Sağlık Bilimleri Fakültesi / Faculty of Health Sciences
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Publication A comparison of Gordon's functional health patterns model and standard nursing care in symptomatic heart failure patients: A randomized controlled trial(W.B. Saunders, 2020-06) Türen, Sevda; Enç, NurayBackground Heart failure (HF) is associated with poor quality of life and increased morbidity and mortality. Aim This study aimed to investigate effect of application of Gordon's functional health pattern (FHP) model in nursing care of symptomatic HF patients on quality of life, morbidity and mortality in the post-discharge 30-day. Methods This is a prospective randomized controlled study conducted in a single center. Experimental group received nursing care planned in accordance with Gordon's FHP model. 60 control and 60 experimental HF patients were included in the study. In the control group nursing care was given according to the standard protocol of the hospital whereas in the experimental group nursing care was given in accordance with Gordon's FHP model. Patients in both groups were followed up after discharge at 30th day. Results Mean Minnesota Living with Heart Failure Questionnaire score improved significantly in the experimental group compared to the control group at 30th day (40.2 ± 23.5 vs 62.3 ± 22.9 respectively, p = 0.001). Seven patients (11.7%) in the experimental group and 17 patients (28.3%) in the control group were readmitted in the post discharge 30-day (p = 0.02). Kaplan-Meier survival curve analysis revealed significant difference in 30-day event free survival rates between groups (log-rank p = 0.31). Conclusion Application of Gordon's FHP model in the nursing care of HF patients was associated with significantly improved quality of life, and reduced hospital readmission rates at 30th day. This was the only independent predictor of 30-day event free survival.Publication A novel dorsal trimline approach for passive-dynamic ankle-foot orthoses(Assoc Mechanical Engineers Technicians Slovenia, Po Box 197-Iv, Ljubljana 61001, Slovenia, 2018) Sürmen, Hasan Kemal; Fetvacı, Mahmut Cüneyt; Arslan, Yunus Ziya; AKALAN, NAZİF EKİN; 123435; 176320; 19199; 110120An ankle-foot orthosis (AFO) is an externally applied assistive device that encompasses the lower leg, ankle, and foot of the human body. In the current one-piece passive-dynamic AFO design, the trimming process is performed from lateral and medial parts of the ankle to ensure desired rotational displacement (hereafter referred to as Design I). In most cases, stress concentrations occurring over the trimmed regions during walking can cause permanent damage to the AFO. In this study, to reduce the stress concentration and ensure a homogeneous stress distribution, a new trimming approach is presented, in which the trim zones were transferred from lateral and medial to dorsal (hereafter referred to as Design II). Finite element analyses of the Designs I and II models were carried out. Displacement and von Mises stress values for both models under the same loading and boundary conditions were obtained. Maximum displacement values were 8.51 mm and 9.05 mm for Design I and Design II, respectively. Maximum stress values were 15.19 MPa and 6.70 MPa for Design I and Design II, respectively. For the similar range of motion of ankle joint, the novel design produced less stress and more homogeneous stress distribution than the currently used design, thus indicating that Design II would be more resistant to plastic deformation than Design I.Publication Awareness of health sciences students about colorectal cancer risk factors(2019-05) Üstündağ, Hülya; Zengin, Neriman; Andsoy, Işıl Işık; GÜL, ASİYEObjective This descriptive study was conducted in order to determine the risk factors, symptoms and awareness of health sciences students with regards to colorectal cancer (CRC). Methods This study included 1,028 health science students from two different universities. Data for this study were collected via a questionnaire form that included questions about CRC risk factors, protective approaches and symptoms. Frequencies, percentages and averages of the data were assessed with Kruskal-Wallis and Mann-Whitney U tests. Results The most frequent risk factors of the students (mean age: 21.25 years) were smoking (90.5%), excessive alcohol consumption (87.4%), family history of cancer (84.2%) and obesity (82.6%), while the most common protective approaches were smoking cessation, avoiding alcohol, regular