Early diagnosis is extremely important for children with autism spectrum disorder (ASD), as other children having developmental disabilities. In early diagnosis, which is one of the most important elements of the treatment process, parents have a special place with different factors. Considering the importance of parents in early diagnosis, the aim of the study is to examine the opinions of the mother on early developmental differences in children with autism. The research is a case study designed in a qualitative research model. Accordingly, an interview form was developed by the researchers and data were collected in the scanning model in the first step of the study. In the second step of the study, data were obtained by using the semi-structured interview method, which is one of the qualitative research methods. In the study group of the research, 110 mothers were interviewed, whom were selected via purposeful sampling, and 87 mothers, who gave full answers to the questions, were included in the study. The data obtained were subjected to descriptive and thematic analysis. As a result of the study, it was found that children diagnosed with autism and children with development showed similar developmental characteristics during pregnancy and after birth. It was observed that mothers with a child diagnosed with autism have the awareness on the suspicion of autism in their children when they are between 18 and 24 months and 31 and 36 months, and they experienced problems in breast-feeding and falling asleep.

Fixation of trochanteric fractures with an intramedullary nail in a non-physiological position can cause poor functional outcomes. The aim of this study is to evaluate the effect of intraoperative patient position on rotational alignment in intramedullary nail fixation of trochanteric fractures. The femoral rotational alignment of 84 trochanteric fracture patients who underwent intramedullary nailing was measured by computed tomography (CT) images. Patients were divided into two groups: the supine position on the fracture table (FT) (Group 1, n = 42) and the lateral decubitus (LD) position (Group 2, n = 42). Femoral malrotation angles were measured and divided into three subgroups: insignificant, significant, and excessive. The number of intraoperative fluoroscopy images, preparation time, surgery time, and anesthesia time in both groups were compared. The malrotation degrees of patients in Group 1 ranged from 17° external rotation (ER) to 57° internal rotation (IR), with a mean of 10° IR. Of the patients in Group 1, 27 were insignificant, 5 were significant, and 10 were in the excessive subgroup. The malrotation degrees of patients in Group 2 ranged from 33° ER to 47° IR, with a mean of 11° IR. Of the patients in Group 2, 21 were insignificant, 12 were significant, and 9 were in the excessive subgroup. There was no statistically significant relationship between patient position and malrotation angle. The number of intraoperative fluoroscopy images, preparation time, and anesthesia time were statistically lower in Group 2. There was no statistically significant difference between Group 1 and Group 2 in terms of surgery time. Intramedullary nailing in the LD position is a reliable and practical surgical method in the treatment of femoral trochanteric fractures since there is no need for the use of a FT, the surgeon is exposed to less radiation, there is no risk of complications related to the traction of the FT, and there is a shorter operation time.

OBJECTIVE:In pediatric patients, femoral neck fracture is a relatively rare injury with a high complication rate despite proper diagnosis and treatment. Fixation of femoral neck fractures is usually performed with screws placed along the neck axis. In this study, we aim to compare two different implants and methods in terms of biomechanics. MATERIALS AND METHODS:Twenty-eight right-left fresh femur bones of 6-month-old male Ovis aries lambs grown on the same farm were used. Bones were randomly divided into 4 groups (n=7). In group 1, the Delbet type III femoral neck fracture model was fixed with two 4.5 mm cannulated screws, one screw crossing the physis. In group 2, two 4.5 mm cannulated screws, which did not cross the physis, were used. In group 3, Delbet type III femoral neck fracture model was fixed with a 3.5 mm proximal femoral anatomical plate and five screws, one screw crossing the physis. Finally, in group 4, Delbet type III femoral neck fracture model was fixed with one 3.5 mm proximal femoral anatomical plate and five screws that did not exceed the physis. RESULTS:Biomechanical tests were performed using a Zwick/Roell AllroundLine 100 kN device. While axial failure burden (F = 6.819, p<.05, d = .46) and axial stiffness (F = 3.576, p<.05, d = .30) have been found to be significantly different between the independent treatment groups, axial failure displacement (F = .622, p>.05) and axial failure energy (F = .727, p>.05) have been found not to be significant between the independent groups. The effect sizes of the axial failure load and axial stiffness variables were 0.46 and 0.30, respectively, suggesting a moderate clinical effect. The highest axial failure load was recorded in group 3, while the smallest load was recorded in group 2. Similarly, the axial stiffness level in group 3 was statistically higher than the axial stiffness measurement recorded in group 2, p<.05. CONCLUSIONS:Consequently, we found that the biomechanical fixation success was the highest with a 3.5 mm proximal femoral anatomical plate, a 3.5 mm locking screw crossing the physis, and five 3.5 mm screws.

