Introduction. Coronavirus 2019 disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread to more than 200 countries worldwide. We aimed to present ...acute pancreatitis (AP) cases caused by SARS-CoV-2 viral infection. Methods. The study was conducted retrospectively between April 2020 and June 2020 in Necmettin Erbakan University Meram, Medical Faculty Hospital, and 150 hospitalized patients diagnosed with COVID-19 were included. The degree of acute pancreatitis was determined according to the Atlanta classification. Organ failures of the patients were evaluated in terms of respiratory, cardiovascular, and nephrology according to the modified Marshall scoring (MMS) system, and CTSI (Balthazar score) and Imrie score were determined. Modified Marshall score≥2 was considered organ failure. Results. A total of 29 patients were diagnosed with acute pancreatitis. All 29 patients with pancreatitis had respiratory failure during hospitalization. After the diagnosis of pancreatitis, there was no change in respiratory failure. According to the Atlanta classification, 19 patients had mild AP and 10 patients had moderate AP. Patients with acute pancreatitis were scored according to the CTSI (Balthazar score), and there were no patients with ≥6 severe pancreatitis. The CTSI score of 4 patients was 3. In addition, the Imrie score of the patients was determined and 8 patients with Imrie score≥3 were identified. Conclusion. The rate of pancreatic damage in SARS-CoV-2 infection was found to be 19% (n=29) in our study. In our study, we highlight acute pancreatitis as a complication associated with COVID-19 and the importance of pancreatic evaluation in patients with COVID-19 and abdominal pain is demonstrated.
As marine cargo traffic continues to grow, ports are experiencing increasing problems with congestion. To address this issue without requiring significant capital investment, neighboring ports can ...share their capacity to meet the rising demand for cargo throughput. While there are many planning level studies on inter-port cooperation, there is a scarcity of operational-level studies, and there is currently no available dry port integrated cooperation scheme for port clusters that utilizes a microsimulation approach. This study aims to contribute to the existing literature by proposing a conceptual port integration scheme that includes a dry port for improved coordination between ports in clusters. The discrete event simulation (DES) approach was used to construct three representative microsimulation models with dry port integration considering vessel transfer policies and no-cooperation scenario. The outputs of the models were evaluated using performance metrics (vessel delays, storage capacities, and the number of serviced vessels) using t-test statistics. The results show that the cooperation scheme with the vessel transfer policy and the strategic management of vessel transfer can significantly reduce the vessel operation delay by over 39% for the no-cooperation scenario with an integrated dry port and this value is further improved to 62% if a simulation-based port selection module (PSM) is used for vessel transfer policy. Additionally, the mean number of containers of the average of two port storages decreased by 40% and further decreased by 69% with the PSM. In terms of decision-making performance for vessel transfer decisions with varying quay lengths, PSM was determined to be superior to the vessel transfer policy considering the number of vessels in port queues. The proposed conceptual port integration model and approach can assist decision-makers in evaluating the effectiveness of different cooperation schemes and vessel transfer policies for adjacent ports in port clusters.
Solid pseudopapillary neoplasia (SPN) of the pancreas is an extremely rare epithelial tumor of low malignant potential. SPN accounts for less than 1% to 2% of exocrine pancreatic tumors. The aim of ...this study is to report our experience with SPN of the pancreas. It includes a summary of the current literature to provide a reference for the management of this rare clinical entity.
A retrospective analysis was performed of all patients diagnosed and treated for SPN in our hospital over the past 15 years (1998 to 2013). A database of the characteristics of these patients was developed, including age, gender, tumor location and size, treatment, and histopathological and immunohistochemical features.
During this time period, 255 patients with pancreatic malignancy (which does not include ampulla vateri, distal choledocal and duodenal tumor) were admitted to our department, only 10 of whom were diagnosed as having SPN (2.5%). Nine patients were women (90%) and one patient was a man (10%). Their median age was 38.8 years (range 18 to 71). The most common symptoms were abdominal pain and dullness. Seven patients (70%) presented with abdominal pain or abdominal dullness and three patient (30%) were asymptomatic with the diagnosis made by an incidental finding on routine examination. Abdominal computed tomography and/or magnetic resonance imaging showed the typical features of solid pseudopapillary neoplasm in six (60%) of the patients. Four patients underwent distal pancreatectomy with splenectomy, one patient underwent a total mass excision, and one patient underwent total pancreatic resection. Two required extended distal pancreatectomy with splenectomy. Two underwent spleen-preserving distal pancreatectomy.
