Widespread exploitation of the honeybee by early Neolithic farmers.

The pressures on honeybee (Apis mellifera) populations, resulting from threats by modern pesticides, parasites, predators and diseases, have raised awareness of the economic importance and critical role this insect plays in agricultural societies across the globe. However, the association of humans with A. mellifera predates post-industrial-revolution agriculture, as evidenced by the widespread presence of ancient Egyptian bee iconography dating to the Old Kingdom (approximately 2400 BC). There are also indications of Stone Age people harvesting bee products; for example, honey hunting is interpreted from rock art in a prehistoric Holocene context and a beeswax find in a pre-agriculturalist site. However, when and where the regular association of A. mellifera with agriculturalists emerged is unknown. One of the major products of A. mellifera is beeswax, which is composed of a complex suite of lipids including n-alkanes, n-alkanoic acids and fatty acyl wax esters. The composition is highly constant as it is determined genetically through the insect's biochemistry. Thus, the chemical 'fingerprint' of beeswax provides a reliable basis for detecting this commodity in organic residues preserved at archaeological sites, which we now use to trace the exploitation by humans of A. mellifera temporally and spatially. Here we present secure identifications of beeswax in lipid residues preserved in pottery vessels of Neolithic Old World farmers. The geographical range of bee product exploitation is traced in Neolithic Europe, the Near East and North Africa, providing the palaeoecological range of honeybees during prehistory. Temporally, we demonstrate that bee products were exploited continuously, and probably extensively in some regions, at least from the seventh millennium cal BC, likely fulfilling a variety of technological and cultural functions. The close association of A. mellifera with Neolithic farming communities dates to the early onset of agriculture and may provide evidence for the beginnings of a domestication process.

The Syrian civil war: The experience of the Surgical Intensive Care Units.

OBJECTIVE: Since the civilian war in Syria began, thousands of seriously injured trauma patients from Syria were brought to Turkey for emergency operations and/or postoperative intensive care. The aim of this study was to present the demographics and clinical features of the wounded patients in Syrian civil war admitted to the surgical intensive care units in a tertiary care centre. METHODS: The records of 80 trauma patients admitted to the Anaesthesia, General Surgery and Neurosurgery ICUs between June 1, 2012 and July 15, 2014 were included in the study. The data were reviewed regarding the demographics, time of presentation, place of reference, Acute Physiology and Chronic Health Evaluation II (APACHE II) score and Injury Severity Score (ISS), surgical procedures, complications, length of stay and mortality. RESULTS: A total of 80 wounded patients (70 males and 10 females) with a mean age of 28.7 years were admitted to surgical ICUs. The most frequent cause of injury was gunshot injury. The mean time interval between the occurrence of injury and time of admission was 2.87 days. Mean ISS score on admission was 21, and mean APACHE II score was 15.7. APACHE II scores of non-survivors were significantly increased compared with those of survivors (P=0.001). No significant differences was found in the age, ISS, time interval before admission, length of stay in ICU, rate of surgery before or after admission. CONCLUSION: The most important factor affecting mortality in this particular trauma-ICU patient population from Syrian civil war was the physiological condition of patients on admission. Rapid transport and effective initial and on-road resuscitation are critical in decreasing the mortality rate in civil wars and military conflicts.

Earliest date for milk use in the Near East and southeastern Europe linked to cattle herding.

The domestication of cattle, sheep and goats had already taken place in the Near East by the eighth millennium bc. Although there would have been considerable economic and nutritional gains from using these animals for their milk and other products from living animals-that is, traction and wool-the first clear evidence for these appears much later, from the late fifth and fourth millennia bc. Hence, the timing and region in which milking was first practised remain unknown. Organic residues preserved in archaeological pottery have provided direct evidence for the use of milk in the fourth millennium in Britain, and in the sixth millennium in eastern Europe, based on the delta(13)C values of the major fatty acids of milk fat. Here we apply this approach to more than 2,200 pottery vessels from sites in the Near East and southeastern Europe dating from the fifth to the seventh millennia bc. We show that milk was in use by the seventh millennium; this is the earliest direct evidence to date. Milking was particularly important in northwestern Anatolia, pointing to regional differences linked with conditions more favourable to cattle compared to other regions, where sheep and goats were relatively common and milk use less important. The latter is supported by correlations between the fat type and animal bone evidence.

Effect of preserving the hepatic vagal nerve during laparoscopic Nissen fundoplication on postoperative biliary functions.

