Liver transplantation is the gold standard treatment for end-stage liver failure, and early extubation in the postoperative period is recommended to improve graft function. Coronary artery bypass grafting (CABG) is a surgical procedure to restore normal blood flow to an obstructed coronary artery. Patients undergoing cardiac surgery are often heparinized, which increases the risk of hematoma associated with regional anaesthesia, particularly central neuraxial techniques. Effective analgesic management plays a crucial role in achieving early extubation in both surgical procedures. Opioid agents are often preferred for analgesia management. However, the use of opioids in these patients increases the risk of complications; therefore, regional anaesthesia techniques are preferred. In the intensive care unit, we performed a combination of modified thoracoabdominal nerve block and pecto-intercostal fascial plane block as rescue analgesia in a patient who had undergone simultaneous liver transplantation and CABG.

Aslında birbirine sıkı sıkıya bağlı iki kavram… Pestisit ve aflatoksin kalıntıları ürünlerin güvenliğini nasıl etkiliyor? İşin teknik ve ekonomik boyutu kadar etik anlamda sorun yaşanmıyor mu? Çiftçi kazanamıyor, üretimden çekiliyor. Türkiye tarım ürünleri ithal etmek zorunda kalıyor. Ülkemiz son 25 yılda Hollanda büyüklüğünde tarımsal arazi kaybediyor. 2002de köy nüfusu toplam nüfusun %20si iken, bugün %7e düşüyor. Ortalama çiftçi yaşı 59a yükseliyor. Maliyetler çok yüksek olduğu için köylüler ekip biçmek yerine, arazilerini inşaat için satıyor. Böyle giderse gıdaya erişmek ve gıda enflasyonunu dizginlemek hayli güçleşecek, gıda ürünleri bugünkünden pahalı olacak, tarım ürünleri ithalatına milyar dolarlar harcanacak. Bir ülke biyoteknolojiye yatırım yaparsa, sadece sağlık sistemi değil, tarımsal üretimi, gıda güvenliği ve gıda güvencesi de artacaktır. Bu bağlamda, Gıda Güvenliğinden Gıda Güvencesine Bitki Sağlığı adlı eserde yer alan Türkiye ve dünyada pestisit kalıntısı ve stratejik iletişim boyutu ve gıda güvenliğinde yeni tarım uygulamaları bölümleri gıda güvencesi açısından konuyu derinlemesine incelemektedir. Gıda güvenliğinin teminatı tarım diplomasisi bölümü ise bu önemli konunun uluslararası ilişkilerdeki yerini vurgulamaktadır. Organik gıda güvenilir gıda başlığı altında, organik tarımın sunduğu fırsatlar ve karşılaşılan zorluklar ele alınırken, kitabın diğer bölümleri bitki sağlığını tehdit eden hastalık ve zararlılar ile bunlara karşı geliştirilen biyolojik mücadele yöntemlerine ışık tutmaktadır. İlginizi çekeceği düşüncesi ile…

The sweet potato/cotton whitefly Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae) is one of the most destructive vegetable pests in greenhouses in Türkiye. While the preferred method of control primarily relies on insecticides such as neonicotinoids, organophosphates and pyrethroids, their intensive use has caused whiteflies to rapidly become resistant. Samples were collected from 13 Turkish B. tabaci greenhouse populations. Bioassays from the Marmara Region identified as high as a 53-fold increase in resistance to chlorpyrifos-ethyl, a 303-fold increase to imidacloprid and a 282-fold increase to acetamiprid. Bioassays in the Central Anatolia Region reported a 76-fold increase in resistance to deltamethrin and—15-fold increase to thiamethoxam. Most of the populations showed cross-resistance for neonicotinoids. All collected B. tabaci populations were determined to be MEAM 1 (also referred to as biotype B) for diagnostic band E 0.14 . The E 0.14 esterase variant that helps to diagnose biotype B insects was found in all individuals from field populations. Almost all populations showed higher non-specific esterase, glutathione-S-transferase (GST) and monooxygenase activity when compared to susceptible SUD-S population. AChE insensitivity assays for individual B. tabaci suggest a target-site modification as a mechanism of resistance to chlorpyrifos-ethyl. This is the first report of AChE variants identified based on their sensitivities to chlorpyrifos ethyl-oxon and pirimicarb in Turkish B. tabaci populations. Fixed ace mutations in the target-site of organophosphates and pyrethroids were identified in six populations. Resistance to organophosphates and neonicotinoids were at least partially related to both ace mutations and insensitive AChE and monooxygenase activities, respectively. The results will help develop effective resistance management programs of B. tabaci in Türkiye. Graphical Abstract

