wistar rats were divided into two groups of 10 rats each Group I (control) and Group II. In Group II intraperitoneal hydatidosis was performed. Then DMBA was applied to mammary tissues of all rats. Immunohistochemistry studies for Ki-67 and S-100 in the tumoral tissue sections of DMBA induced mammary tumor in rats were performed. TUNEL Assay was used to detect apoptotic cells of tumoral tissue. In vivo anticancer activity testing was carried out by preventing the tumorigenesis by DMBA in mammary tissue of rats. The expressions of the Ki-67 and S-100 protein decreased in rats who had Hydatid Disease (HD) (Group II), compared with the control rats (Group I). TUNEL positive cells were higher in rats with HD (Group II), compared with the control rats (Group I). In vivo studies showed that HD prevented the tumorigenesis by DMBA in mammary tissue of rats with 50 percent.In the light of the evidence the present study showed that HD may have chemopreventive effects on DMBA induced breast cancer.

Does addition of 'mud-pack and hot pool treatment' to patient education make a difference in fibromyalgia patients? A randomized controlled single blind study

The aim of this randomized controlled single-blind study is to explore whether addition of mud-pack and hot pool treatments to patient education make a significant difference in short and mild term outcomes of the patients with fibromyalgia. Seventy women with fibromyalgia syndrome were randomly assigned to either balneotherapy with mud-pack and hot pool treatments (35) or control (35) groups. After randomization, five patients from balneotherapy group and five patients from control group were dropped out from the study with different excuses. All patients had 6-h patient education programme about fibromyalgia syndrome and were given a home exercise programme. The patients in balneotherapy group had heated pool treatment at 38 °C for 20 min a day, and mud-pack treatment afterwards on back region at 45 °C. Balneotherapy was applied on weekdays for 2 weeks. All patients continued to take their medical treatment. An investigator who was blinded to the intervention assessed all the patients before and after the treatment, at the first and the third months of follow-up. Outcome measures were FIQ, BDI and both patient's and physician's global assessments. Balneotherapy group was significantly better than control group at after the treatment and at the end of the first month follow-up assessments in terms of patient's and physician's global assessment, total FIQ score, and pain intensity, fatigue, non-refreshed awaking, stiffness, anxiety and depression subscales of FIQ. No significant difference was found between the groups in terms of BDI scores. It is concluded that patient education combined with 2 weeks balneotherapy application has more beneficial effects in patients with fibromyalgia syndrome as compared to patient education alone.

Effects of the Pringle manoeuvre on the healing of left colonic anastomoses in rats

BACKGROUND

Whether to perform colorectal cancer and liver metastasis resections simultaneously or in separate procedures is controversial. The aim of the present study was to investigate the effect of the Pringle manoeuvre on the healing of left-sided colonic anastomoses in rats.

METHODS

Sixteen rats were randomly separated into two groups. In Groups 1 and 2, 1 cm of descending colon was resected and a primary anastomosis was performed. In Group 2, an intermittent pedicle clamp (the Pringle manoeuvre) was performed. On postoperative day 5, laparotomy was performed and the bursting pressures of all colon anastomoses were determined. Tissues were sampled for assay of hydroxyproline levels. Cultures of intraperitoneal swabs were also performed.

RESULTS

Clostridium was twice as abundant in the Pringle manoeuvre group as in the control group (p < 0.05). Anastomosis-bursting pressures and tissue hydroxyproline levels were significantly lower in the Pringle manoeuvre group than in the control group (p < 0.05).

CONCLUSIONS

The Pringle manoeuvre may compromise the viability of colonic anastomoses.

Effects of tyrosine kinase inhibitor E7080 and eNOS inhibitor L-NIO on colorectal cancer alone and in combination

OBJECTIVE

To investigate the effects of E7080 and N (5)-(1-iminoethyl)-L-ornithine dihydrochloride (L-NIO) on colorectal cancer alone and in combination.