SPN is a rare neoplasm that primarily affects young women. The prognosis is favorable even in the presence of distant metastasis. Although surgical resection is generally curative, a close follow-up is advised in order to diagnose a local recurrence or distant metastasis and choose the proper therapeutic option for the patient.
This paper develops operational methods for the minimization of the energy consumption of manufacturing equipment. It is observed that there can be a significant amount of energy savings when ...non-bottleneck (i.e. underutilized) machines/equipment are turned off when they will be idle for a certain amount of time. Using this fact, several dispatching rules are proposed. A detailed performance analysis indicates that the proposed dispatching rules are effective in decreasing the energy consumption of especially underutilized manufacturing equipment. In addition, a multi-objective mathematical programming model is proposed to minimize the energy consumption and total completion time. Using this approach, a production manager will have a set of non-dominated solutions (i.e. the set of efficient solutions) which he/she can use to determine the most efficient production sequence which will minimize the total energy consumption while optimizing the total completion time.
Hepatitis A immunity in Yozgat, Turkey Kader, Çigdem; Göçmen, Ayse Yesim; Demir, Münire Islak ...
Annals of Saudi medicine,
2019 Jan-Feb, 2019-01-00, 20190101, 2019-01-01, Letnik:
39, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Since routine immunization could change the epidemiological profile of hepatitis A virus (HAV) infection in the future, it is important to determine the baseline immunity to HAV across Turkey.
The ...aim of this study was to determine the seroprevalence of hepatitis A among individuals 6 years of age and older in Yozgat, Turkey.
Cross-sectional.
Community in central region of Turkey.
Questionnaires and blood specimens were collected and the presence of hepatitis A IgG antibodies against hepatitis A virus was determined quantitatively by ELISA.
The rates of hepatitis A immunity by age group.
1862.
Immunity to hepatitis A was 79.1% (n=1473). The mean (SD) age was 17.1 (14.7) years in the nonimmune group and 37.8 (19.5) years in the immune group (P less than .001), and immunity increased with age. No significant difference in immunity rate was detected between gen.ders in children and adults. The seropositivity rate for subjects ages 6-19 years was lower than in subjects aged 20-96 years (52.2% versus 93.9%; P less than .001).
A catch-up vaccination program is needed for persons aged 6-19 years in Yozgat.
Single region data which can not be generalized. For this reason, a multi-centered study that can reflect the whole country is recommended.
None.
Background and Aim. Endoscopic stenting is a generally safe and effective palliative treatment for esophageal malignancies. In this study, we aimed to present endoscopic stent applications, adverse ...events, and relative advantages of covered versus uncovered stents in our center. Methods. We examined cases of endoscopic stenting for palliative treatment of advanced stage esophageal cancers between January 2014 and July 2019. Age, gender, location of mass, adverse events, survival time, and stent type were evaluated. Outcomes of fully covered and uncovered self-expanding stents were compared with regard to adverse events, including stent migration and occlusion. Results. The mean age of the patients was 66.4±1, 52 were male, and 8 were female. Patients were followed up for a mean of 133 days. The most common complication due to stenting was migration. 13 patients developed adverse events. Migration was the most common adverse event, occurring in 8 (13%) patients. Although the migration rate of fully covered stents was higher than uncovered stents, there was no statistically significant difference (p=0.47). Stent occlusion was observed in 4 patients. In three cases, it was due to the tumor; an uncovered stent was placed again in these cases. Food-related occlusion developed in one patient. There was no statistical difference in terms of overall adverse event rate when comparing fully covered stents to uncovered stents (p=0.68). Conclusion. Endoscopic stenting is a viable palliative method with low morbidity and mortality in experienced centers. Though there are relative advantages with covered versus uncovered stents in individual cases, the overall adverse event rate is low and relatively similar.