physical activity and a low-fat diet. There was a significant difference in the CRC awareness of students in terms of gender, the department and grade level at which they were studying, and having a family history of cancer. Conclusion Results of this study revealed that students had a sufficient awareness about risk factors and what they could do to diminish their risk, but their knowledge about CRC symptoms was less than expected. We believe that health sciences students should be given more education on CRC symptoms.Publication Breastfeeding Practices in Medical Nutrition Treatment of Phenylketonuria(2019-09) Çakır Biçer, Nihan; Ersoy, Melike; 25392Objective: Phenylketonuria (PKU) is an inherited metabolic disease with the increase of phenylalanine (phe) in the blood and body fluids in the absence of phenylalanine hydroxylase enzyme. PKU was the first inborn error of metabolism treated with medical nutrition therapy (MNT). The aim o f this study was to evaluate the breastfeeding practices in the MNT of PKU patients followed up at Dr. Sadi Konuk Training and Research Hospital, metabolism reference clinic for three years. Methods: Forty-two patients were reviewed for infants diagnosed with PKU between 2016 and 2019. Eighteen PKU patients (8 mild-PKU, 10 classic-PKU) over two years old and diagnosed with National Newborn Screening Program were included the study. MNT, blood phe, tyrosine (tyr) levels and anthropometric measurements of patients were evaluated retrospectively. Results: The mean age of patients is 2,5±0,4 years and 44% were male. The patients were diagnosed at a mean age of 13,7±6,7 days with blood phe and tyr levels of the patients were 1756 pmol/dL and 65 pmol/dL. After the diagnosis, 24-hour-BH4-loading test was applied, breastfeeding was interrupted until the blood phe level was <600 pmol/dL (mean 3,7±1,6 days) and breast milk was stored for reuse. In this process, MNT was applied phe-free medical formula with an average of 2,1 g/kg/day essential amino acid (eaa), 108 kcal/kg/day energy and 150 ml/kg/day fluid. After the blood phe level was <600 pmol/dL, free breastfeeding was initiated. Mean breastfeeding duration of patients was 17,8±9,3 moths. In the first 6 moths 0.9 g/kg/day eaa, 43 kcal/kg/day and 57 ml/kg/day fluid were applied and average blood phe and tyr levels were 240 pmol/dL and 70 pmol/dL. Complementary feeding education was given to all patients at 6 months. At the age of 6-12 months the patients received MNT containing average 0,9 g/kg/day eaa, 0,54 g/kg/day natural protein, 25 mg/kg/day phe, 74 kcal/kg/day energy and average blood phe and tyr levels were 314 pmol/dL and 69 pmol/dL. At the age of 12-24 months, the MNT containing average of 1,1 g/kg/day eaa, 1 g/kg/day natural protein, 26 mg/kg/day phe, 109 kcal/kg/day was recommended to patients and average blood phe and tyr levels were 312 pmol/dL and 82 pmol/dL and phe:tyr ratio was 3,8. Anthropometric measurements of the patients were observed to be within normal range during the study. Conclusion: Free breastfeeding is a successful and reliable practice that supports the healthy growth and development of the child in the life-long MNT of PKU.Publication Case report: Necrotising fasciitis after removing the intrauterine device(2018-12) Özkaya, B.; Küçük, A.; Tosun, H.; GÜL, ASİYENecrotising fasciitis is a rapidly progressive, destructive soft tissue infection that mainly involves fascia and subcutaneous tissues. Rapidly spread necrosis in tissues is often caused by systemic sepsis, toxic shock syndrome, multiorgan failure and thrombosis in the subcutaneous vasculature. Necrotising fasciitis can be seen in all the anatomical regions of the body; the extremities and perineum are frequently affected. In this case report, we emphasised the importance of nursing care of a necrotising fasciitis patient who has been treated for a long time with aggressive surgical treatment. Vacuum-assisted closure application is a non-invasive method with controlled and localised negative pressure on the wound to accelerate healing in acute/chronic wounds. Necrotising fasciitis can be successfully treated with early diagnosis, adequate debridement, and appropriate antibiotic therapy. A multidisciplinary approach is necessary for the comprehensive care of these patients.Publication Chemotherapy and radiation induced pulmonary dysfunction in hodgkin lymphoma patients(2016-12) İzmir Güner, Şebnem; Teoman Yanmaz, Mustafa; Selvi, Ahmet; Usul, ÇiğdemAlthough the deterioration in pulmonary functions is a well-known important problem due to the treatment of the Hodgkin's lymphoma patients, the immediate and long term effects of the therapy and its distinctive components were not shown clearly yet. We planned to investigate effects of multiple agent chemotherapy and/or radiotherapy to pulmonary functions immediately and thereafter and the possible effects of the managing this situation. 