METHODS

HT29 colorectal cancer cell line from Sap Institute was used. Real-time cell analysis (xCELLigence system) was performed to determine the effects of E7080 and L-NIO on colorectal cell proliferation. While apoptosis was determined with Annexin V staining, and the effect of agents on angiogenesis was determined with chorioallantoic membrane (CAM) model.

RESULTS

We found that E7080 has a strong antiproliferative effect with an half maximum inhibition of concentration (IC50) value of 5.60×10(-8) mol/L. Also it has been observed that E7080 showed antiangiogenic and apoptotic effects on HT29 colorectal cancer cells. Antiangiogenic scores of E7080 were 1.2, 1.0 and 0.6 for 100, 10 and 1 nmol/L E7080 concentrations, respectively. Furthermore, apoptosis has been detected in 71% of HT29 colorectal cancer cells after administration of 100 nmol/L E7080 which may indicate strong apoptotic effect. Meanwhile administration of L-NIO alone did not show any effect, but the combination of E7080 with L-NIO increased the antiproliferative, antiangiogenic and apoptotic effects of E7080.

CONCLUSIONS

Results of this study indicate that E7080 may be a good choice in treatment of colorectal tumors. Furthermore the increased effects of E7080 when combined with L-NIO raise the possibility to use a lower dose of E7080 and therefore avoid/minimize the side effects observed with E7080.

Hematological presentation in systemic lupus erythematosus and its relationship with disease activity

Abnormalities of hematological system are very common in systemic lupus erythematosus (SLE). The aim of the study is to evaluate hematological findings in patients with SLE at the time of referral and their relationship with disease activity and organ involvement. The study was carried consecutive 115 patients, including 20 males and 85 females. Most of the cases had anemia at the time of presentation due to various etiologies. Anemia of chronic disease was seen in 46% and it was the most common encountered picture. The rate of hemolytic anemia was 28%, and Coombs' positivity rate was 22% among our patients. Leukopenia ( < 4.0 x 10(9)/l), neutropenia ( < 1.8 x 10(9)/l), and lymphopenia ( < 1.5 x 10(9)/l) rates were 57, 20, and 82%, respectively. Thrombocytopenia was seen in 40% for < 150 x 10(9)/l, 26% for < 100 x 10(9)/l, and 8% for < 50 x 10(9)/l. Of our patients, 10% had antiphospholipid syndrome (APS) at the time of diagnosis. Increased fibrinogen levels were observed in 35% without relating to disease activity. The rates of C3 and C4 hypocomplementemia were 86 and 64%, respectively, and both are closely correlated with the disease activity. Moreover, C3 hypocomplementemia was more prominent in cases with renal or serosal involvement. Leukopenia and hyperfibrinogenemia were more common in patients with skin/mucosal involvements. C3 hypocomplementemia, APS and elevated IgG levels were more common in our patients with renal involvement. SLE should be kept in mind while evaluating patients with mentioned hematological findings, especially in those with accompanying organ involvements.

Antitumoral effects of Melissa officinalis on breast cancer in vitro and in vivo

BACKGROUND

There is a long standing interest in the identification of medicinal plants and derived natural products for developing cancer therapeutics. Here we investigated the antiproliferative properties of Melissa officinalis (MO) from Turkey on breast cancer.

METHODS

MO extracts were studied for cytotoxicity against breast cancer cell lines (MCF-7, MDA-MB-468 and MDA-MB-231). In vitro apoptosis studies were performed by annexin V staining and flow cytometry analyses. Immunohistochemistry for Ki-67 and caspase 7 in the tumoral tissue sections of DMBA-induced mammary tumors in rats was also performed, along with TUNEL assays to detect apoptotic cells. In vivo anticancer activity testing was carried out with reference to inhibition of growth of DMBA induced mammary tumors in rats.

RESULTS

MO showed cytotoxicity against three cancer cell lines, inducing increase in Annexin-positive cells. Expression of caspase-7 protein and TUNEL positive cells were much higher in rats treated by MO, compared with the untreated control group, while expression of Ki-67 was decreased. Furthermore, in vivo studies showed that mean tumor volume inhibition ratio in MO treated group was 40% compared with the untreated rats.

