Background: Polypharmacy and nonadherence to treatment regimens confront as an ever-mounting problem in hemodialysis patients. The aim of the present study was to emphasize the importance of polypharmacy and tablet load problem and to evaluate the adherence to phosphorus binding agent treatment and to examine the factors that cause to non-adherence. Material and Method: 361 patients who were in regular dialysis program in 4 different hemodialysis centers in Samsun city were included in the study. By meeting face to face, a questionnaire that was composed of 35 questions which investigated the factors that effect the polypharmacy and treatment adherence was filled to patients by a physician. Adherence to phosphorus binding treatment was measured according to both serum phosphorus level and Modified Morisky Adherence Scale. Results: In hemodialysis patients, the mean daily used drug groups were found as 5, the tablet count was found as 10. It was determined that the phosphorus levels of % 40.4 of patients who were using phosphorus binding agents were found above the target phosphorus level that was recommended in the guidelines. According to the adherence questionnaire that was performed to the patients, nonadherence rate to the phosphorus binding agents was found 77,3 %. In addition, age, educational background, smoking and tablet load are the factors that were not found effective on the adherence to the phosphorus binding agents treatment .Conclusion: Polypharmacy and non-adherence to the phosphorus binding treatment are serious and worth-stressing problems that should be solved in hemodialysis patients. We think that more, more advanced and quality research is needed to improve adherence on this subject

Background: This study was carried out to determine the morphometry of the dry tibia bones of the Turkish population using the photo analysis method.Materials and Methods: 33 dry tibia bones were included in the study. The bones obtained were photographed with a professional camera. The photos were transferred to image processing program Image J (Version 1.53e) in jpeg format. From the images transferred, the parameters of articular surface width of medial condyle (MC-ASW), articular surface height of medial condyle (MC-ASH), articular surface width of lateral condyle (LC-ASW), articular surface height of lateral condyle (LC-ASH), distance between medial and lateral intercondylar tubercle (LMIT-D), medium width of body of tibia (BT-MW), length of total tibia (TT-L), height of medial malleolus (MM-H), angle of medial condyle-tibial tuberosity-lateral condyle (MCTTLG-A),angle of fibular notch-tibial tuberosity-medial malleolus (FNTTMM-A), height of inferior articular facet (IAS-H), width of inferior articular facet (IAS-W), distance between nutrient foramen-interosseous border (NFIB-D) were measured. Results: Morphometric analysis results were:MC-ASW 6.558±0.896 cm, MC-ASH 9.502±1.364 cm, LC-ASW 6.035±0.988 cm, LC-ASH 8.655±1.673 cm, LMIT-D 3.169±0.632 cm, BT-MW 2.382±0.312 cm, TT-L 36.784±2.734 cm, MM-H 1.296±0.209 cm, MCTTLG-A 97.14±11.63°, FNTTMM-A 7.313±0.514°, IAS-H 6.219±0.776 cm, IAS-W 6.540±1.011 cm, NFIB-D 0.958±0.326 cm. A statistically significant correlation was found between MC-ASW and MC-ASH, LC-ASW, LC-ASH parameters, between MC-ASH and LC-ASH, TT-L parameters, and betweenBT-MW and TT-L parameters (p =0.05).Conclusion:As a result of our study, the morphometry of the parameters of the dry tibia bone in the Turkish population and the relationships between these parameters were revealed

ackground:Balanced chromosomal re-arrangements (BCR) are re-arrangements with no loss or gain of genetic material and usually not associated with clinical abnormalities. However, BCR carriers may have children with a chromosomal anomaly as a result of an unbalanced transfer of chromosomes to the offsprings. The children with unbalanced chromosomaltranslocations may exhibit many congenital anomalies, especially motor-mental retardasyon. We report unbalanced translocation and multiple congenital anomalies in two siblings. Chromosomal microarray analysis was performed on the both siblings using Agilent Oligonucleotide Microarray 8 × 60K. Chromosomal microarray analysis showed partial deletion in 5p and partial duplication in 7q (arr[GRCh37] 5p15.33-p15.2x1, 7q36.1-q36.3x3) in one sibling, and partial duplication in 5p and partial deletion in 7q (arr[GRCh37] 5p15.33-p15.2x3, 7q36.1-q36.3x1) in the other sibling were detected. Subtelomeric Fluorescent In Situ Hybridization (FISH) analysis was performed on the entire family using Cytocell Telomark Probe. The father was found to have 46,XY.ish t(5;7)(p15-,q36+;q36-,p15+) balanced chromosomal translocation structure, while the mother was found to have 46,XX normal chromosome structure. To the best of our knowledge, 5p partialtrisomy+7q partial monosomy and 5p partial monosomy+7q partial trisomy have not been previously reported. These findings provide us with the conclusion that Copy Number Variation(CNV) analysis with microarrayis important in the diagnosis of congenital anomalies, especially motor-mental retardation.