Musculoskeletal infections, including septic arthritis, osteomyelitis, and soft tissue infections, are critical morbidity factors for children and adolescents. This study investigated the role of D-dimer levels for diagnosing childhood musculoskeletal infections. This single-center prospective study was initiated in April 2020 following approval from the local ethics committee. The study included 54 children, divided into the infection group (n = 21), comprising patients who underwent surgical treatment for childhood musculoskeletal infections and had macroscopically visible purulent discharge during surgery, and the control group (n = 33), comprising healthy children. In the infection group, the mean values of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), plasma D-dimer, and white blood cell (WBC) were 39.42 ± 27.00 mm/h, 101.50 ± 76.90 mg/l, 2.34 ± 2.59 mg/l, and 15.55 ± 6.86 × 109/l, respectively. On comparison, the infection group showed higher levels of WBC, CRP, ESR, D-dimer, and neutrophil-to-lymphocyte ratio than the control group. When the D-dimer cutoff value of 0.43 mg/l was taken, it was observed that it had 95.2% sensitivity and 81.8% specificity. The area under curve (AUC) of the above-mentioned parameters calculated via receiver operating characteristic curves showed CRP levels as the optimum predictor of childhood musculoskeletal infections, followed by the ESR, plasma D-dimer, and WBC levels in descending order (AUC: 0.999, 0.997, 0.986, and 0.935, respectively). D-dimer is another test, which in combination with other conventional established tests (CRP and ESR) can be helpful in diagnosis of pediatric infection. We recommend the addition of D-Dimer to ESR, CRP, and WBC as a first-line investigation in cases with suspected pediatric musculoskeletal infections.

Background: Fixation of trochanteric fractures with intramedullary nail in non-physiological position can cause poor functional outcomes. The aim of this study, evaluate the effect of intra-operative patient position on rotational alignment in intramedullary nail fixation of trochanteric fractures. Methods: Femoral rotational alignment of 84 trochanteric fracture patients who underwent intramedullary nailing was measured by comuted tomography (CT) images. Patients were divided into two groups: Supine position on fracture table (Group-1, n:42) and lateral decubitus (LD) position (Group-2, n:42). Femoral malrotation angles were measured and divided into three subgroups as insignificant, significant and excessive. Number of intra-operative fluoroscopy imaging, preparation time, surgery time and anesthesia time in both groups compared. Results: Malrotation degrees of patients in Group-1 ranged from 17° external rotation (ER) to 57° internal rotation (IR), with a mean of 10° IR. Of the patients in Group-1, 27 were in insignificant, 5 were in significant, and 10 were in excessive subgroup. Malrotation degrees of patients in Group-2 ranged from 33° ER to 47° IR, with a mean of 11° IR. Of patients in Group-2, 21 were in insignificant, 12 were in significant, and 9 were in excessive subgroup. There was no statistically significant relationship between patient position and malrotation angle. Number of intra-operative fluoroscopy imaging, preparation time and anesthesia time were statistically lower in Group-2. There was no statistically significant difference between Group-1 and Group-2 in terms of surgery time. Conclusion: Intramedullary nailing in LD position is a reliable and practical surgical method in treatment of femoral trochanteric fractures, since there is no need for use of a fracture table, surgeon is exposed to less radiation, no risk of complications related to traction of fracture table, and shorter operation time.