CONCLUSION

These results indicated that MO extrcts have antitumoral potential against breast cancer.

Antitumor effects of Origanum acutidens extracts on human breast cancer

PURPOSE

There has been a long-standing interest in the identification of medicinal plants and derived natural products for developing anticancer agents. This work aimed at investigating the antiprolipherative properties of Origanum acutidens (OA) on breast cancer.

METHODS

OA water extracts were studied for cytotoxicity against the breast cancer cell lines MCF-7, MDA-MB-468 and MDA-MB-231. In vitro apoptosis studies of these cancer cell lines were performed by annexin V staining in flow cytometry analyses. Immunohistochemistry studies for Ki-67 and caspase-7 of tumor tissue sections of dimethylbenzanthracene (DMBA) -induced mammary cancer in rats were also performed. TUNEL assay was used to detect apoptotic cells of tumor tissue. In vivo anticancer activity testing was carried out by inhibiting the growth of DMBA-induced mammary cancer in rats.

RESULTS

OA showed cytotoxicity on all 3 cancer cell lines. Annexin-positive cells level in OA-treated cell lines were significantly higher compared with untreated control cells (p=0.002). The expressions of caspase-7 protein and TUNEL-positive cells were much higher for the rats treated by OA, compared with the untreated control group (p<0.05). The expressions of the Ki-67 decreased in the treated groups compared with the control group (p<0.05). In vivo studies showed that the mean tumor volume inhibition ratio in OA-treated group was 41 % compared with the untreated rats (p<0.05).

CONCLUSION

These results indicate that OA has antitumor activity against breast cancer cell lines.

Effects of cannabinoid agonists on sheep sphincter of oddi in vitro

BACKGROUND/AIMS

According to recent studies, the endocannabinoid system plays an important role in both physiological and pathophysiological situations. The purpose of the present study was to investigate the effects of cannabinoid (CB) agonists on isolated sheep sphincter of Oddi (SO)in vitro.

METHODS

The isolated sheep SO tissues were mounted in organ baths and tested for isometric tension and cyclic GMP levels (cGMP) in response to the non-selective CB receptor agonist WIN 55,212-2 and the potent CB1 receptor agonist methanandamide in the presence and absence of the selective CB1 antagonist SR 141716A, the selective CB2 antagonist SR 144528 and the nonspecific inhibitor of nitric oxide (NO) synthase L-NAME.

RESULTS

CB agonists relaxed SO in a concentration-dependent manner. These relaxations did not reduce in the presence of SR 144528 but were significantly reduced by SR 141716A and L-NAME. Carbachol significantly increased the cGMP levels compared with the control group and both of the CB receptor agonists significantly increased the cGMP levels compared with the control and carbachol groups. On the other hand, L-NAME prevented the increase in cGMP levels caused by CB agonists.

CONCLUSION

These results show that the relaxation by the agonists may be through CB1 receptors. The decrease of CB relaxation responses by L-NAME, a nonspecific inhibitor of NO synthase, and the increase of cGMP levels in the SO tissues by CB agonists which decreased by L-NAME show that the relaxation effects of these agonists may also partially be via increasing the NO synthesis or release.

Balneotherapy in fibromyalgia: a single blind randomized controlled clinical study

We aimed to evaluate the effectiveness of balneotherapy in fibromyalgia management. Fifty women with fibromyalgia under pharmacological treatment were randomly assigned to either the balneotherapy (25) or the control (25) group. Four patients from the balneotherapy group and one patient from the control group left the study after randomization. The patients in the balneotherapy group (21) had 2 thermomineral water baths daily for 2 weeks in Tuzla Spa Center. The patients in the control group (24) continued to have their medical treatment and routine daily life. An investigator who was blinded to the study arms assessed the patients. All patients were assessed four times; at the beginning of the study, at the end of the 2nd week, the 1st month, and the 3rd month after balneotherapy. Outcome measures of the study were pain intensity, Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), patient's global assessment, investigator's global assessment, SF-36 scores, and tender point count. Balneotherapy was found to be superior at the end of the cure period in terms of pain intensity, FIQ, Beck Depression Inventory, patient's global assessment, investigator's global assessment scores, and tender point count as compared to the control group. The superiority of balneotherapy lasted up to the end of the 3rd month, except for the Beck Depression Inventory score and the investigator's global assessment score. Significant improvements were observed in PF, GH, and MH subscales of SF-36 during the study period in the balneotherapy group; however, no such improvement was observed in the control group. Balneotherapy was superior only in VT subscale at the end of therapy and at the end of the third month after the therapy as compared to the controls. It was concluded that balneotherapy provides beneficial effects in patients with fibromyalgia.