Video-assisted thoracic surgery (VATS) is currently used for the repair of pectus excavatum. Analgesia after thoracic surgery can be provided with nerve blocks, intravenous drugs, or neuraxial techniques. Serratus posterior superior intercostal plane block (SPSIPB) is a novel interfascial plane block and it is performed between the serratus posterior superior muscle and the intercostal muscles at the level of the second and third ribs. In this case, we present our successful analgesic experience with SPSIPB in a patient who underwent minimally invasive pectus excavatum repair with a VATS technique.

The six -toothed pine bark beetle, Ips sexdentatus (Borner, 1776) (Coleoptera: Scolytidae), is one of the important pests of Pinus and Picea species in the forests of Turkiye. Baskent University Baglica Campus was established in 1993 and approximately 5 million trees have been planted in the area to date, including those that have dried up. Pheromone traps were hung in campus for monitoring the adult population development, determining the flight activities of the insect and controlling it on IPM principles. The first adult emergence of I. sexdentatus in Baglica took place in the first half of April, the highest flight activity was in April. Ips sexdentatus produced three generations in the region. The highest numbers of adults caught in traps were 741 (27 July 2021) and 421 (25 April 2022), respectively. In the Baglica Campus, a total of over 19,000 insects were caught and eliminated. Almost 328 tC of carbon stock was preserved and prevented from being released into nature and at least 11.100 black pine trees were saved or 26.640 USD was contributed to the economy. Using pheromone traps for the control of I. sexdentatus is recommended as a sustainable method that protects biodiversity, without any disturbance of the ecological balance.

Tarım sektörü, artan gıda talebi, dünya nüfusundaki hızlı artış, verimli tarım arazilerinin giderek azalması, biyolojik çeşitlilik kaybı, çevre kirliliği, iklim değişikliği, kuraklık, bitkisel üretimi sınırlayan zararlı organizmaların sayısının artması, bitki koruma ürünlerine (BKÜ) karşı gelişen direnç, BKÜ’lerin faydalı böcekler üzerine olan olumsuz etkileri, kalıntı, genç nüfusun tarımdan uzaklaşması vb. gibi çok çeşitli yerel ve küresel risklerle karşı karşıya bulunmaktadırlar. Günümüzde tarımsal üretimde yaşanan bu sorunlardan birisi olan tarımsal üretimde verim ve kaliteyi etkileyen hastalık, zararlı ve yabancı otlarla mücadelede en çok tercih edilen yöntem kimyasal mücadele olup, Bitki Koruma Ürünleri (BKÜ) kullanılmaktadır. Türkiye’de 2022 yılında 55.374 ton BKÜ kullanılmıştır. Türkiye’de BKÜ kullanımın incelendiginde, hektara düşen oran 2.26 kg/ha olup, gelişmiş ülkelere göre oldukça düşüktür. Ancak tarımsal üretim faaliyetlerinin yoğun olarak yapıldığı Akdeniz, Ege ve Marmara bölgelerinde BKÜ tüketim miktarı fazladır. Dünyada tarımda BKÜ kullanımı 2021 yılında 2020 yılına göre %4 artışla 3,5 milyon ton aktif madde, toplam pestisit ticareti ise 7,1 milyon ton formüle edilmiş ürün ve toplam değeri 43,2 milyar ABD dolarıdır. Bu çalışma kapsamında, Dünya’da ve Türkiye’de BKÜ kullanımı incelenmiş ve önerilerde bulunulmuştur.