Özet Amaç: Bu çalışmanın amacı; Gelişimsel kalça displazisi (GKD) nedeniyle sonografik tarama sırasında Tip2a kalça tespit edilen 4-8 haftalık çocuk, kalçanın sonografik bozulması ile ilişkili risk faktörlerini belirlemektir. Gereç ve Yöntemler: Ocak 2018-Aralık 2020 arasında, tek bir merkezde GKD taraması nedeniyle başvuran 4-8 haftalık 1746 çocuğun, 3492 kalçası retrospektif olarak incelendi. Hastanemize başvuran ve sonografik incelemesinde Tip2a tespit edilen ve 4 hafta sonraki kontrolüne gelerek sonografik inceleme yapılan 195’i (%70) kadın, 84’ü (%30) erkek toplam 279 çocuğun 360 kalçası çalışmaya alındı. Bulgular: Olguların 91’i (%32.6) sağ, 107’si (%38.3) sol, 81’i (%29) bilateral olmak üzere incelenen 360 kalçanın sonraki sonografik incelemelerinde, %85’inin (n=306) kendiliğinden düzeldiği ve %15’inin (n=54) sonografik olarak kötüleştiği görülmüştür. Makat geliş ve nörolojik hastalık (p=0,000) ile sonografik bozulma arasında ise istatistiksel olarak anlamlı bir ilişki olduğu tespit edilmiştir (sırasıyla; p=0,002, p=0,000). Sonografik bozulma riski makat gelişi olanlarda olmayanlara göre 5,3 kat, nörolojik hastalığı olanlarda olmayanlara göre 9,6 kat daha yüksek bulunmuştur. Sonuç: GKD nedeniyle yapılan sonografik tarama sırasında Graf Tip2a kalça tespit edilen çocuklarda, nörolojik hastalık ve makat geliş varlığı sonografik kötüleşme için bağımsız risk faktörüdür. Bu çocukların takiplerinde dikkatli olunması ve ailelerin bilgilendirilmesi önemlidir.

Aim: The present study aims to evaluate clinical and functional results of arthroscopic single row rotator cuff repair and acromioplasty in patients with Rotator cuff tears (RCT). Materials and Methods: Sixty one patients whom were applied arthroscopic single row rotator cuff repair and arthroscopic acromioplasty between 2016 and 2019 were included in the present study. Patients’ rotator cuff tears (Patte classification) and acromion were classified based on X-ray and Magnetic Resonance Imaging (MRI) results. In addition, patients’ Constant Murley Scores, Shoulder Range of Motion (ROM) and visual analogue scale (VAS) scores were also analyzed prior to and following the surgical operation. Results: Forty one (67.2%) out of 61 patients in the present study were applied surgery on the right shoulders, while 20 of them (32.8%) were applied surgery on the left shoulders. Twenty one (34.4%) of patients were male, while 40 (65.6%) of them were female. Patients were divided into three groups as type 1 (n=10), type 2 (n=41), type 3 (n=10) based on their acromion classification and three stages as stage 1 (n= 15), stage 2 (n=36), and stage 3 (n=10) based on their rotator cuff tears. In addition, while their mean preoperative Constant-Murley and VAS scores were 29.8±0.79 and 9.14±0.11, respectively, it increased to 81.1±1.07 and decreased to 2.06±1.07 in the postoperative period, respectively. Finally, while patients’ preoperative mean abduction ROM was 60.73°±1.31°, it increased to 126.22°±2.27° in the postoperative period. Conclusion: Arthroscopic single row rotator cuff repair and arthroscopic acromioplasty in patients suffering from RCT contributes to significant relief of pain and remarkable increase in shoulder abduction ROM, thus offering an effective and reliable surgical treatment which allows the active use of extremities.