34 patients were included the study. The patients were evaluated for peak expiratory flow (PEF), forced expiratory volume in 1 s (FEV1), forced expiratory vital capacity (FVC), mean total lung capacity (TLC) values, FEV1/FVC ratio, diffusing capacity for carbonmonoxide (DLco), diffusing capacity for carbonmonoxide corrected for hemoglobin concentration (DLCO) before and at 1, 6 and 12 months after the initiation of the treatment. Demographic characteristics; disease stages; chemotherapy protocols; whether radiotherapy is received; if yes, the region and the dose received were recorded. The tests were finally analysed in two separated groups; group A treated with only chemotherapy and group B; treated with combination therapy, chemotherapy and radiotherapy. In group A, FVC and FEV1 is similar before and after treatment. FEV1/FVC ratio was increased (P = 0.0001) in this group despite increasing in mean TLC values (P = 0.001). No meaningful changes were observed in PEF and DLCO values in group A. In group B, FVC, FEV1 and PEF were decreased after treatment (for FVC P = 0.028, for FEV1 P = 0.04). Despite a decrease in first month of the treatment in FEV1/FVC ratio and DLco these two parameters were recovered at the end of the first year in group B patients. TLC values were increased after treatment in group B as in group A (P = 0.035). We believe that, if these patients are managed well in 1 year; necessary precautions are provided; and patients are well-informed, then there wouldn't be too much risk and mortality rate for long-term side effects of ABVD and mediastinal RT.Publication Correlations Between Hypermobility, Muscle Strength and 3D Gait Parameters in Children With Increased Femoral Anteversion(2019-09) EVRENDILEK, HALENUR; 268497Introduction Increased femoral anteversion is a transverse plane problem that cause gait alterations in developing children and because of the moment arm changes produces muscle weakness around the hip (1). Especially, in addition with hypermobility, these children mostly have fatigue, additional muscle weakness and functional deterioration on lower extremity (2). Therefore, the aim of this study was to determine the relations between the hypermobility, muscle strength and gait parameters in children with IFA. Research Question Are there any correlation between the hypermobility, muscle strength and gait parameters in children with IFA? Methods 7 children with IFA (14 limbs, av.age: 9.14 ± 0.3, trochanteric prominens angle test (TPAT): 28 ± 6.2°) have participated in this study. As part of physical assessment; hypermobility, femoral anteversion angle, maximum isometric hip extensor and abductor, knee extensor and flexor muscles strengths were evaluated by Beighton test (3), TPAT (4) and hand-held dynamometer (HHD) (Lafayette Instruments,USA)(5) respectively. Furthermore, all participants' self-selected of walking were analyzed by 3D gait analysis (BTS Bioengineering). Kinematic gait parameters of pelvis, hip and knee were interested gait parameters. According to data distributions, Pearson's or Spearman's coefficient test were utilized for statistics (p<0.05) and interpreted by Cohen's classification (6). Results High-level correlation was found between Beighton scores and both hip extensor (r: -.70) and knee extensor (r: -.91) muscle strengths, and mean and minimum knee knee flexion angles. TPAT was highly correlated with only hip abductor HHD scores and mean hip rotation angle during walking (Table 1). Discussion In the literature, number of gait alterations were determined in children with IFA as increased mean hip internal rotation, pelvic obliquity range, peak knee extension at stance(7). The present study revealed that some of the kinematic alterations might be related to muscle strengths of the weak hip extensor and abductor, knee extensor and flexor muscles. Although, in agreement with the literature the mean hip internal rotation and hip abductors muscles strength were found significantly related to TPAT. In additionally, hypermobility, which is a commonly seen with the children with IFA, might have a role at the weakness of the hip and