Acinetobacter baumannii, associated with nosocomial infections, is considered a significant mortality risk if not adequately addressed. A. baumannii infections typically occur after surgery or trauma. Our patient developed complicated A. baumannii meningitis with lateral ventriculitis and a lumbar abscess post -surgery following a fall. The patient was treated with a 21 -day regimen of intrathecally administered colistin and polymyxin B. Following this therapeutic period, the patient's condition improved, leading to successful recovery and subsequent discharge. This case report highlights the effectiveness of intrathecal administration of antibiotics, which normally have limited potential for crossing the blood -brain barrier, in improving survival outcomes in multi -drug -resistant nosocomial meningitis.

Türkiye’de tarımsal üretimin biyolojik çeşitliliği koruyarak sürdürülebilir bir şekilde yürütülmesi önem arz etmektedir. Ülkemiz tarım sektörünün üretimde yaşadığı, bazılarının ise kronikleştiği çeşitli sorunları bulunmaktadır. Verimli tarım alanlarının azalması, artan gıda talebi, genç neslin tarımdan uzaklaşması, girdi maliyetleri, kırsal kalkınma, küçük aile işletmeciliğinin ve buna bağlı olarak parçalı arazi yapısının yaygın olması ve iklim değişikliği gibi tarımsal üretimi ve verimliliği etkileyen pek çok sorun bulunmaktadır. Üretimde verimliliği etkileyen sebeplerden birisi de tarımsal üretimde görülen hastalık, zararlı ve yabancı otlardır. Biyolojik çeşitliliği koruyarak sürdürülebilir bir şekilde tarımsal üretim yapılmasının yolu Entegre Zararlı Yönetiminin (IPM) uygulanmasından geçmektedir. Entegre Zararlı Yönetiminde tarımsal zararlılara karşı bütün mücadele yöntemlerinin uyumlu bir şekilde kullanılması esas olup, biyolojik, biyoteknik ve kültürel önlemlere öncelik verilmektedir. En son çare olarak, Bitki Koruma Ürünlerinin (BKÜ) uygulanması istenmektedir. Bu nedenle, kullanılacak BKÜ’lerin insan sağlığına zararlı olmaması, çevre kirliliğine yol açmaması, parazitoid, predatör, pollinatörleri olumsuz etkilememesi ve ürünlerde kalıntıya sebep olmaması gerekmektedir. Yani BKÜ uygulamalarının gelişi güzel, bilinçsizce değil, akla, bilime, bilgiye dayalı ve biyolojik çeşitliliğin korunmasına yardımcı olacak şekilde sürdürülebilir olarak yürütülmesi esastır. Entegre Zararlı Yönetiminde kullanılacak BKÜ’lerin seçiminde, insan ve çevre sağlığı açısından oluşabilecek riskleri ortaya koyabilmek amacıyla aktif maddelerin memeli hayvanlar, balıklar, hedef dışı organizmalar (parazitoitler, predatörler) ve balarılarına etkileri ile topraktaki kalıcılıkları göz önüne alınarak risk değerlendirmeleri yapılmakta olup, biyolojikler, böcek gelişme düzenleyicileri gibi BKÜ’lere öncelik verilmektedir. Yürütülen risk değerlendirmesi çalışmaları sonucunda 495 aktif madde, 204 adet karışım, 13 adet biyolojik preparat, 21 adet biyolojik mücadele etmeni ve 1 adet safener olmak üzere toplam 734 adet BKÜ incelenmiş ve uygun olanlar entegre mücadele teknik talimatlarında üreticilerimizin ve ülke tarımımızın hizmetine sunulmuştur.