BACKGROUND: Cutting the hepatic branch of the anterior vagus nerve (HB-AVn) technically facilitates the laparoscopic Nissen fundoplication. The aim of this study was to investigate the effects of preserving or sacrificing this branch on postoperative gallbladder functions. METHODS: The patients (n = 40) were prospectively randomized into two groups. The HB-AVn was preserved during the dissection of the lesser omentum in the first group. The nerve was cut in the second group. Postoperative fasting gallbladder volumes were calculated by ultrasonography. Postoperative gallbladder ejection fraction (GEF) and gallbladder emptying time (GET) were determined by calculating intestinal transit time scintigraphically. RESULTS: Fasting gallbladder volumes and GEF values were not different between the groups. On the other hand, in patients with HB-AVn preserved, GET measurements were found to be significantly shorter than those with HB-AVn sacrificed. CONCLUSIONS: Sacrificing the hepatic branch causes prolongation in the GET. This change in the motor functions of the gallbladder does not cause any symptomatic effect during the early postoperative period. However, the delay in the GET may increase the risk of gallbladder stone formation in the long term.

Evaluation of nutritional risk screening-2002 and subjective global assessment for general surgery patients: a prospective study.

OBJECTIVE: To investigate the reliability of nutritional risk screening (NRS-2002) and Subjective Global Assessment (SGA) tools to predict the length of hospital stay, complications and mortality, and to compare these tools in predicting outcomes of surgical patients. METHODS: The prospective study was conducted at the Surgery Department of Numune Training and Research Hospital, Adana, Turkey, from March 30 to September 30, 2010. The patients were divided into 3 groups. Group 1 included patients requiring major surgical operations for gastrointestinal malignancy; Group 2 and 3 included patients undergoing moderate surgery and minor surgical operations respectively. Discrimination characteristics of the scoring systems were evaluated using receiver operating characteristic curves. RESULTS: Nutritional risk at admission was found to be increased in 132 (22.5%) patients by NRS-2002, and 90 (15.3%) by SGA. The sensitivity and specificity of NRS-2002 for complications were 53.3% and 96.6% respectively. The SGA values were 55% and 98.5% respectively. NRS-2002 and SGA at admission had a reliable power of discrimination (AUC > 0.8) for mortality and to predict complications in major gastrointestinal surgical patients. CONCLUSION: SGA and NRS-2002 methods had positive predictive power in estimating the mortality risk in general surgical patient population. Both scoring tools were also positive in estimating post-operative complication risk in major surgical patients.

Ectopic breast cancer: A case report.

Ectopic breast may be present at any site, from the axilla to the vulva, other than its normal location. Cysts, adenofibromas and rarely carcinomas have been reported in ectopic breasts. In this case report, we present a patient with ectopic breast cancer. The patient had a thickening and enlarging of her ectopic breast tissue, on the left arcus costarium. Tru-cut biopsy revealed "invasive lobular carcinoma". Left ectopic mastectomy and level I-II axillary dissection were performed and then chemotherapy+radiotherapy+endocrine therapy treatment was commenced. During follow up, the patient is doing well; in spite of R1 resection, she has no evidence of local recurrences or distant metastases.

Increased nutritional risk in major trauma: correlation with complications and prolonged length of stay.

BACKGROUND: Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Trauma Injury Severity Score (TRISS) are physiological and anatomical severity scores to predict trauma outcome. Nutritional Risk Screening (NRS-2002) is used for the screening of nutritional risk, which can affect outcome adversely. The objective of this study was to determine the reliability of these scales to predict disease severity, complications and mortality, and to compare the reliability of the NRS-2002 in predicting outcome with different scoring systems in trauma-intensive care unit (ICU) patients. METHODS: The study enrolled 100 consecutive patients who were admitted to the ICU in a training hospital due to trauma in the six-month study period (1 July 2008 and 1 January 2009). Discrimination characteristics of the scoring systems were evaluated using receiver operating characteristic (ROC) curves. RESULTS: Overall mortality was 14%, and the complication rate was 22%. Nutritional risk at admission was found to be increased in 58% of the patients. The NRS-2002 score was increased in patients with complication. ISS, TRISS and APACHE II at admission had a reliable power of discrimination (AUC>0.8) for mortality and complication prediction. The NRS-2002 score had moderate discrimination power for complication prediction (AUC=0.708) but showed high correlation with increased length of stay (LOS). CONCLUSION: A significant percent of trauma patients are at nutritional risk. The NRS-2002 score can be useful in predicting complication and prolonged LOS in trauma patients.

Effectiveness of Booster Measles-Mumps-Rubella Vaccination in Lower COVID-19 Infection Rates: A Retrospective Cohort Study in Turkish Adults.