knee extensors and hyperextension at stance phase. In conclusion, it is important to strength hip extensor and abductor, knee extensor and flexor muscles to contribute to lower extremity function in children with IFA especially if the child is hypermobile.Publication Detection and molecular examination of pathogens in honey and bees in the northern Marmara Region, Turkey(Kafkas Universitesi Veteriner Fakultesi, 2020-03-02) Bayrakal, Gülay Merve; Akkaya, Hayrettin; Sezgin, Funda Hatice; Dümen, Emek; EKİCİ, GÖZDEHoney, which has many positive health effects, is fondly consumed in our country and in the world. Although honey is considered to be a micro-organism-free food because of its antimicrobial and bacteriostatic effects, studies refute this idea. In addition to primary contamination, personnel, tools and equipment used in beekeeping and honey production is a potential source of secondary contamination. In addition, honey, which can carry many microorganisms as a result of cross-contamination, is among the important foods and can threat public health. Therefore, it is thought that screening of pathogens that may be present in honey would contribute to the studies. Due to the geographical location, the diversity of climate and vegetation, Turkey is located in the upper row of honey producting countries. In this study, 900 samples examined in Kırklareli province in Northern Marmara Region. Kırklareli region has been chosen as the research area since it is considered as an important province in honey production and is a border province located in the industrial zone. The aim of the study was to investigate the presence of parasitological, bacterial, fungal and viral parameters which are important for the quality of the consumer, bee, larvae, colony and honey. According to the obtained data, positive results were found in many parameters and statistically significant results were obtained.Publication Determination of Biomechanical İnfluences of İncreased Femoral Anteversion (twisted leg) on Running for Developing İndividua(2018-08) APTİ, ADNAN; ARAT, REFİK; 259584Publication Determination of Playing Related Postural Problems in Guitar Students(2019-06) AKEL, BURCU SEMİN; 114564Objective: A significant percentage (%37) of musicians suffer musculoskeletal disorders that are sufficiently serious to affect performance. A common risk factor for musculoskeletal disorders is a poor posture.ln this study, we aimed to determine of playing-related postural problems in guitar students. Materials and Methods: Nineteen guitar bachelor students participated. Demographic data were recorded and static and dynamic posture analysis were performed via observation and video recordings; which were analyzed by a physiotherapist, an occupationaltherapist and a guitarist. Awkward postures were recorded. Posture was evaluated both globally and for individual body regions. Overall posture was divided into 3 categories: rigid, slumped, physiological. Pain was assessed with The Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians. Results: Most of the individuals (55%) experienced pain or problems that might hinder their playing skills in the last year.The most common locations of pain or problems were: shoulder, wrist, scapula and neck.The overall static posture was poor in 38% of participants when standing(33%rigid, 5% slumped). During playing, the posture was more often slumped than rigid(66%). The location of the gravity axis in the sagittal plane were forward-shifted(%55), however the physiological posture was maintained at the frontal plane.The most common problems encountered were shoulder imbalance (%61), rotation of the head(%77), rotation of body(%72), right wrist excessive ulnar deviation(%33) and thumb positioning(%72). Conclusions: According to the posture analysis, rotation and slumpy positioning was the main problem. This situation puts greater problems on the muscles of the back and abdomen and may effect proper breathing. The regions that have poor posture was neck, shou Ider, wrist and thumb. Considering this, we believe that educating music students in proper playing posture and postural awareness can be beneficial in decreasing performance-related postural problems.Publication Development of Fistula in a Patient With Crohn's Disease: a case report(2019-06) GÜL, ASİYE; 112620INTRODUCTION: A fistula is an abnormal connection between two epithelized surfaces. 