Bu calismanin amaci, duygusal ve davranissal sorunlarla ilgili Turkiye’de yapilan lisansustu tezlerin incelenmesidir. Arastirmada nicel arastirma yontemlerinden betimsel tarama modeli kullanilmistir. Arastirmanin orneklemini Yuksek Ogretim Kurumu Ulusal Tez Merkezi internet sitesinden ulasilan 145 yuksek lisans, doktora ve tipta uzmanlik tezleri olusturmaktadir. Arastirmada veri toplama araci olarak,  arastirmacilar tarafindan arastirmanin amacina uygun olarak hazirlanan veri toplama formu olusturulmustur. Incelenen tezler, veri toplama formunda yer alan sorular dogrultusunda incelenmis, elde edilen verilerin frekans ve yuzdeleri analiz edilmistir. Arastirma sonucunda duygusal ve davranissal sorunlari iceren en fazla calismanin tipta uzmanlik tezi (%44.83) oldugu; yillara gore bakildiginda en fazla 2000-2009 yillari arasinda (%41) calisma yapildigi saptanmistir. Calisma gruplarina bakildiginda en fazla farkli yas grubundaki cocuklar (%39.31) uzerinde calismalarin yapildigi; lisansustu calismalarinda en fazla amacsal ornekleme tekniginin (%58.62) kullanildigi gorulmustur.  Hastalik turu/calisilan sorun turune gore en fazla birden fazla bozukluk turunu ayni anda calisilan (%50.34) lisansustu tezlere rastlanmistir. Incelenen lisansustu tezlerin cogunlukla tam metin (%79.31) olarak ulasildigi; anabilim dallari incelendiginde duygusal ve davranissal sorunlarla ilgili lisansustu calismalarin cogunlugunun Cocuk Ruh Sagligi/Cocuk Ergen Ruh Sagligi ve Hastaliklari anabilim dalinda (%30.34)  yayinlandigi tespit edilmistir. Incelenen lisansustu tezlerde model ve desen olarak en fazla betimsel model (%42.76) calisildigi; yontemine bakildigindaysa en fazla nicel arastirma yonteminin (%67.59) kullanildigi gorulmustur.

This study was conducted to investigate the relationship between self-regulation skills of 48-62 months children and their parents' level of communication. The sample of the study, which was designed in the relational screening model, consisted of 317 randomly selected children attending pre-school education in Bingol and Hatay. “Personal Information Form”, Mother-Father-Child Communication Assessment Tool (ABCIDA) ”and“ Self-Regulation Skills Scale (Mother Form) ”scale were used as data collection tool. Descriptive statistics (mean, standard deviation, minimum and maximum), number and percentage, Duncan test, Pearson Correlation coefficient were calculated to analyze the obtained data. After all; a very weak and significant relationship was found between parents' level of communication with their children and their self-regulation skills.

Bu çalışmanın amacı, duygusal ve davranışsal sorunlarla ilgili Türkiye’de yapılan lisansüstü tezlerin incelenmesidir. Araştırmada nicel araştırma yöntemlerinden betimsel tarama modeli kullanılmıştır. Araştırmanın örneklemini Yüksek Öğretim Kurumu Ulusal Tez Merkezi internet sitesinden ulaşılan 145 yüksek lisans, doktora ve tıpta uzmanlık tezleri oluşturmaktadır. Araştırmada veri toplama aracı olarak, araştırmacılar tarafından araştırmanın amacına uygun olarak hazırlanan veri toplama formu oluşturulmuştur. İncelenen tezler, veri toplama formunda yer alan sorular doğrultusunda incelenmiş, elde edilen verilerin frekans ve yüzdeleri analiz edilmiştir. Araştırma sonucunda duygusal ve davranışsal sorunları içeren en fazla çalışmanın tıpta uzmanlık tezi (%44.83) olduğu; yıllara göre bakıldığında en fazla 2000-2009 yılları arasında (%41) çalışma yapıldığı saptanmıştır. Çalışma gruplarına bakıldığında en fazla farklı yaş grubundaki çocuklar (%39.31) üzerinde çalışmaların yapıldığı; lisansüstü çalışmalarında en fazla amaçsal örnekleme tekniğinin (%58.62) kullanıldığı görülmüştür. Hastalık türü/çalışılan sorun türüne göre en fazla birden fazla bozukluk türünü aynı anda çalışılan (%50.34) lisansüstü tezlere rastlanmıştır. İncelenen lisansüstü tezlerin çoğunlukla tam metin (%79.31) olarak ulaşıldığı; anabilim dalları incelendiğinde duygusal ve davranışsal sorunlarla ilgili lisansüstü çalışmaların çoğunluğunun Çocuk Ruh Sağlığı/Çocuk Ergen Ruh Sağlığı ve Hastalıkları anabilim dalında (%30.34) yayınlandığı tespit edilmiştir. İncelenen lisansüstü tezlerde model ve desen olarak en fazla betimsel model (%42.76) çalışıldığı; yöntemine bakıldığındaysa en fazla nicel araştırma yönteminin (%67.59) kullanıldığı görülmüştür.

