Emsworth Hospital

AIM: Laparoscopy has been widely used in surgical practice in pediatric age, and many techniques for laparoscopic hernia repair have been described till now. In this study, we compared two laparoscopic techniques performed by two surgeons; each surgeon practicing only one of the two techniques. MATERIALS AND METHODS: A retrospective analysis was performed on the surgical charts, enrolling 71 patients with uncomplicated inguinal hernia. Patients were divided into two groups according to the type of surgery: (Group A, 24 patients aged 2 months-8 years) laparoscopic percutaneous internal ring suturing technique and (Group B, 47 patients aged 35 days-12 years) three-port mini-laparoscopic technique. The hernia sac was ligated at the level of internal ring, using nonabsorbable 4/0-3/0 suture. Any unexpected contralateral opening was repaired in the same manner for both groups. Follow-up period was 4 months-2 years and 9 months-8 years, respectively. Operative time and complications were analyzed. RESULTS: Operation time (19.58 ± 7.06 minutes versus 35.87 ± 10.34 minutes, P < .001) was shorter in the percutaneous repair group. However, when subdivided by unilateral and bilateral presentation, only unilateral operative time was shorter compared to three-port group. There were no recurrences in Group A, while two recurrences occurred in Group B during the learning curve period. A contralateral opening accompanied the presenting unilateral hernia in 3 cases for Group A and 16 for Group B. One patient had to be converted open resulting from epigastric vessel injury, and postop hydrocele formation was seen in another in Group A. No intraoperative complications were seen in Group B. CONCLUSION: The overall experience shows that laparoscopic repair is a reliable approach regardless of the chosen technique. Percutaneous repair seems to be a less invasive method with shorter operative time, but it is not free of complications according to this series.

Introduction: It is widely accepted that obesity is a major public health problem in the world. The rapid rise in prevalence suggests environmental factors are responsible. Increased use of information and communication technology is also reported to be associated with increased rates of obesity. Objectives: Although many studies have analyzed the impact of televison viewing on obesity, the association of excessive Internet use with body mass index (BMI) has heretofore been evaluated only in relatively few studies. Aims: The purpose of this study was to investigate Internet use patterns and Internet addiction among adolescents and to examine the correlation between problematic Internet use and BMI. Methods: The study was conducted among 1938 students, aged between 14 and 18 years. Internet Addiction Test (IAT), Eating Attitudes Test, and a sociodemographic query form were used in the collection of data. Results: According to the IAT, 10.5% of the study sample was a ‘problematic Internet user’ or an ‘Internet addict’. A significant positive correlation between BMI and IAT (r = 0.307; p < 0.01) and weekly Internet use (r = 0.215; p < 0.01) was found. Linear regression analysis revealed a significant independent association of IAT with BMI (r = 0.235; p < 0.001). Web surfing, watching online videos, chat rooms and Internet messaging, and playing online games were significantly associated with increased BMI (p< 0.05). Conclusions: These results indicate an association between the Internet addiction and BMI. Further studies are needed to describe the causality of this association.

The author suggests that minimal manuals don't appeal to everyone, and that these nonminimalists can be identified and catered to. He identifies different type of learners and how they learn. For example, dynamic learners would be impatient with direct instruction, would probably ignore the instruction, and just experiment. Focused learners are likely to be highly responsive to an authoritative coach. Contemplative learners insist that instructors provide evidence for their claims. Rigorous learners would respond well to thoroughly prepared instruction, but not to ad-hoc sessions. After instruction, they would want to be given a chance to work out the process by themselves. Finally, the author presents a list of techniques, based on learning style preferences, that might help writers engage their audience.