The agricultural sector faces a wide range of local and global risks such as increasing food demand, rapid increase in world population, gradual decrease in fertile agricultural land, loss of biodiversity, environmental pollution, climate change, drought, increasing number of harmful organisms limiting crop production, resistance to plant protection products (PPPs), negative effects of PPPs on beneficial insects, residue, young population moving away from agriculture, etc. Nowadays, chemical control is the most preferred method of controlling diseases, pests and weeds that affect yield and quality in agricultural production, and Plant Protection Products (PPPs) are used. In 2022, 55,374 tonnes of PPP was used in our Turkiye. In Turkiye, PPP usage in the rate per hectare is 2.26 kg/ha, which is quite low compared to developed countries. However, in the Mediterranean, Aegean and Marmara regions where agricultural production activities are intensively carried out, the amount of PPP consumption is high. The use of PPP by groups in the world, it has increased by 53% to 111% compared to the 1990s. The use of PPPs in agriculture in the world is 3.5 million tonnes of active ingredients in 2021 with an increase of 4% compared to 2020, and the total pesticide trade is 7.1 million tonnes of formulated products with a total value of 43.2 billion USD. In this study, the use of PPPs in the world and our country was analysed and recommendations were made.

Özet Avrupa Birliği 2019 yılında yayınladığı Avrupa Yeşil mutabakatı (AYM) (European Green Deal) ile iklim değişikliği ile mücadele, tek sağlık ve sürdürülebilir bir gelecek, için AB ekonomisini şekillendirmeyi amaçlayan ve tüm sektörleri ilgilendiren düzenlemeleri onaylamış bulunmaktadır. AYM sadece AB üye ülkeleri için değil, aynı zamanda AB ile siyasal, ekonomik ve coğrafi açıdan ilişkisi bulunan tüm ülkeler gibi, Türkiye için de büyük bir önem arz etmektedir. AYM 2050 yılına kadar Avrupa kıtasını iklim nötr hale getirmek için sanayiden ekonomiye bir dizi dönüşümü kapsamaktadır. AYM’nin kalbi olan "Çiftlikten Çatala" stratejisinin detaylı olarak incelenmesi, mevcut ve yeni çıkacak olan mevzuatların yakından takip edilmesi gerekmektedir. Türkiye’nin yaş meyve sebze ihracatının %37’si AB ülkelerine yapılmaktadır. İhracatı yapılan başlıca meyveler ise kiraz, vişne, şeftali, elma ve üzümdür. Türkiye olarak özellikle tarım sektörünün rekabet gücünü sürdürebilmesi ve bu dönüşüme uyum sağlaması için tarımsal destek sistemimiz dahil pek çok konuda hazırlıklı olmamız, stratejik planlarımızı ve mevzuatlarımızı güncellememiz gerekmektedir.

In this prospective, randomized study, we aimed to compare the global recovery scores and postoperative pain management between US-guided mTLIP block versus QLB after lumbar spine surgery. 60 patients with ASA score I-II planned for microendoscopic discectomy under general anesthesia were included. We allocated the patients into two groups: the QLB group (n = 30) or the mTLIP group (n = 30). QLB and mTLIP was performed with 30 ml 0.25 mTLIP provided superior analgesia compared to posterior QLB. The QoR-40 scores in the mTLIP group were higher than those in the QLB group.

Aims: Extra corporeal membrane oxygenation (ECMO) has been used as a supportive treatment in ARDS due to COVID-19. Although different results have been reported in the literature regarding its efficacy, ECMO is recommended as a salvage therapy for severe forms of the disease after standard therapy fails. In our study,we aimed to evaluate the survival outcomes of patients supported with ECMO for COVID-19. Methods: Our study was conducted by scanning the data of consecutive adult patients hospitalized in our intensive care unit due to COVID-19. The ECMO process was planned according to the Extracorporeal Life Support Organization (ELSO) and Berlin criteria. Results: 51 patients hospitalized for acute respiratory failure due to COVID-19 were taken to ECMO. Demographic data of patients; 39 (76.5%) men and 12 (23.5%) women. 46 (90.2%) of the patients died. The mean intubation time before ECMO is 3.9 days, and the mean time for non-invasive mechanical ventilation is 5.8 days. The mean PaO2 value before ECMO was79.09 mmHg, the mean PCO2 value was 63.62 mmHg and the mean PaO2/FiO2 ratio was 82.80. Conclusion: The use of ECMO by considering prognostic factors and guidelines is seen as factors that increase the chance of success.Despite the fact that the patients were admitted to ECMO in accordance with the guidelines in our study, the high mortality rate suggests that there is a need for investigation of other supportive treatments and studies to reduce ECMO complications.