Ureteroinguinal herniation is a rare event, usually diagnosed during the surgical repair of inguinal hernias and most reported cases have occurred in obese men during the fifth and sixth decades of life. Here, we describe the first case of unilateral renal and spermatic cord agenesis accompanying to the ureteral inguinal herniation in an infant.

In this study, it is aimed to examine and compare the opinions of the class teacher, branch teacher and administrator working in primary and secondary schools in the field of inclusion education and practices. The research is qualitative research. A semistructured interview form was used for data collection. Data within the scope of the study were obtained through interviews. The research population consits of class teachers, branch teachers and administrators. The research sample is made up of 9 class teachers, 6 branch teachers and 2 administrators working in Kırıkhan district of Hatay province. An easily accessible sampling method was used to determine the sample. According to the results, it was observed that the class teachers did not have a positive attitude towards inclusive students and the same statements were used by branch teachers. It has been observed that some of the branch teachers have problems in the assessment and evaluation system, but the class teachers do not have such problems. All of the teachers who participated in the study stated that inclusive students are excluded by their friends and their families’ support is insufficient. It can be said that the previous trainings of teachers on inclusion contribute positively to their professional lives. On the other hand, the administrators stated that they are sensitive to inclusion education, follow the regulations and provide control of the education provided within the school. Based on the findings obtained; suggestions such as providing guidance to families, providing inclusion training for teachers with inclusive students, and giving inclusion training to all teachers have been made.

Electrospraying assures many advantages with taking less time and costing less relatively to the other conventional particle production methods. In this research, we investigated the encapsulation of melatonin (MEL) hormone in polycaprolactone (PCL) microparticles by using electrospraying method. Morphology analysis of the produced particles completed with Scanning Electron Microscopy (SEM). SEM images demonstrated that micro-particles of 3 wt% PCL solution has the most suitable particle diameter size (2.3 ± 0.64 μm) for melatonin encapsulation. According to the characterization of the particles, electrospraying parameters like optimal collecting distance, the flow rate of the solution and voltage of the system detected as 8 cm, 0.5 ml/h, and 10 kV respectively. For determining the chemical bonds of scaffold Fourier-Transform Infrared Spectroscopy (FTIR) were used and FTIR results showed that melatonin successfully loaded into PCL micro-particles. Drug release kinetics of the melatonin loaded particles indicated that melatonin released with a burst at the beginning and release behavior became sustainable over a period of 8 h with the encapsulation efficiency of about 73%. In addition, both in-vitro and in-vivo studies of the graft materials also completed. Primary human osteoblasts (HOB) cells and female Sprague Dawley rats were used in in-vitro and in-vivo studies. Test results demonstrate cell population, and bone volume of the rats grafted with composites has remarkably increased, this caused remodelling in bone structure. Overall, these findings indicate that encapsulation of melatonin in the PCL particles with electrospray method is optimum for new synthetic graft material.

Background: Meningomyelocele (MMC) is a condition that is originated by the fusion defect of the neural tube. It is a congenital anomaly and can be characterized by spinal cord defects and impaired skin integrity. It is very important to close the skin openings via three-dimensional artificial skin like construction for preventing infection and maintaining the healthy skin structure. Therefore, we aim to generate artificial skin like structures formed by the own cells of donor for treating the MMC-related skin disorder. Methods: In this study, waste placental tissues were collected and decellularization process was applied. Decellularized and normal placental tissues were compared by immunohistochemistry (IHC). Donor's own placental stem cells were seeded onto biological scaffold and were differentiated into skin related cell types. Finally, gene expressions were evaluated, and the structural integrity were analyzed with IHC. Tube formation assay was also performed for examining the angiogenesis formation of the tissue in order to evaluate the possibility of a healthy organ development. Results: Characterization experiments proved that the decellularized skin preserved a normal skin 3D construction and vasculature along with significant ECM arrangements. The well-kept placental ECM scaffold was cytocompatible, supportive of mesenchymal cell types. Native organ related scaffold is expected to carry a huge influence in skin tissue engineering via delivering a niche for skin-based cells and even for stem/progenitor cells. Regarding to the data obtained from this study, in vivo investigation the skin-like structure in animal models is thought to be the next step as a future prospect. Conclusion: This study is a reference investigation for skin engineering based on placental stem cells and biological scaffolds. (C) 2018 Elsevier Ltd. All rights reserved.