OBJECTIVE: The aim of this study was to investigate the effectiveness of booster vaccination of adults with measles-mumps-rubella in the COVID-19 infection rates. METHODS: In order to investigate this hypothesis, we tested COVID-19 positivity rate through PCR assay on the participants (n=245; male), who had to share the same student accommodation together with the same dining hall to provide governmental service. Participants were divided into two groups based on their booster vaccination status with measles-mumps-rubella: the non-vaccinated group (n=207) and the vaccinated group (n=38). The rate of COVID-19 seropositivity, age, body mass index (BMI), active smoking and presence of comorbidity were also measured and recorded. RESULTS: All of the participants were healthy, and age distribution, comorbidity rates, active smoking status and BMI did not vary significantly among the two groups (p=0.305, p=0.594, p=0.280, and p=0.922, respectively). About 36.7% (n=90) of the participants were found to be COVID-19 positive by PCR among which the non-vaccinated cases had higher rates of COVID-19 seropositivity than the vaccinated cases (40.6% vs 15.8%) (OR=3.6, 95%CI: 1.5-9.0, p=0.004). CONCLUSION: Based on these results, we cautiously predict that immunity produced by MMR vaccination boosters may provide some degree of protection against COVID-19 in the adult population.

Peripheric stem cell transplantation in children with dilated cardiomyopathy: preliminary report of first two cases.

We report two pediatric patients with IDC who underwent autologous PSCT. Both cases were referred to our clinic for cardiac transplantation because of end-stage heart failure resistant to conventional therapy with digoxin, diuretics, ACE inhibitors, and sympathomimetics. They had ejection fractions below 35%. In each case, autologous stem cell transplantation was performed via the coronary arteries, and five wk after the procedure transthoracic echocardiography showed a striking gain in their ejection fractions and an improvement in the left ventricular dimensions compared with the initial measurements. Although heart transplantation is the only option for children with IDC, stem cell transplantation can lessen the waiting list mortality and prolong the time for a patient to wait for a suitable donor.

An unusual case of a giant pseudoaneurysm formation after myocardial infarction.

In the era of early and invasive therapeutic approaches, myocardial rupture has become an uncommon complication of myocardial infarction. We report an uncommon complication following inferior myocardial infarction with both left ventricular and right ventricular rupture and subsequent communication via a shared pseudoaneurysm.

The role of urine trypsinogen-2 test in the differential diagnosis of acute pancreatitis in the Emergency Department.

BACKGROUND: The aim of the study was to investigate the role and importance of the urine trypsinogen-2 dipstick test in the differential diagnosis of acute pancreatitis in the Emergency Department and to compare results with those of conventional tests. METHODS: The study was performed prospectively in the patients admitting to the Emergency Department due to upper abdominal pain. Thirty-two of the 87 patients included in the study had acute pancreatitis diagnosis. Serum amylase, lipase, C-reactive protein (CRP) and urine trypsinogen-2 using Actim pancreatitis dipstick were studied in all patients. The statistical analysis was performed using SPSS 11.5 package program. RESULTS: Urine trypsinogen-2 was found positive in 21 (65.6%) of 32 patients. The sensitivity of the test for pancreatitis was identified as 64%, specificity as 85%, positive predictive value as 72%, and negative predictive value as 81%. These values were statistically significant compared to the control group (p<0.01). CONCLUSION: Although it has lower sensitivity and specificity compared to amylase and lipase, we suggest that urine trypsinogen-2 test may be an important diagnostic tool in excluding the diagnosis of acute pancreatitis, since it provides results within 5 minutes in the Emergency Department, is cheaper, has a higher negative predictive value, and is easy to use.

Tissue oxidative stress level and remote organ injury in two-hit trauma model of sequential burn injury and peritoneal sepsis are attenuated with N-acetylcysteine treatment in rats.

BACKGROUND: The second hit in trauma leads to an exaggerated inflammatory response and multiple organ failure. Infection following burn injury is a useful model for two-hit trauma studies. The aim of this study was to investigate the effect of N-acetylcysteine (NAC) treatment as an antioxidant in a two-hit trauma model. METHODS: 30% scalding burn injury was performed in 45 rats and cecal ligation-puncture (CLP) was performed 72 hours later. Groups were allocated as follows: Group I: No treatment was performed; Group II: Rats were treated with 150 mg/kg/day i.p. NAC for 72 h following CLP; Group III: Rats were treated with 150 mg/kg/day i.p. NAC for 6 days following thermal injury. Tissue samples were collected to study the tissue malonyldialdehyde (MDA) and glutathione (GSH) levels, and for histopathological examination on day 7. RESULTS: No difference in mortality between groups was detected. Tissue MDA levels significantly decreased in the liver (p=0.01, p=0.02) and ileum (p=0.01, p=0.02) in the treatment groups. Lung tissue GSH levels were found to be significantly increased in Group II (p=0.02). Lung injury scores were decreased in Group II (p=0.005) compared to the control group. CONCLUSION: NAC attenuated tissue oxidative stress level and remote organ injury in two-hit trauma. Further experimental and clinical studies on this subject are necessary.