15- 25% of the fistulas develop spontaneously and 75-85% develop after surgery. Spontaneous fistulas develop after radiotherapy, diverticulitis, appendicitis, peptic ulcer perforation, pancreatitis, intestinal tuberculosis, inflammatory bowel disease. Malnutrition, sepsis, shock, circulatory failure, corticosteroid treatment, difficulties in surgical anastomosis cause fistula formation. Fistula develops 20% -40% with Crohn's disease. 75% of intestinal fistulas open to the skin. It has psychological, physiological, sociological and economic effects in patients with fistula. Objective: In this study, it was emphasized the importance of nursing care of a patient with Crohn's disease, difficult management, and long-standing fistula. Case: Mr. ET who has Crohn's disease, is 27 years old, married, graduated from primary school, lived in the village outside of Istanbul. The patient admitted to the emergency department with severe abdominal pain at the time of his visit to his brother. The emergency operation performed due to Ileus and common small intestinal dilatation. Segmenter small intestine resection and ileostomy performed and the patient followed up in the intensive care unit. Because of intraabdominal abscess, a vacuum system is applied. Afterward, two fistulas developed in the abdominal region. The total parenteral and enteral food is used for weight loss. Antibiotic therapy initiated for infection. Three months later, the fistula healed and the patient discharged on his own request. Conclusion: Complicated nursing care and multidisciplinary care must be provide for the problems that may occur in the patient who is hospitalize for a long time after the fistula.Publication Distinguishing the Influences of Increased Femoral Anteversion From Hypermobility During Walking For Neurologically Intact Individuals(2018-09) Akalan, Ekin; Karaca, Gülşah; Kuchimov, Shavkat Nadir; Bilgili, Fuat; Temelli, Yener; Leblebici, Gökçe; Ertürk, Gamze; Evrendirek, Halenur; ÖNERGE, KÜBRA; APTİ, ADNAN; 176320; 268498; 259584; 237820; 190878; 229941; 283338; 268636; 268497Increased femoral anteversion (IFA) is a transverse plane problem that may lead to alterations on lower body kinematics during walking (1,2). IFA and hypermobility syndrome are commonly seen together in healthy individuals (3). Therefore, describing the pure effects of IFA related gait parameters is very difficult for children with hypermobility and IFA together.Publication Does clinically measured ankle plantar flexor muscle strength or weakness correlate with walking performance in healthy individuals?(2018) Akalan, N.Ekin; Kuchimov, Shavkat Nadir; Temelli, Yener; Ören, Merve; Nene, Anand; APTİ, ADNANOBJECTIVE: Muscle strength is usually measured using isometric hand-held dynamometers (HHDs) in the clinic. However, during functional activities, the muscle acts more dynamically. The aim of this study was to investigate the relation between clinically measured plantar flexor (PF) muscle strength (PFMS) and laboratory measurements of peak ankle plantar flexion power generation (APFPG), peak ankle moment (PAM), peak plantar flexion velocity (PFV) and mean gait velocity in healthy participants. METHODS: The maximum PFMS on non-dominant sides in 18 able-bodied persons 23.88 (SD 3.55 years) was measured before (Pre-S) and after a stretching (Post-S) procedure (135 sec. x 13 rep. with 5 sec. rest) by using a HHD. The stretching procedure was used to generate temporary PF muscle weakness. Gait analysis was carried out for Pre-S and Post-S conditions. Normalized (by weight and height) and non-normalized HHD scores and differences for both conditions were correlated by Pearson correlation coefficient calculations (p < 0.05). RESULTS: Reduced PFMS (%23, p < 0.001) in Post-S, according to the HHD scores, has only a weak correlation with APFPG (r > 0.3, p < 0.5). Gait velocity was found to be strongly correlated with APFPG only in the Post-S condition (r = 0.68, p < 0.002). HHD scores and PAM were moderately correlated with the non-normalized Post-S condition (r = 0.44, p = 0.70) and strongly correlated with the non-normalized Pre-S condition (r = 0.62, p < 0.01). DISCUSSION: HHD scores of plantar flexor muscles give very limited information about the PF performance during walking in healthy individuals. Simple normalization did not improve the relations. Clinically measured isometric muscle strength and muscle weakness have only moderate strengths for establishing a treatment protocol and for predicting performance during walking in neurologically intact individuals.Publication Does hip flexor muscle weakness cause stiff-knee gait in long-term after medial open reduction surgery for children with developmental dislocation?