A destructive urban transformation project resulting with a social transformation process in Ankara-Turkey

Introduction

Dikmen Valley is a slum district where the Municipality of Ankara intended to start an urban transformation project. Dikmen neighborhood includes nearly 1000 houses which the Municipiality attempted to pull down suddenly at night in the winter of 2007.

Residents of Dikmen Valley resisted and managed to stop this attempt. Whole event was experienced as an acute trauma as well as a continuous experience of anxiety because of ongoing risk of another attack.

Aim

The aim of the present study was to investigate the psychological consequences of the whole process.

Methods

The study sample consisted of 201 individuals from 106 households, and a total of 178 individuals from 102 households was taken as comparison group from another slum neighborhood where residents did not experience any threat to their houses. The Beck Depression Inventory, the Spielberger Trait Anxiety Scale, and the General Self-Efficacy Scale were used for assessment.

Results

Dikmen sample was found to have a statistically significant higher mean score of anxiety and depression compared to the comparison group. Dikmen had a higher level of general self-efficacy belief than the comparison group after controlling for depression and anxiety scores.

Conclusions

Although the traumatic process after an attack of pulling down and the threat of losing one's house resulted with a depressive state and anxiety in Dikmen residents, unexpectedly they had a high level of general self-efficacy. To the researchers’ observations, a social transformational process has been realized resulting with an overall high general self-efficacy level in Dikmen neighborhood.

Small bowel tumors in emergency surgery

BACKGROUND

The aim of the present study was to describe the clinical presentation, diagnostic work-up, surgical therapy, and prognosis of 13 patients with small bowel tumor admitted for surgical procedures in an emergency setting.

METHODS

From 1996 to 2008, 13 consecutive surgical cases of small bowel tumors were treated at the Cumhuriyet University Faculty of Medicine, Department of General Surgery, and Kütahya State Hospital, Department of General Surgery. Clinical and radiological charts of these patients were reviewed retrospectively from the department database.

RESULTS

Intestinal obstruction (7 cases) and perforation (5 cases) were the most common clinical presentations, followed by intussusception (1 case). Adenocarcinoma was the most frequent histologic type (4 cases), while small bowel sarcoma was seen in three cases and non-Hodgkin lymphoma in two cases. The remaining cases had carcinoid tumor, small bowel angioleiomyoma, Brunner's gland adenoma, and inflammatory pseudotumor of the small intestine.

CONCLUSION

Small bowel tumors are rare, the symptoms often non-specific, and the accuracy of different diagnostic tests remains to be improved. Timing and type of the intervention to the process and biological behavior of the pathological cells predict the prognosis.

Epigenetic inactivation of tumor suppressor SFRP2 and point mutation in KRAS proto-oncogene in fistula-associated mucinous type anal adenocarcinoma: report of two cases

The secreted frizzled-related proteins (SFRPs) genes are unmethylated in normal colorectal mucosa tissue but aberrant methylation profiles can be detected in colorectal cancer (CRC), adenomas, and in aberrant crypt foci. The aim of the current study was to clarify whether SFRP2 methylation and K-ras structural mutation in fecal DNA can be found in stool and tumoral tissues of individuals with fistula-associated mucinous type anal adenocarcinomas (MTAA).Two man patients (68 and 56 years old) were treated for anorectal fistula in the surgical department. Patients were evaluated for clinical findings, tumoural tissue samples were examined histopathologically and DNA from fecal and tumoral tissue samples were isolated. K-ras mutation and promoter hypermethylation of SFRP2 gene in tumoral tissues were assessed by methylation-specific PCR based stripAssay hybridisation technique (Me-PCR) and compared to the healthy controls. Fecal and tumoural tissue samples from both patients were found to be fully hypermethylated profiles for SFRP2 gene and combined point mutations were detected in codon 12 and 13 of K-ras proto-oncogene. The current results showed that the combined effects of somatic mutations in K-ras and epigenetic alterations in SFRP2 genes may play an active role in the development of mucinous type anal adenocarcinoma.