AIMS: To evaluate the prognostic significance of the preprocedural albumin - bilirubin (ALBI) score on short- and long-term outcomes after transcatheter aortic valve implantation (TAVI). METHODS: We retrospectively analyzed 737 consecutive patients who underwent TAVI. Patients were stratified into tertiles according to ALBI score. Baseline clinical, echocardiographic, laboratory features were compared across tertiles. The primary endpoint was long-term all-cause mortality; secondary endpoints included in-hospital mortality and major complications. Kaplan-Meier analysis assessed survival, and Cox-regression models evaluated predictors of long-term mortality after adjustment for conventional risk factors. RESULTS: Higher ALBI tertiles were associated with a greater comorbidity burden, worse ventricular function, and elevated biomarkers of inflammation and cardiac stress. In-hospital mortality increased across tertiles (5.3%, 7.3%, 11.8%). Long-term mortality also rose progressively (7.3%, 9.8%, 11.8%), with 60-month survival rates of approximately 90% (T1), 88% (T2), and 73% (T3). ALBI score independently predicted long-term mortality (HR 1.86, 95% CI 1.23-2.82), along with chronic kidney disease and lower TAPSE. Restricted cubic spline analysis demonstrated a near-linear association between ALBI and mortality risk. CONCLUSION: Preprocedural ALBI score is independently associated with both short and long-term mortality after TAVI and may reflect systemic vulnerability not captured by conventional risk models. Incorporating ALBI into preprocedural assessment could enhance risk stratification.

Kişilerin öz-yeterlilik inançları; nasıl düşündüklerini, hissettiklerini, davrandıklarını ve kendilerini nasıl motive ettiklerini belirlemektedir. Öz-yeterlilik bireyin kendisinin, toplumsal yeterlilik ise kişinin üyesi olduğu grubun belli bir işi yapabilme kapasitesine ilişkin algısı olarak ifade edilmektedir. Bu araştırmada Covid-19 pandemisinin toplulukçu yeterlilik algıları üzerindeki etkileri incelenmiştir. Araştırmada veri toplama aracı olarak "Toplulukçu Yeterlilik Ölçeği" ve araştırmacı tarafından hazırlanan 7 soruluk demografik form kullanılmıştır. Bu bağlamda bu araştırmada sağlık çalışanlarının Covid-19 öncesi ve sonrası toplulukçu yeterlilik algılarının değişimleri incelenmiştir. Çalışmanın örneklemi özel bir hastanede çalışan 209 sağlık çalışanıdır. Elde edilen veriler analiz edilirken, betimsel istatistiklere, korelasyon ve fark analizlerine bakılmıştır. Verilerin analizi SPSS 23 programıyla yapılmıştır. Elde edilen sonuçlara Toplulukçu Yeterlilik Ölçeği Toplam puanının ön test ve son test puanları arasında istatistiksel olarak anlamlı ve orta kuvvette bir ilişki bulunmuştur. Toplulukçu Yeterlilik Ölçeğinin ve "Kararlılık ve Yılmama", "Birlik ve Dayanışma" ve " Ortak Bilinç" alt boyutlarının son test puanları, ön test puanlarına göre daha düşük olduğu belirlenmiştir. Buradan yola çıkarak Covid-19'un sağlık çalışanlarını olumsuz olarak etkilediği sonucuna erişebilmekteyiz.

Objective: This study aims to evaluate the clinical and radiological results of patients who were followed for at least 4 years after treatment with total hip arthroplasty, which was performed using a direct anterior approach and to compare the results with different surgical approaches in the literature. Materials and Methods: The study included 37 patients who underwent total hip replacement using the direct anterior approach. Harris hip scores and lower extremity functional scores were recorded. The correlations between the scores and gender, diagnosis, body mass index, time of walking time, length of hospital stay, and inclination angle were examined. Results: Of the cases,26(70.3%) were female and 11(29.7%) were male. The mean age was 51.2 (26-76) years. The patients were followed up for an average of 58 (48-72) months. No significant difference was determined between the improvement in Harris hip score and gender, age, body mass index, and length of hospital stay. Postoperative acetabular inclination was 40.8° (35 - 55). The early dislocation was observed in one of our patients. Serous discharge developed in three patients. In three patients, n.cutaneus femoralis lateralis injury developed. The periprosthetic fracture was observed during surgery in five patients. Conclusion: In our study, it was seen that patients have successful and fast functional results when total hip replacement using a direct anterior approach was performed. Compared to the literature, faster recovery is observed in the early period compared to other approaches; however, no difference is seen between the approaches in the mid- and long term. Keywords: Direct anterior approach, Total hip arthroplasty, mid-term results