(2019-09) EVRENDILEK, HALENUR; 268497Introduction Medial open reduction surgery (MOR) is performed as a treatment for children with developmental dislocation of the hip (DDH) by sectioning iliopsoas tendons [1]. A 10 years follow-up study of MOR was determined that hip flexor strength decreased in children with DDH [2] . Furthermore, the weakness of iliopsoas muscle was any one of the reasons of stiff knee gait pattern (SKG) [3], Therefore, the aim of the study was to determine whether the sagittal plane knee kinematics alters in long-term after bilateral MOR for children with DDH. Research Question What are the long-term biomechanical effects of bilateral MOR on sagittal plane knee kinematics in children with dislocation of the hip? Methods Five children (DDH group, 10 limbs, Av. age: 11.2 ± 2.8 y.o.) who had medial open reduction surgery bilaterally (10.4 years ago, Av. age: 9.6 ± 6 months o.) and six children without any orthopedic disorder (Control group, 12 limbs, Av. age: 10.8 ± 2.4 y.o) have participated in this study. All participants' selfselected speed of gait were analyzed by 3D gait analysis (BTS Bioengineering). The spatiotemporal parameters, sagittal plane hip and knee parameters and four defined SKG parameters (Pl: peak knee flexion angle, P2: range of knee flexion from toe-off to peak flexion, P3: total range of knee motion, P4: timing of peak knee flexion in swing, >3 significantly changed SKG parameters described as stiff knee ) [4] were examined. Independent t-test and Mann Whitney U test were used for comparison (p < 0.05) Results Between two groups, age, mean velocity were not significantly different (p>0.05). In DDH group, sagittal plane hip and knee range, P l, P2, P3,P4, maximum hip and knee flexion velocity were lower significantly than control group (Table 1). Discussion Normally, in late-stance, the iliopsoas is elongated depending on hip extension, then contracts at the beginning of the swing to initiate hip flexion. [5], Weakness of iliopsoas muscle, as a long-term effect of MOR surgery, reduces hip and knee flexion velocity at pre-swing and swing phases. This study showed that DDH altered all four SKG parameters significantly [4] relative to controls. This study also confirmed that hip flexion weakness may cause SKG pattern even neurologically intact individuals (3). Because of the SKG pattern increases not only the risk of reduced toe clearance and tripping but also energy expenditure [4], adding hip flexor strengthening exercises into rehabilitation programs might have a critical role for SKG treatment.Publication Does One Leg Standing Duration Have Relation With GMFM Scores and Stability in Stance Phase for Hemiplegic Children ?(2018-09) N. Ekin Akalan; Halenur, Evrendilek; Karaca, Gülşah; Bilgili, Fuat; Ertürk, Gamze; 268636; 176320; 268497; 268498; 237820This paper reports the results of a study to validate a measure of gross motor function in detecting change in the motor function of disabled children. Physiotherapists used this instrument to assess 111 patients with cerebral palsy, 25 with head injury and 34 non-disabled preschool children on two occasions, the second after an interval of four to six months. Parents and therapists independently rated the children's function within two weeks of each assessment, and a sample of paired assessments was videotaped for 'blind' evaluation by therapists. Correlations between scores for change on this measure and the judgments of change by parents, therapists and 'blind' evaluators supported the hypothesis that the instrument would be responsive to both negative and positive changes.Publication Effect of nutrient intake on some biochemical parameters in the first six months after sleeve gastrectomy(2019) Alphan, M.E.; BATAR, NAZLIAim: The aim of this study is to determine the possible nutrient and protein deficiency in the first six months after sleeve gastrectomy and to determine its effect on some biochemical parameters. Material and Methods: This study is an intervention study including 102 patients (75 female and 27 male) aged between 18-65 years, who had undergone sleeve gastrectomy operation at the General Surgery Clinic of Şişli Florence Nightingale Hospital between 13.07.2017 and 06.01.2018 and been followed up by a dietician for at least six months postoperatively. Anthropometric measurements, three-day food intake, and biochemical parameters were followed pre-operatively and during the first