OBJECTIVE:The aims of this survey study were to evaluate the contribution of YouTube to nerve-block learning/education and the advantages and disadvantages of the YouTube.MATERIALS AND METHODS:A total of 24 questions were selected for the survey by consensus of the authors. Information in the form of web data was obtained through an electronic data form that was distributed via WhatsApp to known email addresses and phone numbers of 300 practitioners (anesthesia residents, anesthesiologists, and academicians). There were a total of 24 questions on the survey. The first section included 5 questions collecting demographic data, and the second part encompassed 19 questions about the YouTube nerve block videos.RESULTS:Among the participants, 232 of practitioners (86.9%) performed peripheral nerve blocks, and only 35 practitioners (13.1%) had no experience of nerve blocks so and used YouTube videos for educational purposes. According to our results, YouTube videos frequently improved performance. In addition, YouTube improved the training of practitioners in terms of the type of block procedure, identifying anatomical landmarks, target structures like nerves and blood vessels, needle visualization, needle depth, and patient position.CONCLUSION:YouTube contributes to the performance of regional anesthesia and to learning at all academic levels. It should not be forgotten that such videos are not peer reviewed by professionals in the relevant field.

The six-toothed pine bark beetle, Ips sexdentatus (Börner, 1776) (Coleoptera: Scolytidae), is one of the important pests of Pinus and Picea species in the forests of Türkiye. Başkent University Bağlıca Campus was established in 1993 and approximately 5 million trees have been planted in the area to date, including those that have dried up. Pheromone traps were hung in campus for monitoring the adult population development, determining the flight activities of the insect and controlling it on IPM principles. The first adult emergence of I. sexdentatus in Bağlıca took place in the first half of April, the highest flight activity was in April. Ips sexdentatus produced three generations in the region. The highest numbers of adults caught in traps were 741 (27 July 2021) and 421 (25 April 2022), respectively. In the Bağlıca Campus, a total of over 19,000 insects were caught and eliminated. Almost 328 tC of carbon stock was preserved and prevented from being released into nature and at least 11.100 black pine trees were saved or 26.640 USD was contributed to the economy. Using pheromone traps for the control of I. sexdentatus is recommended as a sustainable method that protects biodiversity, without any disturbance of the ecological balance.

Objective:Non-invasive mechanical ventilation (NIV) and high-flow nasal oxygen therapy (HFNO) are the most frequently used methods for treating hypoxemia in those diagnosed with coronavirus disease-2019 (COVID-19) in the intensive care unit (ICU). In this prospective study, we compared the effects of these two treatment modalities applied alternately in the same patient.Materials and Methods:Standard oxygen therapy (SOT) was administered for 1 hour to patients hospitalized in the ICU with a diagnosis of acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS) due to COVID-19. HFNO and NIV were applied alternately to patients who met the inclusion criteria, and we evaluated the effects of HFNO and NIV applied to the same patient.Results:Thirty of forty-five patients admitted to the ICU for COVID-19 ARDS met the inclusion criteria for the study. According to the first and second arterial blood gas (ABG) values, the PaO2/FiO2 (P/F) ratio was significantly higher during NIV compared to both baseline and HFNO. In addition, the ROX index was significantly higher during NIV than HFNO, and SpO2 in NIV increased significantly compared with the baseline value. In both methods, patient satisfaction according to the visual analog scale was better than that of SOT. Eighty percent (24/30) of the patients were orotracheally intubated; 13 patients were transferred to the ward (43.3%), 2 patients were discharged home (6.7%), and 15 patients died (50%).Conclusion:Starting respiratory support with HFNO and/or NIV rather than SOT is more effective in improving oxygenation in patients with AHRF and ARDS due to COVID-19 and other causes. NIV is more effective than HFNO in increasing the SpO2 and P/F ratio.