Levothyroxine versus ketotifen in the treatment of patients with chronic urticaria and thyroid autoimmunity

BACKGROUND

Thyroid hormone replacement therapy has previously been discussed as a feasible therapeutic approach in patients with chronic urticaria and/or angio-oedema (CUA) and thyroid autoimmunity (TA).

OBJECTIVE

The efficacy of levothyroxine was investigated in patients with CUA and TA by comparing it with ketotifen treatment.

METHODS

A total of 60 patients with CUA and TA were included in the study. Patients were divided into two groups, which were matched with respect to sex, age and symptom score. Each group consisted of 30 patients. Patients in one group were treated with ketotifen and the other with levothyroxine. After completion of the treatment periods, the pre- and post-treatment symptom scores, onset time of drug effects, duration of symptom-free period, recurrence ratios, recurrence times and side effects were evaluated for each drug. The two drugs were compared with each other according to these parameters.

RESULTS

Ketotifen treatment provided significant relief of symptoms. However, these beneficial effects were observed only in ongoing treatment. Symptoms reappeared in all patients during the drug-free follow-up period. On the other hand, 18 of 30 patients were completely improved and three patients partially improved with levothyroxine treatment. Symptoms did not recur in the completely improved patients.

CONCLUSION

Levothyroxine is an important and inexpensive treatment alternative in patients with CUA and TA.

Feasibility analysis of color removal from textile dyeing wastewater in a fixed-bed column system by surfactant-modified zeolite (SMZ)

In this study, the ability of surfactant-modified zeolite (SMZ) to remove color from real textile wastewater was investigated. Tests were performed in a fixed-bed column reactor and the surface of natural zeolite was modified with a quaternary amine surfactant hexadecyltrimethylammonium bromide (HTAB). The zeolite bed that was modified at 1 g L(-1) HTAB concentration and HTAB flow rate of 0.015 L min(-1) showed good performance in removing color. Effects of wastewater color intensity, flow rates and bed heights were also studied. Wastewater was diluted several times in the ratios of 25%, 50% and 75% in order to assess the influence of wastewater strength. The breakthrough curves of the original and diluted wastewaters are dispersed due to the fact that breakthrough came late at lower color intensities and saturation of the bed appeared faster at higher color intensities. The column had a 3-cm diameter and four different bed heights of 12.5, 25, 37.5 and 50 cm, which treated 5.25, 19.50, 35.25 and 51 L original textile wastewater, respectively, at the breakthrough time at a flow rate of 0.025 L min(-1). The theoretical service times evaluated from bed depth service time (BDST) approach for different column variables. The calculated and theoretical values of the exchange zone height were found with a difference of 27%. The various design parameters obtained from fixed-bed experimental studies showed good correlation with corresponding theoretical values, under different bed heights. The regeneration of the SMZ was also evaluated using a solution consisting of 30 g L(-1) NaCl and 1.5 g L(-1) NaOH at pH 12 and temperature 30 degrees C. Twice-regenerated SMZ showed the best performance compared with the others while first- and thrice-regenerated perform lower than the original SMZ.