six months. Results: There was a 27.4% decrease in body weight of the patients in first six months after surgery. Both decrease in body weight, and decrease in body fat ratio and body mass index were found statistically significant (p<0.001). A statistically significant difference was found between preoperative and postoperative 6th month biochemical parameters; serum HbA1c, insulin, uric acid, total protein, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, iron, iron binding capacity, ferritin, zinc, vitamin D, calcium, parathormone, folate and vitamin B12 levels of the patients (p<0.001). The difference between 6th month serum total protein levels of patients using and not using whey protein powder in the first month after sleeve gastrectomy was found statistically significant (p=0.002). Conclusion: It should be kept in mind that regulating patients’ lifestyle with post-operative multidisciplinary team and regular follow-up, and supporting with active life are necessary for obesity treatment to be sustainable.Publication Escherichia coli and food safety(IntechOpen, 2019-02-21) Dümen, Emek; EKİCİ, GÖZDEFoodborne pathogens are evaluated as an important risk factor in terms of public health in developed and developing countries due to their extensiveness all around the world. Escherichia coli and other coliform bacteria are important foodborne pathogens. Some of the most important sources of contamination for these groups of microorganisms are reported as: areas with unfavorable hygiene, contaminated waste water, meat products, cereal products and vegetables. Total coliform bacteria and E. coli count is known to be the indicator of unfavorable hygienic conditions and fecal contamination in foods. Foodborne diseases, however, are a global issue. A joint approach by all countries and related international organizations is a prerequisite for detection and control of foodborne problems that pose a threat to human health and international trade. Despite their complicate biology, epidemiology and analyses, most foodborne diseases are preventable. It is of vital importance for public health that consumers and food producers act in accordance with the principles regarding internationally accepted safety methods.Publication Evaluation of Nutritional Status in Relation with Oral and Dental Health of Patient in Geriatric Outpatient Clinic(2019-04) Cin, Pelin; Tanrıöver, Özlem; Yavuzer, Hakan; Erdinçler, Deniz Suna; 264857; 102553Background: The deterioration of oral and dental health in elderly may make them more susceptible to malnutrition by affecting their ability to chew along with taste perception, swallowing capacity and nutrient intake. The relationship between oral health and nutritional status in elderly is controversial and there are limited number of studies. The aim of this study was to evaluate the association between oral and dental health in relation with nutritional status of elderly individuals. Materials and methods: This study was carried out in 215 volunteer patients aged 65 years or older, consisted of 70 males and 145 females who applied to Geriatric outpatient clinic between May 2018 and November 2018. Demographic characteristics of the patients included in the study were recorded. A questionnaire was used to evaluate the oral and dental health status. Mini Nutritional Test - Long Form was used to assess nutritional status. In addition, the food and beverages consumed by the patients were recorded with a 24-hour retrospective recall method and daily energy and nutrient intake was analyzed with the full version of the Nutrition Information System (BeBiS) software program. Results: Of the patients 32.6% were males and 67.4% were females. The mean age of the males was 78.6±6.8 years and the mean age of females was 74.9±6.9 years. Forty-four point two of the patients were primary school graduates, 20% were high school graduates and 9.8% were secondary school graduates. Eighty percent o f males were married and 41.4 percent of females were married. The percentage of men with difficulty in chewing and swallowing was 24.3%, while the percentage of women was 23.4%. It was observed that 30.2% of the patients had tooth loss, 54.9% had full-dentures and 14.9% had no tooth loss (Table 1). The prevalence of malnutrition (n=7) and risk of malnutrition (n=53) was 3.3% and 24.7% respectively. Patients with malnutrition and risk of malnutrition were found to have less appetite, more tooth loss and more frequent difficulty swallowing and chewing compared to patients