Aim of study: This study aimed to determine the effects
of glass fiber reinforced polymer (GFRP) and adhesives type on the diagonal
compression and tensile strength in L-type corner joints connected ...by a wood
biscuit.
Material and Methods: Medium density fiberboard coated with melamine plate
(MDFlam), wood biscuit with a size number of 20 (dimension: 56 × 23 × 4 mm) as
the joining member, GFRP for strengthening purposes, and polyvinyl acetate
(PVAc-D4), polyurethane (PU-D4), and epoxy glues as adhesives were used. The
diagonal compression and tension tests were carried out under static load
according to ASTM-D1037 standards.
Main results: Results indicated that using GFRP
significantly increased the diagonal compression and tensile strength of L-type
corner joints connected by a wood biscuit.
Highlights: It is recommended to use the combination of GFRP and
epoxy adhesive in the corner joints to have better compression and tensile
strength in furniture.
This study introduces the problem of minimizing average relative percentage of imbalance (ARPI) with sequence-dependent setup times in a parallel-machine environment. A mathematical model that ...minimizes ARPI is proposed. Some heuristics, and two metaheuristics, an ant colony optimization algorithm and a genetic algorithm are developed and tested on various random data. The proposed ant colony optimization method outperforms heuristics and genetic algorithm. On the other hand, heuristics using the cumulative processing time obtain better results than heuristics using setup avoidance and a hybrid rule in assignment.
Accident prevention is relatively a complex issue considering the effectiveness of the injury prevention technologies as well as more detailed assessment of the complex interactions between the road ...condition, vehicle and human factor. For many years, highway agencies and vehicle manufacturers showed great efforts to reduce the injuries resulting from the vehicle crashes. Many researchers used a broad range of methods to evaluate the impact of several factors on traffic accidents and injuries. Recent developments lead up to capable for determining the effects of these factors. According to World Health Organization (WHO), cyclists and pedestrians comprise respectively 1.6% and 16.3% in traffic crash fatalities in 2013. Also in Turkey crash fatalities for pedestrian and cyclists are respectively 20.6% and 3% according to Turkish Statistical Instıtute data in 2013. The relationship between cycling and pedestrian rates and injury rates over time is also unknown. This paper aims to predict the crash severity with the traffic injury data of the Konya City in Turkey by implementing the Artificial Neural Networks (ANN), Regression Trees (RT) and Multiple Linear Regression modelling (MLRM) method.
The superficial cervical plexus block (SCPB) is utilized in pediatric patients to perform certain surgical procedures, but there is no evidence supporting its use in hemodialysis catheter placement. ...We evaluated the analgesic effectiveness, intraoperative complications, and patient satisfaction associated with SCPB for pediatric patients in renal failure undergoing emergent dialysis catheterization. A total of 52 patients ranging from 1 to 17 years old that required emergent dialysis catheter placement and received SCPB were included in this study. During the catheterization, intraoperative pain scores, requirement for additional analgesia, catheterization access site, and intraoperative complications were recorded. The Children's Hospital of Eastern Ontario Pain Scale (mCHEOPS) was used to determine pain ratings during skin puncture with the needle, skin dilatation, and securing the catheter with stitches. The patients had an average age of 8.46 ± 5.3 years. The preferred catheterization entry site was through right internal jugular vein, which was achieved in 80.7% of patients. However, 19.3% of patients required access through the right subclavian vein. The average mCHEOPS score during skin puncture was 1.4 ± 0.5, and the mean mCHEOPS score was 2.3 ± 0.6 for skin dilatation. Finally, the average mCHEOPS score while securing the catheter with stitches was 1.3 ± 0.4. No patient required fentanyl for additional analgesia. No intraoperative complications occurred. The benefits gained from using SCPB performed by an experienced anesthesiologist for hemodialysis catheter placement include providing sufficient analgesia and optimal surgical conditions while avoiding the complications associated with general anesthesia for pediatric patients with renal failure.
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