Color removal from textile dyebath effluents in a zeolite fixed bed reactor: determination of optimum process conditions using Taguchi method

Taguchi method was applied as an experimental design to determine optimum conditions for color removal from textile dyebath house effluents in a zeolite fixed bed reactor. After the parameters were determined to treat real textile wastewater, adsorption experiments were carried out. The breakthrough curves for adsorption studies were constructed under different conditions by plotting the normalized effluent color intensity (C/C(0)) versus time (min) or bed volumes (BV). The chosen experimental parameters and their ranges are: HTAB concentration (C(htab)), 1-7.5 gL(-1); HTAB feeding flowrate (Q(htab)), 0.015-0.075 L min(-1); textile wastewater flowrate (Q(dye)), 0.025-0.050 L min(-1) and zeolite bed height (H(bed)), 25-50 cm, respectively. Mixed orthogonal array L(16) (4(2)x2(2)) for experimental plan and the larger the better response category were selected to determine the optimum conditions. The optimum conditions were found to be as follows: HTAB concentration (C(htab))=1g L(-1), HTAB feeding flowrate (Q(htab))=0.015 L min(-1), textile wastewater flowrate (Q(dye))=0.025 L min(-1) and bed height (H(bed))=50 cm. Under these conditions, the treated wastewater volume reached a maximum while the bed volumes (BV) were about 217. While HTAB concentration, gL(-1) (A); zeolite bed height, cm (D) and wastewater flowrate, L min(-1) (C) were found to be significant parameters, respectively, whereas, HTAB flowrate, L min(-1) (B) was found to be an insignificant parameter.

Performance of emergency medicine residents in the interpretation of radiographs in patients with trauma

BACKGROUND

Radiographs are vital diagnostic tools that complement physical examination in trauma patients. A study was undertaken to assess the performance of residents in emergency medicine in the interpretation of trauma radiographs.

METHODS

348 radiographs of 100 trauma patients admitted between 1 March and 1 May 2007 were evaluated prospectively. These consisted of 93 cervical spine (C-spine) radiographs, 98 chest radiographs, 94 radiographs of the pelvis and 63 computed tomographic (CT) scans. All radiological material was evaluated separately by five emergency medicine residents and a radiology resident who had completed the first 3 years of training. The same radiographs were then evaluated by a radiologist whose opinion was considered to be the gold standard. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated.

RESULTS

The mean (SE) age of the patients was 29 (2) years (range 2-79). There were no statistically significant differences in terms of pathology detection between the emergency medicine residents and the radiologist. The agreement between the emergency medicine residents and the radiology resident was excellent for radiographs of the pelvis and the lung (kappa (kappa) = 0.928 and 0.863, respectively; p<0.001) and good for C-spine radiographs and CT scans (kappa = 0.789 and 0.773, respectively; p<0.001).

CONCLUSIONS

Accurate interpretation of radiographs by emergency medicine residents who perform the initial radiological and therapeutic interventions on trauma patients is of vital importance. The performance of our residents was found to be satisfactory in this regard.

Reduced dose of lenograstim is as efficacious as standard dose of filgrastim for peripheral blood stem cell mobilization and transplantation: a randomized study in patients undergoing autologous peripheral stem cell transplantation

In vitro studies have demonstrated a 27% increased efficacy of lenograstim over filgrastim. However, equal doses of 10 microg/kg/day of filgrastim and lenograstim have been recommended for mobilization of CD34+ cells without associated chemotherapy. In this study, we investigated whether a 25% reduced dose of lenograstim at 7.5 microg/kg/day is equavalent to 10 microg/kg/day filgrastim for autologous peripheral blood stem cell (PBSC) mobilization and transplantation. A total of 40 consecutive patients were randomized to either filgrastim (n = 20) or lenograstim (n = 20). The two cohorts were similar in regard to disease, sex, body weight, body surface area, conditioning regimens, previous chemotherapy cycles and radiotherapy. Each growth factor was administered for 4 consecutive days. The first PBSC apheresis was done on the 5th day. In the posttransplant period, the same G-CSF was given at 5 microg/kg/day until leukocyte engraftment. Successful mobilization was achieved in 95% of patients. Successful mobilization with the first apheresis, was achieved in 10/20 (50%) patients in the filgrastim group versus 9/20 (46%) patients in the lenograstim group. No significant difference was seen in the median number of CD34+cells mobilized, as well as the median number of apheresis, median volume of apheresis, percentage of CD34+ cells, and CD34+ cell number. Leukocyte and platelet engraftments, the number of days requiring G-CSF and parenteral antibiotics, the number of transfusions were similar in both groups in the posttransplant period. Lenograstim 7.5 microg/kg/day is as efficious as filgrastim 10 microg/kg/day for autologous PBSC mobilization and transplantation.