with normal nutritional status. In addition, mean daily energy, carbohydrate, fat, fiber intake and water consumption were found to be statistically lower than those with normal nutrition status (Table 2). Conclusion: In aging process, besides additional diseases, oral and dental health problems, problems related to chewing and swallowing function and social difficulties in reaching food are effective in food intake. As a result, inadequate intake of energy and macronutrients occur. Patients in geriatrics outpatient clinics, should be screened routinely on their nutritional status to determine those who need nutritional support and to apply effective nutrition interventions. In order to reduce the risk of malnutrition, all elderly patients should be questioned about oral and dental health, and appropriate guidance should be given.Publication Evaluation of the effects of neural therapy in patients diagnosed with fibromyalgia(2019) Terzi, Rabia; Başaran, Aynur; Tolu, Sena; Küçüksaraç, Seher; ALTINBİLEK, TURGAYObjectives: This study aims to compare the effects of neural therapy and exercise on pain, quality of life, depression, anxiety, and functioning status in patients diagnosed with fibromyalgia syndrome (FMS). Patients and methods: This multi-center study included a total of 72 patients (60 females, 12 males; mean age: 39.2 +/- 9.5 years; range, 22 to 53 years) who were diagnosed with FMS according to the 1990 American College of Rheumatology (ACR) criteria between January 2015 and June 2015. The patients were randomly divided into two groups: the first group (n=30) received an exercise program (strengthening, stretching, relaxation, and aerobic exercises, three days a week), and the second group (n=42) received a total of six sessions of neural therapy as one session a week in addition to the same exercise program. Pain severity was assessed with the Visual Analog Scale (VAS), emotional state with the Beck Depression Scale (BDS) and Beck Anxiety Inventory (BAI), quality of life with Short Form-36 (SF-36), and functioning status with the Fibromyalgia Impact Questionnaire (FIQ). The patients were evaluated at the end of treatment (week 6) and one month after the end of treatment. Results: The mean disease duration was 34.3 +/- 9.3 months, the mean VAS score was 7.3 +/- 2.2, and the mean FIQ score was 58.4 +/- 13.2. There were significant improvements in the VAS, FIQ, SF-36, BDS, and BAI scores after the treatment in both groups (p<0.05). Post-treatment BDS and VAS scores were significantly lower in the neural therapy group (p=0.038; p=0.049; p<0.05). There was no significant difference in any parameter one month after the treatment between the groups (p>0.05). Conclusion: When neural therapy is combined with exercise in FMS patients, it may be advantageous in terms of pain and depression, compared to exercise alone.Publication Gait analysis of patients subjected to the atrophic mandible augmentation with Iliac bone graft(HINDAWI LTD, ADAM HOUSE, 3RD FLR, 1 FITZROY SQ, LONDON, W1T 5HF, ENGLAND, 2019) Temelli, Yener; Arslan, Yunus Ziya; Cansız, Erol; Karabulut, Derya; Doğru, Suzan Cansel; AKALAN, NAZİF EKİN; 190878; 110120; 42880; 249199; 181247; 176320In this study, we aimed to quantitatively monitor and describe the gait functions of patients, who underwent iliac crest bone grafting in atrophic jaw augmentation operation, by taking into account the alterations of gait parameters and muscle forces in the early recovery course. To do so, temporospatial and kinematic gait parameters of ten patients during pre- and postoperative periods were recorded, and forces of the gluteus medius, gluteus maximus, and iliacus muscles were calculated. Three postoperative periods were specified as one week (post-op1), two weeks (post-op2), and three weeks (post-op3) after the surgery. Restoring process of the gait patterns was comparatively evaluated by analyzing the gait parameters and muscle forces for pre- and postoperative periods. Temporospatial and kinematic parameters of post-op3 were closer to those obtained in pre-op than those in post-op1 and post-op2 (p<0.05). Muscle forces calculated in post-op3 showed the best agreement with those in pre-op among the postoperative periods in terms of both magnitude and correlation (p<0.05). In conclusion, the patients began to regain their preoperative gait characteristics from the second week after surgery, but complete recovery in gait was observed three weeks after the surgery.
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