Detection of Helicobacter pylori DNA in aortic and left internal mammary artery biopsies.

We investigated the relationship between acute coronary ischemia and the presence of Helicobacter pylori DNA in aortic regions that were absent macroscopic atheromatous plaques. The study group (Group 1) consisted of 42 patients who underwent coronary artery bypass grafting. Biopsy samples were obtained from 2 different locations: from regions of the aorta that were free (macroscopically) of atheromatous plaque (Group 1A), and from the internal mammary artery (Group 1B). The control group (Group 2) of 10 patients who had no atherosclerotic vascular disease provided aortic tissue samples for comparison. The real-time polymerase chain reaction method was used to detect H. pylori DNA in all biopsy samples. Eleven of 42 aortic tissue samples (26%) in Group 1A were positive for H. pylori DNA. Neither biopsies from the left internal mammary arteries of those patients nor biopsies from the aortas of the control group (Group 2) were positive for H. pylori DNA. There was a statistically significant difference between 1A and 1B in terms of H. pylori positivity (P=0.001). In Group 1 as a whole, acute coronary ischemia was more prevalent in the H. pylori-positive patients than in the H. pylori-negative patients (P=0.001). To our knowledge, this is the 1st study to investigate the detection of H. pylori DNA in aortic biopsy samples that are macroscopically free of atheromatous plaque. Such detection in patients who have atherosclerotic coronary artery disease could be an important indication of the role of microorganisms in the pathogenesis of atherosclerosis.

Mitochondrial DNA analysis shows a Near Eastern Neolithic origin for domestic cattle and no indication of domestication of European aurochs.

The extinct aurochs (Bos primigenius primigenius) was a large type of cattle that ranged over almost the whole Eurasian continent. The aurochs is the wild progenitor of modern cattle, but it is unclear whether European aurochs contributed to this process. To provide new insights into the demographic history of aurochs and domestic cattle, we have generated high-confidence mitochondrial DNA sequences from 59 archaeological skeletal finds, which were attributed to wild European cattle populations based on their chronological date and/or morphology. All pre-Neolithic aurochs belonged to the previously designated P haplogroup, indicating that this represents the Late Glacial Central European signature. We also report one new and highly divergent haplotype in a Neolithic aurochs sample from Germany, which points to greater variability during the Pleistocene. Furthermore, the Neolithic and Bronze Age samples that were classified with confidence as European aurochs using morphological criteria all carry P haplotype mitochondrial DNA, suggesting continuity of Late Glacial and Early Holocene aurochs populations in Europe. Bayesian analysis indicates that recent population growth gives a significantly better fit to our data than a constant-sized population, an observation consistent with a postglacial expansion scenario, possibly from a single European refugial population. Previous work has shown that most ancient and modern European domestic cattle carry haplotypes previously designated T. This, in combination with our new finding of a T haplotype in a very Early Neolithic site in Syria, lends persuasive support to a scenario whereby gracile Near Eastern domestic populations, carrying predominantly T haplotypes, replaced P haplotype-carrying robust autochthonous aurochs populations in Europe, from the Early Neolithic onward. During the period of coexistence, it appears that domestic cattle were kept separate from wild aurochs and introgression was extremely rare.

A rat model of polypropylene graft infection caused by Staphylococcus epidermidis.

BACKGROUND: The aim of this study was to constitute a valid graft infection model with Staphylococcus epidermidis in rats. METHODS: Rats were divided into seven groups. In groups 1 and 2, 2 cm x 2 cm polypropylene grafts were incubated with 10(8) c.f.u./mL slime-positive S. epidermidis at 37 degrees C for 2 and 24 h and were then placed subfascially to the groins of rats. In the third group, naive grafts were placed and 0.5 mL of 3 x 10(7) c.f.u. slime-positive S. epidermidis were injected on the inside of the wounds. Rifampicin (30 mg/kg) in group 4 and teicoplanin (20 mg/kg) in group 5 were applied i.p. to rats with 2-h incubated grafts for prophylaxis. The same prophylactic regimens were given to groups 6 and 7 in which rats were incubated for 24 h. At eighth day, rats were killed and wounds were assessed with macroscopic evaluation and cultures. RESULTS: No death occurred in any of the groups. In groups 1 and 2, 100% infection rates were achieved. However, graft infection was detected in only two (20%) of the rats in group 3 (P = 0.001). Prophylactic application of teicoplanin or rifampicin decreased the infection rates significantly in the short-incubation groups. CONCLUSION: Incubation of polypropylene grafts with slime-producing S. epidermidis for 2 and 24 h in the pre-application period achieved the occurrence of a standardized graft infection. Prophylactic use of teicoplanin and rifampicin decreased the infection rates. We propose to use this reproducible and reliable animal model of graft infection in future studies.