The current maritime defence sector is held back by a risk averse attitude to technology uptake. This is starting to change in the use of autonomous systems, however this is at the expense of other more wide reaching technologies. In this paper several promising technologies are applied to a frigate design dubbed E-SPARTAN, and their effect compared to a baseline frigate concept, SPARTAN. The designs are then compared across key metrics such as capability, sustainability, through life cost and stability. The technologies investigated were the large-scale adoption of composites and sustainable propulsion options based on an IFE propulsion system. Through rules based structural design the use of composites was demonstrated to save at least 50% of the structural weight in a like for like comparison, equating to up to 22% of lightship. This weight saving facilitated the increase in mass of the IFE propulsion system, in addition to a 240t battery bank to allow peak shaving and silent running. Alternative fuels were investigated and biodiesel was found to the most effective alternative fuel, increasing engine performance whilst being a sustainable product, producing low emissions and facilitating the use of MDO in operational areas where biodiesel is not available. Other commonly discussed alternatives such as batteries and hydrogen were found to require too large a storage volume and/or mass to be viable for the existing mission profile. The vessel operating costs were shown to be less than the equivalent conventional frigate, this is due to a reduction in non-attributable growth, a reduction in hull maintenance and the flexibility of upgrading an IFE solution. Overall the changes gave additional capability, with added design and operational flexibility, both key to a cost effective general purpose frigate (GPF). The structure requires less maintenance, due to a reduction in fatigue and corrosion. The build would be more technically challenging, requiring upskilling of the workforce for composite construction, however with life cycle savings circa £21.5M. The proposed changes constitute a stability improvement due to a lower center of gravity and the opportunity to locally optimize the layup and materials to improve survivability and signatures. The design provides additional capability due to signature reduction and silent running, both key for central frigate roles such as mine counter measures (MCM) and anti-submarine warfare (ASW), as well as providing additional sustainability credentials and facilitating operation in emissions controlled areas. The authors conclude that the implementation of such a radical concept would entail upskilling of the ship construction workforce, but the benefits of such a solution are seen across capability, flexibility and through life cost when considered over a class of vessels.

A new near-field - far-field transformation technique with planar spiral scanning is here proposed. It makes use of a very flexible source modelling, which fits very well a lot of actual antennas. By employing such a modelling, instead of the spherical one, it is possible to significantly reduce the error related to the truncation of the scanning zone, since the near-field data can be now acquired on a spiral lying on a measurement plane at a distance smaller than one half the source maximum size. Some numerical tests, assessing the accuracy of the technique and its stability with respect to random errors affecting the data, are reported.

An effective probe compensated near-field-far-field transformation technique from irregularly spaced near-field data acquired via the recently proposed planar-wide-mesh-scanning is developed in this work. The singular value decomposition method is applied for recovering the uniformly distributed samples, whose position is fixed by a nonredundant sampling representation of the electromagnetic field. Then an optimal sampling interpolation algorithm is used to reconstruct the plane-rectangular data required to carry out the standard near-field-far-field transformation. Numerical examples are reported to assess the effectiveness of the proposed technique.

Theodicy in the World of the Bible Antti Laato Johannes C. De Moor . Brill, Leiden 2003. liv + 830. Price: €119.00/$142.00 . hardback. ISBN: 90-04-13275-9

New Zealand, an outstandingly beautiful country, offers an opportunity for the psychiatrist from the UK to work in an alternative environment. There is currently a shortage of trained psychiatrists to fill the available posts. The experience of a locum consultant post in adult mental health in the Nelson Marlborough Mental Health Service at the top of the South Island, at the beginning of the new millennium, forms the basis of observations made in this article, the purpose of which is to describe points of interest in the similarities and differences in psychiatric practice between the UK and New Zealand.