Magnesium, Zinc, Copper, Manganese, and Selenium Levels in Postmenopausal Women with Osteoporosis. Can Magnesium Play a Key Role in Osteoporosis?

Introduction: There has been a resurgence of interest in studies concerning the role of elements in the development and maintenance of the skeleton. The aim of the study was to assess the plasma and red blood concentrations of some elements in postmenopausal women with osteoporosis. Materials and Methods: Seventy-seven postmenopausal women with osteoporosis aged 61 years (median interquartile range, 7.5; range, 46 to 74) and 61 age- and BMI-matched healthy postmenopausal women aged 60 years (median interquartile range, 8.0; range, 44 to 76) were included in the study. Element concentrations in plasma and red blood cells including magnesium (Mg), zinc, copper, manganese, and selenium were measured by atomic absorption spectrophotometry in both postmenopausal women with osteoporosis and healthy postmenopausal women. Results: Only statistically significant difference between the osteoporotic (51.51 [15.40] μg/mL) and healthy subjects (54.54 [15.42] μg/mL) was observed in red blood cell (RBC) magnesium concentration (Z = -2.07, P = 0.039). However, no significant difference was found between patient and control groups, both in plasma and in red blood concentrations, for zinc, copper, manganese, and selenium. Conclusion: Mg levels in red blood cells are significantly lower in postmenopausal women with osteoporosis. It is concluded that Mg transport mechanism(s) into the cell could be affected in patients with osteoporosis. Key words: Copper, Magnesium, Manganese, Osteoporosis, Selenium, Zinc

Magnesium, zinc, copper, manganese, and selenium levels in postmenopausal women with osteoporosis. Can magnesium play a key role in osteoporosis?

INTRODUCTION

There has been a resurgence of interest in studies concerning the role of elements in the development and maintenance of the skeleton. The aim of the study was to assess the plasma and red blood concentrations of some elements in postmenopausal women with osteoporosis.

MATERIALS AND METHODS

Seventy-seven postmenopausal women with osteoporosis aged 61 years (median interquartile range, 7.5; range, 46 to 74) and 61 age- and BMI-matched healthy postmenopausal women aged 60 years (median interquartile range, 8.0; range, 44 to 76) were included in the study. Element concentrations in plasma and red blood cells including magnesium (Mg), zinc, copper, manganese, and selenium were measured by atomic absorption spectrophotometry in both postmenopausal women with osteoporosis and healthy postmenopausal women.

RESULTS

Only statistically significant difference between the osteoporotic (51.51 [15.40] microg/mL) and healthy subjects (54.54 [15.42] microg/mL) was observed in red blood cell (RBC) magnesium concentration (Z=-2.07, P=0.039). However, no significant difference was found between patient and control groups, both in plasma and in red blood concentrations, for zinc, copper, manganese, and selenium.

CONCLUSION

Mg levels in red blood cells are significantly lower in postmenopausal women with osteoporosis. It is concluded that Mg transport mechanism(s) into the cell could be affected in patients with osteoporosis.

Ammonium removal from sanitary landfill leachate using natural Gördes clinoptilolite

Removal of ammonium ion (NH(4)(+)) from leachate from Odayeri sanitary landfill, located in the European part of Istanbul, was examined using Gördes (Turkish) clinoptilolite. The effects of pH, flow rate, ammonium concentration and competitive cations on the removal efficiency were investigated in both batch and column studies. Thomas model were used to analyze the breakthrough data. Nonlinear least square method was applied for fitting the column data. The competitive effect was observed more effective in lower ammonium concentration and higher cation concentrations. Conditioning and regeneration using NaCl improved removal efficiency of ammonium from leachate.