The Green apple aphid, Aphis pomi de Geer (Hemiptera: Aphididae), is one of the most common and serious insect pests of apple orchards in Turkey. This species feeds on succulent tissue of trees, which can lead to leaf curling, stunting, distorted tip growth, black-sooty mold, and a vector of some plant viruses. Growers prefer to apply insecticide applications heavily to control the green apple aphid in commercial apple orchards. However, there have not been conducted any research study on insecticide resistance of A. pomi in Turkey. The resistance status of A. pomi populations collected from commercially apple orchards in the Central Anatolia region was investigated to: acetamiprid (neonicotinoid), the specific aphicide pirimicarb (carbamate), beta-cyfluthrin (synthetic pyrethroid), and chlorpyrifos-ethyl (organophosphate) insecticides. All populations were characterised for the first time using polyacrylamide gel electrophoresis to determine the esterase banding patterns. Biochemical assays revealed higher activity of total esterase. This is the first study conducted to determine glutathione S-transferase activity related to the insecticide resistance of A. pomi. It was determined that the resistance levels reached to 14.93 fold to acetamiprid, 3.74 fold to beta-cyfluthrin, 4.19 fold to chlorpyrifos-ethyl, and 4.33 fold to pirimicarb. The present study revealed neonicotinoid, organophosphate, carbamate, and pyrethroid resistance in A. pomi populations from the Central Anatolia Regions of Turkey. It also clearly showed that the enhanced esterase enzyme activity is the main resistance mechanism against carbamate pirimicarb resistance. The present study is the first insecticide resistance study on A. pomi for Turkey.

BACKGROUND/AIM: Considering comorbidity rates in patients diagnosed with coronavirus disease 2019 (COVID-19), polypharmacy will be inevitable when the treatment for COVID-19 is added to the treatment of existing chronic disease conditions. In our study, we evaluated the effects of comorbidities, drug-drug interactions and complications on the clinical course of the disease in COVID-19 patients. MATERIALS AND METHODS: This study was conducted retrospectively with thirty five COVID-19 patients of various age and gender groups who had been admitted to the intensive care unit in a university hospital in March and April, 2020. The demographic, laboratory and clinical data were collected. RESULTS: In our study, the average number of days intubated in patients with acute respiratory distress syndrome and sepsis was found to be statistically significantly higher than those without complications. serious-use alternative interaction was detected in 85.7% of the patients, monitor closely interaction in 60%, and minor interaction in 34.3%. In 88.6% of the patients, at least one of these interactions was observed, while all three interactions occurred at the same time in 20% of them. CONCLUSION: According to the results of this study, managing the risks, interventions such as drug dosage adjustment, and drug changes and monitoring of any parameters that may indicate drug side effects for the patient may be necessary.

BACKGROUND: We aimed to compare the effects of observation of the physician (POB) or by adhering to the protocol-based (PB) weaning methods on total antioxidant capacity (TAC) and total oxidative stress (TOS) levels and weaning success levels.METHODS: Our study was conducted on patients admitted from the emergency department between January 2015 and January 2018 in the intensive care unit of our hospital. During the spontaneous breathing trial (SBT), when one of the criteria specified in developed, SBT was terminated and the previous mechanical ventilator parameters were returned. The patient was planned to be taken to SBT again the next morning. If the SBT was successful, extubation was decided. The extubation decision based on physician observation was made according to the patient's state of consciousness and adequate chest expansion during the daily visit. RESULTS: The decrease in TAC average value before and after extubation was found to be significant in the POB group patients (p=0.001). The decrease in the average TAC value of the PB group patients before and after extubation was found to be significant (p=0.03).CONCLUSION: In our study, TAC values were found to be higher in the PB group than in the POB group, and in addition, the reintubation rate was found to be lower. We think that the management of weaning as a PB may contribute to maintaining the balance between TAC and TOS and reduce the rate of reintubation.