Hematopoietic stem cell transplantation (HSCT) is a treatment method that can provide cure for most hematological malignant diseases. In addition to hematological malignancy, HCT is also used as a treatment method in benign hematological diseases, solid tumors, and autoimmune diseases. Autologous hematopoietic stem cell transplantation (AHCT) is the most common procedure performed in solid tumors. Transplantation is performed first as high-dose chemotherapy (HDC) and then as OHCT. In our transplant center between 2021 and 2023, were evaluated data of high-dose chemotherapy (HDC) and OHCT. Our first case is a 43-year-old female patient who received multiple treatments with the diagnosis of refractory primary peritoneal adenocarcinoma. Our second case is a 22-year-old male neuroblastoma patient who was first diagnosed with a retroperitoneal mass. Our third case is a 27-year-old male patient diagnosed with refractory Ewing Sarcoma. Our fourth patient is a 29-year-old male, who was diagnosed with refractory testicular cancer and to whom we performed a transplant.

Evaluation of data from unrelated hematopoietic stem cell transplants performed in our transplant center. At the Private Emsey Hospital Adult Stem Cell Transplantation Unit were evaluated retrospectively between 2016 and 2023 to Allogeneic hematopoietic stem cell transplantations performed on 76 patients with different diagnoses from unrelated donors. Data of patients with a mean age of 41.9 years were retrospectively analyzed. All donors were from a Turkish stem cell bank and 51% had HLA 1 allele incompatibility. 28 transplants were performed between different genders. Average follow-up was 17.3 months. Neutrophil engraftment occurred in an average of 18.1 days. Acute GVHD was detected in 26% and chronic GVHD in 41%. 1-year overall survival was 37% and disease-free survival was 32%. Non-relative stem cell transplantation is an important option especially in hematological diseases where there is no family donor and allogeneic transplantation is required. It has been observed that non-relative data performed in our clinic are similar to data from other centers.

Aim: In order to achieve adequate stability in segmental humerus fractures, the PHILOS fixation with minimal invasive approach comes into use instead of conventional plating. However, according to the AO classification, 12C type segmental humerus fractures treated with minimally an invasive method are prone to complications. The purpose of this prospective study is to compare functional outcomes and complication rates following two different angled helical PHILOS plate fixation. Material and Method: This multicenter study is a prospective review of cases with a final follow-up outcome. Twenty-two patients with AO 12-C humerus fractures underwent PHILOS fixation with contoured PHILOS plates between January 2016 and June 2019. Patients evaluated in two groups. Group 1 consisted 12 patients who were treated with a 30° helical plate and Group 2 consisted 10 patients who were treated with 70° helical plate. Clinical outcomes were noted according to the Constant-Murley scoring system. Results: The mean age of patients treated in groups 1 and 2 were 49±15.8 and 50.7±17, respectively. Fractures healed in an average of 13.1±3.9 weeks in Group 1 and 13.8±3.1week in Group 2, respectively. The mean follow-up period of the patients was 18±6.1months in Group 1 and 22±4.2 months in Group 2. Mean Constant-Murley scores at final follow-up were 88±2.7 and 90±2.5 in Groups 1 and 2 respectively (p=.665). Radial nerve neuropraxia was seen in 2 cases in Group 1, and a sensorial injury of the musculocutaneous nerve was seen in 1 patient in Group 2 (p=.365). Conclusion: Similar union rates and successful clinical results were obtained from both groups. However, this study suggests that the 70° angled helical PHILOS technique could be performed relatively easily in AO 12-C fractures with fewer complication rates. Musculocutaneous nerve affliction can be as functionally destructive as radial nerve affliction.

Bu çalışmada, hemşirelik öğrencilerinin günlük olarak deneyimledikleri hoş olmayan olaylar karşısındaki bireysel sıkıntılarını açma eğilimleri ile algıladıkları sosyal destek düzeylerinin ve bu değişkenler arasındaki ilişkinin belirlenmesi amaçlanmıştır. Kesitsel ve ilişki arayıcı tipte olan bu araştırma bir devlet üniversitesinde okuyan 386 hemşirelik öğrencisi ile gerçekleştirilmiştir. Verilerin değerlendirilmesinde istatistiksel yöntemlerden ortalama, standart sapma, yüzde, mod, medyan kullanılmıştır. Değişkenler arasındaki ilişkiyi değerlendirmede Spearman korelasyon analizi uygulanmıştır. İstatistiksel anlamlılık sınır değeri p<0.05 olarak belirlenmiştir. Çalışmaya katılan öğrencilerin öznel sıkıntıları açma ölçeği puan ortancası 41.00, çok boyutlu algılanan sosyal destek ölçeği puan ortancası 63.00 olarak bulunmuştur. Çalışmada hemşirelik öğrencilerinin öznel sıkıntılarını açma eğilimleri ile sosyal destek algıları arasında pozitif yönde anlamlı bir ilişki olduğu belirlenmiştir.