Background: The aim of our study is to determine the radiation dose to which the breast is exposed in pediatric female undergoing routine thoracic multislice computed tomography (MSCT) and to investigate the effectiveness of bismuth shielding in reducing this dose.Materials and Methods: Twenty patients who were referred to the radiology department for routine thorax MSCT between January 2012 and April 2012 were included in the study. A Thermolucent dosimeter (TLD) (3x3x1mm; Harshaw Lif TLD-100; Saint-Gobain Industrial Ceramics, Solon, Ohio) was placed on both breast skins of the patients to measure the radiation dose. An in-plane bismuth breast shield was placed on the right breast, and the left breast was chosen as the unshielded side. Radiation doses in the shielded and unshielded breast were calculated and compared using the Paired-t test.Results: The mean radiation doses were calculated as 7.0075 mSv and 9.0730 mSv for the shielded right breast and the unshielded left breast, respectively. It was found that in-plane bismuth breast shielding could lower the radiation dose to the right breast by 22.76 %. The difference between the radiation doses of the shielded side of the breast and the unshieldeded side was found to be significant (p<0.001). No deterioration was detected in the image quality of the lung parenchyma on the side where bismuth shield was placed.Conclusions: In-plane bismuth shielding significantly reduces the radiation dose of the breast in pediatric female undergoing routine thoracic MSCT examination without impairing the image quality.

Background:This study aimed to compare the impact of midazolam,propofol, dexmedetomidine infusions for 24thhour ontotal antioxidant status (TAS), totaloxidantstatus(TOS),oxidativestres index(OSI)andprolidaselevels.Material and Method:75 patient ICU patient who were mechanically ventilated enrolled to the study. Patients randomised to three groups. Group I (n=25, midazolam): 0.02 mg/ kg/h midazolam, Group II (n = 25, propofol): 1mg/kg/h propofol, Group III (n=25, dexmedetomidine): 0.2 µg/ kg/h dexmedetomidine infusions was started. Dosage were arrange to achieve Ramsay sedation score 3. Blood samples were collected in basal, 6.,12.,18., 24. hour, and hemodynamic parameters were also recorded in the same time intervals. Results: In midazolam group 24. hour TAS levels were significantly decreased and TOS, prolidase and OSI levels were significantly increased compared to the basal level (p<0.05). 24. hour TAS levels were significantly decreased and TOS, prolidase and OSI levels were significantly increased compared to basal level in propofol group (p<0,05). In dexmedotimidine groups 24.hour TAS and prolidase levels were significantly decreased, OSI levels were increased compared to the basal levels (p<0.05). Increase in TOS levels were not statistically significant (p>0.05). Basal TAS, TOS, prolidase, OSI levels were not statistically significantly between the different groups (p>0.05).Conclusion: Dexmedetomidine was found to be having statistically significant favorable results in comparison to others. Howeverthere results should be clinically and molecularity verified with large scale further studies

Background: The aim of this study is to determine the level of burnout syndrome in residents receiving urology training and determine factors that may cause it.Materials and Methods: A cross-sectionaldescriptive study.A survey containing questions on sociodemographic characteristics and the Maslach Burnout Inventory were administered to 46 urology residents in different years of residency training at different clinics.Results: The mean age of the urology residents participating in the study was 29.0±2.1 years. It was determined that most participants had high scores in the Maslach Burnout Inventory subscales. The mean subscales scores of the participants were determined as 24.7±6.3 for emotional exhaustion, 11±3.4 for depersonalization, 19.2±4.1 personal achievement. When the residents’ sociodemographic characteristics, such as marital status, year ofresidency training, smoking status and alcohol consumption habits were separately examined, there was no significant difference in the Maslach Burnout Inventory subscale scores according to these variables (p>0.05). However, the participants who reported that they would not preferurology again if they were given anopportunity to change their specialty had significantly higher scores in the emotional exhaustion and depersonalization subscales compared to those stated that they would have made the same choice (p=0.001 and p=0.02, respectively). Conclusion: Burnout syndrome is frequently seen in residents undergoing urology specialty training. There is a need to carefully determine causes of burnout syndrome and establish policies that will increase the motivation of urology residents.It is important to determine how to spot it and take action with a multidisciplinary approach from primary healthcare to occupational healthcare.

Aflatoxins are secondary metabolites that produced by Aspergillus fungi which are soilborne and involved in the decomposition of plant materials in nature. Aspergillusspecies find opportunity to produce aflatoxins in high humidity and temperature conditions such as tropical and subtropical environment. Therefore, in changing climatic conditions caused by global warming, geographical distribution of these fungi to have changed day by day, and find out an opportunity to grow in different feed materials. Aflatoxin B1 (AFB1) is the most toxigenic mycotoxin in these group and threatens both human and animal health due to its carcinogenic and mutagenic properties. In cattle, commonly known adverse effects of AFB1 depending on the chronic exposure such as decreasing milk production and quality, reducing the feed efficiency in beef cattle, increase susceptibility to diseases following suppression of the immune system, compromise ruminal functions, disruption of ruminal microorganism growth and functions. In this study, the negative effects of AFB1 on bull sperm has been examined. Topics such as negative effects of AFB1 on sperm proteomes, increase in the reactive oxygen species, changes in sperm DNA and plasma membrane integrity are discussed.