The protective effect of low-dose dopamine on renal functions in hypotensive rats: an experimental study.

BACKGROUND: The aim of this study was to investigate the effect of low-dose dopamine on markers of the renal functions in a rat model of hypotension. METHODS: Forty Wistar rats were divided into control, hypotension, dopamine, and hypotension+dopamine groups. Hypotension was achieved by sodium-nitroprusside infusion. Samples were drawn for analysis during the two-hour study period. RESULTS: Blood urea nitrogen levels were significantly increased in hypotension group during the early phase but this difference disappeared at the end of the second hour. Dopamine infusion had no effect on creatinine and potassium clearance. Despite the significance of improved sodium clearance in the hypotensive rats treated with dopamine, natriuresis did not occurred in the dopamine-only group. CONCLUSION: It can be stated that low dose dopamine infusion at a rate of 0.5 microg kg(-1) min(-1) has a short-term preventive action against the increase of blood urea nitrogen during the early phase of pharmacologically induced hypotension.

[Remarks of 52 physicians participating into 8th Ankara Emergency Rooms (ERs) Meeting 2005 on resuscitative thoracotomy intervention]. / 2005 yili 8. Ankara Aciller Toplantisi'na katilan 52 hekimin resüsitatif torakotomi girisimi ile ilgili görüsleri.

BACKGROUND: The aim of this study was to define the opinions of 52 emergency physicians working in different ERs in Ankara and participated in the 8th Ankara Emergency Meeting 2005, on resuscitative thoracotomy (RT). METHODS: A questionnaire form containing 14 questions was designed for the opinions of physicians on RT. Responders filled in the forms through answering the questions by themselves. Data were analyzed using Student's t-test and ANOVA. RESULTS: The survey concluded three common points: 1. Resuscitative thoracotomy should be performed in the emergency rooms (65,4%), 2. It should be performed by specialists however; it is a procedure which can and should be conducted by every experienced emergency physician easily when the indications are clear (69,23%). 3. Majority of the responders stated that they would like to get a post-education course on this subject (96,15%). CONCLUSION: Theoretical and practical policies of our medical education on RT should be revised. Emergency rooms should be equipped for this intervention. Resuscitative thoracotomy should be applied by the experienced people, indications should be clarified well and emergency physicians should be trained on resuscitative thoracotomy by regular post-graduation courses.

[Prehospital life support in trauma patients: basic or advanced trauma life support]. / Travma olgularinda hastane öncesi yasam destegi seçimi: temel ya da ileri travma yasam destegi.

The controversy between Advanced Trauma Life Support (ATLS) and Basic Life Support (BLS) in the prehospital care of trauma patients has not been resolved yet. The purpose of this study was to examine the literature with respect to the type of prehospital care applied to the trauma patients. A total of 76 papers on ATLS and/or BLS for trauma were reviewed regarding the variables such as intravenous catheter application, prehospital fluid resuscitation, transport time, intubation and mortality. As a conclusion, the data in the literature do not support the routine use of on-field ATLS in trauma patients. Prospective randomized trials comparing ATLS and BLS in prehospital management of trauma patients are needed to clarify this issue.

The epidemiology of the railway related casualties.

BACKGROUND: Railway related accidents and incidents account for 150-200 deaths per 100 million passengers annually in Turkey. The aim of this study was to evaluate the epidemiological aspects of these casualties. METHODS: The data about railway related casualties between January 1997 and December 2003 were retrospectively analyzed in Turkey. RESULTS: Railway related accidents and incidents resulted in 213,3 deaths per year per 100 million passengers during the study period. Train-pedestrian accidents caused highest number of mortality and level crossing accidents caused highest numbers of casualty. Furthermore, suicide attempts had highest mortality ratio in railway related accidents. The majority of the fatalities and injuries occurred in males for every type of incident and most of the injuries have taken place in the 25-60 age group. Summer time was the season with the highest number of fatalities and injuries. CONCLUSION: Measures should be taken to improve railway safety. These include prevention of direct exposure of pedestrians to the railway tracts and conditioning the level crossings.