An appropriate vascular access is always needed for the success of hemodialysis. Internal jugular vein is the safest and less complicated access in between central veins. At the same time, it is the most commonly used temporary vascular access for hemodialysis. The blind method after anatomical marking for the central vascular path is the most used technique in many centers. The use of ultrasound in the placement of hemodi-alysis catheters in the central vein increases the success rate of catheterization. Ultrasound can show IJV locali-zation, anatomical variations, the presence of thrombus in the vein, and whether the vein is open. The aim of this study is to compare the success rate and complication frequency of temporary catheters placed in the IJV with and without ultrasound for hemodialysis. A total of 124 consecutive patients who required hemodialysis catheters in Haydarpaşa Numune Trai-ning and Research Hospital between February 2012 and December 2012 were randomized to the study. The patients were divided into two groups as non USG-assisted (blindly) (Group 1) and ultrasound-assisted (Group 2). The use of ultrasound significantly increased the successful catheterization rates of both experienced specialist and resident. In addition, there was no statistical difference between the success rates between the specialist and the resident. USG-assisted vein catheterization can be performed safely, easily, quickly, more painlessly and with minimal complication rates. Catheter intervention should be performed under the guidance of USG in risky patient groups who need temporary catheters. In centers that do not have USG, especially in such risky patients, blind catheter interven-tion should not be attempted after anatomical marking. USG-assisted vein catheterization can be easily perfor-med by all clinicians and residents, since the training period is short, practical and much more safe.

This paper considers the ethics of ageing among practitioners in the psychotherapy profession and the rights, responsibilities, and risks that come with an increasing number of people working at an older age. It suggests that the process of ageing is relevant to us all and how we engage with this is crucial to developing a professional community which lives—or seeks to live—according to the ethics of humanistic psychology.

Interdigital pilonidal sinus disease, also called “barber’s disease,” is an acquired occupational disease. Although sacrococcygeal pilonidal sinus disease is a common surgical issue, interdigital pilonidal sinus disease is rare and more likely localized between the fingers and toes. Approximately 50 cases of this disease have been published. However, there are insufficient publications on the incidence of this disease. This disease is caused by the penetration of newly cut, short, and sharp hair through interdigital skin. Although it is known as barber’s disease, it can be observed in patients in other professions related to hair and feature cut. Surgical excision is the accepted approach for treating this disease. Because of the complex structure of the hand anatomy and the high overall recurrence rate of pilonidal disease, preoperative determination of the best excision boundaries is important. It is thought that personal hygiene and use of protective measures are essential for preventing interdigital pilonidal sinus disease, which is acquired occupationally. In this study, we explain the importance and methods for prevention, protective surgical approach, and treatment of interdigital pilonidal sinus disease.

Journal Article Brad E. Kelle and Frank Ritchel Ames (eds), Foreword by Susan Niditch, Writing and Reading War: Rhetoric, Gender, and Ethics in Biblical and Modern Contexts Get access Brad E. Kelle and Frank Ritchel Ames (eds), Foreword by Susan Niditch, Writing and Reading War: Rhetoric, Gender, and Ethics in Biblical and Modern Contexts (Society of Biblical Literature Symposium Series 42). Society of Biblical Literature, Atlanta 2008. Pp. xii + 265. Price: $34.95 paperback. ISBN: 978-1-58983- 354-8. C.S. Rodd C.S. Rodd Emsworth, Hants Search for other works by this author on: Oxford Academic Google Scholar Journal of Semitic Studies, Volume 56, Issue 1, Spring 2011, Pages 189–191, https://doi.org/10.1093/jss/fgq067 Published: 01 March 2011

Revelation and the God of Israel Norbert M.Samuelson , Cambridge University Press, Cambridge 2002. x + 259. Price: £45.00 hardback. ISBN: 0-521-81202-X